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Historical Background
Overall Content
The SCID assesses both current and lifetime
Development
diagnoses and prompts the interviewer to docu-
The SCID was developed and piloted in the years
ment age of illness onset and to rate current
following the publication of the DSM-III
illness severity.
(c. 1980; Spitzer et al. 1992). Directly linked to
# Springer Science+Business Media Singapore 2015
T. Wade (ed.), Encyclopedia of Feeding and Eating Disorders,
DOI 10.1007/978-981-287-087-2_80-1
2 Structured Clinical Interview for DSM-IV (SCID)
or by contacting the authors at scid5@columbia. module that can be administered and scored rel-
edu. The SCID-5 must be purchased through the atively quickly.
American Psychiatric Publishing Inc.’s website: There are also two key improvements from the
http://www.appi.org/products/structured-clinical- SCID-IV to the SCID-5.
interview-for-dsm-5-scid-5. Pricing is based on
the intended use of the measure. First, specific questions to establish impairment
have been added to the OSFED section. These
Psychometrics include questions assessing how eating symp-
The reliability of the SCID has been assessed toms have affected functioning in relation-
using one of two methods: by comparing two or ships, at work or school, and at home, as well
more independent ratings of a single interview or as the degree to which the individual is both-
by having the same patient interviewed by inde- ered by the symptoms. This information helps
pendent raters at two different time points. The the interviewer to distinguish between an eat-
first method has typically led to higher reliability ing disorder and non-eating disorder diagno-
scores (kappa values of 0.60–1.0), as all raters sis, using the impairment and distress
hear the same story and are aware of the inter- guidelines provided in the DSM-5 definition
viewer’s decisions regarding skips and follow-up of a mental disorder (American Psychiatric
questions. Reliability is generally weaker when Association 2013, p. 20).
using the second method (kappa values of Second, guidance on assigning severity catego-
0.40–0.85), as patients may provide different ries for anorexia nervosa (based on a table of
responses to the same questions at different time adult heights and weights for each severity
points. Two independent studies have found fair category) and bulimia nervosa (based on fre-
to good test-retest reliability of eating disorder quency of compensatory behaviors) has also
diagnoses in patient samples, and one study has been included in the updated version.
found good to excellent inter-rater reliability for
anorexia nervosa and bulimia nervosa diagnoses In general, limitations of the SCID include its
in a patient sample. For a listing of specific stud- cost and its extensive skip logic, which can result
ies, see http://www.scid4.org/. Reliability and in the potential loss of meaningful clinical infor-
validity data for the SCID-5 has not been mation that might be of interest to clinicians or
published to date. researchers. The duration of the interview is highly
The validity of the SCID has been assessed by variable and typically dependent on the number of
comparing diagnoses assigned on the basis of the modules administered and the number of symp-
interview to those given by expert diagnosticians toms endorsed. The assessment of an uncompli-
using data collected over time. Several studies cated problem may take as little as 20 min, while
have demonstrated superior validity of the SCID cases with a high degree or diagnostic complexity
over standard clinical intake interviews (for spe- or comorbidity can take as long as 2 h.
cific studies, see http://www.scid4.org/). No stud- The SCID-5 has several specific limitations
ies have reported the validity of eating disorder with regard to diagnostic information captured.
diagnoses based on the SCID-5. Although it assesses the presence of an eating
disorder, it does not ask about feeding disorder
symptoms (i.e., pica, rumination disorder) and
Strengths and Limitations does not attempt to determine with precision the
individual’s BMI or the particular frequencies of
The SCID has several strengths, including a range of behavioral disturbances such as objec-
(1) generating diagnoses based on DSM criteria; tive and subjective binge eating episodes. Also,
(2) strong empirical support for its reliability, because the ARFID module is optional and there-
although additional data will be needed for the fore may not be routinely administered, limited
DSM-5 version; and (3) an eating disorder data will be collected to enhance understanding
4 Structured Clinical Interview for DSM-IV (SCID)
of this nascent diagnostic category. Finally, the References and Further Reading
options available for designating other specified
feeding and eating disorder diagnoses include a American Psychiatric Association. (2013). Diagnostic
and statistical manual of mental disorders (5th ed.).
list of possible clinical presentations but lack
Arlington, VA: American Psychiatric Publishing.
prompts to guide the interviewer. First, M. B., Spitzer, R. L., Gibbon, M., & Williams,
J. B. W. (1996). Structured clinical interview for
DSM-IV axis I disorders, clinician version
(SCID-CV). Washington, DC: American Psychiatric
Future Directions Press.
First, M. B., Spitzer, R. L., Gibbon, M., & Williams,
J. B. W. (2002a). Structured clinical interview for
A psychometric update of the SCID using the DSM-IV-TR axis I disorders, research version, patient
newest version is warranted, as is cross- edition. (SCID-I/P). New York: Biometrics Research,
validation of the SCID-5 with other feeding and New York State Psychiatric Institute.
eating disorder-specific semi-structured inter- First, M. B., Spitzer, R. L., Gibbon, M., & Williams,
J. B. W. (2002b). Structured clinical interview for
view measures such as the Eating Disorder DSM-IV-TR axis I disorders, research version,
Assessment for DSM-5 (feeding and eating dis- non-patient edition. (SCID-I/NP). New York: New
orders) and the Eating Disorder Examination York State Psychiatric Institute.
(eating disorders only), as well as questionnaire First, M. B., Spitzer, R. L., Gibbon, M., & Williams,
J. B. W. (2008). Structured clinical interview for
measures (e.g., Eating Disorder Diagnostic DSM-IV axis I disorders (SCID-I). In A. J. Rush,
Scale). Researchers and clinicians alike might M. B. First, & D. Blacker (Eds.), Handbook of psychi-
also benefit from the development of an elec- atric measures. Washington, DC: American Psychiat-
tronic application of the SCID-5, which could ric Publishing.
First, M. B., Williams, J. B. W., Karg, R. S., & Spitzer,
automate the extensive skip rule logic. R. L. (2015). Structured clinical interview for DSM-5-
research version (SCID-5 for DSM-5, research ver-
sion; SCID-5-RV, version 1.0.0). Arlington: American
Psychiatric Association.
Cross-References Spitzer, R. L., Williams, J. B. W., Gibbon, M., & First,
M. B. (1992). The structured clinical interview for
DSM-III-R (SCID) I: History, rationale, and descrip-
▶ Assessment Burden
tion. Archives of General Psychiatry, 49(8), 624–629.
▶ Choosing an Instrument/Method Structured Clinical Interview for DSM Disorders (SCID).
▶ Eating Disorder Assessment for DSM-5 Resource document. www.scid5.org/index.html.
▶ Eating Disorder Diagnostic Scale Accessed 22 Apr 2015.
Ventura, J., Liberman, R. P., Green, M. F., Shaner, A., &
▶ Eating Disorder Examination
Mintz, J. (1998). Training and quality assurance with
▶ Purpose of Assessment the structured clinical interview for DSM-IV (SCID-I/
▶ Severity Dimensions P). Psychiatry Research, 79(2), 163–173.
▶ Thresholds for Clinical Significance