Reliability of global assessment of functioning ratings made by clinical psychiatric staff
2005 (English)In: Psychiatric Services, ISSN 1075-2730, Vol. 56, no 4, 434-438 p.Article in journal (Refereed) Published
Objective: In the Swedish psychiatric care system, systematic follow-upof clinical work with patients is becoming a part of regular service, anda number of care providers are using the Global Assessment of Functioning(GAF) to measure outcomes. This study investigated the reliabilityof the GAF and analyzed certain factors that affect measurementerrors when the scale is used by regular psychiatric staff.
Methods: Eighty-one raters from various psychiatric outpatient clinics ratedeight case vignettes. Interrater reliability was assessed by using intraclasscorrelation coefficients (ICCs), and factors associated with reliabilitywere analyzed by using raters’ unique residual values.
Results: The results showed that staff who are responsible for assessing firsttimepatients at outpatient psychiatric clinics and making diagnoses areusing the GAF with satisfactory reliability (ICC1,1=.81). The factors associatedwith reliability were raters’ subjective attitude toward the GAF and motivation to use the scale and other measurement instruments inpsychiatry.
Conclusions: GAF ratings made by an individual rater can beused to measure changes and outcomes at the group level. However, themeasurement error is too large for assessment of change for an individualpatient, in which case it might be necessary to use several raters. If raters are positively inclined to use rating instruments, measurementerrors are minimized and reliability is maximized.
Place, publisher, year, edition, pages
Washington, D.C.: American Psychiatric Association , 2005. Vol. 56, no 4, 434-438 p.
IdentifiersURN: urn:nbn:se:umu:diva-5641OAI: oai:DiVA.org:umu-5641DiVA: diva2:145225