GAD 7 (A test sample)

In this blog post, we will examine what GAD 7 is, what it measures, the intended population and a sample test. 

GAD 7: What is it for?

The Generalized Anxiety Disorder Assesment or (GAD 7) is a self-test questionnaire used as a screening tool to measure the severity of the symptoms in Generalized Anxiety Disorder (GAD). 

The GAD 7 has seven items and it is scored as follows:

  • Not at all (0 points)
  • Several days (1 point)
  • More than half the days (2 points)
  • Nearly every day (3 points)

Generalized Anxiety Disorder (GAD)

Generalized Anxiety Disorder is characterized but an exaggerated or excessive worry about daily life activities or events with no apparent reason to worry.

People with GAD tend to expect disaster and can’t stop worrying about their medical condition, financial related problems, their family or their work. 

Symptoms of GAD

According to the Mayo Clinic, Generalized Anxiety Disorder Symptoms can Vary from one person to another, but there are some common physical symptoms that someone with GAD might experience:

  • Persistent worrying or anxiety about a number of areas that are out of proportion to the impact of the events
  • Overthinking plans and solutions to all possible worst-case outcomes
  • Perceiving situations and events as threatening, even when they aren’t
  • Difficulty handling uncertainty
  • Indecisiveness and fear of making the wrong decision
  • Inability to set aside or let go of a worry
  • Inability to relax, feeling restless, and feeling keyed up or on edge
  • Difficulty concentrating, or the feeling that your mind “goes blank”

Physical signs and symptoms may include:

  • Fatigue
  • Trouble sleeping
  • Muscle tension or muscle aches
  • Trembling, feeling twitchy
  • Nervousness or being easily startled
  • Sweating. Check the best antiperspirants for anxiety sweat.
  • Nausea, diarrhea or irritable bowel syndrome
  • Irritability

Causes of GAD

Many researchers agree that the causes for Generalized Anxiety Disorder may be a combination of multiple factors, such as in many other mental health disorders, which can include:

  • Brain structures, functions, and chemistry
  • Genetics (inherited component)
  • Differences in how threats are perceived
  • Child development
  • Personality traits

Risk Factors of GAD

Some researchers suggest that women might have a higher risk than men since they tend to get diagnosed more often than they do.

Some of the identified factors that may increase the chance of developing GAD are:

  • Personality traits: someone that is timid or negative towards life or is constantly avoiding danger, may have a higher risk of developing Generalized Anxiety Disorder.
  • Genetics: if you have a relative with the condition you may be at a higher risk of developing GAD too.
  • Life experiences: if we compare the history of life events or changes from people with GAD we may find they all share some traumatic or negative experiences while growing up or recently they have experienced a traumatic event. 

When to look for help?

Generalized Anxiety Disorder can be a very disabling condition.

If you identify with some of the items above you might consider seeking for some professional help:

  • If your anxiety is preventing you from performing tasks in an efficient or quick way because you have difficulties concentrating.
  • If your anxiety is time-consuming and it’s preventing you from focusing on other activities than worrying. 
  • If Anxiety is taking away your energy, it is making you feel drained of sleepy all the time. 
  • If besides the feeling anxiety, you are also starting to feel depressed.

Worsening physical health

People with Generalized Anxiety Disorder have a higher risk of having or worsening the symptoms of the following health conditions:

  • Digestive problems: irritable bowel syndrome or ulcers.
  • Migraines and headaches.
  • Chronic Pain
  • Insomnia or difficulties when going to sleep.
  • Heart-related illnesses. 

Generalized Anxiety Disorder and Co-morbidity

According to the Mayo Clinic, Generalized Anxiety Disorder often tends to co-exist with other mental health disorders that can make diagnosis more difficult due to symptom overlap and misdiagnosis.

Subsequently, suggesting a treatment plan can become challenging.

Some of the most common mental health disorders that co-occur with GAD are:

  • Specific Phobias
  • Panic Disorders
  • Post-traumatic stress disorder (PTSD)
  • Obsessive-compulsive disorder (OCD)
  • Depression
  • Suicidal thoughts or attempt to commit suicide
  • Substance abuse

Sample of the test

Here you can find the sample test for GAD 7 and you can also click here to find a printable version (Source: from the NHS)

GAD-7 Anxiety

Instructions: 

“Over the last 2 weeks, how often have you been bothered by the following problems? (Use “✔” to indicate your answer” 

  1. Feeling nervous, anxious or on edge

Not at all (0)

Several days (1)

More than half the days (2)

Nearly every day (3)

  1. Not being able to stop or control worrying

Not at all (0)

Several days (1)

More than half the days (2)

Nearly every day (3)

  1. Worrying too much about different things

Not at all (0)

Several days (1)

More than half the days (2)

Nearly every day (3)

  1. Trouble relaxing

Not at all (0)

Several days (1)

More than half the days (2)

Nearly every day (3)

  1. Being so restless that it is hard to sit still

Not at all (0)

Several days (1)

More than half the days (2)

