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PubMed1977

The effect of interviewer bias on mental illness questionnaire responses.

The purpose of this study was to investigate how interviewer behavior affects information obtained from a respondent during an interview. The five factors of interviewer behavior that were studied were social reinforcement, interviewer disclosure, verbal modeling, interviewer dress, and seating arrangement. The dependent variable was the number of symptoms reported on the 22-item Mental Health Inventory. A total of 128 male and female adult patients under treatment for mental illness were interviewed under procedures using all combinations of the five factors. Control of patient sex, age, ethnicity, and education was effected through the use of a balanced design. The results demonstrated that the behavior of the interviewer influenced the respondent's report of psychiatric symptoms. The largest number of psychiatric symptoms were reported when the interviewer gave social reinforcement while wearing a lab coat and sitting across a desk from the respondent.

Adult↗
PubMedDate not supplied

Self-report versus interview data of women's subjective theories of illness: concordance and predictive validity in a psychosomatic-gynecological liaison service.

Between-method comparisons of patient data from standardized self-report instruments and corresponding patient interview data frequently have poor agreement. We investigated the concordance and predictive validity of self-report measures and expert-rated interview data of women's subjective theories of illness in a psychosomatic-gynecological consultation liaison service. 31 patients completed two questionnaires (KKG, PATEF) on subjective theories of illness and were interviewed with a semistructured instrument on the same topic at the time of the initial appointment and after 1.5 years. External criteria for assessing the predictive validity of questionnaire versus interview data were: follow-up participation and psychotherapy utilization during the follow-up interval. Questionnaire and interview rating data were only modestly associated. Rater concordance on the interview data was low. Neither the initial-assessment interview nor the questionnaire data had predictive validity for patients' participation in the follow-up. None of the interview rating data but a portion of the questionnaire data, had predictive validity for patients' utilization of psychotherapy during the follow-up interval. The cognitive conceptualization of subjective theories of illness may fail in patients with psychosomatic disorders, due to their very mode of experience. A wider approach that includes assessment of nonverbal communication and countertransference might be useful.

Adult↗
PubMed2003

Can findings from postal questionnaires be combined with interview results to improve the response rate among ethnic minority populations?

STUDY OBJECTIVE: To maximise the response rate in a community survey among ethnic minorities by combining postal questionnaires and interviews and to evaluate the validity of combining results from these different methods. DESIGN: A cross-sectional community survey of a local population using postal questionnaires with interview questionnaires for non-respondents. Postal questionnaires were in English and interview questionnaires were prepared in South Asian languages. A sub-sample completed both postal and interview questionnaires. SETTING: Two general practices in Tameside, Greater Manchester, UK. PARTICIPANTS: Questionnaires were mailed to 1,267 people. People were included if they defined their ethnicity as Indian, Pakistani, Bangladeshi or a combination of these. Fifty-five people who returned postal questionnaires were also interviewed. MAIN RESULTS: Overall response rate was 75%. Comparison of questionnaire and interview responses produced values of kappa ranging from marginally below zero to one. Equivalence was greater with a shorter time between postal completion and interview and where questions were more objective. CONCLUSIONS: It is possible to achieve a good response rate for an epidemiological study among ethnic minorities by using both postal questionnaires and interviews. Care should be taken when results from these two methods are combined, since equivalence is uncertain.

Adolescent↗
PubMed2004

Making a structured psychiatric diagnostic interview faithful to the nomenclature.

Psychiatric diagnostic interviews to be used in epidemiologic studies by lay interviewers have, since the 1970s, attempted to operationalize existing psychiatric nomenclatures. How to maximize the chances that they do so successfully has not previously been spelled out. In this article, the authors discuss strategies for each of the seven steps involved in writing, updating, or modifying a diagnostic interview and its supporting materials: 1) writing questions that match the nomenclature's criteria, 2) checking that respondents will be willing and able to answer the questions, 3) choosing a format acceptable to interviewers that maximizes accurate answering and recording of answers, 4) constructing a data entry and cleaning program that highlights errors to be corrected, 5) creating a diagnostic scoring program that matches the nomenclature's algorithms, 6) developing an interviewer training program that maximizes reliability, and 7) computerizing the interview. For each step, the authors discuss how to identify errors, correct them, and validate the revisions. Although operationalization will never be perfect because of ambiguities in the nomenclature, specifying methods for minimizing divergence from the nomenclature is timely as users modify existing interviews and look forward to updating interviews based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and the International Classification of Diseases, Eleventh Revision.

