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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.

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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.

Author: Micah Abraham, BSc Psychology, last updated Sep 28, 2017.

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