Anxiety screen

Status: stable Category: psychosocial Added: 2026-04-20 Last reviewed: 2026-04-21

Summary

The Generalized Anxiety Disorder-7 (GAD-7) is Trinity's anxiety- symptom screening instrument. Seven items, each scored 0–3, summing to 0–21 and mapping to four severity bands. GAD-7 is commonly co-administered with depression_screen to cover both anxiety and depression in a single psychosocial screen.

Resource identity

Field	Value
Category	psychosocial
Resource	anxiety_screen
Instrument ID	anxiety_screen
Rubric version	1.0.0
Path prefix	/api/psychosocial/anxiety_screen

Operations

Operation	Method	Path	Contract
Questions	GET	/api/psychosocial/anxiety_screen/questions	patterns-questions.md
Score	POST	/api/psychosocial/anxiety_screen/score	patterns-score.md

Items

Seven items, each on a 0–3 scale.

ID	Prompt (paraphrased)
item_1	Feeling nervous, anxious, or on edge.
item_2	Not being able to stop or control worrying.
item_3	Worrying too much about different things.
item_4	Trouble relaxing.
item_5	Being so restless that it is hard to sit still.
item_6	Becoming easily annoyed or irritable.
item_7	Feeling afraid, as if something awful might happen.

Answer choices per item:

Value	Label
0	Not at all
1	Several days
2	More than half the days
3	Nearly every day

Scoring

Field	Value
Method	simple_sum over all seven items.
Score range	0 – 21.

Bands

Band	Range (inclusive)	Clinical meaning
minimal	0 – 4	Minimal or no anxiety symptoms.
mild	5 – 9	Mild anxiety symptoms.
moderate	10 – 14	Moderate anxiety symptoms.
severe	15 – 21	Severe anxiety symptoms.

Cutoffs match the widely-published GAD-7 thresholds.

Required items

All seven items are required for a strict /score call.

Worked example

Every item answered with 2. See quickstart.md for per-language scaffolding and patterns-score.md for the shared /score contract.

Send:

POST /api/psychosocial/anxiety_screen/score HTTP/1.1
Host: engine.tripod-health.com
apikey: $ENGINE_API_KEY
Content-Type: application/json
X-Request-ID: docs-anxiety_screen-score-basic

{
  "responses": {
    "item_1": 2, "item_2": 2, "item_3": 2, "item_4": 2,
    "item_5": 2, "item_6": 2, "item_7": 2
  }
}

Receive (200 OK):

{
  "instrument": "anxiety_screen",
  "category": "psychosocial",
  "finding": {
    "algorithm_id": "anxiety_screen",
    "algorithm_version": "1.0.0",
    "score": 14,
    "band": "moderate",
    "raw": {
      "rubric_version": "1.0.0",
      "responded_items": 7
    },
    "context": null,
    "imputed": false,
    "sd": null,
    "prior_source": null
  },
  "confidence": {
    "overall": 1,
    "tier": "high",
    "breakdown": {
      "input_completeness": 1,
      "imputation_variance": null,
      "model_certainty": null
    }
  },
  "recommendations": null,
  "depth": "basic",
  "catalog_version": "0.13.0",
  "request_id": "docs-anxiety_screen-score-basic",
  "timestamp": "2026-04-21T23:14:58.422456+00:00"
}

Computation: sum = 2 × 7 = 14 → band moderate (10–14). A more mixed response like {2,2,2,1,0,1,1} sums to 9 → band mild (5–9).

Calling in your language

curl

curl -sS -X POST "https://engine.tripod-health.com/api/psychosocial/anxiety_screen/score" \
  -H "apikey: $ENGINE_API_KEY" \
  -H "Content-Type: application/json" \
  -d '{"responses":{"item_1":2,"item_2":2,"item_3":2,"item_4":2,"item_5":2,"item_6":2,"item_7":2}}'

Python (requests)

# Uses the call() helper from quickstart.md.
responses = {f"item_{i}": 2 for i in range(1, 8)}
result = call("POST", "/api/psychosocial/anxiety_screen/score",
              {"responses": responses})
print(result["finding"]["score"], result["finding"]["band"])

Node.js (native fetch)