Algorithms↗
PubMedDate not supplied

Do participants' reports of symptom prevalence or severity vary by interviewer gender?

BACKGROUND: Although interviews are commonly used to gather research data, the integrity of interview data can be threatened by discrepancies between interviewers and respondents on such characteristics as race, gender, or age. OBJECTIVES: To determine if participants' reports of the prevalence and severity of 30 symptoms varied as a function of interviewer gender. Symptoms that were assessed included general physical symptoms (diarrhea, headaches), psychological symptoms (feel blue and depressed, worry about nervous breakdown), and menopausal symptoms (hot flashes, vaginal dryness). METHOD: Structured telephone interviews were completed by 137 women who were a mean of 56.5 years old (SD = 11.1, range 36-83) and a mean of 38.8 months (SD = 23.6) postdiagnosis of breast cancer. Interviewers included two women and two men. RESULTS: Symptom prevalence and severity did not vary as a function of interviewer gender. CONCLUSIONS: Findings suggest that both male and female interviewers can be used successfully to assess participants' reports of physical, psychological, or menopausal symptoms.

Adult↗
PubMed1995

Optometry admission interviewing practices in Canada and United States.

This study of optometry programs in Canada and the United States identified both the extent of and approach to admission interviewing as well as the reasons for its inclusion or exclusion. A written questionnaire was designed, piloted, and revised before it was sent to each of the 18 optometry programs. The 15 (83%) completed questionnaires were analyzed and discussed in terms of comparisons with similar surveys of medical and dental programs. Evidence in the psychology literature was presented about the strengths and limitations of this selection tool. Eighty percent of the optometry programs that responded provided admission interviews. Concerns about interview reliability, validity, and costs precluded its use by 20% of the responding programs. Of four variables, the interview was the third most important variable in admission decisions. Unlike medical and dental programs, optometry programs frequently used a panel format; an approach which is recommended in the psychology literature. Similar to surveys of dental and medical programs, the reliability and validity of optometry admission interviews were likely reduced by insufficient interviewer training and interview structure. A need for greater program evaluation of the optometry interview process as well as dissemination of the results was indicated.

Canada↗
PubMedDate not supplied

The stress interview as a tool for examining physiological reactivity.

Most studies of cardiovascular reactivity utilize tasks that are highly standardized and controlled. However, there is some concern whether the information obtained from these tasks is relevant to understanding the cardiovascular responses to behavioral stimuli encountered in real life. Historically, various forms of a stress interview have been used to examine physiological concomitants of emotional arousal. However, these tools fell into disuse because of ethical concerns, their intensive time requirements, and the perception that the interviews could not be standardized. We have developed a short (16-minute) interview that is not aversive or threatening. In studies on 24 normotensives and 19 hypertensives, the interview elicited greater blood pressure elevations than those elicited by mathematical calculations or cold pressor (p less than 0.0001). The interview increased systolic and diastolic pressures by 38/32 mm Hg in hypertensives and 31/24 mm Hg in normotensives. The variance in BP elicited by this interview is not appreciably greater than that found in highly structured tasks such as mathematical calculations. The test-retest stability of the interview is comparable to that of resting baseline blood pressure and is superior to that of mathematical calculations or cold pressor. Techniques such as the interview may be at least as useful as highly standardized tasks and possibly more valid as models for examining cardiovascular reactivity.

Adult↗
PubMed1990

Teaching psychiatric interview skills to medical students.

