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PubMed2004

The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI).

This paper presents an overview of the World Mental Health (WMH) Survey Initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI) and a discussion of the methodological research on which the development of the instrument was based. The WMH-CIDI includes a screening module and 40 sections that focus on diagnoses (22 sections), functioning (four sections), treatment (two sections), risk factors (four sections), socio-demographic correlates (seven sections), and methodological factors (two sections). Innovations compared to earlier versions of the CIDI include expansion of the diagnostic sections, a focus on 12-month as well as lifetime disorders in the same interview, detailed assessment of clinical severity, and inclusion of information on treatment, risk factors, and consequences. A computer-assisted version of the interview is available along with a direct data entry software system that can be used to keypunch responses to the paper-and-pencil version of the interview. Computer programs that generate diagnoses are also available based on both ICD-10 and DSM-IV criteria. Elaborate CD-ROM-based training materials are available to teach interviewers how to administer the interview as well as to teach supervisors how to monitor the quality of data collection.

Adult↗
PubMedDate not supplied

How well do faculty evaluate the interviewing skills of medical students?

OBJECTIVE: To study the reliability and validity of using medical school faculty in the evaluation of the interviewing skills of medical students. DESIGN: All second-year University of North Carolina medical students (n = 159) were observed interviewing standardized patients for 5 minutes by one of eight experienced clinical faculty. Interview quality was assessed by a faculty checklist covering questioning style, facilitative behaviors, and specific content. Twenty-one randomly chosen students were videotaped and rated: by the original rater as well as four other raters; by two nationally recognized experts; and according to Roter's coding dimensions, which have been found to correlate strongly with patient compliance and satisfaction. SETTING: Medical school at a state university in the southeastern United States. PARTICIPANTS: Faculty members who volunteered to evaluate second-year medical students during an annual Objective Structured Clinical Exam. INTERVENTIONS: Interrater reliability and intrarater reliability were tested using videotapes of medical students interviewing a standardized patient. Validity was tested by comparing the faculty judgment with both an analysis using the Roter Interactional Analysis System and an assessment made by expert interviewers. MEASUREMENTS AND MAIN RESULTS: Faculty mean checklist score was 80% (range 41-100%). Intrarater reliability was poor for assessment of skills and behaviors as compared with that for content obtained. Interrater reliability was also poor as measured by intraclass correlation coefficients ranging from 0.11 to 0.37. When compared with the experts, faculty raters had a sensitivity of 80% but a specificity of 45% in identifying students with adequate skills. The predictive value of faculty assessment was 12%. Analysis using Roter's coding scheme suggests that faculty scored students on the basis of likability rather than specific behavioral skills, limiting their ability to provide behaviorally specific feedback. CONCLUSIONS: To accurately evaluate clinical interviewing skills we must enhance rater consistency, particularly in assessing those skills that both satisfy patients and yield crucial data.

Clinical Competence↗
PubMed2004

Negative and positive participant responses to the Composite International Diagnostic Interview. Results of the Netherlands Mental Health Survey and Incidence Study.

BACKGROUND: Little is known about the emotional responses of participants in community surveys to standardised psychiatric interviews like the Composite International Diagnostic Interview (CIDI). This study investigates the proportion of subjects responding negatively or positively to the CIDI, and identifies their sociodemographic, psychopathological, personality and social characteristics. METHODS: At the end of the three-wave Netherlands Mental Health Survey and Incidence Study, 4796 participants aged 18-64 at baseline were questioned about how the interviews had affected them. RESULTS: In all, 2.7% found the interviews quite distressing and 9.5% somewhat distressing. Compared to those without distress, they were more likely to be female, not living with a partner, not in paid employment, and to have a somatic disorder. A total of 5.7% of subjects reported that participation had helped them cope better with problems, and 3.4% reported they could now seek help more easily. These were more likely to be older, less educated, not in paid employment (except those seeking help more easily) and to have a somatic disorder. Both negative and positive responses were associated with mood, anxiety and substance use disorders and comorbidity, as well as with neuroticism, external mastery, low self-esteem and low social support. CONCLUSION: Only a small minority of participants reported distress from the interviews. This is an important finding for ethics committees charged with approving general population surveys that use the CIDI. It can also be valuable for planning such studies, enabling researchers to inform participants more fully about the effects of the interview before asking them for informed consent.

