Reliability and Concurrent Validity of the GAIN Short Screener Among Youth Utilizing Integrated Health Services.

OBJECTIVES

There is increasing interest in the identification of mental disorders among youth through routine screening in integrated health services. One tool currently being used in Canada is the Global Appraisal of Individual Needs Short Screener (GAIN-SS). The aims of this study were to (1) estimate the internal consistency of the GAIN-SS and its internalizing disorder screener (IDScr) (2) examine concurrent validity of the GAIN-SS and IDScr in an integrated youth health service centre, and (3) identify clinical cut-points for youth aged 17-24 years.

METHOD: Participants [n=201, gender=44% women, median age 21 (min,max: 17,24) years] were recruited from an integrated youth health service in Vancouver, British Columbia. Participants completed the GAIN-SS and three reference measures: Kessler Psychological Distress Scale (K10), Patient Health Questionnaire (PHQ-9), and Generalized Anxiety Disorder Scale (GAD-7). Cronbach's alpha, sensitivity, and specificity of the GAIN-SS and IDScr were examined using the K-10, PHQ-9 and GAD-7 as reference measures. Receiver operator characteristic curves were generated to identify optimal cut-points for the GAIN-SS and IDScr.

RESULTS

A cut-point of seven for the GAIN-SS optimized sensitivity (90%) and specificity (42%) with Cronbach's alpha of 0.91. A similar pattern of results was found for the IDScr and the reference measures it was tested against.

CONCLUSION

The results indicate that the GAIN-SS and IDScr have acceptable sensitivity but poor specificity that could be improved via the optimal cut-points identified in this study. This low specificity may be acceptable within an integrated youth health service that provides follow-up diagnostic assessments by a clinician.