Validity and Reliability of the Staden Schizophrenia Anxiety Rating Scale

Abstract

In schizophrenia, none of the standard anxiety measures exhibit strong psychometric properties, and all performed poorly against quality assessment criteria. Developed for the schizophrenia population, this study examined the validity and reliability of the Staden Schizophrenia Anxiety Rating Scale (S-SARS) that measures both specified and undifferentiated anxiety. Among 353 schizophrenia patients, strong correlations with anxiety parameters supported the S-SARS’s convergent validity. Criterion-related validity testing yielded accuracy, sensitivity, and specificity rates of around 95%. Its discriminant validity was observed for measures of depression, psychosis, akathisia, fatigue, vigour, procrastination, behavioural inhibition and activation, and personal growth and initiative. Structural validity was found in a single-factor unidimensional model with a 0.953 factor score. Excellent results were found for internal consistency (Cronbach’s alpha = 0.931; Spearman–Brown coefficient = 0.937; Guttman split-half coefficient = 0.928) and inter-rater reliability (Krippendorff’s alpha = 0.852). It incurred no more than a small error of measurement whereby the observed scores were within 1.54 to 3.58 of a true score on a zero to 50 scale. These strong psychometric properties suggest that the S-SARS is a valid and reliable instrument for measuring specified and undifferentiated anxiety in schizophrenia, providing the means for the accurate measurement of anxiolytic treatment effects.

Validity and reliability of the agentive steadfastness index

“…Discriminant validity of the ASI was found in its negative correlations and statistically significant differences with ego‐strength and anxiety. This confirmed the theoretical anticipation that agentive steadfastness would be distinct from ego‐strength and anxiety (Erikson, 1968; Van Staden et al, 2022). Unlike ego‐strength, agentive steadfastness was not conceptualised as pertaining to the domain of subconscious psychological defences but as a psychological foundation for taking action.…”

Testing the validity and reliability of the Chinese version of the Staden schizophrenia anxiety rating scale

“…Hence, Van Staden et al developed a scale named Staden Schizophrenia Anxiety Rating Scale (S-SARS) (26), which had . /fpsyt.…”

“…", the sixth item is "The patient has been afraid or scared when objectively hallucinating.". The third subscale also included 6 items, the first item is "No anxiety attacks during the past 7 days, " the second item is "Unclear whether anxiety attacks have been present or absent, " the third item is "The patient has had at least one discreet episode of intense fear without much concern about a further attack or its cause or its implications, " the fourth item is "The patient has had at least one discreet episode of intense fear, and has been concerned about a further episode or its cause or its implications, " the fifth item is "The patient has had more than one discreet episode of intense fear and has been very concerned about a further episode or its cause or its implications, " the sixth item is "The patient has had more than one discreet episode of intense fear, and has been very concerned that these episodes may be an indication of his/her impending death (26).…”

“…Hence, Van Staden et al developed a scale named Staden Schizophrenia Anxiety Rating Scale (S-SARS) ( 26 ), which had 3 sub-scales, including 18 items, and was explicitly used to assess the quantity of anxiety symptoms in schizophrenia patients. Each item has six narrative anchor points on a scale from 0 to 5 to indicate the severity of the anxiety during the preceding week and was accompanied by pre-designed guided questions during the interview to inform the ratings.…”

“…The first part is used to assess the specific anxiety, and the first item of this sub scale is “no persecutory or nihilistic anxiety during the past 7 days,” the second item is “unclear whether persecutory or nihilistic anxiety has been present or absent, ” the third item is “The patient has been concerned about the attitude, intentions, or plans of other beings toward him/her, or the patient is afraid that life has lost its meaning for him/her, ” the fourth item is “The patient is afraid that he/she may be persecuted, or may be a victim of malicious intent, or the patient is afraid that his/her life or livelihood is drawing to an end,” the fifth item is “The patient is afraid as part of his/her belief that something bad or harmful is about to be done to him/her, or the patient is afraid as part of his/her belief that his/her life is in danger.,” the sixth item is “The patient is afraid as part of his/her belief that something bad or harmful is being done or was done to him/her, or the patient is afraid as part of his/her belief that he/she is dying, decaying, or ceasing to exist fully.” The second subscale of S-SARS consists of six items, the first item is “No anxiety attacks during the past 7 days,” the second item is “Unclear whether anxiety attacks have been present or absent,” the third item is “The patient has been concerned about things or people he/she hears, sees, feels tactually, smells or tastes, and these sensory perceptions are dreams, images, illusions, or hallucinations”, the fourth item is “The patient has been afraid of the things or people he/she hears, sees, feels tactually, smells or tastes, and these sensory perceptions are dreams, images, illusions, or hallucinations.”, the firth item is “The patient has been afraid and has been startled by the things or people he/she hears, sees, feels tactually, smells or tastes, and these sensory perceptions are dreams, images, illusions, or hallucinations.”, the sixth item is “The patient has been afraid or scared when objectively hallucinating.”. The third subscale also included 6 items, the first item is “No anxiety attacks during the past 7 days,” the second item is “Unclear whether anxiety attacks have been present or absent,” the third item is “The patient has had at least one discreet episode of intense fear without much concern about a further attack or its cause or its implications,” the fourth item is “The patient has had at least one discreet episode of intense fear, and has been concerned about a further episode or its cause or its implications,” the fifth item is “The patient has had more than one discreet episode of intense fear and has been very concerned about a further episode or its cause or its implications,” the sixth item is “The patient has had more than one discreet episode of intense fear, and has been very concerned that these episodes may be an indication of his/her impending death ( 26 ).…”