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ADAPTEDPHQ-9&GAD-7QUESTIONNAIRES
Howtofillinthesequestionnaires:
Thesequestionnairesareusedby
psychologyservicestohelpusunderstand
howpeoplefeel.
• Onequestionnairemeasureshowsad
peoplefeel.
• Onequestionnairemeasureshow
worriedpeoplefeel.
Questionnairesalsohelpusseeifpeople
feelbetteraftertheyseeus.
Thesequestionnairesaskyouabouthow
youhavebeenfeelinginthepast2weeks.
Itmighthelpyoutothinkaboutsomething
thatyoudid2weeksagotoanswerthese
questions
Foreachquestion,tickoneoftheboxesto
showhowyouhavebeenfeelinginthepast
2weeks.
Ifyouneedhelporhavequestions,youcan
talktoyourtherapist.Questions
?
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1 FEELINGSAD(PHQ-9)
Haveyoufeltlessinterestedin
doingthings?
Nodays Somedays Alotofdays Nearlyeveryday
2
Haveyoufeltsad?
Nodays Somedays Alotofdays Nearlyeveryday
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3
Haveyouhadproblemswithyour
sleep?
Nodays Somedays Alotofdays Nearlyeveryday
4
Haveyoubeenfeelingtired?
Nodays Somedays Alotofdays Nearlyeveryday
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5
Haveyoubeenmoreorlesshungry
thannormal?
Nodays Somedays Alotofdays Nearlyeveryday
6
Haveyoubeenfeelinglikeyouhave
letyourselfdownorletother
peopledown?
Nodays Somedays Alotofdays Nearlyeveryday
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7
Hasitbeenhardtoconcentrateon
things?
Nodays Somedays Alotofdays Nearlyeveryday
8
Haveyoubeen
• movingorspeakingmoreslowly?
OR
• movingorspeakingalotfaster?
Nodays Somedays Alotofdays Nearlyeveryday
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9
Haveyouhadthoughtsabout:
• Hurtingyourselfonpurpose?
• Killingyourself?
Nodays Somedays Alotofdays Nearlyeveryday
PHQ-9TOTAL
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1 FEELINGWORRIED(GAD-7)
Haveyoubeenfeeling
worried?
Nodays Somedays Alotofdays Nearlyeveryday
2
Hasitbeenhardtostop
worrying?
Nodays Somedays Alotofdays Nearlyeveryday
STOP
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3
Haveyoubeenworryingabout
lotsofdifferentthings?
Nodays Somedays Alotofdays Nearlyeveryday
4
Hasitbeenhardtorelax?
Nodays Somedays Alotofdays Nearlyeveryday
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5
Hasitbeenhardtositstill?
Nodays Somedays Alotofdays Nearlyeveryday
6
Haveyoufeltangry?
Nodays Somedays Alotofdays Nearlyeveryday
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Isthereanythingyouwanttotellusaboutyouranswers?
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Thankyou!
THESEQUESTIONNAIRESWEREADAPTEDBYJBREEN&KTHEODOREASPARTOFACLINICALPSYCHOLOGY
DOCTORATEATROYALHOLLOWAYUNIVERSITY(2017)
7
Haveyoufeltscared?
Nodays Somedays Alotofdays Nearlyeveryday
GAD-7TOTAL
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ClinicianGuidelinesforusingtheadaptedPHQ-9andGAD-7clinicalmeasuresRESEARCHTITLE:AdaptingtheGAD-7andPHQ-7clinicalmeasuresforpeoplewithintellectualdisabilities.RESEARCHERS:JennyBreen(TraineeClinicalPsychologist)&DrKateTheodore(ClinicalTutor),RoyalHollowayUniversity.
Generalguidelines:TheadaptedversionsofthePHQ-9andGAD-7measuresareintendedforusewithclientswhorequirereasonableadjustmentstoaccesspsychologyservices,namelythosewithlearningdifficultiesordisabilities.TheyweredevelopedinathesisresearchprojectaspartofclinicalpsychologytrainingwithinputfromserviceuserswithlearningdisabilitiesaswellasprofessionalsworkinginspecialistLearningDisabilityandIAPTservices.Theliteraturesuggeststhatideallyinformationforpeoplewithlearningdifficultiesordisabilitiesshouldbetailoredtotheindividualandsoitisimportantforclinicianstothinkabouttheindividual’sneedsandadapttheadministrationandchoiceofoutcomemeasuresusedaccordingly.Somepeoplewillhaveapreferenceforvisualprompts,othersprefereasyreadEnglishonly,somewillrequiresupportwithadministrationandothersbeabletocompletethemeasuresthemselvesindependently.Theeasyreadguidelinesforserviceusersonthefirstpageoftheseadaptedmeasuresoffersomesupportforclinicianstocoversomeofthesepoints.Someadditionalusefulgeneralpointsforusingthemeasureswithclientsinclude:
• Usingtheterm“questionnaires”ratherthan“clinicalmeasures”• Introducingthemeasurestoclientsandexplainingwhyyouareaskingthemtodothese
o E.g.“Weaskeveryonewhoisseeninthisservicetodothesequestionnaires.Thisisimportantasithelpsustounderstandhowpeoplefeelandgivesusanideaifpeoplegetwellafterseeingus”
• Peoplewithlearningdisabilitiesarelikelytoneedahigherlevelofsupporttocompletethesequestionnairesthanotherclients.Thismayinvolvecompletingthequestionnaireswiththeclientinsessionsatfirst,tomakesurethattheyareabletoreporttheirsymptomsaccurately.Itmaybethatovertime,clientsneedlesssupporttocompletethesemeasures.
