Assigning Clinical Significance and Symptom Severity Using the Zung Scales: Levels of Misclassification Arising from Confusion between Index and Raw Scores

Author(s)
Dunstan, Debra A
Scott, Ned
Publication Date
2018-01-21
Abstract
<I>Background.</I> The Zung Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) are two norm-referenced scales commonly used to identify the presence of depression and anxiety in clinical research. Unfortunately, several researchers have mistakenly applied index score criteria to raw scores when assigning clinical significance and symptom severity ratings. This study examined the extent of this problem. <I>Method</I>. 102 papers published over the six-year period from 2010 to 2015 were used to establish two convenience samples of 60 usages of each Zung scale. <I>Results</I>. In those papers where cut-off scores were used (i.e., 45/60 for SDS and 40/60 for SAS), up to 51% of SDS and 45% of SAS papers involved the incorrect application of index score criteria to raw scores. Inconsistencies were also noted in the severity ranges and cut-off scores used. <I>Conclusions</I>. A large percentage of publications involving the Zung SDS and SAS scales are using incorrect criteria for the classification of clinically significant symptoms of depression and anxiety. The most common error—applying index score criteria to raw scores—produces a substantial elevation of the cut-off points for significance. Given the continuing usage of these scales, it is important that these inconsistencies be highlighted and resolved.
Citation
Depression Research and Treatment, v.2018, p. 1-13
ISSN
2090-133X
2090-1321
Link
Language
en
Publisher
Hindawi Limited
Rights
Attribution 4.0 International
Title
Assigning Clinical Significance and Symptom Severity Using the Zung Scales: Levels of Misclassification Arising from Confusion between Index and Raw Scores
Type of document
Journal Article
Entity Type
Publication

Files:

NameSizeformatDescriptionLink
openpublished/AssigningClinicalDunstanScott2018JournalArticle.pdf 1619.773 KB application/pdf Published version View document