Wittchen H U, Zhao S, Abelson J M, Abelson J L, Kessler R C
Max-Planck-Institut für Psychiatrie Klinisches Institut, Munich, Germany.
Psychol Med. 1996 Nov;26(6):1169-77. doi: 10.1017/s0033291700035893.
We evaluate the long-term test-retest reliability and procedural validity of phobia diagnoses in the UM-CIDI, the version of the Composite International Diagnostic Interview, used in the US National Co-morbidity Survey (NCS) and a number of other ongoing large-scale epidemiological surveys. Test-retest reliabilities of lifetime diagnoses of simple phobia, social phobia, and agoraphobia over a period between 16 and 34 months were K = 0.46, 0.47, and 0.63, respectively. Concordances with the Structured Clinical Interview for DSM-III-R (SCID) were K = 0.45, 0.62, and 0.63, respectively. Diagnostic discrepancies with the SCID were due to the UM-CIDI under-diagnosing. Post hoc analysis demonstrated that modification of UM-CIDI coding rules could dramatically improve cross-sectional procedural validity for both simple phobia (K = 0.57) and social phobia (K = 0.95). Based on these results, it seems likely that future modification of CIDI questions and coding rules could lead to substantial improvements in diagnostic validity.
我们评估了用于美国国家共病调查（NCS）及其他一些正在进行的大规模流行病学调查的综合国际诊断访谈（CIDI）版本——密歇根-综合国际诊断访谈（UM-CIDI）中恐惧症诊断的长期重测信度和程序效度。在16至34个月期间，单纯恐惧症、社交恐惧症和广场恐惧症终生诊断的重测信度分别为K = 0.46、0.47和0.63。与《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）结构化临床访谈（SCID）的一致性分别为K = 0.45、0.62和0.63。与SCID的诊断差异是由于UM-CIDI诊断不足所致。事后分析表明，修改UM-CIDI编码规则可显著提高单纯恐惧症（K = 0.57）和社交恐惧症（K = 0.95）的横断面程序效度。基于这些结果，未来对CIDI问题和编码规则的修改似乎有可能大幅提高诊断效度。
