ABSTRACT
The reliability of diagnoses of mental retardation severity was examined through the comparison of psychiatric and psychological case reports found in client records. For a sample of 126 dually diagnosed clients, overall chance-corrected agreement was .47, ranging from .38 (for diagnoses of moderate mental retardation) to .55 (for diagnoses of borderline mental retardation). Results showed that the analysis of naturally occurring variation in diagnostic practices (including variability in professional judgment and assessment methods) may offer a more realistic appraisal of the reliability of diagnostic decisions in professional practice situations than do studies in which important sources of diagnostic error are controlled.
Subject(s)
Intellectual Disability/diagnosis , Adolescent , Adult , Aged , Decision Making , Female , Humans , Male , Middle Aged , Professional Competence , Professional-Patient Relations , Psychiatric Status Rating Scales , Psychological Tests , Severity of Illness IndexABSTRACT
The second-order factor structure of the Devereux Adolescent Behavior Rating Scale was examined in (a) a sample of 254 adolescents who were receiving residential treatment for severe emotional/behavior disorders and (b) an independent sample of 404 adolescents hospitalized for substance abuse. A plausible range of factors was estimated for each group through parallel and average partial analyses and suggested wither a two- or three-factor solution. Subsequent congruence analyses provided tentative support for a three-factor model: (a) undercontrolled/disruptive behaviors; (b) withdrawn/psychotic behaviors; and (c) needs approval/dependent behaviors. The third factor was poorly defined in the residential treatment sample, but extraction of the third factor increased the across-group replicability of the first two factors.
