Outcome Measure
Panic Disorder Severity Scale – Self-Report
What it measures?
- The severity of Panic Disorder symptoms during the past week. Specifically, the instrument assesses the frequency of panic attacks, distress during panic attacks, anticipatory anxiety, agoraphobic fear and avoidance, body sensation fear and avoidance, and impairment in work and social functioning
- Five items assess each core symptom of Panic Disorder with our without Agoraphobia, as outlined in the Diagnostic & Statistical Manual of Mental Disorders, 4th Edition (DSM-IV). Two items assess occupational and social impairment.
- The PDSS-SR is a modification of the clinician-administered PDSS. The changes made include shortening the time frame to the past week (rather than the previous month), and minor alterations to the wording of questions so that patients can answer them independently (Houck et al., 2002).
Who is it for?
Adults and adolescents aged 13 years +
Instrument Quality
- The PDSS-SR has well-established psychometric properties and is one of the most widely-used self-report measures of panic symptom severity (Elkins, Pincus & Comer, 2014; Keough, Hoge, Pollack & Shear, 2012).
Structure
- 7 items.
- A 5-Point Likert scale captures the frequency of panic attacks and limited symptom episodes (LSEs), distress caused by panic and LSEs, anticipatory anxiety, agorophobic fear/avoidance, panic-related sensation fear/avoidance and social impairment (E.g. “How many panic and limited symptoms attacks did you have during the week?”)
Scoring instructions
- Sum item responses to derive the full-scale score.
| Subscale | Item number |
|---|---|
Full-scale (PDSS-SR) |
1,2,3,4,5,6,7 |
Score Interpretation
What higher scores mean?
- More severe Panic Disorder symptomatology.
How to assess symptom severity & change?
| Description | Score Range | |
|---|---|---|
| Normal | 0 | |
| Borderline ill | 2 | |
| Panic Disorder | >=8 | Provisional Diagnosis |
| Slightly ill | 6 | |
| Moderately ill | 10 | |
| Markedly ill | 14 | |
| Maximum | 28 |
Instrument developers
- Shear MK, Brown TA, Barlow DH, Money R, Sholomskas DE, Woods SW, Gorman JM, Papp LA. Multicenter collaborative Panic Disorder Severity Scale. American Journal of Psychiatry 1997;154:1571-1575
Refrences
Furukawa, T. A., Katherine Shear, M., Barlow, D. H., Gorman, J. M., Woods, S. W., Money, R., ... & Leucht, S. (2009). Evidence‐based guidelines for interpretation of the Panic Disorder Severity Scale. Depression and anxiety, 26(10), 922-929. Houck PR, Spiegel DA, Shear MK, Rucci P. Reliability of the self-report version of the panic disorder severity scale. Depress Anxiety. 2002;15(4):183-5. doi: 10.1002/da.10049. PMID: 12112724. Keough ME, Porter E, Kredlow MA, Worthington JJ, Hoge EA, Pollack MH, Shear MK, Simon NM. Anchoring the Panic Disorder Severity Scale. Assessment. 2012 Jun;19(2):257-9. doi: 10.1177/1073191112436668. Epub 2012 Feb 11. PMID: 22327206; PMCID: PMC3600865. Roberge P, Marx P, Couture J, Carrier N, Benoît A, Provencher MD, Antony MM, Norton PJ. French adaptation and validation of the Panic Disorder Severity Scale-self-report. BMC Psychiatry. 2022 Jun 27;22(1):434. doi: 10.1186/s12888-022-03989-x. PMID: 35761266; PMCID: PMC9235095. Shear MK, Rucci P, Williams J, Frank E, Grochocinski V, Vander Bilt J, Houck P, Wang T. Reliability and validity of the Panic Disorder Severity Scale: replication and extension. J Psychiatr Res. 2001 Sep-Oct;35(5):293-6. doi: 10.1016/s0022-3956(01)00028-0. PMID: 11591432. Wuyek LA, Antony MM, McCabe RE. Psychometric properties of the panic disorder severity scale: clinician-administered and self-report versions. Clin Psychol Psychother. 2011 May-Jun;18(3):234-43. doi: 10.1002/cpp.703. Epub 2010 May 25. PMID: 21110405.
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Severity ranges
Values and labels are based on patient data from two large randomised controlled trials of panic disorder (N = 568). The ranges are based on administration of the PDSS, not the PDSS-SR — as no range anchors have to-date been reported for the PDSS-SR.
Provisional diagnosis
Shear et al (2001) found that a PDSS-SR score of 8 accurately differentiated patients with and without Panic Disorder.
Reliable change and clinically significant improvement
Using a large sample of panic disorder patients (N = 568), Furukuwa et al (2009) reported that a 10%-39% reduction in PDSS scores indicated that a patient had “minimally improved”. A decrease of 50%-74% constituted “much improved”, and a decrease of 75%-100% was considered “very much improved”. The authors proposed that “remission” of panic disorder was indicated where a PDSS score was 5 or less, and that “response” to treatment (i.e. very much improved) is demonstrated by a 40% or greater score reduction.
Reliability