The 14-item short health anxiety inventory (SHAI-14) used as a screening tool: appropriate interpretation and diagnostic accuracy of the Swedish version

Abstract

Background The 14-item Short Health Anxiety Inventory (SHAI-14) is a common measure of health anxiety but its screening properties have not been studied. The aims of this study were to evaluate the SHAI-14 as a screening instrument, identify cut-offs for clinically significant health anxiety and investigate which scores correspond to different severity levels. Method The study included 1729 psychiatric patients and 85 healthy controls. Participants completed the SHAI-14 and underwent a diagnostic interview. Cut-off scores were evaluated in three scenarios to approximate screening 1) in a psychiatric clinic, 2) in a low prevalence setting and, 3) of healthy volunteers (cut-off for remission). Receiver operating characteristics were used. Classification of severity was based on the distribution of SHAI-14 scores reported by patients with clinically significant health anxiety. Results The area under the curve (AUC) values were high in all scenarios (above 0.95). The optimal cut-off scores on the SHAI-14 were 22 in the psychiatric context, 29 in a setting with low prevalence of psychiatric disorders and 18 versus healthy controls. SHAI-14 scores of 0–27 represented no or mild health anxiety, 28–32 moderate health anxiety and 33–42 substantial health anxiety. Conclusion Brief self-report measures used as screening instruments are a simple way of gathering information about the presence of specific symptoms and thus a way to detect the likelihood of a diagnosis. The SHAI-14 shows evidence of good diagnostic utility in both clinical and non-clinical settings. However, which cut-off score is to be used, depends on the intended purpose and the setting where the cut-off is used.

Preventing Health Anxiety: The Role of Self-Evaluation, Sense of Coherence, Self-Rated Health and Perceived Social Support

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Brief digital self-care intervention for health anxiety in a Swedish Medical University Clinic: a prospective single-group feasibility study

“…The primary outcome was a change in health anxiety as measured with the widely used SHAI-14, which has excellent psychometric properties 21 and shows evidence of good diagnostic utility in both clinical and non-clinical settings. 22 Participants completed the SHAI-14 at baseline, each week during treatment, after treatment (week 8), after four additional weeks (week 12) and at the 3-month follow-up (week 24).…”

The Impact of the New Coronavirus Disease on University Students: Anxiety, Health Anxiety, and Physical Activity

“…The scoring of the scale is between 0 and 3 for each item, and a high score indicates a high level of health anxiety. HAI-SF scores of 0-27 represented no or mild health anxiety, 28-32 moderate health anxiety and 33-42 substantial health anxiety (13,14). The anxiety level of the participants in the last one week were evaluated with the "Beck Anxiety Inventory".…”