CHILD AND ADOLESCENT PSYCHIATRIC ASSESSMENT (CAPA)

CHILD AND ADOLESCENT PSYCHIATRIC ASSESSMENT

(CAPA)

Core Diagnostic Modules for DSM 5

(Depression, Anxiety, ODD/CD, ADHD, and Impairment Modules)

CHILD INTERVIEW

Version 10.0.0

ADRIAN ANGOLD MRCPsych

Center for Developmental Epidemiology Department of Psychiatry and Behavioral Sciences

Duke University Medical Center Durham, North Carolina 27710-3454

ANTHONY COX, FRCPsych MICHAEL PRENDERGAST, MRCPsych

MICHAEL RUTTER, MD, FRS EMILY SIMONOFF, MRCPsych

MRC Child Psychiatry Unit Institute of Psychiatry

London SE5 8AF England

A Angold, A Cox, M Prendergast, M Rutter, E Simonoff Copyright (1987,1989,1991,1992,1993,1994,1995,1996,1997)

Table of Contents

A. Demographics with Ethnicity

Page A 1-11

B. Family Section

Page B 1-8

Please review Food Section to decide if you want to use ARFID.

C. Food Preferences and Appetite (Short)

Page C 1-2

C. Food Preferences and Appetite (Short)

Page C 1-10

D. School Work Performance and Behavior

Page D 1-11

E. School and Separation Anxiety

Page E 1-12

F. Worries

Page F 1-4

G. Anxious Affect

Page G 1-24

H. Sleep Problems

Page H 1-4

I. Depressed Affect

Page I 1-23

J. Oppositional and Conduct Disorder Section Page J 1-47

K. Incapacity Section

Page K 1-50

L. Ending the Interview

Page L 1-1

Child and Adolescent Psychiatric Assessment Definitions and questions INTERVIEW #

INTERVIEWER INITIALS

INTERVIEW DATE

FIRST DAY OF PRIMARY PERIOD 3 Months ago from Interview Date

TIME AT START OF INTERVIEW

TIME AT END OF INTERVIEW

LOCATION OF INTERVIEW H = Subjects Home P = Project Office T = Treatment Setting C = Custodial Institution O = Other

Codes CAPAID

CAA3X01 PVIEWER

CAA4O01

/ /

CAA5O01

/ /

CAQ1D01

:

CQA9X12

:

CAQ0X01

A-1

Child and Adolescent Psychiatric Assessment

Definitions and questions

QUALITY OF INTERVIEW

Code your subjective impression as to the quality of the information collected during the interview. The subject may have refused to provide adequate descriptions of symptoms or been deliberately misleading on occasion.

Quality of interview Adequacy of Interview

0= Adequate

2= The interview is inadequate, in relation to the specified area, only in certain parts of the interview. Note the section where data is probably inadequate.

3= The whole interview is inadequate.

Misleading Answers or Lies

Did Not Answer Many Questions Verbally

Guarded Informant

Codes CQA9X01 CQA9X02 CQA9X03 CQA9X04

Refused to Continue

CQA9X05

Impaired Consciousness

CQA9X06

Intoxicated with Alcohol or Drugs

CQA9X07

Unsuitable Interview Environment

CQA9X08

Interviewer Comments ________________________________ ________________________________ ________________________________ ________________________________

A-2

Child and Adolescent Psychiatric Assessment Definitions and questions

SUBJECT

GENDER 1 =Male 2 = Female

DATE OF BIRTH What is your birth date?

GENDER 1 =Male 2 = Female

DATE OF BIRTH

Codes

CAA0X01 PSEX

CAA1O01 DOB

HISPANIC Are you Spanish, Hispanic, or Latino?

HISPANIC 0 = Absent 2 = Present

CUB5X01

ETHNIC ORIGIN

What race are you? You can choose more than one. Are you American Indian or Alaskan Native? Or Asian? African-American or Black American? White, that is, of European, Middle Eastern, or North African origin? Native Hawaiian or other Pacific Islander? Some other race that I have not mentioned?

ETHNIC ORIGIN 1=African American 2= American Indian or Alaskan Native 3= Asian or Pacific Islander 4= Hispanic 5= Other 6= White (European or Middle Eastern)

What language do you speak at home?

AGE AT ADOPTION

Are you adopted? How old were you when you were adopted?

FOSTER CARE Have you been in foster care? How long have you been in foster care? When did you first go into foster care?

How many foster care homes have you been in?

LANGUAGE SPOKEN AT HOME 1= English 2= Spanish 3= Other

AGE AT ADOPTION (Years and Months)

CUB5X02

CAP7I01

CAP9X01

:

CAB0O01

/ /

CAB1F01

A-3

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