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UBC Theses and Dissertations

Validity of the global appraisal of individual needs short screener (GSS) in an integrated youth health service Khanano, Raymond

Abstract

OBJECTIVES: There is increasing interest in the identification of mental illnesses among youth through routine screening in clinical settings. One tool currently being used in Canada is the Global Appraisal of Individual Needs (GAIN) Short Screener (GSS). The first objective of this study was to provide the results of a detailed literature search of existing literature on the GAIN and GSS. The second and third objectives were to contribute to literature on the validity of the GAIN by examining the sensitivity and specificity of the GSS and the GSS Internalizing Disorder Screener (GSS-I) respectively in an integrated youth health service. METHOD(S): Participants [n=201, 44% women, mean age 21.3 (SD=2.0) years] were recruited from an integrated youth health service in Vancouver, British Columbia. Data collection of the GSS, the Kessler Psychological Distress Scale 10 (K10), the Patient Health Questionnaire 9 (PHQ-9), and the Generalized Anxiety Disorder Scale 7 (GAD-7) was completed. Pearson’s correlational coefficient, Cronbach’s Alpha, Cohen’s Kappa coefficient, sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV) of the GSS and GSS-I were calculated. Receiver Operator Characteristic (ROC) curves were generated, and Youden’s J Statistic was calculated to determine optimal cut-points for the tools in this study. Finally, Area Under the Curve (AUC) values for each ROC curve were calculated. RESULTS: Sensitivity and specificity of the GSS total score referenced with the K10 total score were 100% and 9.6% respectively. An optimal cut-point of 7 yielded sensitivity and specificity values of 96.0% and 40.4% respectively. A similar pattern of results was found for the GSS-I in relation to the K10, PHQ-9, and GAD-7. CONCLUSION: The results indicated that the GSS and GSS-I have acceptable sensitivity but poor specificity that could be improved via the use of an optimized cut-point. In the context of an integrated youth health service where follow-up assessments are readily available low specificity may be acceptable. Future research examining the validity of the GSS and GSS-I should examine the sensitivity and specificity of the tools with a clinical assessment gold standard, for use in integrated youth health services as well as other non-clinical settings.

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Attribution-NonCommercial-NoDerivatives 4.0 International