Additionally, and most importantly, it is unknown whether these semistructured interviews yield symptom severity dimensions that are reliable and valid. Some researchers have used semistructured interviews such as the SCID or Anxiety Disorders Interview Schedule (ADIS‐IV Brown, DiNardo, & Barlow, 1994) to assess psychopathology dimensionally, but they have only focused on a single symptom domain (Abela, Skitch, Auerbach, & Adams, 2005) and have not examined past, as well as current, psychopathology (Brown, Chorpita, & Barlow, 1998 Kotov, Gamez, & Watson, 2005). Although there are several interviews designed to assess one or more dimensions of a single area of psychopathology (e.g., Positive and Negative Syndrome Scale for Schizophrenia Kay, Fiszbein, & Opler, 1987), there is no semistructured interview designed to assess a broad array of psychopathology both categorically and dimensionally and for both current and past symptoms. Compared to paper‐and‐pencil questionnaires, semistructured interviews such as the Structured Clinical Interview for DSM (SCID First, Williams, Karg, & Spitzer, 2015) allow for the probing and clarification of responses and are not as impacted by respondents' reading level, an important concern of many questionnaires (Schinka, 2012). Most measures designed to assess psychopathology dimensionally are paper‐and‐pencil questionnaires that either only assess current psychopathology (e.g., a depression scale that assesses symptoms during previous 2 weeks) or broader traits (e.g., personality disorder measures such as the Personality Inventory for DSM‐5 Krueger, Derringer, Markon, Watson, & Skodol, 2012). Additionally, a meta‐analysis reported that compared to when psychopathology is assessed categorically, psychopathology defined dimensionally has 15% greater reliability and 37% greater validity (Markon, Chmielewski, & Miller, 2011).ĭespite these psychometric advantages, the best method to assess psychopathology dimensionally is lacking. Indeed, numerous taxometric and simulation studies have shown that most psychopathologies are not discrete entities and are better conceptualized as continuous (i.e., dimensional) constructs (Haslam, Holland, & Kuppens, 2012 Ruscio & Marcus, 2007) or perhaps hybrids of dimensional and categorical constructs (Muthen, 2006). One of the major critiques of the DSM is that it conceptualizes disorders as discrete (i.e., categorical) entities in which hard cut points are used to classify individuals as either “with” or “without” the disorder (Helzer, Kraemer, & Krueger, 2006 Insel et al., 2010). These results highlight the feasibility and utility of the SCID to assess reliable and valid symptom severity dimensions of both current and lifetime psychopathology.Īlthough the modern Diagnostic and Statistical Manuals of Mental Disorders (DSM post‐1980) have provided stakeholders of mental health services (researchers, clinicians, patients, etc.) a common nomenclature to describe psychopathology, the system has received numerous critiques (Thyer, 2015 Wakefield, 2016 Widiger & Clark, 2000). The psychometric properties of SCID‐identified symptom scales were far superior to the psychometrics of categorical diagnoses for both current and lifetime psychopathology. Symptom severity scales demonstrated significant incremental validity over and above categorical diagnoses for both current and prospective outcomes. The SCID's severity scales demonstrated substantial internal consistency (all Cronbach's αs >.80), test–retest reliability, and concurrent and predictive validity. Dimensional severity scales were created from an adapted version of the SCID for both current and lifetime major depression, alcohol, substance, post‐traumatic stress disorder, panic, agoraphobia, social anxiety, specific phobia, obsessive–compulsive disorder, and generalized anxiety disorder. Retest reliability and prospective predictive validity (symptoms and functioning 1 year later) were examined in subsamples of participants. Participants ( N = 234) were recruited from the community and clinics. The present study also examined whether these severity dimensions have better psychometric properties (internal consistency, test–retest reliability, and concurrent and predictive validity) than categorical diagnoses. This study examined whether the Structured Clinical Interview for DSM (SCID), a widely used semistructured interview designed to assess psychopathology categorically, can be adapted to identify reliable and valid severity dimensions of psychopathology.
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