Instruments Developed by the Program
Since 1987, a variety of psychometrically validated rating instruments have been developed in the Duke Anxiety and Traumatic Stress Program. These tools may be used to facilitate screening and diagnosis of anxiety disorders and assessment of illness severity and response to treatment over time. The scales described below are available in English, with several of the scales also available in other languages. Below are brief descriptions of the instruments available. The SARA, SIP, SOS, TQ and TOP-8 are available for general non-commercial use, subject to acknowledgement of copyright, which is identical for English and translated forms. The SPIN, MINI-SPIN and SPRINT are not in the public domain and permission for use should be obtained from the copyright holder, Dr. Davidson, at firstname.lastname@example.org.
The Mini-SPIN is 3-item self-rated scale derived from the Social Phobia Inventory. The Mini-SPIN is may be used as a screening tool to help identify individuals at increased risk for having social phobia (or social anxiety disorder). Using a cutoff score of 6 or greater, the Mini-SPIN demonstrated 90% accuracy (efficiency) in diagnosing the presence or absence of GSAD in a managed care population and those in need of further evaluation.
Connor KM, Kobak KA, Churchill LE, Katzelnick D, Davidson JR. Mini-SPIN: a brief screening assessment for generalized social anxiety disorder. Depression and Anxiety 2001; 14:137-140.
Self-Assessment of Resilience and Anxiety (SARA)
The SARA is an 8-item self-rating including questions designed to measure calmness, mental clarity, confidence, physical wellbeing, sociability, and resilience. In a study of an herbal anxiolytic in patients with generalized anxiety disorder (GAD), the SARA scale was responsive to symptom change over time and correlated with comparable GAD symptom measures. The SARA scale demonstrated solid psychometric properties in this sample, however its performance has not been assessed outside of GAD nor conventional treatment modalities.
Barnett SD, Connor KM, Davidson JR. The self-assessment of resilience and anxiety: psychometric properties. CNS Spectrums 2001; 6:854-857.
Short PTSD Rating Interview (SPRINT)
The SPRINT provides a brief global assessment for PTSD, as well as for each of the individual symptom clusters associated with the disorder (i.e., intrusion and re-experiencing; avoidance and numbing; hyperarousal). The SPRINT is responsive to symptom change over time and correlates with comparable PTSD symptom measures. In victims of trauma, a score of 14-17 is associated with 96% diagnostic accuracy, whereas in those with PTSD, highest efficiency corresponded to a range of 11-13. The SPRINT demonstrates solid psychometric properties and can serve as a reliable, valid and homogeneous measure of PTSD illness severity and of global improvement.
Connor KM, Davidson JR. SPRINT: a brief global assessment of post-traumatic stress disorder. International Clinical Psychopharmacology 2001; 16:279-284.
Vaishnavi S, Payne, V, Connor, K, Davidson JR. A comparison of the SPRINT and CAPS assessment scales for posttraumatic stress disorder. Depression and Anxiety 2006; Jul 13 [Epub ahead of print].
Social Phobia Inventory (SPIN)
The SPIN is a 17-item self-rating for social anxiety disorder (or social phobia). The scale is rated over the past week and includes items assessing each of the symptom domains of social anxiety disorder (fear, avoidance, and physiologic arousal). A total score of 19 distinguished between social phobia subjects and controls. The SPIN demonstrates solid psychometric properties and shows promise as a measurement for the screening and treatment response of social phobia.
Connor KM, Davidson JR, Churchill LE, Sherwood A, Foa E, Weisler RH. Psychometric properties of the Social Phobia Inventory (SPIN). New self-rating scale. British Journal of Psychiatry 2000; 176:379-386.
Structured Interview for PTSD (SIP)
The SIP was developed to be used in any individual who has experienced a traumatic event when the objective is to assess posttraumatic symptom severity or diagnosis. The rater administered scale is comprised of 17 items which assess each of the 3 PTSD symptom clusters: re-experiencing; avoidance and numbing; and hyperarousal. Note 2 items assessing survivor and behavior guilt are also included, representing holdovers from the original DSM-III criteria. Each item is rated from 0-4 and represents a composite assessment of frequency, severity, and functional impairment. Optimal diagnostic sensitivity is attained at a cutoff score of 20. While originally developed to DSM-III defined PTSD, the scale was modified in 1995 to reflect DSM-IV criteria for PTSD.
Davidson JR, Malik MA, Travers J. Structured Interview for PSTD (SIP): psychometric validation for DSM-IV criteria. Depression and Anxiety 1997; 5:127-129.
Davidson JRT, Smith RD, Kudler HS. Validity and reliability of the DSM-III criteria for posttraumatic stress disorder. Journal of Nervous and Mental Disease 1989; 177:366-341.
Symptom Occurrence Scale (SOS)
The SOS is a self-rating developed by our group to evaluate treatment emergent-side effects in clinical trials of anxiety and mood disorders. The scale is also useful in clinical practice to assist in monitoring medication tolerability.
Connor KM, Davidson JR, Churchill LE. Adverse-effect profile of kava. CNS Spectrums 2001; 6:848, 850-853.
Trauma Questionnaire (TQ)
The TQ provides an assessment of lifetime history of trauma exposure. The scale includes assessment of a wide range of traumatic experiences, including age of the event, frequency of occurrence, and, if more than one trauma was experienced, identification of the worst trauma. The TQ was originally developed and validated in an adult inpatient mood disorders population, however it has subsequently been widely used by our group an others in clinical research and practice. The TQ may be administered by an clinician or other rater or self-rated.
Escalona R, Tupler LA, Saur CD, Krishnan KR, Davidson JR. Screening for trauma history on an inpatient affective-disorders unit: a pilot study. Journal of Traumatic Stress 1997; 10:299-305.
Treatment Outcome PTSD scale (TOP-8)
The TOP-8 scale was developed as a brief, clinician-administered scale for use in assessing responses to treatment in patients with post-traumatic stress disorder. The instrument was developed from a larger post-traumatic stress disorder evaluation scale (SIP, see above) based on items which occurred frequently in the population and which responded substantially to treatment across time. The 8 resultant items were drawn from all three symptom clusters for post-traumatic stress disorder, and showed an improved ability to detect drug versus placebo differences in comparison with the original scale.
Connor KM, Davidson JR. Further psychometric assessment of the TOP-8: a brief interview-based measure of PTSD. Depression and Anxiety 1999; 9:135-137.
Davidson JR, Colket JT. The eight-item treatment-outcome post-traumatic stress disorder scale: a brief measure to assess treatment outcome in post-traumatic stress disorder. International Clinical Psychopharmacology 1997; 12:41-45.