Psychology & well-being
Anxiety scale: GAD-7 and the DASS-21 anxiety subscale
- Concept
- Anxiety
- Field
- Psychology & well-being
- Scales in the library
- 2
- Items
- 14
Anxiety is a state of excessive worry and tension accompanied by physical symptoms such as a racing heart and shortness of breath. The GAD-7 was developed to screen for generalized anxiety disorder using DSM-IV criteria, while the DASS-21 anxiety subscale focuses on physiological arousal and the feeling of fear. In theses in Vietnam, anxiety often goes with stress and depression in studies on the mental health of students, healthcare workers, and social media users.
Comparing the scales
| Scale | Author (year) | Items | Response format | When to use it |
|---|---|---|---|---|
| Anxiety Severity (GAD) GAD-7 anxiety scale | Spitzer, Kroenke, Williams & Löwe (2006) | 7 | 4-point | Choose when anxiety is the main variable and you need clear screening cut-offs; asks about the past 2 weeks. |
| Anxiety (A) DASS-21 scale | Lovibond & Lovibond (1995) | 7 | 4-point | Choose when you need to measure depression, anxiety, and stress together; asks about the past week. |
Items of each scale
Original English wording from the published source. Replace placeholders such as [system] or
[brand] with what your study is about, and pilot the questionnaire with 20 to 30 respondents first.
Anxiety Severity (GAD) · GAD-7 anxiety scale
| Code | Item |
|---|---|
| GAD1 | Feeling nervous, anxious or on edge |
| GAD2 | Not being able to stop or control worrying |
| GAD3 | Worrying too much about different things |
| GAD4 | Trouble relaxing |
| GAD5 | Being so restless that it is hard to sit still |
| GAD6 | Becoming easily annoyed or irritable |
| GAD7 | Feeling afraid as if something awful might happen |
Source: Spitzer, Kroenke, Williams & Löwe (2006). Response scale, licence and APA reference: GAD-7 anxiety scale.
Anxiety (A) · DASS-21 scale
| Code | Item |
|---|---|
| A2 | I was aware of dryness of my mouth |
| A4 | I experienced breathing difficulty (eg, excessively rapid breathing, breathlessness in the absence of physical exertion) |
| A7 | I experienced trembling (eg, in the hands) |
| A9 | I was worried about situations in which I might panic and make a fool of myself |
| A15 | I felt I was close to panic |
| A19 | I was aware of the action of my heart in the absence of physical exertion (eg, sense of heart rate increase, heart missing a beat) |
| A20 | I felt scared without any good reason |
Source: Lovibond & Lovibond (1995). Response scale, licence and APA reference: DASS-21 scale.
Tips
- The GAD-7 is scored 0 to 3 per item, total 0 to 21. Cut-offs of 5, 10, and 15 correspond to mild, moderate, and severe anxiety.
- The DASS-21 anxiety subscale score must be multiplied by 2 before comparing with the classification cut-offs.
- Both scales use a 4-point frequency scale. Do not convert to an agreement Likert scale, because you would lose the comparison cut-offs.
- These are screening tools, not a substitute for diagnosis. Include psychological support information at the end of the questionnaire.
Once you have a scale, put the concept in the research model drawer to state your hypotheses, work out the minimum sample size, and after data collection check reliability with the Cronbach's alpha calculator.
Frequently asked questions
Should I use the GAD-7 or the DASS-21 to measure anxiety?
The GAD-7 measures generalized anxiety symptoms and has a screening cut-off widely used in health care. The DASS-21 suits topics that need depression, anxiety, and stress in one questionnaire.
Is the GAD-7 free?
Yes. The GAD-7 is released free, and no permission is needed to use it.
What sample size is enough for an anxiety study in students?
If the goal is to estimate anxiety prevalence, use the formula for estimating a proportion. If you run regression or SEM, use a sample size calculator based on the number of independent variables.