Adolescent↗
PubMed2006

The effect of emotional distance on psychophysiologic concordance and perceived empathy between patient and interviewer.

This preliminary study investigated the effect of emotional distance on psychophysiologic concordance and perceived empathy in a clinical population. Participants included 20 adult outpatients from a mental health clinic that underwent a brief semi-structured interview with a trained psychiatrist in either an emotionally neutral or an emotionally distant condition. Simultaneous skin conductance (SC) levels of the patient and interviewer were recorded and used to calculate a measure of psychophysiologic concordance. Interviewer gaze was rated by an independent observer and used as a proxy indicator of emotional distance. Observer ratings of interviewer gaze, SC concordance, and patient ratings of perceived interviewer empathy were significantly lower in the emotionally distant condition compared with the emotionally neutral condition (p < 0.05). Results suggest that increased emotional distance is associated with decreased psychophysiologic concordance and reduced subjective ratings of perceived empathy. The observed differences in psychophysiologic concordance support the use of this measure as a potential marker of empathy in a clinical population in an interview setting.

Adult↗
PubMed2005

Interjections in interviews.

A psycholinguistic hypothesis regarding the use of interjections in spoken utterances, originally formulated by Ameka (1992b, 1994) for the English language, but not confirmed in the German-language research of Kowal and O'Connell (2004 a & c), was tested: The local syntactic isolation of interjections is paralleled by their articulatory isolation in spoken utterances i.e., by their occurrence between a preceding and a following pause. The corpus consisted of four TV and two radio interviews of Hillary Clinton that had coincided with the publication of her book Living History (2003) and one TV interview of Robin Williams by James Lipton. No evidence was found for articulatory isolation of English-language interjections. In the Hillary Clinton interviews and Robin Williams interviews, respectively, 71% and 73% of all interjections occurred initially, i.e., at the onset of various units of spoken discourse: at the beginning of turns; at the beginning of articulatory phrases within turns, i.e., after a preceding pause; and at the beginning of a citation within a turn (either Direct Reported Speech [DRS] or what we have designated Hypothetical Speaker Formulation [HSF]. One conventional interjection (OH) occurred most frequently. The Robin Williams interview had a much higher occurrence of interjections, especially nonconventional ones, than the Hillary Clinton interviews had. It is suggested that the onset or initializing role of interjections reflects the temporal priority of the affective and the intuitive over the analytic, grammatical, and cognitive in speech production. Both this temporal priority and the spontaneous and emotional use of interjections are consonant with Wundt's (1900) characterization of the primary interjection as psychologically primitive. The interjection is indeed the purest verbal implementation of conceptual orality.

Electronic Data Processing↗
PubMed2005

Subjective versus interviewer assessment of global quality of life among persons with schizophrenia living in the community: a Nordic multicentre study.

BACKGROUND: Few studies have investigated differences between subjective and externally assessed quality of life in individuals with a severe mental illness. In a sample of 387 patients with schizophrenia living in the community the present study investigated the association between subjective and interviewer-rated quality of life, clinical and sociodemographic factors related to the two assessments, and if discrepancies in the assessments were related to any clinical or social features of the patients. METHOD: The study was a Nordic multicentre study with a cross-sectional design. Instruments used were the Lancashire Quality of Life Profile, the Brief Psychiatric Rating Scale, the Interview Schedule for Social Interaction, Camberwell Assessment of Needs and General Assessment of Functioning. RESULTS: The correlation between subjective and interviewer-rated quality of life was moderate (ICC = 0.33). More severe affective symptoms, fewer emotional relations and a lower monthly income were related to poorer subjectively rated quality of life but in a stepwise multiple regression analysis accounted for only 14.1% of the variance. Poorer interviewer-rated quality of life was mainly related to a more severe psychopathology but also to a lower monthly income, fewer emotional relations and not being employed. Together these factors accounted for 45.5% of the variance. A greater discrepancy between the subjective and the interviewer rating was found in patients with less affective symptoms, unemployment, and a better social network. CONCLUSION: Only a moderate correlation between subjective and interviewer-assessed global quality of life was found, implying that the sources of assessment differed, as was also shown in subsequent regression models. It is concluded that both perspectives on the patient's quality of life may be valuable for treatment planning, especially in cases where differences in quality of life assessment related to the patient's psychopathology may be expected.

