---
title: "Zung Anxiety Scale: Free Self-Rating Anxiety Test (SAS)"
id: "10275"
type: "snax_quiz"
slug: "zung-anxiety-scale"
published_at: "2026-09-08T15:55:59+00:00"
modified_at: "2026-09-08T15:55:59+00:00"
url: "https://psymed.info/all_quiz/zung-anxiety-scale/"
markdown_url: "https://psymed.info/all_quiz/zung-anxiety-scale.md"
excerpt: "The Zung Anxiety Scale is a classic 20-item questionnaire that measures how often you’ve experienced common anxiety symptoms, giving you a score for your overall anxiety severity. Formally called the Zung Self-Rating Anxiety Scale (SAS), it’s one of the most..."
taxonomy_category:
  - "Anxiety and Fear Disorders"
taxonomy_snax_format:
  - "Personality quiz"
---

[Take the test now](#begin-test-section)

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- **Published:** September 8, 2026

The **Zung Anxiety Scale** is a classic 20-item questionnaire that measures how often you’ve experienced common anxiety symptoms, giving you a score for your overall anxiety severity. Formally called the Zung Self-Rating Anxiety Scale (SAS), it’s one of the most established self-rating anxiety tests in clinical use. This free version reproduces the real scale, scores it instantly, and keeps your answers completely private.

Developed by the psychiatrist Dr. William W.K. Zung in 1971, the SAS has been used for decades in clinics, primary care, and research to gauge the intensity of anxiety symptoms. It’s a screening tool, not a diagnosis — but it gives a clear, structured snapshot of where your anxiety sits, and whether it may be worth discussing with a professional. Below you’ll find the full 20-item test, honest scoring, and what your result means.

This test is for understanding, not diagnosis. If anxiety is overwhelming you, or you’re having thoughts of harming yourself, you deserve support now — call or text **988** (Suicide & Crisis Lifeline, 24/7, free and confidential in the US). Feeling anxious is common and treatable, and reaching out is a good step.

## What Is the Zung Self-Rating Anxiety Scale?

The Zung Self-Rating Anxiety Scale (SAS) is a 20-item self-report questionnaire designed to quantify the severity of a person’s anxiety symptoms. It was created in 1971 by Dr. William W.K. Zung, a professor of psychiatry at Duke University, who wanted a simple, standardized way for people to rate their own anxiety that clinicians could use quickly and consistently. It became one of the most widely adopted anxiety measures in the world and is still used across mental health, primary care, and research settings today.

The scale works by asking how often you’ve experienced each of twenty specific symptoms recently, using a simple four-point frequency scale. Fifteen of the items describe anxiety symptoms directly, while five are worded in the opposite direction (describing calm or ease) and are reverse-scored — a deliberate design choice that helps counter the tendency to answer everything the same way. Your answers are added into a total score that maps onto a severity range, from normal to extreme.

## What the Zung Anxiety Scale Measures

The Zung SAS captures anxiety across four symptom domains, which together reflect how anxiety shows up in both mind and body. This breadth is part of why the scale has stayed useful: anxiety is rarely just “worry” — it lives in the nervous system.

- **Cognitive symptoms** — the mental experience of anxiety: nervousness, apprehension, fear that something bad will happen, panic, and a sense of falling apart.
- **Autonomic symptoms** — the body’s stress response: a racing or pounding heart, dizziness, faintness, flushing, and disrupted sleep.
- **Motor symptoms** — how anxiety moves through the body: trembling hands and limbs, restlessness, and body aches.
- **Central nervous system symptoms** — including tingling or numbness, weakness, fatigue, headaches, and digestive upset. By sampling all four, the scale reflects the full physical and mental footprint of anxiety rather than worry alone.

## Signs of Anxiety the Zung Scale Detects

The Zung Anxiety Scale screens for the everyday signs that anxiety may be elevated. As you read these, notice how many feel familiar over the past week or two — they’re the same experiences the 20 items ask about.

### Feeling nervous, fearful, or panicky

A frequent sense of being more nervous or anxious than usual, feeling afraid for no clear reason, or getting upset and panicky easily. This is the cognitive core of anxiety — the mind bracing for threat even when nothing specific is wrong.

### A racing or pounding heart

Noticing your heart beating fast or hard, sometimes with a sense of dizziness or faintness. These autonomic symptoms are among the most common and most frightening features of anxiety, and they’re often what drives people to seek help.

### Trembling, shaking, or restlessness

Hands or limbs that shake or tremble, and a physical restlessness that makes it hard to sit still or feel settled. Anxiety is an activating state, and the body often shows it before the mind names it.

### Physical aches and tension

Headaches, neck and back pain, muscle tightness, and general fatigue or weakness. Chronic anxiety keeps the body in a low-grade state of tension that wears it down over time.

### Tingling, numbness, or “pins and needles”

Feelings of numbness or tingling in the fingers and toes, a classic nervous-system sign of anxiety and over-breathing that can feel alarming but is very common.

