Scale library · Psychology & mental health
GAD-7 anxiety scale: Spitzer et al. (2006)
The GAD-7 was developed by Spitzer, Kroenke, Williams and Löwe (2006) to screen for generalized anxiety disorder and measure anxiety symptom severity, with validation in 2,740 primary care patients. It asks how often respondents have been bothered by 7 anxiety symptoms over the last 2 weeks. It belongs to the same family as the PHQ-9, is short and free, and is often used alongside it to measure both depression and anxiety, for example in theses on exam anxiety among students, employees, healthcare workers and patients.
Cite the original, not the blog.
- Model or scale: GAD-7
- Constructs: 1
- Items: 7
Original English items
Items marked (R) are reverse-coded: recode them before computing reliability or scale scores. Replace bracketed placeholders such as [system] with the name of the system, brand or organization you study.
Anxiety Severity (GAD, 7 items)
| Code | Item wording | Reverse-coded |
|---|---|---|
| GAD1 | Feeling nervous, anxious or on edge | No |
| GAD2 | Not being able to stop or control worrying | No |
| GAD3 | Worrying too much about different things | No |
| GAD4 | Trouble relaxing | No |
| GAD5 | Being so restless that it is hard to sit still | No |
| GAD6 | Becoming easily annoyed or irritable | No |
| GAD7 | Feeling afraid as if something awful might happen | No |
Response scale
4-point frequency scale, not an agreement scale, referring to the last 2 weeks: 0 = Not at all, 1 = Several days, 2 = More than half the days, 3 = Nearly every day. Summing the 7 items gives a total of 0–21; according to the authors, cut-offs of 5, 10 and 15 indicate mild, moderate and severe anxiety. There are no reverse-coded items.
Licence and permission
According to the PHQ Screeners website and the note printed on the questionnaire, the GAD-7 was developed by Spitzer, Williams, Kroenke and colleagues with an educational grant from Pfizer and is in the public domain: no permission is required to reproduce, translate, display or distribute it.
Sources (APA 7)
- Duong, N. L. M., Nguyen, V. H., Ngo, M. T., Le, D. M., Nguyen, T. D., Nguyen, T. T. T., Nguyen, H. T., Kim, B. G., & Pham, T. T. (2025). Academic motivation in association with mental health and quality of life among medical and health science students: A survey in Vietnam. BMC Medical Education, 25, 986. https://doi.org/10.1186/s12909-025-07368-4
- Löwe, B., Decker, O., Müller, S., Brähler, E., Schellberg, D., Herzog, W., & Herzberg, P. Y. (2008). Validation and standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the general population. Medical Care, 46(3), 266–274. https://doi.org/10.1097/MLR.0b013e318160d093
- Nguyen, T. T., Nguyen, D. C., Nguyen, H. T., Do, H. T., Ngo, T., Pham, A. B. G., Tran, T. Q., Hoang, L. P., Dang, H., Boyer, L., Fond, G., Auquier, P., Latkin, C. A., Ho, R. C. M., Ho, C. S. H., & Zhang, M. W. B. (2025). Exposure to fake news on social media, coping mechanisms, and mental health impact among Vietnamese adolescents and young adults. Scientific Reports, 15, 35117. https://doi.org/10.1038/s41598-025-19175-4
- Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092–1097. https://doi.org/10.1001/archinte.166.10.1092
Vietnamese translation
A Vietnamese translation of every item, with sample-size advice and studies that used the scale, is on the Vietnamese page for this scale.