Table of Contents
Instructions:
Please read each statement and select from “Not at all” to “Nearly every day” to indicate how much the statement applied to you over the past two weeks.
| Not at all | Several days | More than half the days | Nearly every day | ||
| Feeling nervous, anxious or on edge | 0 | 1 | 2 | 3 | |
| Not being able to stop or control worrying | 0 | 1 | 2 | 3 | |
| Worrying too much about different things | 0 | 1 | 2 | 3 | |
| Trouble relaxing | 0 | 1 | 2 | 3 | |
| Being so restless that it is hard to sit still | 0 | 1 | 2 | 3 | |
| Becoming easily annoyed or irritable | 0 | 1 | 2 | 3 | |
| Feeling afraid as if something awful might happen | 0 | 1 | 2 | 3 | |
Description
The GAD-7 is a brief measure of symptoms of anxiety, based on the generalized anxiety disorder diagnostic criteria described in DSM-IV. This assessment asks patients to evaluate their level of symptoms over the last two weeks and can be used to track treatment progress over time. Given the simple language used in the assessment it is appropriate for individuals as young as 14 years. When used as a screening tool, further evaluation is recommended when the score is 10 or greater. Using the threshold score of 10, the GAD-7 has a sensitivity of 89% and a specificity of 82% for generalized anxiety disorder. It is moderately good at screening three other common anxiety disorders – panic disorder (sensitivity 74%, specificity 81%), social anxiety disorder (sensitivity 72%, specificity 80%), and post-traumatic stress disorder (sensitivity 66%, specificity 81%) (Kroenke, et al. 2007).
Validity and Reliability
Lowe et al. (2008) investigated the validity and reliability of the GAD-7. Confirmatory factor analyses substantiated the 1-dimensional structure of the GAD-7. Internal consistency was identical across all subgroups (alpha = 0.89). Intercorrelations with the PHQ-2 and the Rosenberg Self-Esteem Scale were r = 0.64 (P < 0.001) and r = -0.43 (P < 0.001), respectively. As expected, women had significantly higher mean (SD) GAD-7 anxiety scores compared with men [3.2 (3.5) vs. 2.7 (3.2); P < 0.001]. Approximately 5% of subjects had GAD-7 scores of 10 or greater, and 1% had GAD-7 scores of 15 or greater. Norms were developed by Lowe et al. (2008) with a German sample of 5030 subjects (53.6% female) with a mean age (SD) of 48.4 (18.0) years.
Interpretation
A raw score (from 0 to 21) is presented as well as a percentile rank based on the Lowe et al. (2008) community sample. Given that females score slightly higher than males, a percentile for each gender is presented – the appropriate gender percentile should be selected for interpretation.
Developer
Number Of Questions
7
References
Kroenke K, Spitzer RL, Williams JB, et al; anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med. 2007:146(5):317-25.
Löwe, B., Decker, O., Müller, S., Brähler, E., Schellberg, D., Herzog, W., & Herzberg, P. Y. (2008). Validation and standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the general population. Medical care, 46(3), 266.