### Stomach upset and frequent urination

Digestive discomfort, indigestion, or needing to empty your bladder often. The gut and bladder are highly sensitive to the body’s stress response, so anxiety frequently shows up there.

### Disrupted sleep and nightmares

Trouble falling asleep or getting restful sleep, and distressing dreams or nightmares. Anxiety and sleep have a two-way relationship — each one worsens the other, which is why sleep is one of the scale’s telling items.

## How the Zung Anxiety Scale Is Scored

Your Zung SAS score is the sum of your answers to all 20 items, producing a raw total between 20 and 80 — the higher the number, the greater your anxiety symptoms. Each item is rated on a four-point frequency scale, and the total is matched to one of four severity ranges.

Each item scores from 1 to 4: **a little of the time = 1, some of the time = 2, a good part of the time = 3, most of the time = 4.** For the five reverse-worded items (which describe calm rather than anxiety), the scoring is flipped, so that answering “most of the time” earns the lowest anxiety points. Because every item contributes at least 1 point, the lowest possible total is 20, not 0.

The raw total is interpreted using Zung’s severity ranges: **20–44 normal, 45–59 mild to moderate, 60–74 marked to severe, and 75–80 extreme.** (Zung also described converting the raw score into an “Anxiety Index” using the formula raw ÷ 80 × 100; the severity labels on this page are applied to the raw score, which is the convention used in most clinical and research reproductions of the scale.) Remember that this is a screening measure — it indicates the intensity of symptoms, not a diagnosis.

## Take the Zung Anxiety Scale

Answer each of the 20 statements based on how you’ve felt over the **past week or two**, choosing the frequency that fits best. Be honest rather than optimistic — the scale only helps if it reflects your real experience.

## Understanding Your Zung Anxiety Scale Score

Your total score falls into one of four ranges, each reflecting a different level of anxiety symptom severity. Find your total below.

| Raw Score | Anxiety Level | What It Suggests |
| --- | --- | --- |
| 20 – 44 | Normal Range | Anxiety symptoms are within the normal range and not currently at a clinically significant level. |
| 45 – 59 | Mild to Moderate | Mild to moderate anxiety is present and may be worth attention, self-care, and possibly professional support. |
| 60 – 74 | Marked to Severe | Marked to severe anxiety symptoms. Speaking with a mental health professional is strongly recommended. |
| 75 – 80 | Extreme | Extreme anxiety symptoms. Professional evaluation and support are important next steps. |

## Zung Anxiety Scale vs. Other Anxiety Tests

The Zung SAS is one of several well-established anxiety measures, and knowing how it differs helps you choose the right one. Its distinctive feature is a strong emphasis on the physical (somatic) symptoms of anxiety, alongside the mental ones.

| Test | Items | Best For |
| --- | --- | --- |
| Zung Anxiety Scale (SAS) | 20 | A broad snapshot of anxiety severity, with strong coverage of physical symptoms |
| GAD-7 | 7 | A quick, modern screen focused on generalized anxiety and worry |
| General anxiety screening | Varies | A broad starting point across different anxiety types |

If you’d like a shorter, worry-focused screen, our [Generalized Anxiety Disorder (GAD-7) Test](https://psymed.info/all_quiz/generalized-anxiety-disorder-test/)
 is a good companion, and our broader [anxiety test](https://psymed.info/all_quiz/anxiety-test/)
 is a helpful starting point if you’re not sure where to begin. Because anxiety often travels with specific fears, you might also look at our [social anxiety test](https://psymed.info/all_quiz/social-anxiety-test/)
 or [panic disorder test](https://psymed.info/all_quiz/panic-disorder-test/)
.

## What to Do If Your Score Is Elevated

An elevated Zung score means your anxiety symptoms are frequent or intense enough to deserve attention — and the good news is that anxiety is one of the most treatable mental health concerns. Effective help ranges from self-directed strategies to professional care, and often a combination works best.

**Talk to a professional.** A doctor or therapist can assess what’s happening and discuss options. Cognitive Behavioral Therapy (CBT) has strong evidence for anxiety, helping you identify and shift the thought patterns and behaviors that fuel it. For some people, medication is a helpful part of treatment, decided with a prescribing doctor.

**Use self-help strategies.** Regular physical activity, consistent sleep, reduced caffeine and alcohol, and daily relaxation practices (slow breathing, progressive muscle relaxation, mindfulness) all measurably lower anxiety. **Address the whole picture.** Anxiety often co-occurs with low mood, so if you’ve also been feeling persistently down, our [depression test](https://psymed.info/all_quiz/clinical-depression-test/)
 may be worth taking. And be patient and kind with yourself — recovery from anxiety is usually gradual, and setbacks are a normal part of it.

## Frequently Asked Questions

### What is the Zung Anxiety Scale?

The Zung Anxiety Scale, formally the Zung Self-Rating Anxiety Scale (SAS), is a 20-item self-report questionnaire that measures the severity of a person’s anxiety symptoms. It was developed in 1971 by Dr. William W.K. Zung, a psychiatrist at Duke University, and has been widely used ever since in clinical, primary care, and research settings. Each item asks how often you’ve experienced a particular anxiety symptom, and your answers are summed into a total score that reflects your anxiety severity, from normal to extreme. It covers both the mental and physical symptoms of anxiety, and it’s designed as a screening tool rather than a diagnostic test.

