title: Diagnostic validity across racial and ethnic groups in the assessment of adolescent DSM-IV disorders.
abstract: We examine differential validity of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnoses assessed by the fully-structured Composite International Diagnostic Interview Version 3.0 (CIDI) among Latino, non-Latino Black, and non-Latino White adolescents in comparison to gold standard diagnoses derived from the Schedule for Affective Disorders and Schizophrenia for School-age Children (K-SADS). Results are based on the National Comorbidity Survey Replication Adolescent Supplement, a national US survey of adolescent mental health. Clinicians re-interviewed 347 adolescent/parent dyads with the K-SADS. Sensitivity and/or specificity of CIDI diagnoses varied significantly by ethnicity/race for four of ten disorders. Modifications to algorithms sometimes reduced bias in prevalence estimates, but at the cost of reducing individual-level concordance. These findings document the importance of assessing fully-structured diagnostic instruments for differential accuracy in ethnic/racial subgroups.
authors.affiliation: School of Education, Boston University, Boston, MA, USA.
authors.forename: Jennifer Greif
authors.initials: JG
authors.lastname: Green
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Gruber
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Kessler
authors.forename: Julia Y
authors.initials: JY
authors.lastname: Lin
authors.forename: Katie A
authors.initials: KA
authors.lastname: McLaughlin
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Sampson
authors.forename: Alan M
authors.initials: AM
authors.lastname: Zaslavsky
authors.forename: Margarita
authors.initials: M
authors.lastname: Alegria
mesh_terms: D000293:Adolescent; D000465:Algorithms; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005006:Ethnicity; D005260:Female; D006801:Humans; D007406:Interview, Psychological / Q000379:methods; D008297:Male; D001523:Mental Disorders / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology*; D011569:Psychiatric Status Rating Scales; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires