The Hamilton anxiety rating scale (HARS) is known as the most commonly used semi structured assessment
scale in treatment outcome studies of anxiety (Bruss, Gruenberg, Goldstein, & Barber, 2002). It has been
suggested however that the operator differences in the way we as clinicians assess the severity of a client’s
symptoms may in fact reduce the reliability of this tool. The HARS interview guide was essentially developed to
standardize clinical probe questions and to reduce interrater variance (Bruss, Gruenberg, Goldstein, & Barber,
2002). Studies have also revealed that the hamilton anxiety rating scale interview guide is more reliable than
the semistructured hamilton anxiety rating scale because it meets established standards of reliability
assessment (Maier, Buller, Philipp, & Heuser, 1988).
The main purpose of the hamilton anxiety rating scale is to assess the severity of symptoms of anxiety in a
given individual. the elements include anxious mood, tension, fears, insomnia, intellectual, depressed mood,
somatic (muscular), somatic (sensory), cardiovascular symptoms, respiratory symptoms, gastrointestinal
symptoms, genitourinary symptoms, autonomic symptoms, and behavior at interview (Maier, Buller, Philipp, &
Heuser, 1988). These elements are rated on a scale of 0-4 with 0 meaning that symptom or feeling is not
present and 4 meaning symptom is very severe. In terms of scoring, each item is scored on a between 0-4 and
there are 14 elements being monitored and the total score will then range between 0-56, where <17 indicates
mild severity, 18-24 mild to moderate severity, and 25-30 represents moderate to severe (Maier, Buller, Philipp,
& Heuser, 1988). It is best to introduce this assessment tool when the patient appears to be getting distracted
or losing concentration during the interview because this will help to reengage the patient’s interest or attention
since it has a different formating but yet the interviewer is asking a relevant question (Bech, 2011).
References
Bech, P. (2011, September 12). Measuring States of anxiety WITH clinician-rated and Patient-Rated Scales.
Retrieved March 10, 2021, from https://www.intechopen.com/books/different-views-of-anxietydisorders/measuring-states-of-anxiety-with-clinician-rated-and-patient-rated-scales
Bruss, G. S., Gruenberg, A. M., Goldstein, R. D., & Barber, J. P. (2002, May 29). Hamilton anxiety rating scale
Interview Guide: Joint interview And test-retest methods for Interrater reliability. Retrieved March 10, 2021,
from https://www.sciencedirect.com/science/article/abs/pii/0165178194901104