[{"data":1,"prerenderedAt":355},["ShallowReactive",2],{"assessment-pass":3,"assessments-related-pass":333},{"id":4,"title":5,"body":6,"category":251,"categoryTitle":252,"clinicalCitations":253,"copyright":251,"description":263,"downloadLink":251,"extension":264,"faqs":265,"featured":281,"firstPublished":282,"i18nReady":281,"icon":251,"inHiBoop":283,"interpreter":284,"interpreterExempt":251,"lastReviewed":321,"meta":322,"navigation":323,"path":324,"permissionsNote":251,"published":323,"recommendedFrequency":251,"relatedCodes":251,"relatedConditions":251,"relevantSpecialty":251,"reviewedBy":251,"seo":325,"slug":326,"status":327,"stem":328,"summary":329,"takeaways":251,"timeline":251,"type":330,"usedToDiagnose":331,"__hash__":332},"assessments\u002Fassessments\u002Fpass.md","PASS Scoring · Perinatal Anxiety Screening Scale (31-Item)",{"type":7,"value":8,"toc":241},"minimark",[9,22,27,35,43,72,76,120,124,157,161,195,199],[10,11,12,13,17,18,21],"p",{},"The PASS (Perinatal Anxiety Screening Scale) is a 31-item self-report questionnaire that screens for problematic anxiety in pregnancy and after birth. Totals run 0 to 93, and 26 or more is the screening cutoff ",[14,15],"cite-ref",{"n":16},"1"," ",[14,19],{"n":20},"3",".",[23,24,26],"h2",{"id":25},"what-does-the-pass-measure","What does the PASS measure?",[10,28,29,30,32,33,21],{},"The PASS measures a broad range of anxiety symptoms as they present in perinatal women, so it can screen for risk of significant anxiety in antenatal clinics, hospital wards and mental health services ",[14,31],{"n":16},". General anxiety scales can count physical changes of pregnancy as symptoms, which is one reason a perinatal scale was built ",[14,34],{"n":20},[10,36,37,38,17,40,42],{},"Its 31 items form four subscales ",[14,39],{"n":16},[14,41],{"n":20},":",[44,45,46,54,60,66],"ul",{},[47,48,49,53],"li",{},[50,51,52],"strong",{},"Acute anxiety and adjustment"," (8 items): panic, dissociation and adjustment.",[47,55,56,59],{},[50,57,58],{},"General worry and specific fears"," (10 items): generalized anxiety and phobias.",[47,61,62,65],{},[50,63,64],{},"Perfectionism, control and trauma"," (8 items): obsessive-compulsive and post-traumatic symptoms.",[47,67,68,71],{},[50,69,70],{},"Social anxiety"," (5 items).",[23,73,75],{"id":74},"how-do-you-give-the-pass","How do you give the PASS?",[44,77,78,86,94,102,108],{},[47,79,80,83,84,21],{},[50,81,82],{},"Who completes it."," The client, in pregnancy or after birth ",[14,85],{"n":16},[47,87,88,91,92,21],{},[50,89,90],{},"Time window."," The past month ",[14,93],{"n":20},[47,95,96,99,100,21],{},[50,97,98],{},"Response scale."," Each item is rated 0 (not at all), 1 (sometimes), 2 (often) or 3 (almost always) ",[14,101],{"n":20},[47,103,104,107],{},[50,105,106],{},"Context."," Note whether the client is antenatal or postnatal, and the weeks of pregnancy or the baby's age, so scores are read in context.",[47,109,110,113,114,119],{},[50,111,112],{},"Pairing."," Give it with the ",[115,116,118],"a",{"href":117},"\u002Fassessments\u002Fepds\u002F","EPDS"," to screen for perinatal depression and anxiety together.",[23,121,123],{"id":122},"how-do-you-score-and-interpret-the-pass","How do you score and interpret the PASS?",[125,126,127,132,138,146,149,152],"ol",{},[47,128,129,130,21],{},"Add the 31 item ratings for a total from 0 to 93 ",[14,131],{"n":20},[47,133,134,135,21],{},"Compare the total with the screening cutoff. A score of 26 or more identifies women at risk of problematic anxiety ",[14,136],{"n":137},"2",[47,139,140,141,143,144,21],{},"Place the total in a severity range: 0 to 20 minimal, 21 to 41 mild to moderate and 42 to 93 severe anxiety ",[14,142],{"n":20},". The ranges were set with the Jacobson-Truax method in 410 antenatal and postnatal women ",[14,145],{"n":137},[47,147,148],{},"The scorer at the top of this page splits the mild to moderate range at the cutoff, so 21 to 25 reads as mild to moderate but below the cutoff, and 26 to 41 as at or above it.",[47,150,151],{},"Add each subscale's items to see which kind of anxiety drives the total.",[47,153,154,155,21],{},"Use the ranges over time to track deterioration, improvement or stability, and to prioritize referrals ",[14,156],{"n":137},[23,158,160],{"id":159},"psychometric-properties","Psychometric