Clinical Psychology and Psychotherapy

Clin. Psychol. Psychother. 18, 339346 (2011)

Published online 30 August 2010 in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/cpp.724

Assessment
Preliminary Validation of an Ultra-brief Version
of the Penn State Worry Questionnaire
David Berle,1* Vladan Starcevic,2 Karen Moses,1 Anthony Hannan,1
Denise Milicevic1 and Peter Sammut3
1
Nepean Anxiety Disorders Clinic, Sydney West Area Health Service, Penrith, NSW, Australia
2
University of Sydney, Sydney Medical School Nepean, Discipline of Psychiatry, Sydney, NSW, Australia
3
Department of Psychiatry, Nepean Hospital, Penrith, NSW, Australia

The Penn State Worry Questionnaire (PSWQ) is widely regarded as the gold standard self-report
questionnaire for pathological worry. However, the factorial structure of the scale remains contentious.
We sought to determine whether a psychometrically sound brief version of the PSWQ, which avoids
contentious items and yet incorporates the essential features of pathological worry, could be derived
from the existing PSWQ item pool. After inspecting items of the PSWQ and the findings of previous
factor analytic studies, three items were selected that capture the essence of pathological worry (i.e.,
high frequency, perceived uncontrollability and multiple domains of worry), according to the Diagnostic
and Statistical Manual of Mental Disorders (Fourth Edition). We then compared the psychometric
properties of the 3-item PSWQ with the full PSWQ in a sample of 225 clients attending an anxiety
disorders clinic. Despite its brevity, the 3-item PSWQ had internal consistency comparable with that
of the standard PSWQ, and performed equally well with regards to convergent and discriminant valid-
ity, in screening for a generalized anxiety disorder diagnosis and in detecting change with treatment.
The 3-item ultra-brief version of the PSWQ is quick to administer, simple to score and possesses psy-
chometric properties very similar to the 16-item version. Further research should confirm the psycho-
metric properties of the 3-item version when administered independently of the other items and assess
the scales testretest reliability. Copyright 2010 John Wiley & Sons, Ltd.

Key Practitioner Message:

The 3-item version of the Penn State Worry Questionnaire (PSWQ) captures the essence of pathological
worry, as defined by the Diagnostic and Statistical Manual of Mental Health Disorders (Fourth
Edition).
The 3-item version of the PSWQ appears to have similar psychometric properties to the full, 16-item
version, and is therefore a good measure of pathological worry.
The 3-item PSWQ is quick to administer in time-pressured clinical settings.
The 3-item PSWQ is simple to score and does not include reverse-keyed items.

Keywords: Worry, Questionnaire, Assessment, Scale, Validity, Self-report

INTRODUCTION testretest reliability (rs = 0.74 to 0.93 across a 1-month

The Penn State Worry Questionnaire (PSWQ; Meyer,
Miller, Metzger, & Borkovec, 1990) is a widely used
16-item self-report measure of pathological worry. It has
very good internal consistency (Cronbachs of 0.86 to
0.93 in Brown, Antony, & Barlow, 1992) and favourable
* Correspondence to: David Berle, Nepean Anxiety Disorders Clinic,
Sydney West Area Health Service, PO Box 63, Penrith NSW 2751,
Australia.
E-mail: dberle@psy.unsw.edu.au; berled@wahs.nsw.gov.au
period, Meyer et al., 1990). It also correlates well with
other measures of worry (r = 0.75 with the Brief Measure
of Worry Severity, Gladstone et al., 2005; r = 0.61 with the
Worry Domains Questionnaire, van Rijsoort, Emmelkamp,
& Vervaeke, 1999). Despite these favourable psychomet-
ric properties, the scale also has noteworthy limitations.
First, the factorial structure of the scale remains conten-
tious. Some researchers have found that the PSWQ is best
represented by a single factor (Brown, 2003; Brown et al.,
1992), whereas others have proposed a two-factor model
(Carter et al., 2005; Fresco, Heimberg, Mennin, & Turk,

Copyright 2010 John Wiley & Sons, Ltd.

