Cited by 3,716Psychological Testing and AssessmentChild and Adolescent Psychosocial and Emotional DevelopmentPsychometric Methodologies and Testing

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A Children's Global Assessment Scale (CGAS)

Shaffer, David·1983·Archives of General Psychiatry

DOI 10.1001/archpsyc.1983.01790100074010

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Abstract

We evaluated the Children's Global Assessment Scale (CGAS), an adaptation of the Global Assessment Scale for adults. Our findings indicate that the CGAS can be a useful measure of overall severity of disturbance. It was found to be reliable between raters and across time. Moreover, it demonstrated both discriminant and concurrent validity. Given these favorable psychometric properties and its relative simplicity, the CGAS is recommended to both clinicians and researchers as a complement to syndrome-specific scales.

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The Global Assessment Scale: A Procedure for Measuring Overall Severity of Psychiatric Disturbance
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Hemager, N., Plessen, K. J., Thorup, A. A. E., Christiani, C. J., Ellersgaard, D., Spang, K. S., Burton, B. K., Gregersen, M., Søndergaard, A., Greve, A. N., et al. (2018) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2018.1415 · Cited by 89
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Stevens, A. J., Purcell, R. V., Darling, K. A., Eggleston, M. J. F., Kennedy, M. A., & Rucklidge, J. J. (2019) · Scientific Reports · doi:10.1038/s41598-019-46146-3 · Cited by 88
One Family at a Time: A Prevention Program for At‐Risk Parents
Nicholson, B. C., Anderson, M., Fox, R. A., & Brenner, V. (2002) · Journal of Counseling & Development · doi:10.1002/j.1556-6678.2002.tb00201.x · Cited by 88
Cognitive therapy as an early treatment for post‐traumatic stress disorder in children and adolescents: a randomized controlled trial addressing preliminary efficacy and mechanisms of action
Meiser‐Stedman, R., Smith, P. A., McKinnon, A., Dixon, C., Trickey, D., Ehlers, A., Clark, D. M., Boyle, A. A., Watson, P., Goodyer, I. M., et al. (2016) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12673 · Cited by 88
“The Children’s Global Assessment Scale (CGAS; Shaffer et al., 1983) provided a clinician-rated measurement of general functioning.”
Method
Treatment of Pediatric Anxiety Disorders: An Open-Label Extension of the Research Units on Pediatric Psychopharmacology Anxiety Study
Walkup, J. T., Labellarte, M. J., Riddle, M. A., Pine, D. S., Greenhill, L. L., FAIRBANKS, J., KLEIN, R. G., Davies, M., Sweeney, M., Abikoff, H., et al. (2002) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/104454602760386879 · Cited by 88
“…Anxiety Rating Scale (PARS; RUPP Anxiety Study Group in press) (Greenhill et al. 1998; Walkup and Davies 1999), clinically significant impairment as assessed with the Children’s Global Assessment Scale (CGAS < 60; Shaffer et al. 1983), and availability of parent and child for weekly visits.”
Early onset psychotic disorders: Diagnostic stability and clinical characteristics
McClellan, J., & McCurry, C. (1999) · European Child & Adolescent Psychiatry · doi:10.1007/pl00010686 · Cited by 88
Determinants of Reliability in Psychiatric Surveys of Children Aged 6–12
Fallon, T., & Schwab‐Stone, M. (1994) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.1994.tb01282.x · Cited by 88
Are Attentional-Hyperactivity Deficits Unidimensional or Multidimensional Syndromes? Empirical Findings from a Community Survey
Bauermeister, J. J., Alegria, M. M., Bird, H., Rubio‐Stipec, M., & CANINO, G. J. (1992) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199205000-00007 · Cited by 88
Multicenter Open‐Label Sertraline Study in Adolescent Outpatients With Major Depression
Ambrosini, P. J., Wagner, K. D., Biederman, J., Glick, I. D., TAN, C., Elia, J., Hebeler, J. R., RABINOVICH, H., Lock, J., & GELLER, D. A. (1999) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199905000-00018 · Cited by 88
Influence of Religiosity on 12-Step Participation and Treatment Response Among Substance-Dependent Adolescents
Kelly, J. F., Pagano, M. E., Stout, R. L., & Johnson, S. M. (2011) · Journal of Studies on Alcohol and Drugs · doi:10.15288/jsad.2011.72.1000 · Cited by 87
“Regarding psychosocial outcomes, the GAATOR was signifi cantly correlated with the NPI-entitlement; the SOS was signifi cantly correlated with the NPI-entitlement and the Children’s Global Assessment Scale.”
Influential
Early signs of anomalous neural functional connectivity in healthy offspring of parents with bipolar disorder
Singh, M. K., Chang, K., Kelley, R. G., Saggar, M., Reiss, A. L., & Gotlib, I. H. (2014) · Bipolar Disorders · doi:10.1111/bdi.12221 · Cited by 89
