Anxiety and depression screening across diverse populations: Testing measurement and structural invariance of the Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9 across Black and White groups.
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Abstract
The Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 are two of the most commonly used measures of anxiety and depression in clinical practice and research. Although the measures are frequently used, little is known about their measurement invariance across diverse populations. Because both measures were originally developed and validated in largely White samples, it is necessary to ensure that the psychometric properties of the measures are similar across populations. In the present study, we use a national sample of college students from the Healthy Minds Study to examine the measurement and structural invariance of GAD-7 and Patient Health Questionnaire-9 in Black and White individuals (n = 4,669 for each group). Findings support the one-factor structure of each measure. Within-gender analyses suggested that Black males demonstrated residual invariance on both measures with White males. Black females demonstrated residual invariance on Patient Health Questionnaire-9 and metric invariance on GAD-7 with White females. Findings suggest that males will often score lower than females on each measure even when they have the same latent levels of depression and anxiety, and Black females will likely score lower than White females on GAD-7 even at the same latent levels of anxiety. The measures failed to demonstrate structural invariance with the correlation of latent anxiety and depression factors being significantly stronger in Black individuals. Findings highlight the need to weigh means to account for measurement bias of GAD-7 and for researchers and practitioners to carefully examine the scores of participants and patients when making inferences regarding inclusion in clinical research and the probable presence of diagnoses. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
期刊介绍：
Psychological Assessment is concerned mainly with empirical research on measurement and evaluation relevant to the broad field of clinical psychology. Submissions are welcome in the areas of assessment processes and methods. Included are - clinical judgment and the application of decision-making models - paradigms derived from basic psychological research in cognition, personality–social psychology, and biological psychology - development, validation, and application of assessment instruments, observational methods, and interviews
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