Abstract

Authors critically noted that in spite of the numerous empirical findings of independent relation between psychiatric symptom and functioning, were overly symptom-based both the current psychiatric disability-identifying system and its functional measure, GAF. Accordingly, it was proposed to construct a standardized, self-report functional assessment scale which is not symptom-based but functioning-focused. In study I, 169 items were generated from the literature review and three separate focus group interviews with the psychiatrically ill, their families, and professionals. Then, 133 items were selected from the initial pool, on the basis of item appropriateness and degree of independent performance on each item, respectively rated by the professionals and psychiatrically ill. In study II, a 133-item scale was administered to 369 persons with psychiatric illness. Factor analysis on the resultant data derived a 95-item scale of 8 subscales.. In study III, the cross-validation on an independent sample demonstrated the scales` stability. Confirmatory factor analytic results showed good fit between the specified factor structure and the actual data. The final scale succeeded in separating the discharged from the hospitalized, and the combined patient group from the non-patient group. More importantly, two groups of patients and non-patients showed the differences in functional patterns as well as functional levels. The scale was only weakly related to GAF. It also failed to classify the psychiatric disability-registered patients into their respective groups according to three disability levels. However, these results are more likely to indicate problems inherent in the GAF and current psychiatric disability-identifying system, rather than low validity of this scale. To test this possibility, further study is needed to examine multi-relationships among symptom measure, GAF, disability levels, and this scale. Implications and limitations of this study were discussed.