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An Internet Version of the Diagnostic Interview Schedule for Children (DISC-IV): Correspondence of the ADHD Section With the Paper-and-Pencil Version
Psychological Assessment
Abstract
The authors recently developed an Internet version of the Diagnostic Interview Schedule for Children-Version 4 (DISC-IV), parent version (D. Shaffer, P. Fisher, C. P. Lucas, M. K. Dulcan, & M. E. Schwab-Stone, 2000), with the main purpose of using it at home without an interviewer. This offers many advantages (e.g., extended applicability, fast communication, reduction of costs) but requires thorough study of correspondence between diagnostic outcomes of the interview and self-administered Internet versions. This is the 1st study to report on Internet administration of the DISC-IV. Using the attention-deficit/hyperactivity disorder (ADHD) section, the authors investigated whether the 2 versions yielded the same diagnostic outcome. Parents (N = 120) of patients visiting a child and adolescent psychiatry outpatient clinic were randomly divided into 4 groups, each completing 1 test and about 2 weeks later another according to 1 of these patterns: Internet-interview, interview-Internet, interview-interview, and Internet-Internet. Correspondence between the Internet and interview versions at the level of symptom scores was excellent, and correspondence with respect to the presence/absence of ADHD was good. Although highly comparable diagnostic outcomes between self-administration through the Internet and interviewer administration were found, further study using other DISC-IV modules is required.
... Some research also shows that youth disclose more stigmatizing behaviors when they audio-record their interview responses [26] and that automatic administration removes interviewer error [15]. While these computerized and voice-recording systems have clear benefits, difficulties updating software have also been experienced [27] limiting their longevity and reach. ...
... Results showed similar prevalence rates and the authors concluded that the online version was "good enough" for service planning. To date, the only study that has directly compared face to face and internet administration of a diagnostic interview for youth specifically evaluated a module of the Diagnostic Interview Schedule for Children (DISC) for youth ADHD [27]. The results showed excellent agreement between the two forms of administration, providing good support for the validity of diagnosis over the internet. ...
... Indeed, most of the existing online assessments produce an automated/algorithm-based diagnostic decision or symptom score using the forced-choice responses provided by respondents. However, they typically also allow clinician review of additional free text responses to increase validity [27,29]. Not surprisingly, clinician judgement has typically been found to produce better agreement against traditional administration methods, yet algorithm results are promising (e.g., agreement between interviewer and online DISC agreement for ADHD diagnosis and symptoms was moderate to strong; κ = 0.71, ICC = 0.87) [27]. ...
This study developed an online diagnostic tool for anxiety disorders in youth, and evaluated its reliability and validity amongst 297 children aged 6–16 years (Mage = 9.34, 46% male). Parents completed the online tool, the Youth Online Diagnostic Assessment (YODA), which is scored either using a fully-automated algorithm, or combined with clinician review. In addition, parents and children completed a clinician-administered diagnostic interview and self-report measures of internalizing and externalizing symptoms and wellbeing. The fully-automated YODA demonstrated relatively weak agreement with the diagnostic interview for identifying the presence of any anxiety disorder and specific anxiety disorders, apart from separation anxiety (which had moderate agreement). The clinician-reviewed YODA showed better agreement than fully-automated scoring, particularly for identifying the presence of any anxiety disorder. The YODA demonstrated good agreement with parent-reported measures of symptoms/interference. The YODA offers a fully or largely automated method to determine the presence of anxiety disorders in youth, with particular value in situations where low-resource assessments are needed. While it currently requires further research and improvement, the YODA provides a promising start to the development of such a tool.
... Children with a total score of 15 or higher were excluded from this study. The attention/hyperactivity, ODD and Conduct Disorder modules of the Diagnostic Interview Schedule for Children IV (DISC-IV; Steenhuis et al., 2009) were administered by the research assistant(s) by telephone to confirm ADHD diagnose and to rule out for potential Conduct Disorder. Parents were also asked to send a copy of the diagnostic psychiatric report of their child to establish the subtype of ADHD and rule out other potential psychiatric problems that met exclusion criteria. ...
... The expert view, based on the diagnostic psychiatric report, was leading for establishing the subtype of ADHD. If the subtype was not described in the report, we used the Attention/Hyperactivity module of the DISC-IV (Steenhuis et al., 2009) to establish the subtype. A short version of the WISC-III-nl (Wechsler, 2005) with the subtests Similarities, Block Design, Vocabulary and Information was administered to estimate the Total Intelligence quotient if there were no prior recordings available. ...
The goal of this randomized controlled trial was to replicate and extend previous studies of Cogmed Working Memory Training (CWMT) in children with Attention-deficit/hyperactivity disorder (ADHD). While a large proportion of children with ADHD suffer from academic difficulties, only few previous efficacy studies have taken into account long term academic outcome measures. So far, results regarding academic outcome measures have been inconsistent. Hundred and two children with ADHD between the age of 8 and 12 years (both medicated and medication naïve) participated in current randomized controlled trial. Children were randomly assigned to CWMT or a new active combined working memory- and executive function compensatory training called ‘Paying Attention in Class.’ Primary outcome measures were neurocognitive functioning and academic performance. Secondary outcome measures contained ratings of behavior in class, behavior problems, and quality of life. Assessment took place before, directly after and 6 months after treatment. Results showed only one replicated treatment effect on visual spatial working memory in favor of CWMT. Effects of time were found for broad neurocognitive measures, supported by parent and teacher ratings. However, no treatment or time effects were found for the measures of academic performance, behavior in class or quality of life. We suggest that methodological and non-specific treatment factors should be taken into account when interpreting current findings. Future trials with well-blinded measures and a third ‘no treatment’ control group are needed before cognitive training can be supported as an evidence-based treatment of ADHD. Future research should put more effort into investigating why, how and for whom cognitive training is effective as this would also potentially lead to improved intervention- and study designs.
... 5 Most often, the aim of EEG neurofeedback is to increase β activity (or sensorimotor rhythm, 12-15 Hz over the motor cortex), while suppressing θ activity. 6 This goal is based on the observation that slow-wave activity (primarily θ [4][5][6][7]) is increased and fast-wave activity (β [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]) is decreased in most patients with ADHD (see the review by Barry et al 7 ). Different EEG neurofeedback treatment protocols are in use. ...
... The presence of comorbid disorders was assessed with the Diagnostic Interview Schedule for Children, Version IV (DISC-IV). 18,19 General functioning was measured using the Children's Global Assessment Scale (CGAS), 20 and the severity of ADHD was assessed with the Clinical Global Impressions-Severity of Illness scale. 21 If intelligence had not been assessed in the past 1.5 years, 2 subtests of the Wechsler Intelligence Scale for Children 3rd Edition (WISC-III) [22][23][24] were administered (ie, vocabulary and block design) to estimate intelligence. ...
A double-blind, randomized, placebo-controlled study was designed to assess the efficacy and safety of electroencephalographic (EEG) neurofeedback in children with attention-deficit/hyperactivity disorder (ADHD). The study started in August 2008 and ended in July 2012 and was conducted at Karakter Child and Adolescent Psychiatry University Centre in Nijmegen, The Netherlands.
Forty-one children (aged 8-15 years) with a DSM-IV-TR diagnosis of ADHD were randomly assigned to treatment with either EEG neurofeedback (n = 22) or placebo neurofeedback (n = 19) for 30 sessions, given as 2 sessions per week. The children were stratified by age, electrophysiologic state of arousal, and medication use. Everyone involved in the study, except the neurofeedback therapist and the principal investigator, was blinded to treatment assignment. The primary outcome was severity of ADHD symptoms on the ADHD Rating Scale IV, scored at baseline, during treatment, and at study end. Clinical improvement as measured by the Clinical Global Impressions-Improvement scale (CGI-I) was a secondary outcome.
While total ADHD symptoms improved over time in both groups (F1,39 = 26.56, P < .001), there was no significant treatment effect, ie, group × time interaction (F1,39 = 0.36, P = .554); the same was true for clinical improvement as measured by the CGI-I (P = .092). No clinically relevant side effects were observed. Among the children and their parents, guessing treatment assignment was not better than chance level (P = .224 for children, P = .643 for parents).
EEG neurofeedback was not superior to placebo neurofeedback in improving ADHD symptoms in children with ADHD.
ClinicalTrials.gov identifier: NCT00723684.
... Non-genetic clinical and survey research has demonstrated that recruiting research study participants via the internet is effective Arab et al., 2010;Miller and Sonderland, 2010;Smith et al., 2007), especially for specialized populations (Miller and Sonderlund, 2010;Mangan and Reips, 2007;Skitka and Sargis, 2006), although it carries the attendant risk of unrepresentative samples (Klovning et al., 2009;Miller and Sonderlund, 2010;Skitka and Sargis, 2006). Web-based questionnaires have been shown to be reliable (Rankin et al., 2008;Young et al., 2009;Lieberman, 2008), and valid for various psychiatric diagnoses such as depression, ASD, and ADHD using DSM criteria (Cawthorpe, 2001;Cuijpers et al., 2008;Lin et al., 2007;Steenhuis et al., 2009). Scores from interviews and surveys adapted for Internet have been found equivalent to standard method scores (Coles et al., 2007), while some studies report more severity and pathology in Internet-assessed samples (Cuijpers et al., 2008;Sanders et al., 2010;Whitehead, 2007). ...
... The validity of Internet-facilitated questionnaires for psychiatric diagnosis has been reported for other disorders (Cawthorpe, 2001;Cuijpers et al., 2008;Lin et al., 2007;Steenhuis et al., 2009). Our finding contributes to the limited published research on the psychometric properties of web-based questionnaires designed specifically for rapid phenotyping. ...
