An Examination of Factor Structure of the Hamilton Anxiety Rating Scale in a Non-Clinical Persian Sample

Abstract

The Hamilton Anxiety Rating Scale is an internationally used assessment tool for anxiety level however its acceptable factor structure remains fluid. The aim of this paper is to examine the psychometric properties and establish normative anxiety prevalence rates with a Persian randomized sample. A cross sectional survey was distributed to a randomised sample of adults (n = 1260) in the Middle East. A two-factor model was deemed the most statistically and theoretically appropriate measurement model. This represented a split between cognitive and physiological symptoms. Overall, 15.2% of respondents reported at least mild anxiety, with 2.3% experiencing severe anxiety. Lower anxiety scores on the scale were reported among males, the married, younger and higher educated people. The Hamilton Anxiety Scale continues to be a useful tool in the measurement of anxiety. The two factor model separates anxiety into two dimensions, cognitive and physiological aspects and both are highly correlated with each other suggesting a single overarching construct of anxiety. The two-factor model may help provide a better understanding of the effectiveness of different therapeutic techniques. The pooled prevalence of ADs in a non-clinical Persian sample was relatively lower than those of some other countries.

SIGH, what’s in a name? An examination of the factor structure and criterion validity of the (Structured Interview Guide for the) Hamilton Anxiety scale (SIGH-A) in a sample of African American adults with co-occurring trauma experience and heavy alcohol use.

“…Results of the factor analysis suggested that the SIGH-A yields a highly correlated two-factor solution with good internal consistency and item-test correlations, consistent with previous studies examining other versions of the Hamilton Scale in predominately White samples (Beck & Steer, 1991; Clark & Donovan, 1994; Hamilton, 1959; Slater et al, 2019). Despite these promising results, factor loadings were modest, and post hoc modifications, i.e., allowing error covariances between Items 11 (Gastrointestinal symptoms) and 14 (Behavior at interview), were recommended.…”

“…Despite these promising results, factor loadings were modest, and post hoc modifications, i.e., allowing error covariances between Items 11 (Gastrointestinal symptoms) and 14 (Behavior at interview), were recommended. While such recommendations to the two-factor solution are not unexpected in light of previous factor analytic studies using the Hamilton scale (i.e., Clark & Donovan, 1994; Slater et al, 2019), it is noteworthy that the error terms implicated in these post hoc modifications differ from those in previous studies, possibly suggesting that these changes are based on statistical improvements to the model rather than a priori theoretical bases (see MacCallum et al, 1992). Alternatively, the differential modifications to error terms across studies may signal that some of the Hamilton’s item content is not invariant across racial populations (i.e., that the constructs operationalized on the Hamilton scale have different meanings across racial groups; Kline, 2016), thus highlighting the importance of continued examination of the Hamilton scale among non-White samples.…”

“…Despite these promising results, factor loadings were modest, and post hoc modifications, i.e., allowing error covariances between Items 11 (Gastrointestinal symptoms) and 14 (Behavior at interview), were recommended. While such recommendations to the two-factor solution are not unexpected in light of previous factor analytic studies using the Hamilton scale (i.e., Clark & Donovan, 1994;Slater et al, 2019), it is noteworthy that the error terms implicated in these post hoc modifications differ from those in previous studies, possibly suggesting that these changes are based on statistical improvements to the model rather than a priori theoretical bases (see MacCallum et al, 1992).…”

“…This article is intended solely for the personal use of the individual user and is not to be disseminated broadly. samples (Beck & Steer, 1991;Clark & Donovan, 1994;Hamilton, 1959;Slater et al, 2019). Despite these promising results, factor loadings were modest, and post hoc modifications, i.e., allowing error covariances between Items 11 (Gastrointestinal symptoms) and 14 (Behavior at interview), were recommended.…”

Measurement fidelity of clinical assessment methods in a global study on identifying reproducible brain signatures of obsessive–compulsive disorder.

“…Studies validating the HAM-A in clinical populations (including OCD) have not assessed the factor structure systematically. Two-factor model for HAM-A similar to what we reported, was also found in a nonclinical Persian population (Slater et al, 2019), and in a alcoholism-PTSD comorbid sample (Marks et al, 2021) In our study, both the HAM-D and the HAM-A met configural invariance with acceptable RMSEA values, but did not meet the cutoff for metric invariance, indicating that items have different loadings between sites. One of the reasons for this could be the heterogeneity in the sample characteristics across the sites, with respect to the rates of comorbid MDD and anxiety disorders.…”