assessment of emotions: anxiety, anger, .inventory (staxi), and the state-trait personality...
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Assessment of Emotions: Anxiety, Anger,Depression, and Curiosityaphw_1017 271..302
Charles D. Spielberger* and Eric C. ReheiserUniversity of South Florida, Tampa, USA
Anxiety, anger, depression, and curiosity are major indicators of psychologicaldistress and well-being that require careful assessment. Measuring these psy-chological vital signs is of critical importance in diagnosis, and can facilitatetreatment by directly linking intense emotions to the events that give rise tothem. The historical background regarding theory and research on anxiety,anger, depression, and curiosity is briefly reviewed, and the nature and assess-ment of these emotional states and personality traits are examined. The con-struction and development of the State-Trait Anxiety Inventory (STAI), theState-Trait Anger EXpression Inventory (STAXI-2), and the State-Trait Per-sonality Inventory (STPI) to assess anxiety, anger, depression, and curiosity,and the major components of these emotional states and personality traits, aredescribed in detail. Findings demonstrating the diverse utility and efficacy ofthese measures are also reported, along with guidelines for their interpretationand utilisation in research and clinical practice. Research with the STAI,STAXI and STPI over the last 40 years has contributed to understanding vitallyimportant measurement concepts that are especially applicable to the assess-ment of emotions. These concepts included the statetrait distinction, itemintensity specificity, and the importance of items that describe the presence orabsence of emotions.
Keywords: anger, anxiety, curiosity, depression, STAI, STAXI
Emotions motivate behavior and have a significant impact on health andpsychological well-being. According to the World Health Organization(2006), Normally, emotions such as anxiety, anger . . . pain or joy interact tomotivate a person to a goal-directed action. However, when certain emotionspredominate and persist beyond their usefulness in motivating people fortheir goal-directed behaviour, they become morbid or pathological. It istherefore essential to evaluate and monitor emotional states in diagnosis and
* Address for correspondence: Charles D. Spielberger, Department of Psychology, Universityof South Florida, Tampa, FL, USA. Email: email@example.com
APPLIED PSYCHOLOGY: HEALTH AND WELL-BEING, 2009, 1 (3), 271302doi:10.1111/j.1758-0854.2009.01017.x
2009 The Authors. Journal compilation 2009 International Association of AppliedPsychology. Published by Blackwell Publishing Ltd., 9600 Garsington Road, Oxford OX4 2DQ,UK and 350 Main Street, Malden, MA 02148, USA.
treatment just as physicians in medical examinations routinely measure pulserate, blood pressure, and temperature, the vital signs that provide essentialinformation about physical health.
When a physician detects an abnormal pulse or elevated blood pressureduring a medical examination, these symptoms may indicate a potentiallysignificant problem in the functioning of the cardiovascular system. Intenseanxiety and anger may be considered as analogous to elevations in pulse rateand blood pressure. The presence of a fever, as indicated by abnormally highbody temperature, can be considered as roughly analogous to depression.While running a high fever may indicate that the immune system is notprotecting the person from harmful viruses, symptoms of depression oftenreflect the presence of pervasive unresolved conflicts that contribute to anemotional fever.
Manifestations of anxiety, anger, and depression are critical psychologicalvital signs that are strongly related to an individuals well-being. Variations inthe intensity and duration of these emotions provide essential informationabout a persons mental health that help to identify recent events and long-standing conflicts that have a significant impact on the individuals life.Assessing emotional vital signs and providing timely and meaningful feedbackwill also enhance awareness and understanding of a persons feelings, and helpindividuals to recognise and cope more effectively with their emotions.
Symptoms of high anxiety are typically found in almost all emotionaldisorders. From a psychoanalytic perspective, Freud (1936, p. 85) regardedanxiety as the fundamental phenomenon and the central problem of neuro-sis. Observations of daily life and recent research findings indicate thatproblems with anger are also ubiquitous (Deffenbacher, 1992). Conse-quently, careful assessment of the experience, expression, and control ofanger is essential in psychological diagnosis and treatment planning (Sharkin,1988).
