Diagnostic Validity of the Generalized Anxiety Disorder - 7 (GAD-7) among Pregnant Women.
Diagnostic Validity of the Generalized Anxiety Disorder - 7 (GAD-7) among Pregnant Women.
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DOI：
10.1371/journal.pone.0125096
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Williams MA
中科院分区：
文献类型：
--
作者：
Zhong QY;Gelaye B;Zaslavsky AM;Fann JR;Rondon MB;Sánchez SE;Williams MA
妊娠期广泛性焦虑障碍（GAD）与几种不良的孕产妇和围产期结局有关。一个可靠和有效的广泛性焦虑症筛查工具应该导致早期发现和治疗。在秘鲁孕妇中，一种简短的筛查工具GAD-7尚未得到验证。本研究旨在评估GAD-7的信度和效度。在2,978名参加了第一次围产期护理访问并进行了GAD-7筛查的妇女中，946名进行了综合国际诊断访谈（CIDI）。计算Cronbach’s alpha来检验信度。我们通过计算操作特征来评估标准的效度。运用因子分析及与健康状况的关联来评估建构效度。采用Rasch评定量表模型（RSM）探讨了跨文化效度。GAD-7的信度较好（Cronbach’s alpha = 0.89）。若临界值达到或高于约登指数，则敏感性为73.3%，特异性为67.3%。探索性因子分析和验证性因子分析证实了GAD-7的单因子结构。同时效度的证据表明，较高的GAD-7分数与较差的自评身心健康有关。Rasch RSM进一步证实了GAD-7的跨文化有效性。结果表明，西班牙语版本的GAD-7可以作为秘鲁孕妇的筛查工具。GAD-7具有良好的信度、析因效度和并发效度。通过最大化约登指数获得的最优分数线应谨慎考虑；筛查呈阳性的妇女可能需要进一步调查以确认广泛性焦虑症的诊断。
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. 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). 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. 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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DOI：
10.1016/0002-9378(74)90549-3
发表时间：
1974-01-01
影响因子：
9.8
作者：
BURSTEIN, I;KINCH, RAH;STERN, L
通讯作者：
STERN, L
影响因子：
6.6
作者：
de Paz, Nicole C.;Sanchez, Sixto E.;Williams, Michelle A.
通讯作者：
Williams, Michelle A.
影响因子：
3.6
作者：
Abbey, Craig K.;Eckstein, Miguel P.;Boone, John M.
通讯作者：
Boone, John M.
影响因子：
3.6
作者：
García-Campayo J;Zamorano E;Ruiz MA;Pardo A;Pérez-Páramo M;López-Gómez V;Freire O;Rejas J
通讯作者：
Rejas J
影响因子：
1.7
作者：
Fluss, R;Faraggi, D;Reiser, B
通讯作者：
Reiser, B