Generalized Anxiety Disorder-7 (GAD-7)

Seven experiences make up the scale: feeling nervous, anxious or on edge; being unable to stop or control worrying; worrying too much about different things; having trouble relaxing; being so restless that it is hard to sit still; becoming easily annoyed or irritable; and feeling afraid that something awful might happen. Each is rated by how often it has occurred over the past two weeks, from not at all to nearly every day. Taken together, the items describe the core of generalized anxiety: worry that is frequent, hard to control and spread across many areas of life, accompanied by tension and irritability.

Spitzer, Kroenke, Williams and Löwe (2006) developed the scale as a brief self-report screen for generalized anxiety disorder in primary care, where most anxious patients are first seen and where long interviews are rarely practical. The item content follows the diagnostic description of the disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM), and the format mirrors that of the depression module of the Patient Health Questionnaire (PHQ-9; Kroenke et al., 2001), so the two are often given together. Subsequent work indicated that the scale is also sensitive to panic, social anxiety and posttraumatic stress symptoms, which suggests that it captures a general anxious distress shared across these conditions as well as generalized anxiety itself (Kroenke et al., 2007).

The seven ratings are summed into a single total. Lower totals indicate that anxious symptoms have been occasional or absent over the past two weeks; higher totals indicate symptoms that have been frequent and, at the upper end of the range, present on most days. The report places the total within the published severity bands and describes in plain language what that range tends to mean. A high score is a reason for a fuller conversation with a qualified clinician, not a diagnosis, and a low score does not rule out an anxiety condition that the seven items do not cover.

The scale is used to screen for anxiety in medical and mental health settings, to track change across the course of treatment, and in research as a common outcome measure. On this site it sits alongside the PHQ-9 for depressive symptoms, the Penn State Worry Questionnaire (PSWQ) for worry as a stable trait rather than a recent state, the Kessler Psychological Distress Scale (K10) for broader non-specific distress, and the Depression Anxiety Stress Scales (DASS-21), which separate anxious arousal from stress and low mood.

Criterion validity in primary care showed that a GAD-7 total at the published cutoff had sensitivity ≈ .89 and specificity ≈ .82 for generalized anxiety disorder (Spitzer et al., 2006). Convergently, higher scores related to functional impairment and to other anxiety presentations; the same cutoff also screened for panic, social anxiety, and PTSD at useful operating characteristics in that report. Discriminantly, GAD-7 is intended as an anxiety-severity instrument rather than a general distress catch-all, though anxiety and depression screens commonly co-elevate in practice (e.g., GAD-7 with PHQ depression modules). A positive screen warrants clinical follow-up, not a standalone diagnosis.

At the published cutoff sensitivity is 0.89 and specificity 0.82 for generalized anxiety disorder (Spitzer et al., 2006).

“Feeling nervous, anxious, or on edge”

Illustrative only. During administration items are presented one screen-set at a time; response-key direction is never shown to respondents.

Item responses are summed to a total score and compared against published screening cutoffs.

The report explains which published screening bands your score falls in and what they mean.