期刊
JOURNAL OF ABNORMAL PSYCHOLOGY
卷 124, 期 3, 页码 764-769出版社
AMER PSYCHOLOGICAL ASSOC
DOI: 10.1037/abn0000069
关键词
DSM-IV; DSM-5; diagnosis; reliability; test-retest; SCID
资金
- National Institute of Mental Health [R01-MH068472]
Diagnostic reliability is essential for the science and practice of psychology, in part because reliability is necessary for validity. Recently, the DSM-5 field trials documented lower diagnostic reliability than past field trials and the general research literature, resulting in substantial criticism of the DSM-5 diagnostic criteria. Rather than indicating specific problems with DSM-5, however, the field trials may have revealed long-standing diagnostic issues that have been hidden due to a reliance on audio/video recordings for estimating reliability. We estimated the reliability of DSM-IV diagnoses using both the standard audio-recording method and the test-retest method used in the DSM-5 field trials, in which different clinicians conduct separate interviews. Psychiatric patients (N = 339) were diagnosed using the SCID-I/P; 218 were diagnosed a second time by an independent interviewer. Diagnostic reliability using the audio-recording method (N = 49) was good to excellent (M kappa = .80) and comparable to the DSM-IV field trials estimates. Reliability using the test-retest method (N = 218) was poor to fair (M kappa = .47) and similar to DSM-5 field-trials' estimates. Despite low test-retest diagnostic reliability, self-reported symptoms were highly stable. Moreover, there was no association between change in self-report and change in diagnostic status. These results demonstrate the influence of method on estimates of diagnostic reliability.
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