ResponseOptions&Scoring:Whenintroducingthescale,itishelpfultoorientclientstothescale,particularlytheresponseoptions.Itmaybehelpfultothinkwiththemaboutsomethingtheydidtwoweeksearlierandusingthisasananchorintime:
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o E.g.“TodayisTuesday.CanyouremembersomethingthatyoudidtwoTuesdaysago?OK,whenansweringthesequestions,IwantyoutothinkabouthowyouhavefeltbetweennowandwhenyoudidX”
Somepeoplemayneedadditionalsupporttounderstandtheresponseoptions.Ifso,itmaybehelpfulexplainthevisualsbydrawingnumbersontothevisualcueslikeascaletorepresentthenumberofdaysthateachoptionisaskingaboutsopeoplecanunderstandthismoreclearly.Forexample–thevisualhereshows‘alotofdays’(whichcorrespondstotheoriginalPHQ-9andGAD-7responseitem‘morethanhalfthedays’,hencethenumberswrittenonthevisualscaleitem.TheadaptedversionsofthePHQ-9andGAD-7measuresarescoredinexactlythesamewayastheoriginalmeasures:AdaptedResponseoption OriginalResponseoption ScoreNodays Notatall 0Somedays Severaldays 1Alotofdays Morethanhalfthedays 2Nearlyeveryday Nearlyeveryday 3Individualitemscoresineachmeasureshouldbetotalledtoobtainoverallscoresforeachofthemeasures.ThetotalscoresforthePHQ-9andGAD-7measurecanbewritteninthetotalscoreboxattheendofeachmeasure.Alternativeitemexplanations:ThetablesonthefollowingpagesprovidesuggestedalternativesfortermsusedandexamplesofpromptswhichyoucouldusewithclientswhichmayhelpthemunderstandtheindividualitemsonthePHQ-9andGAD-7measures.Manyofthesehavebeensuggestedbyadultswithlearningdisabilitieswhowereinvolvedinthedevelopmentoftheadaptedversionsoftheclinicalmeasures.
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PHQ-9ITEMNUMBER
PHQ-9ITEMWORDING ADAPTEDWORDING SUGGESTEDALTERNATIVEHELPFULTERMS
EXAMPLESOFPROMPTS
1 Lessinterestorpleasureindoingthings
Haveyoufeltlessinterestedindoingthingsyounormallyliketodo?
None • Likejustwantingtostayathome
• Notwantingtohangoutwithyourfriends
• Notwantingtowatchyourfavouritesoaps/tvshows
• Notwantingtodoyourfavouritehobbies
2 Feelingdown,
depressedorhopelessHaveyoufeltsad?
• Depressed
• Wantingtobeonyourownmore
• Cryingalot
3 Troublefallingorstayingasleeporsleepingtoomuch
Haveyouhadproblemswithyoursleep?
None • Likefindingithardtofallasleepatnight
• Sleepingtoomuchlikenotwantingtowakeupinthemorning
• Wakingupinthenightalot
4 Feelingtiredorhavinglittleenergy
Haveyoubeenfeelingtired?
• Noenergytodothings
• Feelingtiredallthetime• Likewhenyoudon’twanttodo
much• Wantingtosleepallthetime
5 Poorappetiteor
overeating
Haveyoubeenmoreorlesshungrythannormal?
• Appetite
• Eatingless/morefoodthannormal
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6 Feelingbadaboutyourselforthatyouareafailureorhaveletyourselforyourfamilydown
Haveyoufeltlikeyouhaveletyourselfdownorletotherpeopledown
• Haveyoubeenfeelinglikeyou’renogood?
• Failure
• Feelinglikeyou’veletpeopledown
• Feelinglikeyou’veletyourselfdown
7 Troubleconcentrating
onthings,suchasreadingthenewspaperorwatchingtelevision
Hasitbeenhardtoconcentrateonthings?
• Findingithardtofocus
• Beingdistracted• Gettingbored
easily
• Likewhenwatchingyourfavouritetvprogramme
8 Movingorspeakingsoslowlythatotherpeoplecouldhavenoticedortheoppositebeingsofidgetyorrestlessthatyouhavebeenmovingaroundalotmorethanusual
Haveyoubeenmovingorspeakingmoreslowlyoralotfaster?
• Fidgetingalot• Feelingrestless
9 Thoughtsthatyouwouldbebetteroffdeadorofhurtingyourselfinsomeway
Haveyouwantedto• Hurtyourselfon
purpose?• Killyourself?
• Selfharming • Usingaknifetocutyourself• Takinglotsoftablets• Feelinglikeyoudon’twantto
liveanymore• Wantingtoendyourlife
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GAD-7ITEMNUMBER
GAD-7WORDING ADAPTEDWORDING SUGGESTEDALTERNATIVEHELPFULTERMS
EXAMPLESOFPROMPTS
1 Feelingnervous,anxiousoronedge
Haveyoubeenfeelingworried?
• Nervous
2 Notbeingabletostoporcontrolworrying
Hasitbeenhardtostopworrying?
None • Worryingalot
3 Worryingtoomuchaboutlotsofdifferentthings
Haveyoubeenworryingaboutlotsofdifferentthings?
None • Money,bills,gettingajob,friends,family,passingexams
4 Troublerelaxing Hasitbeenhardtorelax?
• Chillout• Calmdown
• Thinkingwiththepersonhowtheynormallyrelax
5 Beingsorestlessthatitis
hardtositstill
Hasitbeenhardtositstill?
• Feelingrestless• Fidgetingalot
6 Becomingeasilyannoyed
orirritableHaveyoufeltangry?
• Annoyed
7 Feelingafraidasifsomethingawfulmayhappen
Haveyoufeltscared?
• Worried• Afraid
• Worryingthatsomethingbadmighthappentoyouorsomeoneelse
• Notfeelingsafe• Worryingthatyoumightget
hurt• Beingmuggedorhavingyour
bagorphonetaken