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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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Crossref · 10.1186/1477-7525-8-8

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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 = 0.080
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.
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.
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.
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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Research works printed but not linked: 3

  1. Chocrón Bentata L Vilalta Franch J Legazpi Rodríguez I Auquer Ky Franch L Prevalencia de Psicopatología en un centro de atención primaria Aten Primaria 1995 16 586 590 8555389
  2. Bobes J Garcia-Calvo C Prieto R Garcia-Garcia M Rico-Villademoros F Propiedades psicométricas de la versión española de la Escala de Detección del Generalized anxiety disorder según DSM-IV de Carroll y Davidson Actas Esp Psiquiatr 2006 34 2 83 93 16552636
  3. Nunnally JCy Bernstein IJ Teoría Psicométrica México: McGraw-Hill 1995 3

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Metadata

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
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
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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