Stefana, A., Furuta, M., Cena, L., Trainini, A., Palumbo, G., Mirabella, F., & Gigantesco, A. (2025). Development of a short version of the Spielberger state and trait anxiety inventory (STAI) for pregnant women. Mediterranean Journal of Clinical Psychology 13(1). https://doi.org/10.13129/2282-1619/mjcp-4505

Background: The Spielberger state-trait anxiety inventory (STAI) is a widely recognized tool for
assessing state and trait anxiety components in the general population. While reliable and valid, each
scale in the STAI has 20 items, which limits its usability in certain real-world clinical settings.
Additionally, certain items can inaccurately increase anxiety scores among expectant women. This
study aimed to develop a concise yet dependable and valid version of these scales tailored for pregnant
individuals.
Methods: We engaged 1,158 expectant women who completed the STAI and other assessments to
determine criterion validity. Our methodology incorporated item response theory, confirmatory factor
analysis, and k-fold cross-validation. Additionally, Bland-Altman regressions and plots assisted in
gauging score accuracy, and receiver operating characteristic analyses determined discriminative
validity. We also set clinical change benchmarks.
Results: Confirmatory factor analysis yielded the following fit indices: X2

(5) = 32.08, CFI = .99, TLI =
.97, RMSEA = .07 (90% CI [.05, .09]), and SRMR = .02 for the state anxiety scale (omega total = .85),
and X2
(5) = 23.58, CFI = .99, TLI = .97, RMSEA = .06 (90% CI [.04, .08]), and SRMR = .02 for the
trait anxiety scale (omega total = .79). Furthermore, both scales showed meaningful correlations with
measures depression.
Conclusion: The resulting five-item STAI short forms manifested robust psychometric attributes and
reliability, providing a theoretically grounded and reliable anxiety assessment during pregnancy. This
can be effectively applied in obstetric and gynecological settings, offering a streamlined response
experience for expectant women.