Genome-wide association studies (GWAS) and other emerging technologies offer great promise for the identification of genetic risk factors for complex psychiatric disorders, yet such studies are constrained by the need for large sample sizes. Web-based collection offers a relatively untapped resource for increasing participant recruitment. Therefore, we developed and implemented a novel web-based screening and phenotyping protocol for genetic studies of Tourette syndrome (TS), a childhood-onset neuropsychiatric disorder characterized by motor and vocal tics. Participants were recruited over a 13-month period through the membership of the Tourette Syndrome Association (TSA; n = 28,878). Of the TSA members contacted, 4.3% (1,242) initiated the questionnaire, and 79.5% (987) of these were enrollment eligible. 63.9% (631) of enrolled participants completed the study by submitting phenotypic data and blood specimens. Age was the only variable that predicted study completion; children and young adults were significantly less likely to be study completers than adults 26 and older. Compared to a clinic-based study conducted over the same time period, the web-based method yielded a 60% larger sample. Web-based participants were older and more often female; otherwise, the sample characteristics did not differ significantly. TS diagnoses based on the web-screen demonstrated 100% accuracy compared to those derived from in-depth clinical interviews. Our results suggest that a web-based approach is effective for increasing the sample size for genetic studies of a relatively rare disorder and that our web-based screen is valid for diagnosing TS. Findings from this study should aid in the development of web-based protocols for other disorders. © 2012 Wiley Periodicals, Inc.
... To reduce costs further, developers have begun to eliminate the need for interviewers by preprogramming questions, probes, skip patterns and scoring algorithms into computer or web-based software (e.g. DISC: Steenhuis, Serra, Minderaa, & Hartman, 2009;and K-SADS-PL: Townsend et al., 2020). However, licensing fees and inflexibility continue to represent challenges to users. ...
Background
The standard approach for classifying child/youth psychiatric disorder as present or absent in epidemiological studies is lay‐administered structured, standardized diagnostic interviews (interviews) based on categorical taxonomies such as the DSM and ICD. Converting problem checklist scale scores (checklists) to binary classifications provides a simple, inexpensive alternative.
Methods
Using assessments obtained from 737 parents, we determine if child/youth behavioral, attentional, and emotional disorder classifications based on checklists are equivalent psychometrically to interview classifications. We test this hypothesis by (1) comparing their test–retest reliabilities based on kappa (κ), (2) estimating their observed agreement at times 1 and 2, and (3) in structural equation models, comparing their strength of association with clinical status and reported use of prescription medication to treat disorder. A confidence interval approach is used to determine if parameter differences lie within the smallest effect size of interest set at ±0.125.
Results
The test–retest reliabilities (κ) for interviews compared with checklists met criteria for statistical equivalence: behavioral, .67 and .70; attentional, .64 and .66; and emotional, .61 and .65. Observed agreement between the checklist and interviews on classifications of disorder at times 1 and 2 was, on average, κ = .61. On average, the β coefficients estimating associations with clinical status were .59 (interviews) and .63 (checklists); and with prescription medication use, .69 (interviews) and .71 (checklists). Behavioral and attentional disorders met criteria for statistical equivalence. Emotional disorder did not, although the coefficients were stronger numerically for the checklist.
Conclusions
Classifications of child/youth psychiatric disorder from parent‐reported checklists and interviews are equivalent psychometrically. The practical advantages of checklists over interviews for classifying disorder (lower administration cost and respondent burden) are enhanced by their ability to measure disorder dimensionally. Checklists provide an option to interviews in epidemiological studies of common child/youth psychiatric disorders.
... Also, the studies selected focused on measuring the prevalence of the following psychiatric disorders: ADHD, conduct disorder (CD), oppositional defiant disorder (ODD), depression, and anxiety disorders (AD) in children with SLD. Measures used to diagnose the presence of these psychiatric disorders are (1) Developmental Psychopathology Checklist for Children (DPCL) [13], (2) the Diagnostic and Statistical Manual-IV Based Disruptive Behavior Disorders Screening and Rating Scale [14], (3) Children's Depression Inventory (CDI) [15], (4) Conners' Teacher Rating Scale [16], (5) Diagnostic Interview Schedule for Children, Version IV (DISC) [17], and (6) Mini International Neuropsychiatric Interview Kid (MINI Kid) [18]. Children who participated in each of the studies selected did not receive any medical treatment for the psychiatric disorder they had. ...
Background
Understanding comorbidity of psychiatric disorders with specific learning disorders (SLD) is important because the presence of any additional disorder to the learning disability may affect the severity and prognosis of the SLD symptoms and requires specific treatments and interventions.
Main body of the abstract
The purpose of this systematic review was to describe the prevalence of comorbid psychiatric disorders among children with SLD between 6 and 18 years. English studies published between 2013 and 2018 were located through searches of PubMed and ScienceDirect. In this review, only 5 articles met the inclusion criteria. The quality of the included studies was assessed with the Cochrane risk of the bias assessment tool. The prevalence of ADHD and anxiety disorder was reported in 4 studies. Prevalence of conduct disorder (CD) and depression was reported by 3 studies, and 2 studies reported the prevalence of oppositional defined disorders (ODD). Although this review included a small number of studies that used a diversity of methods to diagnose psychiatric disorders, the results of the prevalence rates were homogenous.
Short conclusion
The included studies reported that ADHD had the highest prevalence rate among children with SLD followed by anxiety and depressive disorders. Both CD and ODD were the least prevalent and are linked to the existence of ADHD. Further worldwide future studies are needed to estimate the prevalence rate of such psychiatric disorders among children with SLD, taking into consideration the use of agreed assessment methods for diagnosing the psychiatric disorders and the SLD.
... At the present time, in treatment settings, such as busy emergency departments, the diagnostic information attained with the self-report KSADS-COMP can best be used to expedite evaluations and help clinicians finalize diagnostic impressions. Whereas there are validated internet-based mental health screens for adolescents, 63 unvalidated diagnostic internet-based assessment tools available for purchase, 64 preliminary work that has been conducted on the development and validation of the internet and voice Diagnostic Interview Schedule for Children for DSM-IV, 65,66 and more extensive work completed on the Development and Well-Being Assessment (DAWBA) instruments, [67][68][69] there are many features that are unique to the three KSADS-COMP instruments that enhance their utility. To the best of our knowledge, the three versions of the KSADS-COMP are the only computer-administered child and adolescent psychiatric diagnostic interviews that use information attained in the introductory interview to guide probing of symptoms (eg, information about bullying to guide questions generated when probing about paranoid ideation), and the only assessment tools to include a screen interview that provides a comprehensive diagnostic overview to facilitate differential diagnoses before surveying the full range of symptoms associated with the different diagnoses. ...
Objective: To present initial validity data on three web-based computerized versions of the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS-COMP). Method: The sample for evaluating the validity of the clinician-administered KSADS-COMP included 511 youths 6-18 years of age who were participants in the Child Mind Institute Healthy Brain Network. The sample for evaluating the parent and youth self-administered versions of the KSADS-COMP included 158 youths 11-17 years of age recruited from three academic institutions. Results: Average administration time for completing the combined parent and youth clinician-administered KSADS-COMP was less time than previously reported for completing the paper-and-pencil K-SADS with only one informant (91.9 AE 50.1 minutes). Average administration times for the youth and parent self-administered KSADS-COMP were 50.9 AE 28.0 minutes and 63.2 AE 38.3 minutes, respectively, and youths and parents rated their experience using the web-based self-administered KSADS-COMP versions very positively. Diagnoses generated with all three KSADS-COMP versions demonstrated good convergent validity against established clinical rating scales and dimensional diagnostic-specific ratings derived from the KSADS-COMP. When parent and youth self-administered KSADS-COMP data were integrated, good to excellent concordance was also achieved between diagnoses derived using the self-administered and clinician-administered KSADS-COMP versions (area under the curve ¼ 0.89-1.00). Conclusion: The three versions of the KSADS-COMP demonstrate promising psychometric properties, while offering efficiency in administration and scoring. The clinician-administered KSADS-COMP shows utility not only for research, but also for implementation in clinical practice, with self-report preinterview ratings that streamline administration. The self-administered KSADS-COMP versions have numerous potential research and clinical applications, including in large-scale epidemiological studies, in schools, in emergency departments, and in telehealth to address the critical shortage of child and adolescent mental health specialists. Clinical trial registration information: Computerized Screening for Comorbidity in Adolescents With Substance or Psychiatric Disorders; https:// clinicaltrials.gov/; NCT01866956.
... Also, the studies selected focused on measuring the prevalence of the following psychiatric disorders: ADHD, conduct disorder (CD), oppositional defiant disorder (ODD), depression, and anxiety disorders (AD) in children with SLD. Measures used to diagnose the presence of these psychiatric disorders are (1) Developmental Psychopathology Checklist for Children (DPCL) [13], (2) the Diagnostic and Statistical Manual-IV Based Disruptive Behavior Disorders Screening and Rating Scale [14], (3) Children's Depression Inventory (CDI) [15], (4) Conners' Teacher Rating Scale [16], (5) Diagnostic Interview Schedule for Children, Version IV (DISC) [17], and (6) Mini International Neuropsychiatric Interview Kid (MINI Kid) [18]. Children who participated in each of the studies selected did not receive any medical treatment for the psychiatric disorder they had. ...
Background
Children diagnosed with learning disability (LD) have a high incidence of psychiatric comorbidities especially Attention-Deficit/Hyperactivity Disorder (ADHD). These comorbidities are either a direct consequence of the same deficits in the central processing patterns that generate the learning problems, or they tend to stress the role of frustration and failure in academic achievement. These difficulties are claimed to move a vicious circle that leads the child towards ever-greater cognitive and social–emotional impoverishment.
