Concurrent validity of the Global Assessment of Functioning Scale for clients with schizophrenia

Although the Global Assessment of Functioning (GAF) scale is a widely utilized instrument, little data on construct validity is available about its use with clients having schizophrenia. This study compared point-specific GAF scores with concurrent ratings of symptomatology and social and occupational impairments using the Functional Assessment Rating Scale (Ward & Dow, 1994). A linear multiple regression analysis of empirical data from investigations of clients' global functioning showed that increased work and school-related problems, danger to others, and psychotic symptoms predicted lower GAF scores. In general, GAF scores seem to reflect the construct of global psychological, social, and occupational functioning that the scale was designed to measure.     

Don't Take Out This Appendix! Generalizability of the Global Assessment of Relational Functioning Scale

This study investigated the generalizability of the Global Assessment of Relational Functioning (GARF) Scale. Found in an appendix of the Diagnostic and Statistical Manual of Mental Disorders under "Criteria Sets for Axes Provided for Future Study," the GARF Scale provides a global rating of a relational unit (family or couple). Thirty-two raters assigned GARF ratings to five relational units. Generalizability analyses indicate extremely high dependability of GARF scores across raters. Higher generalizability coefficients were found for raters who had formal education in family systems theory. Overall, these results are an encouraging step towards adopting the GARF for widespread use.     

Construct validity of the Bender-Gestalt II: comparison with Wechsler Intelligence Scale for Children-III

This study investigated the relationships of visuomotor constructs as measured by the Bender-Gestalt II with the subtests of the WISC-III. A factor analysis included the standardized Copy and Recall scores of the Bender-Gestalt II and subtest scores of the WISC-III. The Copy score was predicted to load on measures of visual and spatial thinking and the Recall score on a short-term memory factor. The results of a principal components analysis suggest a four-factor solution with the Bender-Gestalt II Copy score loading on a visual and spatial thinking factor primarily with WISC-III Perceptual Organization subtests. The Recall score loaded on a visual and spatial thinking factor as well as a short-term memory factor with the WISC-III Digit Span subtest. The results suggest the Bender-Gestalt II Copy subtest shared commonality with the visual and spatial tasks given the similarity in the visuomotor demands of each test and was less influenced by processing speed or cultural knowledge than other tests on the visual and spatial thinking factor. Also, results suggest Bender-Gestalt II Recall measures elements of both visual and spatial thinking as well as aspects of short-term memory and memory retrieval. Clinical guidelines for co-administration and underlying processing demands are discussed.     

A team format for the Global Assessment Scale: reliability and validity on an inpatient unit

The Global Assessment Scale (GAS) is a 100-point rating instrument which purports to measure psychological adjustment on a continuum from self-actualization to severe regression. Its reliability and validity were examined on the admitting ward of a state hospital where GAS ratings are assigned to patients by computing a mean of the individual ratings assigned by a team of clinicians. Results showed such team GAS ratings to have good reliability. As for validity, team GAS predicted the outcomes of court hearings at two stages of the civil commitment process and showed construct validity in its relevant correlations with the Psychotic Inpatient Profile. A predicted association between team GAS and a ward atmosphere measure was not obtained. Taken as a whole, the results support the use of team GAS ratings in inpatient settings.     

There's more in a number than you think: new validity data for the Global Assessment Scale

Holcomb and Otto (1988) recently suggested that the widely used Global Assessment Scale may have ". . . questionable validity as an index of psychopathology." The present paper points out procedural and conceptual problems in their study and presents extensive evidence supporting the concurrent and predictive validity of the scale.     

The pattern of subjective anxiety during in-session exposures over the course of cognitive-behavioral therapy for clients with social anxiety disorder

Exposure-based therapies are efficacious treatments for social anxiety disorder (i.e., Gould et al., 1997). Much of the theory behind these treatments is derived from Foa and colleagues' (Foa, Huppert, & Cahill, 2005; Foa & Kozak, 1986) work on emotional processing. However, there has been little research examining individual differences in emotional processing patterns within and between treatment sessions among clients with social anxiety disorder. This study utilized longitudinal data analytic methods to examine changes in subjective anxiety during the first 3 exposure sessions in group and individual cognitive-behavioral therapy for social anxiety disorder. The results of this study provide preliminary evidence that, although anxiety generally decreases across exposures, some individuals experience considerable fluctuations in anxiety during a single exposure. Although anxiety during the first exposure was not significantly related to outcome, the relationship between anxiety during exposure and outcome became stronger during subsequent exposures. Overall, this study highlights the need to conduct more fine-grained analyses to better understand the mechanisms underlying exposure-based therapies for social anxiety disorder.     

