GAD-7: two-week adult anxiety symptom score

Overview

The adult English GAD-7 asks seven questions about anxiety symptoms during the past two weeks. Survey Doctor adds the 0-to-3 answers into a 0-to-21 total. Published bands begin at 5, 10, and 15. The score describes symptom frequency; it does not diagnose an anxiety disorder or select treatment.

A full assessment adds functioning, history, medical factors, other symptoms, and your own account. The number starts that conversation. It cannot finish it.

Who should take this assessment?

The GAD-7 can support an adult screening or symptom review when worry, nervousness, difficulty relaxing, restlessness, irritability, or fear are concerns.

The evidence summarized here concerns the adult English form. Youth use requires guidance for the exact version, population, and setting.

What to expect

You will answer seven questions about the past two weeks. Each answer uses the same frequency scale:

• Not at all: 0
• Several days: 1
• More than half the days: 2
• Nearly every day: 3

All seven answers are required in the native Survey Doctor workflow. Completing the questionnaire usually takes only a few minutes, but consider the whole two-week period.

Score interpretation

Survey Doctor adds the seven values. There is no weighting or reverse scoring.

These supported bands are descriptive. They do not prescribe care, and a minimal band never means that someone should stop current care or avoid asking for help.

A total of 10 or higher supports a closer assessment of anxiety symptoms. It does not confirm generalized anxiety disorder. One point is small. Interpret boundary scores cautiously.

For a plain-language walkthrough, see what your GAD-7 score means.

Optional functional companion

Some GAD-7 materials append an unscored question about difficulty at work, at home, or with other people. The seven-item total remains unchanged because functional difficulty is separate from symptom scoring.

Survey Doctor shows this optional companion when any scored symptom is above zero. It saves the response separately and never adds it to the symptom total. An all-zero result does not show the question.

Historical, manual, and imported rows without companion data mean it was not collected. Do not infer a functional response from the symptom score.

Absence is not an answer.

Evidence boundary

Spitzer et al.'s 2006 adult primary-care study enrolled 2,740 patients, with 965 completing an independent telephone interview. At a score of 10, sensitivity was 89% and specificity was 82% in that criterion sample.

Those figures are not universal performance guarantees. Population, setting, language, and the comparison assessment can change them. Survey Doctor therefore uses 10 as a supported follow-up boundary, not as proof of generalized anxiety disorder.

Cutoffs need context.

What the questions measure

The seven items cover nervousness, difficulty controlling worry, worry about different things, trouble relaxing, restlessness, irritability, and fear that something awful may happen.

The pattern is useful when screening generalized anxiety symptoms. It cannot distinguish generalized anxiety disorder from panic, trauma reactions, specific fears, another mental health condition, a medical cause, a medication effect, a substance effect, or situational distress.

The two-week window provides a current snapshot. It does not describe long-term course or symptoms that did not occur during that period.

The GAD-7 also has no suicide or self-harm item. A low score cannot replace a separate safety assessment when the history or presentation raises concern.

Safety stays separate.

If you need help now. In the US, Call 988 or text 988. Call 911 if you are in immediate danger. Outside the US, contact your local emergency number or find support in your country.

Using repeated scores

Complete native GAD-7 results can be compared over time when the form and administration conditions remain similar. Review the seven item responses alongside the total.

There is no single point change, percentage change, remission rule, or retest interval that applies in every setting. Published approaches vary by population and purpose. Use an explicit, source-backed protocol when applying one.

Native score history can show the separately stored companion response when it was collected. It adds context but does not change the score or trend. Historical, manual, and imported rows without companion data mean it was not collected.

Some imported historical GAD summaries are not native GAD-7 results. They used different wording, answer anchors, and completion controls, then retained only a summary score. Survey Doctor keeps those values separate from native bands and trends because the original answers cannot be recovered.

Important limitations

• The total cannot diagnose an anxiety disorder or identify its cause.
• The questionnaire does not distinguish among anxiety presentations.
• The functional companion is optional, appears only after a scored symptom is endorsed, and remains separate from the total.
• Physical illness, medication effects, substances, and life events can affect answers.
• A score-only manual record cannot establish item completeness.
• This audited implementation establishes the adult English form, not adolescent use.
• A low score does not override a person's concerns or current care plan.

Related assessments

GAD-2: Generalized Anxiety Disorder 2-item:
A two-item anxiety screen drawn from the first two GAD-7 items

PHQ-9: Patient Health Questionnaire-9:
A nine-item screen for depression symptoms

PHQ-4: Patient Health Questionnaire-4:
A four-item questionnaire combining two anxiety and two depression items

DASS-21: Depression Anxiety Stress Scales:
A one-week questionnaire that reports separate doubled depression, anxiety, and stress scores