A comparative study of anxiety symptoms in Chinese and Rwandan adolescents: a cross-cultural measurement invariance study of the GAD-7 scale
IntroductionCultural factors and assessment methods significantly influence how anxiety symptoms are expressed and reported. However, few cross-cultural studies have employed culturally appropriate and validated tools, and even fewer have provided substantial comparisons across different groups with...
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Frontiers Media S.A.
2025-05-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1571753/full |
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| author | Lisa Cynthia Niwenahisemo Lisa Cynthia Niwenahisemo Qi Zhang Qi Zhang Wo Wang Wo Wang Dan-dan Geng Dan-dan Geng He-yan Xu He-yan Xu Jin-hui Hu Jin-hui Hu Ling-li Ma Ling-li Ma Jian-yu Tan Jian-yu Tan Yi-ting Kong Yi-ting Kong Su Hong Su Hong Li Kuang Li Kuang |
| author_facet | Lisa Cynthia Niwenahisemo Lisa Cynthia Niwenahisemo Qi Zhang Qi Zhang Wo Wang Wo Wang Dan-dan Geng Dan-dan Geng He-yan Xu He-yan Xu Jin-hui Hu Jin-hui Hu Ling-li Ma Ling-li Ma Jian-yu Tan Jian-yu Tan Yi-ting Kong Yi-ting Kong Su Hong Su Hong Li Kuang Li Kuang |
| author_sort | Lisa Cynthia Niwenahisemo |
| collection | DOAJ |
| description | IntroductionCultural factors and assessment methods significantly influence how anxiety symptoms are expressed and reported. However, few cross-cultural studies have employed culturally appropriate and validated tools, and even fewer have provided substantial comparisons across different groups with diverse cultural backgrounds. This study aimed to assess the measurement invariance of the GAD-7 scale across Chinese and Rwandese adolescents, enabling reliable cross-cultural comparisons.MethodsThis study included 2017 Chinese adolescents and 1813 Rwandan adolescents. Cronbach’s alpha, exploratory factor analysis (EFA), and multiple group confirmatory factor analysis (MGCFA) were used to assess the validity of the GAD-7 scale across the two groups. Measurement invariance testing was employed to investigate cross-cultural equivalence.ResultsThe GAD-7 demonstrated good psychometric properties. CFA supported a one-factor model for the GAD-7 in both samples, though model fit indices varied. Measurement invariance testing confirmed configural and metric invariance but found partial scalar invariance. A latent mean comparison indicated a trend toward higher anxiety levels in Rwandan adolescents compared to Chinese adolescents, though the difference was not statistically significant (z = 0.02, d = 0.033, p = 0.98).DiscussionThe GAD-7 showed reliability in measuring generalized anxiety in both Chinese and Rwandese adolescents, confirming its cross-cultural construct validity. However, partial scalar invariance suggests that while the GAD-7 effectively detects anxiety symptoms, the severity of reported symptoms may not be directly comparable across cultures due to response patterns and possible linguistic factors. These findings highlight the importance of culturally sensitive instruments for accurate anxiety assessment and expand evidence on reliable symptom screening and treatment monitoring across diverse populations. |
| format | Article |
| id | doaj-art-b71b4e9e2443421fbcc214389202d7e9 |
| institution | OA Journals |
| issn | 1664-0640 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Psychiatry |
| spelling | doaj-art-b71b4e9e2443421fbcc214389202d7e92025-08-20T02:28:20ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402025-05-011610.3389/fpsyt.2025.15717531571753A comparative study of anxiety symptoms in Chinese and Rwandan adolescents: a cross-cultural measurement invariance study of the GAD-7 scaleLisa Cynthia Niwenahisemo0Lisa Cynthia Niwenahisemo1Qi Zhang2Qi Zhang3Wo Wang4Wo Wang5Dan-dan Geng6Dan-dan Geng7He-yan Xu8He-yan Xu9Jin-hui Hu10Jin-hui Hu11Ling-li Ma12Ling-li Ma13Jian-yu Tan14Jian-yu Tan15Yi-ting Kong16Yi-ting Kong17Su Hong18Su Hong19Li Kuang20Li Kuang21Department of Psychiatry, the First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaPsychiatric Center, the First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Psychiatry, the First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaPsychiatric Center, the First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaPsychiatric Center, the First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Psychiatry, the University-town Hospital of Chongqing Medical University, Chongqing, ChinaPsychiatric Center, the First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Psychiatry, the University-town Hospital of Chongqing Medical University, Chongqing, ChinaPsychiatric Center, the First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Psychiatry, the University-town Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Psychiatry, the