Working alliance for clients with social anxiety disorder: relationship with session helpfulness and within-session habituation

It has been suggested that a strong working alliance encourages clients to take risks during therapy (Raue, Castonguay, & Goldfried, 1993). This encouragement may be important for clients who fear negative evaluations as they engage in risk-taking elements of therapy. This study examined the relationship between working alliance, session helpfulness and measures of emotional processing in 18 clients undergoing cognitive behavior therapy (CBT) for social anxiety disorder. Results indicate a positive correlation between client-rated, but not observer-rated, working alliance and session helpfulness. Moderate levels of working alliance were associated with higher initial anxiety and deeper within-session habituation. Overall, a strong alliance was associated with clients engaging with the session and finding the session helpful. Implications for the use of CBT for social anxiety are discussed.     

Construct validity of the MMPI-2 College Maladjustment (Mt) Scale

The construct validity of the MMPI-2 (Minnesota Multiphasic Personality Inventory-2) College Maladjustment (Mt) Scale was examined using 376 student clients at a university psychological clinic. A principal components analysis and correlations of Mt scale scores with clients' and therapists' ratings of symptoms and functioning showed that the Mt scale identifies the presence of maladjustment as defined in terms of depressive and anxious symptoms. There is no evidence to show that the scale is specific to college students or that it is sensitive to severe psychological disturbance. The Mt scale does not inform the clinician as to why a person is distressed. In addition, there is no evidence from this study to suggest the superiority of the Mt scale over other MMPI-2 maladjustment measures. Therapists should use the entire MMPI-2 profile, not just the Mt scale, to gain the most comprehensive and specific understanding of clients.     

Reliability and validity of the Yale Global Tic Severity Scale

To investigate the reliability and validity of the Yale Global Tic Severity Scale (YGTSS), 28 youth aged 6 to 17 years with Tourette's syndrome (TS) participated in the study. Data included clinician reports of tics and obsessive-compulsive disorder (OCD) severity, parent reports of tics, internalizing and externalizing problems, and child reports of depression and anxiety. All children participated in a 2nd YGTSS administration by the same rater 48 days later. Good internal consistency and stability were found for the YGTSS scores. YGTSS scores demonstrated strong correlations with parent-rated tic severity (r = .58-.68). YGTSS scores were not significantly related to measures of clinician ratings of OCD severity (r = .01-.15), parent ratings of externalizing and internalizing behavior (r = -.07-.20), and child ratings of depression (r = .02-.26) and anxiety (r = -.06 -.28). Findings suggest that the YGTSS is a reliable and valid instrument for the assessment of pediatric TS.     

Psychometric evaluation of the Fear of Positive Evaluation Scale in patients with social anxiety disorder

The Fear of Positive Evaluation Scale (FPES; J. W. Weeks, R. G. Heimberg, & T. L. Rodebaugh, 2008) was designed to assess fear of positive evaluation, a proposed cognitive component of social anxiety. Although previous findings on the psychometric properties of the FPES have been highly encouraging, only 1 previous study has examined the psychometric profile of the FPES in a sample of patients with social anxiety disorder (T. A. Fergus et al., 2009). The primary purpose of the present study was to conduct a large multisite examination of the psychometric profile of the FPES among patients with a principal diagnosis of social anxiety disorder (n = 226; generalized subtype = 97.8%). Responses of nonanxious control participants (n = 42) were also examined. The factorial validity, internal consistency, test-retest reliability, construct validity, and treatment sensitivity of the FPES were strongly supported by our findings. Furthermore, an FPES cutoff score was identified for distinguishing levels of fear of positive evaluation characteristic of patients with social anxiety disorder from those characteristic of the control group. Results provide additional support for the psychometric properties of the FPES in clinical samples.     

Validation of the Norwegian version of the Social Functioning Scale (SFS) for schizophrenia and bipolar disorder

Hellvin, T., Sundet, K.,Vaskinn, A., Simonsen, C.,Ueland, T., Andreassen, O.A. & Melle, I. (2010). Validation of the Norwegian version of the Social Functioning Scale (SFS) for schizophrenia and bipolar disorder. Scandinavian Journal of Psychology 51, 525–533. Studies of social functioning in severe mental disorders are disadvantaged by the multitude of different assessment instruments in use. The present study aims to establish reliability and validity of the Norwegian version of the Social Functioning Scale (SFS) and to examine social functioning in bipolar disorder (BD) compared to schizophrenia (SZ) and healthy controls (HC). SFS, a 76 item questionnaire divided into seven subscales measuring various aspects of daily life functioning, was administered to samples diagnosed with BD (n = 100) or SZ (n = 100) and to HC (n = 100), recruited from the ongoing Tematic Organized Psychosis (TOP) study. Reliability analyses prove adequate psychometric properties both for the composite full scale score (α: 0.81) as well as for the seven subscale scores (α: 0.60–0.88). Principal component analysis of the subscales confirms a one‐component structure, explaining 59% of the variance. Although significantly correlated with the Global Assessment of Functioning, our results indicate that the SFS measures different aspects of social functioning, is less influenced by demographic and clinical characteristics, but differentiates at the same time significantly BD from SZ. Thus, SFS adds valuable information as a supplement to standard clinician‐rated assessment tools of social functioning, suited both for research and clinical work.     