Adult↗
PubMed2004

Diagnostic interviews.

This review addresses issues related to the use of structured psychiatric diagnostic interviews in children and adolescents. Structured diagnostic interviews improve the diagnostic process by better organizing the collection of clinical data and eliminating biases when applying diagnostic criteria. Available interviews generally fall into two categories. Highly structured (or respondent-based) measures use a set script and record subject's responses without interpretation. Thus, they are useful for epidemiologic surveys or other settings in which nonclinical interviewers are used. Semistructured (or interviewer-based) tools allow clinical interpretation of responses as well as the incorporation of other sources of information, thereby making them more relevant for clinicians. Structured diagnostic instruments are currently most often used in research settings, but potentially are useful for clinical settings as well. This review also addresses challenges in psychiatric diagnosis, a brief history of diagnostic standards, and the potential limitations/advantages of using structured diagnostic interviews.

Adolescent↗
PubMed1988

Evaluation of an instructions and modeling procedure for training behavioral assessment interviewing.

Ten undergraduate psychology majors served as participants in two experiments training behavioral assessment interviewing skills. In the first study four participants received training with instructions and audio and written modeling in a multiple baseline across participants design. All participants increased interviewing performance substantially with training. The second study was conducted to evaluate the written instructional material alone. After baseline interviews all six remaining participants received training with instructions in a multiple baseline across participants fashion. For four participants who did not increase interview performance to 90% correct with instructions, the modeling component was added as a third phase. By the end of a subsequent feedback phase all participants increased their performance to 90% or better. Social validation measures of participants' interviewing performance were than added to evaluate process-related variables in the interview.

Audiovisual Aids↗
PubMed1981

Speech-rhythm characteristics of client-centered, Gestalt, and rational-emotive therapy interviews.

The aim of this study was to discover whether client-centered, Gestalt, and rational-emotive psychotherapy interviews could be described and differentiated on the basis of quantitative measurement of their speech rhythms. These measures were taken from the sound portion of a film showing interviews by Carl Rogers, Frederick Perls, and Albert Ellis. The variables used were total session and percentage of speaking times, speaking turns, vocalizations, interruptions, inside and switching pauses, and speaking rates. The three types of interview had very distinctive patterns of speech-rhythm variables. These patterns suggested that Rogers's Client-centered therapy interview was patient dominated, that Ellis's rational-emotive therapy interview was therapist dominated, and that Perls's Gestalt therapy interview was neither therapist nor patient dominated.

Gestalt Therapy↗
PubMed1995

Observed behavior of patients with seasonal affective disorder and an interviewer predicts response to light treatment.

We investigated whether observable behavior of seasonal affective disorder (SAD) patients and an interviewer during an interview before light treatment is related to the response to the light treatment. Different observed behavioral elements of 24 SAD patients and of 2 interviewers, assessed before light treatment, were reduced to "behavioral factors." Forward multiple regression analyses were applied to investigate whether these factors might predict the response to light therapy (3 h of bright light between 09:00 and 12:00 h or between 18:00 and 21:00 h on 5 consecutive days). In addition, it was investigated whether the interviewers' factors could be predicted from the patients' factors. Both patients' and interviewers' factors predicted the response to light treatment. Response-related factors of patients and interviewers were interrelated. The results suggest that behavioral processes may play a role in the mechanisms underlying the response to light treatment in SAD. They support the relevance of interpersonal theories in seasonal depression.

Adult↗
PubMed1993

Reliability and validity of interview data on chronic diseases. The Mini-Finland Health Survey.

