Linking the GAD-7 and PHQ-9 to the TBI-QOL Anxiety and Depression Item Banks

Aaron J. Boulton, Callie E. Tyner, Seung W. Choi, Angelle M. Sander, Allen W. Heinemann, Tamara Bushnik, Nancy Chiaravalloti, Mark Sherer, Pamela A. Kisala, David S. Tulsky*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Objective: To link scores on commonly used measures of anxiety (7-item Generalized Anxiety Disorder Scale; GAD-7) and depression (9-item Patient Health Questionnaire; PHQ-9) to the Traumatic Brain Injury Quality of Life (TBI-QOL) measurement system. Setting: 5 Traumatic Brain Injury Model Systems. Participants: A total of 385 individuals with traumatic brain injury (TBI) (31% complicated mild; 14% moderate; and 54% severe). Design: Observational cohort. Main Measures: GAD-7, PHQ-9, TBI-QOL Anxiety v1.0 and TBI-QOL Depression v1.0. Results: Item response theory-based linking methods were used to create crosswalk tables that convert scores on the GAD-7 to the TBI-QOL Anxiety metric and scores on the PHQ-9 to the TBI-QOL Depression metric. Comparisons between actual and crosswalked scores suggest that the linkages were successful and are appropriate for group-level analysis. Linking functions closely mirror crosswalks between the GAD-7/PHQ-9 and the Patient-Reported Outcomes Measurement Information System (PROMIS), suggesting that general population linkages are similar to those from a TBI sample. Conclusion: Researchers and clinicians can use the crosswalk tables to transform scores on the GAD-7 and the PHQ-9 to the TBI-QOL metric for group-level analyses.

Original languageEnglish (US)
Pages (from-to)353-363
Number of pages11
JournalJournal of Head Trauma Rehabilitation
Issue number5
StatePublished - Sep 1 2019


  • anxiety
  • brain injuries
  • depression
  • patient-reported outcome measures
  • psychometrics
  • quality of life
  • traumatic

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation
  • Clinical Neurology


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