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Global assessment of functioning. A modified scale

R C Hall1

  • 1Center for Psychiatry, Florida Hospital, Orlando 32803, USA.

Psychosomatics
|May 1, 1995
PubMed
Summary
This summary is machine-generated.

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The modified Global Assessment of Functioning (GAF) scale shows improved reliability and validity compared to the original. Its structured format enhances interrater agreement, making it valuable for diverse clinical settings.

Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Health Services Research

Background:

  • The original Global Assessment of Functioning (GAF) scale is widely used but lacks detailed criteria and a structured scoring system.
  • Variability in GAF scores can arise from differences in rater training and subjective interpretation.

Purpose of the Study:

  • To compare the reliability and validity of a modified Global Assessment of Functioning (GAF) scale against the original GAF scale.
  • To evaluate the modified GAF's performance across raters with varying training levels.

Main Methods:

  • Raters with different training levels assigned hospital admission and discharge GAF scores using both the original and modified GAF scales from patient charts.
  • Interrater reliability was assessed using intraclass correlation coefficients (ICCs).

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  • Validity was examined by comparing GAF scores with Zung Depression scores.

    • Main Results:

    • The modified GAF demonstrated higher interrater reliability for admission scores (ICC=0.81) compared to the original GAF (ICC=0.62).
    • High correlation (0.80) was observed between the modified and original GAF scores, indicating good concurrent validity.
    • The modified GAF showed a strong negative correlation with Zung Depression scores (-0.73).

    Conclusions:

    • The modified GAF scale offers enhanced reliability and validity, particularly beneficial for maximizing interrater agreement.
    • Its structured format makes it more resistant to rater bias and suitable for use by clinicians with diverse backgrounds and training levels.
    • The modified GAF is a valuable tool for objective patient functioning assessment in clinical practice and research.