properties",[44,162,163,171,179,187],{},[47,164,165,168,169,21],{},[50,166,167],{},"Original study."," In 437 antenatal and postpartum women at a tertiary obstetric hospital in Western Australia, the PASS correlated with other measures of depression and anxiety, and its subscales and total had high to excellent reliability. At the optimal cutoff it identified 68% of women with a diagnosed anxiety disorder, against 36% for the anxiety subscale of the EPDS ",[14,170],{"n":16},[47,172,173,176,177,21],{},[50,174,175],{},"Reliability."," Internal consistency for the whole scale was excellent (Cronbach's α = 0.96) and test-retest reliability adequate (ρ = 0.74) ",[14,178],{"n":20},[47,180,181,184,185,21],{},[50,182,183],{},"Severity ranges."," In 410 antenatal and postnatal women, cut-off points between minimal, mild to moderate and severe groups were derived against standardized scales and diagnostic interviews ",[14,186],{"n":137},[47,188,189,192,193,21],{},[50,190,191],{},"Italian validation."," In 289 women in the third trimester and 60 perinatal psychiatric outpatients, the four-factor structure held with small differences, and the cutoff of 26 gave an area under the curve of 0.85 ",[14,194],{"n":20},[23,196,198],{"id":197},"limitations","Limitations",[44,200,201,207,225,233],{},[47,202,203,206],{},[50,204,205],{},"Screening, not diagnosis."," A score at or above 26 identifies risk; it needs a clinical assessment to confirm an anxiety disorder.",[47,208,209,212,213,217,218,222,223,21],{},[50,210,211],{},"Sample diagnoses."," The most common diagnoses in the severity study were adjustment disorder, mixed anxiety and depression, generalized anxiety and ",[115,214,216],{"href":215},"\u002Fconditions\u002Fptsd\u002F","post-traumatic stress disorder",", which may limit the ranges for other anxiety disorders such as ",[115,219,221],{"href":220},"\u002Fconditions\u002Focd\u002F","obsessive-compulsive disorder"," and specific phobia ",[14,224],{"n":137},[47,226,227,230,231,21],{},[50,228,229],{},"Factor structure varies."," Translations have found slightly different item groupings across the four subscales ",[14,232],{"n":20},[47,234,235,238,239,21],{},[50,236,237],{},"Built in one setting."," The original development was at one obstetric hospital in Western Australia ",[14,240],{"n":16},{"title":242,"searchDepth":243,"depth":243,"links":244},"",3,[245,247,248,249,250],{"id":25,"depth":246,"text":26},2,{"id":74,"depth":246,"text":75},{"id":122,"depth":246,"text":123},{"id":159,"depth":246,"text":160},{"id":197,"depth":246,"text":198},null,"Anxiety",[254,257,260],{"text":255,"link":256},"Somerville S, Dedman K, Hagan R, Oxnam E, Wettinger M, Byrne S, Coo S, Doherty D, Page AC. The Perinatal Anxiety Screening Scale: development and preliminary validation. Arch Womens Ment Health. 2014;17(5):443-54.","https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F24699796\u002F",{"text":258,"link":259},"Somerville S, Byrne SL, Dedman K, Hagan R, Coo S, Oxnam E, Doherty D, Cunningham N, Page AC. Detecting the severity of perinatal anxiety with the Perinatal Anxiety Screening Scale (PASS). J Affect Disord. 2015;186:18-25.","https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F26226429\u002F",{"text":261,"link":262},"Koukopoulos A, Mazza C, De Chiara L, et al. Psychometric Properties of the Perinatal Anxiety Screening Scale Administered to Italian Women in the Perinatal Period. Front Psychiatry. 2021;12:684579.","https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F34239465\u002F","PASS scoring guide: 31-item Perinatal Anxiety Screening Scale, totals 0 to 93, screening cutoff 26, and minimal, mild to moderate and severe ranges.","md",[266,269,272,275,278],{"question":267,"answer":268},"What is the Perinatal Anxiety Screening Scale?","The Perinatal Anxiety Screening Scale (PASS) is a 31-item self-report questionnaire, developed by Somerville and colleagues in Western Australia, that screens for a broad range of anxiety symptoms as they present in pregnancy and after birth. It was published in 2014 and has four subscales.",{"question":270,"answer":271},"How do you score the PASS?","Each of the 31 items is rated 0 (not at all), 1 (sometimes), 2 (often) or 3 (almost always) for the past month. Add the 31 ratings for a total