Reliability and validity of DSM-IV Axis V scales in a clinical sample of veterans with posttraumatic stress disorder.
OBJECTIVE
Psychometric properties of the DSM-IV Axis V scales in measuring adaptational functioning of psychotraumatised veterans have been chosen as the focus of this study.


METHODS
The reliability and validity of the Global Assessment of Functioning Scale (GAF), the Social and Occupational Assessment Scale (SOFAS), and the Global Assessment of Relational Functioning (GARF) were examined in a clinical sample of 129 veterans with posttraumatic stress disorder (PTSD).


RESULTS
The interrater reliability of the GAF (ICC=0.82) and the SOFAS (ICC=0.83) was excellent, while the interrater reliability of the GARF (ICC=0.75) was good. Correlations with other clinician-rated scales of psychopathology and overall functioning showed that the GAF is primarily related to a reduction in functioning due to psychiatric symptoms, while an assessment of functioning beyond psychopathology, considering the effects of the individual's general medical condition as well, was provided by the SOFAS and the GARF, which is of importance for a comprehensive evaluation of the patients' health status. The factor analysis of the Axis V scales revealed a theoretically meaningful, single common factor (variance accounted for by the extracted factor = 76.91%), while observed differences, between the subjects with complete and partial PTSD, in scores on the axis V scales support further use of the axis V scales as useful outcome variables.


CONCLUSIONS
The issue of a valid and reliable measurement of functional impairment is of paramount importance not only in the domain of clinical psychiatry but in forensic practice as well. In this respect, our findings give strong support to extending the scope of the DSM axis V scales with the two experimental scales which provide both conceptual framework and useful tools for reliable and valid evaluation of adaptatinal functioning in persons suffering from PTSD.
Jovanović
Aleksandar A
AA
Institute of Psychiatry, Clinical Centre of Serbia, Belgrade, Serbia.
Gasić
Miroslava Jasović
MJ
Ivković
Maja
M
Milovanović
Srdjan
S
Damjanović
Aleksandar
A
D000328:Adult; D010054:Brief Psychiatric Rating Scale / Q000706:statistics & numerical data; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004185:Disability Evaluation; D005163:Factor Analysis, Statistical; D005555:Forensic Psychiatry / Q000379:methods; D006304:Health Status; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D011594:Psychometrics; D012372:ROC Curve; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D012917:Social Adjustment; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000523:psychology; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data; D015022:Yugoslavia / Q000453:epidemiology