Hamilton Anxiety Rating Scale

PsycTESTS Citation:
Hamilton, M. (1959). Hamilton Anxiety Rating Scale [Database record]. Retrieved from PsycTESTS. doi:
https://dx.doi.org/10.1037/t02824-000

Instrument Type:
Rating Scale

Test Format:
A total of 14 items are rated on a five-point scale.

Source:
Guy, William. (1976). ECDEU Assessment Manual, 612 pp. US Department of Health, Education and Welfare (HEW)
doi: https://dx.doi.org/10.1037/e591322011-001

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048 HAM A
HAMILTON
ANXIETY
SCALE
MH-9-48 HAMILTON ANXIETY SCALE
6-73

INSTRUCTIONS: Code 01 under Sheet Number.

Be sure to record your answers in the appropriate spaces (positions through 4),
Columns 1—5, on the left half of the General Scoring Sheet.

USE A NO. 2 LEAD PENCIL. BE SURE TO MAKE MARKS HEAVY AND DARK. ERASE COMPLETELY ANY MARKS YOU WISH TO CHANGE.
 -

The Hamilton Anxiety Scale (HAMA) is a 1^-item scale formatted for use with
the General Scoring Sheet. The HAMA was designed by Hamilton and intended for
use with patients already diagnosed as suffering from neurotic anxiety states
not for assessing anxiety in patients suffering from other disorders. Until the
contrary is proved, it must be regarded as invalid for the rating of anxiety in
any other setting. This limits the range of usefulness of the scale but, within
these limits, patients can be compared meaningfully. The scale places great
emphasis on the patient's subjective state. This follows from the medical bias
of the author. In treatment, the patient's subjective state takes first place
both as a criterion of illness, which brings the patient for treatment and as a
criterion of improvement.

REFERENCES 1. Hamilton, M., The Assessment of Anxiety States by

Rating, Brit. J. Med. Psychol., 32, 50-55, 1959.
2. Hamilton, M., Diagnosis and Rating of Anxiety, in:
Studies of Anxiety, Lader, M. H., Brit. J. Psychiat.
Spec. Pub. 3, 76-79, 1969

APPLICABILITY Adults with diagnosis of anxiety neurosis

UTILIZATION Once at pretreatment at least one posttreatment assess-

;

ment. Additional ratings are at the discretion of the

investigator.

TIME SPAN RATED Now or during the past week

CARD FORMAT - ITEMS CARD 01 = (19x, l4ll)

Item
1
FACTOR COMPOSITION

Hamilton has presented both centroid and orthogonal factor structures in

his 1959 article. Since other ECDEU factors are orthogonal and unipolar, this
structure - rather than the centroid one - will be employed for analyses. When
a sufficient sample is accumulated, factor analysis will be performed on ECDEU
data

1 . Somat ic Anxiety I I . Psychic Anxiety

7 - Somatic, muscular 1 - Anxious mood
8 - Somatic, sensory 2 - Tens ion
9 - Cardiovascular symptoms 3 - Fears
10 - Respiratory symptoms k - insomnia
11 - Gastro-intest inal symptoms 5 - Intellectual
12 - Gen to-urinary symptoms
i 6 - Depressed mood
13 - Autonomic symptoms 14 - Behavior at interview

SPECIAL INSTRUCTIONS

1. Assessments are made on a 5-point scale. In practice, however, the last scale
point (very severe, grossly disabling) is very rarely used for out-patients and
serves more as a marker, a method of delimiting the range, rather than as a grade
of practical use.

2. Each of the 14 items represents a set of symptoms grouped together according

to their nature or where clinical experience indicates that they were associated.
The symptom groups which serve as cues for the rater are:

1 . Anxious mood 3. Fears

Worries Of Dark
Anticipation of the worst Strangers
Apprehension (fearful Being left alone
ant icipat ion) Large animals etc. ,

I rri tabi 1 i
ty Traffic
Crowds
2. Tension
Insomnia
Feelings of tension
Fat iguabi ty
1 i Difficulty in falling asleep
Inabi 1 ity to relax Broken sleep
Startle response Unsatisfying sleep and
Moved to tears easily fatigue on waking
Trembl ing Dreams
Feelings of restlessness Nightmares
Night terrors

196
 5. Intellectual (cognitive) 11. Gastro-intestinal symptoms

Difficulty in concentration Difficulty in swallowing

Poor memory Wind
Dyspeps ia:
6. Depressed mood pain before and after means
burning sensations
Loss of interest ful Iness
Lack of pleasure in hobbies waterbrash
Depress ion nausea
Early waking vomi ting
Diurnal swing s inking feel ings
'Working' in abdomen
7. General somatic (muscular) Borborygmi
Looseness of bowels
Muscular pains and aches Loss of weight
Muscular stiffness Constipation
Muscular twitchings
Clonic jerks 12. Gen to-urinary symptoms
i

Grinding of teeth
Unsteady voice Frequency of micturition
Urgency of micturition
8. General somatic (sensory) Amenorrhea
Menorrhagia
Tinnitus Development of frigidity
Blurring of vision Ejaculatio praecox
Hot and cold flushes Loss of erection
Feelings of weakness Impotence
Pricking sensations
13. Autonomic symptoms
9. Cardiovascular symptoms
Dry mouth
Tachycardia Flushing
Pa p ta t ons
1 i i Pallor
Pain in chest Tendency to sweat
Throbbing of vessels G iddiness
Fa inting feel ings Tension headache
Missing beat Raising of hair

10. Respiratory symptoms

Pressure or constriction in
chest
Choking feel ings
S ighings
Dyspnoea

197
1^. Behavior at interview

a. General b. Physiological

Tense, not relaxed Swallowing

Fidgeting: hands, Belching
picking fingers. High resting pulse rate
clenching, tics Respiration rate over 20/min.
handkerchief Brisk tendon jerks
Restlessness: pacing Tremor
Tremor of hands Dilated pupils
Furrowed brow Exophthalmos
Strained face Sweating
increased muscular tone Eye-1 id^ twitching
Sighing respirations
Facial pallor

DOCUMENTATION

a. Raw score printout

b. Factor score printout
c. Means and standard deviations of factor scores
d. Variance analyses

198