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. 2017 Nov;29(4):227-234A.

The Generalized Anxiety Disorder 7-item scale in adolescents with generalized anxiety disorder: Signal detection and validation

Sarah A Mossman, Marissa J Luft, Heidi K Schroeder, Sara T Varney, David E Fleck, Drew H Barzman, Richard Gilman, Melissa P DelBello, Jeffrey R Strawn  1
Affiliations

The Generalized Anxiety Disorder 7-item scale in adolescents with generalized anxiety disorder: Signal detection and validation

Sarah A Mossman et al. Ann Clin Psychiatry. 2017 Nov.

Abstract

Background: In pediatric patients with anxiety disorders, existing symptom inventories are either not freely available or require extensive time and effort to administer. We sought to evaluate a brief self-report scale-the Generalized Anxiety Disorder 7-item scale (GAD-7)-in adolescents with generalized anxiety disorder (GAD).

Methods: The Pediatric Anxiety Rating Scale (PARS) and the GAD-7 were administered to youth with GAD (confirmed by structured interview). Relationships between the measures were assessed, and sensitivity and specificity was determined with regard to a global symptom severity measure (Clinical Global Impression-Severity).

Results: In adolescents with GAD (N = 40; mean age, 14.8 ± 2.8), PARS and GAD-7 scores strongly correlated (R = 0.65, P ≤ .001) and a main effect for symptom severity was observed (P ≤ .001). GAD-7 scores ≥11 and ≥17 represented the optimum specificity and sensitivity for detecting moderate and severe anxiety, respectively.

Conclusions: The PARS and GAD-7 similarly reflect symptom severity. The GAD-7 is associated with acceptable specificity and sensitivity for detecting clinically significant anxiety symptoms. GAD-7 scores may be used to assess anxiety symptoms and to differentiate between mild and moderate GAD in adolescents, and may be more efficient than the PARS.

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Conflict of interest statement

Disclosures: The other authors report no biomedical conflicts of interest.

Figures

FIGURE 1
FIGURE 1. GAD-7 scores and Clinical Global Impression-Severity (CGI-S) scores
Frequency plots of GAD-7 scores with regard to Clinical Global Impression-Severity (CGI-S) scores in adolescents with GAD. Red bars indicate CGI-S scores of 1–3, green bars represent CGI-S scores of 4 and 5 and blue bars represent CGI-S scores of 6 and 7.
FIGURE 2
FIGURE 2. GAD-7 scores and Pediatric Anxiety Rating Scale (PARS) Scores
GAD-7 scores significantly and positively correlated with PARS scores (R=0.65, p<0.001). Clinical Global Impression-Severity (CGI-S) scores of 1–3 are denoted by red dots, scores of 4–5 are represented by green dots and scores of 6 and 7 are shown as blue dots (A). Additionally, individual correlation coefficients between GAD-7 items and PARS items are shown in a heat map with cooler colors reflecting larger correlation coefficients. Colored circles represent p-values <0.05 while white boxes reflect non-significant correlations (B).
FIGURE 3
FIGURE 3. Sensitivity and specificity for the GAD-7 with regard to CGI-Severity Score ≤4 (moderate illness)
Solid and dashed lines represent sensitivity and specificity curves, respectively. A GAD-7 score of ≥11 represents the optimal compromise between sensitivity (97%) and specificity (100%) for classification of patients as at least “moderately ill.”
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