Construct validity of the Kendrick Battery with institutionalized aged

In this study, we attempted to explore the construct validity of the Kendrick Battery by using an American sample and psychometric tests as indexes of diffuse organicity, depression, and normality. Institutionalized residents (N = 53) were tested twice (6-week interval). When organicity was defined by disorientation and memory deficits, then both the Object Learning test and the Digit Copying test were accurate in differentiating preestablished criterion groups. When organicity was defined more broadly, including sensorimotor function, the Digit Copying test alone was more accurate when depression was defined in terms of irritability, restlessness, and despair. These data suggest that although the Kendrick scales appeared to be sensitive to organicity and depression in this sample, their validity varied with the criteria for each when such were defined psychometrically.     

Construct validity of the Rosenzweig Picture-Frustration Study

Projective and semiprojective techniques are both tools and tests. A schema for assessing the validity of projective devices is proposed: (1) Primary, consisting of (a) construct validity i.e., the soundness of the techniques vis-a-vis its underlying concepts; and (b) criterion-related validity, i.e., the concordance between tool results and specified external criteria. (2) Secondary, viz., pragmatic validity, i.e., the usefulness of the instrument in applied fields. Discussion then focuses on the construct validity of the conceptually-based, semiprojective Rosenzweig P-F Study. specifically the evidence on (a) the self-consistency of its conceptual dimensions; (b) the sequential. social development of the Types and Directions of Aggression; (c) levels of behavior elicited; (d) sensitivity to scorable changes after induced frustration: and (e) physiological correlates oft he aggression categories. In each of these areas evidence exists in support of the validity of the P-F Study.     

Global Assessment of Relational Functioning Scale (GARF): II. Reliability and Validity in a Sample of Families of Bipolar Patients

The companion article by the Group for the Advancement of Psychiatry (GAP) Committee on the Family (see p. 155, this issue) describes the development of the Global Assessment of Relational Functioning (GARF) scale. The present study evaluated the reliability and concurrent validity of a manualized version of the GARF in recently episodic bipolar patients (N = 73 ) participating with family members in laboratory interaction tasks. The GARF was applied with high reliability by raters with little clinical experience. GARF ratings discriminated between families rated high and low in expressed emotion, with families rated as high in emotional overinvolvement showing the lowest relational functioning scores. GARF scores also correlated with affective negativity scores derived from the interactional task-based affective style and coping style coding systems. However, relational ratings were independent of levels of concurrent symptoms or illness chronicity among individual patients. GARF ratings may inform the treatment plans for patients with psychiatric disorders, but the optimal methods of data collection and rater training must be determined.     

Construct validity of the Life Orientation Test

The Life Orientation Test (LOT; Scheier & Carver, 1985) is a common measure of optimism. Previous studies of the convergent and discriminant (vis-à-vis neuroticism) validity of the LOT have relied solely on questionnaires. Our Study 1 was a multitrait, multimethod investigation of the LOT incorporating Gottschalk and Gleser's (1969) method of content analysis of speech samples as a nonquestionnaire assessment method. The LOT did not correlate significantly with the Gottschalk Hope Scale (Gottschalk, 1974) derived from speech samples. Study 2 was an initial attempt to determine the nature of the differences between these alternate measures of optimism. In particular, it was hypothesized and found that the LOT was more fakable than the Hope Scale. Participants who received special instructions to "fake good" scored significantly higher on the LOT than did control participants who received no special instructions. Faking instructions did not significantly affect scores on the Hope Scale.     

The Personality Assessment Inventory Drug Problems Scale: a validity analysis

An analysis of the relationship among the Personality Assessment Inventory (PAI; Morey, 1991, 1996) Drug Problems (DRG) scale scores, the Addiction Severity Index (ASI; McLellan et al., 1992) scores, and urine toxicology reports revealed that the PAI Drug Problem scale scores of 100 substance-using and substance-abusing men and women were distributed in a manner that was in agreement with the guidelines suggested by Morey (1991, 1996) in the PAI manual. There were significant correlations among the PAI DRG scale and the ASI scales related to frequency of use, negative consequences of use, and need and desire for treatment. Overall, higher scores did reflect both more serious involvements with drug use and more serious problems as a consequence of their involvement.