Nearly every day (3)

  1. Becoming easily annoyed or irritable

Not at all (0)

Several days (1)

More than half the days (2)

Nearly every day (3)

  1. Feeling afraid as if something awful might happen

Not at all (0)

Several days (1)

More than half the days (2)

Nearly every day (3)

GAD-7 Anxiety Column totals: ___ + ___ + ___ + ___ = Total Score _____

 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 (  )

Source: From the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire (PRIME-MD PHQ). The PHQ was developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke, and colleagues. For research information, contact Dr. Spitzer at rls8@columbia.edu. PRIME-MD® is a trademark of Pfizer Inc. Copyright© 1999 Pfizer Inc. All rights reserved. Reproduced with permission

Score

Here is the scoring total and what it means:

  1. From 5 to 9 points, Mild Anxiety
  2. From 10 to 14 points, Moderate Anxiety
  3. More than 15 points, Severe Anxiety

Who can take the test?

This test has been validated to be applied to the general population, adolescents with a diagnosis of Generalized Anxiety Disorder (GAD) and primary care patients. 

Can I take it in a different language?

Yes, you can. Just click here to go to Pfizer’s website to choose the test and the available languages. 

Considerations

This test should be used only for screening, by no means is considered to replace a rigorous assessment and diagnosis from mental health or related professional. 

Example GAD 7

Let’s see how the test should look like if we simulate having this screening test because I suspect I have Generalized Anxiety Disorder (GAD). 

GAD-7 Anxiety

Instructions: 

“Over the last 2 weeks, how often have you been bothered by the following problems? (Use “✔” to indicate your answer” 

  1. Feeling nervous, anxious or on edge

Not at all 

Several days 

More than half the days (2)

Nearly every day 

  1. Not being able to stop or control worrying

Not at all 

Several days

More than half the days 

Nearly every day (3)

  1. Worrying too much about different things

Not at all 

Several days 

More than half the days 

Nearly every day (3)

  1. Trouble relaxing

Not at all 

Several days 

More than half the days (2)

Nearly every day 

  1. Being so restless that it is hard to sit still

Not at all 

Several days 

More than half the days (2)

Nearly every day 

  1. Becoming easily annoyed or irritable

Not at all

Several days 

More than half the days (2)

Nearly every day 

  1. Feeling afraid as if something awful might happen

Not at all 

Several days 

More than half the days (2)

Nearly every day 

GAD-7 Anxiety Column totals: _0__ + _0__ + _10__ + _6__ = Total Score _16__

 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  (x )

Extremely difficult (  )

Interpreting “my test”

In this case, my total score per column was 0+0+10+6= 16.

This means that according to the results I would have the corresponding severe anxiety symptomatology for Generalized Anxiety Disorder. 

This indicates that I should probably share my results with a mental health professional so he/she can assess in-depth the reason why I scored as severely anxious. 

Why is this blog post about GAD 7 important?

We discussed what the GAD 7 is, what it is supposed to measure, a sample of the related questions, how it gets scored and how to interpret them. 

Also, we know now this is a really good tool (self-assessment) with scientific-based research of its use in effectively identifying possible cases of Generalized Anxiety Disorder and to assess the severity of anxiety symptoms.

Frequently Asked Questions (FAQ’s) about GAD 7

What is a GAD 7 score?

The Scores of the GAD 7 of 5, 10, and 15 are cut off points to determine the category for mild, moderate and severe anxiety. 

Since GAD 7 is a screening tool when there is a score of 10 or greater it is recommended to monitor, follow and evaluate.

What is the GAD 7 test?

The GAD-7 is a useful self-assessment screening tool used in mental health settings to measure the severity of the most common anxiety disorders (Generalized Anxiety Disorder, Panic Disorder, Social Phobia, and Posttraumatic Stress Disorder).

How is GAD 7 score calculated?

The GAD-7 score gets calculated when adding up the scores from the seven questions.

The minimum score can be 0 and the maximum 21.

What are PHQ and GAD scores?

The PHQ-8 and PHQ-9 are scored the same way and the total scores can range between 0 to 24. You can interpret the GAD 7 scores through cut points.

There are 3 existing cut points: 5, 10 and 15 being interpreted as mild, moderate and severe levels of anxiety. 

How do you interpret a GAD 7 score?

You can interpret the GAD 7 scores through cut points.

There are 3 existing cut points: 5, 10 and 15 being interpreted as mild, moderate and severe levels of anxiety. 

  1. The Generalized Anxiety Disorder Workbook: A Comprehensive CBT Guide for Coping with Uncertainty
  2. Cognitive-Behavioral Treatment for Generalized Anxiety Disorder: From Science to Practice (Practical Clinical Guidebooks)
  3. Conquering Anxiety: Stop worrying, beat stress and feel happy again
  4. The Anxiety Workbook: A 7-Week Plan to Overcome Anxiety, Stop Worrying, and End Panic 
  5. Pfizer screening test GAD 7

References

CORC UK

Mayo Clinic