Evaluation Studies Of Self-Rating Anxiety Scale Applying Results In Chinese University Students

[Research Objective]To evaluate the reliability and validity of Self-rating Anxiety Scale applying in Chinese university students; and to understand the status quo of Chinese university students' anxiety and its influencing factors.[Research Subjects]Pre-survey stage:A total of 3508 one Guangzhou Medical University students are engaged in and 3244 questionnaires are recycled with recovery rate of 92.47%.Clinical interview stage:Based on the statistical results of the pre-survey stage, according to the demarcation criteria of Self-rating Anxiety Scale (standard core? 50),87 students of pre-investigated 3508 are diagnosed with anxiety problem including 30 boys and 57 girls. These 87 students (named anxiety group) are arranged to continually take part in clinical assessment and diagnosis.265 students of the left are chosen as the control group (one of every 10 students in the descending order of anxiety standard score).National survey stage:with stratified sampling method, in accordance with the dividing standards of administrative regions in China (including North China, Northeast, East, South, Southwest, and Northwest a total of six administrative) students from universities of Northeast Province?ShanXi Province?Beijing City? Shanghai City?Guangzhou City?Wuhan City and Guangxi Province are chosen as reach subjects.8950 university students are engaged in and 8602 questionnaires (recovery rate of 95.53%) are recycled with 8262 valid questionnaires (effective rate 95.56%) including 3133 boys(37.60%) and 5147 girls(62.40%).[Research Method]The method of Questionnaire?Clinical interview and Clinical assessment are employed in the research with the scales of Self-rating Anxiety Scale, Hamilton Anxiety Scale and Self-rating Depression Scale. Epidata software is used to establish the database and SPSS 19.0 to analysis the data with the methods of Item Analysis, Exploratory Factor Analysis, Confirmatory Factor Analysis, Two Independent Sample t Test, Variance Analysis, Two Independent Sample Logistic Regression Analysis.[Research Results]1 Application evaluation study of Self-rating Anxiety Scale in Chinese university students1.1 Item Analysis of Self-rating Anxiety ScaleThe item analysis descend and ascend the standard SAS score to get the 27% of high score group (data boundary 35) and 27% of low score group (data boundary 27). Item Analysis results show that the total 20 items' decision t values of Self-rating Anxiety Scale range from 9.639 to 29.871 (p=0.000), the correlation coefficient between each item and the total score are all above 0.400(p=0.000), if item 18 removed from the scale, the total internal consistency coefficient increase from 0.741 to 0.742and the common and factor loading capacity of Self-rating Anxiety Scale‘ 20 items are met ?2.00??4.50 standards.Descriptive statistic analysis of Self-rating Anxiety Scale's 20 entries of shows that only the positive dimension's single entry mean is higher than 2.00, and the percentage of following in 4th grade for entry 5,9,13,17 ranges from 10.5%-33.0%, significantly higher than the others; in addition, the probability for entry 6,12,14 with 1th grade are all higher than 85%, ranging from 86.0%-89.7%.1.2 Validity of Self-rating Anxiety Scale(1) construct validity of Self-rating Anxiety ScaleConstruct Validity:With the factor analysis result of SPSS 19.0, this study have sufficient sample size and suitable for factor analysis with the KMO value of 0.836, Bartlett test of sphericity ?2= 8243.868 (df= 190, p ?0.001). The extracted four common factors'eigenvalue (all eigenvalue>1) are 3.824,1.710,1.464 and 1.121 with contribution rates 19.119%,8.548%,7.318%,5.603% (cumulative contribution rate of 40.587%); According to the contents of each items and relevant literature, four common factors are named:anxiety mood (including the item 1?2?3?4), somatic anxiety(including item 7?8?11?15?16?19?20), positive dimension (including the item 5?9?13?17?19) and Autonomic anxiety (including item 6?10?12?14? 18). After the Exploratory Factor Analysis has been done, we continue to conduct Confirmatory Factor Analysis. Self-rating Anxiety Scale'minimum fitness function ?2 =322.423(df=164,p>0.05), Absolute fitness index RMSEA=0.049, GFI=0.96>0.9, AGFI=0.95>0.9, SRMR=0.040<0.5, valve-added fitness index NFI=0.95, RFI=0.95, IFI=0.96, NNFI=0.95, CFI=0.96 all>0.9, simple fitness index PNFI=0.82>0.5, CN=530.62>200.