Adaptation and psychometric properties of the Anxiety Symptoms Questionnaire for Brazil

Ujihara, Milena Miyuki Hiratuca; Rodrigues, Jaqueline de Carvalho

doi:10.1590/1982-0275202441e220035

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Brasil

Estudos de Psicologia (Campinas)

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Sumário

RESEARCH REPORT | Psychological Assessment • Estud. psicol. 41 • 2024 • https://doi.org/10.1590/1982-0275202441e220035 copy

Adaptation and psychometric properties of the Anxiety Symptoms Questionnaire for Brazil

Adaptação e propriedades psicométricas do Questionário de Sintomas de Ansiedade para o Brasil

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

The present study aimed to adapt the Anxiety Symptoms Questionnaire and analyze its psychometric properties for the Brazilian population.

Method

The adaptation was conducted in six stages: translation, synthesis, back translation, expert analysis, evaluation by the target population, and a pilot study. A total of 441 adults (M = 35.36; SD = 11.08 years) were interviewed, with 301 classified as healthy, 105 as having anxiety, and 35 as having depression.

Results

The Anxiety Symptoms Questionnaire results demonstrated evidence of content validity, exhibiting high internal consistency (Cronbach’s alpha = 0.975 and McDonald’s omega = 0.976). Moreover, the questionnaire showed evidence of criterion validity by effectively distinguishing between groups with and without anxiety (F(2.438) = 22.647; p < 0.01), as well as convergent validity with the structured clinical interview for DSM-5 (ρ = 0.70, p < 0.01), and correlations with anxiety (ρ = 0.62, p < 0.01), depression (ρ = 0.64, p < 0.01), and stress (ρ = 0.70, p < 0.01) scores from another instrument.

Conclusion

The Anxiety Symptoms Questionnaire is valid and reliable for use by healthcare professionals in the Brazilian population.

Keywords
Anxiety; Evaluation; Psychopathology; Test reliability; Test validity

Characteristics		Total sample N = 441	Healthy n = 301	Anxiety and Anxiety/depression n = 105	Depression n = 35
Mean Age (SD)		35.36 (11.08)	36.09 (11.56)	32.94 (9.52)	36.29 (10.42)
		%
Gender
	Male	31.5	36.2	20.0	25.7
	Female	68.3	63.5	80.0	74.3
	Other	00.2	0.3	0	0
Marital status
	Single	42.6	40.9	46.7	45.7
	Married/Common-law marriage	48.6	50.2	43.8	48.6
	Separated/Divorced	07.5	07.6	07.6	05.7
	Widowed	2	0.3	0	0
	Other	01.1	1	01.9	0
Education
	Incomplete Primary Education	00.2	0.3	0	02.9
	Complete Primary Education	00.5	0.3	0	0
	Incomplete Secondary Education	01.1	0.7	02.9	0
	Complete Secondary Education	07.7	9.0	06.7	0
	Incomplete Higher Education	32.7	31.6	38.1	25.7
	Complete Higher Education	57.8	58.1	52.4	71.4
Family Income (minimum wages)
	Up to one minimum wage	01.6	0.7	02.9	05.7
	From one to two minimum wages	11.8	12.6	12.4	02.9
	From three to five minimum wages	36.3	39.5	26.7	37.1
	Above five minimum wages	50.3	47.2	58.1	54.3