340
2002; Olatunji, Schottonbauer, Rodriguez, Glass, &
Ankoff, 2007), with a possible single higher order factor.
These factors have been labelled general worry/worry
engagement and absence of worry (Carter et al., 2005;
Fresco et al., 2002; Olatunji et al., 2007). Brown (2003) has
argued that the two-factor model reflects method vari-
ance associated with reverse-keyed items. Moreover,
studies of confirmatory factor analysis (e.g., Woods, 2006)
indicate that developers of questionnaires are likely to
misinterpret unidimensional scales as multifactorial if
participants respond to as few as 10% of reverse-keyed
items in a careless way. Regardless of whether previous
results that have supported the two-factor model of the
PSWQ are an artefact of a method factor, the lack of con-
sistency in these findings raises questions about what a
total score on the PSWQ actually reflects.
The reverse-keyed items also make the scale cumber-
some to score without a scoring template. These items
preclude a clinician and client from quickly inspecting the
columns of responses to identify whether the general
pattern of scoring is high or low. This means that it is
difficult to make simple comparisons between pre- and
post-treatment PSWQ scores to see how much they have
generally increased or decreased (e.g., to what extent the
scores have changed from ratings of very typical of me
to ratings of not at all typical of me for most items).
A second limitation of the PSWQ is that there appears
to be item overlap and redundancy (e.g., I worry all the
time and I am always worrying about something;
Brown, 2003), suggesting that some items contribute only
small amounts of independent variance in measuring the
construct of pathological worry. Scale development
researchers have suggested that for most constructs, four
to six items are usually sufficient to achieve adequate
coverage of the construct, which would prevent unneces-
sary redundancies of item content (e.g., Hinkin, 1998; see
also Tabachnick & Fidell, 2001). Thus, a shorter version of
the PSWQ might reduce the number of overlapping items
while still adequately measuring the construct of patho-
logical worry.
With the above issues in mind, we sought to determine
whether a psychometrically sound ultra-brief version of
the PSWQ, which does not have reverse-scored items or
items that overlap in content and yet assesses essential
features of pathological worry, could be derived from the
existing PSWQ item pool. Given that four items or fewer
have been sufficient in capturing other domains of psy-
chopathology (e.g., depression: Hakstian & McLean, 1989;
social anxiety: Weeks, Spokas & Heimberg, 2007), we
expected that an abbreviated version of the PSWQ need
not be more than three or four items long. We hypothe-
sized that such a version of the PSWQ could achieve
equivalent levels of internal reliability, convergent and
discriminant validity, and be similarly sensitive to change
with treatment. If the hypothesis is correct, these charac-
Copyright 2010 John Wiley & Sons, Ltd.
D. Berle et al.
teristics of an ultra-brief version of the PSWQ would
suggest that it may be a valid and time-efficient scale that
is suitable for use by busy practitioners.
METHOD
Item Selection
We took the following steps to arrive at the items for the
abbreviated PSWQ.
First, we only considered items for inclusion if they
were not reverse-scored. Although there are advantages
to including reverse-scored items in self-report scales (for
instance, to ensure that respondents are carefully consid-
ering the content of each question rather than simply
endorsing every item), we felt that avoiding such items
would allow for clearer and less confusing items and
would reduce the possibility of an artificially multifacto-
rial structure. In doing so, we disregarded the five nega-
tively scored items of the PSWQ, leaving 11 items for
further consideration.
We then considered whether each of the remaining 11
items corresponded to one of the worry-related criteria
that are necessary for a Diagnostic and Statistical Manual
of Mental Disorders (Fourth Edition) (DSM-IV) diagnosis
of generalized anxiety disorder (GAD), i.e., uncontrolla-
bility of worry, high frequency, multiple domains of
worry, and its persistence for 6 months or more. This
would help to ensure that a new abbreviated PSWQ still
captures the essence of pathological worry necessary for
a diagnosis of GAD.
Items 2 (My worries overwhelm me), 6 (When I am
under pressure I worry a lot), and 13 (I notice that I have
been worrying about things) did not seem to correspond
to any of the DSM-IV criteria, and were no longer consid-
ered for inclusion.
Of the remaining eight items, we thought that items 5
(I know I should not worry about things, but I just cant
help it) and 14 (Once I start worrying I cannot stop)
corresponded to the uncontrollability of worry criterion,
items 7 (I am always worried about something) and 15
(I worry all the time) were considered to reflect the high
frequency of worry, and items 4 (Many situations make
me worry), 9 (As soon as I finish one task, I start to worry
about everything else I have to do), and 16 (I worry
about projects until they are all done) were thought to be
relevant for the multiple domains of worry criterion. The
DSM-IV also stipulates that pathological worry must have
