However, some issues remain regarding the BAI's discriminant validity against depressive disorders. While depression is defined as the experience of being sad, gloomy, and empty which is typically associated with events experienced in the past and decreased autonomic activity, anxiety is defined as feelings of fear and tension, and apprehension which is usually related to anticipation of future events and activation of autonomic nervous system ( 28). This 21-item self-report questionnaire was originally developed to assess clinical anxiety (i.e., an excess of normal anxiety resulting in significant distress and impairment of functioning ( 23, 24), differentiated from normal anxiety (i.e., an adaptive emotional responses to danger or threat, ( 25, 26), as well as the unique aspects of anxiety disorders that are assumed to differ from those of depressive disorders ( 27). According to the meta-analysis of BAI ( k = 117), BAI was reported to manifest an excellent internal consistency in clinical (0.91) and non-clinical sample (0.91) and a good test-retest reliability in clinical (0.66) and non-clinical (0.65) ( 1). Among counselors in primary health care settings, BAI is reported to be the ninth most commonly used tools in the United States ( 22), owing to the advantages in cost-effectiveness and brevity in the application procedure.
The BAI requires about 5–10 min to administer (about 10 min for oral administration), and <5 min to interpret the scores. Strong psychometric evidences have been established in diverse samples, including diverse clinical samples mixed psychiatric patients ( 8– 14), panic disorder with and without agoraphobia ( 15), adolescent psychiatric patients ( 13, 16, 17), and older adult psychiatric patients ( 18) to non-clinical samples ( 19– 21). The Beck Anxiety Inventory (BAI) is a prominent screening and outcome research tool for measuring the anxiety ( 1), and is validated in a number of languages, including German, French, Chinese, Spanish, Persian, Nepal, Icelandic, and others ( 2– 7). Further clinical implications of the BAI based on these results and some limitations of the study are discussed. Our data supports the BAI reliability and validity as a tool to measure the severity of general anxiety in clinical and non-clinical populations however, it fails to capture the unique characteristics of anxiety disorders that distinguish them from depressive disorders. However, BAI mean score was not higher for the anxiety-only group than the depression-only group. The comparison of BAI and BDI mean scores for different diagnostic groups revealed that BAI and BDI scores were higher in the depressive or anxiety disorders group than in the non-clinical group. The ROC analysis failed to provide cutoff scores with adequate sensitivity and specificity for identifying participants with anxiety disorders (85.0% sensitivity, 88.1% specificity, and 92.8% AUC). The BAI was found to have high correlations with depression-related self-report measures (0.747–0.796) and moderate to high correlations with anxiety-related self-report measures (0.518–0.776). ROC analysis and calculation of positive and negative predictive values were conducted to examine diagnostic utility. A total of 1,157 participants were involved in the final psychometric analysis, which included correlational analysis with other anxiety and depression self-report measures and mean score comparison with the Beck Depression Inventory (BDI). This study aims to clarify the clinical utility of the BAI as a screening tool for anxiety disorders according to DSM-IV criteria, based on blind recruitment and diagnostic interviews of both clinical and non-clinical participants in the Korean population. 4Department of Psychiatry, Ilsan Paik Hospital, College of Medicine, Inje University, Goyang, South Koreaĭespite the prominent use of the Beck Anxiety Inventory (BAI) in primary healthcare systems, few studies have confirmed its diagnostic utility and psychometric properties in non-Western countries.3Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, South Korea.2Department of Adolescent Counseling, Hanyang Cyber University, Seoul, South Korea.1Department of Psychology, Clinical and Counseling Psychology, Korea University, Seoul, South Korea.Hyeonju Oh 1, Kiho Park 1, Seowon Yoon 1, Yeseul Kim 1, Seung-Hwan Lee 2, Yoon Young Choi 3,4 and Kee-Hong Choi 1 *
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