Computerized adaptive self-report diagnostic assessment for mental health: the SC

DESCRIPTION (provided by applicant): In order to improve our understanding and treatment of mental illnesses, the primary mission of the National Institutes of Mental Health (NIMH), one must first accurately diagnose research participants and patients receiving routine clinical care. In this way, the appropriate links may be drawn between specific disorders, biological markers, and the effectiveness of treatments. The gold-standard for diagnosing mental health disorders is a standardized clinician-administered interview. However, such diagnostic interviews are not always practical in research and clinical practice due to time, expertise, and monetary requirements. Currently only one validated self-report diagnostic assessment exists, namely the Psychiatric Diagnostic Screening Questionnaire (PDSQ). However, this instrument was not developed for and has not been validated with a community mental health population. The PDSQ also lacks many important features that ease respondent and staff burden and increase usefulness in research and clinical practice. Given the tremendous need for valid cost-effective diagnostic assessments, we propose to develop the SCID-SR, a computerized, adaptive self-report diagnostic assessment with self-scoring, instantaneous narrativereport generation, and a searchable response database. The SCID-SR will contain 15 diagnostic categories and will be based on the SCID-I, a gold-standard clinician administered diagnostic assessment for Axis I disorders, which uses criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). The SCID-SR will be appropriate for use with an adult community mental health population, including SPMI individuals. It will be developed using rigorous item authoring methods that have been used successfully in previous SBIR projects and produce items that are easy to read and understand, hold widespread cultural relevance, and are amenable to direct translation to other languages. SCID-SR items will be reviewed and rated by an Expert Panel during development and subsequently tested with three iterative rounds of cognitive interviewing with 60 adult community mental health outpatients from one of the largest private non-profit mental health organizations in the U.S.Cognitive interviews will include thinkalouds by participants while responding to the SCID-SR self-report items, follow-up interview questions pertaining to vocabulary, timeframe and selection of responses, as well as a modified set of SCID-I questions inorder to establish correspondence between SCID-SR responses and SCID-I ratings by a trained interviewer. Results of cognitive interviews will inform the selection of the final set of SCID-SR items by the Expert Panel. The final set of SCID-SR items will undergo full quantitative validation with a large, diverse sample of community mental health outpatients in Phase II. Necessary revisions of the SCID-SR to conform with DSM-V, scheduled for release in 2013, will also be completed in Phase II. PUBLICHEALTH RELEVANCE: Accurate diagnoses are the necessary first step to improving our understanding and treatment of mental illnesses, the primary mission of the National Institutes of Mental Health (NIMH). Availability of the SCID-SR, a computerized, adaptive self-report diagnostic assessment of Axis I mental health disorders, will provide researchers and clinicians with a rigorous, cost-effective alternative to clinician-administered diagnostic assessments. The SCID-SR will include Likert response sets, concise, easy to read and understand questions, automated scoring, instantaneous generation of comprehensive narrative reports, and a searchable response database, which will ease staff and respondent burden and increase usefulness in research and clinical practice.