title: Interrater reliability of the assessment of DSM-IV Axis IV psychosocial stressors and environmental problems.
abstract: The interrater reliability of the DSM-IV axis IV psychosocial stressors was investigated in a retrospective chart review study. The complete charts of 98 patients admitted to a specialized psychiatric ward were independently evaluated by three trained clinicians and rated on a questionnaire form comprising the presence and severity of the nine psychosocial stressors of DSM-IV axis IV (DSMSTR9; absent scored 0; mild, 1-3; moderate, 4-6; severe, 6-10). Chance-corrected intraclass correlations (ICC) were calculated for the interrater reliability of DSMSTR9 stressors. DSMSTR9 stressors exhibited sufficiently high levels of interrater reliability regarding presence (ICC = 0.560-0.943; p < 0.0005) and severity (ICC = 0.584-0.953; p < 0.0005) of stressors with slightly higher ICCs for severity assessments. Problems related to the social environment showed the lowest ICCs. According to the present results, the presence and severity of DSM-IV axis IV stressors can be scored sufficiently reliably even in retrospective studies. Including the assessment of presence and severity of DSM-IV axis IV psychosocial and environmental problems in future DSM versions, using a 4-point scale can therefore be recommended.
authors.affiliation: Vitos Clinical Centre, Cappeler Strasse 98, Giessen-Marburg, Germany. dr.matthias.mueller@vitos-giessen-marburg.de
authors.forename: Matthias Johannes
authors.initials: MJ
authors.lastname: Müller
authors.forename: Eckhardt
authors.initials: E
authors.lastname: Koch
mesh_terms: D000328:Adult; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D008875:Middle Aged; D011594:Psychometrics; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012931:Social Environment; D013315:Stress, Psychological / Q000175:diagnosis* / Q000523:psychology