Determining the Psychometric Properties of Siddiqui Anxiety Scale-Revised


  • Sabaenah Salim Shaukat Khanum Memorial Cancer Hospital
  • Salma Siddiqui National University Sciences and Technology


Anxiety, indigenous anxiety scale, Pakistan, psychometric assessment


This study aimed to determine the psychometric properties of the Siddiqui Anxiety Scale (Hasnain & Siddiqui, 1993) in the Pakistani community. A pilot study with 15 males and 15 females (mean age = 25.07 years) was carried out to reassess its language and comprehensiveness, followed by a committee review by four mental health professionals. The validity and reliability estimates of Siddiqui Anxiety Scale-Revised (SAS-R) with 27 items were determined in the main study, using a convenient sample of university students (N=494) including 215 males and 279 females with a mean age of 20.8 years. Cronbach’s alpha reliability of SAS-R was found to be 0.90. The exploratory factor analysis revealed two factors in SAS-R (i.e., cognitive-affective and somatic), accounting for 34.48% cumulative variance. The convergent and divergent validity was determined by comparing it with Urdu translations of Beck Anxiety Inventory (BAI) (Raza, 2013) and Life Orientation Scale-Revised (LOT-R) (Shaheen, Tabassum, & Andleeb, 2015), respectively. SAS-R has a positive correlation with BAI and a significant negative correlation with LOT-R for optimism subscale and pessimism subscale. Furthermore, a cut-off score of 30 was determined using ROC curve analysis, obtaining a sensitivity index of 81.4 %, specificity index of 77.66%, the positive predictive power of 53.3%, and negative predictive power of 93% in the community sample. The psychometric properties of SAS-R are found to be robust enough to be recommended for screening anxiety symptoms in the Pakistani community.


Ahmer, S., Faruqui, R. A., & Aijaz, A. (2007). Psychiatric rating scales in Urdu: A systematic review. BioMed Central Psychiatry, 7(59).

Ali, B. S., Reza, H., Khan, M. M., & Jehan, I. (1998). Development of an indigenous screening instrument in Pakistan: The Aga Khan University Anxiety and Depression Scale. Journal of Pakistan Medical Association, 48(9), 261-65.

Arrindell, W. A., & Van der Ende, J. (1985). An empirical test of the utility of the observations-to-variables ratio in factor and component analysis. Applied Psychological Measurement, 9, 165-178.

Ayub, M., Poongan, I., Masood, K., Gul, H., Farrukh, A., Ali, M., Shaheen,

A… Naeem, F. (2012). Psychological morbidity in children 18 months after Kashmir Earthquake of 2005. Child Psychiatry and Human Development, 43(3), 323-36.

Baxter, A. J., Vos, T., & Whiteford, H. (2013). Global prevalence of anxiety disorders: A systematic review and meta-regression. Psychological Medicine, 43(5), 897-913.

Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56(6), 893-897.

Bloom, D. E., Cafiero, E., Jané-Llopis, E., Abrahams-Gessel, S., Bloom, L. R., & Fathima, S. et al. (2011). The global economic burden of noncommunicable diseases (Report No. 87). World Economic Forum. Retrieved from

Carver, C. S., & Scheier, M. F. (2001). Optimism, pessimism and self-regulation. In E. C. Chang (Ed.), Optimism and pessimism: Implications for theory, research, and practice (pp. 31-51). Washington, DC: American Psychological Association.

Chisholm, D., Sweeny, K., Sheehan, P., Rasmussen, B., Smit, F., Cuijpers, P., & Saxena, S. (2016). Scaling-up treatment of depression and anxiety: a global return on investment analysis. Lancet, 3, 415-424.

Creamer, M., Foran, J., & Bell, R. (1995). The Beck Anxiety Inventory in a non-clinical sample. Behavior Research and Therapy, 33(4), 477-85.

Dewberry, C., Ing, M., James, S., Nixon, M., & Richardson, S. (1990). Anxiety and unrealistic optimism. Journal of Social Psychology, 130(2), 151-6.

Field, A. P. (2005). Discovering statistics using SPSS (2nd Ed). London: Sage.

Groth-Marnat, G. (2009). Handbook of Psychological Assessment (5th ed). New Jersey: John Wiley & Sons Inc.

Hasnain, M., & Siddiqui, S. (1993). Development of an anxiety scale for clinical use. Paper presented at 8th International Conference of Pakistan Psychological Association, Islamabad.

Hazlett-Stevens, H. (2008). Psychological Approaches to Generalized Anxiety Disorder - A clinician's guide to assessment and treatment. Boston, MA: Springer.

Hofmann, S. G., & Hinton, D. E. (2014). Cross-Cultural Aspects of Anxiety Disorders. Current Psychiatry Reports, 16(6), 450-59.

Hoge, E. A., Tamrakar, S. M., Christian, K. M., Mahara, N., Nepal, M. K., Pollack, M. H., & Simon, N. M. (2006). Cross-cultural differences in somatic Presentation in patients with generalized anxiety disorder. The Journal of Nervous and Mental Disease, 194, 962-66.

