Generalized Anxiety Disorder 7

The GAD-7 has seven items, which measure severity of various signs of GAD according to reported response categories with assigned points. The GAD-7 items include:

1. Nervousness
2. Inability to stop worrying
3. Excessive worry
4. Restlessness
5. Difficulty in relaxing
6. Easy irritation
7. Fear of something awful happening{{cite journal | vauthors = Zhong QY, Gelaye B, Zaslavsky AM, Fann JR, Rondon MB, Sánchez SE, Williams MA | title = Diagnostic Validity of the Generalized Anxiety Disorder - 7 (GAD-7) among Pregnant Women | journal = PLOS ONE | volume = 10 | issue = 4 | pages = e0125096 | date = 2015-04-27 | pmid = 25915929 | pmc = 4411061 | doi = 10.1371/journal.pone.0125096 | bibcode = 2015PLoSO..1025096Z | doi-access = free }}

Response options range from “not at all” (= 0 points), “several days” (= 1 point), “more than half the days” (= 2 points), and “nearly every day” (= 3 points) with a score range from 0-21 points.

The assessment is indicated by the total score, which is made up by adding together the scores for the scale of all seven items, with responses getting 0 to 3 points:

• Not at all (0 points)
• Several days (1 point)
• More than half the days (2 points)
• Nearly every day (3 points){{cite journal | vauthors = Swinson RP | title = The GAD-7 scale was accurate for diagnosing generalised anxiety disorder | journal = Evidence-Based Medicine | volume = 11 | issue = 6 | pages = 184 | date = December 2006 | pmid = 17213178 | doi = 10.1136/ebm.11.6.184 | s2cid = 42283551 }}

The normative data enable users of the GAD-7 to discern whether an individual's anxiety score is normal, or mildly, moderately, or severely elevated.{{cite journal | vauthors = Löwe B, Decker O, Müller S, Brähler E, Schellberg D, Herzog W, Herzberg PY | title = Validation and standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the general population | journal = Medical Care | volume = 46 | issue = 3 | pages = 266–274 | date = March 2008 | pmid = 18388841 | doi = 10.1097/MLR.0b013e318160d093 | s2cid = 16052239 | jstor = 40221654 }} However, while the GAD-7 seem to be able to provide probable cases of GAD, it cannot be used as replacement for clinical assessment and additional evaluation should be used to confirm a diagnosis of GAD.{{cite book | vauthors = Dugas MJ, Charette CA, Gervais NJ |editor-first1=John |editor-first2=Eric J. |editor-last1=Hunsley |editor-last2=Mash |title=A Guide to Assessments That Work |chapter=Generalized Anxiety Disorder | edition = 2nd |date=2018 |pages=293–310 |publisher=Oxford University Press |doi=10.1093/med-psych/9780190492243.003.0014 |isbn=978-0-19-049224-3 }}

The GAD-7 was originally validated in a primary care sample and a cutoff score of 10 (which the authors considered optimal) had a sensitivity value of 0.89 and a specificity value of 0.82 for identifying GAD. The authors of the questionnaire also found acceptable sensitivity and specificity values when the questionnaire was used as a general screen to identify other anxiety disorders (Panic Disorder, Social Anxiety, and PTSD) (GAD-7, score ≥ 8: sensitivity: 0.77, specificity: 0.82).{{cite journal | vauthors = Plummer F, Manea L, Trepel D, McMillan D | title = Screening for anxiety disorders with the GAD-7 and GAD-2: a systematic review and diagnostic metaanalysis | journal = General Hospital Psychiatry | volume = 39 | pages = 24–31 | date = 2016-03-01 | pmid = 26719105 | doi = 10.1016/j.genhosppsych.2015.11.005 }}

