Definition
The GAD-7 (Generalized Anxiety Disorder-7) is a seven-item self-report instrument developed by Spitzer, Kroenke, Williams, and Lowe (2006) to screen for generalized anxiety disorder (GAD) and monitor anxiety symptom severity. Each item is scored from 0 (not at all) to 3 (nearly every day), with a total score of 0 to 21.
Cut-off scores
| Score | Severity |
|---|---|
| 0-4 | Minimal or no anxiety |
| 5-9 | Mild anxiety |
| 10-14 | Moderate anxiety |
| 15-21 | Severe anxiety |
A cut-off of 10 or above has 89% sensitivity and 82% specificity for generalized anxiety disorder (Spitzer et al., 2006).
When it is used
- When the primary complaint includes excessive and hard-to-control worry, chronic muscle tension, irritability without apparent cause, or difficulty relaxing.
- To differentiate anxiety symptoms from depressive symptoms in mixed presentations (in combination with the PHQ-9).
- In treatment follow-up for generalized anxiety disorder.
- As initial screening in primary care or general psychology.
When it is not sufficient on its own
The GAD-7 is designed specifically for generalized anxiety disorder. It has moderate sensitivity for other anxiety disorders (74% for panic disorder, 72% for social anxiety disorder), but does not assess them with the same precision. For differential assessment of anxiety disorders, specific scales are used (PDSS for panic, SPIN for social anxiety, PCL-5 for PTSD).
Combined use with PHQ-9
Depression-anxiety comorbidity exceeds 50% in clinical populations. Administering both scales at the start of the process and at periodic reviews provides a complete picture of the symptomatic presentation and allows tracking of how each dimension evolves independently with treatment.
Example of use in session
An HR professional uses the GAD-7 in a wellbeing assessment interview with an executive who reports difficulty "turning the mind off" outside work. The executive scores 12 (moderate). The professional uses this result as a basis for a psychology referral, documenting the score and context in their report.
How CauceOS supports this
CauceOS allows GAD-7 results to be recorded within the session flow and linked to the clinical note or post-session report. The score and date are stored for longitudinal client tracking.
References
- Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Lowe, B. (2006). A brief measure for assessing generalized anxiety disorder. Archives of Internal Medicine, 166, 1092-1097.
- Kroenke, K., Spitzer, R. L., Williams, J. B. W., Monahan, P. O., & Lowe, B. (2007). Anxiety disorders in primary care: Prevalence, impairment, comorbidity, and detection. Annals of Internal Medicine, 146, 317-325.