Connecting national survey data with DSM-IV criteria.

PURPOSE: To show how connections can be made among items in a nationally representative survey of adolescents and criteria for "Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition" (DSM-IV) diagnoses.

METHODS

Data for this study came from the Wave I in-home interview of the National Longitudinal Study of Adolescent Health (Add Health), a nationwide study of approximately 90,000 adolescents and their parents. Proxy variables were developed for four DSM-IV diagnoses based on Wave I survey questions: conduct disorder, alcohol abuse, cannabis abuse, and major depressive disorder (single episode). Prevalence rates, comorbidity rates, and detailed item analyses of these four constructs are reported.

RESULTS

Of the adolescents in the sample under study, 3.4% scored above the threshold for conduct disorder. For the alcohol abuse proxy 4.7% scored above the threshold, compared with 6.3% for the cannabis abuse proxy, and 1% scored above the threshold for major depressive disorder (single episode). Adolescents who scored above the threshold for conduct disorder were three times more likely to receive psychological counseling than adolescents who scored below the threshold for conduct disorder. The rates for alcohol abuse, cannabis abuse, and major depressive disorder (single episode) were 2.0, 3.0, and 5.0, respectively.

CONCLUSIONS

The prevalence rates for the four constructs in the Add Health data set were generally lower or comparable to prevalence rates found in other epidemiological studies in which DSM-IV criteria were applied. The approach described in this study provides a way to identify adolescents who are likely at risk for the development of mental health problems.