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. 2017 Mar;62(3):211-222.
doi: 10.1177/0706743716670129. Epub 2016 Sep 24.

Reliability, Validity, and Clinical Utility of the Dominic Interactive for Adolescents-RevisedA DSM-5-Based Self-Report Screen for Mental Disorders, Borderline Personality Traits, and Suicidality

Lise Bergeron  1   2 , Nicole Smolla  1   3 , Claude Berthiaume  1 , Johanne Renaud  4   5 , Jean-Jacques Breton  1   3 , Marie St-Georges  1 , Pauline Morin  1 , Elissa Zavaglia  2 , Réal Labelle  1   6   7
Affiliations

Reliability, Validity, and Clinical Utility of the Dominic Interactive for Adolescents-RevisedA DSM-5-Based Self-Report Screen for Mental Disorders, Borderline Personality Traits, and Suicidality

Lise Bergeron et al. Can J Psychiatry. 2017 Mar.

Abstract
in English, French

Objectives: The Dominic Interactive for Adolescents-Revised (DIA-R) is a multimedia self-report screen for 9 mental disorders, borderline personality traits, and suicidality defined by the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders ( DSM-5). This study aimed to examine the reliability and the validity of this instrument.

Methods: French- and English-speaking adolescents aged 12 to 15 years ( N = 447) were recruited from schools and clinical settings in Montreal and were evaluated twice. The internal consistency was estimated by Cronbach alpha coefficients and the test-retest reliability by intraclass correlation coefficients. Cutoff points on the DIA-R scales were determined by using clinically relevant measures for defining external validation criteria: the Schedule for Affective Disorders and Schizophrenia for School-Aged Children, the Beck Hopelessness Scale, and the Abbreviated-Diagnostic Interview for Borderlines. Receiver operating characteristic (ROC) analyses provided accuracy estimates (area under the ROC curve, sensitivity, specificity, likelihood ratio) to evaluate the ability of the DIA-R scales to predict external criteria.

Results: For most of the DIA-R scales, reliability coefficients were excellent or moderate. High or moderate accuracy estimates from ROC analyses demonstrated the ability of the DIA-R thresholds to predict psychopathological conditions. These thresholds were generally capable to discriminate between clinical and school subsamples. However, the validity of the obsessions/compulsions scale was too low.

Conclusions: Findings clearly support the reliability and the validity of the DIA-R. This instrument may be useful to assess a wide range of adolescents' mental health problems in the continuum of services. This conclusion applies to all scales, except the obsessions/compulsions one.

Objectifs:: Le Dominique Interactif pour Adolescents-Révisé (DIA-R) est un instrument multimédia auto-administré pour dépister 9 troubles mentaux, les traits de la personnalité limite et la suicidalité tels que définis dans le Manuel diagnostique et statistique des troubles mentaux, 5e édition (DSM-5). Cette étude visait à examiner la fidélité et la validité de cet instrument.

Méthodes:: Des adolescents francophones et anglophones, âgés de 12 à 15 ans (N = 447), ont été recrutés dans des écoles et des établissements cliniques de Montréal et évalués à deux reprises. La cohérence interne a été estimée par des coefficients alpha de Cronbach, et la fidélité test-retest, par des coefficients de corrélation intraclasse. Les seuils sur les échelles du DIA-R ont été déterminés en utilisant des mesures cliniquement pertinentes pour définir les critères externes de validation: l’Échelle des troubles de l’humeur et de la schizophrénie pour les enfants d’âge scolaire, l’Échelle de désespoir de Beck et l’Entrevue diagnostique abrégée pour la personnalité limite. Les analyses de la fonction d’efficacité du récepteur (FER) ont été utilisées pour estimer les indicateurs de performance (aire sous la courbe FER, sensibilité, spécificité, rapport de vraisemblance) afin d’évaluer la capacité des échelles du DIA-R à prédire les critères externes.

Résultats:: La majorité des échelles du DIA-R présentent des coefficients de fidélité excellents ou modérés. Selon les analyses FER, la performance élevée ou modérée du DIA-R démontre la capacité des seuils à prédire les conditions psychopathologiques. Toutefois, la validité de l’échelle des obsessions/compulsions est insuffisante.

Conclusions:: Les résultats appuient clairement la fidélité et la validité du DIA-R. Cet instrument peut être utile pour évaluer de nombreux problèmes de santé mentale, chez les adolescents, dans le continuum des services. Cette conclusion s’applique à toutes les échelles du DIA-R, à l’exception de celle des obsessions/compulsions.

Keywords: DSM-5; Dominic Interactive for Adolescents–Revised; borderline traits; mental disorders; reliability; self-report screen; suicidality; validity.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr. Bergeron, the principal investigator, obtained a free copy of the new DIA-R version for this validation study. Dr. Jean-Pierre Valla, the author of the DIA-R, was not involved in the realisation of this study, in the analyses of data, and in the interpretation of the results. Dr. Bergeron and the other authors do not hold any of the copyrights, do not receive licensing fees, and are not associated with the selling and distribution of all versions of the Dominic, including the DIA-R. Dr. Renaud reports grants from Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention, during the conduct of the study. The other authors declare that there is no financial relationship to disclose.

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