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A Correlational Study Using the Beck Anxiety Inventory and Clinical Anger Scale

Jhilmil Nigam (A037)

SDOS, NMIMS

BSc. Applied Psychology

Ms. Mayola Rodrigues & Ms. Shivani Shinde

April 15th, 2024

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Introduction

Anxiety is defined as an emotion characterized by feelings of tension, worried

thoughts, and physical changes like increased blood pressure by the APA. Anxiety disorders

are the most common group of mental health conditions in Australia. They affect 1 in 4

Indians at some stage in their life. Having an anxiety disorder is not just a matter of feeling

too anxious. People with anxiety disorders have ongoing fears that cause distress and stop

them from doing things they want to and should be doing. According to the Diagnostic and

Statistical Manual of Mental Disorders (5th ed.; DSM-5), anxiety disorders are among the

most prevalent mental health conditions and they affect approximately 31% of individuals at

some point in their lives (APA, 2013).

Anger is a normal human emotion. Certain people may show clinical anger which is

chronic and pervasive anger. The difference between anger and clinical anger may be

comparable to the difference between feeling down and clinical depression. In other words,

when an otherwise common emotion becomes long-lasting, it becomes a clinical problem.

Although, to many, anger may seem like a maladaptive response to interpersonal distress, the

emotion is intended to serve an adaptive function, as it has as its most basic purpose the

preparation of human beings to respond to real threats in the environment (Kemper, 1987).

However, when generalized to contexts beyond those in which it is likely to be useful and

adaptive, this otherwise normal emotion can lead to chronically heightened arousal and is

associated with dysfunctional and problematic behavior. For many individuals, heightened

intensity, frequency, and duration of anger, which we have defined as “clinical anger,” are

precursors to a variety of interpersonal, health, occupational, and legal difficulties (Del

Vecchio & O’Leary, 2004; Kassinove & Sukhodolsky, 1995).

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The reason why the Beck Anxiety Inventory (BAI) and the Clinical Anger Scale

(CAS) were selected is because of their proven reliability, validity, and relevance to the

concepts of anxiety and anger. The BAI, created by Aaron T. Beck and his team in 1988, is a

commonly used questionnaire that allows individuals to self-report the severity of their

anxiety symptoms. The Clinical Anger Scale (CAS) is a self-report instrument that measures

clinical anger. The following symptoms of anger are measured by the CAS items: anger at

current life, anger at the future, anger at failure, anger at things, angry-hostile feelings,

irritating others, anger at self, misery, wanting to harm others, screaming at people, current

annoyance, social interference, decision-making interference, alienating others, work

interference, sleep interference, fatigue, appetite interference, thought interference, and

sexual interference.

This essay aims to identify the correlation using Spearman rho between these two

variables, i.e. anger and anxiety, with the help of CAS and BAI.

Methodology

The administrator arranged the tables and called a group of ten participants in the

laboratory. Rapport was established. After ensuring that the participant was ready to answer

the test, the following instructions from Beck’s Anxiety Inventory were read from the

questionnaire: Below is a list of common anxiety symptoms. Please carefully read each item

in the list. Indicate how much you have been bothered by that symptom during the past

month, including today, by circling the number in the corresponding space in the column next

to each symptom.

After the participant answered all the questions on the scale, the participant was then

debriefed and introduced to the Clinical Anger Scale by Snell. These instructions were read
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from the questionnaire: “The group of items below inquire about the types of feelings you

have. Each of the 21 groups of items has four options.

For example, ITEM 99

A. I feel fine.

B. I don't feel all that well.

C. I feel somewhat miserable.

D. I feel completely miserable.

For each cluster of items, read and identify the statement that best reflects how you

feel. For example, you might choose A in the above example. If so, then you would darken in

the letter (A) on the answer sheet next to the item number associated with that group of

statements. In this example, that item number would have been "99." Now go ahead and

answer the questions on the answer sheet. Be sure to answer every question, even if you're

not sure, and use a #2 pencil. Make sure you select only one statement from each of the 21

clusters of statements.” After the participants were done, they were debriefed and escorted

out of the laboratory.

The scores were as follows:

BAI 32 25 51 36 39 28 18 36 32 61

CAS 43 42 17 21 28 19 39 32 46 59

Then, the scores were ranked for each inventory separately.

