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Zung Self-Rating Anxiety Scale

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The Zung Self-Rating Anxiety Scale (SAS) was designed by William W. K. Zung
M.D, (1929-1992) a professor of Psychiatry from Duke University, to quantify a
patient's level of anxiety.[1] [2]
The SAS is a 20-item self-report assessment device built to measure anxiety levels,
based on scoring in 4 groups of manifestations: cognitive, autonomic, motor and central
nervous system symptoms. Answering the statements a person should indicate how
much each statement applies to him or her within a period of one or two weeks prior to
taking the test. Each question is scored on a Likert-type scale of 1-4 (based on these
replies: "a little of the time," "some of the time," "good part of the time," "most of the
time"). Some questions are negatively worded to avoid the problem of set response.
Overall assessment is done by total score.
The total raw scores range from 20-80. The raw score then needs to be converted to an
"Anxiety Index" score using the chart on the paper version of the test that can be found
on the link below. The "Anxiety Index" score can then be used on this scale below to
determine the clinical interpretation of one's level of anxiety:

20-44 Normal Range

45-59 Mild to Moderate Anxiety Levels

60-74 Marked to Severe Anxiety Levels

75-80 Extreme Anxiety Levels

Zung Self-Rating Anxiety Scale

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For each item below, please check the column which best describes how often
you felt or behaved this way during the past several days.
1

20

1478534117

A little of the Some of the Good part of


time
time
the time
1. I feel more nervous and anxious than
usual.
2. I feel afraid for no reason at all.

3. I get upset easily or feel panicky.


4. I feel like Im falling apart and going to
pieces.
5. I feel that everything is all right and
nothing bad will happen.
6. My arms and legs shake and tremble.
7. I am bothered by headaches neck and
back pain.
8. I feel weak and get tired easily.

9. I feel calm and can sit still easily.

10. I can feel my heart beating fast.

11. I am bothered by dizzy spells.

12. I have fainting spells or feel like it.

13. I can breathe in and out easily.


14. I get numbness and tingling in my
fingers and toes.
15. I am bothered by stomach aches or
indigestion.

Most of the
time

A little of the Some of the Good part of


time
time
the time

Most of the
time

16. I have to empty my bladder often.

17. My hands are usually dry and warm.

18. My face gets hot and blushes.


19. I fall asleep easily and get a good nights
rest.
20. I have nightmares.

Score my Answers

Sources
1. William WK Zung. A Rating Instrument for Anxiety Disorders. 12(6):
Psychosomatics 371-379. 1971.

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What is the Zung Self-Rating Anxiety Scale

While millions of people suffer from anxiety, anxiety itself has a very
strong subjective component. Nearly everyone struggling with anxiety
feels that their anxiety is fairly intense, which is why doctors,
psychologists, and psychiatrists often struggle to recommend the
right treatment or provide useful advice.
So some doctors, hospitals, and research labs use assessment tools to
get a better understanding of a person's anxiety. One popular one is
known as the Zung Self-Rating Anxiety Scale.

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Introduction to the Zung Self-Rating Anxiety Scale
The Zung Self-Rating scale was developed by Dr. William W. K. Zung
of Duke University. He developed this ratings instrument in 1971, and
it's been in use for many years since.
The value of the scale is in its simplicity. We've developed our own
type of anxiety test that you can take for free. The Zung scale is a
survey of only 20 statements. Examples of some of these statements
include:

"I am bothered by dizzy spells."

"I feel more nervous or anxious than usual."

"I can breathe in and out easily."

Each one is a positive or negative statement that relates to some of


the symptoms of anxiety. Patients are expected to answer these
questions on their own by selecting any one of the following four
answers:

A little of the time.

Some of the time.

Good part of the time.

Most of the time.

There is neither a "none of the time" nor an "all of the time" option on
this scale, presumably to force people to think more about their true
symptoms.

How is the Zung Self-Rating Anxiety Scale Scored?


Despite its simplicity, the Zung Self Rating Scale for anxiety is widely
used in the psychiatric field. It is not considered a replacement for a
professional diagnosis, but has been proven at least internally reliable
in many different tests, and continues to be used in the clinical field.
The rating scale is scored from 1 to 4 points. Most answers go in order
of 1 (a little of the time) to 4 (most of the time). However, questions

5, 9, 13, 17, and 19 are scored in the opposite order, since they
represent positive/non-anxiety statements.
Scores are then calculated and individuals are given the following
results:

20-44 Normal Range

45-59 Mild to Moderate Anxiety Levels

60-74 Marked to Severe Anxiety Levels

75-80 Extreme Anxiety Levels

This is designed to give you a better idea of your anxiety in terms of


severity.

Confusions and Criticisms of the Zung Self-Rating Anxiety Scale


For those living with anxiety, this test can cause a lot of confusion. For
starters, it contains very few of the any symptoms of anxiety that
people experience every day. Most are "basic" symptoms that occur
with the activation of the fight or flight system. It's possible that you
may be experiencing several symptoms that are not listed on the
scale.
Secondly, many people that struggle with anxiety for years wonder
why they do not score higher. It's important to note that "mild" and
"moderate" anxiety can be very severe when you live with them each
and every day. Since you may also be suffering from symptoms not on
the list as well, it's easy to see why you may be surprised by your
lower score on this type of test.
However, remember that the Zung Self-Rating Anxiety Scale is not a
professional diagnosis. It's simply a tool like many others designed to
get a quick idea of how your anxiety rates. If you feel that you suffer
from severe anxiety, then you do, because if the anxiety is severe to
you then it has become a serious problem.
If you haven't yet, make sure you take my anxiety test now. It'll
provide you with a comprehensive set of symptoms and give you
scores based on your answers. It will then give you an idea of how to
treat it.
Start my test here.
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References
Knight, Richard G., Hendrika J. Waal-Manning, and G. F. Spears. Some
norms and reliability data for the State-Trait Anxiety Inventory and the
Zung Self-Rating Depression scale. British Journal of Clinical
Psychology 22.4 (2011): 245-249.
Lindsay, W. R., and A. M. Michie. Adaptation of the Zung self-rating
anxiety scale for people with a mental handicap*. Journal of
Intellectual Disability Research 32.6 (1988): 485-490.
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