Validation of the Diagnostic Interview Schedule for Children (DISC-5) Tic Disorder and Attention-Deficit/Hyperactivity Disorder Modules

ABSTRACT

Effective methods to assess mental disorders in children are necessary for accurate prevalence estimates and to monitor prevalence over time. This study assessed updates of the tic disorder and attention-deficit/hyperactivity disorder (ADHD) modules of the Diagnostic Interview Schedule for Children, Version 5 (DISC-5) that reflect changes in diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders (Fifth edition, DSM-5). The DISC-5 tic disorder and ADHD parent- and child-report modules were compared to expert clinical assessment for 100 children aged 6–17 years (40 with tic disorder alone, 17 with tic disorder and ADHD, 9 with ADHD alone, and 34 with neither) for validation. For the tic disorder module, parent-report had high (>90%) sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy, while the youth-report had high specificity and PPV, moderate accuracy (81.4%), and lower sensitivity (69.8%) and NPV (67.3%). The ADHD module performed less well: parent-report had high NPV (91.4%), moderate sensitivity (80.8%), and lower specificity (71.6%), PPV (50.0%), and accuracy (74.0%); youth-report had moderate specificity (82.8%) and NPV (88.3%), and lower sensitivity (65.0%), PPV (54.2%), and accuracy (78.6%). Adding teacher-report of ADHD symptoms to DISC-5 parent-report of ADHD increased sensitivity (94.7%) and NPV (97.1%), but decreased specificity (64.2%), PPV (48.7%), and accuracy (72.2%). These findings support the use of the parent-report tic disorder module alone or in combination with the child report module in future research and epidemiologic studies; additional validation studies are warranted for the ADHD module.

Acknowledgments

We gratefully acknowledge the contributions of the clinical assessors: Kristina Borneman, Meenal Goyal, Sarah Scaccia, Zoey Shaw, Alexis Werner; Study Coordinators: Kristen Bonifacio; Alyssa Thatcher; Students: Margaux Masten, Maria Yidi; and the DISC Advisory Board: Steven Cuffe, Mina Dulcan, Michael First, Laurence (Larry) Greenhill, Ellen Leibenluft, Daniel Pine, Moira Rynn, David Shaffer, Hector Bird, Christopher P. Lucas.

Disclosure statement

Dr. Fisher has received grant support from TeleSage, Inc. (under a Small Business Innovation Research grant to TeleSage, Inc. from the Centers for Disease Control) to develop a computerized version of the DISC-5. No potential conflict of interest was reported by the other authors.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/23794925.2023.2191352.

Additional information

Funding

This study was supported by the Disability Research and Dissemination Center (DRDC) cooperative agreement U01DD001007, which was funded by the Centers for Disease Control and Prevention (CDC). The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. This project was supported in part by an appointment to the Research Participation Program at the Centers for Disease Control and Prevention administered by the Oak Ridge Institute for Science and Education through an interagency agreement between the U.S. Department of Energy and the Centers for Disease Control and Prevention.