DSM-III field trials: I. Initial interrater diagnostic reliability

Robert L. Spitzer; J B Forman; J. Nee

doi:10.1176/ajp.136.6.815

Cited by 395Reliability and Agreement in MeasurementMental Health and PsychiatryPersonality Disorders and Psychopathology

DSM-III field trials: I. Initial interrater diagnostic reliability

Robert L. Spitzer, J B Forman, J. Nee·1979·American Journal of Psychiatry

DOI 10.1176/ajp.136.6.815

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Abstract

The interrater agreement for major diagnostic categories in studies using DSM-I and DSM-II was usually only fair or poor. In phase one of the DSM-III field trials the overall kappa coefficient of agreement for axis I diagnoses of 281 adult patients was .78 for joint interviews and .66 for diagnoses made after separate interviews; for axis II--personality disorders and specific developmental disorders--the coefficients of agreement were .61 and .54. The interrater reliability of DSM--III is, in general, higher than that previously achieved and may be due to changes in the classification itself, the separation of axis I from axis II conditions, the systematic description of the various disorders, and the inclusion of diagnostic criteria.

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The published DSM-III field trial provided kappa values for disorder groupings rather than specific disorders, which would tend to maximize reliability results.
“The published results of DSM-III field trial provided kappa values for disorder groupings rather than for specific disorders 32 , which would tend to maximize reliability results because disagreements within a grouping are substantially more likely than disagreements concerning disorders from different groupings.”
From The ICD‐11 developmental field study of reliability of diagnoses of high‐burden mental disorders: results among adult patients in mental health settings of 13 countries (2018) · cites this paper as [32]

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Authors: Spitzer, R. L., Forman, J. B., & Nee, J.
ORCID: Robert L. Spitzer
Venue: American Journal of Psychiatry
Publisher: American Psychiatric Association Publishing
Published: 1979-06-01
Volume: 136
Issue: 6
Pages: 815-817
ISSN: 0002-953X (ISSN-L)
1535-7228
DOI: 10.1176/ajp.136.6.815
OpenAlex: W2228575385
Cited by: 394
References: 3
Citations by year: 2026: 2 · 2025: 1 · 2024: 3 · 2023: 4 · 2022: 4 · 2021: 3 · 2020: 5 · 2019: 6 · 2018: 3 · 2017: 7 · 2016: 5 · 2015: 9 · 2014: 5 · 2013: 9 · 2012: 10
FWCI: 74.87
Type: journal article
Language: en
Open access: closed
Locations: American Journal of Psychiatry (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Reliability and Agreement in Measurement
Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Keywords: DSM-III, inter-rater reliability, diagnostic agreement, Axis I diagnoses, personality disorders, developmental disorders, diagnostic criteria, psychiatric classification, field trials
MeSH terms: Adolescent, Adult, Mental Disorders, Evaluation Studies as Topic, Humans, Manuals as Topic, United States

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DSM-III field trials: I. Initial interrater diagnostic reliability

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