persisted for at least 6 months; however, there were no
PSWQ items that corresponded to this requirement. Items
such as I have been a worrier all my life (item 12) may
not capture individuals who may have had pathological
worry only in recent years.
In deciding among the remaining seven items, we con-
sidered the factor loadings that were reported in four key
Clin. Psychol. Psychother. 18, 339346 (2011)
Ultra-brief Penn State Worry Questionnaire
psychometric articles on the PSWQ. The psychometrics
articles were those by Brown (2003); Carter et al. (2005);
Fresco et al. (2002) and van Rijsoort et al., (1999), as the
initial validation study of Meyer et al. did not report
factor loadings. Although van Rijsoort et al. (1999) used
principal components analysis (where factor loadings are
based on both shared and unique sources of variance)
rather than exploratory factor analysis (where factor load-
ings only indicate shared variance), we decided to con-
sider the component loadings from this study as a way of
ensuring that we surveyed a wide range of the previous
psychometric studies.
For the uncontrollability of worry criterion, the factor
loadings of items 5 (I know I should not worry about
things, but I just cant help it) and 14 (Once I start wor-
rying, I cannot stop) were similar across the four studies
(in each case 0.74 or above). We favoured item 14 over
item 5 due to its greater clarity and brevity.
Likewise, for the high frequency of worry domain,
items 7 (I am always worried about something) and 15
(I worry all the time) had comparably sufficient factor
loadings across the four studies (none lower than 0.73). In
this instance, we chose item 15 instead of item 7 due to
greater clarity of wording.
In choosing between items 4 (Many situations make me
worry), 9 (As soon as I finish one task, I start to worry
about everything else I have to do), and 16 (I worry
about projects until they are all done), we noticed that
each had factor loadings of comparable magnitude across
the studies. We decided to include item 4 because it was
concise and less context-dependent than the other items
(i.e., it did not refer to completing projects or tasks).
We were then left with the following three items:
1. Many situations make me worry (PSWQ item 4).
2. Once I start worrying, I cannot stop (PSWQ item 14).
3. I worry all the time (PSWQ item 15).
Participants
Participants were 225 clients who were commencing
treatment at the Nepean Anxiety Disorders Clinic and
had a primary diagnosis of panic disorder with/without
agoraphobia (PD/PDA, n = 122), social anxiety disorder
(SAD, n = 33), GAD (n = 48) or obsessivecompulsive
disorder (OCD; n = 22). Persons with a current psychosis,
bipolar disorder, substance abuse or dependence, severe
personality disorder, self-harming behaviour and suicid-
ality are not treated in the clinic, and consequently did
not participate in the study.
Of the overall sample, 169 (75.1%) were female, 144
(64.0%) were married or in a de facto relationship, 45
(20.0%) had obtained post-secondary school qualifica-
tions, and 113 (50.2%) were currently engaged in paid
Copyright 2010 John Wiley & Sons, Ltd.
341
employment. The mean age of participants was 36.21
(standard deviation (SD) = 11.70, Median = 34).
There were no significant differences between primary
diagnosis groups in terms of gender, marital and employ-
ment status. However, there were significant differences
in the proportions who had obtained post-secondary
school qualifications (2 = 11.72, df = 3, p = 0.01), with the
OCD group having the smallest proportion (13.6%). There
were also significant differences in the mean age of
primary diagnosis groups (F = 4.42, df = 3, p = 0.01, partial
2 = 0.06), with the GAD group being the oldest (mean =
39.0, SD = 13.1), and the OCD group the youngest (mean
= 31.1, SD = 8.3).
Procedure
Participants were administered the Mini International
Neuropsychiatric Interview (MINI; Sheehan et al., 1999)
by one of the clinical psychologists experienced in the
area of anxiety and related disorders and trained in the
use of diagnostic interviews. This was used to establish
the primary and co-occurring DSM-IV diagnoses. The
MINI has been validated against other widely used struc-
tured diagnostic interviews, and has been found to have
good psychometric properties (Lecrubier et al., 1997;
Sheehan et al., 1997, 1998).
In addition to the PSWQ, the following self-report mea-
sures were also administered for the purpose of assessing
convergent and discriminant validity: the Symptom
Checklist 90-Revised (SCL-90R; Derogatis, 1994) and the
Anxious Thoughts and Tendencies scale (AT&T;
Uhlenhuth, McCarty, Paine, & Warner, 1999).
The SCL-90R assesses symptom distress and psychopa-
thology by means of the scores on its nine subscales:
Somatization, ObsessiveCompulsive, Interpersonal
Sensitivity, Depression, Anxiety, Hostility, Phobic
Anxiety, Paranoid Ideation, and Psychoticism. The
SCL-90R also yields a Global Severity Index as a measure
of overall distress and psychopathology. All subscales
appear to have good convergent and discriminant valid-
ity (Peveler and Fairburn, 1990) and satisfactory internal
consistency (ranging from 0.77 for Psychoticism to 0.90
for Depression in a study by Derogatis, Rickels, & Rock,
1976; and from 0.79 for Paranoid Ideation to 0.90 for
