Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-18T16:49:10.589Z Has data issue: false hasContentIssue false

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

Published online by Cambridge University Press:  09 July 2009

Bruce P. Dohrenwend*
Affiliation:
New York State Psychiatric Institute and Columbia University, New York, USA
*
2Address for correspondence: Dr B. P. Dohrenwend, NY State Psychiatric Institute, 722 West 168th Street, Box 8, New York, NY 10032, USA.

Synopsis

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.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1990

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

1

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.

References

Anthony, J. C. & Dryman, A. (1987). Analysis of Discrepancy in lifetime diagnosis of mental disorders: results from the NIMH epidermiologic catchment area Psychiatric Association; Section on Epidemiology and Community Psychiatry, Reykjavik: Iceland.Google Scholar
Anthony, J. C., Folstein, M., Romanoski, A. J., Von Korff, M. R., Nestadt, G. R.Chahal, R., Merchant, A., Hendricks Brown, C., Shario, S., Kramer, M. & Gruenberg, E. (1985). Comparison of the lay diagnostic interview schedule and a standarized psychiatric diagnosis: experiencej in Eastern Baltimore. Archives of General psychiatry 42, 667675.CrossRefGoogle Scholar
Bash, K. W. (1967). Untersuchungen über die Epidemiologie neurolpsychiatrischer Erkrankungen unter der Lnadbevölkerung der Psrovinz Fars, Iran. Aktuelle Fragen der Psychiatrie und Neurolgie 5, 162178Google Scholar
Breslau, N. (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.CrossRefGoogle Scholar
Brown, G. W. & Harris, T. (1978). Social Origins of Depression. Free Press: New York.Google ScholarPubMed
Cohen, J. (1960). A coefficient of agreement for nominal scales. Educational Psychological Measurement 20, 3746.CrossRefGoogle Scholar
Cooper, B. & Morgan, H. G. (1973). Epidemiological Psychiatry. C. C. Thomas: Springfield, IL.Google ScholarPubMed
Derogatis, L. R. (1977). SCL-90R. (revised) Manual I. Clinical Psychometrics Research Unit. Jonhs Hopkins University School of Medicine: Baltimore, MD.Google Scholar
Dohrenwend, B. P. & Dohrenwend, B. S. (1965). The problem of validity in field studies of psychological disorder. Journal of Abnoramal Psychology 70, 5269.CrossRefGoogle ScholarPubMed
Dohrenwend, B. P. & Dohrenwend, B. S. (1974). Social and cultural influences on psycholpathology. Annual Review of Psychology 25, 417452.CrossRefGoogle Scholar
Dohrenwend, B. P. & Dohrenwend, B. S. (1981). Socioenvironmental factors, strees, and psychopathology – Part 1: Quasi-experimental evidence on the social causation-social selection issue posed by class differnces. American journal of Community Psychology 9, 146159.Google Scholar
Dohrenwend, B. P. & Dohrenwend, B. S. (1982). Perspectives on the past and future of psychiatric epidemiolgy. American Journal of Public Health 72, 12711279.CrossRefGoogle Scholar
Dohrenwend, B. P., Yager, T. J., Egri, G. & Mendelsohn, F. S. (1978). The psychiatric status schedule (PSS) as a measure of dimensions of psychopathology in the general population. Archives of General Psychiatry 35, 721739.CrossRefGoogle ScholarPubMed
Dohrenwend, B. P., Oksenberg, L., Shrout, P. E., Dohrenwend, B. S. & Cook, D. (1979). What brief psychiatric screening scales measure.In Health Survey Research Methods: Third Biennial Research Conference, pp. 188198. National Center for Health ServicesResearch. US Department of Health and Human Services, DHHS pub. no. (PHS) 81–3268: Washington, D.C.Google Scholar
Dohrenwend, B. P., Dohrenwend, B. S., Gould, M. S., Link, B., Neugebauer, R. & Wunsch-Hitzig, R. (1980 a). Mental Illness in the United State: Epidemiologic Estimates. Praeger: New York.Google Scholar