The GAD-7 has further been studied and validated in numerous other samples and settings.{{cite journal | vauthors = Kroenke K, Spitzer RL, Williams JB, Löwe B | title = The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: a systematic review | journal = General Hospital Psychiatry | volume = 32 | issue = 4 | pages = 345–359 | date = 2010-07-01 | pmid = 20633738 | doi = 10.1016/j.genhosppsych.2010.03.006 }} It has been shown to correlate with other measures of anxiety and has been considered superior to other questionnaires.{{cite journal | vauthors = Dear BF, Titov N, Sunderland M, McMillan D, Anderson T, Lorian C, Robinson E | title = Psychometric comparison of the generalized anxiety disorder scale-7 and the Penn State Worry Questionnaire for measuring response during treatment of generalised anxiety disorder | journal = Cognitive Behaviour Therapy | volume = 40 | issue = 3 | pages = 216–227 | date = September 2011 | pmid = 21770844 | doi = 10.1080/16506073.2011.582138 }}{{cite journal | vauthors = Simpson W, Glazer M, Michalski N, Steiner M, Frey BN | title = Comparative efficacy of the generalized anxiety disorder 7-item scale and the Edinburgh Postnatal Depression Scale as screening tools for generalized anxiety disorder in pregnancy and the postpartum period | journal = Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie | volume = 59 | issue = 8 | pages = 434–440 | date = August 2014 | pmid = 25161068 | pmc = 4143300 | doi = 10.1177/070674371405900806 }}{{cite journal | vauthors = Peters L, Peters A, Andreopoulos E, Pollock N, Pande RL, Mochari-Greenberger H | title = Comparison of DASS-21, PHQ-8, and GAD-7 in a virtual behavioral health care setting | journal = Heliyon | volume = 7 | issue = 3 | pages = e06473 | date = March 2021 | pmid = 33817367 | pmc = 8010403 | doi = 10.1016/j.heliyon.2021.e06473 | doi-access = free | bibcode = 2021Heliy...706473P }} The GAD-7 has been evaluated in samples of both children and young individuals{{cite journal | vauthors = Guzick A, Storch EA, Smárason O, Minhajuddin A, Drummond K, Riddle D, Hettema JM, Mayes TL, Pitts S, Dodd C, Trivedi MH | title = Psychometric properties of the GAD-7 and PROMIS-Anxiety-4a among youth with depression and suicidality: Results from the Texas youth depression and suicide research network | journal = Journal of Psychiatric Research | volume = 170 | pages = 237–244 | date = February 2024 | pmid = 38169247 | doi = 10.1016/j.jpsychires.2023.12.033 }} as well as older adults.{{cite journal | vauthors = Wild B, Eckl A, Herzog W, Niehoff D, Lechner S, Maatouk I, Schellberg D, Brenner H, Müller H, Löwe B | title = Assessing generalized anxiety disorder in elderly people using the GAD-7 and GAD-2 scales: results of a validation study | journal = The American Journal of Geriatric Psychiatry | volume = 22 | issue = 10 | pages = 1029–1038 | date = October 2014 | pmid = 23768681 | doi = 10.1016/j.jagp.2013.01.076 }} It has been used in more than 2500 peer reviewed publications indexed in PubMed (current search [https://pubmed.ncbi.nlm.nih.gov/?term=%28%22anxiety%22%5BMeSH+Terms%5D+OR+%22anxiety%22%5BAll+Fields%5D+OR+%22anxieties%22%5BAll+Fields%5D+OR+%22anxiety+s%22%5BAll+Fields%5D%29+AND+%22gad7%22%5BAll+Fields%5D&sort= here]). The consensus is that it can efficient tool for screening for GAD and assessing its severity in clinical practice and research.{{cite journal | vauthors = Spitzer RL, Kroenke K, Williams JB, Löwe B | title = A brief measure for assessing generalized anxiety disorder: the GAD-7 | journal = Archives of Internal Medicine | volume = 166 | issue = 10 | pages = 1092–1097 | date = May 2006 | pmid = 16717171 | doi = 10.1001/archinte.166.10.1092 | doi-access = free }}{{Cite journal |last1=Spitzer |first1=Robert L. |last2=Kroenke |first2=Kurt |last3=Williams |first3=Janet B. W. |last4=Löwe |first4=Bernd |date=2006-05-22 |title=A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7 |url=https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/410326 |journal=Archives of Internal Medicine |volume=166 |issue=10 |pages=1092–1097 |doi=10.1001/archinte.166.10.1092 |pmid=16717171 |issn=0003-9926|url-access=subscription }} A meta-analysis found that it achieved acceptable accuracy at a cutoff point of 8 (sensitivity of 0.83, specificity: 0.84, pooling 12 samples and 5223 participants).{{cite journal | vauthors = Plummer F, Manea L, Trepel D, McMillan D | title = Screening for anxiety disorders with the GAD-7 and GAD-2: a systematic review and diagnostic metaanalysis | journal = General Hospital Psychiatry | volume = 39 | pages = 24–31 | date = 2016 | pmid = 26719105 | doi = 10.1016/j.genhosppsych.2015.11.005 }}

The use of sumscores (i.e. summing the scores of each item) is supported by psychometric studies in some contexts, but using techniques based on factor analysis are deemed more precise.{{cite journal | vauthors = De Man J, Absetz P, Sathish T, Desloge A, Haregu T, Oldenburg B, Johnson LC, Thankappan KR, Williams ED | title = Are the PHQ-9 and GAD-7 Suitable for Use in India? A Psychometric Analysis | journal = Frontiers in Psychology | volume = 12 | pages = 676398 | date = 2021-05-13 | pmid = 34054677 | pmc = 8155718 | doi = 10.3389/fpsyg.2021.676398 | doi-access = free }}

• Diagnostic classification and rating scales used in psychiatry
• Patient Health Questionnaire

• {{official website|https://www.phqscreeners.com/}}

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Category:Anxiety screening and assessment tools