Validation of Generalized Anxiety Disorder 6 (GAD-6)—A Modified Structure of Screening for Anxiety in the Adolescent French Population

Anja Todorović, Cédric Baumann, Myriam Blanchin and Stéphanie Bourion-Bédès ()
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Anja Todorović: UR4360 APEMAC, School of Public Health, Faculty of Medicine, University of Lorraine, 54000 Nancy, France
Cédric Baumann: UR4360 APEMAC, School of Public Health, Faculty of Medicine, University of Lorraine, 54000 Nancy, France
Myriam Blanchin: SPHERE U1246, University of Nantes, University of Tours, INSERM, 44000 Nantes, France
Stéphanie Bourion-Bédès: UR4360 APEMAC, School of Public Health, Faculty of Medicine, University of Lorraine, 54000 Nancy, France

IJERPH, 2023, vol. 20, issue 8, 1-15

Abstract: Anxiety disorders remain underdiagnosed and undertreated, especially in child and adolescent populations. This study aimed to examine the construct validity of the Generalized Anxiety Disorder Scale 7 (GAD-7) in a sample of French adolescents by combining the Classical Test Theory (CTT) and the Item Response Theory (IRT) and to assess the invariance of items. A total of 284 adolescents enrolled in school in the Lorraine region were randomly selected to participate in a cross-sectional study. A psychometric evaluation was performed using a combination of CTT and IRT analyses. The study of psychometric properties of GAD-7 revealed poor adequation to the sample population, and engendered the deletion of one item (#7) and the merger of two response modalities (#2 and #3). These modifications generated the new GAD-6 scale, which had a good internal consistency reliability (Cronbach α = 0.85; PSI = 0.83), acceptable goodness-of-fit indices (χ2 = 28.89, df = 9, P = 0.001; RMSEA (90% CI) = 0.088 [0.054; 0.125]; SRMR = 0.063; CFI = 0.857), and an acceptable convergent validity (r = –0.62). Only one item (#5) had a consistent Differential Item Functioning (DIF) by gender. This study evaluated the structure of the GAD-7 scale, which was essentially intended at discriminating adolescent patients with high levels of anxiety, and adapted it to a population of adolescents from the general population. The GAD-6 scale presents better psychometric properties in this general population than the original GAD-7 version.

Keywords: Generalized Anxiety Disorder; GAD-7; GAD-6; anxiety; adolescence; Differential Item Functioning; self-reported health status (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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