First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaPsychiatric Center, the First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Psychiatry, the First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaPsychiatric Center, the First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Psychiatry, the First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaPsychiatric Center, the First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Psychiatry, the First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaPsychiatric Center, the First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaPsychiatric Center, the First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Nursing, the First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Psychiatry, the First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaPsychiatric Center, the First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaIntroductionCultural factors and assessment methods significantly influence how anxiety symptoms are expressed and reported. However, few cross-cultural studies have employed culturally appropriate and validated tools, and even fewer have provided substantial comparisons across different groups with diverse cultural backgrounds. This study aimed to assess the measurement invariance of the GAD-7 scale across Chinese and Rwandese adolescents, enabling reliable cross-cultural comparisons.MethodsThis study included 2017 Chinese adolescents and 1813 Rwandan adolescents. Cronbach’s alpha, exploratory factor analysis (EFA), and multiple group confirmatory factor analysis (MGCFA) were used to assess the validity of the GAD-7 scale across the two groups. Measurement invariance testing was employed to investigate cross-cultural equivalence.ResultsThe GAD-7 demonstrated good psychometric properties. CFA supported a one-factor model for the GAD-7 in both samples, though model fit indices varied. Measurement invariance testing confirmed configural and metric invariance but found partial scalar invariance. A latent mean comparison indicated a trend toward higher anxiety levels in Rwandan adolescents compared to Chinese adolescents, though the difference was not statistically significant (z = 0.02, d = 0.033, p = 0.98).DiscussionThe GAD-7 showed reliability in measuring generalized anxiety in both Chinese and Rwandese adolescents, confirming its cross-cultural construct validity. However, partial scalar invariance suggests that while the GAD-7 effectively detects anxiety symptoms, the severity of reported symptoms may not be directly comparable across cultures due to response patterns and possible linguistic factors. These findings highlight the importance of culturally sensitive instruments for accurate anxiety assessment and expand evidence on reliable symptom screening and treatment monitoring across diverse populations.https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1571753/fullgeneralized anxiety disorder-7 (GAD)GAD-7 scalecultural differencesadolescent mental healthmeasurement invariancecross-cultural comparison |
| spellingShingle | Lisa Cynthia Niwenahisemo Lisa Cynthia Niwenahisemo Qi Zhang Qi Zhang Wo Wang Wo Wang Dan-dan Geng Dan-dan Geng He-yan Xu He-yan Xu Jin-hui Hu Jin-hui Hu Ling-li Ma Ling-li Ma Jian-yu Tan Jian-yu Tan Yi-ting Kong Yi-ting Kong Su Hong Su Hong Li Kuang Li Kuang A comparative study of anxiety symptoms in Chinese and Rwandan adolescents: a cross-cultural measurement invariance study of the GAD-7 scale Frontiers in Psychiatry generalized anxiety disorder-7 (GAD) GAD-7 scale cultural differences adolescent mental health measurement invariance cross-cultural comparison |
| title | A comparative study of anxiety symptoms in Chinese and Rwandan adolescents: a cross-cultural measurement invariance study of the GAD-7 scale |
| title_full | A comparative study of anxiety symptoms in Chinese and Rwandan adolescents: a cross-cultural measurement invariance study of the GAD-7 scale |
| title_fullStr | A comparative study of anxiety symptoms in Chinese and Rwandan adolescents: a cross-cultural measurement invariance study of the GAD-7 scale |
| title_full_unstemmed | A comparative study of anxiety symptoms in Chinese and Rwandan adolescents: a cross-cultural measurement invariance study of the GAD-7 scale |
| title_short | A comparative study of anxiety symptoms in Chinese and Rwandan adolescents: a cross-cultural measurement invariance study of the GAD-7 scale |
| title_sort | comparative study of anxiety symptoms in chinese and rwandan adolescents a cross cultural measurement invariance study of the gad 7 scale |
| topic | generalized anxiety disorder-7 (GAD) GAD-7 scale cultural differences adolescent mental health measurement invariance cross-cultural comparison |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1571753/full |
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