title: Screening young adult cancer survivors for distress with the Distress Thermometer: Comparisons with a structured clinical diagnostic interview.
abstract: BACKGROUND
  The validity of the Distress Thermometer (DT) as a screen for psychological distress in young adult cancer survivors was assessed by comparing it with the results of a psychiatric diagnostic interview, the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) (SCID), to evaluate the accuracy of the DT and identify optimal cutoff scores for this population.
  
  
  METHODS
  A total of 247 survivors aged 18 to 40 years completed the DT and SCID. Based on the SCID, participants were classified as having: 1) ≥ 1 SCID diagnoses; 2) significant symptoms, but no SCID diagnosis; or 3) no significant SCID symptoms. Receiver operating characteristic analyses determined the sensitivity and specificity of all possible DT cutoff scores for detecting survivors with a SCID diagnosis, and subsequently for survivors with significant SCID symptoms or a SCID diagnosis.
  
  
  RESULTS
  The recommended DT cutoff score of ≥5 failed to identify 31.81% of survivors with a SCID diagnosis (sensitivity of 68.18% and specificity of 78.33%), and 32.81% of survivors with either significant SCID symptoms or a SCID diagnosis. No alternative DT cutoff score met the criteria for acceptable sensitivity (≥85%) and specificity (≥75%).
  
  
  CONCLUSIONS
  The DT does not reliably identify young adult cancer survivors with psychiatric problems identified by a "gold standard" structured psychiatric interview. Therefore, the DT should not be used as a stand-alone psychological screen in this population. Cancer 2016;122:296-303. © 2015 American Cancer Society.
authors.affiliation: Dana-Farber Cancer Institute, Perini Family Survivors' Center, Boston, Massachusetts.|Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Recklitis
authors.affiliation: Dana-Farber Cancer Institute, Perini Family Survivors' Center, Boston, Massachusetts.
authors.forename: Jaime E
authors.initials: JE
authors.lastname: Blackmon
authors.affiliation: Department of Psychiatry, VA Boston Healthcare System, Brockton, Massachusetts.|Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.
authors.forename: Grace
authors.initials: G
authors.lastname: Chang
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D015994:Incidence; D007407:Interviews as Topic; D008297:Male; D008403:Mass Screening / Q000379:methods*; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D012372:ROC Curve; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D013315:Stress, Psychological / Q000175:diagnosis* / Q000453:epidemiology; D017741:Survivors / Q000523:psychology*; D013821:Thermometers; D055815:Young Adult
keywords: 4th Edition (SCID); Distress Thermometer; Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders; anxiety; cancer survivors; depression; validation