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M Schwab-Stone

Publications and source records attributed to M Schwab-Stone.

27 records · Page 2Linked to original sources
PubMed1994

Reliability of diagnostic reporting for children aged 6-11 years: a test-retest study of the Diagnostic Interview Schedule for Children-Revised.

OBJECTIVE: This study examined the reliability of symptom reporting by community children of elementary school age and their parents on a version of the Diagnostic Interview Schedule for Children-Revised (DISC-R). METHOD: A sample of 109 children aged 6-11 years from an ongoing epidemiologic study were recruited for retest DISC-R interviews after completion of the study protocol. Retest interviews took place 7-18 days after the first interview and were conducted by interviewers who had no prior information about the subjects. Test-retest reliability for five common childhood psychiatric diagnoses was evaluated with the kappa statistic; the intraclass correlation coefficient was used to evaluate test-retest reliability of symptom scales. RESULTS: The reliability of the parents' reports on the DISC-R was good to excellent for attention deficit hyperactivity disorder and separation anxiety disorder; it was fair for overanxious disorder, oppositional defiant disorder, and conduct disorder. The children reported many fewer symptoms than the parents except for separation anxiety disorder; reliability was fair for separation anxiety disorder and poor for attention deficit hyperactivity disorder. The children were particularly unreliable in reporting about time factors, such as duration and onset of symptoms. When symptoms were considered without duration and onset, children's reports reached fair reliability for separation anxiety disorder, overanxious disorder, and attention deficit hyperactivity disorder but remained poor for oppositional defiant disorder. CONCLUSIONS: The results suggest that highly structured diagnostic interviews such as the DISC-R may not be appropriate for use with younger children of elementary school age in community-based studies.

Adolescent↗
PubMed1993

The Diagnostic Interview Schedule for Children-Revised Version (DISC-R): I. Preparation, field testing, interrater reliability, and acceptability.

OBJECTIVE: To describe the history and assessment strategies used to investigate and revise the Diagnostic Interview Schedule for Children (DISC), a highly structured interview form used by lay interviewers to elicit diagnostic criteria for the common psychiatric disorders of childhood and adolescence. METHOD: Revision was based on clinical and community data that identified unreliable and undiscriminating items in an earlier version of the instrument (DISC-1). A field study was carried out with 74 parent-child pairs. Interrater reliability and acceptability to patients was high. Accompanying papers describe the test-retest and construct validity of the instrument. CONCLUSIONS: Taken together, the findings suggest that the DISC is an acceptable, brief, inexpensive, and convenient instrument for ascertaining a comprehensive range of child and adolescent diagnoses whose methodological properties are comparable with other child diagnostic instruments.

Adolescent↗
PubMed1993

The Diagnostic Interview Schedule for Children-Revised Version (DISC-R): II. Test-retest reliability.

OBJECTIVE: Test-retest reliability and internal consistency of the Diagnostic Interview Schedule for Children-Revised Version (DISC-R) were examined to evaluate the effects of a recent revision process. METHOD: A sample of outpatients 11 to 17 years old and their parents were administered the DISC-R in a test-retest design. RESULTS: For the parent interview, four diagnoses had sufficient cases to examine reliability; agreement was good to excellent for three of these. For the child interview, two of the four diagnoses with adequate cases showed good or excellent reliability. Using a combined parent-child algorithm, three of five diagnoses showed good or excellent reliability. Test-retest reliability for symptom scales was excellent for the parent DISC-R and good for the child version, except for oppositional defiant disorder. Maternal depressive symptoms did not affect reliability of reporting about the child's symptomatology. Internal consistency was satisfactory for symptom items comprising most diagnoses. CONCLUSIONS: Although some revision of the instrument will be necessary, the findings from this study suggest that the DISC-R is a promising research instrument for the diagnosis of psychopathology in older children and adolescents.

Adolescent↗
PubMed1993

The Diagnostic Interview Schedule for Children-Revised Version (DISC-R): III. Concurrent criterion validity.

