Multidimensional AIDS Anxiety Questionnaire

Abstract

The Multidimensional AIDS Anxiety Questionnaire (MAAQ) is a 50-item, self-report psychometric instrument designed to quantify the amount and specific nature of anxiety experienced by individuals concerning AIDS (Acquired Immune Deficiency Syndrome). Developed by William E. Snell, Jr. and Phillip D. Finney, the MAAQ utilizes a 5-point Likert-type scale format for responses, ranging from “not at all characteristic of me” to “very characteristic of me.” The instrument is structured around five distinct factors of AIDS-related anxiety, identified through factor analysis, allowing for a nuanced assessment of physiological, cognitive, and behavioral manifestations of this concern.

Keywords

AIDS anxiety, HIV/AIDS, psychological measurement, self-report scale, physiological arousal, sexual inhibition, discussion inhibition, psychometrics, fear, cognitive worry.

Authors

William E. Snell, Jr., Phillip D. Finney.

Purpose

The primary purpose of the MAAQ is to systematically measure the public’s reaction to the AIDS epidemic by operationalizing the construct of AIDS-related anxiety. While considerable medical attention focused on the disease itself, the developers recognized a need to understand the psychological and social impact of the disease, specifically the anxiety it fostered across various segments of society.

This multidimensional approach allows researchers and clinicians to move beyond a singular measure of general worry, instead providing insight into how anxiety manifests across physiological responses, cognitive processes, and specific behavioral domains like sexual practices and communication.

Construct

The MAAQ measures the overarching construct of AIDS-related anxiety, conceptualized as a multidimensional phenomenon comprising five core concepts, confirmed through principal components factor analysis with varimax rotation. These five dimensions capture the spectrum of emotional, physical, and behavioral reactions to the threat of AIDS.

The five primary subscales, representing these dimensions, are:

• Physiological Arousal: Measures somatic symptoms and stress related to thoughts about AIDS.
• Fear of AIDS: Measures specific dread and apprehension regarding contracting the disease.
• Cognitive Worry: Measures obsessive or persistent thoughts and mental tension about the epidemic.
• Sexual Inhibition: Measures behavioral avoidance or nervousness regarding sexual activity due to AIDS concerns.
• Discussion Inhibition: Measures difficulty or discomfort in communicating about AIDS-related issues with others, particularly intimate partners.

Validity

Validity evidence for the MAAQ was established primarily through principal components factor analysis, which yielded five factors with eigenvalues greater than 1, confirming the intended multidimensional structure. The structure aligns with anticipated physiological (arousal and fear factors), cognitive (worry factor), and behavioral (sexual and discussion inhibition factors) manifestations of AIDS anxiety.

Further research supported the MAAQ’s validity profile by demonstrating convergent validity through positive correlations with other measures of general anxiety and discriminant validity from constructs such as social desirability and other personality characteristics. Additionally, MAAQ scores, particularly those reflecting physiological arousal, were found to be associated with more positive personal approaches to AIDS and were positively correlated with reliable contraceptive behaviors among males, suggesting predictive validity regarding health behaviors related to HIV prevention.

Reliability

The internal consistency of the MAAQ subscales was assessed using Cronbach alphas. The coefficients for all five primary scales demonstrated high internal consistency, with reliability coefficients ranging from a low of .85 to a high of .94, indicating that the items within each subscale reliably measure the same underlying construct.

Test-retest reliability coefficients varied across the subscales. The Physiological Arousal (.65), Fear of AIDS (.78), and Sexual Inhibition (.63) subscales demonstrated quite high stability over time. However, the Cognitive Worry (.40) and Discussion Inhibition (.40) subscales showed comparatively lower test-retest coefficients, suggesting that these specific manifestations of anxiety may be more state-dependent or susceptible to short-term changes.

Factor Analysis

A principal components factor analysis utilizing varimax rotation was conducted on the 50 items to determine the underlying structure of AIDS-related anxiety. This analysis identified five factors with eigenvalues exceeding 1, confirming the multidimensional theoretical framework that separates anxiety into physiological, cognitive, and behavioral components.

The resulting five factors and their psychometric properties are:

• Factor 1: Physiological Arousal (16 items). Eigenvalue = 17.00, accounting for 34% of the variance.
• Factor 2: Fear of AIDS (6 items). Eigenvalue = 4.43, accounting for 8.9% of the variance.
• Factor 3: Sexual Inhibition (6 items). Eigenvalue = 2.24, accounting for 4.5% of the variance.
• Factor 4: Cognitive Worry (5 items). Eigenvalue = 1.23, accounting for 2.5% of the variance.
• Factor 5: Discussion Inhibition (5 items). Eigenvalue = 1.16, accounting for 2.3% of the variance.

The MAAQ also includes items for a sixth potential subscale, Anxiety About AIDS Exposure (Items 20, 49, 50), although the eigenvalue for this subscale was less than 1, indicating it was psychometrically weak in the initial analysis. However, the authors anticipated it might gain prominence in future research.

Instrument

Test Type: Self-Report Questionnaire (Psychometric Scale)

Format: 50 items utilizing a 5-point Likert-type scale. Responses range from A (Not at all characteristic of me, scored 0) to E (Very characteristic of me, scored 4).

Language Available: English (Original development language).

Population Group: General adult population; frequently used with university students.

Age Group: Adults (typically university age and older).

Population Details: Designed to assess anxiety in segments of society reacting to the AIDS epidemic.

