Validation of the diagnoses of panic disorder and phobic disorders in the US National Comorbidity Survey Replication Adolescent (NCS-A) Supplement

School of Education, Boston University, Boston, MA, USA.
International journal of methods in psychiatric research 06/2011; 20(2):105-15. DOI: 10.1002/mpr.336
Source: PubMed


Validity of the adolescent version of the World Health Organization Composite International Diagnostic Interview (CIDI) Version 3.0, a fully-structured research diagnostic interview designed to be used by trained lay interviewers, is assessed in comparison to independent clinical diagnoses based on the Schedule for Affective Disorders and Schizophrenia for School-age Children (K-SADS). This assessment is carried out in the clinical reappraisal sub-sample (n = 347) of the US National Comorbidity Survey Adolescent (NCS-A) supplement, a large (n = 10,148) community epidemiological survey of the prevalence and correlates of adolescent mental disorders in the United States. The diagnoses considered are panic disorder and phobic disorders (social phobia, specific phobia, agoraphobia). CIDI diagnoses are found to have good concordance with K-SADS diagnoses [area under the receiver operating characteristic curve (AUC) = 0.81-0.94], although the CIDI diagnoses are consistency somewhat higher than the K-SADS diagnoses. Data are also presented on criterion-level concordance in an effort to pinpoint CIDI question series that might be improved in future modifications of the instrument. Finally, data are presented on the factor structure of the fears associated with social phobia, the only disorder in this series where substantial controversy exists about disorder subtypes.

Download full-text


Available from: Alan M Zaslavsky
  • [Show abstract] [Hide abstract]
    ABSTRACT: As part of a comprehensive review of clinical research tools used in adolescent psychiatric disorders, a survey of 200 recent studies of adolescent anxiety (publication dates of December 1994 to May 2001) identified 70 different diagnostic and symptom measurement instruments. The design features and psychometric properties of the 15 most commonly used instruments were reviewed, and their strengths and weaknesses were evaluated. The conclusions arising from this review are: (1) too many different instruments are being used by investigators; (2) more than 20% of studies did not report the use of developmentally appropriate (i.e., child/adolescent-specific) diagnostic instruments; (3) another 15% of these studies relied on diagnostic instruments that demonstrate substantial weaknesses in reliability and validity; (4) the concordance between anxiety disorder diagnoses from different interview schedules is unknown; (5) the relative validity of diagnoses and ratings of anxiety severity based on information yielded by parents versus information yielded by adolescents is unclear; (6) clinician-rated symptom severity scales specific to anxiety disorder are rarely utilized; (7) the most commonly used self-report measures discriminate poorly between anxiety and depression, and their items are not indexed to specific anxiety disorders; and (8) some newer self-report anxiety instruments discriminate well between anxiety and depression and have diagnostic validity for specific anxiety disorders.
    No preview · Article · Feb 2003 · Journal of Child and Adolescent Psychopharmacology
  • [Show abstract] [Hide abstract]
    ABSTRACT: The goal of this chapter is to emphasize the impact of culture on the meaningful life story and behavioral perspectives of patients presenting to acute care settings, such as an emergency department (ED), in crisis. Evaluating psychiatric patients is difficult, and can be time-consuming under routine circumstances. In the ED, it is complicated by overcrowding, a fast pace, lack of privacy, and poor preparation of the patient who may be brought in under duress by family members or the police. Evaluating patients can be further complicated by language and cultural differences between the patient and examining provider. The intent of this chapter is to facilitate such an examination by focusing on the cultural differences and related aspects of interviewing and examining patients. The definition of culture includes the customary beliefs, social forms, and material traits of a racial, religious, or social group. Cultural differences play a role in assessment and treatment of patients, including the attitude and behavior of both the provider and the patient regarding illness. Notions of sickness are derived from systems of medical understanding that exist within a culture. Beyond that, epistemic systems dictate how an individual expresses suffering. In many patients, their indigenous understandings of medicine and systems of coping with illness may partially or fully persist and continue to exert an influence on behavior, despite the seemingly outward expression of complete adoption of the Western system of medicine and response to illness.
    No preview · Article · Jan 2011
  • Source

    Full-text · Chapter · Oct 2011
Show more