A scale-based measurement reflecting the degree to which a person’s current symptoms affect their psychological, social, and occupational functioning on a range from 0 to 100. A higher score reflects higher functioning in everyday life based on scored criteria.
minutes
Preschool Children
2 - 5
yearsChild
6 - 12
yearsAdolescent
13 - 17
yearsAdult
18 - 64
yearsElderly Adult
+
yearsSinyoung Park, Megan Ramirez and Noppawan Tunsirimas
The American Psychiatric Association introduced the use of GAF in the DSM III-TR and continued to include it in the DSM IV and DSM IV-TR (1987, 1994, 2000).
Psychiatric disorders in inpatients: (Spitzer 1979)
Psychiatric disorders:(Jones et al., 1995)
Psychiatric disorders:(Söderberg et al., 2005)
Acceptable internal consistency (Cronbach’s alpha = 0.98), first-time patients at outpatient psychiatric clinics
Concurrent Validity
Schizophrenia: (Schwartz et al, 2007; n = 170 participants with schizophrenia diagnosis per DSM-IV; mean age = 39.2 (9.8) years)
Schizophrenia: (Schwartz et al., 2007; n = 170 participants with schizophrenia diagnosis per DSM-IV; mean age = 39.2 (9.8) years)
|
Variables |
Beta weights |
t165 |
Correlation |
|
severe psychotic symptoms |
-2.6 |
-6.7 |
-0.55* |
|
work and school related problems |
-1.0 |
-3.2 |
-0.31* |
|
danger to others |
-1.6 |
-3.3 |
-0.40* |
|
danger to self |
-.44 |
-.82 |
-0.05 |
Anxiety Disorder: (Schwartz & Prete-Brown, 2003; n = 33 participants with anxiety disorder per DSM-IV-R; mean age = 31.0 (10.6) years)
Psychiatric disorders: (Roy-Byrne et al., 1996; n= 337 psychiatric inpatients) examined the content validity of the GAF scale by comparing the GAF scores with nurses’ rating of the Lehman’s Quality of Life Scale and found that the GAF is most strongly correlated with ratings of clinical symptoms
Not statistically assessed; however, several researches report that the GAF is the standard method of assessing mental health patient’s global functioning. Also, the GAF was previously the most widely utilized clinician rating psychiatric diagnostic scale used in conjunction with the DSM-IV (Schwartz & Del Prete-Brown, 2003).
Aas, I. M. (2010). Global Assessment of Functioning (GAF): Properties and frontier of current knowledge. Annals of General Psychiatry, 9, 20. https://doi.org/10.1186/1744-859X-9-20
Aas I. H. (2011). Guidelines for rating Global Assessment of Functioning (GAF). Annals of general psychiatry, 10, 2. https://doi.org/10.1186/1744-859X-10-2
American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., text rev.). Washington, DC: Publisher.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Publisher.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). https://doi.org/10.1176/appi.books.9780890423349
American Psychiatric Association. (2013). Assessment Measures. In Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher.
Bates, L. W., Lyons, J. A., & Shaw, J. B. (2002). Effects of Brief Training on Application of the Global Assessment of Functioning Scale. Psychological Reports, 91(3), 999–1006. https://doi.org/10.2466/pr0.2002.91.3.999
Endicott, J., Spitzer, R. L., Fleiss, J. L., & Cohen, J. (1976). The Global Assessment Scale: A Procedure for Measuring Overall Severity of Psychiatric Disturbance. Archives of General Psychiatry, 33(6), 766–771. https://doi.org/10.1001/archpsyc.1976.01770060086012
Goldman, M., Dequardo, J. R., Tandon, R., Taylor, S. F., & Jibson, M. (1999). Symptom correlates of global measures of severity in schizophrenia. Comprehensive Psychiatry, 40(6), 458–461. https://doi.org/10.1016/S0010-440X(99)90090-1
Goldman, H. H., Skodol, A. E., & Lave, T. R. (1992). Revising axis V for DSM-IV: a review of measures of social functioning. The American Journal of Psychiatry, 149(9), 1148-1156. DOI: 10.1176/ajp.149.9.1148
Hall, R.C. (1995). Global assessment of functioning: A modified scale. Psychosomatics, 36(3), 267-275. https://doi.org/10.1016/S0033-3182(95)71666-8
Jones, S., Thornicroft, G., Coffey, M., & Dunn, G. (1995). A Brief Mental Health Outcome Scale: Reliability and Validity of the Global Assessment of Functioning (GAF). British Journal of Psychiatry, 166(5), 654-659. doi:10.1192/bjp.166.5.654
Pedersen, G., Urnes, Ø., Hummelen, B., Wilberg, T., & Kvarstein, E. H. (2018). Revised manual for the global assessment of functioning scale. European Psychiatry, 51, 16-19. DOI: 10.1016/j.eurpsy.2017.12.028
Roy-Byrne, P., Dagadakis, C., Unutzer, J., & Ries, R. (1996). Evidence for limited validity of the revised Global Assessment of Functioning Scale. Psychiatric Services, 47, 864-866.
Shaffer, D., Gould, M. S., Brasic, J., Ambrosini, P., Fisher, P., Bird, H., & Aluwahlia, S. (1983). A Children’s Global Assessment Scale (CGAS). Archives of General Psychiatry, 40(11), 1228–1231. https://doi.org/10.1001/archpsyc.1983.01790100074010
Schwartz, R. C. (2007). Concurrent Validity of the Global Assessment of Functioning Scale for Clients with Schizophrenia. Psychological Reports, 100(2), 571–574. https://doi.org/10.2466/pr0.100.2.571-574
Schwartz, R. C., & Del Prete-Brown, T. (2003). Construct Validity of the Global Assessment of Functioning Scale for Clients with Anxiety Disorder. Psychological Reports, 92(2), 548–550. https://doi.org/10.2466/pr0.2003.92.2.548
Söderberg, P., Tungström, S., & Armelius, B. A. (2005). Special Section on the GAF: Reliability of Global Assessment of Functioning Ratings Made by Clinical Psychiatric Staff. Psychiatric Services, 56(4), 434–438. https://doi.org/10.1176/appi.ps.56.4.434
Spitzer RL, Forman JBW: DSM-III field trials, II: initial experience with the multiaxial system. Am J Psychiatry 1979; 136: 818-820
Støre-Valen, J., Ryum, T., Pedersen, G. A. F., Pripp, A. H., Jose, P. E., & Karterud, S. (2015). Does a web-based feedback training program result in improved reliability in clinicians’ ratings of the Global Assessment of Functioning (GAF) Scale? Psychological Assessment, 27(3), 865–873. https://doi-org.ezproxy.library.wisc.edu/10.1037/pas0000086
We have reviewed more than 500 instruments for use with a number of diagnoses including stroke, spinal cord injury and traumatic brain injury among several others.