Assessment tools have two significant roles in healthcare. This includes measuring and diagnosing diseases, and also evaluating a patient's response to a particular treatment. However, in most cases, these tools usually measure similar conditions and responses. What usually differs is their effectiveness. In order for one to determine the appropriate tool for use, several factors have to be considered -For instance, their weaknesses and strengths. These two factors are used to determine where a tool is to be used. Herein, the assessment tool, the Hamilton Anxiety Scale (HAM-A), is subject to the psychotherapy field. As a result, this paper will outline the psychometric features and the appropriateness of HAM-A.
Psychometric Features
Generally, HAM-A is used in the assessment and quantification of severity that occurs as a result of anxiety. Its scale comprises of 14 items. They measure both psychic and somatic anxieties. However, in psychotherapy, researchers have raised questions about the validity of this tool's scale. For instance, the factors behind these questions are that HAM-A does not capture anxiety's essential aspects. According to Dissanayaka et al. (2015), in a study conducted to determine the adequacy of the scale in PD, no sufficient measurements used in measuring PD anxiety properties were present. This depicts the inadequacy of the tool in measuring anxiety in PD patients, thus proving why its validity is questioned. However, the items of this tool usually capture symptoms thought to be characteristics of depression rather than anxiety. Porter et al. (2017), carried out research to determine the psychometric features of the Hamilton Anxiety and Depression scales using reconstructed and original scales. Various assumptions were made, thus bringing out precise psychometric properties of the tool.
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From the research, the internal consistency of the tool was assessed. However, internal consistency was achieved whereby the scales of HAM-A were recorded at 75 and 68 for the reconstructed and original scales, respectively (Porter et al., 2017). Besides, correlations of the two scales between reconstructed scales were found to be small whereas, for the original scales, it was substantial. However, the small difference in the reconstructed scale was found to be consistent with some of the previous studies while it was inconsistent in others. However, the reason for the difference is due to distinctions in study populations. Thus, outline the correlational property of the tool.
Psychopharmacologic Medications
On the other hand, the above properties are used to determine the efficacy of HAM-A in determining psychopharmacologic medications. Often, it is a widely used tool in determining a client's anxiety symptoms severity. However, it is not that appropriate due to its apparent inaccuracy in distinguishing betwixt anxiolytic and somatic anxiety effects. Therefore, when used, it usually generalizes the types of medications that could be used for both controlling anxiolytic and somatic anxieties. However, its validity has been proven to be sufficient as anxiety treatments usually serve for both anxiolytic and somatic anxieties (Thompson, 2015) . Thus, this tool is appropriate for use in determining anxiety among individuals.
Conclusively, for determination of psychopharmacologic medications, it has been found that clinical officers assess symptom severity in a manner that may lower the reliability in the original semi-structured assessments. As a result, the Hamilton Anxiety Rating Scale Interview Guide (HARS-IG) was developed. However, its reliability in assessment has been proven to be much more significant as compared to the original. This implies that diversity of medications has been narrowed down. Thus, a client with anxiolytic anxiety effects can receive different medication from a client with somatic anxiety effects based on the symptoms determined by the tool. Also, this tool will help determine whether a client requires both medication and psychotherapy or medication alone. A psychiatrist, when involved, will play a role in monitoring a client's medication and also in offering psychiatric medication. Thus, this tool is significant as it helps fasten recovery to an individual who has suffered from an anxiety disorder.
References
Porter, E., Chambless, D. L., McCarthy, K. S., DeRubeis, R. J., Sharpless, B. A., Barrett, M. S., Milrod, B., Hollon, S. D., & Barber, J. P. (2017). Psychometric Properties of the Reconstructed Hamilton Depression and Anxiety Scales. The Journal of nervous and mental disease , 205 (8), 656–664. https://doi.org/10.1097/NMD.0000000000000666
Dissanayaka, N. N., Torbey, E., & Pachana, N. A. (2015). Anxiety rating scales in Parkinson's disease: a critical review updating recent literature. International Psychogeriatrics , 27 (11), 1777-1784.
Thompson, E. (2015, October). Hamilton Rating Scale for Anxiety (HAM-A). Occupational Medicine, 65 (7), p. 601. doi:10.1093/occmed/kqv054