Hong, J. J. (2014). Anxiety disorders in Asians and Asian Americans. Asian Journal of Psychiatry, 7(1), 74-76.

Jahangir, S. F., Nawaz, N., & Khan, N. (2014). Effects of media (television) on mental health. FWU Journal of Social Sciences, 8(1), 97-107.

Khan, A. A., Marwat, S. K., Noor, M. M., & Fatima, S. (2015). Reliability and validity of Beck Depression Inventory among general population in Khyber Pakhtunkhwa, Pakistan. Journal of Ayub Medical College Abbottabad, 27(3), 373-375.

Lam, R. W., Michalak, E. E., & Swinson, R. P. (2005). Assessment Scales in Depression, Mania and Anxiety. Oxfordshire: Taylor and Francis Group.

Lee, S., Tsang, A., Chui, H., Kwok, K., & Cheung, E. (2007). A community epidemiological survey of generalized anxiety disorder in Hong Kong. Community Mental Health Journal, 43(4), 305-319.

Majeed, A., & Siddiqui, S. (2007). A validity study of Siddiqui Anxiety Scale (Unpublished master’s dissertation). Department of Psychology, Government College University, Lahore, Pakistan.

Maqbool, S. (2015). Mental Health Impact of APS Attack Begins to Surface. The News. Retrieved from mental-health-impact-of-aps-attack-begins-to-surface.

Marques, L., Robinaugh, D. J., LeBlan, N. J., & Hinton, D. (2011). Cross-cultural variations in the prevalence and presentation of anxiety disorders. Expert Review of Neurotherapeutics, 11(2), 313-322.

Marsella, A. J. (2009). Some reflections on potential abuses of psychology’s knowledge and practices. Psychological Studies, 1, 13-15.

Minhas, F., Iqbal, K., & Mubbashar, M. H. (1995). Validation of self-reporting questionnaire in primary care setting of Pakistan. Pakistan Journal of Clinical Psychiatry, 5, 60-69.

Mirza, I., & Jenkins, R. (2004). Risk factors, prevalence, and treatment of anxiety and depressive disorders in Pakistan: a systematic review. British Medical Journal, 328(7443), 794.

Mumford, D. B., Bavington, J. T., Bhatnagar, K. S., Hussain, Y., Mirza, S., & Naraghi, M. M. (1991). The Bradford Somatic Inventory. A multi-ethnic inventory of somatic symptoms reported by anxious and depressed patients in Britain and the Indo-Pakistan subcontinent. British Journal of Psychiatry, 158, 379-86.

Nasim, S., M. Khan & S. Aziz (2014). Impact of Terrorism on Health and Hospital Anxiety Depression Scale Screening in Medical Students, Karachi, Pakistan. Journal or Medical Sciences, 4(3) 275-280.

Nunnally, J. C., & Bernstein, I. H. (1994). Psychometric theory (3rd Ed.). New York: McGraw Hill.

Pike, K. (1967). Language in relation to a unified theory of structure of human behavior (2nd ed.). Hague: Mouton.

Raza, K. K. (2013). Anxiety prevalence and its academic influences among university students (Unpublished doctoral dissertation). Department of Psychology, University of Peshawar, Pakistan.

Rehm, J., Shield, K. D. (2019). Global burden of disease and the impact of mental and addictive disorders. Current Psychiatry Reports, 21(2), 10.

Scheier, M. F., Carver, C. S., & Bridges, M. W. (2013). Retrieved from files/lotr_scale.pdf

Shaheen, N., Tabassum, N., & Andleeb, S. (2015). Pessimism, optimism and psychological distress in breast cancer women. FWU Journal of Social Sciences, 9(2), 125-35.

Siddiqui, S., & Shah, S. A. (1997). Siddiqui-Shah Depression Scale (SSDS): development and validation. Psychology and Developing Societies, 9(2).

Sonuga-Barke, E. J. (2014). Editorial: Building global science capacity in child psychology and psychiatry—between the etic and emic of cross-cultural enquiry. Journal of Child Psychology and Psychiatry, 55(4), 301-303.

Vos, T., Abajobir, A. A., Abbafati, C., et al. (2017). Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries, 1990–2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet, 390, 1211-1259

Weitzman, C., & Wegner, L. (2015). Promoting optimal development: Screening for behavioral and emotional problems. Pediatrics, 135(2), 384-395.

World Health Organization. (2013). Mental Health Action Plan 2013-2020. Geneva: World Health Organization.

World Health Organization. (2015). Mental health ATLAS 2014. Geneva: World Health Organization.

World Health Organization. (2017). Depression and other common mental disorders: Global health estimates. Geneva: World Health Organization

Yusufzai, A. (2014). Peshawar Massacre to Cause Mental Problems among Students, Parents. Dawn. Retrieved from 51832.

Zigmond, A. S., & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67(6), 361-70.