CRITERION VALIDITY OF THE NIMH DIAGNOSTIC INTERVIEW SCHEDULE FOR CHILDREN VERSION-2.3 (DISC-2.3)

Objective: To examine the criterion validity of the NIMH Diagnostic In terview Schedule for Children (DISC) Version 2.3 in the NIMH Methods f ar the Epidemiology of Child and adolescent Mental Disorders (MECA) St udy, using a design that permitted several comparisons of DISC-generat ed diagnoses with diagnoses based on clinician symptom ratings. Method : Two hundred forty-seven youths were selected from the 1,285 parent-y outh pairs that constituted the four-site MECA sample. Subjects who sc reened positive for any of the five diagnostic areas under investigati on in the validity study (attention-deficit hyperactivity disorder, op positional defiant disorder, conduct disorder, depressive disorder, an d the major anxiety disorders) were recruited, as well as a comparable number of screen negatives. Clinicians reinterviewed separately both the youth and the primary caregiver using tile DISC followed by a clin ical-style interview, and then they rated the presence of symptoms and impairment. Computer algorithms combined this information into diagno ses using comparable rules for both DISC and clinical rating diagnoses . Results: In general, the DISC showed moderate to good validity acros s a number of diagnoses. Conclusions: Results suggest some specific di agnostic areas in which further revision of the DISC is warranted. Thr ee main sources of variability in DISC-clinician diagnostic agreement were evident over and above that due to the instrument itself, includi ng (1) the informant used, (2) the algorithm applied in synthesizing s ymptom reports, and (3) the design of the validity comparison.