Aim
The aim of this work is to conduct a systematic review of ADHD as a comorbid condition in learning disabled children to determine its incidence in learning disabled children in order to estimate the size of the problem to be able to delineate an efficient program in therapeutic intervention later.
Study design
This was a systematic review.
Methods
Two electronic databases (PubMed and Science Direct) were searched for articles. Relevant studies were further evaluated and studies that met inclusion criteria were reviewed.
Results
The literature search yielded 593 studies. Twenty-eight articles were further evaluated to be included. Five studies met all inclusion criteria and were chosen for review. The studies provide prevalence of ADHD in learning disabled children. We have found higher scores of ADHD in learning disabled children than in the normal population, in all the included studies. The studies reviewed demonstrated the effect of this comorbidity and the importance of its diagnosis for improvement of prognosis of the learning disability.
Conclusion
The current systematic review determines the probable prevalence of the ADHD in learning disabled children.
... In the TRAILS clinical cohort, information on the presence or absence of ADHD was assessed with the Diagnostic Interview Schedule for Children (DISC-IV parent version) [26]. ...
Environmental noise may play a role in the manifestation and severity of attention deficit/hyperactivity disorder (ADHD) symptoms, but evidence is limited. We investigated the cross-sectional associations between residential and school road traffic noise exposure and ADHD symptoms and diagnosis. The sample included n = 1710, 10–12-year-old children from the TRAILS study in The Netherlands. ADHD symptoms were measured using a DSM-IV based subscale from the Child Behavior Checklist. Children with diagnosed ADHD originated from the clinic-referred cohort. Road traffic noise (Lden) was estimated at the residence and school level, by model calculation. Risk ratios for ADHD symptoms and ADHD diagnoses, and regression coefficients for symptom severity were estimated separately and simultaneously for residential and school road traffic noise. Adjusted multinomial models with residential road traffic noise showed that residential noise was not associated with ADHD symptoms, but was associated with lower risks for ADHD diagnosis (RR = 0.93; 95% CI 0.89, 0.97). Similar associations were observed for models including school road traffic noise and models including both exposures. No clear exposure response relationship was observed for associations between residential or school noise and ADHD symptom severity. We found no evidence for a harmful association between road traffic noise and ADHD. Associations between noise and lower risks for ADHD were observed only in referred cases with a confirmed ADHD diagnosis and may be due to residual confounding or selection bias. Future studies should focus on residential and school noise exposure, and study associations with ADHD symptoms and diagnosis over time.
... Another salient issue is that the use of online assessments is increasing in popularity [33,34]. Few differences have been found between online and paper formats for measures of depression, panic, traumatic stress, and other clinical constructs [35][36][37]. ...
One major obstacle to the accurate diagnosis of ADHD in college students is malingering, although many symptom self-report measures used in the diagnostic process do not contain validity scales to identify feigners. The Infrequency Index (CII) for the Conners’ Adult ADHD Rating Scale–Self-Report: Long Version (CAARS-S: L) was developed in response to this concern, although further validation of this index is needed. Another topic of interest in ADHD malingering research is the increasing use of online assessments. However, little is known about how ADHD is malingered in an online format, particularly on the CAARS-S: L. The current study utilized a coached simulation design to examine the feigning detection accuracy of the CII and provide initial results on the effect of administration format (paper vs. online) on CAARS-S: L profiles. Data from 139 students were analyzed. Students with ADHD and students instructed to feign the disorder produced statistically comparable elevations on seven of eight CAARS-S: L clinical scales. Clinical scale elevations were generally comparable between paper and online forms, although some differences in the clinical and simulated ADHD groups suggest the need for further research. The CII demonstrated modest sensitivity (0.36) and adequate specificity (0.85) at the recommended cut score across administration formats. Specificity reached desirable levels (>= .90) at a raised cut score. These values were similar across administration formats. Results support the use of the CII and online CAARS-S: L form
... In the present study, we sampled the children with ADHD from the TRAILS clinic-referred cohort. These participants had a preadolescent lifetime diagnosis of ADHD according to the internet version of the Diagnostic Interview Schedule for Children [16,17]) administered face to face by trained interviewers at measurement wave T1. In addition, we made sure that they still had current ADHD symptoms at age 11 as indicated by a score above the 80th percentile derived from the population cohort based on the parent or teacher report (see instruments section below). ...
Background:
Compared to typically developing individuals, individuals with attention-deficit-hyperactivity disorder (ADHD) are on average more often exposed to stressful conditions (e.g., school failure, family conflicts, financial problems). We hypothesized that high exposure to stress relates to a more persistent and complex (i.e., multi-problem) form of ADHD, while low-stress exposure relates to remitting ADHD over the course of adolescence.
Method:
Longitudinal data (ages 11, 13, 16, and 19) came from the Tracking Adolescents' Individual Life Survey (TRAILS). We selected children diagnosed with ADHD (n = 244; 167 males; 77 females) from the TRAILS clinical cohort and children who screened positive (n = 365; 250 males; 115 females) and negative (gender-matched: n = 1222; 831 males; 391 females) for ADHD from the TRAILS general population sample cohort (total n = 1587). Multivariate latent class growth analysis was applied to parent- and self-ratings of stress exposure, core ADHD problems (attention problems, hyperactivity/impulsivity), effortful control, emotion dysregulation (irritability, extreme reactivity, frustration), and internalizing problems (depression, anxiety, somatic complaints).
Results:
Seven distinct developmental courses in stress exposure and psychopathology were discerned, of which four related to ADHD. Two persistent ADHD courses of severely affected adolescents were associated with very high curvilinear stress exposure peaking in mid-adolescence: (1) Severe combined type with ongoing, severe emotional dysregulation, and (2) combined type with a high and increasing internalization of problems and elevated irritability; two partly remitting ADHD courses had low and declining stress exposure: (3) inattentive type, and (4) moderate combined type, both mostly without comorbid problems.
Conclusions:
High-stress exposure between childhood and young adulthood is strongly intertwined with a persistent course of ADHD and with comorbid problems taking the form of either severe and persistent emotion dysregulation (irritability, extreme reactivity, frustration) or elevated and increasing irritability, anxiety, and depression. Conversely, low and declining stress exposure is associated with remitting ADHD and decreasing internalizing and externalizing problems. Stress exposure is likely to be a facilitating and sustaining factor in these two persistent trajectories of ADHD with comorbid problems into young adulthood. Our findings suggest that a bidirectional, continuing, cycle of stressors leads to enhanced symptoms, in turn leading to more stressors, and so forth. Consideration of stressful conditions should, therefore, be an inherent part of the diagnosis and treatment of ADHD, to potentiate prevention and interruption of adverse trajectories.
... Online diagnostic administration also offers greater flexibility for parents, who can complete the assessment independently at a time that best fits into busy family lives. To date, online administration of the DISC-IV and the DAWBA show promise for reliably diagnosing psychiatric disorders in school-aged children (Krebs, Liang, Hilton, Macdiarmid, & Heyman, 2012;Steenhuis, Serra, Minderaa, & Hartman, 2009). Recently, the Youth Online Diagnostic Assessment (YODA) was also developed specifically for school-age children's anxiety disorders (ages: 7-17) (McLellan et al., 2016). ...
Background
The Online Assessment of Preschool Anxiety (OAPA) is a newly developed measure that assesses anxiety disorders in preschool children aged 3–6 years. This study aimed to explore the OAPA's initial psychometric properties with a particular focus on examining its construct validity, both convergent and discriminant.
Method
The OAPA was completed online by a community sample of 319 Australian parents of temperamentally inhibited preschool children (M: 5.3 years). Preliminary diagnoses were automatically generated before assessment reports were reviewed by a psychologist. Construct validity was examined by assessing the degree of agreement between the OAPA and existing valid questionnaire measures that were simultaneously administered online.
Results
Nearly half of participants met criteria for a child anxiety disorder according to the OAPA, most commonly social phobia. Findings supported convergent validity with the Revised Preschool Anxiety Scale (an anxiety symptom measure), the Children's Anxiety Life Interference Scale – Preschool Version (a measure of life interference from anxiety), the Emotional Symptoms scale of the Strengths and Difficulties Questionnaire‐Parent Version (a measure of broader internalizing symptoms), as well as an over‐involved/protective parenting scale. Findings also supported initial discriminant validity with the Conduct Problems scale of the Strengths and Difficulties Questionnaire‐Parent Version.
Conclusions
Results of this study provide evidence for the OAPA's preliminary construct validity. With further research into the OAPA's reliability (test–retest and interrater) and confirming construct validity, the OAPA may be a useful instrument for use in research settings and clinical practice.
... In the TDI group, the absence of a clinical psychiatric diagnosis was assessed based on parent report. For all three groups, legal guardians were asked to fill out a digital version [39] of the National Institute of Mental Health Diagnostic Interview Schedule for Children (DISC-IV; [40]). Legal guardians were asked to fill out the following sections: Attention-Deficit/Hyperactivity Disorder, ODD, CD, Tic Disorder, Alcohol, Marihuana, and Other Drugs, to control for possible psychiatric comorbidities. ...