Depression in a study by Horowitz, Rosenberg, Baer,
Ureno, & Villasensor, 1988). Testretest reliability over 10
weeks ranged from 0.68 for Somatization to 0.83 for
Paranoid Ideation (Horowitz et al., 1988).
The 15-item AT&T is a measure of a general anxiety-
prone cognitive style that incorporates catastrophizing,
selective abstraction and intrusive thoughts. The AT&T
Scale has high internal consistency ( = 0.90 in Khawaja
& Dyer, 2004; = 0.91 in Uhlenhuth et al., 1999) and
acceptable testretest reliability (r = 0.75 pre- to
Clin. Psychol. Psychother. 18, 339346 (2011)
342
post-treatment for a sample of PD patients in Uhlenhuth
et al., 1999). Clinically anxious individuals appear to score
higher than students (Khawaja & Dyer, 2004) and indi-
viduals in the community (Uhlenhuth et al., 2002). The
AT&T Scale correlates moderately with the SCL-90
(Lipman, Covi & Shapiro, 1979) somatization, anxiety and
phobia subscales (0.34, 0.51 and 0.39, respectively;
Uhlenhuth et al., 1999).
We also obtained scores on the abovementioned self-
report measures from 18 of 44 GAD participants after a
course of individual cognitive-behaviour therapy (mean
number of sessions = 17.6, SD = 10.5). Given the routine
clinical setting in which the present study was conducted,
we were not able to collect post-treatment data from all
44 GAD participants, as not all participants returned their
post-treatment questionnaires and clinicians did not
administer post-treatment questionnaires to all of their
participating clients. These 18 participants did not differ
from the 26 primary GAD participants without post-
treatment data in terms of their mean age, gender mix,
the proportion with co-occurring depression, PD/PDA,
SAD or OCD, and mean scores on all self-report
questionnaires.
RESULTS
1. Internal Consistency of the PSWQ and
3-item PSWQ
The Cronbach alpha level for the 3-item PSWQ was 0.85,
compared with 0.91 for the full PSWQ.
2. PSWQ and 3-item PSWQ Scores Across Disorders
We predicted that PSWQ scores would be highest among
participants with primary GAD, but elevated in each of
the other primary diagnosis groups due to the presence
Table 1. PSWQ scores and 3-item PSWQ scores across disorders
PD/PDA GAD
(n = 122) (n = 48)
Mean (SD)
PSWQ (range of a
58.94 (13.60) b
67.00 (8.25)
scores: 080)
3-item PSWQ (range 10.42a (3.44) 12.90b (2.02)
of scores: 015)
Note. Groups with different superscripts differ significantly from each other (p < 0.05) on Turkeys Honestly Significant Difference (HSD) post hoc
pairwise comparison tests.
Given that the homogeneity of variance assumption was violated for the PSWQ and 3-item PSWQ ANOVAs, we also calculated Welchs F tests fol-
lowed by Dunnetts T3 post hoc comparisons. The pattern of results was identical in each case. For PSWQ, Welchs F = 7.53, df = 3, 71.4, p < 0.001; for
3-item PSWQ, Welchs F = 11.04, df = 3, 70.09, p < 0.001.
PSWQ = Penn State Worry Questionnaire. PD = panic disorder without agoraphobia. PDA = panic disorder with agoraphobia. GAD = generalized
anxiety disorder. SAD = social anxiety disorder. OCD = obsessivecompulsive disorder. ANOVA = analysis of variance. SD = standard deviation.
Copyright 2010 John Wiley & Sons, Ltd.
D. Berle et al.
of GAD as a secondary diagnosis in 45 clients (25.4%) and
the transdiagnostic nature of pathological worry (Harvey,
Watkins, Mansell, & Shafran, 2004).
Table 1 shows that the patterns of scores on the PSWQ
and the 3-item PSWQ were similar across the primary
diagnosis groups, with the GAD group having the highest
mean scores, followed by the SAD and OCD groups, and
the PD/PDA group scoring the lowest.
To check that the pattern of PSWQ and 3-item PSWQ
scores across disorders was not influenced by differing
rates of co-occurring GAD between the PD, SAD and
OCD groups, we also compared the rates of co-occurring
GAD across each of these groups. The numbers and pro-
portions of clients with other primary diagnoses who had
a co-occurring GAD were as follows: 33 (27.0%) clients
with PD/PDA, 9 (27.3%) clients with SAD, and 3 (13.6%)
clients with OCD. The differences in these proportions
were not significant (2 = 1.84, df = 2, p = 0.40).
3. Convergent and Discriminant Validity
We predicted that scores on the PSWQ and the 3-item
PSWQ would show medium- to large-size positive cor-
relations with scores on the SCL-90R Anxiety, Depression,
Interpersonal Sensitivity (which is often considered as a
measure of social anxiety) and ObsessiveCompulsive
subscales, given that pathological worry may be transdi-
agnostic and also characterize depression (Starcevic,
1995), SAD (Starcevic et al., 2007) and OCD (Brown et al.,
1992). We also predicted that both versions of the PSWQ
would show strong correlations with the AT&T, given
that these instruments are considered to be measures of
anxiety-related cognitions. This would provide prelimi-
nary evidence for convergent validity.
Furthermore, we predicted that scores on the PSWQ
and 3-item PSWQ would show a small-magnitude
correlation with scores on two conceptually unrelated
SAD OCD One-way ANOVA
(n = 33) (n = 22) comparing across
disorders
64.12a,b (10.54) 65.09a,b (9.17) F = 6.44, df = 3, 221,
p < 0.001, p2 = 0.08
11.85a,b (2.37) 11.55a,b (2.74) F = 8.54, df = 3, 221,
p < 0.001, p2 = 0.10
Clin. Psychol. Psychother. 18, 339346 (2011)
Ultra-brief Penn State Worry Questionnaire 343

