New Study Develops Transdiagnostic Hyperarousal Dimensions Questionnaire for Mental Health Assessment

Researchers have identified seven distinct dimensions of hyperarousal and developed a new questionnaire to standardize its assessment across multiple mental health disorders. The Transdiagnostic Hyperarousal Dimensions Questionnaire (THDQ) is a 27-item tool designed to measure hyperarousal consistently in conditions such as insomnia, depression, anxiety, posttraumatic stress disorder, and attention deficit/hyperactivity disorder.

The development of the THDQ addresses a long-standing challenge in mental health research and clinical practice: hyperarousal has been a key symptom in the severity of several disorders, but it has been measured using different questionnaires across conditions, making comparisons and integrated understanding difficult. By creating a unified tool, researchers aim to improve diagnostic precision and support personalized treatment approaches.

The questionnaire was validated with a sample of 592 participants and demonstrated strong reliability, with a Cronbach’s alpha of 0.90. It also maintained consistency in measurements when tested again a year after initial administration, indicating stability over time.

According to study author Tom Bresser, the goal of the research was to better understand hyperarousal and how It’s measured in different mental disorders. He noted that despite its recognized role in multiple conditions, hyperarousal had remained a loosely defined construct assessed with varying tools.

The THDQ framework could facilitate large-scale studies using existing data resources, such as the UK Biobank, by providing a standardized method for assessing hyperarousal across diverse populations. Researchers suggest the tool may help streamline diagnosis and enable more targeted interventions based on individual hyperarousal profiles.

Hyperarousal refers to a heightened state of physiological and emotional activation in which the body’s “fight-or-flight” response remains active beyond immediate threats. Symptoms associated with hyperarousal include hypervigilance, exaggerated startle responses, sleep difficulties, irritability, palpitations, and sensory sensitivity.

The study was published in eClinicalMedicine in 2026 and represents a step toward a more transdiagnostic approach in mental health assessment, focusing on underlying biological and psychological processes that cut across traditional disorder categories.