Generalized Anxiety Disorder Questionnaire-IV

PsycTESTS Citation:
Newman, M. G., Zuellig, A. R., Kachin, K. E., Constantino, M. J., Przeworski, A., Erickson, T., &
Cashman-McGrath, L. (2002). Generalized Anxiety Disorder Questionnaire-IV [Database record].
Retrieved from PsycTESTS. doi: https://dx.doi.org/10.1037/t04994-000

Instrument Type:
Inventory/Questionnaire

Test Format:
The GAD-Q-IV is a pencil-and-paper instrument which includes a yes/no checklist of whether the
participant has experienced excessive and uncontrollable worry for at least 6 months, a section
where the participant writes his or her worry topics, and a checklist of 6 DSM-IV GAD symptoms.
Two final questions require participants to rate the degree of interference and distress experienced
as a result of their worry, each on an 8-point Likert scale.

Source:
Supplied by author.

Original Publication:
Newman, Michelle G., Zuellig, Andrea R., Kachin, Kevin E., Constantino, Michael J., Przeworski,
Amy, Erickson, Thane, & Cashman-McGrath, Laurie. (2002). Preliminary reliability and validity
of the Generalized Anxiety Disorder Questionnaire-IV: A revised self-report diagnostic measure of
generalized anxiety disorder. Behavior Therapy, Vol 33(2), 215-233. doi:
https://dx.doi.org/10.1016/S0005-7894(02)80026-0

