Global Appraisal of Individual Needs - Short Screener  (GAIN-SS)

Overview | Psychometrics | Instrument | Manual | Software

Overview: The 5-minute GAIN-Short Screener (GAIN-SS) is designed primarily for 3 things: First, it serves as a screener in general populations to quickly and accurately identify clients (also known as patients, respondents, or research participants) whom the full 1.5 to 2-hour GAIN-Initial would identify as having 1 or more behavioral health disorders (e.g., internalizing or externalizing psychiatric disorders, substance use disorders, or crime/violence problems), which would suggest the need for referral to some part of the behavioral health treatment system. It also rules out those who would not be identified as having behavioral health disorders. Second, it serves as an easy-to-use quality assurance tool across diverse field-assessment systems for staff with minimal training or direct supervision. Third, it serves as a periodic measure of change over time in behavioral health. It is designed for self- or staff administration with paper and pen, on a computer, or on the web. It can be easily converted to a scannable form or incorporated into existing instrument batteries or systems. Versions in different languages (such as Spanish) are also available. GAIN-SS responses are given in terms of the recency of the problem described in the questions: 3 = past month; 2 = 2 to 12 months ago; 1 = 1+ years ago; 0 = never. The number of past-month symptoms (number of 3s) is used as a measure of change; the number of past-year symptoms (number of 3s or 2s) is used to identify who is likely to have a current diagnosis; and the number of lifetime symptoms (number of 3s, 2s, or 1s) is used as a covariate measure of lifetime severity. The recency measures can also be combined to create course specifiers (e.g., early remission means having a lifetime problem but not in the past month; sustained remission means having a lifetime problem but not in the past year). An alternate past-year version of the GAIN-SS is also available below (link?). The past-year version is simplified to ask only about problems in the past 12 months using a 0 = no and 1 = yes response set. The past-year version of the GAIN-SS can give only a past-year symptom count and is scored by counting the number of 1s, but it is otherwise parallel to the version of the GAIN-SS described in this manual. While the past-year version does have a slightly shorter administration time and is in use by some systems as the “minimum” required screener, it is generally not recommended for use because it lacks the ability to provide past-month symptom counts (measure of change) or lifetime symptom counts (as a covariate). Spanish and other language versions will be made available via the website as they are released as well.

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Psychometrics: Dennis, Chan, and Funk (2006) found that for both adolescents and adults the 20-item total disorder screener (TDScr) and its 4 5-item sub-screeners (internalizing disorders, externalizing disorders, substance disorders, and crime/violence) have good internal consistency (alpha of .96 on the total screener), were highly correlated (r = .84 to .94) with the 123-item scales in the full GAIN-I, had excellent sensitivity (90% or more) for identifying people with a disorder, and excellent specificity (92% or more) for correctly ruling out people who did not have a disorder. A confirmatory factor analysis of the structure of the GAIN-SS shows that it is also consistent with the full GAIN model (see Figure 1 of article) after allowing adolescent and adult path coefficients to vary and cross-loading paths between conduct disorder items with crime/violence items. The confirmatory factor analysis was slightly less accurate than the full-scale version in terms of the confirmatory fit index (CFI; .87 for the GAIN-SS vs. .92 for the full GAIN, where as the CFI approaches 1 the model fits the data better) and slightly more precise in terms of the root mean square error of approximation (RMSEA; .05 for GAIN-SS vs. .06 for the full GAIN, where as the RMSEA goes down there is less unexplained variance). This suggests that each of the sub-screeners has good discriminant validity and that the total structure is consistent with the model used with the full GAIN (see Figure 1 of article). GAIN Model of Emotional, Behavioral, Substance, Crime, and Violence Problems * Conduct disorder cross-loads with the Crime/Violence Scale in statistical versions of this model. As reliable as the GAIN-SS is, it is still just a self-reported screener and should supplement (not replace) the judgment of clinical line staff who may have urine test results, collateral reports, or other background information available to them. This is particularly important when screening in settings that involve jails, welfare investigations, or other situations where the fear of possible consequences or concerns about confidentiality may influence client answers or affect the validity of their responses. Click below for a copy of the article.

Dennis, M.L., Chan, Y-.F., & Funk, R.R. (2006). Development and validation of the GAIN Short Screener (GAIN-SS) for psychopathology and crime/violence among adolescents and adults. The American Journal on Addictions, 15(supplement 1), 80-91. [permission granted by journal to post on 3/7/07]

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Instrument: The GAIN-SS is 20 questions with a recency response set (past month, 2-12 months ago, 1+ years ago, or never) and takes about 5 minutes to administer.

GAIN Short Screener:

• GAIN-SS English (version 2.0.2, Recency) - The 2-page instrument in English.
• GAIN-SS Spanish (version 2.0.2, Recency) - The 2-page instrument in Spanish.

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Manual:

• GAIN-SS Manual - 28 pages. (PDF version - 658 KB)

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Software:

• GAIN-Short Screener Demonstration

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For additional information concerning the larger family of GAIN instruments and their underlying psychometrics go to the GAIN Home Page.