Measuring Mental Disorders Tamsin Ford, University of Exeter What the survey was about Why did we need to collect it And what did we hope to achieve from this survey

The assessment of mental health conditions DAWBA – validated standardised diagnostic interview based on DSM-5 and ICD-10 criteria Broad – covers comorbid disorders Validated for 2-18 year olds Efficient: ‘Skip rules’ Continuity with previous surveys – acceptable and feasible

Why use multiple informants increase validity (Versions for children aged 11 plus, teachers and parents) Increase clinical relevance But introduces potential disagreement – from 1999 and 2004, intercorrelations on the SDQ scores between parents, young people and teachers ranged from 0.34-0.52

Teacher Questionnaire Survey link sent in an email from the office Teachers of children aged 5-16 Parental consent to contact a teacher Teacher’s name and email address collected in CAPI using the school look-up called Edubase Online self-completion questionnaire with option for paper questionnaire if no response from teacher to online survey. Email sent out from the office with a link to the online survey At the end of the parent CAPI, parents of 5-16 year olds are asked for permission to contact a teacher (one they feel knows their child the most) If the parent agrees, you will collect the teacher’s name and email address in CAPI

Mental Health and Mental Disorders Any disorder Emotional Depression Anxiety Behavioural Oppositional defiant disorder A number of conduct disorders Hyperactivity Hyperkinetic disorder Other hyperactivity disorder Other Less Common Autism spectrum disorder Eating disorder, Tic disorder and others The survey is distinctive because it examined different types of disorder. Emotional disorders, Include anxiety and depression. Behavioural disorders, including oppositional defiant disorder and a number of other conduct disorders. Hyperactivity disorders Hyperactivity disorder includes a more restrictive set of criteria than ADHD, so prevalence reported here is likely lower than the prevalence of ADHD. Other less common disorders Includes autism spectrum disorders (ASD), eating disorders, tic disorders, and a number of conditions experienced rarely in children.

Types of anxiety disorder Separation anxiety Specific phobia Social phobia Panic and agoraphobia Obsessive Compulsive Disorder Post Traumatic Stress Disorder Generalised anxiety disorder Body dysmorphic disorder

Why clinical rating? Highly structured questions relating to diagnostic criteria (highly structured assessments are very reliable but not always valid Informants prompted to provide qualitative data about difficulties, (semi-structured data is highly valid but not always reliable) Disagreements between informants; who is right? Not otherwise specified diagnoses 2 clinical raters independently rated 500 children in the 1999 survey: ₭ = 0.86 for any disorder 0.57 for emotional disorders & 0.98 for externalising disorders http://www.dawba.com/py/dawbainfo/b4.py