Oppositional defiant disorder, conduct disorder (ODD/CD), and autism spectrum disorder (ASD) share poor empathic functioning and have been associated with impaired emotional processing. However, no previous studies directly compared similarities and differences in these processes for the two disorders. A two-choice emotional valence detection task requiring differentiation between positive, negative, and neutral IAPS pictures was administered to 52 adolescents (12–19 years) with ODD/CD, 52 with ASD and 24 typically developing individuals (TDI). Callous–unemotional (CU) traits were assessed by self- and parent reports using the Inventory of callous–unemotional traits. Main findings were that adolescents with ODD/CD or ASD both performed poorer than TDI in terms of accuracy, yet only the TDI—not both clinical groups—had relatively most difficulty in discriminating between positive versus neutral pictures compared to neutral–negative or positive–negative contrasts. Poorer performance was related to a higher level of CU traits. The results of the current study suggest youth with ODD/CD or ASD have a diminished ability to detect emotional valence which is not limited to facial expressions and is related to a higher level of CU traits. More specifically, youth with ODD/CD or ASD seem to have a reduced processing of positive stimuli and/or lack a ‘positive perception bias’ present in TDI that could either contribute to the symptoms and/or be a result of having the disorder and may contribute to the comorbidity of both disorders.
... Many paper and pencil questionnaires are beginning to be turned into online assessment tools. For example, Steenhuis, Serra, Minderaa, and Hartman (2009), transformed the ADHD portion of the Diagnostic Interview Schedule for Children-Version 4 (DISC-IV) into a technologically friendly form that could be completed online. They had parents complete the form in paper and pencil and online, finding similar results across modalities and suggesting that the online tool may be a valid way to administer the measure; however, the authors did suggest that additional research is necessary before significant conclusions can be drawn. ...
Technology has become increasingly important in the assessment and treatment of high-incidence disorders such as learning disabilities (LDs) and attention-deficit hyperactivity disorder. The use of computer and other assistive technologies (e.g., screen readers, voice recognition, biofeedback, virtual environments, etc.) has developed much faster than the research that demonstrates the efficacy of these various methods. We discuss some of these technologies as they are applied to assessment, classroom instruction, cognitive and executive functioning, and test accommodations. We also review the research findings on specific technologies, and note the advantages, limitations, and efficacy of the various technologies. We conclude with a plea for more research in this rapidly expanding area.
... Based on these reports, subtype of ADHD could be established for 76 children. For the remaining 22 children, the subtype was not described in the report and information was obtained from the Attention/ Hyperactivity module of the Diagnostic Interview Schedule for Children-Version IV (DISC-IV; Steenhuis, Serra, Minderaa, & Hartman, 2009) that was administered by the research assistant by telephone. There was a small group of children (n = 4) who were diagnosed with the subtype "Not Otherwise Specified." ...
Objective: To explore whether clinical variables and initial cognitive abilities predict or moderate (far) transfer treatment outcomes of cognitive training. Method: A total of 98 children (aged 8-12 years) with ADHD were randomly assigned to Cogmed Working Memory Training or a new cognitive training called “Paying Attention in Class.” Outcome measures included neurocognitive assessment, parent and teacher rated questionnaires of executive functioning behavior and academic performance. Predictor/moderator variables included use of medication, comorbidity, subtype of ADHD, and initial verbal and visual working memory skills. Results: Parent and teacher ratings of executive functioning behavior were predicted and moderated by subtype of ADHD. Word reading accuracy was predicted by subtype of ADHD and comorbidity. Use of medication and initial verbal and visual spatial working memory skills only predicted and moderated near transfer measures. Conclusion: Cognitive training can be beneficial for certain subgroups of children with ADHD; individual differences should be taken into account in future trials.
... anxiety and mood disorders) and externalizing disorders (i.e. disruptive disorders) at wave 1 and 2 and was scored using the internet software (Steenhuis et al. 2009) of the Dutch translation of the DISC-IV-P (Ferdinand and Van der Ende 1998). The anxiety disorder module consists of nine disorders; social phobia (SoPh), separation anxiety disorder (SAD), specific phobia (SP), panic disorder (PD), agoraphobia (AG), generalized anxiety disorder (GAD), selective mutism (SM), obsessive compulsive disorder (OCD) and posttraumatic stress disorder (PTSD). ...
The current study was a 7-year follow-up of 74 6-12 year old children with Pervasive Developmental Disorder-Not Otherwise Specified. We examined the rates and 7 year stability of comorbid psychiatric diagnoses as ascertained with the Diagnostic Interview Schedule for Children: Parent version at ages 6-12 and again at ages 12-20. Also, we examined childhood factors that predicted the stability of comorbid psychiatric disorders. The rate of comorbid psychiatric disorders dropped significantly from childhood (81 %) to adolescence (61 %). Higher levels of parent reported stereotyped behaviors and reduced social interest in childhood significantly predicted the stability of psychiatric comorbidity. Re-evaluation of psychiatric comorbidity should be considered in clinical practice, since several individuals shifted in comorbid diagnoses.
... This assessment also included the ADHD Rating Scale IV (ADHD-RS) (Zhang, Faries, Vowles, & Michelson, 2005). Autism spectrum disorders were screened with the Social Communication Questionnaire (Berument, Rutter, Lord, Pickles, & Bailey, 1999) and presence of other psychiatric disorders was screened with the Diagnostic Schedule for Children (Shaffer, Fisher, Lucas, Dulcan, & Schwab-Stone, 2000;Steenhuis, Serra, Minderaa, & Hartman, 2009). All were subsequently examined in a clinical assessment. ...
Until now, working memory training has not reached sufficient evidence as effective treatment for ADHD core symptoms in children with ADHD; for young children with ADHD, no studies are available. To this end, a triple-blind, randomized, placebo-controlled study was designed to assess the efficacy of Cogmed Working Memory Training (CWMT) in young children with ADHD.
Fifty-one children (5-7 years) with a DSM-IV-TR diagnosis of ADHD (without current psychotropic medication) were randomly assigned to the active (adaptive) or placebo (nonadaptive) training condition for 25 sessions during 5 weeks. The compliance criterion (>20 sessions) was met for 47 children. The primary outcome measure concerned the core behavioural symptoms of ADHD, measured with the ADHD Rating Scale IV (ADHD-RS). Secondary outcome measures were neurocognitive functioning, daily executive functioning, and global clinical functioning. The influence of the increase in difficulty level (Index-Improvement) for the treatment group was also analysed. Clinical trial registration information - 'Working Memory Training in Young ADHD Children'; www.clinicaltrials.gov; NCT00819611.
A significant improvement in favour of the active condition was found on a verbal working memory task (p = .041; adapted Digit Span WISC-III, backward condition). However, it did not survive correction for multiple testing. No significant treatment effect on any of the primary or other secondary outcome measurements was found. The Index-Improvement significantly contributed to ADHD-RS and the Behavior Rating Inventory of Executive Function, both rated by the teacher, but revealed no significant group difference.
This study failed to find robust evidence for benefits of CMWT over the placebo training on behavioural symptoms, neurocognitive, daily executive, and global clinical functioning in young children with ADHD.
... Data from women were collected using paper-and-pencil questionnaires, whereas data from men were collected 2 months later using the web-based site, Survey Monkey (surveymonkey.com). A literature search found no evidence that paper-and-pencil surveys yield different reliabilities or response sets than Internet-based surveys (Mangunkusumo et al., 2005;Steenhuis, Serra, Minderaa, & Hartman, 2009). ...
This study examined similarities and differences in women’s and men’s comparison tendencies and perfection beliefs when evaluating their face, body shape, and physical abilities, as well as how these tendencies and beliefs relate to their body esteem. College students (90 women and 88 men) completed the Body Esteem Scale and answered questions concerning their social comparison and temporal comparison tendencies related to face, body shape, and physical abilities evaluations as well as personal perfection body beliefs. As predicted, women were more likely than men to compare their face and bodies to other same-sex persons whom they perceived as having either similar or better physical qualities than themselves in those body domains, with their most likely comparison tendency being upward social comparison. More men than women held body perfection beliefs for all three body domains, and men were most likely to rely on future temporal comparison when evaluating their body shape. Comparison tendencies and perfection beliefs also were differentially related to women’s and men’s body esteem: Whereas women relied on self-critical social comparison strategies associated with negative body esteem, men’s comparison strategies and perfection beliefs were more self-hopeful. Implications for practitioners treating body image issues are discussed.
... The Dutch version of the Social Communication Questionnaire (SCQ; Berument, Rutter, Lord, Pickles, & Bailey, 1999) was used to screen for autism spectrum disorders. The presence of other comorbid disorders was assessed with the Diagnostic Interview Schedule for Children (DISC-IV; Shaffer, Fisher, Lucas, Dulcan, & Schwab-Stone, 2000;Steenhuis, Serra, Minderaa, & Hartman, 2009). A positive screening-outcome was followed by diagnostic procedure, including the ADHD and a developmental and psychiatric interview with a child and adolescent psychiatrist. ...
The number of placebo-controlled randomized studies relating to EEG-neurofeedback and its effect on neurocognition in attention-deficient/hyperactivity disorder (ADHD) is limited. For this reason, a double blind, randomized, placebo-controlled study was designed to assess the effects of EEG-neurofeedback on neurocognitive functioning in children with ADHD, and a systematic review on this topic was performed.
Forty-one children (8-15 years) with a DSM-IV-TR diagnosis of ADHD were randomly allocated to EEG-neurofeedback or placebo-neurofeedback treatment for 30 sessions, twice a week. Children were stratified by age, electrophysiological state of arousal, and medication use. Neurocognitive tests of attention, executive functioning, working memory, and time processing were administered before and after treatment. Researchers, teachers, children and their parents, with the exception of the neurofeedback-therapist, were all blind to treatment assignment. Outcome measures were the changes in neurocognitive performance before and after treatment. Clinical trial registration: www.clinicaltrials.gov: NCT00723684.
No significant treatment effect on any of the neurocognitive variables was found. A systematic review of the current literature also did not find any systematic beneficial effect of EEG-neurofeedback on neurocognitive functioning.
Overall, the existing literature and this study fail to support any benefit of neurofeedback on neurocognitive functioning in ADHD, possibly due to small sample sizes and other study limitations.
