The Hamilton Anxiety Scale

The Hamilton Anxiety Scale reveals something important: Not everyone experiences anxiety the same way. This state is also made up of psychic states and extensive psychosomatic symptoms.
Hamilton Anxiety Scale

The Hamilton Anxiety Scale is one of the most common psychological questionnaires used to clarify the degree of anxiety a person suffers from. It is therefore not a diagnostic tool, but a useful and very effective resource for assessing the patient’s condition, psychosomatic symptoms, fears and cognitive processes.

This scale should therefore attract our attention for several reasons. It was designed in 1959 by Max R. Hamilton and is still one of the most used today. If there was one thing that was clear to this professor of psychiatry, and later president of the British Psychological Society , it is that not all anxiety states are created equal.

He did not want to define another instrument to diagnose a disorder. It was thus a question of defining a very rigorous resource making it possible to evaluate the degree of gravity of the anxiety in a person, while differentiating psychic anxiety from somatic anxiety by its importance in the definition of the capacity of people. to control this very tiring reality.

Later, in 1969, Doctor Hamilton wanted to go a step further and improve the scale. Among these items focused on the assessment of somatic anxiety, he therefore made a distinction between somatic muscle signs and somatic sensory signs. So, and with this degree of refinement when it comes to designing the tightest test possible, we already see a clear clue about it.

Each person experiences anxiety in a particular way. No two realities are alike, therefore, we cannot all use the same treatment strategies. Tests such as the one below are very suitable for tailoring treatments according to the particular needs of each patient.

the Hamilton Anxiety Scale test

The goal of the Hamilton Anxiety Scale

The Hamilton Anxiety Scale is a clinical assessment instrument used to measure a person’s degree of anxiety. It is useful for both children and adults. It is also an instrument that can be used by doctors and psychiatrists. But it is clear that it does not determine the diagnosis of a specific disorder (although it can help).

Likewise, there is a problem with this clinical resource that is already perceived by healthcare professionals. The Hamilton Anxiety Scale is freely accessible, anyone can download the instrument or even take the test online. Thus, it is common for many people to go to their doctor with the diagnosis: “ I am suffering from severe anxiety ”.

It is not the right thing to do. This type of test, like any other clinical evaluation test, should be performed by specialized professionals. In addition, the Hamilton Anxiety Scale has another element where the researcher himself must assess the state in which the patient has taken the test.

It is therefore a priority that we be rigorous in this area, because as studies such as those conducted by psychiatrists Katherine Shear and Vander Bilt show, on the Hamilton Anxiety Scale, the interview itself during the Administration of the test is essential to a proper diagnosis.

Items measured by the Hamilton Anxiety Scale

This instrument consists of 14 items. On the other hand, each question has five response options, ranging from “ absent ” to “ maximum intensity ”. Thus, a score of 17 or less indicates mild anxiety. A score between 18 and 24 points would already give us a clue of a moderate state of anxiety. Finally, if we get a score between 24 and 30, it would indicate a serious state of anxiety.

Let’s look at these 14 elements that make up the test:

  • Anxious mood : constant worrying, anxiety when thinking or imagining certain things, always anticipating the worst
  • Tension : trembling, want to cry, feeling of alarm
  • Fears : fear of being alone, of darkness, of the unexpected
  • Insomnia
  • Intellectual functions (cognition) : difficulty in deciding, concentrating, thinking, memory impairment
  • Depressed mood: discouragement, getting up with negativity and feeling like it will be a bad day, irritation, moodiness
  • Symptoms :
    • General somatics (muscular in nature) : bruxism, tremors, muscle stiffness, muscle pain, trembling voice
    • General somatics (sensory in nature)  : tinnitus, blurred vision, feeling cold or hot, feeling weak
    • Cardiovascular : sudden tachycardia or punctures in the chest
    • Respiratory : shortness of breath, pressure, suffocation
    • Gastrointestinal : problems with swallowing, digestion, constipation or diarrhea
    • Genitourinary : constant urination, lack of libido
    • From the autonomic nervous system : dry mouth, pallor, sweating, bristly skin …
  • Behavior during the interview : the expert assesses here the way in which he saw the patient in general
the Hamilton Anxiety Scale test done by a psychologist

In conclusion, only one essential aspect should be addressed. The Hamilton Anxiety Scale is a freely accessible resource, as we know it. We can therefore take the test if we wish. However, it is our psychiatrists or psychologists who are really qualified to do the assessment and diagnosis.

Later, and depending on the result,  we will therefore implement one or the other strategy. In the 1960s, Dr. Hamilton’s goal was to be able to get an accurate and reliable profile of each person’s anxiety level. Only in this way will we be able to act in the best and most suitable way.

And in these cases, evaluating aspects such as the patient’s tone of voice, posture, clarity to understand or not the questions are essential to make a correct evaluation.


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