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Diagnostic validity across racial and ethnic groups in the assessment of adolescent DSM‐IV disorders

We examine differential validity of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM‐IV) diagnoses assessed by the fully‐structured Composite International Diagnostic Interview Version 3.0 (CIDI) among Latino, non‐Latino Black, and non‐Latino White adolescents in comparison to gold standard diagnoses derived from the Schedule for Affective Disorders and Schizophrenia for School‐age Children (K‐SADS). Results are based on the National Comorbidity Survey Replication Adolescent Supplement, a national US survey of adolescent mental health. Clinicians re‐interviewed 347 adolescent/parent dyads with the K‐SADS. Sensitivity and/or specificity of CIDI diagnoses varied significantly by ethnicity/race for four of ten disorders. Modifications to algorithms sometimes reduced bias in prevalence estimates, but at the cost of reducing individual‐level concordance. These findings document the importance of assessing fully‐structured diagnostic instruments for differential accuracy in ethnic/racial subgroups. Copyright © 2012 John Wiley & Sons, Ltd.