... At T3, a subsample of 291 adolescents was invited to perform a series of laboratory tasks (below referred to as the experimental session) in addition to the standard assessments applied in that wave. This subsample had a preadolescent lifetime diagnosis in the internalizing and/or externalizing spectrum according to the internet version of the Diagnostic Interview Schedule for Children (DISC; Costello, Edelbrock, Kalas, Kessler, & Klaric, 1982; Steenhuis, Serra, Minderaa, & Hartman, 2009 ) administered face to face by trained interviewers at T1. A total of 211 (72%) adolescents of the 291 invited agreed to participate in this experimental session. ...
... We found only two studies in which measurement of ADHD via Web-based versions was examined. Steenhuis et al [20] applied a within-subject design to administer the ADHD section of the Diagnostic Interview Schedule for Children (DISC-IV) to parents. Intraclass correlation coefficients ranged between .87 and .94. ...
Satisfactory psychometric properties in offline questionnaires do not guarantee the same outcome in Web-based versions. Any construct that is measured online should be compared to a paper-based assessment so that the appropriateness of online questionnaire data can be tested. Little research has been done in this area regarding Attention-Deficit/Hyperactivity Disorder (ADHD) in adults.
The objective was to simultaneously collect paper-based and Web-based ADHD questionnaire data in adults not diagnosed with ADHD in order to compare the two data sources regarding their equivalence in raw scores, in measures of reliability, and in factorial structures.
Data from the German versions of the Connors Adult ADHD Rating Scales (CAARS-S), the Wender Utah Rating Scale (WURS-k), and the ADHD Self Rating Scale (ADHS-SB) were collected via online and paper questionnaires in a cross-sectional study with convenience sampling. We performed confirmatory factor analyses to examine the postulated factor structures in both groups separately and multiple group confirmatory factor analyses to test whether the postulated factor structures of the questionnaires were equivalent across groups. With Cronbach alpha, we investigated the internal consistency of the postulated factors in the different questionnaires. Mann-Whitney U tests with the effect size "Probability of Superiority (PS)" were used to compare absolute values in the questionnaires between the two groups.
In the paper-based sample, there were 311 subjects (73.3% female); in the online sample, we reached 255 subjects (69% female). The paper-based sample had a mean age of 39.2 years (SD 18.6); the Web-based sample had a mean age of 30.4 years (SD 10.5) and had a higher educational background. The original four factor structure of the CAARS-S could be replicated in both samples, but factor loadings were different. The Web-based sample had significantly higher total scores on three scales. The five-factor structure of the German short form of the WURS-k could be replicated only in the Web-based sample. The Web-based sample had substantially higher total scores, and nearly 40% of the Web-based sample scored above the clinically relevant cut-off value. The three-factor structure of the ADHS-SB could be replicated in both samples, but factor loadings were different. Women in the Web-based sample had substantially higher total scores, and 30% of the Web-based sample scored above the clinically relevant cut-off value. Internal consistencies in all questionnaires were acceptable to high in both groups.
Data from the Web-based administration of ADHD questionnaires for adults should not be used for the extraction of population norms. Separate norms should be established for ADHD online questionnaires. General psychometric properties of ADHD questionnaires (factor structure, internal consistency) were largely unaffected by sampling bias. Extended validity studies of existing ADHD questionnaires should be performed by including subjects with a diagnosis of ADHD and by randomizing them to Web- or paper-based administration.
... Both teacher and parents will rate behaviour problems using 'The Child Behavior Checklist for Ages 6-18 [25] and 'Teacher's Report Form for Ages 6-18' [26]. Before training is started, the Diagnostic Interview Schedule for Children [27] and Social Communication Questionnaire [28] is administered to parents to rule out other behavioural problems or psychiatric problems that meet exclusion criteria. Finally, quality of life is measured by using the Kidscreen-27 [29] questionnaire and is completed by parents and the child. ...
Background
Deficits in executive functioning are of great significance in attention-deficit/hyperactivity disorder (ADHD). One of these executive functions, working memory, plays an important role in academic performance and is often seen as the core deficit of this disorder. There are indications that working memory problems and academic performance can be improved by school-oriented interventions but this has not yet been studied systematically. In this study we will determine the short- and long-term effects of a working memory - and an executive function training applied in a school situation for children with AD(H)D, taking individual characteristics, the level of impairment and costs (stepped-care approach) into account.
Methods/design
The study consists of two parts: the first part is a randomised controlled trial with school-aged children (8–12 yrs) with AD(H)D. Two groups (each n = 50) will be randomly assigned to a well studied computerized working memory training ‘Cogmed’, or to the ‘Paying attention in class’ intervention which is an experimental school-based executive function training. Children will be selected from regular -and special education primary schools in the region of Amsterdam, the Netherlands. The second part of the study will determine which specific characteristics are related to non-response of the ‘Paying attention in class’ intervention. School-aged children (8–12 yrs) with AD(H)D will follow the experimental school-based executive function training ‘Paying attention in class’ (n = 175). Academic performance and neurocognitive functioning (primary outcomes) are assessed before, directly after and 6 months after training. Secondary outcome measures are: behaviour in class, behaviour problems and quality of life.
Discussion
So far, there is limited but promising evidence that working memory – and other executive function interventions can improve academic performance. Little is know about the applicability and generalization effects of these interventions in a classroom situation. This study will contribute to this lack of information, especially information related to real classroom and academic situations. By taking into account the costs of both interventions, level of impairment and individual characteristics of the child (stepped-care approach) we will be able to address treatment more adequately for each individual in the future. Trial registration: Nederlands Trial Register NTR3415.
... Primary outcome Our primary outcome is the time to onset of depression or anxiety disorders in the offspring, based on the Child version of Diagnostic Interview Schedule for Children Version IV NIMH DISC-IV; [40], which is a highly structured diagnostic assessment instrument designed to gather symptom presence for child and adolescent psychiatric disorders based on the symptoms and criteria variables as defined in the Diagnostic and Statistical Manual of Mental Disorders DSM-IV; [41]. The computerized DISC is administered via a computer (the interviewer reads questions from the computer screen and enters responses directly into the computer) and scored by computer algorithm [42]. There are parallel versions of the instrument: the DISC-P for parents, and the DISC-C for direct administration to children. ...
Anxiety and mood disorders are highly prevalent and pose a huge burden on patients. Their offspring is at increased risk of developing these disorders as well, indicating a clear need for prevention of psychopathology in this group. Given high comorbidity and non-specificity of intergenerational transmission of disorders, prevention programs should target both anxiety and depression. Further, while the indication for preventive interventions is often elevated symptoms, offspring with other high risk profiles may also benefit from resilience-based prevention programs.
The current STERK-study (Screening and Training: Enhancing Resilience in Kids) is a randomized controlled clinical trial combining selected and indicated prevention: it is targeted at both high risk individuals without symptoms and at those with subsyndromal symptoms. Individuals without symptoms meet two of three criteria of the High Risk Index (HRI; female gender, both parents affected, history of a parental suicide (attempt). This index was developed in an earlier study and corresponds with elevated risk in offspring of depressed patients. Children aged 8-17 years (n = 204) with subthreshold symptoms or meeting the criteria on the HRI are randomised to one of two treatment conditions, namely (a) 10 weekly individual child CBT sessions and 2 parent sessions or (b) minimal information. Assessments are held at pre-test, post-test and at 12 and 24 months follow-up. Primary outcome is the time to onset of a mood or anxiety disorder in the offspring. Secondary outcome measures include number of days with depression or anxiety, child and parent symptom levels, quality of life, and cost-effectiveness. Based on models of aetiology of mood and anxiety disorders as well as mechanisms of change during interventions, we selected potential mediators and moderators of treatment outcome, namely coping, parent-child interaction, self-associations, optimism/pessimism, temperament, and emotion processing.
The current intervention trial aims to significantly reduce the risk of intergenerational transmission of mood and anxiety disorders with a short and well targeted intervention that is directed at strengthening the resilience in potentially vulnerable children. We plan to evaluate the effectiveness and cost-effectiveness of such an intervention and to identify mechanisms of change.
NTR2888.
... The diagnosis had to be confirmed by clinical scores on the ADHD-DSM-IV rating scale by the investigator (DuPaul et al. 1998). The presence of comorbid disorders was established in the child psychiatric interview and by using the Dutch electronic version of the Diagnostic Interview Schedule for Children (DISC-DSM-IV, parent version; Shaffer et al. 2000; Steenhuis et al. 2009 ). General functioning and severity of clinical symptoms were assessed using the Children's Global Assessment Scale (CGAS; Shaffer et al. 1983 ) and the Clinical Global Impression- Severity Scale (CGI-S; Bangs et al. 2008), respectively. ...
Electroencephalography (EEG)-neurofeedback has been shown to offer therapeutic benefits to patients with attention-deficit/hyperactivity disorder (ADHD) in several, mostly uncontrolled studies. This pilot study is designed to test the feasibility and safety of using a double-blind placebo feedback-controlled design and to explore the initial efficacy of individualized EEG-neurofeedback training in children with ADHD. Fourteen children (8–15 years) with ADHD defined according to the DSM-IV-TR criteria were randomly allocated to 30 sessions of EEG-neurofeedback (n = 8) or placebo feedback (n = 6). Safety measures (adverse events and sleep problems), ADHD symptoms and global improvement were monitored. With respect to feasibility, all children completed the study and attended all study visits and training sessions. No significant adverse effects or sleep problems were reported. Regarding the expectancy, 75% of children and their parent(s) in the active neurofeedback group and 50% of children and their parent(s) in the placebo feedback group thought they received placebo feedback training. Analyses revealed significant improvements of ADHD symptoms over time, but changes were similar for both groups. This pilot study shows that it is feasible to conduct a rigorous placebo-controlled trial to investigate the efficacy of neurofeedback training in children with ADHD. However, a double-blind design may not be feasible since using automatic adjusted reward thresholds may not work as effective as manually adjusted reward thresholds. Additionally, implementation of active learning strategies may be an important factor for the efficacy of EEG-neurofeedback training. Based on the results of this pilot study, changes are made in the design of the ongoing study.
