Assessing Overall Functioning With Adolescent Inpatients

Abstract

The current study looks to evaluate the validity and reliability of a brief measure of overall functioning for adolescents. Clinicians were asked to complete the Overall Functioning Scale for 72 adolescents consecutively admitted to the adolescent psychiatric inpatient service of a community safety net medical center. The results revealed that this new measure is related to the patients’ length of stay, clinician-rated measures of social cognition and object relations, Global Assessment of Functioning score at admission, and global rating of engagement in individual psychotherapy. Results also showed that the OFS was related to patients’ history of non-suicidal self-harm as well as treatment outcome as assessed by measures of psychological health and well-being and symtomatology. Hierarchical regressions reveal that the OFS shows incremental validity above the admission GAF score in predicting length of stay. The results also showed that the OFS demonstrates inter-rater reliability in the excellent range (ICC 1,2) of .88. Clinical implications of the use of this tool as well as areas of future research are discussed.

Social Cognition and Object Relations Scale as level of personality functioning.

“…As such, these steps likely enhanced rater agreement and support the generalization of results from analyses of the variables. While studies examining the SCORS-G have generally been limited to the use of narrative data, our results demonstrate that the SCORS-G is also adaptable to holistic ratings of persons’ functioning based on narrative descriptions of the person (cf., Haggerty et al, 2014, 2015). Thus, this broadens the scope and potential clinical utility of the SCORS-G.…”

“…Ratings with the AMPD LPFS and Criterion B traits were made using instructions in the DSM-5 (APA, 2013); the GAF ratings similarly referred to the text of DSM-IV (APA, 2000). The clinical vignettes were also evaluated with whole-person ratings of the eight SCORS-G dimensions (for a similar application of the SCORS-G, see Haggerty et al, 2014Haggerty et al, , 2015. Thus, the SCORS-G dimensions were rated by considering the information in the vignette as a whole or clinical gestalt, and by applying the ratings heuristically using an assessment method similar to that used in everyday practice.…”