Agreement among Clinician, Patient, and Independent Interviewer Ratings of Adaptive Functioning

Ora Nakash, Maayan Nagar, Drew Westen

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


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.

Original languageEnglish
Pages (from-to)116-121
Number of pages6
JournalJournal of Nervous and Mental Disease
Issue number2
StatePublished - 1 Feb 2018
Externally publishedYes


  • Interrater reliability
  • adaptive functioning
  • diagnostic efficiency
  • validity


Dive into the research topics of 'Agreement among Clinician, Patient, and Independent Interviewer Ratings of Adaptive Functioning'. Together they form a unique fingerprint.

Cite this