Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Identifying Anxiety Symptoms in Multiple Sclerosis

Arch Phys Med Rehab; ePub 2018 Jun 30; Hughes, et al

The Generalized Anxiety Disorder Scale (GAD-2) is a clinically useful and psychometrically valid tool for screening anxiety symptoms in multiple sclerosis (MS) rehabilitation and neurology care settings, according to a recent study. Importantly, this tool has the potential to identify individuals with MS who are at risk for anxiety disorders and who may benefit from rehabilitation psychology interventions to ultimately improve functioning and quality of life. The sample was comprised of 99 adults (aged 19-72; M=46.2; SD=13.0; 75% female) with a physician-confirmed MS diagnosis who were receiving care in a university-affiliated MS center. Disease durations ranged from 1-37 years (M=10.7; SD=8.4). Participants completed the GAD-7 and GAD-2. Internal consistency was calculated for both measures. Researchers found:

  • Internal consistency was excellent for the GAD-7 (Cronbach α=.91) and acceptable for the GAD-2 (α=.77), and the measures were highly correlated (r=.94).
  • The GAD-2 had excellent overall accuracy for identifying clinically significant anxiety symptoms.
  • A GAD-2 cut-off score of ≥3 provided an optimal balance of good sensitivity (0.87) and excellent specificity (0.92) for detecting clinically significant anxiety symptoms.
  • Alternatively, a cut-off score of ≥2 provided excellent sensitivity (1.00) and fair specificity (0.76).


Hughes AJ, Dunn KM, Chaffee T, Bhattarai J, Beier M. Diagnostic and clinical utility of the GAD-2 for screening anxiety symptoms in individuals with multiple sclerosis. [Published online ahead of print June 30, 2018]. Arch Phys Med Rehab. doi:10.1016/j.apmr.2018.05.029.

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