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The GAD-7 is the companion to PHQ-9 for anxiety, and the second-most- administered measure in the library. The two are usually given together as the standard depression-anxiety baseline.

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What it measures

Generalized anxiety severity over the last two weeks, mapped to DSM-5 Generalized Anxiety Disorder criteria. Seven items — nervousness, uncontrollable worry, excessive worry, trouble relaxing, restlessness, irritability, and anticipatory fear. Each rated on the same 4-point frequency scale as the PHQ-9, which makes co-administration smooth.

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When to use it

  • Intake. As a baseline measure on the first session, usually paired with PHQ-9.
  • Every 2–4 weeks during treatment. To track response.
  • Pre/post a discrete intervention. Around an anxiety-focused CBT protocol, exposure work, or a medication change.
  • Discharge. Outcome documentation.
Comorbidity between depression and anxiety is the rule, not the exception, so pairing GAD-7 with PHQ-9 catches presentations either measure alone would miss.

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How clients fill it

Under two minutes on a phone. The 2-week stem prompt is the same shape as the PHQ-9 — “Over the last 2 weeks, how often have you been bothered by the following problems?” — followed by seven items with the same four-option frequency scale:
  • Not at all
  • Several days
  • More than half the days
  • Nearly every day
Because the scale matches the PHQ-9, clients filling both back-to-back move through them quickly.

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How Rivet scores it

Each option carries a score from 0 to 3, and the total is the sum of items 1–7. Range: 0–21. The score appears live in your scoring pill as the client answers.

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Severity bands

A score of 10 or higher is the recommended cutoff for further GAD evaluation (Spitzer 2006).

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Administering alongside PHQ-9

The two measures are designed to be given together. Practical pattern:
  • Send both in one async link before the intake session
  • Both scores appear in the conversation when the client submits
  • Read them as a pair — a high PHQ-9 with a low GAD-7 looks different from a moderate PHQ-9 with a high GAD-7, and shapes where treatment focus lands
The matched 2-week frame and identical frequency scale make the pair easy for the client and clean for chart documentation.

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What GAD-7 doesn’t screen

The GAD-7 is specific to generalized anxiety. It doesn’t capture:
  • Panic disorder — discrete panic attacks aren’t part of the items
  • Social anxiety — use SPIN
  • Obsessive-compulsive disorder — use OCI-R
  • Specific phobias — no validated brief screen in the library; this is interview territory
  • Trauma-related anxiety — use PCL-5 or ITQ
If the presentation isn’t primarily generalized worry, GAD-7 will under- read. Pick the measure that matches the cluster.

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When NOT to use it

  • Clients under 18. Validated in adults; adolescent versions exist but aren’t included under this ID.
  • As a sole diagnostic instrument. Screening, not diagnosis.
  • When the anxiety is clearly situational. A score of 18 the week before a custody hearing isn’t the same construct as a chronic 18; the measure can’t tell the difference, you can.

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GAD-7 vs the other anxiety measures

The GAD-7 screens for generalized anxiety specifically. It does not capture panic, OCD, social anxiety or specific phobias — that’s the single most useful thing to know when deciding whether it’s the right instrument for the client in front of you.
  • vs DASS-21 — the DASS splits into three subscales and captures general stress and arousal that belongs to neither depression nor GAD. Twenty-one items rather than seven, so most practices administer it less often. Pick it when the presentation blurs and you want the pattern; pick the GAD-7 when you want a number you can take every two weeks.
  • vs PSWQ — the GAD-7 measures how frequent the symptoms were recently; the PSWQ measures worry as a stable trait. They answer different questions and are often run together in GAD work.
  • vs SPIN — if the fear is social-evaluative, the SPIN is the instrument. A normal GAD-7 does not rule out social anxiety.
  • vs HAM-A — the same construct rated by you in a structured interview rather than self-reported.
  • vs the BAI — the Beck Anxiety Inventory is licensed by Pearson and paid for per use. Rivet doesn’t include it; the library was built from measures that carry no per-administration fee.

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Is it free to use?

Yes. Covered by the same 2010 Pfizer free-public release as the rest of the PHQ family.

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Citation

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. Copyright Pfizer Inc. Released under the same 2010 Pfizer free-public- use posture as the PHQ-9. Rivet preserves the canonical item wording verbatim.

PHQ-9

The depression companion measure — administered together as the standard baseline.

SPIN

Social Phobia Inventory — for social-evaluative anxiety the GAD-7 won’t capture.

Screening overview

When to screen and the cadence for outcome tracking.