Electronic supplementary material
The online version of this article (doi:10.1007/s00702-010-0524-2) contains supplementary material, which is available to authorized users.
This entry reviews common methods for assessing adolescents' mental disorders, including interviews, questionnaires, and observation methods. Cultural issues regarding application of these assessments across ethnic groups are discussed. These cultural considerations include (1) how differences in cultural values may affect the experience and expression of psychopathological symptomatology, (2) how assessment items are framed and understood in specific cultural contexts, (3) how social norms and cultural values may generate specific response biases depending on the response options offered, and (4) concern over the translation and cross‐cultural adaptation of assessment instruments.
Anxiety disorders are common among youth, posing risks to physical and mental health development. Early screening can help identify such disorders and pave the way for preventative treatment. To this end, the Youth Online Diagnostic Assessment (YODA) tool was developed and deployed to predict youth disorders using online screening questionnaires filled by parents. YODA facilitated collection of several novel unique datasets of self-reported anxiety disorder symptoms. Since the data is self-reported and often noisy, feature selection needs to be performed on the raw data to improve accuracy. However, a single set of selected features may not be informative enough. Consequently, in this work we propose and evaluate a novel feature ensemble based Bayesian Neural Network (FE-BNN) that exploits an ensemble of features for improving the accuracy of disorder predictions. We evaluate the performance of FE-BNN on three disorder-specific datasets collected by YODA. Our method achieved the AUC of 0.8683, 0.8769, 0.9091 for the predictions of Separation Anxiety Disorder, Generalized Anxiety Disorder and Social Anxiety Disorder, respectively. These results provide initial evidence that our method outperforms the original diagnostic scoring function of YODA and several other baseline methods for three anxiety disorders, which can practically help prioritizing diagnostic interviews. Our promising results call for investigation of interpretable methods maintaining high predictive accuracy.
This paper shares learned experiences in teletherapy (also called tele-mental-health, remote video therapy, and virtual therapy) with couples and families. It aims to enhance teletherapy practice with couples and families by providing tools for screening and coaching. The paper describes common pitfalls in teletherapy with couples and families and how to avoid or address them, describes the opportunities for added insight when engaging couples and families in teletherapy from their homes, provides concrete interventions in the form of process-focused questions which therapists can draw from, and provides case examples. The case examples and process-oriented questions focus on four areas: screening, logistical coaching of technology, using the family's meeting place to learn about the family, and avoiding pitfalls.
Objective:
To present initial validity data on three web-based computerized versions of the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS-COMP).
Method:
The sample for evaluating the validity of the clinician-administered KSADS-COMP included 511 youth ages 6-18 who were participants in the Child Mind Institute Healthy Brain Network. The sample for evaluating the parent and youth self-administered versions of the KSADS-COMP included 158 11-17 year-olds recruited from three academic institutions.
Results:
Average administration time for completing the combined parent and youth clinician-administered KSADS-COMP was less time than previously reported for completing the paper-and-pencil KSADS with only one informant (91.9±50.1 minutes). Average administration times for the youth and parent self-administered KSADS-COMP were 50.9±28.0 and 63.2±38.3 minutes, respectively, and youth and parents rated their experience using the web-based self-administered KSADS-COMPs very positively. Diagnoses generated with all three KSADS-COMP versions demonstrated good convergent validity against established clinical rating scales and dimensional diagnostic-specific ratings derived from the KSADS-COMP. When parent and youth self-administered KSADS-COMP data were integrated, good to excellent concordance was also achieved between diagnoses derived using the self-administered and clinician-administered KSADS-COMPs (Area Under the Curves=0.89-1.00).
Conclusion:
The three versions of the KSADS-COMP demonstrate promising psychometric properties while offering efficiency in administration and scoring. The clinician-administered KSADS-COMP shows utility not only for research, but also for implementation in clinical practice, with self-report pre-interview ratings that streamline administration. The self-administered KSADS-COMPs have numerous potential research and clinical applications, including in large-scale epidemiological studies, in schools, emergency departments, and in telehealth to address the critical shortage of child mental health specialists.
The Body Esteem Scale (BES; Franzoi and Shields 1984) has been a primary research tool for over 30 years, yet its factor structure has not been fully assessed since its creation, so a two-study design examined whether the BES needed revision. In Study 1, a series of principal components analyses (PCAs) was conducted using the BES responses of 798 undergraduate students, with results indicating that changes were necessary to improve the scale’s accuracy. In Study 2, 1237 undergraduate students evaluated each BES item, along with a select set of new body items, while also rating each item’s importance to their own body esteem. Body items meeting minimum importance criteria were then utilized in a series of PCAs to develop a revised scale that has strong internal consistency and good convergent and discriminant validity. As with the original BES, the revised BES (BES-R) conceives of body esteem as both gender-specific and multidimensional. Given that the accurate assessment of body esteem is essential in better understanding the link between this construct and mental health, the BES-R can now be used in research to illuminate this link, as well as in prevention and treatment programs for body-image issues. Further implications are discussed.
This chapter provides an overview of evidence-based instruments for the assessment of pediatric anxiety disorders from both categorical and dimensional perspectives. The chapter begins with a brief discussion of a categorical perspective to pediatric anxiety assessment and how interview schedules best capture this perspective. This is followed by a summary of the most widely used interview schedules to assess pediatric anxiety, including the evidence base for accomplishing specific assessment goals (i.e., diagnosis and treatment evaluation). The chapter follows with a brief discussion on a dimensional perspective and how rating scales best capture this perspective. This is followed by a summary of the most widely used rating scales for assessing pediatric anxiety, including research support for their use across contexts (i.e., identifying and quantifying anxiety, screening, and treatment evaluation). Next is a brief summary of objective measures of pediatric anxiety. The chapter concludes with a discussion of future research directions.
As a component of a comprehensive assessment, psychological testing can be a critical tool in evaluating an adolescent's mental health and associated factors. This chapter will review the most commonly implemented, empirically-validated psychological measures for use with adolescents. Given comorbidity, complex etiological factors, and the varied presentations of addictive disorders in adolescents, a breadth of assessment areas will be covered, including general psychopathology, drug and alcohol use, behavior and adaptive functioning, and cognitive ability. These assessments differ in format (e.g., pencil-and-paper, structured interview, self/caregiver/teacher report), length, complexity of administration and scoring, and applicability to specific demographic groups. Moreover, this chapter will present guidelines to help the reader decide when to consult with a psychologist.
Objective:
To conduct a scoping review on the use of technology to deliver mental health services to children and youth in order to identify the breadth of peer-reviewed literature, summarize findings and identify gaps.
Method:
A literature database search identified 126 original studies meeting criteria for review. Descriptive numerical summary and thematic analyses were conducted. Two reviewers independently extracted data.
Results:
Studies were characterized by diverse technologies including videoconferencing, telephone and mobile phone applications and Internet-based applications such as email, web sites and CD-ROMs.
Conclusion:
The use of technologies plays a major role in the delivery of mental health services and supports to children and youth in providing prevention, assessment, diagnosis, counseling and treatment programs. Strategies are growing exponentially on a global basis, thus it is critical to study the impact of these technologies on child and youth mental health service delivery. An in-depth review and synthesis of the quality of findings of studies on effectiveness of the use of technologies in service delivery are also warranted. A full systematic review would provide that opportunity.
Objectives:
To examine intellectual, behavioral, and emotional functioning of children who have syndromic craniosynostosis and to explore differences between diagnostic subgroups.
Methods:
A national sample of children who have syndromic craniosynostosis participated in this study. Intellectual, behavioral, and emotional outcomes were assessed by using standardized measures: Wechsler Intelligence Scale for Children, Third Edition, Child Behavior Checklist (CBCL)/6-18, Disruptive Behavior Disorder rating scale (DBD), and the National Institute of Mental Health Diagnostic Interview Schedule for Children.
Results:
We included 82 children (39 boys) aged 6 to 13 years who have syndromic craniosynostosis. Mean Full-Scale IQ (FSIQ) was in the normal range (M = 96.6; SD = 21.6). However, children who have syndromic craniosynostosis had a 1.9 times higher risk for developing intellectual disability (FSIQ < 85) compared with the normative population (P < .001) and had more behavioral and emotional problems compared with the normative population, including higher scores on the CBCL/6-18, DBD Total Problems (P < .001), Internalizing (P < .01), social problems (P < .001), attention problems (P < .001), and the DBD Inattention (P < .001). Children who have Apert syndrome had lower FSIQs (M = 76.7; SD = 13.3) and children who have Muenke syndrome had more social problems (P < .01), attention problems (P < .05), and inattention problems (P < .01) than normative population and with other diagnostic subgroups.
Conclusions:
Although children who have syndromic craniosynostosis have FSIQs similar to the normative population, they are at increased risk for developing intellectual disability, internalizing, social, and attention problems. Higher levels of behavioral and emotional problems were related to lower levels of intellectual functioning.
The importance of fixturing is often underestimated in the development of precision assembly system for miniature products. A 5-part component of a micro accelerometer is selected as an example in this paper. The sensitive structure that influences the performance of accelerometer most is the flexible beam on one part. A fixture with flexible fastening mechanism was proposed for assembly these miniature parts. The key mechanism is a flexible part, which is with two contacted points and metal flexible linkages. The thermal stress of the component after curing was studied using finite element model (FEM). The simulation results revealed that the height difference was the main cause to the stress on the flexible beam. The assembly sequence and strategy were optimized. The maximum stress was reduced to 72% of the original one while the height difference reached 15 μm. This study implies that an optimized fixture design and assembly sequence can also reduce the assembly stress remarkably.
