TY - JOUR
T1 - Agreement among Clinician, Patient, and Independent Interviewer Ratings of Adaptive Functioning
AU - Nakash, Ora
AU - Nagar, Maayan
AU - Westen, Drew
N1 - Publisher Copyright:
© 2018 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2018/2/1
Y1 - 2018/2/1
N2 - We examined the interrater reliability and diagnostic efficiency of clinician report (both the treating clinician and independent expert clinical interviewer) and patient self-report of clinically meaningful information pertaining to adaptive functioning. A convenience sample of clinicians (N = 80) and patients (N = 170) from eight community mental health clinics in Israel participated in the study. Our findings suggest that clinicians overall reliably report on adaptive functioning of patients (overall correct classification rates range, 0.74-0.98). Yet, in some areas, they may fail to collect necessary information such as self-mutilation history, loss of job in the past 5 years, and adult physical abuse. The patterns of higher versus lower diagnostic efficiency suggest that both treating clinicians and independent clinician interviewers tend to make judgments conservatively, essentially sacrificing sensitivity for specificity, not diagnosing events unless they were certain, thus maximizing false-negatives and minimizing false-positives.
AB - We examined the interrater reliability and diagnostic efficiency of clinician report (both the treating clinician and independent expert clinical interviewer) and patient self-report of clinically meaningful information pertaining to adaptive functioning. A convenience sample of clinicians (N = 80) and patients (N = 170) from eight community mental health clinics in Israel participated in the study. Our findings suggest that clinicians overall reliably report on adaptive functioning of patients (overall correct classification rates range, 0.74-0.98). Yet, in some areas, they may fail to collect necessary information such as self-mutilation history, loss of job in the past 5 years, and adult physical abuse. The patterns of higher versus lower diagnostic efficiency suggest that both treating clinicians and independent clinician interviewers tend to make judgments conservatively, essentially sacrificing sensitivity for specificity, not diagnosing events unless they were certain, thus maximizing false-negatives and minimizing false-positives.
KW - Interrater reliability
KW - adaptive functioning
KW - diagnostic efficiency
KW - validity
UR - http://www.scopus.com/inward/record.url?scp=85041699527&partnerID=8YFLogxK
U2 - 10.1097/NMD.0000000000000765
DO - 10.1097/NMD.0000000000000765
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C2 - 29176497
AN - SCOPUS:85041699527
SN - 0022-3018
VL - 206
SP - 116
EP - 121
JO - Journal of Nervous and Mental Disease
JF - Journal of Nervous and Mental Disease
IS - 2
ER -