Dohrenwend, B. P., Shrout, P. E., Egri, G. & Mendelsohn, F. S. (1980 b). Nonspecific psychological distress and other dimensions psychopathology: measures for use in the general population. Archives of General Psychiatry 37, 12291236.CrossRefGoogle ScholarPubMed
Dohrenwend, B. P., Yager, T. J., Egri, G. & Mendelsohn, F. S. (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.CrossRefGoogle Scholar
Dohrenwend, B. P., Levav, I. & Shrout, P. E. (1986). Screening Scales from the Psychiatric Epidemiology Research Interview (PERI). In Community Surveys of Psychiatric Disorders. (ed. Weissman, M. M., Myers, J. K. and Ross, C.), pp. 349375. Brunswick, N. J.: Rutgers University Press: New Brunswick, NJ.Google Scholar
Duncan-jones, P. & Henderson, S. (1978). The use of a two-phase design in a prevalence survey. Social Psychiatry 13, 231237.CrossRefGoogle Scholar
Endicott, J. & Spitzer, R. L. (1978). A diagnostic interview: The schedule for affective disorders and schizophrenia. Archives of Gerneral Psychiatry 35, 837844.CrossRefGoogle ScholarPubMed
Feighner, J. P., Robins, E., Guze, S. B., Woodruff, R. A., Winokur, G. & Munoz, R. (1972). Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry 26, 5763.CrossRefGoogle ScholarPubMed
Frank, J. D. (1973). persuasion and Healing. Johns Hopkins University Press: Baltimore, MD.Google Scholar
Gillis, L. S., Lewis, J. B. & Slabbert, M. (1965). Psychiatric Disturbance and Alcoholism in the Coloured people of the Cape Peninsula. Univerisity of Cape Town Department of Psychiatry: Cape Town.Google Scholar
Goldberg, D. P. (1972). The Detection of Psychiatric Illness by Questionnaire. Oxford University Press: London.Google Scholar
Hagnell, O. (1966). A Prospective Study of the Incidence of Mental Disorder. Svenska BoKforlaget Norstedts-Bonniers: Stockholm.Google Scholar
Helzer, J. E., Robins, L. N., McEnvoy, L. T., Spitzangel, E. L., Stoltzman, R. K., Farmer, A. & Brockington, I. F. (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.CrossRefGoogle ScholarPubMed
Langner, T. S. (1962). A twenty-two item screening score of psychiatric symptoms indicating impairment. Journal of Health and Human Behaviour 3, 269276.CrossRefGoogle ScholarPubMed
Leckman, J. F., Sholomskas, D., Thompson, D. W., Belanger, A. & Weissman, M. M. (1982). Best estimate of lifetime psychiatric diagnosis: a methodological study. Archives of General Psychiatry 39, 879883.CrossRefGoogle ScholarPubMed
Leighton, D. C., Harding, J. S., Macklin, D. B., Macmillan, A. M. & Leighton, A. H. (1963). The Character of Danger. Basic Books: New York.Google Scholar
Lin, T. (1953). A study of the incidence of mental disorder in Chinese and other cultures. Psychiatry 16, 313336.CrossRefGoogle ScholarPubMed
Link, B. & Dohrenwend, B. P. (1980). Formulation of hypotheses about the true prevalence of demoralization in the United States. In Mental Illness in the United Statse: Epidemiological Estimates (B. P. Dohrenwend, B. S. Dohrenwend, M. S. Gould, B. Link, R. Neugebauer, and R. Wunsch-Hitzig). pp. 114132. Pracger: New York.Google Scholar
Macmilan, A. M. (1957). The health opinion survey: technique for estimating prevalece of psychoneurotic and related types of disorder in communities. Psychological Reports 3, 325329.CrossRefGoogle Scholar
Myers, J. K.Weissman, M. M. (1980). Use of a self-report symptom scale to detect the depressive syndrome. American Journal of Psychiatry 137, 10811084.Google Scholar
Pulver, A. E. & Carpenter, W. T. (1983). Lifetime psychotic symptoms assessed with the DIS. Schizophrenia Bulletin 9, 377382.CrossRefGoogle ScholarPubMed
Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement 1, 385401.CrossRefGoogle Scholar
Raines, G. N. (1952). Foreword in Committee on Nomenclatur and statistics of the Americanm Psychiatric Association. In Diagnostic and Statistical Manual; Mental Disorders. American Psychiatric Association, pp. VXI. Washington, DC.Google Scholar