OBJECTIVE: To examine the concurrent criterion validity of the Revised Diagnostic Interview Schedule for Children (DISC-R), a structured lay-administered instrument designed for use in community studies, under conditions designed to provide strict controls for information and method variance. METHOD: The DISC-R was compared with a semistructured clinical interview that covered a similar information base as the DISC-R, used standardized ratings to record symptom information, and, similar to the DISC-R, was scored by DSM-III-R-based computerized diagnostic algorithms. Subjects were 74 child and adolescent clinic attendees and their adult custodians. RESULTS: Overall, moderate levels of agreement were found between DISC-R and clinician-generated diagnoses; these findings were tempered, however, by the fact that the validation interview was less reliable than the DISC-R. CONCLUSIONS: Although these findings provide preliminary support for the use of the DISC-R, they cast some doubt on the adequacy of clinician-generated diagnoses as validation criteria and suggest that alternate approaches to the assessment of validation should be pursued.

Adolescent↗
PubMed1993

Prevalence and stability of the DSM-III-R personality disorders in a community-based survey of adolescents.

OBJECTIVE: The purpose of this study was to estimate the prevalence, concurrent validity, and stability of DSM-III-R personality disorders in a large community-based sample of adolescents. METHOD: A randomly selected community sample of 733 youths ranging in age from 9 to 19 years was followed over a 2-year period. The protocol consisted of structured interviews with the adolescents and their mothers and self-report questionnaires. Algorithms for 10 DSM-III-R axis II disorders were developed to produce diagnoses at two levels of severity; these were validated against multiple indicators of distress and functional impairment. RESULTS: The overall prevalence of personality disorders peaked at age 12 in boys and at age 13 in girls and declined thereafter. Obsessive-compulsive personality disorder was the most prevalent moderate axis II disorder, narcissistic personality disorder the most prevalent severe disorder, and schizotypal personality disorder the least prevalent axis II disorder, based on both moderate and severe diagnostic thresholds. All moderate axis II disorders were associated with significantly greater odds for at least five of 12 diagnostic validators. Longitudinal follow-up revealed that although most axis II disorders did not persist over a 2-year period, subjects with disorders identified earlier remained at elevated risk for receiving a diagnosis again at follow-up. CONCLUSIONS: These findings suggest that a substantial minority of adolescents who are not in treatment qualify for DSM-III-R personality disorder diagnoses and that these diagnoses are associated with increased risk of psychological distress and functional impairment.

Adolescent↗
PubMed1990

Convergence of DSM-III diagnoses and self-reported symptoms in child and adolescent inpatients.

A systematic study of the relationship between empirically-derived diagnoses and symptom patterns is reported in a sample of 160 preadolescents and adolescents consecutively admitted to a psychiatric inpatient setting. Results show that the DSM-III diagnoses generated using the child version of the Diagnostic Interview Schedule for Children (DISC-C) were significantly associated with several factor analytically-derived symptom scales of the Achenbach and Edelbrock Youth Self-Report. The results included the finding of significant associations for conduct disorders with the delinquency scale, for affective disorders with the depressed scale, and for both affective and anxiety disorders with the broad-band internalizing scales. This study suggests implications about diagnostic categorizations and construct validity as well as implications for clinical evaluation.

Adolescent↗
PubMed1989

Comparison of DISC with clinicians' DSM-III diagnoses in psychiatric inpatients.

A sample of 163 children and adolescents, consecutively admitted to a large, private psychiatric teaching hospital, was interviewed using the child version of the Diagnostic Interview Schedule for Children (DISC-C). Patients, ages 12 to 16, were interviewed during the first month of admission. Kappa coefficients were obtained from cross-tabulated frequencies of DISC and clinician diagnoses. Agreement between clinical and DISC diagnoses was generally poor across diagnostic categories. In general, when algorithms of a higher threshold were used, the percentage of patients in a particular diagnostic group was closer to the percentage diagnosed by the clinician. Discussion focuses on factors that may contribute to the discrepancy between number and type of diagnoses that the DISC yields compared to those made by the clinicians.

Adolescent↗