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J Head Trauma Rehabil. 2019 Sep/Oct;34(5):353-363. doi: 10.1097/HTR.0000000000000529.

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

Author information

Center for Health Assessment Research and Translation, College of Health Sciences (Drs Boulton, Tyner, and Tulsky and Ms Kisala) and Departments of Physical Therapy and Psychological & Brain Sciences (Dr Tulsky), University of Delaware, Newark; Educational Psychology Department, The University of Texas at Austin (Dr Choi); H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine and Harris Health System, Houston, Texas (Dr Sander); TIRR Memorial Hermann, Houston, Texas (Drs Sander and Sherer); Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois (Dr Heinemann); Shirley Ryan AbilityLab, Chicago, Illinois (Dr Heinemann); Rusk Rehabilitation, NYU Langone Health, New York, New York (Dr Bushnik); Kessler Foundation, East Hanover, New Jersey (Dr Chiaravalloti); and Department of Physical Medicine & Rehabilitation, Rutgers New Jersey Medical School, Newark (Dr Chiaravalloti).



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.


5 Traumatic Brain Injury Model Systems.


A total of 385 individuals with traumatic brain injury (TBI) (31% complicated mild; 14% moderate; and 54% severe).


Observational cohort.


GAD-7, PHQ-9, TBI-QOL Anxiety v1.0 and TBI-QOL Depression v1.0.


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.


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.

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