Cited by 673Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychometric Methodologies and TestingHealth Education and Validation

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Cultural adaptation into Spanish of the generalized anxiety disorder-7 (GAD-7) scale as a screening tool

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Garcia-Campayo, Javier, Zamorano, Enric, Ruiz, Miguel A, Pardo, Antonio, Perez-Paramo, Maria, Lopez-Gomez, Vanessa, Freire, Olga, Rejas, Javier·2010·Health and Quality of Life Outcomes

DOI 10.1186/1477-7525-8-8PMC PMC2831043

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Abstract

BACKGROUND: Generalized anxiety disorder (GAD) is a prevalent mental health condition which is underestimated worldwide. This study carried out the cultural adaptation into Spanish of the 7-item self-administered GAD-7 scale, which is used to identify probable patients with GAD. METHODS: The adaptation was performed by an expert panel using a conceptual equivalence process, including forward and backward translations in duplicate. Content validity was assessed by interrater agreement. Criteria validity was explored using ROC curve analysis, and sensitivity, specificity, predictive positive value and negative value for different cut-off values were determined. Concurrent validity was also explored using the HAM-A, HADS, and WHO-DAS-II scales. RESULTS: The study sample consisted of 212 subjects (106 patients with GAD) with a mean age of 50.38 years (SD = 16.76). Average completion time was 2'30''. No items of the scale were left blank. Floor and ceiling effects were negligible. No patients with GAD had to be assisted to fill in the questionnaire. The scale was shown to be one-dimensional through factor analysis (explained variance = 72%). A cut-off point of 10 showed adequate values of sensitivity (86.8%) and specificity (93.4%), with AUC being statistically significant [AUC = 0.957-0.985); p < 0.001]. The scale significantly correlated with HAM-A (0.852, p < 0.001), HADS (anxiety domain, 0.903, p < 0.001), and WHO-DAS II (0.696, p > 0.001). LIMITATIONS: Elderly people, particularly those very old, may need some help to complete the scale. CONCLUSION: After the cultural adaptation process, a Spanish version of the GAD-7 scale was obtained. The validity of its content and the relevance and adequacy of items in the Spanish cultural context were confirmed.

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Figure 1 Maximum likelihood confirmatory solution of items in the adapted version of the GAD-7 scale. Standardized loadings. Chi-Square = 32.59, df = 14, p-value = 0.00330, RMSEA = 0.080CC BY · PubMed Central

Figure 2 ROC curve of GAD-7 total score.CC BY · PubMed Central

Figure 3 Mean and confidence interval (95%) of HAM-A score by severity group according to the GAD-7 scale. Anxiety group according to GAD-7 score; Normal/Minimum (0-7 points), Mild (8-10), Moderate (11-14) and Severe (15-21). p < 0.001 for between-group comparisons in all cases. Diagonal segments are produced by ties.CC BY · PubMed Central

Figure 4 Mean (95% CI) standardized score of WHO DAS II scale, total and by domain, by group of subjects. GAD = Generalized Anxiety Disorder group; Control = Control group; **p < 0.001.CC BY · PubMed Central

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Authors: Garcia-Campayo, J., Zamorano, E., Ruiz, M. A., Pardo, A., Perez-Paramo, M., Lopez-Gomez, V., Freire, O., & Rejas, J.
Affiliations: Universidad Autónoma de Madrid (ES)
Pfizer (Spain) (ES)
ORCID: Pardo, Antonio
Rejas, Javier
Venue: Health and Quality of Life Outcomes
Publisher: Springer Science and Business Media LLC
Published: 2010
Volume: 8
Issue: 1
Pages: 8
ISSN: 1477-7525 (ISSN-L)
DOI: 10.1186/1477-7525-8-8
PMC: PMC2831043
OpenAlex: W2169677418
Cited by: 673
References: 32
Citations by year: 2026: 67 · 2025: 93 · 2024: 73 · 2023: 84 · 2022: 108 · 2021: 86 · 2020: 60 · 2019: 29 · 2018: 13 · 2017: 15 · 2016: 16 · 2015: 10 · 2014: 7 · 2013: 3 · 2012: 5
FWCI: 4.99
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
Locations: Health and Quality of Life Outcomes (publishedVersion, cc-by)
Europe PMC (PubMed Central) (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
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 › Nursing › Research and Theory › Health Education and Validation
Keywords: generalized anxiety disorder, Spanish translation, cross-cultural adaptation, screening tool, content validity, criterion validity, concurrent validity, cut-off values, anxiety assessment
MeSH terms: Acculturation, Adult, Aged, Aged, 80 and over, Anxiety Disorders, Female, Humans, Language, Male, Mass Screening, Middle Aged, Psychometrics, Surveys and Questionnaires, ROC Curve, Spain

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Cultural adaptation into Spanish of the generalized anxiety disorder-7 (GAD-7) scale as a screening tool

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