Top

Published in:

01-01-2018 | Original Paper

A Qualitative Study of Clinicians Experience with Rating of the Global Assessment of Functioning (GAF) Scale

Authors: I. H. Monrad Aas, Ove Sonesson, Steffen Torp

Published in: Community Mental Health Journal | Issue 1/2018

Abstract

The severity of illness in psychiatry is rated using the Global Assessment of Functioning (GAF) scale. The GAF scale is often used in both research settings and in the clinic. The scale ranges from 1 to 100 and is subdivided into ten 10-point intervals, each with verbal rating instructions called anchor points and examples. GAF is an instrument that needs improvement. Studying clinicians’ experiences with this rating system may be important for developing improvements. The aim of this study was to collect information from clinicians about their experiences with the GAF instrument, and to collect their ideas on how the GAF scale can be improved, particularly in the area of verbal instructions (i.e., anchor points and examples). Qualitative interviews were performed with 25 clinicians. Through this interview process, several weaknesses of the GAF scale were revealed. We found that clinicians have unique experiences that can be important for the development of a better GAF scale. Rating with the GAF scale also requires sufficient collection of patient information.

Aas, I. H. M. (2010). Global Assessment of Functioning (GAF): Properties and frontier of current knowledge. Annals of General Psychiatry, 9, 20.CrossRef

Aas, I. H. M. (2011). Guidelines for rating Global Assessment of Functioning (GAF). Annals of General Psychiatry, 10, 2.CrossRef

Aas, I. H. M. (2014). Collecting information for rating Global Assessment of Functioning (GAF): Sources of information and methods for information collection. Current Psychiatry Reviews, 10, 330–347.CrossRef

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: American Psychiatric Association.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Association.CrossRef

Bowling, A. (1993). Measuring health. A review of quality of life measurements scales. Buckingham: Open University Press.

Clark, J. P. (2003). How to peer review a qualitative manuscript. In F. Godlee & T. Jefferson (Eds.), Peer review in health sciences (2nd ed., pp. 219–235). London: BMJ Publishing Group.

DagbehandlingsNettverk. (2016). Revidert Global Assessment of Functioning (GAF) [Revised Global Assessment of Functioning (GAF)]. http://dagbehandlingsnettverk.no/dninfo/prosjekter.htm.

Feinstein, A. R., Josephy, B. R., & Wells, C. K. (1986). Scientific and clinical problems in indexes of functional disability. Annals of Internal Medicine, 105, 413–420.CrossRef

Forsner, T., Hansson, J., Brommels, M., Wisted, A. Å., & Forsell, Y. (2010). Implementing clinical guidelines in psychiatry: A qualitative study of perceived facilitators and barriers. BMC Psychiatry, 10, 8.CrossRef

Godlee, F. (2011). Who should define disease? BMJ (Clinical Research Ed.), 342, d2974.CrossRef

Gold, L. H. (2014). DSM-5 and the assessment of functioning. The World Health Organization Disability Assessment Schedule (WHODAS 2.0). Journal of the American Academy of Psychiatry and the Law, 42, 173–181.PubMed

Goldman, H. H., Skodol, A. E., & Lave, T. R. (1992). Revising axis V for DSM-IV: A review of measures of social functioning. American Journal of Psychiatry, 149, 1148–1156.CrossRef

Goodman, R., Iervolino, A., Collishaw, S., Pickles, A., & Maughan, B. (2007). Seemingly minor changes to a questionnaire can make a big difference to mean scores: A cautionary tale. Social Psychiatry and Psychiatric Epidemiology, 42, 322–327.CrossRef

Karterud, S., Pedersen, G., Løvdahl, H., & Friis, S. (1998). Global assessment of functioning—split version. Background and scoring guidelines. Oslo: Psykiatrisk divisjon, Ullevål universitetssykehus,

Kennedy, J., & Aas, I. H. M. (2013). Axis V: Essential supplement to the DSM-5. Psychiatric Services, 64, 1066.CrossRef

Klein, D. N., Dougherty, L. R., & Olino, T. M. (2005). Toward guidelines for evidence-based assessment of depression in children and adolescents. Journal of Clinical Child and Adolescent Psychology, 34, 412–432.CrossRef

Kvale, S. (1996). Interviews: An introduction to qualitative research interviewing. Newbury Park, CA: Sage Publications.

Kvale, S., & Brinkmann, S. (2009). Det kvalitative forskningsintervju, 2 utg. [The qualitative research interview, 2nd ed.]. Oslo: Gyldendal Norsk Forlag.

Lima, E. N., Stanley, S., Kaboski, B., Reitzel, L. R., Richey, J. A., Castro, Y., et al. (2005). The incremental value of the MMPI-2: When does therapist access not enhance treatment outcome? Psychological Assessment, 17, 462–468.CrossRef

Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. London: Sage Publications.CrossRef

Malterud, K. (2001). Qualitative research: Standards, challenges, and guidelines. Lancet, 358, 483–488.CrossRef

Martinez-Martin, P. (2010). Composite rating scales. Journal of the Neurological Sciences, 289, 7–11.CrossRef

McDowell, I., & Newell, C. (1987). Measuring health: A guide to rating scales and questionnaires. Oxford: Oxford University Press.

Niv, N., Cohen, A. N., Sullivan, G., & Young, A. S. (2007). The MIRECC version of the Global Assessment of Functioning scale: Reliability and validity. Psychiatric Services, 58, 529–535.CrossRef

Pedersen, G. (2014). Global funksjonsskåring—like aktuelt etter siste versjon av diagnosesystemet DSM [Scoring of global functioning—equally relevant after the latest version of the diagnostic system DSM]. Tidsskrift for Den norske Legeforening, 134, 916–917.CrossRef

Pedersen, G., & Karterud, S. (2012). The symptom and function dimensions of the Global Assessment of Functioning (GAF) scale. Comprehensive Psychiatry, 53, 292–298.CrossRef

Rogers, R. (2001). Handbook of diagnostic and structured interviewing. New York: The Guilford Press.

Sederer, L. I., Herman, R., & Dickey, B. (1995). The imperative of outcome assessment in psychiatry. American Journal of Medical Quality, 10, 127–132.CrossRef

Sonesson, O. (2014). Measures, interventions, and outcomes: Exploring inpatient psychiatric care (Doctoral thesis, University of Gothenburg, Sweden). https://gupea.ub.gu.se/bitstream/2077/37238/2/gupea_2077_37238_2.pdf.

Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19, 349–357.CrossRef

Title: A Qualitative Study of Clinicians Experience with Rating of the Global Assessment of Functioning (GAF) Scale
Authors: I. H. Monrad Aas
Ove Sonesson
Steffen Torp
Publication date: 01-01-2018
Publisher: Springer US
Published in: Community Mental Health Journal / Issue 1/2018
Print ISSN: 0010-3853
Electronic ISSN: 1573-2789
DOI: https://doi.org/10.1007/s10597-016-0067-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

A Qualitative Study of Clinicians Experience with Rating of the Global Assessment of Functioning (GAF) Scale

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2018

Forensic Assertive Community Treatment in a Continuum of Care for Male Internees in Belgium: Results After 33 Months

Measuring Mental Health Provider-Based Stigma: Development and Initial Psychometric Testing of a Self-Assessment Instrument

Development of a Shared Decision Making Model in a Community Mental Health Center

Providers’ Behaviors and Beliefs on Prescribing Antipsychotic Medication to Children: A Qualitative Study

Adapting and Validating the Family Resilience Assessment Scale in an Afrikaans Rural Community in South Africa

Training for Direct Support Staff at Group Homes for People with Chronic Mental Illness