An Investigation Of The Consistency Of Diagnostic Concepts Among Five Child And Adolescent Psychiatrists

Five experienced child and adolescent psychiatrists provided descriptions on a 63-item symptom and behavior rating scale of their concepts of typical patients belonging to 18 different diagnostic groups. An empirical classification of the 18 diagnoses into six major categories was accomplished by transposed (Q-type) factor analysis of the mean profiles for the 18 childhood psychiatric disorders. The consistency of the diagnostic concepts held by the five psychiatrists was next examined using a transposed (Q-type) marker variable factor analysis of the 5 X 18 = 90 individual diagnostic profiles. Conceptions of a diagnostic entity were considered consistent if the profiles provided by the several psychiatrists projected most highly on the same oblique reference factor. This permitted identification of 14 diagnoses for which the psychiatrists' conceptions of typical patient profiles were generally consistent, and four diagnoses for which consistency was not evident. The method also permitted examination of the diagnostic conceptions of an individual psychiatrist relative to the consensus of the group.