K-SADS in context: Testing measurement equivalence across race, ethnicity, and socioeconomic factors

Rates of youth mental disorders vary across White, Black, and Hispanic youths in the United States. The weak evidence for the generalizability of diagnostic tools significantly challenges the understanding of racial and ethnic differences in mental disorder risks. The Kiddie-Schedule for Affective Disorders and Schizophrenia is a widely used diagnostic interview. However, its applicability across racial and ethnic groups is questionable. The present study tested the statistical generalizability, or measurement equivalence, of the Kiddie-Schedule for Affective Disorders and Schizophrenia across Hispanic (n = 2,015), non-Hispanic White (n = 6,021) and non-Hispanic Black (n = 1,420) youths, using data from the Adolescent and Brain Cognitive Development Study. The sample was diverse in terms of child's sex assigned at birth. Our results indicated that the Kiddie-Schedule for Affective Disorders and Schizophrenia screening interview had a one-factor structure that was scalar equivalent. However, nearly 50% of its items functioned differently across groups, suggesting unequal probabilities of symptom endorsement at equivalent levels of mental disorder risks. Crucially, socioeconomic factors explained many of the measurement differences across groups, implicating their role in the validity of symptom reporting. Findings from this study can help develop clinical screening tools that are generalizable across race, ethnicity, and socioeconomic factors, which is important for a contextualized understanding of racial and ethnic differences in youth mental disorders. (PsycInfo Database Record (c) 2026 APA, all rights reserved).