Table 2. Correlations between PSWQ and 3-item PSWQ and convergent and discriminant validity measures (N = 225)

Convergent validity measures Discriminant validity

measures

SCL-90R SCL-90R SCL-90R SCL-90R AT&T SCL-90R SCL-90R

Anxiety Dep Int Sen Ob Comp Hostility Psychoticism
PSWQ 0.37* 0.52* 0.44* 0.47* 0.57* 0.27* 0.31*
3-item PSWQ 0.44* 0.57* 0.47* 0.48* 0.64* 0.26* 0.38*
* p < 0.001 (two-tailed).
PSWQ = Penn State Worry Questionnaire. GAD = generalized anxiety disorder. SCL-90R Dep = Symptom Checklist 90-Revised Depression subscale.
SCL-90R Int Sen = Symptom Checklist 90-Revised Interpersonal Sensitivity subscale. SCL-90R Ob Comp = Symptom Checklist 90-Revised Obsessive
Compulsive subscale. AT&T = Anxious Thoughts and Tendencies scale.

Table 3. Sensitivity of the PSWQ and 3-item PSWQ to change with treatment

Pre-treatment Post-treatment Repeated measures t-test Effect size change

comparing pre- and from pre- to
post-treatment post-treatment

Mean (SD) t (df = 17) p-value Cohens d

PSWQ 65.83 (8.73) 48.22 (10.47) 5.94 <0.0001 1.83
3-item PSWQ 12.22 (1.83) 7.72 (2.76) 6.10 <0.0001 1.92
SCL-90R Anxiety 1.38 (0.54) 0.48 (0.37) 6.07 <0.0001 1.94
SCL-90R Depression 1.43 (0.60) 0.54 (0.36) 5.15 <0.0001 1.80
SCL-90R GSI 1.15 (0.41) 0.45 (0.31) 6.12 <0.0001 1.93
AT&T 2.72 (0.47) 1.66 (0.42) 9.36 <0.0001 2.38

Calculated using pooled SD.

