Compliance and documentation
How to use the State Trait Anxiety Inventory and interpret scores
Interested in using the State Trait Anxiety Inventory with clients? This guide helps you interpret scores, ensure accuracy, and streamline your documentation.
July 14, 2025 • Updated on August 29, 2025
5 min read
When you’re treating a patient with anxiety symptoms, you may use an assessment tool to support your diagnosis. The State Trait Anxiety Inventory is one way to better understand a client’s anxiety symptoms so you can determine the best course of treatment.
What is the State Trait Anxiety Inventory?
The State Trait Anxiety Inventory is a self-report assessment tool used to assess clinical anxiety and track treatment outcomes in individuals with anxiety disorders. It gathers information on the severity of two types of anxiety: state anxiety and trait anxiety.
State anxiety is temporary and situation-based — for example, experiencing anxiety before a test or social gathering. Trait anxiety is part of a person’s baseline temperament and might be experienced across a variety of situations.
Differentiating between these types of anxiety can help therapists properly diagnose clients and introduce appropriate interventions in the anxiety treatment plan.
Understanding the structure
The State Trait Anxiety Inventory consists of 40 total items. Half of the test (20 items) assesses state anxiety, while the other half assess trait anxiety. All items are rated on a four-point scale, ranging from “not at all” to “very much so” and “almost never” to “almost always.” Statement examples include “I feel jittery,” and “I make decisions easily.”
How to interpret the scoring system
Each section of the assessment (State and Trait) has a possible score of 20 to 80. In general, higher scores indicate more severe anxiety. Some items on the assessment are reverse scored to account for positively worded items. For that reason, certain questions are scored in reverse (1 is 4, 2 is 3, 3 is 2, and 4 is 1).
There’s no universal cutoff for anxiety levels as with other tests, but State Trait Anxiety Inventory scores could be grouped as:
- 20-37: Low anxiety
- 38-44: Moderate anxiety
- 45-80: High anxiety
It’s also important to consider the score of each part of the inventory. High state anxiety may suggest the respondent is currently feeling very anxious due to a stressful event, reflecting a tendency toward anxiety in certain scenarios.
High trait anxiety may suggest a person tends to feel anxious more often, even in the absence of significant stressors. This may suggest a chronic anxiety tendency or risk for an anxiety disorder.
Understanding the validity and reliability of the results
The State Trait Anxiety Inventory is a well-researched tool that consistently produces reliable and accurate results. In studies, it has shown strong internal consistency, meaning the questions on the test do a good job of measuring the same overall concept. It also has solid reliability over time, which means when people take the test again after a couple of months, their scores tend to stay stable (especially if their anxiety hasn’t changed much).
Researchers have also found strong evidence that the test actually measures what it’s supposed to (this is called construct validity), and that it correlates well with other trusted anxiety measures (known as concurrent validity).
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How to use the State Trait Anxiety Inventory in your practice
The State Trait Anxiety Inventory can be a useful tool for assessing anxiety and customizing a treatment plan to help a client cope. While it’s not a diagnostic tool in and of itself, it can help measure the severity of a client’s anxiety and how their symptoms are impairing their life.
You can use the Inventory as part of an initial assessment to gather a baseline of your client’s anxiety symptoms as well as to inform where your treatment plan should start — and focus. The assessment can also be helpful for measuring changes in anxiety symptoms over time, so you can adjust your treatment plan if needed. It can be completed and scored on paper or electronically. Many EHRs include common mental health assessments, including the State Trait Anxiety Inventory.
Consider using the State Trait Anxiety Inventory alongside other well-known anxiety assessment tools, such as the Beck Anxiety Inventory and GAD-7, for a more comprehensive picture of your client’s symptoms.
Consider these limitations before using.
As with any assessment, the State Trait Anxiety Inventory is not meant to be a diagnostic tool in and of itself. Instead, it can help support a diagnosis and identify changing symptoms along with a clinical assessment conducted by a therapist.
The Inventory also only assesses anxiety symptoms at a specific point in time. It can’t identify a person’s risk factors for anxiety, such as traumatic experiences and a family history of anxiety.
Keep in mind the State Trait Anxiety Inventory is a self-assessment, which means clients rate their own symptoms and experiences. Some respondents may have trouble accurately recognizing and reporting their symptoms. Your clinical expertise plays an important role in diagnosing and treating anxiety symptoms.
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This content is for general informational and educational purposes only and does not constitute clinical, legal, financial, or professional advice. All decisions should be made at the discretion of the individual or organization, in consultation with qualified clinical, legal, or other appropriate professionals.
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