Psychometric comparison of the Generalized Anxiety Disorder Scale-7 and the Penn State Worry Questionnaire for measuring response during treatment of generalised anxiety disorder

Dear, Blake F.; Titov, Nickolai; Sunderland, Matthew; McMillan, Dean; Anderson, Tracy; Lorian, Carolyn; Robinson, Emma

doi:10.1080/16506073.2011.582138

Cited by 282Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychometric Methodologies and TestingMental Health Research Topics

Psychometric comparison of the Generalized Anxiety Disorder Scale-7 and the Penn State Worry Questionnaire for measuring response during treatment of generalised anxiety disorder

Dear, Blake F., Titov, Nickolai, Sunderland, Matthew, McMillan, Dean, Anderson, Tracy, Lorian, Carolyn, Robinson, Emma·2011·Cognitive Behaviour Therapy

DOI 10.1080/16506073.2011.582138

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Abstract

The Penn State Worry Questionnaire (PSWQ) is a widely used measure of the worry characteristic of generalised anxiety disorder (GAD). The 7-item Generalized Anxiety Disorder Scale (GAD-7) is a new brief screening tool for GAD, which is being increasingly used in research and clinical practice. The present study sought to provide comparison data on the relative psychometric properties of these two scales. The data of 195 adults who met Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for GAD and who participated in two randomised treatment controlled trials were used. Factor analyses, internal consistency, correlational analyses, responsiveness to change, and agreement between the scales based on indentified clinical cutoffs were conducted. Factor analyses confirmed a one-factor structure for the GAD-7 and a three-factor structure involving two method factors for the PSWQ. Both the GAD-7 and the PSWQ demonstrated adequate internal consistency (Cronbach's alpha: .79-.91 and .86-.91, respectively), and moderate correlations (r = .51-.71) were observed between the scales across the treatment time points. The scales exhibited small correlations with the Sheehan Disability Scale at pretreatment (GAD-7 r = .38; PSWQ r = .26), but moderate correlations at posttreatment and follow-up (r = .59-.79). Agreement between the scales was limited using various clinical cutoffs identified within the literature. Both measures were sensitive to change, although the GAD-7 appeared to be more sensitive and may, therefore, confer some advantages in clinical work.

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The estimated cost-effectiveness of the therapy suggests that the psychotherapy programme is relatively inexpensive and far below the NICE cost-effectiveness threshold of £25,000-£35,000.
“The estimated cost-effectiveness of the therapy suggests that our psychotherapy programme is relatively inexpensive and far below the National Institute for Health and Clinical Excellence costeffectiveness threshold of £25,000 - £35,000 [45].”
From A prospective service evaluation of acceptance and commitment therapy for patients with refractory epilepsy (2015) · cites this paper as [45]
PHQ-9 and GAD-7 are well-established measures with demonstrated good validity and reliability even when administered via the internet.
“Both PHQ-9 and GAD-7 are well-established measures with demonstrated good validity and reliability even when administered via the internet.49–51”
From Internet-delivered cognitive-behavioural therapy for concerned significant others of people with problem gambling: Study protocol for a randomised wait-list controlled trial (2015) · cites this paper as [51]
The PSWQ has good discriminant and convergent validity, is unrelated to other measures of depression and general anxiety, and is sensitive to cognitive orientated treatment.
“It has been shown to have good discriminant validity and convergent validity, to be unrelated to other measures of depression (measured by the Beck Depression Inventory) and general anxiety (measured by the STAI), and to be sensitive to cognitive orientated treatment (Dear et al., 2011; Meyer et al., 1990).”
From Modeling the cognitive mechanisms linking autism symptoms and anxiety in adults. (2016) · cites this paper as Dear et al., 2011
Both the PHQ-9 and GAD-7 have been shown to be sensitive to change when treatment response is monitored.
“Moreover, both measures have proven sensitive to change when monitoring treatment response.20;33-36”
From Patient Health Questionnaire Anxiety and Depression Scale: Initial Validation in Three Clinical Trials (2016) · cites this paper as [35]
GAD-7 is a reliable, valid, and responsive screening instrument commonly used in primary care settings.
“This is a reliable, valid, and responsive screening instrument commonly used in primary care settings [44] and has been extensively studied and validated in diverse adolescent populations, including for screening in primary care settings in Finland [45], China [46], Korea [47], Ghana [48], and Canada [49].”
From Chatbot-Delivered Cognitive Behavioral Therapy in Adolescents With Depression and Anxiety During the COVID-19 Pandemic: Feasibility and Acceptability Study (2022) · cites this paper as [44]

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Examining self-guided internet-delivered cognitive behavior therapy for older adults with symptoms of anxiety and depression: Two feasibility open trials
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“The measure has good reliability (Dear et al., 2011), in the current study internal consistency was excellent (α = .90).”
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Karyotaki, E., Klein, A. M., Riper, H., Wit, L. D., Krijnen, L., Bol, E., Bolinski, F., Burger, S., Ebert, D. D., Auerbach, R. P., et al. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-028739 · Cited by 28 · see citing works
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“A clinical cut-off score of 8 is indicative of a diagnosis of a DSM-IV anxiety disorder (Dear et al., 2011; Lowe et al., 2008; Richards and Suckling, 2009).”
BackgroundSelf-citation
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“The scale is widely used and has strong psychometric properties (Dear et al. 2011).”
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“The PSWQ-T version has good to excellent internal consistency (Dear et al ., 2011; Molina and Borkovec, 1994) and has demonstrated both content and construct validity (Stöber and Bittencourt, 1998).”
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Authors: Dear, B. F., Titov, N., Sunderland, M., McMillan, D., Anderson, T., Lorian, C., & Robinson, E.
Affiliations: UNSW Sydney (AU)
St Vincent's Hospital Melbourne (AU)
University of York (GB)
Corresponding author: Dear, Blake F.
ORCID: Dear, Blake F.
Titov, Nickolai
Sunderland, Matthew
McMillan, Dean
Venue: Cognitive Behaviour Therapy
Publisher: Informa UK Limited
Published: 2011-07-20
Volume: 40
Issue: 3
Pages: 216-227
ISSN: 1650-6073 (ISSN-L)
1651-2316
DOI: 10.1080/16506073.2011.582138
OpenAlex: W2017761739
Cited by: 282
References: 33
Citations by year: 2026: 13 · 2025: 22 · 2024: 24 · 2023: 21 · 2022: 20 · 2021: 35 · 2020: 24 · 2019: 16 · 2018: 17 · 2017: 15 · 2016: 21 · 2015: 21 · 2014: 15 · 2013: 10 · 2012: 7
FWCI: 13.55
Type: journal article
Language: en
Open access: closed
Locations: Cognitive Behaviour Therapy (publishedVersion)
PubMed (publishedVersion)
Funders: Australian Rotary Health
University of New South Wales
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
Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
Keywords: generalized anxiety disorder, GAD-7, Penn State Worry Questionnaire, worry, psychometric properties, scale comparison, treatment response, responsiveness to change, factor structure, internal consistency, Sheehan Disability Scale
MeSH terms: Adolescent, Adult, Aged, Aged, 80 and over, Anxiety Disorders, Factor Analysis, Statistical, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Psychometrics, Surveys and Questionnaires, Randomized Controlled Trials as Topic

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Psychometric comparison of the Generalized Anxiety Disorder Scale-7 and the Penn State Worry Questionnaire for measuring response during treatment of generalised anxiety disorder

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