“2); these correlations were not significant within the low-risk group (age: r = 3.04, p = 0.22; z = 1.63, p = 0.052; CGAS: r = 0.212, p = 0.397; z = 1.1, p = 0.14).”
MethodInfluential
Maintenance Model of Integrated Psychosocial Treatment in Pediatric Bipolar Disorder
West, A. E., Henry, D. B., & Pavuluri, M. N. (2007) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/01.chi.0000246068.85577.d7 · Cited by 87
Predicting parenting stress: children's behavioural problems and parents' coping
Solem, M., Christophersen, K.-A. A., & Martinussen, M. (2010) · Infant and Child Development · doi:10.1002/icd.681 · Cited by 104
Early-Onset Psychotic Disorders: Course and Outcome Over a 2-Year Period
McClellan, J., MCCURRY, C., Snell, J. L., & DuBose, A. (1999) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199911000-00012 · Cited by 87
Controlled study of switching from attention-deficit/hyperactivity disorder to a prepubertal and early adolescent bipolar I disorder phenotype during 6-year prospective follow-up: Rate, risk, and predictors
Tillman, R., & Geller, B. (2006) · Development and Psychopathology · doi:10.1017/s0954579406060512 · Cited by 87
“The CGAS ~Bird, Canino, Rubio-Stipec, & Ribera, 1987; Shaffer et al., 1983! is a measure of global severity, based on impaired functioning in social, family, school, and work settings.”
Background
Clinical and Treatment Characteristics of Children With Attention-Deficit/Hyperactivity Disorder in Psychiatric Practice
Zarin, D. A., Suarez, A. P., Pincus, H. A., Kupersanin, E., & ZITO, J. M. (1998) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199812000-00009 · Cited by 87
Randomized efficacy trial of two psychotherapies for depression in youth with inflammatory bowel disease
Szigethy, E., Bujoreanu, S. I., Youk, A. O., Weisz, J., Benhayon, D., Fairclough, D., Ducharme, P., Gonzalez-Heydrich, J., Keljo, D., Srinath, A., et al. (2014) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2014.04.014 · Cited by 86
The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis
Macdonald, G. M., Livingstone, N., Hanratty, J., McCartan, C. J., Cotmore, R., Cary, M., Glaser, D., Byford, S., Welton, N. J., Bosqui, T. J., et al. (2016) · Health Technology Assessment · doi:10.3310/hta20690 · Cited by 90
“measured social, psychological and school functioning using the KGAS (1986 version(405)), based on the Children’s Global Assessment Scale (CGAS).(261)”
Method
Parent-Youth Divergence (and Convergence) in Reports of Youth Internalizing Problems in Psychiatric Inpatient Care
Makol, B. A., Reyes, A. D. L., Ostrander, R. S., & Reynolds, E. K. (2019) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-019-00540-7 · Cited by 86
Methylphenidate for children and adolescents with attention deficit hyperactivity disorder (ADHD)
Storebø, O. J., Storm, M. R. O., Ribeiro, J. P., Skoog, M., Groth, C., Edemann-Callesen, H., Schaug, J. P., Rasmussen, P. D., Huus, C.-M. L., Zwi, M., et al. (2023) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd009885.pub3 · Cited by 118
The Mental Health Impacts of COVID-19 on PK–12 Students: A Systematic Review of Emerging Literature
Naff, D., Williams, S. E., Furman, J., & Yeung, M. (2022) · AERA Open · doi:10.1177/23328584221084722 · Cited by 100
A Clinical Trial for Adolescent Depression: Predictors of Additional Treatment in the Acute and Follow-up Phases of the Trial
Brent, D. A., Kolko, D. J., Birmaher, B. B., BAUGHER, M., & Bridge, J. A. (1999) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199903000-00012 · Cited by 83
A Risk Calculator to Predict the Individual Risk of Conversion From Subthreshold Bipolar Symptoms to Bipolar Disorder I or II in Youth
Birmaher, B., Merranko, J. A., Goldstein, T. R., Gill, M. K., Goldstein, B. I., Hower, H., Yen, S., Hafeman, D., Strober, M., Diler, R. S., et al. (2018) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2018.05.023 · Cited by 81
“More specifically, the risk calculator predicted BP-I conversion with 74% discrimination and BP-II conversion with 70% discrimination, comparable to the performance of risk calculators developed to predict psychosis and new-onset BP in offspring of parents with BP and risk calculators currently used in medicine.(18,19…”
Does EEG ‐neurofeedback improve neurocognitive functioning in children with attention‐deficit/hyperactivity disorder? A systematic review and a double‐blind placebo‐controlled study
Vollebregt, M. A., van Dongen‐Boomsma, M., Buitelaar, J. K., & Slaats-Willemse, D. I. E. (2013) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12143 · Cited by 90
“General functioning was measured by the Children’s Global Assessment Scale (CGAS; Shaffer et al., 1983), and the severity of ADHD was assessed with the Clinical Global Impres-sion-Severity Scale (CGI-S; Bangs et al., 2008).”
Method
Use of holding, restraints, seclusion and time-out in child and adolescent psychiatric in-patient treatment.