// Uses the call() helper from quickstart.md.
const responses = Object.fromEntries(
  Array.from({ length: 7 }, (_, i) => [`item_${i + 1}`, 2]),
);
const result = await call("POST",
  "/api/psychosocial/anxiety_screen/score", { responses });
console.log(result.finding.score, result.finding.band);

TypeScript

// Uses the typed call<T>() helper from quickstart.md.
const responses = Object.fromEntries(
  Array.from({ length: 7 }, (_, i) => [`item_${i + 1}`, 2]),
);
const result = await call<ScoreResponse>(
  "POST",
  "/api/psychosocial/anxiety_screen/score",
  { responses },
);

Go

// Uses the call() helper from quickstart.md.
responses := make(map[string]int, 7)
for i := 1; i <= 7; i++ {
    responses[fmt.Sprintf("item_%d", i)] = 2
}
result, err := call("POST", "/api/psychosocial/anxiety_screen/score",
    map[string]any{"responses": responses}, 3)
if err != nil {
    panic(err)
}
finding := result["finding"].(map[string]any)
fmt.Printf("GAD-7: %v (%v)\n", finding["score"], finding["band"])

Java

// Uses the call() helper from quickstart.md.
StringBuilder body = new StringBuilder("{\"responses\":{");
for (int i = 1; i <= 7; i++) {
    if (i > 1) body.append(",");
    body.append("\"item_").append(i).append("\":2");
}
body.append("}}");
String result = call("POST",
    "/api/psychosocial/anxiety_screen/score", body.toString(), 3);
System.out.println(result);

C# (.NET HttpClient)

// Uses the Call() helper from quickstart.md.
var responses = Enumerable.Range(1, 7)
    .ToDictionary(i => $"item_{i}", _ => 2);
var result = await Call(HttpMethod.Post,
    "/api/psychosocial/anxiety_screen/score",
    new { responses });
var finding = result.GetProperty("finding");
Console.WriteLine($"GAD-7: {finding.GetProperty("score").GetDouble()} ({finding.GetProperty("band").GetString()})");

PowerShell

# Uses the Invoke-Engine helper from quickstart.md.
$responses = @{}
1..7 | ForEach-Object { $responses["item_$_"] = 2 }
$result = Invoke-Engine -Method Post -Path "/api/psychosocial/anxiety_screen/score" -Body @{ responses = $responses }
"GAD-7: $($result.finding.score) ($($result.finding.band))"

Clinical interpretation

• What it screens. Generalized anxiety symptom frequency over the past two weeks.
• Not a diagnosis. Like PHQ-9, GAD-7 is a screen. A moderate or higher band prompts a clinical follow-up conversation; the Trinity does not make a clinical determination.
• Threshold. A score ≥ 10 (band moderate or worse) is the commonly-used threshold for further assessment of generalized anxiety.

Intended use

• Domain-specific follow-up after an elevated psychosocial signal (for example a high band on orebro).
• Paired co-administration with PHQ-9 as the standard brief psychosocial screen. The two instruments tap partially distinct constructs; administering both is standard practice.
• Feeding the CDRI composite as the canonical anxiety signal in the psychosocial domain.

Mistaken use

• Do not use the GAD-7 as a general distress measure. It is specific to generalized anxiety; it will not flag depression or pain-related distress on its own.
• Do not interpret severe as panic disorder, PTSD, or another anxiety subtype. The GAD-7 does not differentiate among anxiety disorders.
• Do not swap GAD-7 for PHQ-9 or vice versa. They address different constructs despite sharing a similar shape. Pick the one (or both) that matches what you want to screen for.
• Do not compare totals across rubric versions without checking version — band cutoffs and item wording can change between releases.

Debugging

1. Capture request_id. Present in every response body.
2. 400 ValidationError with missing_items. Send all seven items.
3. Score seems high compared to presentation. Re-check the answer-choice range; 3 is "Nearly every day", not "Not at all". An inverted UI that mis-maps labels to values is the most common source of inflated GAD-7 scores.

Related

• patterns-questions.md, patterns-score.md — shared contracts.
• instruments-depression_screen.md — PHQ-9; the standard co-administered depression screen.
• instruments-orebro.md — yellow-flag screen whose elevated band often motivates targeted GAD-7 + PHQ-9 administration.
• composite-cdri-compute.md — where GAD-7 feeds the psychosocial domain signal.

Change history

Date	Change
2026-04-20	Initial publication.