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 Generalized Anxiety Disorder Questionnaire-IV
(GADQ-IV; Newman, Zuellig, Kachin, Constantino,
Przeworski, Erickson, Cashman-McGrath, 2002).
Psychometric Properties and Description
This is a revised version of the GADQ (Roemer, Borkovec, Posa, & Borkovec, 1995) designed to
diagnose Generalized Anxiety Disorder (GAD) based on DSM-IV and DSM-5 criteria. This 9 item self-
report questionnaire was modeled after the ADIS-IV. Thus, it includes four yes/no questions
designed to assess whether the participant has experienced excessive and uncontrollable worry, a
section where the participant writes his or her most frequent worry topics, and a question about
whether the participant has experienced worry more days than not. If participants indicate that
they have not experienced worry more days than not, they are asked to skip the remaining
questions. The remainder of the questionnaire includes a checklist of the 6 GAD symptoms. Two
final questions require the participant to rate the degree of distress and of interference resulting
from the worry on an 8-point Likert scale, a rating of 0 being none, 4 being moderately, and 8 being
very severely. This questionnaire can be scored two different ways: (a) determination whether an
individual meets diagnostic criteria, and (b) creation of a sum total score. Participants were said to
meet GAD criteria on the GAD-Q-IV if they indicated: (1) having experienced excessive and
uncontrollable worry (i.e., they answered yes to item 1 or item 4, or the combination of items 2 and
3, or any other combination of the 1st four items that indicated that the individual worried
excessively and uncontrollably), (2) the worry occurred more days than not for at least six months
(i.e., they answered yes to item 6), (3) they worried about a number of events or activities (i.e., they
indicated three or more worry topics on item 5), (4) they reported experiencing three or more of
six symptoms during the past six months (i.e., they checked off three or more symptoms in
response to item 7) and the symptoms have caused at least moderate distress or moderate
impairment (i.e., they scored 4 or more on item 8 or 9). To create a total score, all yes answers
were coded as 1 and all no answers as 0 (e.g. items (1) Do you experience excessive worry? (2) Is
your worry excessive in intensity, frequency, or amount of distress it causes, (3) Do you find it
difficult to control your worry? (4) Do you worry about minor things? and (6) worry more days
than not over the prior six months). In addition, for item 5 which asks for a list of most frequent
worry topics, individuals were given 1 point for each topic listed up to 6 and this total was divided
by three. Similarly, for item 7, participants were given 1 point for each physical symptom they
experienced up to six and this total was divided by three. Finally, the numbers circled for items 8
and 9 (i.e., degree of distress and interference) were each divided by four and these numbers were
added together. Because the questionnaire requests that individuals skip the remaining items
when they do not endorse initial criteria, such skipped items were scored as 0. Total scores ranged
from 0 to 13. Receiver Operating Characteristic analyses examined the optimal cut-off to
discriminate participants with GAD from those with social phobia, panic disorder, and nonanxious
controls. Results showed that the optimal balance between sensitivity and specificity is achieved
with a cutoff point of 5.7. This cutoff leads to a sensitivity of 83% (25 of 30) and a specificity of
89% (101 of 113). Thus, using this cutoff, the rate of false positive diagnoses by the GAD-Q-IV was
11% and the rate of false negative diagnoses assigned by the GAD-Q-IV was 17%. Kappa agreement
between the ADIS-IV and the GAD-Q-IV was .67 with 88% of participants correctly classified. The
GAD-Q-IV also demonstrated test-retest reliability. The GAD-Q-IV at Time 2 was reliably predicted
by Time 1 score c (1, N = 148) = 42.1, p < .001 and 92% (136/148) of the sample showed stability
2
 across time in terms of their categorization. Convergent and discriminant validity were also
demonstrated by results showing that the GADQ-IV was significantly more highly correlated (r =
.66) with the PSWQ than it was with the PCL (r = .45) or with the SIAS (r = .34) and that the
correlation between the GAD-Q-IV and PDSS (r = .30) was significantly lower than the correlation
between the GAD-Q-IV and PSWQ (r = .55), t (145) = 2.27, p < .05 and was also lower than the
correlation between the GADQ-IV and RRAQ (r = .58), t (145) = 2.60, p < .05. Moreover, the
correlation between the GAD-Q-IV and SDS (r = .26) was significantly lower than the correlation
between the GAD-Q-IV and PSWQ (r = .55), t (145) = 2.59, p < .05 and was lower than the
correlation between the GADQ-IV and RRAQ (r = .58), t (145) = 3.25, p < .01. Students diagnosed
GAD by the GAD-Q-IV were not significantly different on two measures than a GAD community
sample, but both groups had significantly higher scores than students identified as not meeting
criteria for GAD, demonstrating clinical validity of the GAD-Q-IV. The scale can also be used to
determine if participants meet full GAD diagnostic criteria, which is a more stringent criterion than
the original 5.7 cutoff endorsed by Newman et al. (2002). Using this criterion, Newman et al. found
96% specificity and 67% sensitivity in detecting GAD. Also, in a primary care psychotherapy
seeking sample, Moore, Anderson, Barnes, Haigh, and Fresco (2014) found that requiring
participants to meet full DSM–IV criteria was the optimal strategy for identifying.
Moore, M. T., Anderson, N. L., Barnes, J. M., Haigh, E. A. P., & Fresco, D. M. (2014). Using the GAD-Q-IV to
identify generalized anxiety disorder in psychiatric treatment seeking and primary care medical
samples. Journal of Anxiety Disorders, 28, 25-30. doi:10.1016/j.janxdis.2013.10.009
Newman, M. G., Zuellig, A. R., Kachin, K. E., Constantino, M. J., Przeworski, A., Erickson, T., & Cashman-
McGrath, L. (2002). Preliminary reliability and validity of the Generalized Anxiety Disorder
Questionnaire-IV: A revised self-report diagnostic measure of generalized anxiety disorder.
Behavior Therapy, 33, 215-233. doi:10.1016/S0005-7894(02)80026-0
Newman, M. G., Zuellig, A. R., Kachin, K. E., Constantino, M. J., Przeworski, A., Erickson, T., & Cashman-
McGrath, L. (2002). Generalized Anxiety Disorder Questionnaire-IV (GAD-Q-IV). PsycTESTS.
doi:10.1037/t04994-000
 1of 1

Date Code

GAD-Q-IV

1. Do you experience excessive worry?…………………………………………………………. NO YES

2. Is your worry excessive in intensity, frequency, or amount of distress it causes?……………. NO YES

3. Do you find it difficult to control your worry (or stop worrying) once it starts?……………... NO YES

4. Do you worry excessively and uncontrollably about minor things such as being late for an
appointment, minor repairs, homework, etc.?………………………………………………... NO YES

5. Please list the most frequent topics about which you worry excessively and uncontrollably:

a. d.

b. e.

c. f.

