Generalized anxiety disorder severity scale (GADSS): a preliminary validation study (original) (raw)
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Using Generalized Anxiety Disorder-2 (GAD-2) and GAD-7 in a Primary Care Setting
2020
Anxiety disorders are highly prevalent in the primary care setting and are responsible for significant morbidity as well as a loss of productivity. Evaluation by mental health specialists and behavioral specialists can sometimes be confounded with problems of availability, accessibility, and the patient’s hesitancy to talk to new providers due to lack of prior relationship and trust. Primary care providers already have the advantage of being available for their patients, and have built years of trust behind them to strengthen this relationship. The biggest problems which confront primary care are the time constraints as well as the presence of multiple medical demands. This leads to a constant need for tools that facilitate early recognition and diagnosis of mental health disorders while also providing judicious utilization of clinic time. This article attempts to review the use of two of these popular tools: Generalized Anxiety Disorder scale-2 (GAD-2) and GAD-7 in the primary care...
Generalized anxiety disorder in primary care: mental health services use and treatment adequacy
BMC Family Practice, 2015
Purpose: Generalized Anxiety Disorder (GAD) is a common mental disorder in the primary care setting, marked by persistent anxiety and worries. The aims of this study were to: 1) examine mental health services utilisation in a large sample of primary care patients; 2) explore detection of GAD and minimal standards for pharmacological and psychological treatment adequacy based on recommendation from clinical practice guidelines; 3) examine correlates of treatment adequacy, i.e. predisposing, enabling and needs factors according to the Behavioural Model of Health Care Use. Methods: A sample of 373 adults meeting DSM-IV criteria for Generalized Anxiety Disorder in the past 12 months took part in this study. Data were drawn from the "Dialogue" project, a large primary care study conducted in 67 primary care clinics in Quebec, Canada. Following a mental health screening in medical clinics (n = 14833), patients at risk of anxiety or depression completed the Composite International Diagnostic Interview-Simplified (CIDIS). Multilevel logistic regression models were developed to examine correlates of treatment adequacy for pharmacological and psychological treatments. Results: Results indicate that 52.5 % of participants were recognized as having GAD by a healthcare professional in the past 12 months, and 36.2 % of the sample received a pharmacological (24.4 %) and/or psychological treatment (19.2 %) meeting indicators based on clinical practice guidelines recommendations. The detection of GAD by a health professional and the presence of comorbid depression were associated with overall treatment adequacy. Conclusions: This study suggests that further efforts towards GAD detection could lead to an increase in the delivery of evidence-based treatments. Key targets for improvement in treatment adequacy include regular follow up of patients with a GAD medication and access to psychotherapy from the primary care setting.
Development and validation of the Generalized Anxiety Disorder Inventory (GADI)
Journal of Psychopharmacology, 2007
The psychometric tools used for the assessment of generalized anxiety disorder (GAD) either do not conform to the current concept of the condition or have important limitations. We aimed to develop and validate a new questionnaire for the assessment of symptom profile and severity of GAD.
Journal of Anxiety Disorders, 2014
The fourth edition of the Generalized Anxiety Disorder Questionnaire (GAD-Q-IV) is a self-report measure that is commonly used to screen for the presence of generalized anxiety disorder (GAD). The current investigation attempted to identify an optimal cut score using samples obtained from an outpatient psychiatric (n = 163) and primary care clinic (n = 99). Results indicated that a cut score of 7.67 provided an optimal balance of sensitivity (.85) and specificity (.74) comparable to a previously identified cut score (5.7) across both samples (sensitivity = .90, specificity = .66). However, both cut scores were consistently outperformed by a score representing the criteria for GAD described in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (sensitivity = .89, specificity = .82).
Current Psychology, 2019
There are limitations in the currently available measures for the assessment of generalized anxiety disorder (GAD). While changes have been made in the diagnostic criteria for GAD from DSM-IV to DSM-5, there are no scales which items correspond directly to DSM-5-based GAD symptomatology. Moreover, although recent studies support measuring both symptom frequency and intensity of mental disorders, most GAD measures assess only either symptom frequency or intensity, and there is no DSM-5based self-report measure of GAD that assesses both. In order to address these limitations, two studies were conducted to develop and validate a new GAD self-report scale, the Generalized Anxiety Symptom Severity Inventory (GASSI), which measures symptom severity by assessing both the frequency and intensity of DSM-5-based GAD symptoms in samples of undergraduates and natural disaster survivors. Study 1 provides evidence for a one-factor summed frequency and intensity GAD score using exploratory factor analysis. GASSI was found to have good reliability and evidence of construct validity. Study 2 suggests that both frequency and intensity of symptoms are needed in assessing GAD severity based on the results of invariance testing. These findings have implications for the measurement of GAD symptoms, as well as in the development of interventions for GAD.
International Journal of Clinical Trials, 2021
Background: Anxiety screening in primary care is crucial for the identification and management of the condition. The generalized anxiety disorder-2 (GAD-2) is an abridged version of the tool composed of the first two questions of the GAD-7 for screening for anxiety in the general adult population in primary care settings. Patients who score more than 3 points are further evaluated for anxiety. Although there is a growing body of literature documenting the psychometric properties of the GAD-2 against a structured interview and the GAD-7, no earlier studies have assessed the performance of the GAD-2 in Qatar. This cross-sectional study primarily aims to examine the sensitivity, specificity, positive (PPV) and negative predictive values (NPV) of GAD-2 scores for detecting anxiety among patients attending PHCC in Qatar.Methods: The study will employ a periodic cross-sectional study of electronic medical record data of adult patients attending the primary health care settings between Jan...
Journal of Psychiatric Research, 2008
Fast-acting anxiolytics are important to patients and society. Measuring early onset, however, requires a sensitive and clinically responsive measure. This study develops and evaluates the psychometric properties of a new patient-reported instrument, the Daily Assessment of Symptoms - Anxiety (DAS-A), designed to detect reduction of anxiety symptoms in patients with Generalized Anxiety Disorder (GAD) during the first week of treatment. Clinician interviews and patient focus groups were conducted to identify relevant constructs; discussions focused on early symptom improvement and meaningful changes in GAD symptoms. The draft questionnaire underwent iterative sets of cognitive interviews to inform item reduction and revision. A double-blind, randomized, placebo-controlled study of paroxetine and lorazepam assessed the performance of the new instrument in GAD patients. Analyses evaluated the structure, reliability, validity, and utility of the instrument. There was consistency across focus groups and clinicians in the description of symptoms that improve first. The final item set was easily understood by interview participants. Factor analyses indicated that a unidimensional structure best described the data. Item-level descriptive statistics, Cronbach's alphas, effect sizes, and validity correlations with other scales were favorable. Most importantly, the DAS-A demonstrated separation of lorazepam from placebo within 24h of first dose and correlated with other anxiety measures. This study resulted in the development of a reliable and valid instrument addressing the DSM-IV dimensions of GAD. The DAS-A is capable of detecting reduction in anxiety symptoms within 24h, making it a desirable measure to include in future trials of fast-acting anxiety medications.