Kessler Psychological Distress Scale (K10)/ (K10W - Day 08-29)
Clinical Screening Questionnaires Training - page 2/10
YWHO Substance Monitoring Form (YSMF)
Global Appraisal of Individual Needs: Short Screener (GAIN-SSS)
Introduction
The GAIN-SSS is an 11-item self-report screener to identify substance use disorders (5 questions), and issues with disordered eating, traumatic distress, disordered thinking, gambling, gaming, and internet overuse (6 questions) in youth. It is a shorter version of the GAIN-SS (also available on the YWHO Data Collection platform), which also screens for internalizing, externalizing, and crime/violence disorders, and is validated for use in individuals 12 years and older. Its psychometric properties (e.g., reliability, validity) are strong.
Why are we asking youth to complete this questionnaire?
Youth substance use is common on a national and international scale, although statistics vary depending on the substance being consumed. According to the CAMH Ontario Student Drug Use and Health Survey (OSDUHS), in Ontario in 2019, 41% of Grade 7-12 youth consumed alcohol, and 22% consumed cannabis, in the previous year. In addition, substance use co-occurs with mental health issues; Approximately one third of individuals diagnosed with a mental health disorder will also have a substance use disorder at some time in their lives, and vice versa. Moreover, in Canada, 25–50% of youth who die from suicide meet the criteria for having a substance use disorder. It is therefore critical to ask youth about their substance use, to understand and validate their experiences, monitor changes over time, and incorporate information into plans to meet treatment goals. It is also important to screen for other behaviours and thoughts young people are experiencing that may be negatively impacting their functioning (e.g, internet overuse, trauma-related distress). This contributes to a more comprehensive picture of youth, increased discussion opportunities, and the collaborative determination of appropriate service options.
Responding to youth asking why they are being asked to complete this questionnaire:
The GAIN-SSS asks you questions about behaviours related to alcohol and other drugs, as well as some different behaviours and thoughts, that you may have experienced during the past month, 2 to 12 months ago, more than a year ago, or never. You just choose the last time you may have had trouble with whatever the question asks. It helps us get a sense of how you’re currently doing with drinking or drugs, and other areas like gaming and eating, and then you can decide if there’s anything you might want to talk about here at some point.
Clinical questionnaire:
At the hub, when youth are provided the questionnaire on an iPad (or possibly in hard copy form), they receive the following instructions:
For each of the following questions, please tell us the last time you had a problem with it by answering whether it was in the past month, 2 to 3 months ago, 4 to 12 months ago, or 1 or more years ago. If you have never had the problem, you can choose “never.” If you are not sure about the answer to a question, please make your best guess. |
|---|
1. When was the last time that you used alcohol or drugs weekly or more often?
|
2. When was the last time that you spent a lot of time either getting alcohol or other drugs, using alcohol or other drugs, or recovering from the effects of alcohol or other drugs (e.g. feeling sick)?
|
3. When was the last time that you kept using alcohol or other drugs even though it was causing social problems, leading to fights, or getting you into trouble with other people?
|
4. When was the last time that your use of alcohol or other drugs caused you to give up or reduce your involvement in activities at work, school, home or social events?
|
5. When was the last time that you had withdrawal problems from alcohol or other drugs like shaky hands, throwing up, having trouble sitting still or sleeping, or you used any alcohol or other drugs to stop being sick or avoid withdrawal problems?
|
| Score Total: ______ |
6. When was the last time that you had significant problems with missing meals or throwing up much of what you did eat to control your weight?
|
7. When was the last time that you had significant problems with eating binges or times when you ate a very large amount of food within a short period of time and then felt guilty?
|
8. When was the last time that you had significant problems with being disturbed by memories or dreams of distressing things from the past that you did, saw, or had happen to you?
|
9. When was the last time that you had significant problems with thinking or feeling that people are watching you, following you, or out to get you?
|
10. When was the last time that you had significant problems with videogame playing or internet use that caused you to give up, reduce, or have problems with important activities or people of work, school, home or social events?
|
11. When was the last time that you had significant problems with gambling that caused you to give up, reduce, or have problems with important activities or people at work, school, home, or social events?
|
When do youth respond to these questions?
Young people are asked to complete this questionnaire at their first clinical visit, and subsequent clinical visits of 30 or more days. If young people’s subsequent clinical visit is between 8-29 days later, they complete the YWHO Substance Monitoring Form (YSMF) - a brief measure of the number of days in the past week that youth used alcohol and drugs, and frequency of negative consequences.
Neither of these questionnaires is completed if youth visit the hub for service seven or fewer days after their last clinical visit.
What if a youth don't understand a question?
If a young person requires assistance with an item due to developmental, cognitive, language, or other issues, try to provide these supports:
- Read all items aloud exactly as printed word for word, at an appropriate pace;
- If there is some misunderstanding, repeat the item;
- Determine which word is confusing and define the word, but try not to reword the question (it may alter the meaning of the question, as well as the response); and
- Do not suggest answers.
Scoring/Results:
How can I go over results with youth?
Scoring of the first five questions (substance use) is done automatically on the YWHO Data Collection platform, not by the service provider. (If the youth has not completed all questions, the platform will not automatically generate a score).
- If the youth answers “Never” or “12+ months ago” as one of their answers, then the score for that answer is 0
- If the youth answers “4 to 12 months ago” “2 to 3 months ago” or “Past month” the score for that answer is 1
- Scores are added up and, since there is a total of 5 questions for the substance use domain, they can range from a total low of 0 to a maximum of 5
- Low scores indicate low levels of current substance issues/abuse/dependence and high scores indicate more current levels of substance issues/abuse/dependence
- There is no progress tracker, although past single scores can be viewed for each youth to provide information over time.
The remaining six items are for clinical use only - no score is provided.
In general, scores from youth responses can be interpreted as follows, mapping onto low, medium, or high intensity services:
| Score: | Interpretation/recommended intensity of services (Low, Medium, High) |
|---|---|
| 0 |
|
| 1-2 |
|
| 3-5 |
|
It is at service providers’ discretion if they would like to complete the longer GAIN-SS, which is also available on the YWHO Data Collection platform.
Please remember that this screening instrument does not operate in isolation. Please take into account findings from other screening questionnaires, and use your clinical judgment and discussions with youth and their families to make the most appropriate decisions regarding assessment and interventions available at your specific YWHO site.
Video:
Kessler Psychological Distress Scale (K10)/ (K10W - Day 08-29)
YWHO Substance Monitoring Form (YSMF)
