The Global Assessment of Functioning Scale (GAF) within Psychiatric Inpatient Care - Focus on Reliability and Outcome

Abstract: DEGREE OF LlCENTlATE IN PSYCHOLOGY ABSTRACT Sonesson, Q. (20 Il ). The Glob"J Assessmellf of Fl/lleriolling Scale (GAF) withiII p!J)'chiatric l upariem Care - Foclls 011 Re/fabi/iIY aJ/d Outcome. Departm,cnt of Psychology, Uni versity of GOIhenburg, $wcden. The general nim of this thesis was to invcstigutc thc utililY of the Global Assessment of Functioning scale (GAF) when applied to psychiatric inpaticnt care. Another overa ll aim was lo contribute to thc knowledge about the psychometric propertics of the GAF scale. The reliability oflhc GAF scale was inve stigalcd whcn used by smff at a psychi rltric acutc inpatient care clinic (Sludy I). In an assessment task, 10 I participams ratcd 6 vignettes, using thc GAF sca le. The rcsult showed il good reJiability, with an lntrn Class Coefficicnt of 0.79. Background variables wcre entered into a mul tiple linear regression analys is, yielding no signi ficanl results. Since reli ability was sati sfying a study was accomplished invesligaling the GAF sca le as a measure of ouicome in psychiatric inpatient care (Study II). Gathcrcd data from the healthcare infonnution system used within Sahlgrenska Uni versity Hospital was analyzed. The study group consisled of816 care epi sodes that were GAF rated both at admissioD and at di scharge. The diffcrencc between tbe patient's GAF value at discharge and at admission was used us u mensure ofchnnge in globalievei offunetioning. The overall GAF change was 20.7 points, a movement from a low level of funclioning to a modemte leve!. Cohcn's d showed an overall effeel sizc of 1.67, corrcsponding to a high effect. Of all the patients in the study group. 75% had u GAF ch ange of 2 10 points, and was considered improved. The lowcst mean GAF valoe al admission was l10ted for persons with a diagnosis of schizophreni a and for persons with other psychotic disorders. The highesl mean GAF vulue at discharge WIlS found for persons with mood di sorders. The two studies in this thesis supports the concJusion that the GAF scule could be a useful tool in the context of psychiotric inpatient cure. Keywords: clinicul research, inpatient care, ilssessment, reliability, effectivcness, outeorne, global fu nctioning, GA F ISSN II OI-71 8X ISRN GUfPSYKlAVH--151-SE Ol'e SO/w.mm. Dcparlmcl1I ofP"y chology. U"i1'crsiry ofGothcnblll'g. Box 500. SE·./05 30 GötcbrJ/'}J. PhO/rc: ""46707367179. E·mail: [email protected]