Cited by 297Maternal Mental Health During Pregnancy and PostpartumAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychometric Methodologies and Testing

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Diagnostic Validity of the Generalized Anxiety Disorder - 7 (GAD-7) among Pregnant Women

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Zhong, Qiu-Yue, Gelaye, Bizu, Zaslavsky, Alan M., Fann, Jesse R., Rondon, Marta B., Sánchez, Sixto E., Williams, Michelle A.·2015·PLOS ONE

DOI 10.1371/journal.pone.0125096PMC PMC4411061

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Abstract

OBJECTIVE: Generalized anxiety disorder (GAD) during pregnancy is associated with several adverse maternal and perinatal outcomes. A reliable and valid screening tool for GAD should lead to earlier detection and treatment. Among pregnant Peruvian women, a brief screening tool, the GAD-7, has not been validated. This study aims to evaluate the reliability and validity of the GAD-7. METHODS: Of 2,978 women who attended their first perinatal care visit and had the GAD-7 screening, 946 had a Composite International Diagnostic Interview (CIDI). The Cronbach's alpha was calculated to examine the reliability. We assessed the criterion validity by calculating operating characteristics. The construct validity was evaluated using factor analysis and association with health status on the CIDI. The cross-cultural validity was explored using the Rasch Rating Scale Model (RSM). RESULTS: The reliability of the GAD-7 was good (Cronbach's alpha = 0.89). A cutoff score of 7 or higher, maximizing the Youden Index, yielded a sensitivity of 73.3% and a specificity of 67.3%. One-factor structure of the GAD-7 was confirmed by exploratory and confirmatory factor analysis. Concurrent validity was supported by the evidence that higher GAD-7 scores were associated with poor self-rated physical and mental health. The Rasch RSM further confirmed the cross-cultural validity of the GAD-7. CONCLUSION: The results suggest that the Spanish-language version of the GAD-7 may be used as a screening tool for pregnant Peruvian women. The GAD-7 has good reliability, factorial validity, and concurrent validity. The optimal cutoff score obtained by maximizing the Youden Index should be considered cautiously; women who screened positive may require further investigation to confirm GAD diagnosis.

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Fig 1 Receiver Operating Characteristics (ROC) Curves of Generalized Anxiety Disorder 7-Item (GAD-7) Scores.CC BY · PubMed Central

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Authors: Zhong, Q.-Y., Gelaye, B., Zaslavsky, A. M., Fann, J. R., Rondon, M. B., Sánchez, S. E., & Williams, M. A.
Affiliations: Harvard University (US)
University of Washington (US)
Peruvian University of Applied Sciences (PE)
Corresponding author: Zhong, Qiu-Yue
Gelaye, Bizu
Zaslavsky, Alan M.
Fann, Jesse R.
Sánchez, Sixto E.
Williams, Michelle A.
ORCID: Zhong, Qiu-Yue
Gelaye, Bizu
Zaslavsky, Alan M.
Fann, Jesse R.
Sánchez, Sixto E.
Williams, Michelle A.
Venue: PLOS ONE
Publisher: Public Library of Science (PLoS)
Published: 2015-04-27
Volume: 10
Issue: 4
Pages: e0125096
ISSN: 1932-6203 (ISSN-L)
DOI: 10.1371/journal.pone.0125096
PMC: PMC4411061
OpenAlex: W2077680141
Cited by: 297
References: 78
Citations by year: 2026: 23 · 2025: 33 · 2024: 39 · 2023: 42 · 2022: 45 · 2021: 58 · 2020: 20 · 2019: 14 · 2018: 13 · 2017: 4 · 2016: 3 · 2015: 2
FWCI: 7.86
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0/ (vor)
Locations: PLoS ONE (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
RePEc: Research Papers in Economics (submittedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Figshare (submittedVersion, cc-by)
Repositorio Académico UPC (Universidad Peruana de Ciencias Aplicadas) (submittedVersion, cc-by)
Funders: National Institutes of Health (R01-HD)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD059835)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
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
Keywords: Generalized Anxiety Disorder-7, GAD-7, generalized anxiety disorder, pregnancy, anxiety screening, psychometric validation, Spanish translation, Peruvian women, diagnostic thresholds, Rasch model, cross-cultural validity, factor structure, maternal mental health
MeSH terms: Adolescent, Adult, Anxiety Disorders, Cross-Sectional Studies, Cross-Cultural Comparison, Female, Humans, Interview, Psychological, Middle Aged, Peru, Pregnancy, Pregnancy Complications, Psychiatric Status Rating Scales, Reproducibility of Results, Young Adult

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Diagnostic Validity of the Generalized Anxiety Disorder - 7 (GAD-7) among Pregnant Women

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