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Would You Trust the Opinion of a Doctor if that Opinion was Based Upon a Broken X-Ray, MRI or CT sca

This is the follow-up to my previous entry about Social Security continuing to rely on the Global Assessment of Functioning (GAF) to make disability determinations for the mentally ill despite its material flaws. The flaws of the GAF are so many and so varied that to rely on GAF Scores IMHO is an abuse of discretion by the Judges and a violation of Due Process. The following is a list of academic articles discussing all these flaws. A special thank you goes to two Doctoral Candidate friends of mine who did this research for me.

Routine Evaluation of Mental Health: Reliable Information or Worthless “Guesstimates?”

H. Lovedahl, S. Friis; Acta Psychiatr Scand 1996: 93: 125-128

Reliability and Validity of the Global Assessment of Functioning Scale in Clinical Outpatients with Depressive Disorders, Esther M. Grootenboer MD, Erik J. Giltay MD PhD, Journal of Evaluation in Clinical Practice (ISSN 1365-2753) (2012) 502-507

Does the Global Assessment of Functioning Assess Functioning? Steven E. Bacon Michel J. Collins Edmund V. Plake Journal of Mental Health Counseling Volume 24/Number 3/July 2012/Pages 202-212

The GAF Gaffe: Ethical Quandries for Psychologists in Workers’ Compensation Settings: the GAF Gaffe – Shadi Gholizadeh Vanessa Malcarne Michael schatman Psychol. Inj. And Law (2015) 8:64-81

Reliability and Validity of DSM-IV Axis V Mark J. Hilsenroth Ph.D., Steven J. Ackerman M.A., Mathew D, Blagys M.A., Becky D. Bauman M.A., Mathew R. Baity M.A., Steve R. Smith M.A., Jennifer L. Price M.A., Candy L. Smith M.A., Tracy L. Heindsman M.A., Mollie K. Mount M.A., Daniel J Holdwick Jr., Ph.D.; Am j Psychiatry 2000: 157:1858-1863

Axis IV – Psychosocial and Environmental Problems - in the DSM-IV A. Ramirez M.D. Ph.D., L Ekselius M.D. Ph.D., M. Ramklint MD PhD; Journal of Psychiatric and Mental Health Nursing, 2013: 20: 768-775

Axis V – Global Assessment of Functioning Scale (GAF), Further Evaluation of the Self-Report Version A. Ramirez, L Ekselius, M. Ramklint; European Psychiatry 2008: 23: 575-579

Beyond the Global Assessment of Functioning: Learning from Virginia Apgar Thomas L. Patterson; Psychosomatics, Nov. 2010; University of California, San Diego; DOI: 10.1176/appl.psy 51.6.515 Source: PubMed

Collecting Information for Rating Global Assessment of Functioning (GAF): Sources of Information and Methods for Information Collection I.H. Monrad Aas Current Psychiatry Reviews, 2014, 10, 330-347

Does a Web-Based Feedback Training Program Result in Improved Reliability in Clinicians’ Ratings of the Global Assessment of Functioning (GAF) Scale? 2015 American

Psychological Association Jakob Store-Valen Physcological Assessment 2015, Vol 27 No. 3 865-873

DSM-5 and the Assessment of Functioning: The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) Liza H. Gold MD J Am Acad Psychiatry Law 42:173-81, 2014. Volume 42, Number 2, 2014

Revising Axis V for DSM-IV; A Review of Measures of Social Functioning, Howard H Goldman, M.D. Ph.D. Andrew E. Skodol, M.D. and Tamara R. Lave, B.A. Am J Psychiatry 149.9, September 1992 1148-1156

How to Evaluate Disability, Zohab Sohail, Rahn Kennedy Bailey and William D Ritchie Frontiers in Psychiatry June 2013 Volume 4 Article 54

Global Assessment of Functioning (GAF): Properties and Frontiers of Current Knowledge IH Monrad Aas Annals of General Psychiatry 2010, 9:20

Guidelines for Rating Global Assessment of Functioning (GAF) IH Monrad Aas Aanals of General Psychiatry, 2011, 10:2

Workplace Functional Impairment Due to Mental Disorders Charles Els University of Alberta Canada

Measurement of Pyschological Impairtment in Matters of Civil Litigation – APS Working Group on the Measurement of Psychological Impairment

Selection of Outcome Assessment Instruments for Inpatients with Severe and Persistent Mental Illness Gary M. Burlingham Ph.D. Psychiatric Services Aprl; 2005 Vol 56 No 4

Using the GAF as a National Mental Health Outcome Measure in the Department of Veterans Affairs Greg A. Greenberg, Ph.D. Psychiatric Services Aprl; 2005 Vol 56 No 4

The Concurrent Validity of the Global Assesment of Functioning (GAF) Mike Startup

British Journal of Clinicial Pschologfy (2002) 41, 417-422

Towards a Better Global Assessment of Functioning (GAF): Improving Scale Properties IH Monrad Aas International Journal of Emergency Mental Health and Human Resilience Vol 17 No 1 pp 197-202 ISSN 1522-4821

The Symptom and Function Dimensions of the Global Assessment of Functioning (GAF) Scale Comprehensive Psychiatry Volume 53, Issue 3 April 2012 Pages 292-298

The Professional Counselor from the National Board for Certified Counselors Inc and Affiliates: the GAFF Volume 4 Issue 3 Special Issue: Counseling and the DSSM-5

Frequently Asked Questions about DSM-5 Implementation for Clinicians UPDATED 8/1/2013 – internet address:

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