Interviewing as communication: An alternative way of administering the diagnostic interview schedule for children

Parents of 24 children referred to an outpatient psychology clinic (mean child age 10.8, range 615) were administered the Diagnostic Interview Schedule for Children Version 2.3 (DSIC-2.3) twice in a 1-week test-retest reliability design (mean retesting interval = 7.5 days, range = 6-11 days). An alternative mode of administration of the DISC, based on communication principles, was used, involving (a) a schematic representation of the areas to be covered; (b) definition of a common language for the categories, diagnoses, and criteria; and (c) the respondent being allowed to select the order in which the diagnostic areas were covered. The DISC items and modules were unchanged. Symptom scores derived from the DISC were highly reliable over 1 week (average ICC = .85, range = .67-.95) and showed no attenuation from Time 1 to Time 2. Reliability of DSM diagnoses averaged kappa = .80 (range = .63-1.0). There was no significant attenuation in diagnoses from Time 1 to Time 2. Overall, this alternative way of administering the DISC appears to have promise for reducing attenuation and boosting the reliability - and ultimately the validity - of child psychiatric diagnoses. Further investigations of the mechanisms underlying these effects, and further studies with child and adolescent respondents and nonreferred community samples are recommended.