Measuring and assessing your anxiety levels
The Hamilton anxiety rating scale (HARS) was developed as a tool to be used by doctors and therapists to determine the severity of a patient’s anxiety. In order to measure this anxiety, there is a set of 14 questions which are aimed at the different types of anxiety that patients typically experience. The first thirteen of these questions are answered by the patient based on interviews and questions asked, whereas the last question is used by the therapists to show how they feel the patient is actually doing.
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Max Hamilton developed the HARS test as he felt there was a need to be able to measure both mental and physical or somatic anxiety. The test can be used on children and younger adults although there has also been recent support for its use in older patients. Hamilton created a list of physical and mental symptoms after using factor analysis to create a list of overall symptoms.
The test is administered by the doctor or therapist who asks the patients the corresponding questions on the questionnaire and then rates their answers on a scale from 0-4 with four being the highest level of anxiety. All the scores are totalled and this total is then used to give the therapist an idea of the patients mental state. The questions are equally divided between physical and mental with the intention of providing a a balanced view of the two types of symptom.
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After adding up the results, it is felt that if a person has a score of less than 17 that this person only has mild anxiety which can be easily treated with therapy. Sometimes this can be misleading. Many people will try to mask their true feeling out of embarressment. It takes a well trained therapist to coax the real answers out and to be able to make an accurate diagnosis. If the patient scores between 18-24 then this indicates a moderate level of anxiety which can be helped by learning to meditate or to breathe correctly. Any patient that scores more than 25 is experiencing severe anxiety. When anxiety is this bad there may be a call for the short term use of medication which can be used in conjunction with CBT and other relaxation techniques.
While the test is useful to help therapists to understand a patient’s level of anxiety, it is only as good as the skills of the therapist and the answers are very much subject to interpretation. In fact the questions reflect not only the patients answers but the therapists interpretation of the answers. Whilst not perfect, in the right hands the test has proven to work remarkably well. However questions have been raised regarding the similarity between the responses by those who suffer from anxiety and those who suffer from depression, since those who suffer from depression often score high on the HARS test.
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Despite the possibility of skewed results, the Hamilton anxiety rating scale is still the most popular test used to evaluate patients in use today. The reality is that over very many years HARS has demonstrated that it is accurate and consistent. Combined with the correct type and degree of treatment, many people are able to cure themselves of this debilitating condition.
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