A developmental psychopathology perspective on child and adolescent treatment policy

This article considers the implications of theory and research in developmental psychopathology for existing and emerging social policy concerning treatment of child and adolescent psychopathology. Based on the concept that all psychopathology is a process, four core principles of a developmental psychopathology perspective are discussed. In turn, each is applied to an evaluation of policy issues with implications for intervention, including mental health parity, treatment guidelines, mental health reimbursement, and level of intervention. It is concluded that social policy on treatment must be based on an empirically supported theory of developmental psychopathology and on evidence-based interventions that link treatments to pathogenic processes.

The Children's Global Assessment Scale in clinical practice: an empirical evaluation

OBJECTIVE

The purpose of this study was to examine characteristics of the Children's Global Assessment Scale (CGAS) in the context of clinical practice.

METHOD

Ninety-five children admitted to a psychiatric inpatient unit were rated by their attending psychiatrist and by milieu staff on the CGAS. Measures of severity and type of symptomatology; social, behavioral, and school competence; intellectual level; social relatedness; and family stress were completed by parents and staff raters.

RESULTS

Results indicated that there was significant convergence in CGAS ratings by independent raters. CGAS ratings were unrelated to measures of symptomatology but were significantly related to indices of children's competence.

CONCLUSIONS

This pattern of results diverged from findings from highly controlled research settings and indicated that CGAS ratings obtained in clinical contexts may reflect evaluations of functional competence rather than severity of symptomatology.