The Professional Counselor | Volume 12, Issue 3 227 0 = not at all, 1 = several days, 2 = more than half the days, or 3 = nearly every day (Spitzer et al., 2006, p. 1739). Sample test items include “being so restless that it’s hard to sit still” and “feeling afraid as if something awful might happen.” The GAD-7 items can be summed into an interval-level composite score, with higher scores indicating greater levels of Anxiety Severity. GAD-7 scores can range from 0 to 21 and are classified as mild (0–5), moderate (6–10), moderately severe (11–15), or severe (16–21). In the initial score validation study, Spitzer et al. (2006) found evidence for internal consistency (α = .92) and test-retest reliability (intraclass correlation = .83) of GAD-7 scores among adults in the United States who were receiving services in primary care clinics. In more recent years, a number of additional investigators found internal consistency reliability evidence for GAD-7 scores, including samples of undergraduate college students in the southern United States (α = .91; Sriken et al., 2022), Black and Latinx adults in the United States (α = .93, ω = .93; Kalkbrenner, 2022), and English-speaking college students living in Ethiopia (ω = .77; Manzar et al., 2021). Similarly, the data set in the present study displayed acceptable internal consistency reliability evidence for GAD-7 scores (α = .82, ω = .81). Spitzer et al. (2006) used factor analysis to establish internal structure validity, correlations with established screening tools for convergent validity, and criterion validity evidence by demonstrating the capacity of GAD-7 scores for detecting likely cases of generalized anxiety disorder. A number of subsequent investigators found internal structure validity evidence of GAD-7 scores via CFA and multiple-group CFA (Kalkbrenner, 2022; Sriken et al., 2022). In addition, the findings of Sriken et al. (2022) supported both the convergent and divergent validity of GAD-7 scores with other established tests. The data set in the present study (N = 124) was not large enough for internal structure validity testing. However, a strong negative correlation (r = −.78) between the GAD-7 and MHI-5 revealed convergent validity evidence of GAD-7 scores with the present sample of undergraduate students. In terms of norming and cross-cultural fairness, there were qualitative differences between the normative GAD-7 sample in the original score validation study (adults in the United States receiving services in primary care clinics) and the non-clinical sample of young adult college students in the present study. However, the demographic profile of the present sample is consistent with Sriken et al. (2022), who validated GAD-7 scores with a large sample (N = 414) of undergraduate college students. For example, the demographic profile of the sample in the current study for gender identity closely resembled the composition of Sriken et al.’s sample, which included 66.7% women, 33.1% men, and 0.2% transgender individuals. In terms of ethnic identity, the demographic profile of the present sample was consistent with Sriken et al. for White and Black participants, although the present sample reflected a somewhat smaller proportion of Asian students (19.6%) and a greater proportion of Latinx students (5.3%). Data Analysis and Assumption Checking The present study included two categorical-level independent variables and one continuous-level dependent variable. The first independent variable, program, consisted of three levels: (a) deep breathing with progressive muscle relaxation, (b) group exercise, or (c) both exercise and deep breathing with progressive muscle relaxation. The second independent variable, time, consisted of two levels: the beginning of the semester and the end of the semester. The dependent variable was participants’ intervallevel score on the GAD-7. Accordingly, a 3 (program) X 2 (time) mixed-design analysis of variance (ANOVA) was the most appropriate statistical test for answering the research question (Field, 2018). The data were examined for the following statistical assumptions for a mixed-design ANOVA: absence of outliers, normality, homogeneity of variance, and sphericity of the covariance matrix based on the recommendations of Field (2018). Standardized z-scores revealed an absence of univariate
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