(2) empirical validity of Self-rating Anxiety ScalePearson correlation coefficient between SAS and HAMA is 0.621 (p?0.001), and the Pearson correlation coefficient between SAS and SDS is 0.704 (p<0.001) indicating that Self-rating Anxiety Scale has good criterion-related validity.Secondly, Clinical interview results of two experienced psychological practitioners are regarded as the gold standard to evaluate the empirical validity of Self-rating Anxiety Scale. The false negative rate of Self-rating Anxiety Scale is 17.2% and the false positive rate is 18.4% with x2=61.876, df=1,p=0.000 (two-side test) indicating that there exist inconsistent screening results between these two method. Continually, pointing clinical results as state variable and the standard score of Self-rating Scale as test variable, ROC curve shows that the area under the ROC curve is 0.905 with the standard error of 0.021; 95% confidence interval of ROC area range from 0.864 to 0.946. If 51.88 is chosen for diagnosis cutting point, sensitivity and specificity are 0.76 and 0.87.1.3 Reliability of Self-rating Anxiety ScaleInternal consistency reliability:The Cronbach's alpha conefficient of Self-rating Anxiety Scale is 0.767 andequal-length Spearman-Brown, spilt-half reliability coefficients are both 0.724 with Guttman' s sub-half reliability coefficient of 0.720, all of the three reliability coefficients are lying in 0.700?0.800, showing that Self-rating Anxiety Scale has googd reliability; secondly, the internal consistency reliabiligy for Self-rating Anxiety Scale' four factors are respectively0.787?0.655? 0.502?0.625?all>0.600 except positive dimension factor. After a week,372 students re-test SAS with the re-test reliability r= 0.810 (p<0.01), showing that this scale has good test-retest reliability.2 The status of Chinese university students'anxiety level and its influencing factors(1) The current anxiety level of Chinese university studentsChinese university students' mean score of Self-rating Anxiety Scale is 40.970±8.348, with 40.677±8.446 for male students and 41.146±8.283 for female students. In the aspect of screening rate, the anxiety disorder screening rate of Self-rate Anxiety Scale for Chinese university students is 14.0% including 10.6% of mild and 3.4% of moderate to severe. The results for male and female students are respectively 13.3%?9.8%?3.5%; 14.4%?11.1%?3.4%. Chi-square test results (?2=3.156, p=0.206) show there are no screening difference between male and female students. In further, the screening rates for four grades are sequentially 14.0%?10.1%?3.9% for freshmen; 14.8%?11.4%?3.4% for grade two; 14.6%? 11.4%?3.4% for grade three, and 11.8%?9.8%?2.0% for grade four with the Chi-square test results (x2=13.191, p=0.040), showing there are significant screening difference between male and female students.(2) the influencing factors of Chinese university studentsSingle factor influencing analysis results show that there exists significant difference between the male students1 anxiety mean score (t=2.362, p=0.018); the mean anxiety score of students from Han is significant lower than those from minority (t=-5.456,p=0.000); only-child students' mean anxiety score is no different from that of non only-child students (t=-0.130, p=0.897), same result shows between fresh graduate and non fresh graduate (t=0.362, p=0.018); liberal arts students' anxiety mean score is higher than that of science students(t=-7.93,p=0.000), with the same result between the students whose parental marital breakdown and those not (t=-4.562,p=0.000);students who have clear political beliefs have higher anxiety mean score than those have not clear political beliefs (t=-3.390,p=0.001); those who have ever recoursed to counselor have significant lower anxiety than those not to do so(t=6.844,p=0.000); students who have suffered sexual assault are more easily have high anxiety mean score than those have not (t=6.844, p=0.000). There exist significant differences among different grades (F=15.507,p=0.000), the other three grades show significant lower anxiety mean score; students holding different ideas of afterlife beliefs also have significant different anxiety (t=36.371,p=0.000)Multivariate influencing factor analysis of Chinese university students' anxiety indicate that the demographic variables of Ethnic?discipline type?living area?parents' marital status?the attitude to afterlife belief? whether recourse to counselor and whether have ever suffered sexual assault are finally contained in the Logistic regression equation. If the predicted probability demarcation point is 0.5, the total correct rate for anxiety based on these 6 independent variables is 86.1% with Cox and Snell determination coefficient of 0.015 and Nagelkerke determination coefficient of 0.026 (x2=4.666,p=0.031)[Conclusion]1 Self-rating Anxiety Scale shows acceptable internal consistency reliability, good reliability in Chinese university student population. Based on the findings of this study, the cut-off point of Self-rating Anxiety Scale for Chinese university students should be 53, which is much higher than the national norm (norm=50). We should conduct the anxiety norm separately for Chinese university students.2. If the anxiety cut-off point of Self-rating Anxiety Scale is 50, the screening rate of Chinese college students' anxiety is 14% including 3.4% of students suffered moderate to severe anxiety; if the anxiety cut-off point of Self-rating Anxiety Scale is 53 basing on this study, the screening rate of Chinese college students' anxiety is 8.7%.3. Anxiety level of Chinese university students is 40.970±8.384 and demographic variables of Ethnic?discipline type?living area?parents' marital status? the attitude to afterlife belief?whether recourse to counselor and whether have ever suffered sexual assault are the influencing factors of Self-rating Anxiety Scale.