Diagnostic Validity of the Generalized Anxiety Disorder - 7 (GAD-7) among Pregnant Women

Abstract

ObjectiveGeneralized anxiety disorder (GAD) during pregnancy is associated with several adverse maternal and perinatal outcomes. A reliable and valid screening tool for GAD should lead to earlier detection and treatment. Among pregnant Peruvian women, a brief screening tool, the GAD-7, has not been validated. This study aims to evaluate the reliability and validity of the GAD-7.MethodsOf 2,978 women who attended their first perinatal care visit and had the GAD-7 screening, 946 had a Composite International Diagnostic Interview (CIDI). The Cronbach’s alpha was calculated to examine the reliability. We assessed the criterion validity by calculating operating characteristics. The construct validity was evaluated using factor analysis and association with health status on the CIDI. The cross-cultural validity was explored using the Rasch Rating Scale Model (RSM).ResultsThe reliability of the GAD-7 was good (Cronbach’s alpha = 0.89). A cutoff score of 7 or higher, maximizing the Youden Index, yielded a sensitivity of 73.3% and a specificity of 67.3%. One-factor structure of the GAD-7 was confirmed by exploratory and confirmatory factor analysis. Concurrent validity was supported by the evidence that higher GAD-7 scores were associated with poor self-rated physical and mental health. The Rasch RSM further confirmed the cross-cultural validity of the GAD-7.ConclusionThe results suggest that the Spanish-language version of the GAD-7 may be used as a screening tool for pregnant Peruvian women. The GAD-7 has good reliability, factorial validity, and concurrent validity. The optimal cutoff score obtained by maximizing the Youden Index should be considered cautiously; women who screened positive may require further investigation to confirm GAD diagnosis.

Psychometric Properties of the Pittsburgh Sleep Quality Index (PSQI) in a Cohort of Peruvian Pregnant Women

“…Given the scarcity of studies concerning the psychometric properties of the PSQI when used among pregnant women, and given that prior studies have shown that sleep, mood, and anxiety disorders are highly prevalent among low-income pregnant women in Lima, Peru, 20,21 we sought to evaluate the psychometric properties of the Spanish-language version of the PSQI among pregnant Peruvian women during early pregnancy. We also assessed the relation of maternal early pregnancy sleep quality with measures of stress-induced sleep disturbance, and depressive and anxiety symptoms.…”

“…27 Among pregnant Peruvian women, the GAD-7 has good reliability, factorial validity, and concurrent validity: the optimal cutoff score obtained by maximizing the Youden Index is 7 with a sensitivity of 73.3% and a specificity of 67.3%. 21 In the present analysis, GAD was defined as the GAD-7 score ≥ 7.…”

Psychometric Evaluation of the Ford Insomnia Response to Stress Test (FIRST) in Early Pregnancy

“…Of note, given that prior studies have shown that sleep, mood, and anxiety disorders are highly prevalent among low-income pregnant women in Peru, 18,19 we sought to evaluate the psychometric properties, construct validity and factor structure of the Spanish-language version of FIRST questionnaire (FIRST-S) in early pregnancy (Figure 1). …”

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.…”