Regier, D. A., Myers, J. K., Kramer, M., Robins, L. N., Blazer, D. G., Hough, R. L., Eaton, W. W. & Locke, B. Z. (1984). The NIMH epidemiologic catchment area program. Archives of General Psychiatry 41, 934941.CrossRefGoogle ScholarPubMed
Rin, H., Chu, H. & Lin, T. (1966). Psychological reactions of a rural and suburban population in Taiwan. Acta Psychiatrica Scandinavica 42, 410470.CrossRefGoogle Scholar
Roberts, R. E. & Vernon, S. W. (1983). The center for epidemiologic studies depression scale: its use in a community sample. American Journal of Psychiatry 140, 4146.Google Scholar
Robins, E. & Guze, S. B. (1970). Establishment of diagnostic validity in psychiatric illness: Its application to schizophrenia. American Journal of Psychiatry 126, 983987.CrossRefGoogle ScholarPubMed
Robins, L. N. (1985). Epidemiology: reflections on testing the validity of psychiatric interviews. Archives of General psychiatry 42, 918924.CrossRefGoogle ScholarPubMed
Robins, L. N., Helzer, J. E., Croughan, J. & Ratcliff, K. S. (1981). National Institute of Mental Health Diagnostic Interview Schedule: Its history, characteristics, and validity. Archives of General Psychiatry 38, 381389.CrossRefGoogle ScholarPubMed
Seiler, L. H. (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.CrossRefGoogle Scholar
Shore, J. H., Kinziem, J. D., Hampson, J. L. & Pattison, E. M. (1973). Psychiatric epidemiology of an Indian village. psychiatry 36, 7081.CrossRefGoogle ScholarPubMed
Shrout, P. E., Dohrenwend, B. P. & Levav, I. (1986). A discriminant rule for screening cases of diverse diagnostic types: preliminary results. Journal of Consulting Clinical Psychology 54, 314319.CrossRefGoogle ScholarPubMed
Spitzer, R. L. (1983). psychiatric diagnosis: are clinicians still necessary? Comprehensive Psychiatry 24, 399411.CrossRefGoogle ScholarPubMed
Spitzer, R. L. & Endocott, J. (1968). DIAGNO: a computer program for psychiatric diagnosis utilizing the differential diagnostic procedure. Archives of General Psychiatry 18, 746756.CrossRefGoogle ScholarPubMed
Spitzer, R. L., Endicott, J., Flesis, J. L. & Cohen, J. (1970). The psychiatric status schedule: a technique for evaluating psychopathology and impairment in role functioning. Archives of General Psychiatry 23, 4155.CrossRefGoogle ScholarPubMed
Spitzer, R. L., Endicott, J. & Robins, E. (1978). Research diagnostic criteria: rationale and reliability. Archives of General Psychiatry 35, 773782.CrossRefGoogle ScholarPubMed
Spitzer, R. L., Williams, J. B. W., Gibbon, M. & First, M. (1987). Structured Clinical Interview for DSM-III-R (SCID). Biometrics Research Department, New York State psychiatric Institute: New York.Google Scholar
Srole, L., Langner, T. S., Michael, S. T., Opler, M. K. & Rennie, T. A. C. (1962). Mental Health in the Metropolis. McGraw-Hill: New York.Google Scholar
star, S. A. (1950). The screening of psychoneurotics in the army: technical developments of tests. In Measurement and Prediction (ed. Stouffer, S. A., Guttman, L., Suchman, E. A., Lazarsfeld, P. F., Star, S. A. & Clausen, J. A.). vol. 4, pp. 486547. Princeton University Press: Princeton.Google Scholar
Vernon, S. V. & Roberts, R. E. (1982). Use of the SADS-RDC in tri-ethnic community sample. Archives of General psychiatry 39, 4752.CrossRefGoogle Scholar
Weissman, M. M. & Myers, J. K. (1978). Affective disorders in a US urban community: the use of research diagnostic criteria in an eqidemiological survey. Archives of General Psychiatry 35, 13041311.CrossRefGoogle Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974). The Measurement and Classification of Psychiatric Symptoms. Cambridge University Press: London.Google Scholar
Wing, J. K., Mann, S. A., Leff, J. P. & Nixon, J. M. (1978). The concept of a ‘ case ’ in psychiatric population surveys. Psychological Medicine 8, 203217.CrossRefGoogle ScholarPubMed
Woodruff, R. S., Goodwin, D. W. & Guze, S. B. (1974). Psychiatric Diagnosis. Oxford University Press: New York.Google Scholar