Primarily a childhood diagnosis, oppositional defiant disorder (ODD), refers to a category of negativistic child1 behaviors that impair social functioning and learning opportunities. It was first identified in 1966 and appeared initially
as a formalized diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, 3rd edition (American Psychiatric Association, 1980). ODD has been reported to affect 2–16% of children, with boys more
likely to be diagnosed than girls and most children developing symptoms by age 8 (American Psychiatric Association, 2000;
Steiner and Remsing, 2007).
In a previous open-label study, dopaminergic agents improved Restless Legs Syndrome (RLS) and Periodic Limb Movements in Sleep (PLMS), as well as Attention-Deficit-Hyperactivity Disorder (ADHD) in children with both disorders. We therefore conducted a double-blind placebo-controlled trial of L-DOPA in ADHD children with and without RLS/PLMS.
Two groups of patients (total n = 29), those with ADHD only or those with ADHD and RLS/PLMS, were randomized to L-DOPA or placebo therapy. At baseline and after therapy patients were assessed with Conners' parent and teacher rating scales; polysomnography; RLS rating scale; and neuropsychometric measures of memory, learning, attention, and vigilance.
L-DOPA improved RLS/PLMS symptoms in all patients with those disorders compared with placebo (p = .007). When assessed by the Conners' Scales before therapy, ADHD was more severe in children without RLS/PLMS than in children with RLS/PLMS (p = 0.006). L-DOPA had no effect on Conners' scales, sleep, or neuropsychometric tests when all patients treated with the drug were compared to those on placebo or when patients with ADHD only were compared to those with ADHD and RLS/PLMS.
In this first double-blind study of a dopaminergic therapy in children with RLS/PLMS, L-Dopa significantly improved RLS/PLMS but not ADHD. These results, however, should be interpreted carefully since they may have been influenced by the relatively small sample size and the baseline differences in severity of ADHD symptoms. Further work needs to be done to elucidate the relationship between dopamine, ADHD and RLS/PLMS.
As there are no biological markers for Autism Spectrum Disorders (ASD), screening must focus on behaviour and the presence of a markedly abnormal development or a deficiency in verbal and non-verbal social interaction and communication.
To evaluate the psychometric attributes of a Spanish version of the autism domain of the Autism-Tics, AD/HD and other Comorbidities Inventory (A-TAC) scale for ASD screening.
A total of 140 subjects (43% male, 57% female) aged 6-16, with ASD (n=15), Mental Retardation (n=40), Psychiatric Illness (n=22), Tics (n=12) and controls (n=51), were included for ASD screening. The predictive validity, acceptability, scale assumptions, internal consistency, and precision were analysed.
The internal consistency was high (α=0.93), and the standard error was adequate (1.13 [95% CI, -1.08 a 3.34]). The mean scores of the Autism module were higher in patients diagnosed with ASD and mental disability compared to the rest of the patients (P<.001). The area under the curve was 0.96 for the ASD group.
The autism domain of the A-TAC scale seems to be a reliable, valid and precise tool for ASD screening in the Spanish school population.
Health status questionnaires are important, especially with the growing interest in outcome studies. However, these questionnaires continue to be administered in their original paper format. We hypothesized that total hip arthroplasty outcome data derived with computer-based questionnaires do not differ significantly from those derived with established paper-based formats.
From January 2006 to January 2007, the clinic schedules of four attending arthroplasty surgeons were screened weekly to identify patients who could potentially be included in the study. Charts were reviewed for subjects who were scheduled for or had received primary total hip arthroplasty. Patients were recruited during their office visit or when they attended a preoperative educational class, and five health status questionnaires (the Harris hip score, WOMAC [Western Ontario and McMaster Universities Osteoarthritis Index], SF-36 [Short Form-36], EQ-5D [EuroQol-5D], and UCLA [University of California at Los Angeles] activity score) were administered in three formats: paper, touch screen, and web-based. Repeated-measures analysis of variance and Pearson correlations were used to compare the questionnaire modes for the Harris hip score (normally distributed data), and the Friedman test and Spearman correlations were used to compare the modes for the other health status scores (non-normally distributed data). The study was designed with 90% power for detecting 10% differences between modes in the entire series of sixty-one patients and with 82% and 87% power in preoperative and postoperative subgroups, respectively.
The mean age was sixty-three years, with thirty-seven male and twenty-four female patients in the study. Forty-seven hips (77%) had osteoarthritis as the primary diagnosis. No significant differences were detected, for any of the five health outcome systems, among the paper, touch screen, and web-based modes, and there were highly significant correlations among all questionnaire modes in the entire series of patients and in the preoperative and postoperative subgroups (p < 0.001).
The scores obtained with the paper, touch screen, and web-based modes of the five questionnaires demonstrated excellent agreement. Thus, touch screen and web-based formats can be used to collect and track patient outcome data. Use of electronic formats of these questionnaires will facilitate a more efficient and reliable data collection process.
This study was designed to evaluate the psychometric attributes and screening efficiency of a Spanish version of the Children Predictive Scales (DPS) against the Spanish Diagnostic Interview Schedule for Children (DISC-IV).
This pilot cross-sectional study included 61 children aged 9 to 14 years in a mainstream school. The following psychometric attributes were analyzed: acceptability, scale assumptions, internal consistency, and precision, as well the predictive validity (AUC).
The scale did not show ceiling or floor effects (6.4%, 1.3%, respectively). The internal consistency was high (α=0.92), and the standard error of measurement was adequate (SEM=1.54). The overall DPS AUC was 0.72 against DISC IV corresponding diagnosis.
The Spanish version of the DPS-4.32 seems to be a reliable and precise tool for screening mental health disorders in a school-age population.
Previous studies have suggested that discrepant reporting in a test–retest reliability paradigm is not purely random measurement error, but partly a function of a systematic tendency to say no during retest to questions answered positively at initial testing (attenuation). To examine features of interview questions that may be associated with attenuation, three raters independently assessed the structural and content features of questions from the Diagnostic Interview Schedule for Children (version 2.3) and linked these to data from a test–retest reliability study of 223 community respondents (parent and child reports). Results indicated that for both parent and youth reports, item features most strongly associated with attenuation were (a) being a stem question (asked of all respondents, regardless of any skip structure); (b) question placement in the first half of the interview; (c) question length; (d) question complexity; or (e) requiring assessment of the timing, duration, or frequency of a symptom. Findings may be explained by participants'' conscious efforts to avoid further questions or by their learning more about the nature and purpose of the interview as they gain more experience; alternatively, findings may represent a methodological artifact of structured interview design.
Reliability coefficients often take the form of intraclass correlation coefficients. In this article, guidelines are given for choosing among 6 different forms of the intraclass correlation for reliability studies in which n targets are rated by k judges. Relevant to the choice of the coefficient are the appropriate statistical model for the reliability study and the applications to be made of the reliability results. Confidence intervals for each of the forms are reviewed. (23 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved).
The rapid growth of the Internet provides a wealth of new research opportunities for psychologists. Internet data collection methods, with a focus on self-report questionnaires from self-selected samples, are evaluated and compared with traditional paper-and-pencil methods. Six preconceptions about Internet samples and data quality are evaluated by comparing a new large Internet sample (N = 361,703) with a set of 510 published traditional samples. Internet samples are shown to be relatively diverse with respect to gender, socioeconomic status, geographic region, and age. Moreover, Internet findings generalize across presentation formats, are not adversely affected by nonserious or repeat responders, and are consistent with findings from traditional methods. It is concluded that Internet methods can contribute to many areas of psychology.
The authors examine the comparability of paper and voice formats of the Massachusetts Youth Screening Instrument-Second Version (MAYSI-2) as well as each format’s concordance with the Voice Diagnostic Interview Schedule for Children (DISC) among adjudicated youth. Comparability is assessed among 248 youths admitted to a South Carolina Assessment Center. Mean scores and alpha coefficients are calculated, and area under the curve and positive and negative predictive values are used to compare concordance to the DISC. Paper and voice formats are significantly correlated, have similar alpha coefficients, and have comparable concordance with the DISC, suggesting that the MAYSI-2 paper and voice formats are comparable instruments. The voice format may be preferable to the paper format for screening justice youth for mental health problems because it may reduce incomplete data and increase reporting of stigmatized behaviors and because of its ability to automatically generate scored reports and aggregate data.
There has been relatively little change over recent decades in the methods used in research on self-reported delinquency. Face-to-face interviews and self-administered interviews in the classroom are still the predominant alternatives envisaged. New methods have been brought into the picture by recent computer technology, the Internet, and an increasing availability of computer equipment and Internet access in schools. In the autumn of 2004, a controlled experiment was conducted with 1,203 students in Lausanne (Switzerland), where "paper-and-pencil" questionnaires were compared with computer-assisted interviews through the Internet. The experiment included a test of two different definitions of the (same) reference period. After the introductory question ("Did you ever..."), students were asked how many times they had done it (or experienced it), if ever, "over the last 12 months" or "since the October 2003 vacation". Few significant differences were found between the results obtained by the two methods and for the two definitions of the reference period, in the answers concerning victimisation, self-reported delinquency, drug use, failure to respond (missing data). Students were found to be more motivated to respond through the Internet, take less time for filling out the questionnaire, and were apparently more confident of privacy, while the school principals were less reluctant to allow classes to be interviewed through the Internet. The Internet method also involves considerable cost reductions, which is a critical advantage if self-reported delinquency surveys are to become a routinely applied method of evaluation, particularly so in countries with limited resources. On balance, the Internet may be instrumental in making research on self-reported delinquency far more feasible in situations where limited resources so far have prevented its implementation.
