Anxiety is part of human existence and we have all felt this emotion at some point. While it’s an adaptive response, its excess can mean psychopathology.

It can be said that, in everyday language, a more or less explicit distinction is made between being anxious and being an anxious person. In the first case it refers to feeling, temporarily, anxiety, while in the second case it is a characteristic of the person.

This nuance is something that Spielberger’s group took into account when they developed the State-Trait Anxiety Scale , a tool used in clinical psychology that we will explain below.

What is the State-Trait Anxiety Scale?

The State-Trait Anxiety Inventory (STAI) is a questionnaire that was originally developed by Charles Spielberger, R.L. Gorsuch and R.E. Lushene in the second half of the last century.

This tool consists of a questionnaire to be answered by the patient, answering 40 Likert-type questions in which he will indicate how anxious he feels in various situations .

The main purpose of this scale is to find out how much anxiety the patient suffers, but taking into account whether this anxiety is something characteristic of the patient or if it is something momentary, in response to a stressful event. High scores on this questionnaire are associated with higher levels of anxiety.

The questionnaire has two scales, each with 20 items. On the one hand, it has the anxiety-trait scale, which allows us to know to what extent the person has a personality that predisposes him/her to suffer from anxious symptoms (high levels of neuroticism), while on the other hand there is the anxiety-state scale, which evaluates how anxiety occurs in specific situations.

History of this inventory

Charles Spielberger, together with his colleagues R.L. Gorsuch and R.E. Lushene, developed this questionnaire, starting in 1964 and finishing its final version in 1983. It was elaborated as a method to evaluate the two types of anxiety , understanding this emotion as a trait and as a state, both in the clinical field and in research. In the first phases of the construction of this questionnaire, university samples composed of some 3,000 people were used

Initially, this questionnaire was only going to be administered to adults without diagnosed psychopathology or belonging to risk groups. However, as it proved to be useful as a diagnostic tool, especially for anxiety disorders, and was very easy to administer, passing the sheet to the patient and having him/her fill it in, it ended up being widely used in clinical psychology .

Currently, the State-Risk Anxiety Scale is among the ten most used both in clinical psychology and in research, and it is often used in psychological assessment subjects in psychology schools because of its easy correction.

Anxiety-state and Anxiety-trait: How are they different?

Anxiety, in general terms, is defined as the emotional activation before an element perceived as dangerous, which makes the person set in motion a whole series of responses in order to face it, run away and avoid the possible implications and risks that such a threat may pose . However, as we saw before, the concept of anxiety can be defined according to whether it occurs in a temporary way, that is, in the form of a state, or if it is something that belongs to the personality of the individual, that is, it is a trait.

Anxiety is defined as a state when feelings of fear, nervousness and discomfort, and the associated physiological response, in the form of increased activation of the autonomic nervous system, occur in the face of a perceived stimulus or situation as potentially dangerous. That is, the person feels anxious not because he or she necessarily has a predisposition to feel this way, but because the characteristics of the environment contribute to his or her response. Anxiety-state is usually an adaptive response and ends up disappearing after the threat has been left behind.

Trait-anxiety is a concept that, in terms of symptoms, is not very different from its state-anxiety counterpart , only that the origin of this emotional reaction is different. There are feelings of worry, stress and discomfort, but they are not due to a dangerous stimulus in the environment, but because the person has a personality predisposition to feel anxious, to a greater or lesser extent and in a more or less adaptive way. The person is usually in tension, it is his day to day.

Composition of the questionnaire

The questionnaire is made up of two scales, one measuring the anxiety-state and the other the anxiety-trait, with each one having 20 items and making a total of 40. The items are answered on the Likert scale, from 0 to 3.

In both scales there are items that are formulated with reference to both the absence of anxiety and the presence . For example, an item that is elaborated from the absence of anxiety would be “I feel safe”, indicating that the higher the score for this particular item, the less anxiety the individual feels. Other items, such as “I feel worried” are made in such a way that the higher the score, the greater the anxiety.

What disorders does it serve?

The State-Trait Anxiety Scale is primarily used to detect people who have a predisposition, both genetic and environmental, to suffer from an anxiety disorder. Some of the most characteristic anxiety disorders in which the use of this scale can allow a better understanding of how the patient lives are obsessive-compulsive disorder (OCD), generalized anxiety disorder (GAD), social phobia…

However, anxiety is not only something found in people with anxiety disorders. As we saw, anxiety is an emotional reaction in which symptoms of worry, tension, stress and discomfort can occur .

For this reason this reaction is also detectable in other psychological conditions, such as eating disorders (ED), especially anorexia and bulimia nervosa. In these disorders, patients are very concerned about their body image, which causes them great discomfort. Touching or referring to parts of the body that they feel uncomfortable with can trigger a range of anxious responses equally associated with phobias and other anxiety disorders.

For this reason, both in research and in therapy for people with ATD, the use of the State-Trait Anxiety Scale is quite common, allowing us to know more precisely to what extent the patient feels anxiety with respect to different parts of her body and to focus the therapy on the acceptance of these parts.

For these cases another questionnaire is also used, called PASTAS (Physical Appearance State and Trait Anxiety Scale) which specializes in trait-anxiety and state-anxiety but in different parts of the body (e.g. study by Ferrer-Garcia et al., 2017).

How do you use it?

The main advantage of the State-Risk Anxiety Scale is that it is self-administered, that is, the researcher or therapist gives the questionnaire to the patient and it is the patient who completes it. It may be administered both individually and in groups, and there is no time limit .

Normally, people without psychopathology and in a good mood take six minutes to complete each of the two scales of the questionnaire separately and ten if done together. In people with an altered state of mind or intellectual difficulties, the questionnaire may take more than twenty minutes to complete.

The word “anxiety” should be avoided during administration . Although the purpose of the questionnaire is to measure this feeling, in order to avoid making the patient more nervous and therefore affecting his/her answers, it is advisable to limit oneself to calling it a “self-assessment questionnaire”.

Bibliographic references:

  • Tilton, S. R. (2008). “Review of the state-trait anxiety inventory (STAI). News Notes. 48 (2): 1–3.
  • Spielberger, C.D.; Gorssuch, R.L.; Lushene, P.R.; Vagg, P.R.; Jacobs, G.A (1983). Manual for the State-Trait Anxiety Inventory. Consulting Psychologists Press.
  • Ferrer-García, M., Porras-Garcia, B., González-Ibáñez, C., Gracia-Blanes, M., Vilalta-Abella, F., Pla-Sanjuanelo, J.,… and Gutiérrez-Maldonado, J. (2017). Does owning a “fatter” virtual body increase body anxiety in college students? Annual Review of CyberTherapy and Telemedicine, 15, 147-153.