Interpreting GAD-7 scores

This article explains the Generalized Anxiety Disorder 7-item (GAD-7) screening tool. Learn what it is, how it helps assess anxiety, and how you can use the results to track symptoms, monitor progress, and guide treatment decisions.

Definition and purpose

The GAD-7 is a 7-item self-report measure used to assess the frequency and severity of anxiety symptoms in clients 13 and older. Aligned with the DSM-V-TR criteria for Generalized Anxiety Disorder (GAD) the results of this measure can support accurate diagnoses, establishment of treatment goals based on symptom severity, and guide effective clinical interventions.

Items and scoring

Since your last visit, how often have you been bothered by the following problems?

  1. Feeling nervous, anxious, or on edge
  2. Not being able to stop or control worrying
  3. Worrying too much about different things
  4. Trouble relaxing
  5. Being so restless that it is hard to sit still
  6. Becoming easily annoyed or irritable
  7. Feeling afraid, as if something awful might happen

 

The client responds to each question via a Likert scale ranging from 0-3. 

0 = Not at all

1 = Several days

2 = More than half the days

3 = Nearly every day

 

Responses to all 7 questions are then summed to provide a total score of between 0-21.

A final prompt (not scored) is asked to assess the level of functional impairment as a result of anxiety symptoms.

 

If you checked any problems, how difficult have they 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

Interpreting scores

0 - 4 = No to Minimal symptoms

5 - 9 = Mild symptoms

10 - 14 = Moderate symptoms

15 - 21 = Severe symptoms

 

Higher scores on the GAD-7 indicate more severe anxiety. A score of 10 or more indicates a preliminary diagnosis of GAD, however, use clinical judgment to confirm a diagnosis. Consider if symptoms cause significant distress or impairment, as well as whether the symptoms are better explained by other conditions.

GAD-7 clinical benchmark border.png

Monitoring

The GAD-7 is a powerful tool to measure changes in symptomatology, track clinical progress, and inform treatment planning. It also has been associated with superior client outcomes when compared to usual care.


The GAD-7 is Publicly Available: ADAA https://adaa.org/sites/default/files/GAD-7_Anxiety-updated_0.pdf

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