AT&T = Anxious Thoughts and Tendencies Scale. GSI = Global Severity Index. SD = standard deviation.

measures, the SCL-90R Hostility subscale and the SCL-90R
Psychoticism subscale, thus demonstrating discriminant
validity in a preliminary way.
Correlations between PSWQ and 3-item PSWQ scores
and scores on the convergent and discriminant validity
measures are reported in Table 2. Both versions showed
medium- to large-size associations with each of the conver-
gent validity measures. Medium-sized correlations were
found with the discriminant validity measures (rs of 0.26
to 0.38).
4. Screening for GAD with the PSWQ and
3-item PSWQ
The PSWQ was not designed as a diagnostic screening
instrument for GAD and it does not assess the tension,
vigilance and physiological arousal symptoms of GAD.
However, previous studies have found the PSWQ to be
useful in screening for the presence of GAD (Fresco,
Mennin, Heimberg, & Turk, 2003). We predicted that the
performance of the 3-item PSWQ as a screening instru-
ment for GAD (whether primary or co-occurring) would
be comparable with that of the PSWQ, as evidenced by a
similar Receiver Operating Characteristic (ROC) curve. In
this case, the area under the ROC curve is the probability
that the given scale will yield a higher value for a ran-
domly chosen individual with GAD than for a randomly
chosen individual without GAD (Streiner & Cairney,
2007). Thus, a higher value for the area under the ROC
curve reflects a better ability of a scale to discriminate
between participants with and without disorder, with a
value of 1 representing a perfect sensitivity and specific-
ity of the scale.
Both the PSWQ and 3-item PSWQ showed very similar
screening properties (area under ROC curve for PSWQ =
0.736, standard error (SE) = 0.033, asymptotic p < 0.001;
area under ROC curve for 3-item PSWQ = 0.739, SE =
0.034, asymptotic p < 0.001).
5. Sensitivity to Change with Treatment
We expected that the PSWQ and 3-item PSWQ would
show a similar magnitude of change from pre- to
post-treatment among the participants with primary
GAD from whom post-treatment data were also col-
lected (n = 18).
The results in Table 3 indicate that the magnitude of
change with treatment for the 3-item PSWQ was similar
to that for the PSWQ, as well as similar to the degree of
change captured by other measures.

