Cultural adaptation into Spanish of the generalized anxiety disorder-7 (GAD-7) scale as a screening tool

Abstract

BackgroundGeneralized anxiety disorder (GAD) is a prevalent mental health condition which is underestimated worldwide. This study carried out the cultural adaptation into Spanish of the 7-item self-administered GAD-7 scale, which is used to identify probable patients with GAD.MethodsThe adaptation was performed by an expert panel using a conceptual equivalence process, including forward and backward translations in duplicate. Content validity was assessed by interrater agreement. Criteria validity was explored using ROC curve analysis, and sensitivity, specificity, predictive positive value and negative value for different cut-off values were determined. Concurrent validity was also explored using the HAM-A, HADS, and WHO-DAS-II scales.ResultsThe study sample consisted of 212 subjects (106 patients with GAD) with a mean age of 50.38 years (SD = 16.76). Average completion time was 2'30''. No items of the scale were left blank. Floor and ceiling effects were negligible. No patients with GAD had to be assisted to fill in the questionnaire. The scale was shown to be one-dimensional through factor analysis (explained variance = 72%). A cut-off point of 10 showed adequate values of sensitivity (86.8%) and specificity (93.4%), with AUC being statistically significant [AUC = 0.957-0.985); p < 0.001]. The scale significantly correlated with HAM-A (0.852, p < 0.001), HADS (anxiety domain, 0.903, p < 0.001), and WHO-DAS II (0.696, p > 0.001).LimitationsElderly people, particularly those very old, may need some help to complete the scale.ConclusionAfter the cultural adaptation process, a Spanish version of the GAD-7 scale was obtained. The validity of its content and the relevance and adequacy of items in the Spanish cultural context were confirmed.

Non-suicidal self-injuries in a sample of Mexican university students

“…It is a 7-item Likert type scale with four response options: never, several days, over half the days and nearly every day. The Spanish language version was adapted by García-Campayo et al (2010), finding good internal consistency (Cronbach's alpha of .93) and strong content, criteria, and concurrent validity as assessed by interrater agreement, ROC curve analysis, and associations with other measures of anxiety and impairment. Cronbach's alpha for the scale in this study was .87.…”

Screening for generalized anxiety disorder in Spanish primary care centers with the GAD-7

“…According to Spitzer et al (2006), the total score can be classified into four degrees of severity: minimum (0-4), mild (5-9), moderate (10-14) and severe (15-21). The validated Spanish version (García-Campayo et al, 2010) uses the same classification system, which thus differs slightly from the original PHQ.…”

“…The Spanish version of the PHQ (Diez-Quevedo, 2001) includes a 3-point response scale ranging from 0 ("not at all") to 1 ("several days") and 2 ("more than half the days") and requires an algorithm for GAD with a response of "more than half the days" on item 5a and also on three or more of items 5b-g. As in the original English (Spitzer et al, 2006), the Spanish version of the GAD-7 validated by García-Campayo et al (2010) includes a 4-point response scale ranging from 0 ("never") to 1 ("several days"), 2 ("more than half the days") and 3 ("nearly every day"), providing a total score that ranges from 0 to 21. According to Spitzer et al (2006), the total score can be classified into four degrees of severity: minimum (0-4), mild (5-9), moderate (10-14) and severe (15-21).…”

“…García-Campayo et al (2010) subsequently developed and validated the Spanish version of the GAD-7, which-unlike .93)-similar to the original version-using a cut-off score of 10 for diagnosis. Feasibility and reliability were also excellent and the scale was shown to be one-dimensional through factor analysis, with an explained variance of 72%.…”

Factor structure and construct validity of the Generalized Anxiety Disorder 7-item (GAD-7) among Portuguese college students

“…As a short and objective self-report measure showing strong properties as a screening tool 11 , researchers have tested its psychometric characteristics in several settings. In this context, over the last decade, GAD-7 has been presented as a reliable and valid questionnaire in different languages 14,15,16,17,18 including Portuguese 19 , with heterogeneous psychiatric samples 20,21 for specific medical conditions 22,23,24,25 in the general population 26 and in geriatric samples 27 . However, the one-dimensional nature of GAD-7 proposed by the original model is not consistent in the literature.…”