A teaching package is described for teaching interview skills to large blocks of medical students whilst on their psychiatric attachment. The aims of this package are to reduce students' concerns about interviewing psychiatric patients, to reinforce students' knowledge of basic interviewing skills and to introduce students to the particular skills required in taking a psychiatric history and mental state examination. The package emphasizes the following teaching methods: 'hands-on' experience of interviewing a patient in front of small groups of peers; peer feedback using check-lists which focus on three major aspects of interviewing; elicitation of facts, elicitation of feelings and control of the interview; facilitation of small-group discussions in the presence of senior psychiatrist. The active involvement of all students in interviewing psychiatric patients engages them in the learning process. Peer involvement increases motivation and was deemed by students as a supportive and constructive exercise. The presence of a senior psychiatrist ensures that discussion is focused on the process of interviewing rather than on patient pathology. Ideally this package would precede focused training throughout the subsequent psychiatric placement.

Clinical Clerkship↗
PubMed1993

Medical school entrants: semi-structured interview ratings, prior scholastic achievement and personality profiles.

The Faculty of Medicine at Monash University has decided to take personal qualities as appraised by semi-structured interviews into account alongside academic merit for selection of undergraduate students. To develop competence in these techniques the Faculty interviewed entrants, rather than applicants, in 1991 and 1992. Interviewing panels consist of three members--a member of the Faculty of Medicine, a member of the association of Monash Medical Graduates Inc. and an outside person who is not involved in medicine. The qualities appraised fall into four fields--quality of motivation, appropriateness of cognitive style, appropriateness of interpersonal style and communication skill. Interviewers are also asked to rate the overall suitability of the interviewee for medical studies and medical practice. A pilot study has also been run to explore the value of a psychometric test, the California Psychological Inventory (CPI), as another adjunct to the selection procedure. In this report interview ratings are analysed in relation to both prior scholastic results and scores obtained on the CPI. The study showed that the interview scores have little overlap with prior scholastic results. The associations between interview ratings and CPI scores were often highly significant from a statistical point of view and thus confirm through a different instrument that the interviews do meaningfully appraise personal attributes. However, the correlations are modest in terms of the amount of variance which is shared, suggesting that the CPI could be advantageously used as another component of our selection process.(ABSTRACT TRUNCATED AT 250 WORDS)

Educational Status↗
PubMed1995

Depression in a long-term care facility: clinical features and discordance between nursing assessment and patient interviews.

OBJECTIVE: Nurses commonly observe more depression than is diagnosed and treated in nursing homes. Accordingly, we aimed to describe the clinical features of untreated nursing home residents whom nurses identify as depressed and to compare nurse ratings of depressed nursing home residents with ratings from direct interviews and patient self-reports. DESIGN: Cross-sectional survey followed by semi-structured diagnostic interviews of depressed patients and their nurses. SETTING: A large academic, multi-level, long-term care facility. PARTICIPANTS: Thirty-seven patients aged 74-99 (mean age 88.4) whom nurses identified as having daily symptoms of depression. Subjects had Mini-Mental State Exam (MMSE) scores > 10 (mean score 21.2), were not acutely or terminally ill, and were able to participate in an interview. MEASUREMENTS: DSM-III-R mood diagnoses and separate ratings of interviews with nurses and patients using the Cornell Scale for Depression. RESULTS: Nurses observed daily symptoms of depression in 110 of 495 (22%) long-term care residents on units not reserved for advanced dementia. Of these 110 patients, 58 (53%) were not receiving antidepressants. Of 37 patients eligible for interviews, nine met criteria for major depression, 20 met criteria for another non-major depression diagnosis, and eight did not have a diagnosable mood disorder. Cornell scale ratings derived exclusively from interviews of nurses were similar across the three diagnostic groups (12.5, 9.9, and 9.5, respectively; P = .31; mean 10.5), whereas Cornell scale ratings from patient interviews differed among groups (15.9, 6.9, and 4.1, respectively; P < .001; mean 8.4). Correlation between nurse Cornell ratings and patient Cornell ratings was poor (r = .27), especially for patients with non-major forms of depression (r = -.20). MMSE and Cumulative Illness Rating Scale (CIRS-G) scores were similar in the three groups. CONCLUSIONS: Nurses frequently observed symptoms of depression in a long-term care setting, and many symptomatic patients were not being treated with antidepressants. In these patients, nurse-derived symptom ratings did not vary across DSM-III-R diagnostic categories and correlated poorly with ratings from direct patient interviews. These findings suggest that nurse caregivers may contribute important diagnostic information about non-major depression and raise questions about the application of standard diagnostic categories to late-life depression in the nursing home.