Test Methodology: Responses are recorded on a computer scan sheet or directly on the instrument. Raw scores (0 to 4) are averaged for each subscale, resulting in subscale scores ranging from 0 to 4. Higher scores correspond to greater amounts of specific AIDS-related anxiety. Completion time is approximately 20 to 25 minutes.

Keywords

Psychological assessment, behavioral inhibition, physiological response, test-retest reliability, Cronbach’s Alpha, public health psychology, sexual health, convergent validity.

Authors

Author ORCID Identifier: Not provided in source content.

Affiliation Email addresses: [email protected] (William E. Snell, Jr.)

Correspondence Address: William E. Snell, Jr., Department of Psychology, Southeast Missouri State University, One University Plaza, Cape Girardeau, MO 63701.

Permissions & Fee and Test Year

Test Year: Initial development reported in 1989 (Finney & Snell); formalized as an unpublished manuscript in 1996 (Snell & Finney).

Permissions & Fee: Information regarding current commercial permissions or fees is not provided in the original source content. The scale was initially presented for academic research purposes.

Reference’s

The following references document the development and validation of the MAAQ:

• Finney, P., & Snell, W. E., Jr. (1989, April). The AIDS Anxiety Scale: Components and correlates. Paper presented at the annual meeting of the Southwestern Psychological Association, Houston, TX.
• Snell, W. E., Jr., & Finney, P. (1990). Interpersonal strategies associated with the discussion of AIDS. Annals of Sex Research, 3, 435–451.
• Snell, W. E., Jr., Finney, P., & Godwin, L. J. (1991). Stereotypes about AIDS. Contemporary Social Psychology, 15, 18–38.
• Snell, W. E., Jr., & Finney, P. (1996). The Multidimensional AIDS Anxiety Questionnaire. Unpublished manuscript.

Items of the Multidimensional AIDS Anxiety Questionnaire

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

Instructions: The items listed below refer to feelings and reactions that people may experience about the disease AIDS (Acquired Immune Deficiency Syndrome). As such, there are no right or wrong answers, only the individual reactions that people have. We are interested in how typical these feelings and behaviors are of you. To provide your responses, use the following scale to indicate how characteristic the following statements are for you.

A = Not at all characteristic of me. B = Slightly characteristic of me.

C = Somewhat characteristic of me. D = Moderately characteristic of me. E = Very characteristic of me.

Note: Remember to respond to all items, even if you are not completely sure. Also, please be honest in responding to these statements.

1. Thinking about AIDS makes me feel anxious.

2. I sometimes find it hard to discuss issues dealing with AIDS.

3. I feel tense when I think about the threat of AIDS.

4. I feel quite anxious about the epidemic of AIDS.

5. I feel scared about AIDS when I think about sexual relationships.

6. I’m afraid of getting AIDS.

7. I have trouble talking about AIDS with an intimate partner.

8. I feel flustered when I realize the threat of AIDS.

9. The disease AIDS makes me feel nervous and anxious.

10. I feel scared when I think about catching AIDS from a sexual partner.

11. I’m not worried about getting AIDS.

12. I would feel shy discussing AIDS with an intimate partner.

13. My heart beats fast with anxiety when I think about AIDS.

14. I feel anxious when I talk about AIDS with people.

15. Because of AIDS, I feel nervous about initiating sexual relations.

16. All these discussions of AIDS leaves me feeling a bit alarmed.

17. I would not find it hard to discuss AIDS with an intimate partner.

18. AIDS makes me feel jittery about having sex with someone.

19. I feel uncomfortable when discussing AIDS.

20. I sometimes worry that one of my past sexual partners may have had AIDS.

21. Thinking about catching AIDS leaves me feeling concerned.

22. I would not hesitate to ask a former sex partner about AIDS-related concerns.

23. The issue of AIDS is a very stressful experience for me.

24. I feel nervous when I discuss AIDS with another person.

25. The threat of getting AIDS makes me feel uneasy about sex.

26. I worry about what I should do about AIDS.

27. Anxiety about AIDS is beginning to affect my personal relationships.

28. In general, the media attention on AIDS makes me feel restless.

29. I have feelings of worry when I think about AIDS.

30. Were I to have sexual relations, I would worry about getting AIDS.

31. All this recent media attention about AIDS leaves me feeling on edge.

32. AIDS does not influence my willingness to engage in sexual relationships.

33. When I think about AIDS, I feel tense.

34. I am more anxious than most people are about the disease AIDS.

35. If I were to have sex with someone, I would worry about AIDS.

36. I’m pretty indifferent to the idea of catching AIDS.

37. I would hesitate to involve myself in a sexual relationship because of AIDS.

38. When talking about AIDS with someone, I feel jumpy and high-strung.

39. I become really frightened when I think about the threat of AIDS.

40. The fear of AIDS makes me feel nervous about engaging in sex.

41. The increased chances of being infected with AIDS leaves me feeling troubled.

42. Because of AIDS, I feel too nervous to start a new sexual relationship.

43. The spread of AIDS is causing me to feel quite a bit of stress.

44. I worry that AIDS may directly influence my life.

45. I had a better attitude towards sex before the AIDS epidemic.

46. I get pretty upset when I think about the possibility of catching AIDS.

47. The discussion of AIDS makes me feel uncomfortable.

48. All this talk about AIDS has left me feeling strained and tense.

49. I’m concerned that I might be carrying the AIDS virus.

50. I feel nervous when I think that a past sexual partner could have given me AIDS