Copyright 2010 John Wiley & Sons, Ltd. Clin. Psychol. Psychother. 18, 339346 (2011)
344
DISCUSSION
Our results indicate that the 3-item PSWQ and the PSWQ
possess similar psychometric properties. The somewhat
better internal consistency of the full PSWQ can be
accounted for, at least partly, by its greater number of
items. For instance, if one were to increase the number of
items of the 3-item PSWQ from three to 16, then it can be
calculated that the internal consistency would increase
from 0.85 to 0.97, if one assumes that the inter-item covari-
ance remained constant.
Furthermore, participants with GAD scored higher than
participants in other primary diagnosis groups on both
versions of the scale, although not to a significantly greater
extent when compared with the SAD and OCD groups.
The lack of significant differences cannot be completely
explained by the rates of co-occurring GAD among patients
with SAD and OCD, as they did not differ significantly
from the rate of co-occurring GAD among patients with
PD/PDA. It is possible, though, that the SAD and OCD
patients may have endorsed items on both versions of the
PSWQ because of the similarities between worry about
social situations and obsessional thoughts on one hand,
and frequent and uncontrollable worries, on the other.
Both scales also had comparable correlations with mea-
sures of convergent validity. It is noteworthy that these ver-
sions of the PSWQ correlated only moderately with some
convergent validity measures such as the SCL-90R Anxiety
subscale (for PSWQ, r = 0.37; for 3-item PSWQ, r = 0.44). We
expected stronger associations with SCL-90R subscales, but
in fact, they could not be considered well-established mea-
sures of their respective constructs. For instance, the 10-item
SCL-90R Anxiety subscale includes a number of items that
are more specific for panic anxiety than for worry-related
anxiety (e.g., Suddenly scared for no reason and Spells of
terror or panic). On the other hand, correlations between
each version of the PSWQ and the AT&T were similarly
strong, as was expected given that the AT&T is also a
cognitions-focused measure of anxious tendencies. It will be
important to confirm the convergent validity of both the
3-item PSWQ and the PSWQ using other measures in future
studies.
With regards to discriminant validity, both scales again
showed comparable medium-sized, but not strong,
strengths of association with hostility and psychoticism
measures. This may in part be accounted for by shared
method variance and calls for further studies of discrimi-
nant validity.
The similar screening properties for GAD and similar
responsiveness of each version of the PSWQ to changes
with treatment suggest that clinicians may find the 3-item
PSWQ just as useful as the PSWQ for the purpose of both
ascertaining in a preliminary way whether GAD is present
and for monitoring changes in the levels of pathological
worry with treatment of GAD. So far, as screening
Copyright 2010 John Wiley & Sons, Ltd.
D. Berle et al.
properties are concerned, we did not determine the nega-
tive predictive power (i.e., the probability that a given
individual does not have GAD, if the PSWQ scores indi-
cate an absence of GAD) of either the 3-item PSWQ or the
PSWQ. Therefore, clinicians are cautioned against the use
of both of these instruments for the purpose of diagnostic
screening until such indices of screening accuracy have
been established.
It is noteworthy that we did not sacrifice the psycho-
metric properties of the PSWQ by shortening it. This sug-
gests that the clinical utility of the PSWQ may be improved
by using the 3-item version of the scale. Similar favour-
able psychometrics have been reported when other estab-
lished measures have been abbreviated (e.g., the two-item
Patient Health Questionnaire-2 of Kroenke, Spitzer, &
Williams, 2003; the four-item Brief Symptom Inventory of
Lang, Norman, Means-Christensen, & Stein, 2009).
Compared with the 3-item PSWQ, the usefulness of the
only other brief measure of pathological worry that we
are aware of, the 8-item Brief Measure of Worry Severity
(Gladstone et al., 2005), is limited by lengthy items that
detract from its brevity (e.g., When I think I should be
finished worrying about something, I find myself worry-
ing about the same thing over and over).
Aside from the lack of ideal convergent and discrimi-
nant validity measures, other limitations of the present
study also need to be acknowledged. For instance, the
3-item PSWQ was not administered separately to the full
PSWQ. For this reason, the performance of the three items
when administered independently of the surrounding
items of the PSWQ could not be ascertained. However,
the risk of practice or carry-over effects from administer-
ing both the PSWQ and 3-item PSWQ on the one occasion
would preclude a head-to-head comparison between the
two scales. A further limitation is that the favourable
internal consistency values for both the 3-item PSWQ and
PSWQ may have been inflated as much by overlap in item
wording as by true consistency in tapping the one con-
struct. Thus, each of the 3-item PSWQ items includes the
word worry and each of the PSWQ items includes some
variant of the word worry. Nonetheless, this is a weak-
ness common to both versions of the scale and does not
detract from the advantages of using the 3-item PSWQ
over the PSWQ. We were also not able to investigate the
testretest reliability of either version of the scale across
time in the absence of treatment. Presumably, the 3-item
version will demonstrate similar longitudinal stability to
the PSWQ if it is adequately measuring pathological
worry, which is considered to be a relatively stable ten-
dency across time.
The present study provides preliminary evidence that a
brief, 3-item, easy to score version of the PSWQ, derived
from the full version of the PSWQ to capture the essence
of the DSM-IV-defined pathological worry, retained most
of the psychometric properties of the full version. This
Clin. Psychol. Psychother. 18, 339346 (2011)
Ultra-brief Penn State Worry Questionnaire
suggests that the 3-item PSWQ could be used to measure
pathological worry. The 3-item version may therefore
prove to be a valuable instrument for time-pressured
clinical settings, as it can be quickly administered, scored
and discussed with clients at the time of completion.
Clinicians also need to balance the demands of multiple
measures that achieve a suitable breadth of coverage
of disorders and clinical phenomena, while not burden-
ing clients with hours of self-report questionnaires. In
this regard, the more economical 3-item version of the
PSWQ may be a more suitable choice than the standard
PSWQ.
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