Cognitive Assessment and Case Formulation 131
provides more detailed information and dimensional ratings of anxious symptoms, it is
more time- consuming and assesses a narrower range of disorders. The ADIS-IV can be
purchased from Oxford University Press/Graywind Publications.
Clinician Guideline 5.1
Administer the ADIS-IV current version prior to implementing a course of cognitive therapy
for anxiety. The ADIS-IV provides a precise diagnosis and crucial symptom data for the five
anxiety disorders discussed in this volume.Symptom Measures
A number of standardized self- report questionnaires and clinician rating scales are
available to assess the frequency and severity of anxious symptoms. Here we focus on
broadly based, general measures of anxiety with disorder- specific measures covered in
later chapters. Standardized measures of general anxiety symptoms are useful because
they provide:
••A broad overview or screening of various anxious symptoms.
••A measure of symptom severity that is important for evaluating treatment effec-
tiveness.
••Access to normative data so that the relative severity of an anxiety state can be
determined.
••Opportunity for repeated administration over the course of treatment so that
progress can be charted and symptom clusters identified that have been unre-
sponsive to treatment.Over the years a variety of general anxiety measures have been developed. The fol-
lowing section presents a few measures that we believe are most relevant for cognitive
therapy of anxiety. A more comprehensive review of anxiety measures is provided in an
edited book by Antony, Orsillo, and Roemer (2001).
Beck Anxiety Inventory
The Beck Anxiety Inventory (BAI; Beck & Steer, 1990) is a 21-item questionnaire that
assesses the severity of anxious symptoms on a 0 (“not at all”) to 3 (“severely, I could
barely stand it”) scale. According to the manual (Beck & Steer, 1990), the normal range
for the BAI Total Score is 0–9, mild anxiety is 10–18, moderate severity is 19–29, and
severe anxiety ranges from 30 to 63. Psychometric studies indicate that the BAI has
high internal consistency (alpha = .92) and a 1-week test– retest reliability of .75 (Beck,
Epstein, Brown, & Steer, 1988; Steer, Ranieri, Beck, & Clark, 1993). The BAI Total
Score correlates moderately with other anxious symptom measures like the Hamilton
Rating Scale of Anxiety— Revised, State–Trait Anxiety Inventory, and weekly diary
ratings of anxiety, and patients with anxiety disorders score significantly higher than
those with other psychiatric diagnoses (Beck et al., 1988; Creamer, Foran, & Bell, 1995;
Fydrich, Dowdall, & Chambless, 1992; Steer et al., 1993). As reported in the manual