Aged↗
PubMed1984

Audit of admission to medical school: II--Shortlisting and interviews.

Analysis of shortlisting of applicants for interview at St Mary's Hospital Medical School showed that factor analysis could reduce the selection criteria to three independent scales--"academic ability," "interests," and "community service"--all of which contributed to the interview decision. Early applicants scored more highly on all three factors but were still at a greater advantage in selection for interview than would have been predicted. The dean's judgment of priority for interview from the UCCA form was found to predict a candidate's chance of acceptance at other medical schools besides St Mary's. Analysis of interviewing showed high correlations among interviewers in their assessments, although there was evidence of influence by the chairmen. Factor analysis showed three major factors--academic suitability, non-academic suitability, and health--of which non academic suitability was the major determinant of interview success. Non academic suitability was related to personality (high extraversion and low psychoticism) and to the choices made on the UCCA form. The system of admission interviews enabled greater emphasis to be put on broader interests and achievements than if selection had been on the basis of UCCA application form alone.

Education, Medical, Undergraduate↗
PubMed2006

The semistructured interview for consideration of ethnic culture in therapy scale: initial psychometric and outcome support.

There has been recent pressure for practitioners to consider cultural variables when implementing evidence-based interventions. Therefore, the Semistructured Interview for Consideration of Ethnic Culture in Therapy Scale (SSICECTS) was empirically developed to address this issue. First, psychometric properties of a 6-item scale were evaluated in 279 individuals of various ethnicities. Results indicated two factors accounting for 71% of the variance (ethnic cultural importance and ethnic cultural problems). Internal consistency and convergent validity were satisfactory. Ethnic minority participants demonstrated significantly higher scores than did Caucasians, suggesting this scale may be particularly applicable in ethnic minority populations. In a second study, a controlled trial was conducted to examine clinical utility of the semistructured interview component in a subsample of 151 participants. Participant interviewees were queried about their basic demographic information and were subsequently instructed to evaluate the interviewers' performance. Interviewees were then randomly assigned to receive the SSICECTS or a parallel semistructured interview regarding exercise. After participants completed their respective semistructured interviews, they were again instructed to evaluate the interviewers. Results indicated both semistructured interviews enhanced evaluations. However, interviewers who administered the SSICECTS were perceived as having greater knowledge and respect of participants' ethnic culture.

Acculturation↗
PubMed2000

How sexual abuse interviews go astray: implications for prosecutors, police, and child protection services.

This article argues that child sexual abuse interviews can go astray in two different ways: (a) improper interviewing has the potential to elicit false allegations from children, and (b) clumsy interviewing does not typically produce false allegations, but may have other negative consequences, particularly for child victims. The article clarifies the distinction between the two kinds of bad interviewing and suggests that clumsy interviewing is the more common of the two. The potential negative consequences of both improper and clumsy interviewing are described, along with implications for prosecutors, police, and child protection services. In the authors' opinion, improper interviewing can probably be eliminated rather easily, but clumsy interviewing may be considerably more resistant to change.

Child↗
PubMed1976

Evaluating signs and symptoms: comparison of structured interview ans clinical approaches.

Are research interview techniques adequate in assessing signs and symptoms? This question is investigated by obtaining two sets of interview schedule ratings on 49 patients, one by a research psychiatrist applying the interview and one by the patient's psychiatrist using all available information. The latter was considered a clinical standard with which a cross-sectional research interview could be contrasted. These two data sets were subjected to several types of analysis commonly undertaken with research interview ratings. Results indicated that the research interview adequately represents symptom data, but is seriously lacking in the assessment of observed behaviour. The effect of this difference depends on the goals of the study and the nature of the data analysis. If overall group findings are desired, or if analysis relies primarily on symptom data, results with a research interview may be similar to results based on a far more extensive evaluation. On the other hand, if conclusions are to be drawn on individual patients, or if data analysis relies heavily on observed behaviour, then data derived from research interviews are questionable.

Behavior↗
PubMed1988

A structured diagnostic interview for identification of primary alcoholism: a preliminary evaluation.

