Validity of structured clinical evaluations in adolescents with conduct and substance problems.
OBJECTIVE
To determine discriminative and convergent validity for certain structured diagnostic assessments among adolescents with conduct and substance problems.


METHODS
Patients were 87 adolescents (both genders) in treatment for conduct and substance problems. Most controls (n = 85; both genders) came from patients' neighborhoods. Assessments included Diagnostic Interview Schedule for Children, Composite International Diagnostic Instrument-Substance Abuse Module, Child Behavior Checklist, and others. Patients' data guided clinical care.


RESULTS
Youths' self-reports significantly discriminated patients from controls in DSM-IVconduct and substance use disorders (CD, SUD) and in numerous associated measures. CD and SUD symptoms correlated strongly. However, some patients apparently minimized symptoms. Youths' self-reports did not discriminate patients from controls in attention-deficit/hyperactivity disorder (ADHD) or major depression (MDD). Parent information raised prevalence rates of ADHD and MDD, which then discriminated patients from controls. However, patients and parents usually disagreed on MDD and ADHD diagnoses.


CONCLUSIONS
Despite some dissimulation, patients' self-reports of CD and SUD correlated highly and had superb discriminative validity, making them useful for treatment and research. Self-reports of ADHD and MDD, apparently lacking discriminative validity, are less useful. Parent reports improve these discriminations but present additional problems.
Crowley
T J
TJ
Psychiatry Department, University of Colorado Medical School, Denver 80262, USA. Thomas.Crowley@uchsc.edu
Mikulich
S K
SK
Ehlers
K M
KM
Whitmore
E A
EA
MacDonald
M J
MJ
D000293:Adolescent; D000296:Adolescent Psychiatry; D019955:Conduct Disorder / Q000175:diagnosis* / Q000523:psychology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D012680:Sensitivity and Specificity; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000523:psychology