![]() The end result is that researchers rarely provide specific estimates of diagnostic reliability derived from the studied sample. For example, researchers simply state that interviewers were thoroughly trained, or that the specific interview(s) used were shown to be reliable in the past. This belief, combined with the resources required to obtain estimates of diagnostic reliability, has led to cursory attention being given to diagnostic judgments in the scientific literature. DSM-III’s operationalized criterion sets improved diagnostic reliability, leading to the widespread belief that the manual solved this problem ( Klerman, 1984 Spitzer, Forman, & Nee, 1979). Prior to DSM-III ( American Psychiatric Association, 1980), diagnostic reliability was poor, due in part to the lack of specific diagnostic criteria ( Spitzer & Fleiss, 1974). Finally, diagnostic reliability is essential for diagnostic validity ( Nelson-Gray, 1991 Spitzer & Fleiss, 1974). ![]() Diagnostic unreliability can lead to erroneous interpretations regarding the structure of mental disorders, their natural course, the nature of symptom change, and treatment efficacy moreover, it greatly increases the likelihood that research findings will not replicate. Without reliable diagnoses, accurate identification of risk factors for psychopathology becomes nearly impossible. These results demonstrate the influence of method on estimates of diagnostic reliability.ĭiagnostic reliability is essential for advancing the science and practice of psychology ( Regier et al., 2013). Moreover, there was no association between change in self-report and change in diagnostic status. Despite low test-retest diagnostic reliability, self-reported symptoms were highly stable. 47) and similar to DSM-5 Field-Trials’ estimates. Reliability using the test-retest method ( N = 218) was “poor” to “fair” ( M kappa =. 80) and comparable to the DSM-IV Field Trials estimates. Diagnostic reliability using the audio-recording method ( N = 49) was “good” to “excellent” ( M kappa =. Psychiatric patients ( N = 339) were diagnosed using the SCID-I/P 218 were diagnosed a second time by an independent interviewer. ![]() We estimated the reliability of DSM-IV diagnoses using both the standard audio-recording method and the test-retest method used in the DSM-5 Field Trials, in which different clinicians conduct separate interviews. Rather than indicating specific problems with DSM-5, however, the Field Trials may have revealed long-standing diagnostic issues that have been hidden due to a reliance on audio/video-recordings for estimating reliability. Recently, the DSM-5 Field Trials documented lower diagnostic reliability than past field trials and the general research literature, resulting in substantial criticism of the DSM-5 diagnostic criteria. Diagnostic reliability is essential for the science and practice of psychology, in part because reliability is necessary for validity.
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