Interrater reliability of the DSM-III-R with preschool children

Little attention has been paid to evaluating the use of DSM-III-R with preschool children. Children (N = 510) ages 2 to 5 years who were screened at the time of a pediatric visit were selected to participate in an evaluation which included questionnaires, a semistructured interview, developmental testing, and a play observation. Following the evaluation, two clinical child psychologists independently assigned DSM-III-R diagnoses. For each diagnostic category, kappa and Y coefficients were calculated; Y coefficients are less sensitive to base rates of disorders. For overall agreement, the weighted mean kappa (.61), and mean Y (.66) were moderately high. Overall agreement that the child had at least one of the disruptive disorders was substantial (kappa = .64; Y = .65); agreement that there was at least one of the emotional disorders was moderate for kappa (.54), but substantial for Y (.70). Kappa coefficients were higher for major categories of disorder than for specific disorders; however, Y coefficients did not show a decline for specific disorders. Interrater reliability of DSM-III-R appears to be similar for preschoolers and older children.