Child and Adolescent Psychiatric Assessment (CAPA)

Department of Psychiatry, Duke University Medical Center, Durham, NC, USA.
Psychological Medicine (Impact Factor: 5.94). 08/1995; 25(4):739-53. DOI: 10.1017/S003329170003498X
Source: PubMed


Great advances have been made during the last 20 years in the development of structured and semi-structured interviews for use with psychiatric patients. However, in the field of child and adolescent psychiatry there have been weaknesses in the specification and definition of both symptoms and the psychosocial impairments resulting from psychiatric disorder. Furthermore, most of the available interviews for use with children have been tied to a single diagnostic system (DSM-III, DSM-III-R, or ICD-9). This has meant that symptom coverage has been limited and nosological comparisons have been inhibited. The Child and Adolescent Psychiatric Assessment (CAPA) represents an attempt to remedy some of these shortcomings. This paper outlines the principles adopted in the CAPA to improve the standardization, reliability and meaningfulness of symptom and diagnostic ratings. The CAPA is an interviewer-based diagnostic interview with versions for use with children and their parents, focused on symptoms occurring during the preceding 3 month period, adapted for assessments in both clinical and epidemiological research.

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    • "to assess the severity of behavioral and emotional dysregulation in their offspring during the last 6 months (only parents of BO and NBO completed this questionnaire ); the Self-Report for Childhood Anxiety Related Emotional Disorders, parent version (SCARED-P), to assess offspring anxiety over last 2 weeks (Birmaher et al. 1997); the Children's Affective Lability Scale, parent version (CALS-P; Gerson et al. 1996); the Mood and Feelings Questionnaire, parent version (MFQ-P), to assess the severity of depression during the last 2 weeks (Angold et al. 1995); and a questionnaire to assess sociodemographic status represented by parental education (Hollingshead, 1975). Youth participants completed child report versions of affective symptomatology scales: the CALS-C, SCARED-C and MFQ-C. "
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    ABSTRACT: Background: Offspring of parents with bipolar disorder (BD) (BO) are at higher risk of BD than offspring of parents with non-BD psychopathology (NBO), although both groups are at higher risk than offspring of psychiatrically healthy parents (HC) for other affective and psychiatric disorders. Abnormal functioning in reward circuitry has been demonstrated previously in individuals with BD. We aimed to determine whether activation and functional connectivity in this circuitry during risky decision-making differentiated BO, NBO and HC. Method: BO (n = 29; mean age = 13.8 years; 14 female), NBO (n = 28; mean age = 13.9 years; 12 female) and HC (n = 23; mean age = 13.7 years; 11 female) were scanned while performing a number-guessing reward task. Of the participants, 11 BO and 12 NBO had current non-BD psychopathology; five BO and four NBO were taking psychotropic medications. Results: A 3 (group) × 2 (conditions: win-control/loss-control) analysis of variance revealed a main effect of group on right frontal pole activation: BO showed significantly greater activation than HC. There was a significant main effect of group on functional connectivity between the bilateral ventral striatum and the right ventrolateral prefrontal cortex (Z > 3.09, cluster-p < 0.05): BO showed significantly greater negative functional connectivity than other participants. These between-group differences remained after removing youth with psychiatric disorders and psychotropic medications from analyses. Conclusions: This is the first study to demonstrate that reward circuitry activation and functional connectivity distinguish BO from NBO and HC. The fact that the pattern of findings remained when comparing healthy BO v. healthy NBO v. HC suggests that these neuroimaging measures may represent trait-level neurobiological markers conferring either risk for, or protection against, BD in youth.
    Psychological Medicine 09/2015; DOI:10.1017/S003329171500166X · 5.94 Impact Factor
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    • "Each family was invited to participate in an unstructured screening interview based on the content of the Child and Adolescent Psychiatric Assessment (Angold et al., 1995). General information concerning medical history, developmental history, behavior with the family, and general symptoms was recorded. "
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    ABSTRACT: The Navon effect (Navon, 1977) is an automatic tendency to process the global picture prior to local details when processing compound patterns. However, several recent studies have reported that this effect is lacking in attention-deficit/hyperactivity disorder (ADHD). Although previous research has shown that the Navon effect is strongly affected by visual angles, whether this phenomenon will also be observed in ADHD is yet to be understood. We examine the lack of the Navon effect in ADHD under various visual angles to ensure that this phenomenon is not an artifact of saliency. By employing three different visual angles for the local stimuli, global and local processing of Navon-type hierarchical letters was examined in participants with ADHD (n = 15) and a comparison group (n = 17). ADHD participants presented with a lack of the Navon effect without local processing deficit regardless of visual angle, in comparison to non-ADHD participants. A lack of global precedence and global-to-local interference without local processing deficit can be generalized in ADHD. This suggests that people with ADHD experience difficulties in processing the "whole picture," and it also challenges the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; American Psychiatric Association, 2013) criteria of ADHD in which the failure to pay close attention to details was emphasized. Moreover, the current results have important implications for understanding ADHD and could also have significant clinical value. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
    Neuropsychology 07/2015; DOI:10.1037/neu0000213 · 3.27 Impact Factor
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    • "Forty right handed male participants (19 clinic patients with DSM-IV combined type ADHD, 21 controls) were recruited. Diagnosis of ADHD had been confirmed by a research diagnostic interview, the Child and Adolescent Psychiatric Assessment (CAPA, Angold et al., 1995). Individuals were required to be aged 14–18 years at the point of scanning, and have IQ test scores of N70 as ascertained by WISC-IV (Wechsler, 2003). "
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    ABSTRACT: This analysis examined hypothesised associations between microstructural attributes in specific white matter (WM) tracts selected a priori and measures of clinical variability in adolescents with a diagnosis of attention deficit hyperactivity disorder (ADHD). Firstly, associations were explored between WM microstructure and ADHD severity in the subgenual cingulum. Secondly, to ensure that tract-specific approaches afforded enhanced rather than differential sensitivity, associations were measured between WM microstructure and autistic traits in the right corticospinal tract based on results of a previously-published voxelwise analysis. 40 right-handed males aged 14-18 years (19 with DSM-IV combined type ADHD and 21 healthy controls) underwent a 60 direction diffusion MRI scan. Clinical ADHD and autism variation were assessed by validated questionnaires. Deterministic tractography based on spherical deconvolution methods was used to map the subgenual cingulum and corticospinal tract. Fractional anisotropy was positively correlated and radial diffusivity was negatively correlated with a) ADHD severity in the left subgenual cingulum and b) autistic traits in the inferior segment of the right corticospinal tract. No case-control differences were found. Results shed light on possible anatomical correlates of ADHD severity and autistic symptoms in pathways which may be involved in the ADHD phenotype. They provide further evidence that tract-specific approaches may a) reveal associations between microstructural metrics and indices of phenotypic variability which would not be detected using voxelwise approaches, and b) provide improved rather than differential sensitivity compared to voxelwise approaches.
    Clinical neuroimaging 02/2015; 1064. DOI:10.1016/j.nicl.2015.02.012 · 2.53 Impact Factor
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