A guide to the GAD-7 assessment

About the GAD-7 Assessment

Recommended Frequency: every 2 weeks

The GAD-7 was created in 2006 by Robert L. Spitzer, MD, and colleagues to address the lack of brief clinical measures for assessing generalized anxiety disorder (GAD).

Today, the GAD-7 is one of the most commonly-used measures for evaluating anxiety and the efficacy of treatment. While the GAD-7 was originally developed for use with adult patients (18+), it has also shown success with adolescents (ages 14-17).

As it was developed, the GAD-7 was shaped based on the nine-symptom criteria for generalized anxiety disorder as listed in the DSM-IV. The authors of the instrument began by identifying nine items, each of which corresponded to symptom criteria in the DSM-IV, and adding an additional four items based on other common anxiety scales.

This initial 13-item scale was later reduced to the seven-item scale we use today after further research into the assessment’s reliability.

GAD-7 Confidence Intervals

The authors of the GAD-7 recommended a cut-off score of 10, which demonstrated a sensitivity of 89% and specificity of 82% for generalized anxiety disorder. In other words, a score of 10 or higher is a probable indication of a potential GAD diagnosis.

Specificity and sensitivity rates for other common anxiety disorders are as follows:

• Panic Disorder – sensitivity 74%, specificity 81%
• Social Anxiety Disorder – sensitivity 72%, specificity 80%
• Post-Traumatic Stress Disorder – sensitivity 66%, specificity 81%

In cases where other mental health challenges are present, adding more precise measures to support clients’ individual needs can improve clinical outcomes even further.

For instance, if a client shows signs of anxiety, but you believe they may be linked to panic disorder, adding a measure specific to it can ensure your assessments are more sensitive to the symptoms unique to each condition.

Who is the GAD-7 for?

The GAD-7 may be a good fit for patients or clients who are:

• 14+ years of age
• Experiencing symptoms of anxiety
• Diagnosed with another mental health condition, such as depression, substance use disorders, etc.

GAD-7 Scale

The GAD-7 is designed to be a quick, easy assessment that can be completed regularly. Its scale asks respondents how often, over the past two weeks, they have been bothered by specific items.

Below is an example of the GAD-7 scale as it would appear during assessment:

Over the last 2 weeks, how often have you been bothered by the following problems?

After each column is totaled, all four scores are added together to reach the total, which will be scored to measure anxiety severity. While the GAD-7 is a self-report measure, its questions can be read to patients by providers and non-clinical staff.

And, although the scale has been developed to be easy to understand, it may be wise to review its questions with patients before they complete it for the first time. It also can be beneficial to routinely check in with patients to monitor their thoughts about questions and their answers over time.

Understanding GAD-7 Scoring

The total score from the assessment can range from zero to 21, depending on a patient’s responses in each category. The following cut-offs can be used to identify the severity of a patient’s anxiety:

While the authors of the measure recommend a cut-point of 10 for identifying probable cause of GAD, more recent research suggests that a score of 8 optimizes sensitivity without compromising specificity.

So, when screening for generalized anxiety disorder, a score of 8 or higher may indicate that a patient meets diagnostic criteria. Further assessments may be warranted to determine the type of anxiety disorder present.

GAD-7 & Other Clinical Assessments with Linear Health

Patient-reported questionnaires like the GAD-7 are powerful instruments to have in your arsenal as a treatment provider. Not only do they prompt regular reviews of patient health outcomes, but they also enable you to clearly measure the efficacy of the care you provide.

Make regular clinical assessments a reality for your organization without creating undue administrative burdens with Linear Health. 

Our patient communication and engagement platform is built to leverage digital clinical assessments, which you can securely send to and receive from patients as needed. Save time during in-person appointments by asking patients to complete their assessments ahead of time, or make them accessible whenever you’d like.

Start driving better outcomes and a more engaging experience for your patients today with Linear Health. Reach out today to schedule your demo.