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National comorbidity survey replication adolescent supplement (NCS-A): I. Background and measures
Kathleen R Merikangas1, Shelli Avenevoli1, E Jane Costello1
1Dr. Merikangas is with the Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health; Dr. Avenevoli is with the Division of Developmental Translational Research, National Institute of Mental Health; Dr. Costello is with the Center for Developmental Epidemiology, Department of Psychiatry and Behavioral Sciences, Duke University Medical School; Dr. Koretz is with Harvard University; and Dr. Kessler is with the Department of Health Care Policy, Harvard Medical School.
Objective:
This article presents an overview of the background and measures used in the National Comorbidity Survey Replication Adolescent Supplement (NCS-A).
Method:
The NCS-A is a national psychiatric epidemiological survey of adolescents aged 13 to 17 years.
Results:
The NCS-A was designed to provide the first nationally representative estimates of the prevalence, correlates, and patterns of service use for DSM-IV mental disorders among U.S. adolescents and to lay the groundwork for follow-up studies of risk and protective factors, consequences, and early expressions of adult mental disorders. The core NCS-A diagnostic interview, the World Health Organization Composite International Diagnostic Interview, is a fully structured research diagnostic interview designed for use by trained lay interviewers. A multiconstruct, multimethod, and multi-informant battery was also included to assess risk and protective factors and barriers to service use. Design limitations due to the NCS-A evolving as a supplement to an ongoing survey of mental disorders of U.S. adults include restricted age range of youths, cross-sectional assessment, and lack of full parental/surrogate informant reports on youth mental disorders and correlates.
Conclusions:
Despite these limitations, the NCS-A contains unparalleled information that can be used to generate national estimates of prevalence and correlates of adolescent mental disorders, risk and protective factors, patterns of service use, and barriers to receiving treatment for these disorders. The retrospective NCS-A data on the development of psychopathology can additionally complement data from longitudinal studies based on more geographically restricted samples and serve as a useful baseline for future prospective studies of the onset and progression of mental disorders in adulthood.
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