6. During the last six months, have you often been bothered by excessive and uncontrollable
worries more days than not? ………………………………………………………………… NO YES
IF YES, CONTINUE. IF NO, DISCONTINUE.
7. During the last six months, have you often been bothered by restlessness or feeling keyed up
or on edge more days than not?……………………………………………………………… NO YES

8. During the last six months, have you often been bothered by difficulty falling/staying asleep
or restless/unsatisfying sleep more days than not? …………………………………………. NO YES

9. During the last six months, have you often been bothered by difficulty concentrating or your
mind going blank more days than not?……………………………………………….…….. NO YES

10. During the last six months, have you often been bothered by irritability more days than
not?............................................................................................................................................... NO YES

11. During the last six months, have you often been bothered by being easily fatigued more
days than not? ………………………………………………………………………………….. NO YES

12. During the last six months, have you often been bothered by muscle tension more days
than not? ……………………………………………………………………………………….. NO YES

13. How much do worry and physical symptoms interfere with your life, work, social activities, family,
etc.? Circle one number:
0 1 2 3 4 5 6 7 8
| | | | | | | | |
Not at All Mildly Moderately Severely Very
Severely
14. How much are you bothered by worry and physical symptoms (how much distress does it cause
you)? Circle one number:
0 1 2 3 4 5 6 7 8
| | | | | | | | |
No Distress Mild Distress Moderate Severe Very
Distress Distress Severe
Distress
 Reference

Newman, M.G., Zuellig, A.R., Kachin, K.E., Constantino, M. J., Przeworski, A., Erickson, T., & Cashman-
McGrath, L. (2002). Preliminary reliability and validity of the GAD-Q-IV: A revised self-report
diagnostic measure of generalized anxiety disorder. Behavior Therapy, 33, 215-233.

Scoring
Continuous Scoring system
This scoring system was devised in an attempt to create a score that would best reflect the DSM-IV diagnostic
threshold for the GAD diagnosis. To create a total score, all yes answers were coded as 1 and all no answers as
0 (e.g. items (1) Do you experience excessive worry? (2) Is your worry excessive in intensity, frequency, or
amount of distress it causes, (3) Do you find it difficult to control your worry? (4) Do you worry about minor
things? and (6) worry more days than not over the prior six months). In addition, for item 5 which asks for a
list of most frequent worry topics, individuals were given 1 point for each topic listed up to 6 and this total was
divided by three. Similarly, for items 7-12, participants were given 1 point for each physical symptom they
experienced up to six and this total was divided by three. Finally, the numbers circled for items 13 and 14 (i.e.,
degree of distress and interference) were each divided by four and these numbers were added together. Because
the questionnaire requests that individuals skip the remaining items when they do not endorse initial criteria,
such skipped items were scored as 0.

Categorical scoring system

Participants were said to meet GAD criteria on the GAD-Q-IV if they indicated: (1) having experienced
excessive and uncontrollable worry (i.e., they answered yes to item 1 or item 4, or the combination of items 2
and 3, or any other combination of the 1st four items that indicated that the individual worried excessively and
uncontrollably), (2) the worry occurred more days than not for at least six months (i.e., they answered yes to
item 6), (3) they worried about a number of events or activities (i.e., they indicated three or more worry topics
on item 5), (4) they reported experiencing three or more of six symptoms during the past six months (i.e., they
indicated yes to at least 3 questions in response to items 7-12) and the symptoms have caused at least moderate
distress or moderate impairment (i.e., they scored 4 or more on items 13 or 14).