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‘The problem of validity in field studies of psychological disorders’revisited1

  • Bruce P. Dohrenwend (a1)

Since the turn of the century and up to about 1980, there have been two generations of epidemiological studies of the true prevalence of psychiatric disorders: a pre-World War II first generation and a post-World War II second generation. With the appearance of DSM-III in 1980 and the changes in epidemiological proceducres coincident with it, it has become meaningful in the US to talk about the beginnings of a new, third generation or studies in psychiatric epidemiology. The purposes of this paper are: first, to briefly summarize the problems of validity with the procedures for case identification and diagnosis in the first-and second-generation studies; second, to consider some of the newer developments with regard to diagnostic instruments that either are or should be influencing third-generation studies; third, to discuss some of the problems of validity in the handful of third-generation studies done so far; and fourth, to describe and illustrate an approach that seems to make sense in the context of gaps in knowledge of aetiology and pathogenesis that leave us still dependent on interviews for case identification and classification.

Corresponding author
2Address for correspondence: Dr B. P. Dohrenwend, NY State Psychiatric Institute, 722 West 168th Street, Box 8, New York, NY 10032, USA.
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This paper was presented at the 1988 Annual Meeting of the American Psychopathological Association and is published in The Validity of Psychiatric Diagnosis (ed. L. N. Robins and J. E. Barrett), American Psychopathological Association Serices, Raven Press and includes some updating of the account of the epidemiological study in lsrael.

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J. C. Anthony , M. Folstein , A. J. Romanoski , M. R. Von Korff , G. R. Nestadt R. Chahal , A. Merchant , C. Hendricks Brown , S. Shario , M. Kramer & E. Gruenberg (1985). Comparison of the lay diagnostic interview schedule and a standarized psychiatric diagnosis: experiencej in Eastern Baltimore. Archives of General psychiatry 42, 667675.

N. Breslau (1985). Depressive symptons, major depression and generalized anxiety: a comparison of self-reports of CES-D and results from diagnostic interviews. Psychiatry Research 15, 219229.

J. Cohen (1960). A coefficient of agreement for nominal scales. Educational Psychological Measurement 20, 3746.

B. P. Dohrenwend & B. S. Dohrenwend (1965). The problem of validity in field studies of psychological disorder. Journal of Abnoramal Psychology 70, 5269.

B. P. Dohrenwend & B. S. Dohrenwend (1974). Social and cultural influences on psycholpathology. Annual Review of Psychology 25, 417452.

B. P. Dohrenwend & B. S. Dohrenwend (1982). Perspectives on the past and future of psychiatric epidemiolgy. American Journal of Public Health 72, 12711279.

B. P. Dohrenwend , T. J. Yager , G. Egri & F. S. Mendelsohn (1978). The psychiatric status schedule (PSS) as a measure of dimensions of psychopathology in the general population. Archives of General Psychiatry 35, 721739.

B. P. Dohrenwend , P. E. Shrout , G. Egri & F. S. Mendelsohn (1980 b). Nonspecific psychological distress and other dimensions psychopathology: measures for use in the general population. Archives of General Psychiatry 37, 12291236.

B. P. Dohrenwend , T. J. Yager , G. Egri & F. S. Mendelsohn (1980 c). Some problems of validity with the Psychiatric Status Schedule as an instrument for case identification and classification in the general population (letter to the editor). Archives of General Psychiatry 37, 720721.

P. Duncan-jones & S. Henderson (1978). The use of a two-phase design in a prevalence survey. Social Psychiatry 13, 231237.

J. Endicott & R. L. Spitzer (1978). A diagnostic interview: The schedule for affective disorders and schizophrenia. Archives of Gerneral Psychiatry 35, 837844.

J. P. Feighner , E. Robins , S. B. Guze , R. A. Woodruff , G. Winokur & R. Munoz (1972). Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry 26, 5763.

J. E. Helzer , L. N. Robins , L. T. McEnvoy , E. L. Spitzangel , R. K. Stoltzman , A. Farmer & I. F. Brockington (1985). A comparison of clinical and diagnostic interview schedule diagnoses: physician reexamination of lay-interviewed cases in the general population. Archives of General Psychiatry 42, 657666.

T. S. Langner (1962). A twenty-two item screening score of psychiatric symptoms indicating impairment. Journal of Health and Human Behaviour 3, 269276.

J. F. Leckman , D. Sholomskas , D. W. Thompson , A. Belanger & M. M. Weissman (1982). Best estimate of lifetime psychiatric diagnosis: a methodological study. Archives of General Psychiatry 39, 879883.

A. M. Macmilan (1957). The health opinion survey: technique for estimating prevalece of psychoneurotic and related types of disorder in communities. Psychological Reports 3, 325329.

A. E. Pulver & W. T. Carpenter (1983). Lifetime psychotic symptoms assessed with the DIS. Schizophrenia Bulletin 9, 377382.

L. S. Radloff (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement 1, 385401.

D. A. Regier , J. K. Myers , M. Kramer , L. N. Robins , D. G. Blazer , R. L. Hough , W. W. Eaton & B. Z. Locke (1984). The NIMH epidemiologic catchment area program. Archives of General Psychiatry 41, 934941.

H. Rin , H. Chu & T. Lin (1966). Psychological reactions of a rural and suburban population in Taiwan. Acta Psychiatrica Scandinavica 42, 410470.

E. Robins & S. B. Guze (1970). Establishment of diagnostic validity in psychiatric illness: Its application to schizophrenia. American Journal of Psychiatry 126, 983987.

L. N. Robins (1985). Epidemiology: reflections on testing the validity of psychiatric interviews. Archives of General psychiatry 42, 918924.

L. N. Robins , J. E. Helzer , J. Croughan & K. S. Ratcliff (1981). National Institute of Mental Health Diagnostic Interview Schedule: Its history, characteristics, and validity. Archives of General Psychiatry 38, 381389.

L. H. Seiler (1973). The 22-item scale used in field studies of mental illness: a question of method, a question of substance, and a question of theory. Journal of Health & Social Behavior 14, 252264.

P. E. Shrout , B. P. Dohrenwend & I. Levav (1986). A discriminant rule for screening cases of diverse diagnostic types: preliminary results. Journal of Consulting Clinical Psychology 54, 314319.

R. L. Spitzer (1983). psychiatric diagnosis: are clinicians still necessary? Comprehensive Psychiatry 24, 399411.

R. L. Spitzer & J. Endocott (1968). DIAGNO: a computer program for psychiatric diagnosis utilizing the differential diagnostic procedure. Archives of General Psychiatry 18, 746756.

R. L. Spitzer , J. Endicott , J. L. Flesis & J. Cohen (1970). The psychiatric status schedule: a technique for evaluating psychopathology and impairment in role functioning. Archives of General Psychiatry 23, 4155.

R. L. Spitzer , J. Endicott & E. Robins (1978). Research diagnostic criteria: rationale and reliability. Archives of General Psychiatry 35, 773782.

S. V. Vernon & R. E. Roberts (1982). Use of the SADS-RDC in tri-ethnic community sample. Archives of General psychiatry 39, 4752.

M. M. Weissman & J. K. Myers (1978). Affective disorders in a US urban community: the use of research diagnostic criteria in an eqidemiological survey. Archives of General Psychiatry 35, 13041311.

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