Gaf?

[sbrewer]

Has the GAF score been around for a long time, say 20 yrs ago, or is this something fairly knew?

Thanks,

sbrewer

[Jay Johnson]

Has the GAF score been around for a long time, say 20 yrs ago, or is this something fairly knew?

Thanks,

sbrewer

Here you go -

>>>>>>1.1. History of the GAF

The Global Assessment of Functioning Scale (GAF) was introduced as a new rating scale of overall psychiatric disturbance as Axis V of the revised third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM III-R, American Psychiatric Association, 1987). Since its introduction, its use in clinical settings has expanded due to the need for an easily and quickly administered measure of severity of mental illness. It is currently the most commonly used global assessment instrument for psychiatric patients (Bodlund, Kullgren, Ekselius, Lindstrom, & von Knorring, 1994; Piersma & Boes, 1997).

The GAF is derived from its predecessor, the Global Assessment Scale (GAS; Endicott, Spitzer, & Fleiss, 1976), a measure used to assess a patient’s overall level of functioning for a specified time period (American Psychiatric Association, 1987). The GAF is based on the assumption that the level of current functioning in psychiatric populations holds crucial information for treatment planning and treatment outcome. Furthermore, the GAF can be used in a variety of settings to follow changes in an individual over time without the need or expense of extensive training.

The GAF is similar to the GAS in that it has similar criteria and the same interval design, a value range from 0 (most severe) to 100 (least severe) with 10 anchor points at equal intervals (Hall, 1995). However, unlike the GAS, each interval of the GAF is accompanied by a behavioral descriptor ranging from “superior functioning in a wide range of activities…no symptoms” to “persistent danger of severely hurting self or others…persistent inability to maintain minimal personal hygiene.” Therefore, the interviewer must first determine the descriptor that summarizes the client’s current difficulties, and then indicate the severity of

impairment within a nine-point range. However, the number of criteria required to meet a particular interval is not defined. Furthermore, the rater must make a single rating based upon the patient’s overall level of psychological, social, and occupational functioning. Additionally, impairment in functioning due to physical limitations or psychosocial stressors is not included in the GAF ratings. The absence of these stressors is cited as a major flaw by numerous researchers (Bodlund et. al., 1994; Hall, 1995, & Piersma et.al., 1997), who have suggested that one’s general medical condition may have a major impact upon one’s social and occupational functioning.<<<<<<<<<<<

Edited March 29, 2006 by Jay Johnson

[john999]

I really think the GAF is completely subjective in its use by psychiatrists.

[Jay Johnson]

I really think the GAF is completely subjective in its use by psychiatrists.

Yes and no:-) I think far too many psychiatrists have "agendas" and ignore the basic guidelines set forth by the people who started the new "GAF" system. I also believe that psych's try to prove that they have "cured" too many patients to make themselves feel useful, when there is really no hard evidence to suggest that any psych method can cure mental disease. A good example would be the docs in mental hospitals....every time my wife goes in she gets GAFs in the 10-20 range so they can justify admitting her (both to their superiors and the insurance company). Then, when the insurance company no longer wants to pay, my wife miraculously gets a GAF in the 40 range (which is almost a minimum to discharge someone). It's like the psychs won't admit that my wife is consistently in the 15-30 range, depending on her mood, because they MUST feel as if they are making her better (and, thus, worth the insane amount of money we pay them).

In my opinion, psychiatry is still in the dark-ages of medicine at this point (especially america). Europe is a good deal ahead of us on the topic but still WAY behind where they need to be to actually help people.