Groups		SCID-5	DASS-21 Depression	DASS-21 Stress	DASS-21 Anxiety
Total sample (N = 441)
	ASQ Intensity	0.676^ Significant correlation at the 0.01 level.	0.588^ Significant correlation at the 0.01 level.	0.665^ Significant correlation at the 0.01 level.	0.574^ Significant correlation at the 0.01 level.
	ASQ Frequency	0.681^ Significant correlation at the 0.01 level.	0.590^ Significant correlation at the 0.01 level.	0.670^ Significant correlation at the 0.01 level.	0.575^ Significant correlation at the 0.01 level.
	ASQ Total	0.684^ Significant correlation at the 0.01 level.	0.594^ Significant correlation at the 0.01 level.	0.673^ Significant correlation at the 0.01 level.	0.579^ Significant correlation at the 0.01 level.
Healthy (n = 301)
	ASQ Intensity	0.696^ Significant correlation at the 0.01 level.	0.636^ Significant correlation at the 0.01 level.	0.700^ Significant correlation at the 0.01 level.	0.619^ Significant correlation at the 0.01 level.
	ASQ Frequency	0.694^ Significant correlation at the 0.01 level.	0.629^ Significant correlation at the 0.01 level.	0.700^ Significant correlation at the 0.01 level.	0.608^ Significant correlation at the 0.01 level.
	ASQ Total	0.701^ Significant correlation at the 0.01 level.	0.638^ Significant correlation at the 0.01 level.	0.700^ Significant correlation at the 0.01 level.	0.619^ Significant correlation at the 0.01 level.
Anxiety and Anxiety/Depression (n = 105)
	ASQ Intensity	0.405^ Significant correlation at the 0.01 level.	0.388^ Significant correlation at the 0.01 level.	0.448^ Significant correlation at the 0.01 level.	0.332^ Significant correlation at the 0.01 level.
	ASQ Frequency	0.434^ Significant correlation at the 0.01 level.	0.398^ Significant correlation at the 0.01 level.	0.459^ Significant correlation at the 0.01 level.	0.350^ Significant correlation at the 0.01 level.
	ASQ Total	0.424^ Significant correlation at the 0.01 level.	0.397^ Significant correlation at the 0.01 level.	0.458^ Significant correlation at the 0.01 level.	0.344^ Significant correlation at the 0.01 level.
Depression (n = 35)
	ASQ Intensity	0.719^ Significant correlation at the 0.01 level.	0.423^ Significant correlation at the 0.01 level.	0.554^ Significant correlation at the 0.01 level.	0.465^ Significant correlation at the 0.01 level.
	ASQ Frequency	0.750^ Significant correlation at the 0.01 level.	0.487^ Significant correlation at the 0.01 level.	0.605^ Significant correlation at the 0.01 level.	0.540^ Significant correlation at the 0.01 level.
	ASQ Total	0.742^ Significant correlation at the 0.01 level.	0.459^ Significant correlation at the 0.01 level.	0.585^ Significant correlation at the 0.01 level.	0.507^ Significant correlation at the 0.01 level.

ASQ Total
Groups	Groups	Mean difference	p	95% CI
Groups	Groups	Mean difference	p	Limit inferior	Limit superior
Healthy	Anxiety and Anxiety/depression	-54.111^* * Significant difference at the 0.05 level.	<0.001	-73.39	-34.83
Healthy	Depression	-17.215	00.438	-47.60	13.17
Anxiety and Anxiety/depression	Depression	0036.895^* * Significant difference at the 0.05 level.	00.240	03.69	70.10
ASQ Intensity
Groups	Groups	F	p	95% CI
Groups	Groups	F	p	Limit inferior	Limit superior
Healthy	Anxiety and Anxiety/depression	0-27.742^* * Significant difference at the 0.05 level.	<0.001	-37.50	0-17.99
Healthy	Depression	-9.114	00.398	-24.48	0 6.26
Anxiety and Anxiety/depression	Depression	0018.629^* * Significant difference at the 0.05 level.	00.240	001.83	35.43
ASQ Frequency
Groups	Groups	F	p	95% CI
Groups	Groups	F	p	Limit inferior	Limit superior
Healthy	Anxiety and Anxiety/depression	0-26.368^* * Significant difference at the 0.05 level.	<0.001	-36.07	-16.66
Healthy	Depression	-8.102	00.497	-23.39	0 7.19
Anxiety and Anxiety/depression	Depression	0 18.267^* * Significant difference at the 0.05 level.	00.270	001.56	34.98

Items	Factor loading
Feeling restless, keyed up, or on edge (Intensity)	0.862
Feeling restless, keyed up, or on edge (Frequency)	0.851
Trouble relaxing (Intensity)	0.827
Trouble relaxing (Frequency)	0.825
Anxiety (Frequency)	0.817
Worrying (Frequency)	0.810
Worrying (Intensity)	0.807
Trouble functioning at home, work (Intensity)	0.804
Trouble functioning at home, work (Frequency)	0.802
Fatigue or lack of energy (Intensity)	0.797
Anxiety (Intensity)	0.793
Fatigue or lack of energy (Frequency)	0.790
Problems with concentration or attention (Frequency)	0.789
Anticipating or fearing something bad might happen (Frequency)	0.787
Problems with concentration or attention (Intensity)	0.785
Anticipating or fearing something bad might happen (Intensity)	0.782
Nervousness (Frequency)	0.781
Nervousness (Intensity)	0.761
Irritability (Intensity)	0.757
Irritability (Frequency)	0.751
Shortness of breath, chest tightness or pain, pounding/skipping/racing heartbeat (Intensity)	0.731
Dizziness, lightheadedness, headaches, trembling or shakiness (Intensity)	0.717
Muscle tension or tightness (Frequency)	0.717
Dizziness, lightheadedness, headaches, trembling or shakiness (Frequency)	0.717
Shortness of breath, chest tightness or pain, pounding/skipping/racing heartbeat (Frequency)	0.716
Muscle tension or tightness (Intensity)	0.710
Trouble remembering things (Intensity)	0.709
Trouble remembering things (Frequency)	0.706
Stomach upset, nausea, constipation, diarrhea, or irritable bowels (Intensity)	0.693
Stomach upset, nausea, constipation, diarrhea, or irritable bowels (Frequency)	0.677
Trouble falling or staying asleep (Frequency)	0.636
Numbness, tingling, excessive sweating, or flushing (Frequency)	0.628
Trouble falling or staying asleep (Intensity)	0.626
Numbness, tingling, excessive sweating, or flushing (Intensity)	0.623
Composite reliability	0.978
H-Latent	0.980
H-Observed	0.932