The Mini-Finland Health Survey was designed to obtain a comprehensive picture of health and of the need for care in Finnish adults, and to develop methods for monitoring health in the population as a whole. Out of a nationally representative sample of 8000 people aged 30 or over, 7217 (90%) were both interviewed at home by local public health nurses using simple open-ended questions and, independently of this interview, subsequently examined in a two-phase health examination. The estimate of chronic morbidity based on the health interview (56%) was close to the prevalence of definite somatic diseases diagnosed in the health examination (54%), and the agreement between the two methods was moderate (kappa = 0.53). The estimated prevalence of cardiovascular diseases was the same (23%) in the health interview and in the health examination; the agreement was substantial (kappa = 0.74). The prevalence of respiratory and musculoskeletal diseases and mental disorders was underestimated in the interview by 52, 25 and 78%, respectively; the agreement between results of the two methods was relatively low (kappa = 0.43, 0.38 and 0.30, respectively). These results suggest that both the health examination and the health interview methods, as used in this survey, have useful applications in monitoring the population's health.

Adult↗
PubMed2006

Postal surveys of physicians gave superior response rates over telephone interviews in a randomized trial.

BACKGROUND AND OBJECTIVES: To compare general practitioner (GP) response to a telephone interview with response to a postal survey with three reminders in a randomized controlled trial. METHODS: GPs were randomly assigned to either a telephone interview or a postal survey. GPs in the telephone group were mailed a letter of invitation and asked to undertake a telephone interview. GPs in the postal group were mailed a letter of invitation and questionnaire. Non-responders were sent up to three reminders, the final by registered post. Response rates were calculated for each group. RESULTS: 416 GPs were randomized to the telephone interview and 451 to the postal survey. Eighty-six in the telephone group and 30 in the postal were ineligible. One hundred thirty-four GPs completed the telephone interview with a response rate of 40.6% (95% confidence interval [CI]: 35.3%, 46.1%). Two hundred fifty-two GPs completed the postal survey with a response rate of 59.9% (95%CI: 55.0%, 64.6%). The difference in response was 19.3% (95%CI: 12.2%, 26.3%). CONCLUSIONS: These results show that postal surveys with three reminders can have superior response rates compared with a telephone interview.

Attitude of Health Personnel↗
PubMed2006

Can an interview score sheet assist with student selection onto the bachelor of science/diploma of higher education (adult) nursing programme? Findings from a pilot study.

AIM: To develop an interview score sheet (ISS) to assist with the selection of student nurses on the Bachelor of Science (B.Sc.)/Diploma of Higher Education (DipHE) (Adult). METHOD: A pilot study was undertaken over a 6-month period to design and used a questionnaire to collect information on the candidate at interview. This questionnaire was called the "interview score sheet" (ISS). Using the ISS, each candidate was scored independently by two interviewers. MAIN OUTCOME MEASURES: The study was used to evaluate the usefulness of a score sheet at interview in aiding with the selection of candidates. Also the study was used to identify the demographics of the candidates and to assess the consistency of the scoring system. RESULTS: One hundred and twenty six candidates, ageing from 16 to 51 years were interviewed over 6 months. Ninety of the candidates were accepted onto the course. The highest score achievable on the ISS was 40, and the lowest was 2. Of those candidates accepted (n=90) the average score was 28, and for those candidates rejected (n=36) the average score was 20.6. CONCLUSION: The ISS proved to be a useful tool to decide on candidate suitability. Those candidates accepted onto the course were more likely to be scored higher than those rejected. FUTURE STUDY: Correlation of scores with firstly the characteristics of the successful candidates, and secondly with the characteristics of those who did not complete the 3-year programme.

Adolescent↗
PubMed2002

Use of cognitive interview techniques in the development of nutrition surveys and interactive nutrition messages for low-income populations.

The effectiveness of dietary surveys and educational messages is dependent in part on how well the target audience's information processing needs and abilities are addressed. Use of pilot testing is helpful; however, problems with wording and language are often not revealed. Cognitive interview techniques offer 1 approach to assist dietitians in understanding how audiences process information. With this method, respondents are led through a survey or message and asked to paraphrase items; discuss thoughts, feelings, and ideas that come to mind; and suggest alternative wording. As part of a US Department of Agriculture-funded nutrition education project, 23 cognitive interviews were conducted among technical community college students in North Carolina. Interview findings informed the development of tailored computer messages and survey questions. Better understanding of respondents' cognitive processes significantly improved the language and approach used in this intervention. Interview data indicated 4 problem areas: vague or ineffective instructions, confusing questions and response options, variable interpretation of terms, and misinterpretation of dietary recommendations. Interviews also provided insight into the meaning of diet-related stages of change. These findings concur with previous research suggesting that cognitive interview techniques are a valuable tool in the formative evaluation and development of nutrition surveys and materials.

