期刊
PSYCHIATRIC SERVICES
卷 66, 期 12, 页码 1312-1317出版社
AMER PSYCHIATRIC PUBLISHING, INC
DOI: 10.1176/appi.ps.201400400
关键词
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资金
- U.S. Department of Veterans Affairs (VA) Health Services Research and Development Service's Quality Enhancement Research Initiative Program [SDR 06-331]
- VA Clinical Sciences Research and Development program
- National Institute of Mental Health [1R01MH095737-01A1]
- U.S. Department of Defense [W81XWH-10-2-0181, W81XWH-12-2-0117-PTSD-IIRA-INT]
- Defense Advanced Research Projects Agency [N66001-11-C-4006]
- VA (Cooperative Studies Program) [591]
Objective: One of the major changes in DSM-5 was removal of the Global Assessment of Functioning (GAF). To determine whether the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is a suitable replacement for the GAF, this study compared how well the WHODAS 2.0 and the GAF measured functional impairment and other phenomena related to posttraumatic stress disorder (PTSD) among veterans applying for financial compensation (service connection) for PTSD. Methods: Clinicians evaluating veteran claimants administered the Clinician Administered PTSD Scale (CAPS) and the WHODAS 2.0 to 177 veterans during their evaluations. Veterans also completed the Inventory of Psychosocial Functioning (IPF), a self-report measure of functional impairment, and received a GAF rating from the examiner. Actual benefit determinations and ratings were obtained. Results: Confirmatory factor analyses demonstrated that the WHODAS 2.0 and the IPF were stronger indicators of a latent variable reflecting functioning compared with the GAF. In receiver operating characteristic curve analyses, the WHODAS 2.0, IPF, and GAF all displayed similar ability to identify veterans with PTSD-related impairment assessed by the CAPS. Compared with the GAF, the WHODAS 2.0 and IPF were less strongly related to PTSD symptom severity and disability ratings by the U.S. Department of Veterans Affairs, but these variables are typically influenced by GAF scores. Conclusions: The WHODAS 2.0 and IPF are acceptable replacements for the GAF and can be used to assess functional impairment among veterans seeking compensation for PTSD.
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