Protocol - Behavioral Health Screener
The Global Appraisal of Individual Needs - Short Screener (GAIN-SS) contains 20 items that make up four subscreeners (a five-item internal disorder screener, a five-item external disorder screener, a five-item substance disorder screener, and a five-item crime and violence screener). Each item measures recency of the problem in the past month, 2-12 months ago, more than a year ago, or never.
Because the Global Appraisal of Individual Needs - Short Screener (GAIN-SS) is a self-reported screener, it 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.
Summary of Global Appraisal of Individual Needs (GAIN)
The Global Appraisal of Individual Needs (GAIN) originated in 1993 as a collaborative effort between clinicians, researchers, and policymakers to create a comprehensive and standardized biopsychosocial assessment tool.
The GAIN has developed into a progressive and integrated family of instruments with a series of measures and computer applications designed to support a number of treatment practices, including:
· Initial screenings (GAIN-SS)
· Brief interventions and referrals (GAIN-Q3)
· Standardized clinical assessments for diagnosis, placement, and treatment planning (GAIN-I)
· Monitoring change in clinical status, service utilization, and costs to society (GAIN-M90)
· Subgroup and program-level needs assessment, evaluation, and secondary analysis
The GAIN family of instruments is appropriate for use with both adolescents and adults from a variety of populations in various levels of care, including: outpatient, intensive outpatient, short-term residential, long-term residential, therapeutic community, justice programs, school-based programs, welfare programs, co-occurring disorder programs, and primary health care programs
Protocol Name from Source:
Global Appraisal of Individual Needs - Short Screener (GAIN-SS)
Personnel and Training Required
Interviewer must be trained and found competent to conduct personal interviews with individuals from the general population. The interviewer should be trained to prompt respondents further if a "don’t know" response is provided.
|Specialized requirements for biospecimen collection||No|
|Average time of greater than 15 minutes in an unaffected individual||No|
Mode of Administration
Self-administered or interviewer-administered questionnaire
Adolescent, Adult, Senior, Pregnancy
Adolescents and adults aged 12 years or older
The proposed measure is the Global Appraisal of Individual Needs - Short Screener (GAIN-SS), which is designed to (a) be valid for both adolescent and adult populations; (b) provide measures of severity overall and in the four main dimensions of emotional/behavioral problems (internalizing, externalizing, substance, crime/violence); and (c) triage these dimensions to provide guides to support clinical decisionmaking about diagnosis and treatment needs.
GAIN-SS was developed by selecting items from the full GAIN, based on Rasch analysis, and was validated through internal consistency, efficiency, and receiver operating characteristics (ROC). It is designed for use in general populations to quickly and accurately identify who would have a disorder on the full GAIN (typically, a requirement for treatment entry in behavioral health); to rule out those who would not; and to serve as a measure of change in these same symptoms.
Psychometrics: For both adolescents and adults, GAIN-SS has good internal consistency (alpha of .96 on the 20-item screener); were highly correlated (r = .84 to .94) with the 123-item scales in the full GAIN-Initial; had excellent sensitivity (90% or more) for identifying people with a disorder; and had excellent specificity (92% or more) for correctly ruling out people who did not have a disorder. This screener can also measure change in symptoms over time (Dennis, Chan, & Funk, 2006).
Arabic, Cambodian, English, Farsi, French, Hindi, Indonesian, Korean, Laotian, Mandarin Chinese, Marathi, Mongolian, Portuguese, Punjabi, Russian, Somali, Spanish, Tagalog, Vietnamese
|Common Data Elements (CDE)||Substance use Behavioral Health Questionnaire Assessment Score||3373507||CDE Browser|
Process and Review
The Expert Review Panel #3 (ERP 3) reviewed the measures in Alcohol, Tobacco and Other Substances, and Substance Abuse and Addiction domains.
Guidance from ERP 3 includes:
• Changed name of Measure
• Updated protocol
• New Data Dictionary
Back-compatible: Not back-compatible (vastly different than previous protocol which would require a new data dictionary) and not recommended for use (discredited or no longer considered broadly validated)
Dennis, M. L., Chan, Y.-F., & Funk, R. R. (2006). Development and validation of the GAIN Short Screener (GAIN-SS) for internalizing, externalizing and substance use disorders and crime/violence problems among adolescents and adults. American Journal on Addictions, 15(Suppl. 1), 80-91.
Dennis, M. L., Chan, Y.-F., & Funk, R. (2006). Development and validation of the GAIN Short Screener (GSS) for internalizing, externalizing, and substance use disorders and crime/violence problems among adolescents and adults. American Journal on Addictions, 15(Suppl. 1), 80-91.
Dennis, M. L., Feeney, T., Hanes-Stevens, L., & Bedoya, L. (2008). GAIN-SS: Global Appraisal of Individual Needs-Short Screener (GAIN-SS) administration and scoring manual version 2.0.3. Bloomington, IL: Chestnut Health Systems.
Lucenko, B., Mancuso, D., & Estee, S. (2008). Co-occurring disorders among DSHS clients: A report to the legislature as required by section 601 (2) of the Omnibus Treatment of Mental and Substance Abuse Disorders Act of 2005 (Report No. 3.32). Olympia, WA: Washington State Department of Social and Health Services.
McDonnell, M. G., Comtois, K. A., Voss, W. D., Morgan, A. G., & Ries, R. K. (2009). Global Appraisal of Individual Needs Short Screener (GSS): Psychometric properties and performance as a screening measure in adolescents. American Journal of Drug and Alcohol Abuse, 35(3), 157-160.
|Variable Name||Variable ID||Variable Description||Version||dbGaP Mapping|
|PX560102000000||Protocol 560102 - proprietary. Check DCW for more||N/A|
Behavioral Health Screener
November 21, 2016
An instrument used to identify behavioral health disorders, such as internalizing psychiatric disorders, externalizing psychiatric disorders, substance use disorders, and crime and violence problems.
The purpose of this measure is to screen in four main dimensions of emotional/behavioral problems (internalizing, externalizing, substance, and crime/violence) in both adult and adolescent populations in the past month, year, and lifetime. The Global Appraisal of Individual Needs - Short Screener (GAIN-SS) interpretability relies on dimensional measures categorized into low, moderate, and high.
Global Appraisal of Individual Needs Short Screener, GAIN-SS, Internal Disorders, External Disorders, Substance Use Disorders, Crime and Violence Problems, SAA, Substance Use-related Co-morbidities and Health-related Outcomes, proprietary