Forty alcoholic inpatient men were used to evaluate the test-retest reliability and the validity of a new structured diagnostic interview. The Alcohol Research Center (ARC) Intake Interview was constructed from the Schedule of Affective Disorders and Schizophrenia (SADS) parts I and II and from the Diagnostic Interview Schedule family history section by extracting information on diagnoses most likely to be seen in alcoholic patients and by expanding the data set with questions relevant to alcohol and drug use. The test-retest reliability for patients' primary and secondary diagnoses included a kappa of 1.00 for the comparison of interviewers A and B (100% agreement) and of .76 for interviewers A and C. The validity of ARC Intake Interview patient diagnoses as compared to the SADS demonstrated an overall agreement between 91 and 100%. Reliabilities for labeling of families as positive or negative for specific illness in any first-degree relatives revealed a kappa of 1.00; validities on family diagnoses ranged from 77 to 100%, with the ARC Intake Interview identifying more illness in families than the SADS. Although further evaluation of the ARC Intake Interview is needed, this instrument is recommended to investigators attempting to evaluate the clinical course and treatment needs among alcoholics, especially those patients presenting with multiple diagnoses.

Adult↗
PubMed2000

Alcohol treatment research follow-up interviews and drinking behaviors.

OBJECTIVE: This study, drawing upon data collected as part of a randomized clinical trial of alcohol treatment matching effects, investigates the relationship between research follow-up assessment interviews and subsequent drinking behaviors. METHOD: Subjects (N = 188; 143 men) participated in a day hospital substance-use disorder treatment program at either a private psychiatric hospital (n = 151) or a community hospital (n = 37) and were classified into one of three research groups: regularly scheduled follow-up interviews, missed scheduled follow-up interviews, and delayed Year-2 follow-up interviews. Complete data relevant to the present study were collected on 157 subjects. RESULTS: Study results provided support for a subject reactivity effect related to the research follow-up interview; that is, those subjects classified within the regularly scheduled follow-up interviews condition had the better drinking outcomes. Furthermore, by the end of the second follow-up year, subjects classified within the delayed Year-2 follow-up interviews condition had the poorest drinking outcomes. CONCLUSIONS: There may be considerable potential for subject reactivity effects, specific to the research assessment interview, to confound study results. Therefore, the interpretation of data from alcohol treatment outcome studies that fail to control for such potential confounding effects must be viewed with caution. Researchers are advised to control for these potentially confounding effects via methodological and/or statistical mechanisms.

Adult↗
PubMed1981

Effects of three interview factors on the validity of alcohol abusers' self-reports.

Using 54 outpatient male court-referred alcohol abusers as subjects, this study investigated the effects of three different interview factors--interview setting (group vs individual), method of interview administration (self vs other), and question type (alcohol vs nonalcohol vs demographic)--on the validity of alcohol abusers' self-reports of verifiable life events. Overall, subjects gave relatively valid self-reports, and when answers were invalid they were more often overreported than underreported. Of the three question types, demographic questions were answered the most validly. The validity of subjects' answers was not differentially affected by whether they answered the questions themselves or were interviewed by an experimenter. While subjects who were interviewed individually gave significantly more valid responses to questions than subjects interviewed in a group setting, the difference (5%) was not great. Given that the overall validity rate was quite high for both groups, consideration must be given to whether it is worth the added time of interviewed subjects individually as compared to interviewing subjects in groups and settling for a slightly lower rate of validity.

Alcohol Drinking↗
PubMed2006

The dynamics and validity of the group selection interview.

The authors examined the validity of the group interview, in which several applicants are interviewed simultaneously, vs. the traditional 1-on-1 selection interview. The authors also investigated perceptions of fairness for each interview format and whether the order in which the applicant was asked to respond in the group interview affected the quality of his or her response. Participants were 91 undergraduates who participated in 1-on-1 or group interviews for a scholarship award. The present results supported the hypothesis that interviewers in the 1-on-1 format were significantly better at predicting the applicants' academic potential. Also, in the group interviews, the order in which the applicants were asked to respond affected the quality of their responses significantly.

Adolescent↗