BAI Scores (Ranked):

18(1), 25(2), 28(3.5), 32(5.5), 32(5.5), 36(7.5), 36(7.5), 39(9), 51(10), 61(11)

CAS Scores (Ranked):

17(1), 19(2), 21(3), 28(4.5), 32(6), 39(7), 42(8), 43(9), 46(10), 59(11)
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Then we computed the differences between the ranks of paired observations where we

calculate the difference between each X rank and the mean of X ranks (XRa - Mx), and each

Y rank and the mean of Y ranks (YRa - My). After which we multiplied the differences

calculated in step 2 for X and Y ranks (XRa - Mx) * (YRa - My) and sum them to get the sum

of differences.

Participant XRa - Mx YRa - My Rank Difference Squared

(BAI) (CAS) (d) Difference
(d^2)

1 -4.50 -4.50 0 20.25

2 -3.50 -3.50 0 12.25

3 -2.50 -2.50 0 6.25

4 -1.00 -1.50 0.50 1.50

5 -1.00 -0.50 -0.50 0.50

6 1.00 0.50 0.50 0.50

7 1.00 1.50 -0.50 1.50

8 2.50 2.50 0 6.25

9 3.50 3.50 0 12.25

10 4.50 4.50 0 20.25

The formula for Spearman's rho, denoted as ρ, is a measure of rank correlation between two

variables. It is calculated as follows:

2
6∑𝑑
ρ = 1− 2
𝑛(𝑛 −1)

Where:

2
● ∑𝑑 is the sum of the squared differences between the ranks of corresponding

variables.

● n is the number of paired observations.

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This formula computes the correlation coefficient based on the differences between the ranks

of paired observations. It ranges from -1 to 1, where:

● ρ=1 indicates a perfect positive correlation,

● ρ=−1 indicates a perfect negative correlation, and

● ρ=0 indicates no correlation.

We already have the ranks and squared differences calculated from the provided data. Now

the standard deviations and covariances of the ranks for both BAI and CAS scores are stated

below.

Covariance = 9.06

The standard deviation for BAI ranks (XRa St. Dev.) = 3.01

The standard deviation for CAS ranks (YRa St. Dev.) = 3.03

Now, let's calculate Spearman's rho using the formula:

2
6∑𝑑
ρ = 1− 2
𝑛(𝑛 −1)

6×8.75
ρ = 1− 2
10(10 −1)

6×8.75
ρ = 1− 2
10(10 −1)

52.5
ρ = 1− 990

ρ = 1 − 0. 053

ρ = 0. 947

Therefore, the interpretation of Spearman's rho ρ=0.947 is a strong positive correlation

between the Beck Anxiety Inventory (BAI) and the Clinical Anger Scale (CAS) scores in the

sample.
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Results and Interpretation

The results demonstrated that anxiety and anger have a positive correlation of

approximately 0.947 which is interpreted as a strong monotonic relationship. Correlation is

an effect size so we can verbally describe the strength of the correlation by saying the

absolute value 𝑟𝑠 is very strong.

Conclusion

Our conclusions demonstrated a strong correlation between anxiety and anger which

was done by administering Beck’s Anxiety Inventory (BAI) and Clinical Anger Scale (CAS)

to 30 participants.
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References

American Psychological Association. (2020). Publication Manual of the American

Psychological Association (7th ed.). https://doi.org/10.1037/0000165-000

Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring

clinical anxiety: Psychometric properties. Journal of Consulting and Clinical

Psychology, 56(6), 893-897. https://doi.org/10.1037/0022-006X.56.6.893

Maisto, S. F., & Connors, G. J. (1990). Clinical Anger Scale (CAS): Psychometric properties.

Journal of Substance Abuse, 2(1), 177-183.

https://doi.org/10.1016/S0899-3289(05)80011-6

Miller, S. M. (1987). Spearman's rank correlation coefficient. In The Encyclopedia of

Statistics in Behavioral Science (pp. 1736-1737). John Wiley & Sons, Ltd.

Snell, W. E., Jr., Gum, S., Shuck, R. L., Mosley, J. A., & Kite, T. L. (1995). The clinical anger

scale: Preliminary reliability and validity. Journal of Clinical Psychology, 51(2),

215-226.

Sullivan, G. M., & Feinn, R. (2012). Using effect size—or why the P value is not enough.

Journal of Graduate Medical Education, 4(3), 279-282.

https://doi.org/10.4300/JGME-D-12-00156.1