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Global Distress Scale

The Global Distress Scale (GDS) is the average of the responses to individual items on the global distress outcome questionnaires. The advantage of the PSI is that the range of scores remains the same regardless of the number of items on the questionnaire (which is particularly useful, when some items are left blank). The GDS score is also easy to understand, as it mirrors the range of responses on the questionnaire: 0 for "Never", 1 for "Hardly ever, 2 for "Sometimes", 3 for "Often" and 4 for "Very often." Therefore, a PSI score of 1 indicates that the client's average response to the questions they answered was "Hardly ever". A GDS score of 3, on the other hand, would indicate that the client's average problem frequency was "Often".

Use of the GDS scoring method (the average response to all items answered) as opposed to the more traditional additive scoring method does not alter the results or psychometric properties of the measure in any way.

Published test scores norms from any questionnaire can be converted to GDS scores so long as the item content and Likert scale anchors are comparable. Both the PSI mean and standard deviation may be estimated by dividing the total number of items on the questionnaire into the published mean and standard deviation for the total test scores.

Global Distress Severity Ranges (by questionnaire)

Questionnaire Normal/Mild Distress (25%) Moderate Distress (50%) Severe Distress (25%)
ACORN-Adult 0-1.5 1.6-2.5 2.6-4
ACORN-Youth-Self report 0-1 1.1-1.8 1.9-4
ACORN-Youth-Caregiver report 0-1.2 1.3-9 2-4
PHQ9-GAD 0-.66 .66-1.7 1.8-3 2.2-3

Item List

  • GDS indicates item is included in the Global Distress Scale
    • Items are excluded from the GDS due to a high percentage of respondents reporting no problem and/or low a correlation between them item responses with the global distress factor

Adult Items

  • Symptoms
    • feel unhappy or sad?
    • have little or no energy?
    • worry about a lot of things?
    • feel worthless?
    • feel no interest in things?
    • have a problem with eating (too much or too little)?
    • have problems with sleep (too much or too little)?
    • feel tense or nervous?
    • cry easily?
    • feel lonely?
    • feel hopeless about the future?
    • have a hard time controlling your temper?
    • have a headache or pain in your body?
    • feel irritated?
    • feel bothered by pain?
    • have physical pain or other health problems?
    • feel fearful.
    • worry about medical problems?
    • feel good about yourself?
  • Function (Work/School)
    • have a hard time paying attention?
    • feel unproductive at work or other daily activities?
    • find yourself daydreaming, worrying or staring into space?
    • have trouble with your household chores?
    • accomplish most of what you wanted to do?
    • feel unable to complete your work or other daily tasks in a timely manner?
  • Social
    • have a hard time getting along with family or friends?
    • worry about family problems?
    • make mistakes at work that caused problems? * Self Harm
    • think about harming yourself or others?
    • have thoughts of ending your life?

Youth Items

  • Symptoms
    • eat a lot more or a lot less than usual?
    • feel unhappy or sad?
    • have a hard time controlling your temper?
    • worry about a lot of things?
    • feel worthless?
    • have a hard time having fun?
    • have a hard time sleeping because you were worried?
    • cry easily?
    • get mad?
    • have aches, pains or other body problems?
    • have a hard time falling or staying asleep?
    • feel anxious, worried or fearful?
  • Function (Work/School)
    • have a hard time waiting your turn?
    • have a hard time paying attention?
    • lose things you need?
    • have a hard time sitting still?
    • have a problem doing chores or schoolwork?
  • Social
    • get into trouble?
    • disobey adults? (not do what adults told you to do)
    • interrupt others?
    • lie?
    • lie to get things he/she wanted?
    • have a hard time getting along with family and/or friends?
    • hang out with kids who get into trouble?
    • feel nervous and/or shy around other people?
    • get into fights with family members and/or friends?
    • annoy other people on purpose?
    • argue with adults?
    • think that you don't have any friends?
    • get into trouble with family or friends?
    • have no interest in friends or activities? * Self Harm
    • feel like hurting yourself or somebody else?
    • threaten or attempt self injury?
  • Other
    • have any other problem not listed here?
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