Who's up first? Testing for order effects in structured interviews using a counterbalanced experimental design.

Area of Science:

• Psychological assessment
• Child and adolescent psychiatry
• Clinical research methodology

Background:

• Interview process variables, beyond question wording, can influence participant responses.
• The reliability of diagnostic interviews is crucial for accurate clinical assessment and research.
• Understanding potential biases in structured interviews is essential for improving data quality.

Purpose of the Study:

• To investigate the impact of diagnostic module presentation order on responses within the Diagnostic Interview Schedule for Children (DISC).
• To determine if altering the sequence of DISC modules affects symptom endorsement, impairment ratings, and diagnostic outcomes.

Main Methods:

• A counterbalanced design was employed to administer two DISC diagnostic modules.
• Modules were presented to child and parent participants in either standard or reversed order.
• Data collected included symptom endorsement, reported impairment, and diagnostic criteria fulfillment.

Main Results:

• The order of module administration significantly affected the total number of symptoms endorsed.
• Presentation sequence influenced the reported level of impairment and the likelihood of meeting diagnostic criteria.
• These effects were observed irrespective of whether data came from child or parent respondents.

Conclusions:

• The sequence of diagnostic modules in interviews like the DISC can introduce bias.
• Future assessment instruments and interview protocols must account for order effects.
• Novel approaches in instrument design and interview procedures are needed to mitigate these biases.