Rasch analysis of the structural validity of the anxiety symptom scale in the lolland-falster health study

•The Anxiety Symptom Scale (ASS) is used to screen for anxiety disorders in general practice, but the ASS has not yet been validated.•The ASS seems a promising tool for measuring anxiety, but the reliability is low.•The low reliability is likely to be caused by poor alignment between the ASS and the population studied.•Future research should evaluate the ASS in clinical settings.