Informant-based determinants of symptom attenuation in structured child psychiatric interviews

Area of Science:

• Child and adolescent mental health research
• Psychometric evaluation of diagnostic instruments

Background:

• Item attenuation, or reduced symptom endorsement at retest, is a known issue in diagnostic interviews.
• Understanding informant-related factors influencing attenuation is crucial for reliable child mental health assessments.

Purpose of the Study:

• To examine informant-related determinants of item attenuation in parent and child reports.
• To investigate factors influencing test-retest reliability in the Diagnostic Interview Schedule for Children (DISC-2.3).

Main Methods:

• Utilized data from 245 parent-child pairs in the National Institute of Mental Health Methods for Epidemiology of Child and Adolescent Mental Disorders Study.
• Administered the Diagnostic Interview Schedule for Children (DISC-2.3) twice with a 12-day interval.
• Employed stepwise regression to identify predictors of item attenuation for both parent (DISC-P) and child (DISC-C) informants.

Main Results:

• High item attenuation rates were observed: 42% for adults and 58% for children.
• For adult informants, younger age, older children, and less impaired children predicted higher attenuation.
• For child informants, less impairment, poorer school functioning, and longer retest intervals predicted higher attenuation.

Conclusions:

• Informant characteristics and child symptom severity significantly impact symptom reporting consistency in diagnostic interviews.
• Findings have implications for designing and interpreting data from structured diagnostic tools like the DISC.
• Addressing informant-related factors may improve the accuracy and reliability of child mental health diagnoses.