from 0 to 93. Higher scores mean more anxiety.",{"question":273,"answer":274},"What is the PASS cutoff score?","A total of 26 or more is the clinical cutoff for problematic anxiety, set in the original study and confirmed in an Italian validation. A later study added three severity ranges: 0 to 20 minimal, 21 to 41 mild to moderate and 42 to 93 severe anxiety.",{"question":276,"answer":277},"What are the PASS subscales?","The four subscales are acute anxiety and adjustment (8 items), general worry and specific fears (10 items), perfectionism, control and trauma (8 items) and social anxiety (5 items). Together they cover symptoms of panic, generalized anxiety, phobias, obsessive-compulsive and post-traumatic symptoms, and social anxiety.",{"question":279,"answer":280},"Is the PASS better than the EPDS for anxiety?","In the original study, the PASS at its optimal cutoff identified 68% of women with a diagnosed anxiety disorder, against 36% for the anxiety items of the Edinburgh Postnatal Depression Scale. The EPDS screens mainly for depression; the PASS was built for perinatal anxiety.",false,"2014","For clinics that hold a PASS licence, HiBoop sends it to clients by secure link in pregnancy or after birth, totals it on submission and charts it over time beside its four subscales.",{"heading":285,"scaleLabel":286,"min":287,"max":288,"note":289,"source":290,"calculator":291,"bands":301},"PASS Score Interpreter","Total score",0,93,"31 items, each rated 0 (not at all) to 3 (almost always) for the past month; sum for a total of 0 to 93. Higher scores indicate more anxiety.","Screening cutoff of 26 per Somerville et al. (2014); severity ranges 0–20 minimal, 21–41 mild to moderate and 42–93 severe per Somerville et al. (2015), as reported by Koukopoulos et al. (2021). The mild to moderate range is split at the cutoff of 26.",{"itemCount":292,"maxPerItem":243,"heading":293,"itemLabel":294,"anchors":295,"note":300},31,"PASS Score Calculator","PASS items",[296,297,298,299],"Not at all","Sometimes","Often","Almost always","Enter each of the 31 scored items (0–3) to total them; the range shows below. Items are numbered, not reproduced: enter them from the form in front of you.",[302,307,312,317],{"min":303,"label":304,"level":305,"note":306},42,"Severe anxiety","error","Scores of 42 to 93 fall in the severe range. Prioritize a full clinical assessment.",{"min":308,"label":309,"level":310,"note":311},26,"Mild to moderate anxiety, at or above the cutoff","warning","Scores of 26 to 41 are in the mild to moderate range and at or above the screening cutoff of 26 for problematic anxiety. Follow with a clinical assessment.",{"min":313,"label":314,"level":315,"note":316},21,"Mild to moderate anxiety, below the cutoff","info","Scores of 21 to 25 are in the mild to moderate range but below the screening cutoff of 26. Monitor, and reassess if symptoms rise.",{"min":287,"label":318,"level":319,"note":320},"Minimal anxiety","success","Scores of 0 to 20 fall in the minimal range.","2026-10-25",{},true,"\u002Fassessments\u002Fpass",{"title":5,"description":263},"pass","published","assessments\u002Fpass","The PASS (Perinatal Anxiety Screening Scale) is a 31-item self-report questionnaire that screens for problematic anxiety in pregnancy and after birth, over the past month. Totals run 0 to 93; 26 or more is the screening cutoff, and the severity ranges are 0 to 20 minimal, 21 to 41 mild to moderate and 42 to 93 severe anxiety.","assessment","Perinatal anxiety disorders","KFC9orX5G6pR-QD44Z0BCZ-GJoHdS2TLMi--ZN3uLSk",[334,339,342,345,349,352],{"slug":335,"title":336,"tier":337,"weight":338},"bai","Beck Anxiety Inventory (BAI) Scoring & Interpretation","same",100,{"slug":340,"title":341,"tier":337,"weight":338},"dsm-5-level-1","DSM-5-TR Self-Rated Level 1 Cross-Cutting Symptom Measure, Adult",{"slug":343,"title":344,"tier":337,"weight":338},"gad-7","GAD-7 Scoring and Interpretation",{"slug":346,"title":347,"tier":50,"weight":348},"bdi-ii","BDI-II Scoring Guide · Beck Depression Inventory",65,{"slug":350,"title":351,"tier":50,"weight":348},"ces-d","CES-D: Center for Epidemiologic Studies Depression Scale",{"slug":353,"title":354,"tier":50,"weight":348},"ces-dc","CES-DC Scoring · Center for Epidemiologic Studies Depression Scale for Children",1793176520055]