Sourander, A., Ellilä, H., Valimaki, M. A., & Piha, J. (2002) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-002-0274-2 · Cited by 84
Quality assurance of specialised treatment of eating disorders using large‐scale internet‐based collection systems: Methods, results and lessons learned from designing the Stepwise database
Birgegård, A., Björck, C., & Clinton, D. N. (2010) · European Eating Disorders Review · doi:10.1002/erv.1003 · Cited by 84
“Kid) is used (Sheehan et al., 1998; Swedish version 2.1 was developed by von Knorring, von Knorring and Björck (2003)).”
MethodInfluential
The Relations among Measurements of Informant Discrepancies within a Multisite Trial of Treatments for Childhood Social Phobia
Reyes, A. D. L., Alfano, C. A., & Beidel, D. C. (2009) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-009-9373-6 · Cited by 89
“, clinician, laboratory observer) often determine whether a child experiences positive treatment response based on interviews with other informants (e.g., parent, child, and/or teacher; Guy 1976; Shaffer et al. 1983; Silverman and Albano 1996).”
Background
Disruptive Mood Dysregulation Disorder in a Community Mental Health Clinic: Prevalence, Comorbidity and Correlates
Freeman, A. J., Youngstrom, E. A., Youngstrom, J. K., & Findling, R. L. (2016) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2015.0061 · Cited by 84
Prevalence of Attention-Deficit/Hyperactivity Disorder in a Community Sample of Older Adolescents
Cuffe, S. P., McKeown, R. E., Jackson, K. L., Addy, C. L., Abramson, R. K., & Garrison, C. Z. (2001) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200109000-00012 · Cited by 84
Look for good and never give up: A novel attention training treatment for childhood anxiety disorders
Waters, A. M., Zimmer-Gembeck, M. J., Craske, M. G., Pine, D. S., Bradley, B. P., & Mogg, K. (2015) · Behaviour Research and Therapy · doi:10.1016/j.brat.2015.08.005 · Cited by 80
Metabolic Effects of Antipsychotics on Adiposity and Insulin Sensitivity in Youths: A Randomized Clinical Trial
Nicol, G. E., Yingling, M. D., Flavin, K. S., Schweiger, J. A., Patterson, B. W., Schechtman, K. B., & Newcomer, J. W. (2018) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2018.1088 · Cited by 83
Methylphenidate for Pervasive Developmental Disorders: Safety and Efficacy of Acute Single Dose Test and Ongoing Therapy: An Open-Pilot Study
Di Martino, A., Melis, G., Cianchetti, C., & Zuddas, A. (2004) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/1044546041649011 · Cited by 82
A Meta-Analysis on the Efficacy of Technology Mediated CBT for Anxious Children and Adolescents
Podina, I. R., Mogoase, C., David, D., Szentagotai, A., & Dobrean, A. (2016) · Journal of Rational-Emotive & Cognitive-Behavior Therapy · doi:10.1007/s10942-015-0228-5 · Cited by 83
Differences between children and adolescents who commit suicide and their peers: A psychological autopsy of suicide victims compared to accident victims and a community sample
Freuchen, A., Kjelsberg, E., Lundervold, A. J., & Grøholt, B. (2012) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/1753-2000-6-1 · Cited by 83
“on the Children’s Global Assessment scale (C-GAS) [17] for the lowest level of functioning during the child’s last year.”
Neural activation during encoding of emotional faces in pediatric bipolar disorder
Dickstein, D. P., Rich, B. A., Roberson‐Nay, R., Berghorst, L. H., Vinton, D. T., Pine, D. S., & Leibenluft, E. (2007) · Bipolar Disorders · doi:10.1111/j.1399-5618.2007.00418.x · Cited by 83
Clinical and psychosocial correlates of non-suicidal self-injury within a sample of children and adolescents with bipolar disorder
Esposito-Smythers, C. L., Goldstein, T. R., Birmaher, B. B., Goldstein, B. I., Hunt, J., Ryan, N. D., Axelson, D., Strober, M. A., Gill, M. K., Hanley, A. J., et al. (2010) · Journal of Affective Disorders · doi:10.1016/j.jad.2009.12.029 · Cited by 83
Temperament and Character Factors in a Prepubertal and Early Adolescent Bipolar Disorder Phenotype Compared to Attention Deficit Hyperactive and Normal Controls
Tillman, R., Geller, B., Craney, J. L., Bolhofner, K., Williams, M., Zimerman, B., Frazier, J., & Beringer, L. (2003) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/104454603322724922 · Cited by 83
“The CGAS (Bird et al. 1987; Shaffer et al. 1983) is an overall measure of severity based on psychiatric symptoms and impairment of function in family, social, school, and work settings.”
Suicidality and Its Relationship to Treatment Outcome in Depressed Adolescents
Barbe, R., Bridge, J. A., Birmaher, B. B., Kolko, D. J., & Brent, D. A. (2004) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.34.1.44.27768 · Cited by 82
Treatment Foster Care
Chamberlain, P. (2002) · Oxford University Press eBooks · doi:10.1093/acprof:oso/9780195134575.003.0006 · Cited by 83

