McLean Hospital, Belmont, MA, USA.
Clin Psychol Psychother. 2013 Sep-Oct;20(5):456-64. doi: 10.1002/cpp.1802. Epub 2012 May 17.
Generalized anxiety disorder (GAD) is one of the most prevalent psychiatric presentations; however, GAD has the lowest diagnostic reliability of the anxiety disorders and is poorly recognized in clinical practice. A more reliable assessment of GAD could lead to earlier detection and treatment of the disorder, which has an otherwise debilitating course and significant associated impairment. The 7-item GAD Scale (GAD-7) has shown promise as a measure with good clinical utility and strong psychometric properties in primary care and community settings but has yet to be assessed in acute psychiatric populations. This study examined the validity of the GAD-7 in a sample of 232 patients enrolled in a partial hospital programme. Patients completed a diagnostic interview and a battery of self-report measures before and after treatment. Findings suggest that the GAD-7 has good internal consistency and good convergent validity with worry, anxiety, depression and stress, and the measure was sensitive to change over the course of a short intensive cognitive-behavioural therapy partial hospital programme. However, the confirmatory analysis failed to support the hypothesized unidimensional factor structure; and although the GAD-7 demonstrated good sensitivity (.83), specificity was poor (.46) in identifying patients with GAD. Overall, the GAD-7 appears to be a valid measure of generalized anxiety symptoms in this sample, on the basis of good internal consistency, convergent validity and sensitivity to change, but does not perform well as a screener for GAD.
The GAD-7 Scale is an easy-to-score, self-report measure of core generalized anxiety disorder symptoms. The GAD-7 Scale has good internal consistency and convergent validity with depression, anxiety, stress and worry, and is sensitive to change. The GAD-7 Scale appears to be a good measure of generalized anxiety symptoms in an acute psychiatric sample. The GAD-7 Scale does not perform well as a screener for GAD and should not be used to identify cases of GAD in acute psychiatric samples.
广泛性焦虑障碍（GAD）是最常见的精神科表现之一；然而，GAD 在焦虑障碍中的诊断可靠性最低，在临床实践中也未得到充分认识。对 GAD 进行更可靠的评估可以更早地发现和治疗这种疾病，否则这种疾病会导致衰弱的病程和显著的相关损伤。7 项广泛性焦虑量表（GAD-7）已被证明是一种在初级保健和社区环境中具有良好临床实用性和强大心理测量特性的测量工具，但尚未在急性精神科人群中进行评估。这项研究在参加部分住院计划的 232 名患者中检验了 GAD-7 的有效性。患者在治疗前后完成了诊断访谈和一系列自我报告的测量。研究结果表明，GAD-7 具有良好的内部一致性和与担忧、焦虑、抑郁和压力的良好聚合效度，并且在短时间密集认知行为治疗部分住院计划的过程中对变化敏感。然而，验证性分析未能支持假设的单一维度结构；尽管 GAD-7 在识别 GAD 患者方面具有良好的敏感性（0.83），但其特异性（0.46）较差。总体而言，基于良好的内部一致性、聚合效度和对变化的敏感性，GAD-7 似乎是该样本中广泛性焦虑症状的有效测量工具，但作为 GAD 的筛查工具表现不佳。
GAD-7 量表是一种易于评分的、自我报告的核心广泛性焦虑障碍症状的测量工具。GAD-7 量表具有良好的内部一致性和与抑郁、焦虑、压力和担忧的聚合效度，对变化敏感。GAD-7 量表似乎是急性精神科样本中广泛性焦虑症状的良好测量工具。GAD-7 量表作为 GAD 的筛查工具表现不佳，不应用于识别急性精神科样本中的 GAD 病例。
