title: Dimensional anxiety scales for DSM-5: sensitivity to clinical severity.
abstract: OBJECTIVE
  Psychometric properties and clinical sensitivity of brief self-rated dimensional scales to supplement categorical diagnoses of anxiety disorders in the DSM-5 were recently demonstrated in a German treatment seeking sample of adults. The present study aims to demonstrate sensitivity of these scales to clinical severity levels.
  
  
  METHODS
  The dimensional scales were administered to 102 adults at a university outpatient clinic for psychotherapy. Diagnostic status was assessed using the Munich-Composite International Diagnostic Interview. To establish a wide range of clinical severity, we considered subthreshold (n=83) and threshold anxiety disorders (n=49, including Social Phobia, Specific Phobia, Agoraphobia, Panic Disorder, and Generalized Anxiety Disorder).
  
  
  RESULTS
  Individuals with either subthreshold or threshold anxiety disorder scored higher on all dimensional scales relative to individuals without anxiety. In addition, individuals with a threshold anxiety disorder scored higher on the dimensional scales than individuals with a subthreshold anxiety disorder (except for specific phobia). Disorder-related impairment ratings, global functioning assessments and number of panic attacks were associated with higher scores on dimensional scales. Findings were largely unaffected by the number of anxiety disorders and comorbid depressive disorders.
  
  
  CONCLUSIONS
  The self-rated dimensional anxiety scales demonstrated sensitivity to clinical severity, and a cut-off based on additional assessment of impairment and distress may assist in the discrimination between subthreshold and threshold anxiety disorders. Findings suggest further research in various populations to test the utility of the scales for use in DSM-5.
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany. Electronic address: knappe@psychologie.tu-dresden.de.
authors.forename: S
authors.initials: S
authors.lastname: Knappe
authors.forename: J
authors.initials: J
authors.lastname: Klotsche
authors.forename: A
authors.initials: A
authors.lastname: Strobel
authors.forename: R T
authors.initials: RT
authors.lastname: Lebeau
authors.forename: M G
authors.initials: MG
authors.lastname: Craske
authors.forename: H-U
authors.initials: HU
authors.lastname: Wittchen
authors.forename: K
authors.initials: K
authors.lastname: Beesdo-Baum
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000175:diagnosis*; D001008:Anxiety Disorders / Q000175:diagnosis*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D057566:Self Report; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
keywords: Anxiety; Assessment; DSM; Diagnosis; Sensitivity