GAD-7 (Generalized Anxiety Disorder 7-item)

The GAD-7 is a widely used self-administered diagnostic tool designed to screen for and assess the severity of generalized anxiety disorder (GAD). It comprises seven items that measure the frequency of anxiety symptoms over the past two weeks, with respondents rating each item on a scale from "not at all" to "nearly every day."

Psychometric Testing Therapeutic Assessment Under 5 min Psychoeducation

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At a glance

Activity type
Assessment
Best for
Anxiety
Modalities
Psychometric Testing, Therapeutic Assessment
Tags
weekly-checkin, assessment, screener, intake, anxiety
Length
2 pages
Citations
Spitzer, R. L., Kroenke, K., Williams, J. B. W., Löwe, B. (2006). A Brief Measure for Assessing Generalized Anxiety Disorder — The GAD-7

What is GAD-7 (Generalized Anxiety Disorder 7-item)?

The GAD-7 is a screening tool from psychometric testing, developed in 2006 by Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke, and Bernd Löwe as a brief self-report questionnaire designed to assess symptoms associated with generalized anxiety disorder. The seven items measure the frequency of anxiety symptoms over the past two weeks, with respondents rating each item on a scale from "not at all" to "nearly every day." An eighth item on the standard GAD-7 asks how difficult these problems have made it to do your work, take care of things at home, or get along with other people. This item is not added into the total score.

How therapists use it

Psychometric testing establishes a baseline of the client's cognitive, emotional, and behavioral functioning at the start of therapy, helping the therapist create a detailed treatment plan tailored to the individual's needs and goals and providing measurable markers to track progress throughout the course of treatment. Using psychometric tests at regular intervals throughout treatment enables therapists to monitor the client's progress over time and evaluate the effectiveness of interventions. Assessment results can be used as starting points for discussion, establishing which traits or symptoms cause the client difficulties in their life and considering therapeutic methods to explore and possibly target these for change where appropriate.

Who it's for

The GAD-7 had good reliability, as well as criterion, construct, factorial, and procedural validity, with a cut point that optimized sensitivity (89%) and specificity (82%), and increasing scores were strongly associated with multiple domains of functional impairment. It has sensitivity and specificity as a screener for panic, social anxiety, and posttraumatic stress disorder. The GAD-7 is a screening tool, not a diagnostic instrument; a score in the Moderate or Severe range, or a total score of 10 or greater, indicates elevated likelihood of generalized anxiety disorder, but does not on its own constitute a diagnosis, and interpretation should be made in the context of a full clinical evaluation by a qualified professional.

What clients see

The client rates each of seven items on a scale from "not at all" to "nearly every day" based on how often they experienced anxiety symptoms over the past two weeks. The seven items assess feeling nervous, inability to stop or control worrying, worrying too much about different things, trouble relaxing, restlessness, becoming easily annoyed or irritable, and feeling afraid as if something awful might happen.

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Past two weeks

Feeling nervous, anxious, or on edge Not at all Several days More than half the days Nearly every day
Not being able to stop or control worrying Not at all Several days More than half the days Nearly every day
Worrying too much about different things Not at all Several days More than half the days Nearly every day
Trouble relaxing Not at all Several days More than half the days Nearly every day
Being so restless that it's hard to sit still Not at all Several days More than half the days Nearly every day
Becoming easily annoyed or irritable Not at all Several days More than half the days Nearly every day
Past two weeks
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Functional impact

If you checked off any problems, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people? Not difficult at all Somewhat difficult Very difficult Extremely difficult
Functional impact

Modality fit

Psychometric Testing

Standardized measurement of psychological constructs through validated instruments to establish baseline functioning, track progress, and inform treatment planning.

Therapeutic Assessment

Collaborative use of assessment results to deepen understanding of client difficulties and guide the selection and adjustment of therapeutic interventions.

Common questions

What does a GAD-7 score mean?

Scores represent: 0-5 = Mild anxiety, 6-10 = Moderate anxiety, 11-15 = Moderately severe anxiety, 15-21 = Severe anxiety. When used as a screening tool, further evaluation is recommended when the score is 10 or greater.

Can the GAD-7 diagnose generalized anxiety disorder?

The GAD-7 is a screening tool, not a diagnostic instrument; a score in the Moderate or Severe range, or a total score of 10 or greater, indicates elevated likelihood of generalized anxiety disorder, but does not on its own constitute a diagnosis.

How often should I administer the GAD-7?

Using psychometric tests at regular intervals throughout treatment enables therapists to monitor the client's progress over time and evaluate the effectiveness of interventions. The frequency depends on your treatment goals and the client's needs.

Who should use the GAD-7?

The GAD-7 is a sensitive self-administrated test to assess generalized anxiety disorder normally used in outpatient and primary care settings for referral to psychiatrist pending outcome. It is appropriate for therapists working with clients who present with anxiety symptoms.

Assign the GAD-7 to your client

Use this screener at intake to establish a baseline, then readminister at regular intervals to track changes in anxiety severity and functional impairment over the course of treatment.