of the childhood anxiety disorders, the ADIS assesses for nine other childhood disorders (e.g., mood disorder, oppositional defiant disorder, conduct disorder, attention deficit hyperactivity disorder, enuresis, obsessive-compulsive disorder).
Along with symptom endorsement, children and parents are asked to rate for interference or impairment using a 9-point scale ranging from 0 to 8, with 0 being no impairment or no interference and 8 being significant impairment or interference.
Additionally, the clinician conducting the interview generates an overall Clinician Severity Rating of impairment. A Clinician Severity Rating of 4 (moderate degree of impairment) or greater is required to establish presence of a diagnosis.
To examine the psychometric characteristics of the ADIS, one assessor inter- viewed 62 seven- to 16-year-old children (M age10.15 years) and their parents individually on two different occasions, seven to 14 days apart (Silverman, Saavedra,
& Pina,2001). After each interview, the assessor determined DSM-IV (American Psychiatric Association,1994) diagnoses based upon the child interview alone, the parent interview alone, and the two separate interviews considered together. Data were reported for an older age group (12- to 16-year-old children;N23) and for a younger age group (7- to 11-year-old children;N39); however only data for the younger age group are reported below.
Kappa coefficients were used to examine the agreement between a specific anx- iety disorder diagnosis and specific anxiety symptoms, using Landis and Koch’s (1977) criteria ofκ> 0.81 signifying almost perfect agreement between categorical variables, κ 0.61 to 0.80 representing substantial agreement,κ 0.41 to 0.60 demonstrating moderate agreement, andκ 0.21 to 0.40 meaning fair agreement.
Using the child interview alone (ADIS-C) the κ coefficients for separation anxi- ety disorder, social phobia, specific phobia, and generalized anxiety disorder ranged from 0.71 to 0.84, demonstrating substantial to almost perfect agreement. Similarly, using the parent interview alone (ADIS-P), theκcoefficients reflected substantial to almost perfect agreement, withκcoefficients for each of the aforementioned anxiety diagnoses ranging from 0.73 to 0.92. When both child and parent interviews (ADIS-C and ADIS-P) were used together to establish diagnosis in the younger children, theκ coefficients demonstrated almost perfect agreement, with allκcoefficients0.84 or 0.85. Intraclass correlations were used to assess reliability of symptom scale scores and ranged from 0.86 to 0.99 for parent interview, while intraclass correlations for child interview ranged from 0.85 to 0.92. Additionally, to assess for consistency in Clinician Severity Rating of impairment over time, Pearson correlations were con- ducted at two time points (Minterval11.7 days; range 7–14) and werer0.8 for separation anxiety,r0.84 for social anxiety,r0.84 for specific phobia, andr 0.82 for generalized anxiety (nopvalues were reported; Silverman et al.,2001).
The Anxiety Disorders Interview Schedule is currently the most commonly used diagnostic interview in treatment outcome studies for anxiety disorders in older children and adolescents (Schniering, Hudson, & Rapee, 2000). Further, even in the burgeoning field of treatment studies in younger children, the ADIS-P has been widely used to establish anxiety disorder diagnoses (e.g., Bergman et al., 2013;
Comer et al.,2012; Monga, Rosenbloom, Tanha, Owens, & Young,2015; Monga, Young, & Owens,2009; Oerbeck, Stein, Pripp, & Kristensen,2015; Pincus, Santucci, Ehrenreich, & Eyberg,2008; Waters, Ford, Wharton, & Cobham,2009).
2.3.2 Preschool Age Psychiatric Assessment
The Preschool Age Psychiatric Assessment (Egger et al.,1999) is a structured par- ent interview developed to assess DSM-IV-TR (American Psychiatric Association, 2000) disorders in children aged two to five years. It was adapted from the parent ver- sion of the Child and Adolescent Psychiatric Assessment (Angold, Prendergast, Cox, Harrington, Simonoff, & Rutter,1995), a reliable and valid measure of psychopathol- ogy in children aged nine to 18 years. The Preschool Age Psychiatric Assessment assesses for anxiety disorder, mood disorder, oppositional defiant disorder, conduct disorder, attention deficit hyperactivity disorder, as well as enuresis and encopresis based on DSM-IV-TR criteria. It contains 25 modules, which can be administered separately or in any combination, assesses disturbance in 30 areas including, for example, the child’s relationship with his or her parents, and others, or the child’s functioning in the home, at school, or elsewhere.
Egger, Erkanli, Keeler, Potts, Walter, & Angold (2006) examined the psychometric properties of the Preschool Age Psychiatric Assessment with 1073 parents of two- to five-year-old children who were attending a pediatric clinic. The parents completed the Child Behavior Checklist/1½–5 (Achenbach & Rescorla, 2001) and an initial diagnostic interview using the Preschool Age Psychiatric Assessment. A second interview was conducted about one week later (Minterval11 days; rangethree days to one month) by a different clinician who was blind to the results of the first interview. Kappa coefficients were used to assess agreement on categorical variables between the two time points. Kappa coefficients for the various anxiety disorders were as follows:κ0.36 for specific phobia,κ 0.39 for generalized anxiety,κ 0.53 for selective mutism,κ 0.54 for social anxiety, κ 0.60 for separation anxiety disorder, andκ0.49 for any anxiety disorder. Theseκcoefficients, using Landis and Koch’s (1977) criteria as described above, demonstrate fair to moderate reliability. Kappa coefficients for non-anxiety disorders were generally higher and in the moderate to substantial agreement range, i.e., depression (κ0.72), attention deficit hyperactivity disorder (κ0.74), oppositional defiant disorder (κ0.57), and conduct disorder (κ 0.60). Intraclass correlations were used to assess agreement between syndrome scale scores and ranged from a low of 0.57 for specific phobia to a high of 0.73 for social anxiety disorder, with intraclass correlation0.74 for any anxiety disorder. Again, higher intraclass correlations were generally noted for the behavioral disorders and depression, with a low of 0.67 for oppositional defiant disorder to 0.80 for attention deficit hyperactivity disorder (see Egger et al.,2006, for more details).
Although the Preschool Age Psychiatric Assessment is a semi-structured inter- view developed specifically to assess psychiatric disorders in two- to five-year-old children, to date it has not been used extensively in studies evaluating treatment of preschool anxiety disorders.