Axis V in the DSM: Diagnosis & Disorders

Instructor: Chevette Alston

Dr. Alston has taught intro psychology, child psychology, and developmental psychology at 2-year and 4-year schools.

This lesson gives a brief overview of the fifth axis from the Diagnostic and Statistical Manual of Mental Disorders. You'll learn how this scale is used and how the ratings influence the treatment and care of clients with mental health issues.

Axis V and the Global Assessment of Functioning

The Diagnostic and Statistical Manual of Mental Disorders is a five-axis system that clinicians use to determine a comprehensive diagnosis of a person's mental health functioning. Axis V of this system contains the Global Assessment of Functioning, or the GAF - a rating scale used to assess a client's mental health and determine how their current behaviors are influencing their psychological, social and occupational functioning. The GAF scores mental health on a continuum that does not include impairments in functioning caused by physical and/or environmental limitations.

How the Scale Works

The GAF is a reflection of the clinician's judgment of the patient's ability to function on a day-to-day basis. It utilizes a 100-point scale with ratings that range from superior functioning (100 to 91) all the way down to persistent danger (10 to 1). The middle of the GAF scale, 50 to 41, suggests behaviors that indicate the onset of antisocial and/or socially dysfunctional behaviors. A zero is assigned when there is not enough information to give a rating.

The numbers are important; however, it is also relevant to give attention to what the GAF measures. In order to determine the level of treatment or care needed, the GAF is usually a gauge that indicates the client's current level of functioning at the time of evaluation. Note that a GAF scale can also be used to compare the client's mental health at the time of admission to a mental health facility to their level of functioning at the time of discharge.

Although not commonly used, there is also a Children's Global Assessment Scale for children and teens below the age of 18 years old.

The Global Assessment of Functioning Scale

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