What Are Psychiatric Rating Scales & How Do They Work?

Psychiatric Rating Scales are assessment instruments used to measure the signs and symptoms of DSM IV Disorders such as ADHD and Bipolar Disorder.

Rating Scales list the signs (e.g. hyperactive) and symptoms (e.g. suicidal thoughts) associated with DSM IV Disorders that can either be observed (by the family) and/or reported (by the person) and ask the rater (either the person or family) to rate the presence, frequency, and/or intensity of the signs and symptoms.

The signs and symptoms are rated on a scale where a number (higher or lower) is assigned to a sign or symptom depending on how often or intensely it is being observed by the family or experienced by the person.

For example, if a person is self-reporting on depression using a scale where, Not At All = 0, A Little = 1, Some = 2, and A Lot = 3, and they are feelingthis way A Lot, they would circle 3 on the scale. After completing every item on the scale, the number for each item is added up to obtain a total score. If the total score is above the cutoff score established for that scale, the person has screened positive for the disorder being measured by the rating scale based on their responses to that instrument.

The cutoff or positive score is determined through studies done using the scale on people with the disorder based on the diagnosis being made in a standardized way. This means that everyone with the disorder who is included in the study of the rating scale has been diagnosed in exactly the same way. This is accomplished by using a structured psychiatric interview that requires that the same diagnostic questions are asked of each subject in the same way so that the DSM IV criteria for the disorder being studied are met in arriving at the diagnosis.

This is the best way to assure that those with the disorder have the disorder (as defined by DSM IV) so that when the rating scale is being tested as a screen for the disorder it is being tested on people who really have the disorder (as best as can be objectively determined).

To learn more about how Psychiatric Rating Scales work, please click here to view our "Validity of Psychiatric Rating Scales" page, which will help you understand some of the terminology and methodology used in diagnosing disorders.