The longitudinal use of the Global Assessment Scale in multiple-rater situations

Rj, Dworkin; Lc, Friedman; Rl, Telschow; Kd, Grant; Hs, Moffic; Vj, Sloan

doi:10.1007/bf00752724

Cited by 33 publications

(20 citation statements)

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“…According to the manual, scores higher than 70 indicate satisfactory mental health, good overall functioning, and minimal or transient symptoms or impairment, scores between 60 and 70 indicate mild symptoms or impairment, while scores between 50 and 60 indicate moderate symptoms, social or vocational problems, and scores below 50 severe impairment or symptoms. Several studies have emphasized the importance of formal training and use of group consensus to increase the reliability of GAF (Dworkin et al, 1990;Pedersen, Hagtvet, & Karterud, 2007;Vatnaland, Vatnaland, Friis, & Opjordsmoen, 2007).…”

mentioning

confidence: 99%

Large Variations of Global Functioning over Five Years in Treated Patients with Personality Traits and Disorders

Kvarstein¹,

Karterud²

2012

Journal of Personality Disorders

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The aim of this study was to examine the long-term course of global functioning in patients with personality disorders (PD) and investigate predictors of variation. The Global Assessment of Functioning (GAF) was repeated over five years in 352 patients with PDs of varying severity, all treated in psychotherapeutic day hospitals. Growth models were used for statistical analysis. Large variations in the long-term course of global functioning were evident in this clinical sample. At five-year follow-up, 46% reached a GAF-score above 60 with a mean GAF-score of 71. Their linear change-rate over the five years was estimated to be 4.4 GAF points per year. The average five-year GAF-score for the remaining subgroup (54%) was 50 and their linear yearly change-rate was 0.8 GAF points. Greater relief of symptom distress and interpersonal problems was typical of patients with functional improvement. The number of avoidant PD criteria was associated with slower functional change.

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mentioning

confidence: 99%

Large Variations of Global Functioning over Five Years in Treated Patients with Personality Traits and Disorders

Kvarstein¹,

Karterud²

2012

Journal of Personality Disorders

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“…If this is not done, clinically useful information might be lost [63]. Scoring can also be done for time periods, for example for the last week and the past year [23]; this may cause considerable differences in scores [61] and so, when relevant, scoring can be done for more than one time period [23].…”

Section: Resultsmentioning

confidence: 99%

Guidelines for rating Global Assessment of Functioning (GAF)

2011

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BackgroundGlobal Assessment of Functioning (GAF) is a scoring system for the severity of illness in psychiatry. It is used clinically in many countries, as well as in research, but studies have shown several problems with GAF, for example concerning its validity and reliability. Guidelines for rating are important. The present study aimed to identify the current status of guidelines for rating GAF, and relevant factors and gaps in knowledge for the development of improved guidelines.MethodsA thorough literature search was conducted.ResultsFew studies of existing guidelines have been conducted; existing guidelines are short; and rating has a subjective element. Seven main categories were identified as being important in relation to further development of guidelines: (1) general points about guidelines for rating GAF; (2) introduction to guidelines, with ground rules; (3) starting scoring at the top, middle or bottom level of the scale; (4) scoring for different time periods and of different values (highest, lowest or average); (5) the finer grading of the scale; (6) different guidelines for different conditions; and (7) different languages and cultures. Little information is available about how rules for rating are understood by different raters: the final score may be affected by whether the rater starts at the top, middle or bottom of the scale; there is little data on which value/combination of GAF values to record; guidelines for scoring within 10-point intervals are limited; there is little empirical information concerning the suitability of existing guidelines for different conditions and patient characteristics; and little is known about the effects of translation into different languages or of different cultural understanding.ConclusionsFew studies have dealt specifically with guidelines for rating GAF. Current guidelines for rating GAF are not comprehensive, and relevant points for new guidelines are presented. Theoretical and empirical studies, and international expert panels would be valuable, as well as production of a manual with more information about scoring. Computerised assessment may well be the future.

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“…The GAS is a rating of the patient's lowest level of current functioning on a 10-interval, 1-100 rating continuum. The test-retest correlation (2-3 week interval) in a sample of 192 patients early in treatment was observed at .68, which is within the range of test-retest reliabilities observed in a group of trained clinicians (Dworkin, Friedman, Telschow, Grant, Moffic, & Sloan, 1990). GAS scores were normed from the same sample of 1,268 patients to have a mean intake T score of 50 (SD ϭ 10), with higher scores indicating better functioning.…”

Section: Methodsmentioning

confidence: 98%

Using feedback on patient progress to predict the outcome of psychotherapy

Lueger

1998

J. Clin. Psychol.

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The Dose-Response and Phase Models are useful for informing quality assurance research on the expected patterns for separate categories of outcomes in psychotherapy. Moreover, these models predict the sequence of change for outcomes that may be differentially valued by patients, therapists, stakeholders, and cost managers. Valid feedback on the progress of treatment is critical because patients, therapists, and cost managers make decisions about continuation and focus of treatment while psychotherapy is in progress. In this study, the focus is on the validity of feedback data for therapist appraisal of patient progress. Feedback at patient intake, in early sessions of psychotherapy, and at later sessions of psychotherapy is considered. Among the variables examined are patient and therapist agreement on severity, level of severity, evidence of remoralization, and evidence of symptomatic remission. Data are drawn from archived records of 243 psychotherapy cases conducted in several managed care service delivery settings. The implications of a therapist's use of feedback to adjust the therapeutic process in an individual case are discussed.

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The longitudinal use of the Global Assessment Scale in multiple-rater situations

Cited by 33 publications

References 5 publications

Large Variations of Global Functioning over Five Years in Treated Patients with Personality Traits and Disorders

Large Variations of Global Functioning over Five Years in Treated Patients with Personality Traits and Disorders

Guidelines for rating Global Assessment of Functioning (GAF)

Using feedback on patient progress to predict the outcome of psychotherapy

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