### How is the Zung Anxiety Scale scored?

Each of the 20 items is rated from 1 to 4 based on frequency (“a little of the time” up to “most of the time”), producing a raw total between 20 and 80. Fifteen items are scored directly, while five positively-worded items (numbers 5, 9, 13, 17, and 19) are reverse-scored.

The total is then interpreted using Zung’s ranges: 20–44 is normal, 45–59 is mild to moderate anxiety, 60–74 is marked to severe, and 75–80 is extreme. Zung also described converting the raw score to an “Anxiety Index” by dividing by 80 and multiplying by 100, but most clinical use applies the severity labels to the raw score, as this test does. Higher scores indicate more frequent and intense anxiety symptoms.

### Is the Zung Anxiety Scale accurate and reliable?

The Zung SAS has been studied extensively over more than fifty years and has demonstrated good reliability and validity as a measure of anxiety symptom severity across many populations and settings. It remains a respected, evidence-based screening instrument. That said, like any self-report questionnaire, it reflects how you rate yourself on a given day, which can be influenced by mood and circumstances, and it’s designed for adults rather than children or, without adaptation, older adults. It’s also a screening tool, not a diagnostic one — a high score signals that anxiety is worth evaluating professionally, but only a qualified clinician can diagnose an anxiety disorder.

### Is a high Zung score the same as having an anxiety disorder?

No. A high score on the Zung Anxiety Scale indicates that you’re experiencing frequent or intense anxiety symptoms, but it is not a diagnosis of an anxiety disorder. Diagnosis requires a comprehensive evaluation by a qualified professional, who considers your history, the duration and context of your symptoms, how much they affect your life, and other possible explanations. What a high score does tell you is that your anxiety is significant enough to be worth taking seriously and discussing with a doctor or therapist. Think of the scale as a helpful signal that points toward getting a proper assessment, not as the assessment itself.

### How often can I take the Zung Anxiety Scale?

You can take it as often as is useful. In fact, one of the scale’s strengths is that it’s well suited to tracking anxiety over time — clinicians often use it to monitor whether symptoms are improving with treatment. You might retake it every few weeks to see how you’re doing, particularly if you’ve started therapy, medication, or new self-care strategies. Just try to answer based on the same recent time frame each time (the past week or two) so your scores are comparable. If you notice your scores climbing, or staying high, that’s a useful prompt to reach out for support.

### What’s the difference between the Zung Anxiety Scale and the GAD-7?

Both are well-validated anxiety screening tools, but they differ in length and focus. The Zung SAS has 20 items and casts a wide net across both the mental and physical (somatic) symptoms of anxiety — things like heart palpitations, trembling, and stomach upset feature prominently. The GAD-7 is a shorter, more modern seven-item scale focused specifically on generalized anxiety and worry over the past two weeks. The GAD-7 is quicker and is very commonly used in primary care; the Zung SAS gives a broader picture, especially of how anxiety shows up in the body. Neither is “better” — they’re suited to slightly different purposes, and some people find it useful to take both.

## Related Tests

- [GAD-7 Anxiety Test](https://psymed.info/all_quiz/generalized-anxiety-disorder-test/) — a shorter, worry-focused modern anxiety screen; a natural companion to the Zung SAS
- [Anxiety Test](https://psymed.info/all_quiz/anxiety-test/) — a broad starting point if you’re not sure which anxiety test fits
- [Social Anxiety Test](https://psymed.info/all_quiz/social-anxiety-test/) — for anxiety centered on social situations and fear of judgment
- [Panic Disorder Test](https://psymed.info/all_quiz/panic-disorder-test/) — for sudden, intense episodes of fear and physical panic symptoms
- [Depression Test](https://psymed.info/all_quiz/clinical-depression-test/) — anxiety and depression often occur together; worth checking if your mood has also been low
- [PTSD Test](https://psymed.info/all_quiz/ptsd-test/) — if your anxiety is connected to a traumatic experience

## References

1. Zung, W.W.K. (1971). A rating instrument for anxiety disorders. *Psychosomatics, 12*(6), 371–379. [The original paper introducing the Self-Rating Anxiety Scale] [pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/5172928/)
2. Dunstan, D.A., & Scott, N. (2020). Norms for Zung’s Self-rating Anxiety Scale. *BMC Psychiatry, 20*, 90. [Contemporary norms, cut-offs, and the raw-vs-index scoring issue] [ncbi.nlm.nih.gov](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7048044/)
3. American Psychological Association. Anxiety. [Overview of anxiety and its treatment] [apa.org](https://www.apa.org/topics/anxiety)
4. National Institute of Mental Health. Anxiety Disorders. [Symptoms, types, and evidence-based treatment] [nimh.nih.gov](https://www.nimh.nih.gov/health/topics/anxiety-disorders)

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