Diagnostic Validity of the Generalized Anxiety Disorder - 7 (GAD-7) among Pregnant Women.

<h4>Objective</h4>Generalized anxiety disorder (GAD) during pregnancy is associated with several adverse maternal and perinatal outcomes. A reliable and valid screening tool for GAD should lead to earlier detection and treatment. Among pregnant Peruvian women, a brief screening tool, the...

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Main Authors: Qiu-Yue Zhong, Bizu Gelaye, Alan M Zaslavsky, Jesse R Fann, Marta B Rondon, Sixto E Sánchez, Michelle A Williams
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2015-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0125096
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author Qiu-Yue Zhong
Bizu Gelaye
Alan M Zaslavsky
Jesse R Fann
Marta B Rondon
Sixto E Sánchez
Michelle A Williams
author_facet Qiu-Yue Zhong
Bizu Gelaye
Alan M Zaslavsky
Jesse R Fann
Marta B Rondon
Sixto E Sánchez
Michelle A Williams
author_sort Qiu-Yue Zhong
collection DOAJ
description <h4>Objective</h4>Generalized anxiety disorder (GAD) during pregnancy is associated with several adverse maternal and perinatal outcomes. A reliable and valid screening tool for GAD should lead to earlier detection and treatment. Among pregnant Peruvian women, a brief screening tool, the GAD-7, has not been validated. This study aims to evaluate the reliability and validity of the GAD-7.<h4>Methods</h4>Of 2,978 women who attended their first perinatal care visit and had the GAD-7 screening, 946 had a Composite International Diagnostic Interview (CIDI). The Cronbach's alpha was calculated to examine the reliability. We assessed the criterion validity by calculating operating characteristics. The construct validity was evaluated using factor analysis and association with health status on the CIDI. The cross-cultural validity was explored using the Rasch Rating Scale Model (RSM).<h4>Results</h4>The reliability of the GAD-7 was good (Cronbach's alpha = 0.89). A cutoff score of 7 or higher, maximizing the Youden Index, yielded a sensitivity of 73.3% and a specificity of 67.3%. One-factor structure of the GAD-7 was confirmed by exploratory and confirmatory factor analysis. Concurrent validity was supported by the evidence that higher GAD-7 scores were associated with poor self-rated physical and mental health. The Rasch RSM further confirmed the cross-cultural validity of the GAD-7.<h4>Conclusion</h4>The results suggest that the Spanish-language version of the GAD-7 may be used as a screening tool for pregnant Peruvian women. The GAD-7 has good reliability, factorial validity, and concurrent validity. The optimal cutoff score obtained by maximizing the Youden Index should be considered cautiously; women who screened positive may require further investigation to confirm GAD diagnosis.
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spelling doaj.art-bfcc00f7722540fea5a53597dac00a4a2022-12-21T18:26:20ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01104e012509610.1371/journal.pone.0125096Diagnostic Validity of the Generalized Anxiety Disorder - 7 (GAD-7) among Pregnant Women.Qiu-Yue ZhongBizu GelayeAlan M ZaslavskyJesse R FannMarta B RondonSixto E SánchezMichelle A Williams<h4>Objective</h4>Generalized anxiety disorder (GAD) during pregnancy is associated with several adverse maternal and perinatal outcomes. A reliable and valid screening tool for GAD should lead to earlier detection and treatment. Among pregnant Peruvian women, a brief screening tool, the GAD-7, has not been validated. This study aims to evaluate the reliability and validity of the GAD-7.<h4>Methods</h4>Of 2,978 women who attended their first perinatal care visit and had the GAD-7 screening, 946 had a Composite International Diagnostic Interview (CIDI). The Cronbach's alpha was calculated to examine the reliability. We assessed the criterion validity by calculating operating characteristics. The construct validity was evaluated using factor analysis and association with health status on the CIDI. The cross-cultural validity was explored using the Rasch Rating Scale Model (RSM).<h4>Results</h4>The reliability of the GAD-7 was good (Cronbach's alpha = 0.89). A cutoff score of 7 or higher, maximizing the Youden Index, yielded a sensitivity of 73.3% and a specificity of 67.3%. One-factor structure of the GAD-7 was confirmed by exploratory and confirmatory factor analysis. Concurrent validity was supported by the evidence that higher GAD-7 scores were associated with poor self-rated physical and mental health. The Rasch RSM further confirmed the cross-cultural validity of the GAD-7.<h4>Conclusion</h4>The results suggest that the Spanish-language version of the GAD-7 may be used as a screening tool for pregnant Peruvian women. The GAD-7 has good reliability, factorial validity, and concurrent validity. The optimal cutoff score obtained by maximizing the Youden Index should be considered cautiously; women who screened positive may require further investigation to confirm GAD diagnosis.https://doi.org/10.1371/journal.pone.0125096
spellingShingle Qiu-Yue Zhong
Bizu Gelaye
Alan M Zaslavsky
Jesse R Fann
Marta B Rondon
Sixto E Sánchez
Michelle A Williams
Diagnostic Validity of the Generalized Anxiety Disorder - 7 (GAD-7) among Pregnant Women.
PLoS ONE
title Diagnostic Validity of the Generalized Anxiety Disorder - 7 (GAD-7) among Pregnant Women.
title_full Diagnostic Validity of the Generalized Anxiety Disorder - 7 (GAD-7) among Pregnant Women.
title_fullStr Diagnostic Validity of the Generalized Anxiety Disorder - 7 (GAD-7) among Pregnant Women.
title_full_unstemmed Diagnostic Validity of the Generalized Anxiety Disorder - 7 (GAD-7) among Pregnant Women.
title_short Diagnostic Validity of the Generalized Anxiety Disorder - 7 (GAD-7) among Pregnant Women.
title_sort diagnostic validity of the generalized anxiety disorder 7 gad 7 among pregnant women
url https://doi.org/10.1371/journal.pone.0125096
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