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Given their applicability in diverse settings and for a wide range of purposes, the generalizability of self-report symptom measures is particularly important. An understudied factor in the development and validation of self-report measures is the degree to which they are difficult to comprehend. This study evaluated the difficulty of self-report measures of anxiety with respect to several domains, including formatting, length, and linguistic problems.Ninety-two evidence based measures of anxiety were evaluated for comprehension level.The majority of anxiety measures included challenging elements of formatting, linguistic ability, and readability. Measures of obsessive–compulsive disorder were associated with the highest level of comprehension (i.e., greatest difficulty).The validity of self-report measures relies on the ability of respondents to understand the instructions and measure items. Factors related to the comprehension of self-report measures should be included among the basic psychometric properties in measure development and validation. Future research on the development of self-report measures that can be more broadly applicable across levels of education and literacy are of particular importance to research, clinical, and public health agendas. Depression and Anxiety, 2011. © 2011 Wiley-Liss, Inc.