ArticlePloS one2017
Psychometric analysis of the Generalized Anxiety Disorder scale (GAD-7) in primary care using modern item response theory.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 80 papers, 1 of them a synthesis that pooled it.
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Who cites it
80 citing papers in PubMed, 1 synthesis or guideline pooled it.
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- Cultural Approaches to Promote Indigenous Mental Health: Weaving Healthy Families.Journal of ethnic & cultural diversity in social work · 2025Article
- Psychological resilience to trauma and longitudinal sleep outcomes among current and former nurses.Journal of psychosomatic research · 2025Article
- Assessment and Intervention for Diabetes Distress in Primary Care Using Clinical and Technological Interventions: Protocol for a Single-Arm Pilot Trial.JMIR research protocols · 2025Article
- Echoes of conflict and displacement in maternal health: Life-course violence, timing, and maternal stress after childbirth at the northern Thailand-Myanmar border.Psychoneuroendocrinology · 2025Article
- A pilot study of alcohol and substance use, mental health symptoms and social vulnerabilities among youth in Nairobi's informal settlements.Global mental health (Cambridge, England) · 2025Article
- Feasibility trial of a self-help digital intervention for functional cognitive disorder.Brain communications · 2025Article
20 more citing papers are in PubMed but not listed here.
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe Generalized Anxiety Disorder scale (GAD-7) is one of the most frequently used diagnostic self-report scales for screening, diagnosis and severity assessment of anxiety disorder. Its psychometric properties from the view of the Item Response Theory paradigm have rarely been investigated. We aimed to close this gap by analyzing the GAD-7 within a large sample of primary care patients with respect to its psychometric properties and its implications for scoring using Item Response Theory.
methodsRobust, nonparametric statistics were used to check unidimensionality of the GAD-7. A graded response model was fitted using a Bayesian approach. The model fit was evaluated using posterior predictive p-values, item information functions were derived and optimal predictions of anxiety were calculated.
resultsThe sample included N = 3404 primary care patients (60% female; mean age, 52,2; standard deviation 19.2) The analysis indicated no deviations of the GAD-7 scale from unidimensionality and a decent fit of a graded response model. The commonly suggested ultra-brief measure consisting of the first two items, the GAD-2, was supported by item information analysis. The first four items discriminated better than the last three items with respect to latent anxiety.
conclusionThe information provided by the first four items should be weighted more heavily. Moreover, estimates corresponding to low to moderate levels of anxiety show greater variability. The psychometric validity of the GAD-2 was supported by our analysis.
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