David Shaffer - Study of Diagnosis

Study of Diagnosis

Other research interests have included the development of diagnostic instruments. He was charged by the National Institutes of Health (NIMH) to develop a child version of the DIS for use in large field studies. The NIMH DISC "is a highly structured diagnostic interview, designed to assess more than 30 psychiatric disorders occurring in children and adolescents, and can be administered by "lay" interviewers after a minimal training period." Shaffer has led the development of several editions of the DISC, including the current version (NIMH DISC-IV), which is based closely on DSM-IV. DISC-IV includes a computerized version of the interview that incorporates voice technology. This has greatly reduced the cost of administration, and allowed for self-completion by youth unable to read, obviating the constraining presence of an adult interviewer. The DISC has been translated into nine languages and has been used in approximately two hundred child research projects. Elements of the DISC have been employed by large, multi-site studies, such as the MTA; federally administered regular surveys, such as NHANES; and a number of other longitudinal studies. The availability of the instrument has, for the first time, allowed careful examination of patterns of psychiatric comorbidity and how this emerges over time, a matter of great importance for DSM. The American Psychiatric Association has just funded a grant to Shaffer’s group to reexamine DISC data on twenty-six thousand subjects for the purpose of identifying critical questions for DSM-V.

Shaffer’s contribution to psychiatric classification dates back to 1966, when he collaborated with Sir Michael Rutter to explore the benefits of a multi-axial system for ICD-9. This would subsequently be adapted for DSM-III. He served on the Child and Adolescent Work Group for DSM-III and DSM-IIIR and was co-chair of that group for DSM-IV. He is currently a member of the Child and Adolescent Work Group and the Mood Disorders Work Group for DSM-V and is co-chair of the Disruptive Behaviors Disorder Workgroup for DSM-V.