Abstract
This study investigated the reliability of the Global Assessment of Functioning Scale (GAF) when used by psychiatric staff from acute psychiatric wards. A special focus was attributed to factors predicting the reliability of the GAF.
101 raters from six acute psychiatric wards assessed six GAF-vignettes. Intraclasscorrelation (ICC) with a model of absolute agreement was used as the overall reliability measure.
An overall ICC of 0.79 was obtained. There were no significant differences found between the different occupational groups or psychiatric wards according to reliability. None of the predictive factors in the regression model yielded a significant contribution to reliability.
The present study supports prior results of a reliability coefficient to be found mainly in the good to excellent range. There is supporting evidence that GAF ratings performed by trained psychiatric ward staff comprise a satisfactory reliability. The present study adds to prior research showing no consistent results between studies according to reliability factors. Further studies focusing on factors related to reliability are needed.
References
. GAF scoring vignettes. (2005). From www.gulfwarvets.com/cgibin/ultimatebb.cgi?ubb=print_topic;f=14;t=000065.
. (1994). Diagnostic and statistical manual of mental disorders, 4th ed. Washington DC.
. (2000). Diagnostic and statistical manual of mental disorders, 4th ed., text rev. Washington DC.
(2007). Reliability of the GAF and CGAS with children exposed to trauma. Child Abuse & Neglect, 31, 909–915.
(1976). The Global Assessment Scale: a procedure for measuring overall severity of psychiatric disturbance. Archives of General Psychiatry, 33, 766–771.
(2003). Statistical methods for rates and proportions, 3rd edn. New York: John Wiley & Sons.
(2005). Using the GAF as a national mental health outcome measure in the Department of Veterans Affairs. Psychiatric Services, 56, 420–426.
(2003). Research note – Inter-rater reliability of the Global Assessment of Functioning Scale in a psychogeriatric population. Canadian Journal on Aging, 22, 229–233.
(2000). Reliability and validity of DSM-IV axis V. American Journal of Psychiatry, 157, 1858–1863.
(1995). A brief mental health outcome scale: Reliability and validity of the Global Assessment of Functioning (GAF). British Journal of Psychiatry, 166, 654–659.
(2008). Reliability and validity of DSM-IV axis V scales in a clinical sample of veterans with posttraumatic stress disorder. Psychiatria Danubina, 20, 286–300.
(2002). Research design in clinical psychology. Boston: Allyn & Bacon.
(1996). Routine evaluation of mental health: reliable information or worthless “guesstimates”? Acta Psychiatrica Scandinavica, 93, 125–128.
(1974). Factors influencing clinician’s judgements of mental health: Eighteen experiences with the Health-Sickness Rating Scale. Archives of General Psychiatry, 31, 292–299.
(1996). Forming inferences about some intraclass correlation coefficients. Psychological Methods, 1, 30–46.
(1996). The multiaxial system of ICD-10: Evaluation of a preliminary draft in a multicentric field. Psychopathology, 29, 347–356.
(2007). The MIRECC version of the Global Assessment of Functioning Scale: reliability and validity. Psychiatric Services, 58, 529–535.
(2007). Generalizability studies of the Global Assessment of Functioning-Split version. Comprehensive Psychiatry, 48, 88–94.
(2008). Axis V - Global Assessment of Functioning Scale (GAF), further evaluation of the self-report version. European Psychiatry, 23, 575–579.
(1995). Inter-Rater reliability of Global Assessment of Functioning in a clinical setting. Journal of Child Psychology and Psychiatry, 36, 787–792.
(1995). Global Assessment of Functioning: A modified scale. Psychosomatics, 36, 267–275.
(1979). Intraclass correlations: uses in assessing rater reliability. Psychological Bulletin, 86, 420–428.
. (2008). Short-Term Suicide Risk Vignettes. From soe.syr.edu/academics/grad/counseling_human_services/modules/suicide/vignetteapplication.htm.
(2004). GAF-skalans reliabilitet i kliniskt arbete, forskningsrapport nr 6. (
The reliability of the GAF scale in clinical practice ). Umeå universitet, Institutionen för psykologi.(2005). Reliability of Global Assessment of Functioning ratings made by clinical psychiatric staff. Psychiatric Services, 56, 434-438.
(1997). Interrater reliability issues in multicenter trials: theoretical concepts and operational procedures used in Department of Veterans Affairs cooperative study #394. Psychopharmacology Bulletin, 33, 53–57.
(2007). Are GAF scores reliable in routine clinical use? Acta Psychiatrica Scandinavica, 115, 326-330.
