Six-question anxiety scales cut teen assessment time by 70%, study finds

Six-item versions of the State-Trait Anxiety Inventory retained much of the longer test’s reliability in Turkish adolescents, but researchers say further validation is needed before clinical use.

Turkish researchers have developed and tested shorter versions of one of the best-known anxiety questionnaires for adolescents, finding that six-item forms of the State-Trait Anxiety Inventory can preserve much of the performance of the original 20-item scales while cutting administration time sharply. In a study published in Frontiers in Psychology, the team reported that the abbreviated state and trait measures retained the questionnaire’s two-part structure and showed acceptable reliability in Turkish teenagers.

The project was designed in two phases. First, researchers analysed responses from 420 adolescents receiving outpatient psychiatric care to identify the strongest items for the short forms. They then tested the resulting scales in a separate group of 277 public high school students. Across both groups, the six-item versions showed high internal consistency, and the results suggested that the shortened scales were still tracking the same underlying anxiety dimensions as the full questionnaire.

The study found that the brief state scale and the brief trait scale each kept a clear distinction between items reflecting the absence of anxiety and those reflecting the presence of anxiety. The researchers also reported that the short forms correlated strongly with the original inventory and performed well against the Generalised Anxiety Disorder-7, a widely used screener for anxiety symptoms. In the validation sample, the trait version in particular showed strong ability to distinguish adolescents with higher anxiety scores, while the state version performed somewhat less strongly but remained acceptable.

The findings are notable because anxiety measurement in young people often has to balance precision against time and attention limits. The researchers said the six-item forms reduced administration burden by 70% while preserving the basic psychometric qualities of the longer scales. They also tested whether the items worked similarly across clinical and community adolescents, boys and girls, and younger and older teenagers, and reported that the main measurement properties were stable across those groups.

Still, the authors urged caution. The shorter scales showed mixed model fit on one statistical index, the root mean square error of approximation, which was weaker than the rest of the evidence. The paper also notes that the cut-off scores derived in the study are provisional, since they were calculated and checked in the same samples. The researchers therefore concluded that the six-item forms look promising for research use, but that further testing is needed before they should be used for individual clinical decisions.