Clinical Assessment of Child and Adolescent Personality and ...

258 chapter 11 structured diagnostic interviewsmore symptoms will require more interviewtime because of the need to ask morefollow-up questions. However, as is evidentfrom Box 11.1, the average time toadminister the interviews does not varymuch across the different schedules andlasts typically from 60 to 90 min.Major Sources of VariationAcross Interview SchedulesFrom the previous discussion it is clear thatthe various interview schedules probablyhave more similarities than differences.However, one of the major differencesacross schedules is the degree of structureinherent in the interview format. All of theinterviews provide some degree of structureand give guidelines for standardizedadministration and scoring. However, thereis substantial variation in the amount of“leeway” given the assessor across the variousinterviews. For example, the K-SADSis one of the least structured of the interviews.The original manual for administrationincludes the following instructions:“The K-SADS supplies a series of questionsaddressed to the child for each item to berated. The aim is not to oblige the rater toask all of the questions. They serve as a guidefor questions which have been found mosthelpful and informative. The rater shouldask as many questions as necessary to arriveat a well-documented rating. Needless tosay, probing should be as neutral as possibleand leading questions should be avoided”(Puig-Antich & Chambers, 1978, p. 2).In contrast, the DISC was designed to havea high degree of structure in administration.The manual for its administrationincludes the following instructions:“The DISC symptom questions are designedto be read exactly as written. There is verylimited scope for independent questioning.DO NOT deviate from the prescribedquestion sequence. DO NOT make up yourown questions because you think you have abetter way of getting at the same information,or because you think the question ispoorly worded” (Fisher et al., 1992, p. 31).The trade-off between leeway and structureis obvious. Less structure allows theassessor to tailor the interview accordingto the needs of the individual client. However,these interviews generally require agreater degree of experience to administerand often have lower levels of reliability(Gutterman, O’Brien, & Young, 1987;Hodges & Zeman, 1993).Another major variation among thestructured interviews for children is thetime frame used to assess symptoms anddiagnoses. All of the interviews assesswhether problems are currently evident.This is called a present episode frame of reference.Most interviews consider present episodesto be within the previous six months,although in some instances the time framemay be as short as within the last two weeks(e.g., ISCA for emotional disorders) or aslong as within the last year (e.g., DISC-IVfor Conduct Disorder). Of note, the CAPArestricts the assessment of symptoms tothe previous three months due to concernswith the reliability of memory in childrenand adults over longer time intervals. Similarly,the Dominic-R does not obtain anytemporal information, such as onset andduration of symptoms, given concerns as tothe validity of such information in youngchildren. Nevertheless, the major sourceof variation is whether or not interviewschedules are limited to present episodes.A number of interviews restrict the focusof assessment to the present episode timeframe (e.g., CAPA and ChIPS). However,an increasing number of interviews providefor the assessment of both present and lifetimediagnoses. For example, the DISC-IV providesa more recently incorporated wholelifemodule assessing for whether or not a