Overview
The Generalised Anxiety Disorder Assessment (GAD-7) is a seven-item instrument that is used to measure or assess the severity of generalised anxiety disorder (GAD). Each item asks the individual to rate the severity of his or her symptoms over the past two weeks. Response options include “not at all”, “several days”, “more than half the days” and “nearly every day”.
Terms of use
The GAD-7 is free to use. For more information see Pfizer's terms of use: https://www.phqscreeners.com/terms
Scales and subscales
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How are things? Questionnaire: https://www.corc.uk.net/media/1211/gad-7-how-are-things.pdf
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How are things? Clinical bands: https://www.corc.uk.net/media/1210/gad-7_clinicalbands_selfreport16plus.pdf
Suitability
The GAD-7 has been validated for primary care patients, general population, and adolescents with GAD (Mossman et al., 2018, found that GAD-7 scores may be used to assess anxiety symptoms and to differentiate between mild and moderate GAD in adolescents).
Administration
The GAD-7 is a self-administered patient questionnaire and it takes about 1-2 minutes to complete.
Working remotely with GAD-7
GAD-7 and translations are downloadable from this website and no permission is required to reproduce, translate, display or distribute them. That's why you can find many online versions of GAD-7 in your internet search.
Scoring
The GAD-7 score is calculated by assigning scores of 0, 1, 2, and 3, to the response categories of “not at all,” “several days,” “more than half the days,” and “nearly every day,” respectively, and then adding together the scores for the seven questions.
GAD-7 total score for the seven items ranges from 0 to 21.
Interpretation
Scores of 5, 10, and 15 represent cut-points for mild, moderate, and severe anxiety, respectively.
When used as a screening tool, further evaluation is recommended when the score is 10 or greater.
Normative data for the GAD-7 were generated for boys and girls, and different age levels (see Löwe et al., 2008).
Psychometric properties
| Property | Definition | GAD-7 |
| Internal consistency | Whether several items that propose to measure the same general construct produce similar score. | Research indicates the GAD-7 shows excellent internal consistency (Spitzer, Kroenke, Williams, & Löwe, 2006) |
| Test-retest reliability | Degree to which the same respondents have the same score after a period when a trait should not have changed. | The GAD-7 shows good test-retest reliability (Spitzer et al., 2006) |
| Criterion validity | Extent to which a measure is related to an outcome | The GAD-7 is a useful tool with strong criterion validity for identifying possible cases of GAD (Spitzer et al., 2006) |
| Construct validity | Degree to which a test measures what it claims, or purports, to be measuring | Löwe et al. (2008) substantiated the 1-dimensional structure of the GAD-7 and its factorial invariance for gender and age. |
| Concurrent validity | If a measure correlates well with a measure that has previously been validated | The GAD-7 yielded significant intercorrelations with the PHQ-2 and the Rosenberg Self-Esteem Scale (Löwe et al., 2008) |
| Convergent validity | Degree to which two measures of constructs that theoretically should be related, are in fact related. | Higher GAD-7 scores correlate with disability and functional impairment (in measures such as work productivity and health care utilization) (Spitzer et al., 2006; Ruiz et al., 2011) |
Translation
The GAD-7 is available in various languages. To access GAD-7 in other languages, visit this website: https://www.phqscreeners.com/ and select the language from the drop-down menu.
Useful Resources
Instruction manual including information on the GAD-7: https://phqscreeners.pfizer.edrupalgardens.com/sites/g/files/g10016261/f/201412/instructions.pdf
References
Spitzer, R. L., Kroenke, K., Williams, J. B., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of Internal Medicine, 166(10), 1092-1097.
Löwe, B., Decker, O., Muller, S., Brahler, E., Schellburg, D., Herzog, W. & Herzberg, PY. (2008). Validation and standardisation of the GAD-7. Medical Care, 46(3), 266-274, DOI: 10.1097/MLR.0b013e318160d093
Mossman, S. A., Luft, M. J., Schroeder, H. K., Varney, S. T., Fleck, D. E., Barzman, D. H., … Strawn, J. R. (2017). The Generalized Anxiety Disorder 7-item scale in adolescents with generalized anxiety disorder: Signal detection and validation. Annals of clinical psychiatry: official journal of the American Academy of Clinical Psychiatrists, 29(4), 227–234A.
Ruiz, M., Zamorano, E., García-Campayo, J., Pardo, A., Freire, O., & Rejas, J. (2011). Validity of the GAD-7 scale as an outcome measure of disability in patients with generalized anxiety disorders in primary care. Journal of Affective Disorders, 128(3), 277-286