Depression has been described as the common cold of mental healthproblems that strikes the rich and poor as well as the young and the old(Rosenfeld, 1999, p. 10). The World Health Organization estimates that 340million people currently suffer from clinical depression, and that depressionwill become the leading cause of disability and the 2nd leading contributorto the global burden of disease by the year 2020 (WHO, 2001). Theexperience of curiosity may be considered as a positive emotional vitalsign. As a motivator of exploratory behavior, curiosity often contributes toeffective personal adjustment and successful adaptation to environmentalstimuli.
The goals of this article are to briefly review the evolution of anxiety, anger,depression, and curiosity as emotional concepts, and to evaluate the role ofemotions as psychological vital signs. The construction and development ofthe State-Trait Anxiety Inventory (STAI), the State-Trait Anger Expression
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Inventory (STAXI), and the State-Trait Personality Inventory (STPI) formeasuring state and trait anxiety, anger, depression, and curiosity, and theexperience, expression, and control of anger, will also be examined. In addi-tion, guidelines for interpreting and using these measures in research andclinical practice are described.
HISTORICAL EVOLUTION OF ANXIETY, ANGER,DEPRESSION, AND CURIOSITY AS EMOTIONAL CONCEPTS
Darwin (1872/1965) considered fear and rage to be universal characteristicsof both humans and animals that have evolved over time because theseemotions facilitated successful adaptation and survival (Plutchik, 2001).According to Darwin, If we expect to suffer, we are anxious; if we have nohope of relief, we despair (1872/1965, p. 176). In addition to relating anxietyto depression, Darwin (1872/1965, p. 81) regarded fear as . . . the mostdepressing of all the emotions; and it soon induces utter, helpless prostra-tion. Rage was also considered by Darwin (1872/1965, p. 74) to be a pow-erful emotion that motivated . . . animals of all kinds, and their progenitorsbefore them, when attacked or threatened by an enemy to fight and defendthemselves. He observed that rage was reflected in facial expression (e.g.reddened face, clenched teeth), accelerated heart-rate and muscular tension,and often resulted in violent behavior. For Darwin, anger was a state of mindthat differed . . . from rage only in degree, and there is no marked distinctionin their characteristic signs (1872/1965, p. 244). Thus, Darwin implicitlydefined anger as an emotional state that varies in intensity, from mild irrita-tion or annoyance to intense fury and rage.
Anxiety was defined by Freud (1924) as something felt, a specificunpleasant emotional state or condition that included apprehension, tension,worry, and physiological arousal. Freud (1936) equated objective anxietywith fear, which he considered to be an emotional reaction that was propor-tional in its intensity to a real danger in the external world. Consistent withDarwins evolutionary perspective, Freuds danger signal theory empha-sised the adaptive utility of anxiety for motivating behavior that helped aperson cope more effectively with potentially harmful situations. Aggressionwas considered by Freud (1933/1959) to be an instinctual drive that moti-vated anger and aggressive behavior. When aggression cannot be directlyexpressed against external objects, it is turned back into the self, resulting indepression and other psychosomatic manifestations (Alexander & French,1948; Freud, 1936).
The origin of the concept of depression can be traced to the 5th century BCwritings of Hippocrates, the father of modern medicine (Jackson, 1986). TheGreek term, melancholia, which has the connotation of both anxiety anddepression, was used by Hippocrates to describe a black mood that
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involved prolonged fear and sadness (Jackson, 1995). Galans restatement ofHippocrates description of melancholia as consisting of affective feelings,self-depreciating cognitions, and somatic symptoms prevailed for the next1,500 years.
In theory and research on psychopathology, anxiety and anger have beenrecognised as major contributors to depression for the last 100 years (Freud,1924, 1936; May, 1950/1977). The measurement of anxiety in diagnosis,treatment planning, and research has received significant attention for morethan half a century (Taylor, 1953; Spielberger, 1983). While the assessment ofanger has been relatively neglected, evidence from research on Type A behav-ior and heart disease (Friedman & Rosenman, 1974; Spielberger, Jacobs,Russell, & Crane, 1983; Spielberger & London, 1982), demonstrating thatanger was a major component of the Type A syndrome, has stimulated thedevelopment of measures of anger and hostility (Spielberger, 1976, 1980,1988, 1999).
In summary, fear (anxiety), anger (hostility, rage), and depression (melan-cholia) were considered by Darwin and Freud to be fundamental emotionalstate