GAD-7
Generalized Anxiety Disorder 7-item scale
Seven-item screen and severity measure for generalized anxiety symptoms; also reasonable for panic, social anxiety, and PTSD as a non-specific anxiety indicator.
What it measures
Frequency over the past two weeks of seven core anxiety symptoms: nervousness, uncontrollable worry, excessive worry, trouble relaxing, restlessness, irritability, and fear of awful things happening.
Scoring and bands
Cutoffs
A cutoff of ≥10 yields 89% sensitivity and 82% specificity for GAD. The same cutoff has reasonable sensitivity for panic, social anxiety, and PTSD, though specificity drops.
How to talk about the score
Pair the score with what the client is describing. A high GAD-7 with predominantly worry content suggests GAD; high score with predominantly trauma content needs a PCL-5 or trauma-specific follow-up.
Limitations
- Designed for GAD; over-detects when used as a general anxiety screen
- Two-week window
- Doesn't distinguish among anxiety disorders
- Misses panic-specific or trauma-specific features
Best used for
- Anxiety screening at intake
- Tracking response in CBT for GAD
- Quick re-administration each session
FAQ
Can I use the GAD-7 for panic disorder?
It will catch general arousal but will underestimate panic-specific severity. Use a panic-specific measure (PDSS) alongside if panic is the primary target.
What change is clinically meaningful?
A 4-point reduction is generally considered clinically meaningful, though the field uses a few different thresholds.