Validation of the Nepali version of beck anxiety inventory

Abstract

This study validates a Nepali version of the Beck Anxiety Inventory (BAI). The instrument was
compared against a gold standard diagnosis of generalized anxiety. The diagnosis of Generalized
Anxiety Disorder (GAD) was made according to the Diagnostic and Statistical Manual of Mental
Disorders, Fourth Edition. GAD subjects were selected both from outpatients at Tribhuvan University
Teaching Hospital and a rural sample from Jumla. Healthy (non-psychiatric diagnosis) cases were
taken from a community sample in Jumla; their “healthy” status was obtained by achieving a score
less than 2 on the Nepali General Health Questionnaire-12. This study identifies acceptable sensitivity
and specificity ranges for the measure. A cut-off of 13/14 for the BAI provides sensitivity of 0.91 and
specificity of 0.89. Reliability for the BAI is comparable to most studies in Western countries (0.89). A
factor analysis of the BAI evokes four factors. A number of items reduce the validity and internal
reliability of this measure. Somatic items poorly distinguish psychiatric cases; this may be due to high
burden of physical illness in rural Nepal. Overall, the BAI appears to be a good instrument for clinical
and research use in Nepal.