Outcome Measure
Penn State Worry Questionnaire
What it measures?
- The PSWQ assesses pervasive and uncontrollable worry.
Who is it for?
Adults aged 18 years +
Instrument Quality
- The PSWQ has sound psychometric properties, including good internal consistency and adequate test-retest reliability across clinical and college samples (Myer et al., 1990). The instrument has also been shown to discriminate patients with GAD from community controls and patients with other anxiety disorder. Factor analytics studies support a unitary construct (Liu, Nijmeh & Warren, 2022).
Structure
- 16 items
- 5-point Likert scale
- Respondents are asked to rate how typical (1 = “Not at all typical of me”; 5 = “Very typical of me”) each statement is for them (e.g. “Many situations make me worry”).
Scoring instructions
- Reverse-score items 1, 3, 8, 10 and 11
- After reverse-scoring the above items, sum all item responses to derive the full-scale score
| Subscale | Item number |
|---|---|
Full-scale (PSWQ) |
1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16 |
Score Interpretation
What higher scores mean?
- More severe and pathological levels of worry Greater likelihood of meeting criteria for Generalised Anxiety Disorder (GAD)
How to assess symptom severity & change?
| Description | Score Range | |
|---|---|---|
| Low worry | 0 | |
| Moderate-high worry | 39 | |
| Generalised Anxiety Disorder | >=62 | Provisional Diagnosis |
| High worry | 54 | |
| Maximum | 80 |
Instrument developers
- Meyer, T. J., Miller, M. L., Metzger, R. L., & Borkovec, T. D. (1990). Development and validation of the penn state worry questionnaire. Behaviour research and therapy, 28(6), 487-495
Refrences
* Brown, T. A. (2003). Confirmatory factor analysis of the Penn State Worry Questionnaire: Multiple factors or method effects?. Behaviour research and therapy, 41(12), 1411-1426 * Behar, E., Alcaine, O., Zuellig, A. R., & Borkovec, T. D. (2003). Screening for generalized anxiety disorder using the Penn State Worry Questionnaire: A receiver operating characteristic analysis. Journal of behavior therapy and experimental psychiatry, 34(1), 25-43. * Fresco, D. M., Mennin, D. S., Heimberg, R. G., & Turk, C. L. (2003). Using the Penn State Worry Questionnaire to identify individuals with generalized anxiety disorder: A receiver operating characteristic analysis. Journal of behavior therapy and experimental psychiatry, 34(3-4), 283-291. * Gillis, M. M., Haaga, D. A., & Ford, G. T. (1995). Normative values for the beck anxiety inventory, fear questionnaire, Penn state worry questionnaire, and social phobia and anxiety inventory. Psychological Assessment, 7(4), 450. * Korte, K. J., Allan, N. P., & Schmidt, N. B. (2016). Factor mixture modeling of the Penn State Worry Questionnaire: Evidence for distinct classes of worry. Journal of Anxiety Disorders, 37, 40-47 * Liu, K., Nijmeh, J. S., & Warren, S. L. (2022). Factor structure, measurement invariance, and concurrent validity of the Penn State Worry Questionnaire across development, psychopathology, and culture. Assessment, 29(5), 909-924. Meyer, Miller, Metzger and Borkovec (1990) examined test-retest reliability over a period of 8-10 weeks, employing a sample of patients with high, medium and low scores on the PSWQ (N = 47). * Schroder, H. S., Clark, D. A., & Moser, J. S. (2019). Screening for problematic worry in adults with a single item from the Penn State Worry Questionnaire. Assessment, 26(2), 336-346.
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Severity ranges
Korte, Allan and Schmidt (2016) employed factor-mixture modelling (FMM) to identify a three-class structure of the PSWQ, comprising low, moderate-high, and high classes of worry. Specific cutoff scores were developed to facilitate patient classification, using ROC curve analyses that optimised sensitivity and specificity. The sample employed consisted of 1337 American participants recruited from the community through an anxiety research clinic at a large university. Participants were 56% female with a mean age of 35.99 (SD = 15.12). According to the authors, individuals in the low category are likely experiencing normal worry, as discussed by Borkovec et al (1991). Patients in the moderate-high category are likely to experiencing high levels of worry without GAD (although some cases did meet GAD criteria). Patients in the high category experience a high degree of worry and are likely to meet criteria for GAD.
Provisional diagnosis
* Schroder et al (2020) employed a sample of 1121 undergraduate students (73% female), who completed the full PSWQ and the GAD-7. Examination of the ROC curve for the full-scale PSWQ identified 62 as the score with optimal sensitivity and specificity for identifying the presence of Generalised Anxiety Disorder (GAD)—operationalised as a score of 10 or higher on the GAD-7. The value of 62 was also identified by Behar et al (2003), using a large sample of unselected college students (N = 2449), who completed the PSWQ, as well as the Generalized Anxiety DIsorders Questionnaire for DSM-IV to determine GAD caseness. * Research by Fresco et al (2003) found a score of 65 optimised sensitivity and specificity in discriminating individuals with GAD from individuals with social anxiety disorder.
Reliable change and clinically significant improvement
Wampold et al (2001) conducted a meta analysis of psychotherapy outcome studies and noted that the average improvement was reflected in an effect size (ES) of .80. Because a change of 1 SD corresponds to an ES of 1.0, and .80 is considered to be a large ES, Wise (2004) concludes that a change of 1 SD is a defensible indicator of clinically significant change.
Mean
Standard Deviation
Reliability