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Psychometric evaluation of the Generalized Anxiety Disorder Screener GAD-7, based on a large German general population sample
Abstract
Background The Generalized Anxiety Disorder Scales GAD-7 and GAD-2 are instruments for the assessment of anxiety. The aims of this study are to test psychometric properties of these questionnaires, to provide normative values, and to investigate associations with sociodemographic factors, quality of life, psychological variables, and behavioral factors.Methods A German community sample (n=9721) with an age range of 18-80 years was surveyed using the GAD-7 and several other questionnaires.Results Confirmatory factor analyses confirmed the unidimensionality and measurement invariance of the GAD-7 across age and gender. Females were more anxious than males (mean scores: M=4.07 vs. M=3.01; effect size: d=0.33). There was no linear age trend. A total of 5.9% fulfilled the cut-off criterion of 10 and above. Anxiety was correlated with low quality of life, fatigue, low habitual optimism, physical complaints, sleep problems, low life satisfaction, low social support, low education, unemployment, and low income. Cigarette smoking and alcohol consumption were also associated with heightened anxiety, especially in women. When comparing the GAD-7 (7 items) with the ultra-short GAD-2 (2 items), the GAD-7 instrument was superior to the GAD-2 regarding several psychometric criteria.Limitations The response rate (33%) was low. Because of the cross-sectional character of the study, causal conclusions cannot be drawn. A further limitation is the lack of a gold standard for diagnosing anxiety.Conclusions The GAD-7 can be recommended for use in clinical research and routine.
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“The scale has demonstrated good psychometric properties in previous samples [21, 24, 46].”
From Internet videoconferencing delivered cognitive behavior therapy for generalized anxiety disorder: protocol for a randomized controlled trial (2022) · cites this paper as [21]
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“The GAD‐7 has high internal consistency (α = .85–.89: Hinz et al., 2017).”
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Metadata
- Authors
- Hinz, A., Klein, A. M., Brähler, E., Glaesmer, H., Luck, T., Riedel-Heller, S. G., Wirkner, K., & Hilbert, A.
- Affiliations
- Leipzig University (DE)
- Johannes Gutenberg University Mainz (DE)
- Corresponding author
- Hinz, Andreas
- ORCID
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2017-03
- Volume
- 210
- Pages
- 338-344
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2562471806
- Cited by
- 443
- References
- 43
- Citations by year
- 2026: 39 · 2025: 62 · 2024: 63 · 2023: 59 · 2022: 65 · 2021: 78 · 2020: 47 · 2019: 16 · 2018: 12 · 2017: 2
- FWCI
- 14.20
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Funders
- European Union
- European Regional Development Fund
- Free State of Saxony (713-241202, 14505/2470, 14575/2470)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Keywords
- GAD-7, GAD-2, generalized anxiety disorder, anxiety screening, psychometric properties, reference values, measurement invariance, sex differences in anxiety, quality of life, sleep disorders, social support, smoking, alcohol consumption, German general population
- MeSH terms
- Patient Health Questionnaire, Adolescent, Adult, Aged, Aged, 80 and over, Alcohol Drinking, Anxiety Disorders, Cross-Sectional Studies, Female, Germany, Humans, Male, Middle Aged, Psychometrics, Quality of Life, Surveys and Questionnaires, Risk Factors, Smoking, Socioeconomic Factors, Age Distribution, Sex Distribution, Stress Disorders, Traumatic, Acute, Young Adult
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