Authors: Shaffer, D.
Affiliations: Columbia University (US)
Corresponding author: Shaffer, David
Venue: Archives of General Psychiatry
Publisher: American Medical Association (AMA)
Published: 1983-11-01
Volume: 40
Issue: 11
Pages: 1228
ISSN: 0003-990X (ISSN-L)
DOI: 10.1001/archpsyc.1983.01790100074010
OpenAlex: W2114776324
Cited by: 3,716
References: 5
Citations by year: 2026: 114 · 2025: 102 · 2024: 134 · 2023: 138 · 2022: 178 · 2021: 204 · 2020: 185 · 2019: 156 · 2018: 143 · 2017: 137 · 2016: 171 · 2015: 165 · 2014: 174 · 2013: 163 · 2012: 142
FWCI: 11.25
Type: journal article
Language: en
Open access: closed
Locations: Archives of General Psychiatry (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Applied Psychology › Psychological Testing and Assessment
Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
Keywords: Children's Global Assessment Scale, Global Assessment Scale, child psychiatry, psychometric properties, inter-rater reliability, test-retest reliability, discriminant validity, concurrent validity
MeSH terms: Adolescent, Age Factors, Ambulatory Care, Attention Deficit Disorder with Hyperactivity, Mental Disorders, Child, Child, Preschool, Hospitalization, Humans, Male, Parents, Psychiatric Status Rating Scales, Psychometrics

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A Children's Global Assessment Scale (CGAS)

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