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Parent, Child, and Combined Algorithms

Peter Jensen, MD; Margaret Roper, MS; Prudence Fisher, MS; John Piacentini, PhD; Glorisa Canino, PhD; John Richters, PhD; Maritza Rubio-Stipec, MA; Mina Dulcan, MD; Sherryl Goodman, PhD; Mark Davies, MPH; Donald Rae, MS; David Shaffer, MD; Hector Bird, MD; Benjamin Lahey, PhD; Mary Schwab-Stone, MD

Arch Gen Psychiatry. 1995;52(1):61-71.

Abstract
Background
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).

Methods
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).

Results
Test-retest reliabilities of the DISC-PC ranged from moderate to substantial for diagnoses in the clinical sample. Test-retest 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.

Conclusions
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.

Author Affiliations
From the National Institute of Mental Health, Rockville, Md (Drs Jensen and Richters, Ms Roper, and Mr Rae); the Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons, New York, NY (Ms Fisher, Drs Piacentini, Shaffer, and Bird, and Mr Davies); the Department of Psychiatry, University of Puerto Rico, San Juan (Dr Canino and Ms Rubio-Stipec); the Department of Psychiatry, Emory University School of Medicine, Atlanta, Ga (Drs Dulcan and Goodman); the Department of Psychiatry, University of Miami (Fla) School of Medicine (Dr Lahey); and the Yale Child Study Center, Yale University School of Medicine, New Haven, Conn (Dr Schwab-Stone).

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