• Brian P Marx, Erika J Wolf, Michelle M Cornette, Paula P Schnurr, Marc I Rosen, Matthew J Friedman, Terence M Keane, and Theodore Speroff.
• Dr. Marx, Dr. Wolf, and Dr. Keane are with the National Center for PTSD, VA Boston Healthcare System, Boston (e-mail: brian.marx@va.gov ). They are also with the Department of Psychiatry, Boston University School of Medicine, Boston. Dr. Cornette is with the Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland. Dr. Schnurr and Dr. Friedman are with the Executive Division, National Center for PTSD, White River Junction VA Medical Center, White River Junction, Vermont, and the Geisel School of Medicine at Dartmouth, Hanover, New Hampshire. Dr. Rosen is with the Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, and with the Department of Psychiatry, VA Connecticut Healthcare System, West Haven, Connecticut. Dr. Speroff is with the Center for Health Services Research, Geriatric Research Education and Clinical Center, Veterans Affairs Tennessee Valley Healthcare System, Nashville, Tennessee, and the Vanderbilt University School of Medicine, Nashville, Tennessee.
• Psychiatr Serv. 2015 Dec 1; 66 (12): 1312-7.

ObjectiveOne of the major changes in DSM-5 was removal of the Global Assessment of Functioning (GAF). To determine whether the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is a suitable replacement for the GAF, this study compared how well the WHODAS 2.0 and the GAF measured functional impairment and other phenomena related to posttraumatic stress disorder (PTSD) among veterans applying for financial compensation (service connection) for PTSD.MethodsClinicians evaluating veteran claimants administered the Clinician Administered PTSD Scale (CAPS) and the WHODAS 2.0 to 177 veterans during their evaluations. Veterans also completed the Inventory of Psychosocial Functioning (IPF), a self-report measure of functional impairment, and received a GAF rating from the examiner. Actual benefit determinations and ratings were obtained.ResultsConfirmatory factor analyses demonstrated that the WHODAS 2.0 and the IPF were stronger indicators of a latent variable reflecting functioning compared with the GAF. In receiver operating characteristic curve analyses, the WHODAS 2.0, IPF, and GAF all displayed similar ability to identify veterans with PTSD-related impairment assessed by the CAPS. Compared with the GAF, the WHODAS 2.0 and IPF were less strongly related to PTSD symptom severity and disability ratings by the U.S. Department of Veterans Affairs, but these variables are typically influenced by GAF scores.ConclusionsThe WHODAS 2.0 and IPF are acceptable replacements for the GAF and can be used to assess functional impairment among veterans seeking compensation for PTSD.

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