Programa de Pós-Graduação em Psicologia, Pontifícia Universidade Católica de Campinas Núcleo de Editoração SBI - Campus II, Av. John Boyd Dunlop, s/n. Prédio de Odontologia, 13060-900 Campinas - São Paulo Brasil, Tel./Fax: +55 19 3343-7223 - Campinas - SP - Brazil
E-mail: psychologicalstudies@puc-campinas.edu.br

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Groups		SCID-5	DASS-21 Depression	DASS-21 Stress	DASS-21 Anxiety
Total sample (N = 441)
	ASQ Intensity	0.676^ Significant correlation at the 0.01 level.	0.588^ Significant correlation at the 0.01 level.	0.665^ Significant correlation at the 0.01 level.	0.574^ Significant correlation at the 0.01 level.
	ASQ Frequency	0.681^ Significant correlation at the 0.01 level.	0.590^ Significant correlation at the 0.01 level.	0.670^ Significant correlation at the 0.01 level.	0.575^ Significant correlation at the 0.01 level.
	ASQ Total	0.684^ Significant correlation at the 0.01 level.	0.594^ Significant correlation at the 0.01 level.	0.673^ Significant correlation at the 0.01 level.	0.579^ Significant correlation at the 0.01 level.
Healthy (n = 301)
	ASQ Intensity	0.696^ Significant correlation at the 0.01 level.	0.636^ Significant correlation at the 0.01 level.	0.700^ Significant correlation at the 0.01 level.	0.619^ Significant correlation at the 0.01 level.
	ASQ Frequency	0.694^ Significant correlation at the 0.01 level.	0.629^ Significant correlation at the 0.01 level.	0.700^ Significant correlation at the 0.01 level.	0.608^ Significant correlation at the 0.01 level.
	ASQ Total	0.701^ Significant correlation at the 0.01 level.	0.638^ Significant correlation at the 0.01 level.	0.700^ Significant correlation at the 0.01 level.	0.619^ Significant correlation at the 0.01 level.
Anxiety and Anxiety/Depression (n = 105)
	ASQ Intensity	0.405^ Significant correlation at the 0.01 level.	0.388^ Significant correlation at the 0.01 level.	0.448^ Significant correlation at the 0.01 level.	0.332^ Significant correlation at the 0.01 level.
	ASQ Frequency	0.434^ Significant correlation at the 0.01 level.	0.398^ Significant correlation at the 0.01 level.	0.459^ Significant correlation at the 0.01 level.	0.350^ Significant correlation at the 0.01 level.
	ASQ Total	0.424^ Significant correlation at the 0.01 level.	0.397^ Significant correlation at the 0.01 level.	0.458^ Significant correlation at the 0.01 level.	0.344^ Significant correlation at the 0.01 level.
Depression (n = 35)
	ASQ Intensity	0.719^ Significant correlation at the 0.01 level.	0.423^ Significant correlation at the 0.01 level.	0.554^ Significant correlation at the 0.01 level.	0.465^ Significant correlation at the 0.01 level.
	ASQ Frequency	0.750^ Significant correlation at the 0.01 level.	0.487^ Significant correlation at the 0.01 level.	0.605^ Significant correlation at the 0.01 level.	0.540^ Significant correlation at the 0.01 level.
	ASQ Total	0.742^ Significant correlation at the 0.01 level.	0.459^ Significant correlation at the 0.01 level.	0.585^ Significant correlation at the 0.01 level.	0.507^ Significant correlation at the 0.01 level.