Previous research has not compared the psychometric properties of diagnostic interviews of community samples and clinically referred subjects within a single study. As part of a multisite cooperative agreement study funded by the National Institute of Mental Health, 97 families with clinically referred children and 278 families identified through community sampling procedures participated in a test-retest study of version 2.1 of the Diagnostic Interview Schedule for Children (DISC 2.1).
The DISC was separately administered to children and parents, and diagnoses were derived from computer algorithms keyed to DSM-III-R criteria. Three sets of diagnoses were obtained, based on parent information only (DISC-P), child information only (DISC-C), and information from either or both (DISC-PC).
Test-retest reliabilities of the DISC-PC ranged from moderate to substantial for diagnoses in the clinical sample. Test-retest kappa coefficients were higher for the clinical sample than for the community sample. The DISC-PC algorithm generally had higher reliabilities than the algorithms that relied on single informants. Unreliability was primarily due to diagnostic attenuation at time 2. Attenuation was greatest among child informants and less severe cases and in the community sample.
Test-retest reliability findings were consistent with or superior to those reported in previous studies. Results support the usefulness of the DISC in further clinical and epidemiologic research; however, closely spaced or repeated DISC interviews may result in significant diagnostic attenuation on retest. Further studies of the test-retest attenuation phenomena are needed, including careful examination of the child, family, and illness characteristics of diagnostic stability.
Synopsis
The procedural validity of the computerized version of the Composite International Diagnostic Interview (CIDI-Auto) was examined against the consensus diagnoses of two clinicians for six anxiety disorders (agoraphobia, panic disorder (±agoraphobia), social phobia, simple phobia, obsessive compulsive disorder (OCD), generalized anxiety disorder (GAD) and major depressive episode (MDE)). Clinicians had available to them all data obtained over a 2- to 10-month period. Subjects were 98 patients accepted for treatment at an Anxiety Disorders Clinic, thus, all subjects had at least one of the diagnoses being examined. While the CIDI-Auto detected 88·2% of the clinician diagnoses, it identified twice as many diagnoses as did the clinicians. The sensitivity of the CIDI-Auto was above 0·85 except for GAD, which had a sensitivity of 0·29. The specificity of the CIDI-Auto was lower (range: 0·47–0·99). The agreement between the CIDI-Auto and the clinician diagnoses, as measured by intraclass kappas, ranged from poor ( k = 0·02; GAD) to excellent ( k = 0·81; OCD), with a fair level of agreement overall ( k = 0·40). Canonical correlation analysis suggested that the discrepancies between the CIDI-Auto and clinicians were not due to different diagnostic distinctions being made. It is suggested that the CIDI-Auto may have a lower threshold for diagnosing anxiety disorders than do experienced clinicians. It is concluded that, in a sample where all subjects have at least one anxiety disorder diagnosis, the CIDI-Auto has acceptable validity.
The equivalency of the Composite International Diagnostic Interview delivered by human interviewers (CIDI) and its computerized version (CIDI-Auto) was examined for anxiety and depressive disorders.
Subjects were 40 patients at an Anxiety Disorders Clinic and 40 general medical practice attenders. The CIDI-Auto and CIDI were administered in counterbalanced order on the same day and measures of computer attitudes and the acceptability of the two interview formats were also taken.
The CIDI-Auto and the CIDI were found to be equally acceptable to subjects on the dimensions of comfort and preference, while the CIDI-Auto was rated as less embarrassing but too long in comparison with the CIDI. The agreement between the two formats was acceptable with kappa values for ICD-10 diagnoses being above 0.65 and for DSM-III-R diagnoses above 0.5 except for two diagnoses (generalized anxiety disorder and dysthymia). Discrepancies between the two formats were predicted by computer attitudes and not by computer experiences or the tendency to respond in a socially desirable fashion.
It is concluded that the CIDI-Auto in its self-administered form is an acceptable substitute for the CIDI for suitable subjects.
JADE is a new, computerized structured interview system to design, administer, and report results of the National Institute of Health's Diagnostic Interview Schedule for Children (NIMH-DISC). It has been developed under the auspices of the DISC Group at the Division of Child and Adolescent Psychiatry at Columbia University/New York State Psychiatric Institute. The development of JADE is based on extensive experience in the use of the DISC and with several previous computerized versions. It illustrates the importance to program design of consultation with those experienced in research and clinical application of the system and of the early adoption of a mature software development strategy.
To describe the National Institute of Mental Health Diagnostic Interview Schedule for Children Version IV (NIMH DISC-IV) and how it differs from earlier versions of the interview. The NIMH DISC-IV is a highly structured diagnostic interview, designed to assess more than 30 psychiatric disorders occurring in children and adolescents, and can be administered by "lay" interviewers after a minimal training period. The interview is available in both English and Spanish versions.
An editorial board was established in 1992 to guide DISC development and ensure that a standard version of the instrument is maintained. Preliminary reliability and acceptability results of the NIMH DISC-IV in a clinical sample of 84 parents and 82 children (aged 9-17 years) drawn from outpatient child and adolescent psychiatric clinics at 3 sites are presented. Results of the previous version in a community sample are reviewed.
Despite its greater length and complexity, the NIMH DISC-IV compares favorably with earlier versions. Alternative versions of the interview are in development (the Present State DISC, the Teacher DISC, the Quick DISC, the Voice DISC).
The NIMH DISC is an acceptable, inexpensive, and convenient instrument for ascertaining a comprehensive range of child and adolescent diagnoses.
(1) To accurately assess rate of psychiatric disorder in incarcerated juveniles, and (2) to examine the feasibility of using a self-administered, comprehensive structured psychiatric assessment with those youths.
In 1999-2000, 292 recently admitted males in secure placement with New Jersey and Illinois juvenile justice authorities provided self-assessments by means of the Voice Diagnostic Interview Schedule for Children-IV, a comprehensive, computerized diagnostic instrument that presents questions via headphones.
Assessments were well tolerated by youths, staff, and parents; 92% of approached youths agreed. Rates of disorder were comparable to prior diagnostic assessment studies with interviewers. Beyond expectable high rates of disruptive and substance use disorders, youths reported high levels of anxiety and mood disorders, with over 3% reporting a past-month suicide attempt. Youths with substance use disorder were significantly more likely to be incarcerated for substance offenses than were youths with no disorder or those with other, non-substance use disorders.
Although the study identified rates of disorder generally comparable to those of prior investigations, some differences, understandable in the context of measurement variations, are apparent. Those variations offer recommendations for mental health assessment practices for youths in the justice system that would include using a comprehensive self-report instrument, pooling across parent and youth informants for certain disorders, focusing on current disorder, and flexibility regarding consideration of impairment.
To report prevalence estimates of psychiatric disorder among Scottish adolescents using a self-administered computerized (Voice) version of the DISC.
A total of 1,860 15-year-olds (67%), participating in a school-based survey of health and lifestyles, completed selected modules of the Voice-DISC, producing DSM-IV diagnoses of (specific) anxiety disorders, eating disorders, depressive/dysthymic disorder, behavior disorders, and substance abuse/dependence.
Overall prevalence of any psychiatric diagnosis, including substance abuse/dependence, was 31%, reducing to 15% with strict impairment criteria. Anxiety disorders were more common in females, behavior disorders (except attention-deficit/hyperactivity disorder) in males. Comorbidity within major diagnostic categories was considerable; that between categories was lower, although high comorbidity between conduct disorder and substance abuse/dependence was found.
Prevalence estimates are similar to those reported in other studies, although methodological problems limit comparisons. Of particular interest are the similar or higher rates of behavior disorders, especially conduct disorders, to those in studies involving multiple informants.
To examine the contribution of parent report to youth report in defining psychiatric "caseness" among incarcerated youths. The authors compared reports with each other and examined the influence of varying case definitions.
A total of 569 youths in New Jersey, Illinois, and South Carolina admitted into secure placement from 1999 to 2002 were self-administered the Diagnostic Interview Schedule for Children Version 4 (DISC-IV). Parents of assessed youths were asked to complete a parent version of the DISC-IV by telephone. This paper reports on 122 youth-parent dyads.
There were four major findings: (1) youths report higher rates of disorder than parents, with rates decreasing when agreement between parents AND youths is required and increasing when parent OR youth report is required; (2) parents and youths showed significant agreement on reports of lifetime suicide attempt; (3) parents were more likely than youths to report that disorders were impairing; and (4) only 30% of parents added substantial new information to the youth report.
Parent report potentially adds new information for youths who do not endorse any impairment or deny disorder. However, the value of including parent report for youths in justice and other under-resourced, settings should be balanced with the real challenges involved in obtaining information from parents.
Despite the huge youth population, there is a lack of psychiatric diagnostic instruments with reported psychometric properties in Chinese. This study reports the development of the Chinese version of DISC-IV and examines its test-retest reliability.
Seventy-eight parents and 79 youths (mean age 13.1 years) attending child psychiatric clinics were interviewed twice using the Chinese DISC-IV (Diagnostic Interview Schedule for Children-IV) about 22 days apart.
The kappa coefficients were good to excellent for obsessive compulsive disorder (OCD) (both youth (Y) and parent (P) versions), major depressive disorder (MDD) (P), attention deficit hyperactivity disorder (ADHD) (P); fair for anxiety disorder (P), oppositional defiant disorder (ODD) (P, Y), MDD (Y); but poor for anxiety disorder (Y) and ADHD (Y). Parent informants had better test-retest reliability than youth informants.
The Chinese DISC-IV had comparable test-retest reliability with the original English version.