Adolescent↗
PubMed2002

Assessment of eating disorders: comparison of interview and questionnaire data from a long-term follow-up study of bulimia nervosa.

OBJECTIVE: This paper examines diagnostic agreement between interview and questionnaire assessments of women participating in a long-term follow-up study of bulimia nervosa. METHODS: Women (N = 162) completed follow-up evaluations comprising questionnaires and either face-to-face or telephone interviews. RESULTS: Consistent with previous research, rates of eating disorders were higher when assessed by questionnaire than when assessed by interview; however, rates of full bulimia nervosa were similar. Overall diagnostic agreement was adequate for eating disorders (kappa=.64) but poor for bulimia nervosa (kappa=.49), with greater agreement between questionnaires and telephone interviews (kappa's range: .67-.71) than between questionnaires and face-to-face interviews (kappa's range: .35-.58). CONCLUSION: Findings support the possibility that increased rates of eating pathology on questionnaire assessments may be due, in part, to increased candor when participants feel more anonymous. Questionnaire assessments may not be inferior to interview assessments; they may reveal different aspects of disordered eating.

Adult↗
PubMed2000

Enhancing children's narratives in investigative interviews.

OBJECTIVE: To illustrate the amount of detail that can be elicited from alleged abuse victims using open-ended prompts by closely examining forensic interviews of a 5-year-old and a 15-year-old. METHOD: Interview prompts in the substantive sections of two forensic interviews were characterized as invitations, cued invitations. directive or option-posing, and the number of details they each elicited was tabulated. RESULTS: In both interviews, open-ended prompts predominated and were distributed throughout the substantive phases of the interviews. Most of the information obtained was elicited using open-ended prompts, which remained equivalently effective throughout the interviews. Reconstruction of the children's accounts illustrated how successive prompts continued to elicit information. CONCLUSION: Well-framed open-ended prompts, including those that use details provided by the child as cues, elicit narrative accounts from children of all ages. Because such information is more likely to be accurate, investigators are urged to rely more extensively on open-ended prompts.

Adolescent↗
PubMed1996

Investigative interviews of alleged sexual abuse victims with and without anatomical dolls.

Verbal and nonverbal responses by alleged victims of child sexual abuse were coded for length, amount of information, and the manner in which they were elicited by the interviewer. In 16 of the interviews, anatomical dolls were employed for the purposes of demonstration, whereas they were not used in another eight cases matched with respect to other characteristics of the children and the alleged events. Children interviewed with dolls provided an equivalent number of details and spoke as many words in the substantive portion of the interview as did children interviewed without dolls, and interviewers in the two groups used similar probes to elicit information. However, the average responses by the children were significantly longer and more detailed when dolls were not used. Children gave longer and more detailed responses to open-ended invitations when dolls were not used. Caution is necessary when interpreting these findings.

Child↗
PubMed2003

An investigation into expectation-led interviewer effects in health surveys.

Many large-scale health surveys use interviewers to obtain standardised information about the health of the general population. To improve response rates and data quality, the researchers/designers usually brief the interviewers to familiarise them with the survey procedures and stimulate their interest in the survey. However, it is possible that interviewers, having been exposed to researchers' expectations, may inadvertently influence respondents to produce outcomes consistent with those expectations. Such expectations are referred to here as 'expectation-led interviewer effects'. In this paper, the design and results from an experiment to test for expectation-led interviewer effects are described. The experiment involved conducting two health surveys, called the 'experimental' and the 'control', which were identical in every way except that researchers made a reference to a supposed link between childhood and adult health at the experimental survey briefing. The testing procedure was designed prior to data collection to preclude accusations of data dredging and to ensure that the type I error probability was less than 5 percent. No consistent evidence of expectation-led interviewer effects was found, bar a statistically significant effect for health questions requiring the recall of detailed quantitative information. This effect was small, however.

Adult↗