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Cultural adaptation into Spanish of the generalized anxiety disorder-7 (GAD-7) scale as a screening tool
Open accessAbstract
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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“The version by Garcia-Campayo et al [62] was used for this study, which shows adequate concurrent validity (r≥0.70) and reliability (Cronbach α=0.93) coefficients.”
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“The Spanish version of the GAD-7 [45] was used for this study, and excellent psychometric properties were observed in our sample (αT1=0.89, αT2=0.92, αT3=0.90, αT4=0.92, and αT5=0.91).”
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“GAD-7 has good reliability and validity in its versions in English (Spitzer et al., 2006), Spanish (Garcia-Campayo et al., 2010), Brazilian-Portuguese (Moreno et al., 2016), and Dutch (Donker et al., 2011).”
From Internet-based self-administered intervention to reduce anxiety and depression symptomatology and improve well-being in 7 countries: protocol of a randomized control trial (2024) · cites this paper as Garcia-Campayo et al., 2010
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“The Spanish version (Garcia-Campayo et al., 2010) has obtained excellent reliability (Cronbach's Alpha = 0.94) and high stability of the measure (Test-retest correlation of 0.84).”
From Mindfulness Parenting and Childish Play: A Clinical Trial With Parents of Children With Autism Spectrum Disorders (2023) · cites this paper as Garcia-Campayo et al., 2010
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Plummer, F., Manea, L., Trepel, D., & McMillan, D. (2016) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2015.11.005 · Cited by 1,882
The prevalence of depression, anxiety, and sleep disturbances in COVID-19 patients: a meta-analysis
Deng, J., Zhou, F., Hou, W., Silver, Z., Wong, C. Y., Chang, O., Huang, E., & Zuo, Q. K. (2021) · Annals of the New York Academy of Sciences · doi:10.1111/nyas.14506 · Cited by 771
World Health Organization disability assessment schedule 2.0: An international systematic review
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Sawaya, H., Atoui, M., Hamadeh, A., Zeinoun, P., & Nahas, Z. (2016) · Psychiatry Research · doi:10.1016/j.psychres.2016.03.030 · Cited by 450
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)
- Venue
- Health and Quality of Life Outcomes
- Published
- 2010
- Volume
- 8
- Issue
- 1
- Pages
- 8
- ISSN
- 1477-7525 (ISSN-L)
- 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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