Niwenahisemo Lisa Cynthia, Hong Su, Kuang Li
Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Front Psychiatry. 2024 Mar 11;15:1346267. doi: 10.3389/fpsyt.2024.1346267. eCollection 2024.
Anxiety disorders are among the most common mental health problems experienced by adolescents worldwide because of their evident significant impact on their quality of life and functioning. The generalized anxiety disorder item (GAD-7) was manufactured to identify the severity of self-reported anxiety symptoms. Efforts to address and screen for mental health problems in Rwanda have been limited, and the importance of screening for anxiety disorders is high. The primary aim of this study was to analyze the psychometric properties of the Kinyarwanda version of the Generalized Anxiety Disorder GAD-7, and then test the measurement invariance of the GAD-7 by gender.
We used the Rwandese version of GAD-7 among secondary school students in Kigali city (n=1813). Measurement invariance of the GAD-7 across gender and report on anxiety symptom severity prevalence. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to examine measurement invariance.
Our findings demonstrated that in the sample of 1813 adolescents aged between 12 and 17 years, generalized anxiety symptoms prevalence rates were higher in females (46.4%) than males (n= 29.8%) GAD-7 demonstrated good reliability and validity coefficients with a Cronbach's α of .077 and KMO and Bartlett test of Sphericity = 0.835. In addition to these psychometric properties, the GAD-7 screening scale had equivalence for configural and metric invariance across groups with excellent fit indices, and we confirmed partial scalar invariance across groups.
The GAD-7 can be used in cross-group comparison of generalized anxiety disorder prevalence, and we acknowledge that full scalar invariance is generally difficult to confirm, especially due to gender differences. We recommend that future studies further investigate populations living in rural areas and conduct trials that will focus on anxiety-specific treatment in Rwandan Clinical health care centers to determine the diagnostic accuracy of this screening tool.
焦虑症是全球青少年中最常见的心理健康问题之一，因为它们对青少年的生活质量和功能有明显的重大影响。广泛性焦虑症条目（GAD-7）旨在识别自我报告的焦虑症状的严重程度。卢旺达在解决和筛查心理健康问题方面的努力有限，而筛查焦虑症的重要性很高。本研究的主要目的是分析基尼亚卢旺达语版广泛性焦虑症GAD-7的心理测量特性，然后按性别测试GAD-7的测量不变性。
我们在基加利市的中学生（n=1813）中使用了卢旺达语版的GAD-7。GAD-7在性别间的测量不变性以及焦虑症状严重程度患病率报告。采用探索性因素分析（EFA）和验证性因素分析（CFA）来检验测量不变性。
我们的研究结果表明，在1813名年龄在12至17岁之间的青少年样本中，女性的广泛性焦虑症状患病率（46.4%）高于男性（29.8%）。GAD-7显示出良好的信度和效度系数，克朗巴哈α系数为0.77，KMO和巴特利特球形度检验=0.835。除了这些心理测量特性外，GAD-7筛查量表在不同组间具有构型和度量不变性等价性，拟合指数良好，并且我们确认了不同组间的部分标量不变性。
GAD-7可用于广泛性焦虑症患病率的跨组比较，并且我们认识到完全标量不变性通常难以确认，尤其是由于性别差异。我们建议未来的研究进一步调查农村地区的人群，并在卢旺达临床医疗中心开展专注于焦虑症特异性治疗的试验，以确定该筛查工具的诊断准确性。
