Zung Self-rating Anxiety Scale

If you have a patient with anxiety, hand them the Zung Self-rating Anxiety Scale to gauge their symptoms. Learn more about it through this guide.

By Matt Olivares on Jul 15, 2024.


Fact Checked by Ericka Pingol.

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What is an anxiety scale?

Anxiety scales are useful clinical tools that, more often than not, come in the form of questionnaires. These scales aim to gauge the severity of a patient’s experience with anxiety and their symptoms. Though, even if they are used to assess the severity of symptoms, it’s worth pointing out this early that these scales are not diagnostic tools, meaning the scales on their own are not supposed to be the sole basis for a diagnosis. Despite this, they are still beneficial and important to include in the diagnostic process. These instruments are helpful because they (usually) have score ranges and designations. These will help psychologists and similar mental healthcare professionals evaluate and treat their patients.

Anxiety scales come in the following types:

  • Some are self-assessments issued to patients for them to answer independently
  • Some are used by the healthcare professional, and they will answer the scale’s prompts based on their observations or what their patients say
  • Some are worked on by both the healthcare professional and the patient

For this particular guide, we will focus on the. It is an assessment that is distributed to patients, who will answer and return it at a later time.

Looking for other anxiety-related screening tools? Check out this video:

Zung Self-rating Anxiety Scale Template

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Zung Self-rating Anxiety Scale Example

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How to use the Zung Self-rating Anxiety Scale

The Zung Self-rating Anxiety Scale was created by William W. K. Zung, M.D., and it was meant to be answered independently by patients. Alternatively, healthcare professionals can conduct the questionnaire like an interview and instruct the patient to answer with any one of the preset answers for the scale per item. This makes accomplishing the scale take longer, but the upside is that the professional can have their patient expand on their answers. The more information the healthcare professional has, the easier it will be for them to narrow things down and make an official diagnosis.

The Zung Self-rating Anxiety Scale has twenty items. Here are some examples of what items they need to answer:

  • I feel more nervous and anxious than usual.
  • I feel like I'm falling apart and going to pieces.
  • I get feelings of numbness and tingling in my fingers and toes.
  • I am bothered by dizzy spells.
  • I have nightmares.

They will answer by picking one of the following answer choices per item:

  • None or a little of the time
  • Some of the time
  • Good part of the time
  • Most or all of the time

Each item can get a minimum score of 1 and a maximum of 4, making the minimum total score 20 and a maximum of 80. The answer choices are arranged in the same sequence above. “None or a little of the time” has a score of 1 point, and “Most or all of the time” has a score of 4 points. Some items are reverse-scored, though. That would be items 5, 9, 13, 17, and 19.

After calculating the total score, you may refer to these score ranges:

  • 20–44 = Normal Range
  • 45–59 = Mild to Moderate Anxiety Levels
  • 60–74 = Marked to Severe Anxiety Levels
  • 75+ = Extreme Anxiety Levels

If the patient scores 45+, it’s best to have them undergo a comprehensive examination and then diagnose accordingly. Your treatment plan’s contents will depend on the diagnosis and the severity of symptoms.

When is it best to use the Zung Self-rating Anxiety Scale?

If you’re wondering when it would be best to use the Zung Self-rating Anxiety Scale, the answer will depend on what you are and what you’re using it for.

If you’re a mental healthcare professional treating a patient who presents for an appointment to discuss their anxiety, that’s an appropriate time to issue the Zung Self-rating Anxiety Scale. Of course, it would be best to explain this instrument and get their consent before you issue it to them. They have the right to say no.

It can also be used on patients who have already been diagnosed with anxiety. The scale gauges the severity of the anxiety, and the results, combined with results from other comprehensive examinations they’ve completed, can be used to determine what should go into a treatment plan.

If you’re a non-professional who stumbled upon this guide, you can use the Zung Self-rating Anxiety Scale anytime you want. It’s a self-rating scale, after all. Just note that you shouldn’t diagnose yourself with anxiety if you score 45+. It’s best to see a professional to get an official diagnosis.

What are the benefits of using the Zung Self-rating Anxiety Scale?

This anxiety scale is straightforward and easy to use.

The Zung Self-rating Anxiety Scale is an inexpensive clinical tool. All that needs to be done from your patient’s end is to pick an answer that best represents them for each statement. On your end, you only need to add up the scores and check which score range and designation your patient falls on. Some assessments require more complicated equations, but not this one.

It can help professionals develop treatment plans.

Speaking of having score ranges and designations, the results of the Zung Self-rating Anxiety Scale can be combined with results from a comprehensive evaluation of a patient to create a personalized treatment plan for their anxiety. The scale accounts for the severity of the anxiety, so the treatment plan must take that severity into account alongside whichever anxiety symptoms are adverse.

It can help patients realize how severe their anxiety is.

The Zung Anxiety Scale is a self-rating scale, and it is mostly handed to patients for them to answer independently. Since their answers are based on how each statement applies to them, they are subjective to their experience with anxiety. This allows them to think about their anxiety in ways they normally wouldn’t because it gives them the distance they need to examine themselves in light of this mental health condition.

It can be used to monitor patients.

Let’s stipulate that you have developed a treatment plan for your patient with anxiety, and they’ve been following it for a while now. One way for you to find out if they’re getting better and if your plan is working is to schedule them for a routine checkup. You may use the Zung Self-rating Anxiety Scale to gauge their anxiety again. If their scores are lower than before, your plan is working, and your patient is improving. If not, you might want to adjust your treatment plan.

How long does it take to accomplish the Zung Self-rating Anxiety Scale?
How long does it take to accomplish the Zung Self-rating Anxiety Scale?

Commonly asked questions

How long does it take to accomplish the Zung Self-rating Anxiety Scale?

It can be accomplished in less than five minutes. It depends on the person using it and how it’s being used. If a healthcare professional uses the scale and conducts it like an interview, it’ll take longer.

Is the Zung Self-rating Anxiety Scale a diagnostic tool?

No. It’s a screening tool.

What if I’m not seeing a professional and I’m answering this scale? What do I do if my score is 45+?

If you get that score and believe that your anxiety has negatively impacted your mental well-being, it’s best to see a professional so they can give you an official diagnosis and help you work through it.

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