This Phase II SBIR grant is a follow-up to the Phase I SBIR grant "Computerized Screening for Comorbidity in Adolescents with Substance or Psychiatric Disorders." During Phase I, parent and adolescent self- administered computerized versions of the psychiatric interview, the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS), were developed to assess DSM-IVR diagnoses in adolescents. Since the funding of the Phase I grant, there have been two significant developments in the field: the American Psychiatric Association's release of the DSM-5 manual, and NIMH's launch of the Research Domain Criteria (RDoC) initiative that aims to create the necessary database to derive a new psychiatric nomenclature informed by neuroscience, genetics, and psychology. The primary goals of Phase II include: 1) Update the parent and adolescent self-administered computerized KSADS (KSADS-COMP) so it is compatible with DSM-5 criteria;2) Develop software for a clinician-administered computerized KSADS (KSADS-COMP);3) Create a K- SADS-Bridge product that includes a battery of RDoC computerized neurocognitive tasks that can be completed with the self- or clinician-administered KSADS-COMP;and 4) Examine the criterion, convergent, and discriminant validity of the self-administered KSADS-COMP, and the relationship among DSM-5 diagnoses, dimensional measures of psychopathology, and performance on RDoC neurocognitive tasks. Ultimately the aim of this initiative is to create an instrument that, in addition to providing a reliable comprehensive assessment tool for psychiatric disorders in adolescents, can bridge DSM-5 and RDoC diagnostic perspectives. A sample of 600 adolescents and their parents will be recruited for this study: half will complete the self-administered KSADS-COMP;the other half will complete the clinician-administered KSADS- COMP. All 600 adolescents and their parents, in addition to completing one of the KSADS-COMP versions, will also complete a battery of dimensional symptom rating scales. A subset of 210 adolescents and their parents will then complete the other version of the KSADS-COMP to test diagnostic concordance between the self- and clinician-administered KSADS-COMP. To obtain reliable Kappa estimates, this subset will include 30 adolescents with no psychopathology and 30 adolescents that meet criteria for each of the following diagnoses: conduct disorder, major depression, bipolar;substance use disorders;posttraumatic stress disorder;and attention deficit hyperactivity disorder. This subset of 210 adolescents will also be administered the RDoC battery of neurocognitive computerized tasks. The KSADS-COMP and KSADS-Bridge assessment tools will have multiple clinical and research applications. In addition to helping identify comorbitiy in teens with substance or psychiatric disorders, it will help to create the cross-talk needed between the DSM and RDoC diagnostic perspectives, and will help to improve clinical care in the short- and long-run as the field aims to transition to a new psychiatric nomenclature.
The KSADS-COMP will facilitate identification of comorbid psychiatric and substance use diagnoses frequently missed in clinical practice, and improve adolescent treatment outcomes. The self-administered version of the KSADS-COMP can also be used cost-effectively in schools and juvenile justice settings where there is a growing interest in early identification and referral of youth in need of mental health services. The KSADS- Bridge assessment tool with its RDoC neurocognitive tasks, when completed with the self- or clinician administered KSADS-COMP, will help to create cross-talk between the DSM and RDoC diagnostic perspectives, and begin to generate a database on the relationship between RDoC constructs and treatment outcomes across a range of diagnostic categories.