CORE -- DIAGNOSIS AND SYMPTOM ASSESSMENT

诊断和症状评估核心（DSAC）的主要目标是为精神分裂症神经认知和情感转化中心的项目和核心提供专业的诊断和精神症状评估培训和质量保证程序。DSAC将培训面试官，他们在前驱研究项目、善后研究项目和慢性精神分裂症招募和评估核心中对疾病的三个阶段进行筛查和评估。DSAC将负责建立和维持高水平的评定者间可靠性，防止评定者漂移，并提高中心工具的可靠性和有效性。为了实现这些目标，DSAC将：1）保持良好的标准化，全面和可靠的培训和质量保证方法，用于前驱体征评估，DSM-IV疾病的诊断，精神症状评估和洞察力的测量，2）保持可靠性标准和标准，用于使用评估工具如SCID-I，SCID-II，SIPS、SOPS、BPRS、SANS、SAPS和SUMD-R，3）确保将进行培训和质量保证程序的诊断医生的高水平评估者间可靠性，以及4）扩展DSAC培训录像带库，以包括用于生成诊断的更新的结构化访谈， 症状评定量表。培训计划的第一阶段要求诊断访谈员和症状评估员对至少六盘培训录像带进行评分，并使用附带的“黄金标准”共识诊断和评分计算评分员间可靠性。对于SIPS、SOPS、BPRS、SANS、SAPS和SUMD-R，我们将要求受训者在所有项目和所有六个培训录像带中获得0.80的最小组内相关系数（ICC）。必须满足这些要求，否则受训者将在“毕业”进入培训第二阶段之前参加补救课程，这需要对每项措施进行4次“现场”评估。DSAC还将正式评估面试官的风格，例如，能够探测症状。所有的面试官都将进入一个质量保证计划，旨在防止评分者“漂移”。“每一位面试官将被要求证明， 通过继续进行“现场”访谈和由高级中心诊断医生进行的共同评估，提高了统计数据、评估者间可靠性水平。DSAC将与其他临床样本核心和中心项目合作，围绕仪器开发、方法开发和提高评估者间可靠性等研究问题。

The primary goal of the Diagnosis and Symptom Assessment Core (DSAC) is to provide specialized diagnostic and psychiatric symptom assessment training and quality assurance procedures to projects and cores within the Translational Center for Neurocognition and Emotion in Schizophrenia. The DSAC will train interviewers who conduct screening and evaluation of patients across three phases of illness in the Prodromal Research Project, the Aftercare Research Program, and the Chronic Schizophrenia Recruitment and Assessment Core. The DSAC will be responsible for establishing and maintaining high levels of interrater reliability, preventing rater drift, and improving the reliability and validity of Center instruments. To accomplish these goals, the DSAC will: 1) maintain well standardized, comprehensive and reliable training and quality assurance methods for prodromal signs assessment, diagnosis of DSM-IV disorders, psychiatric symptom assessment, and measurement of insight, 2) maintain reliability standards and criteria for certification of diagnosticians, diagnostic interviewers, and symptom raters who use assessment instruments such as the SCID-I, SCID-II, SIPS, SOPS, BPRS, SANS, SAPS, and SUMD-R, 3) ensure high levels of interrater reliability for diagnosticians who will be conducting training and quality assurance procedures, and 4) expand the DSAC training videotape library to include updated structured interviews for generating diagnoses and symptom rating scales. Phase I of the training program requires that diagnostic interviewers and symptom assessors rate a minimum of six training videotapes and have interrater reliability calculated using the accompanying "Gold Standard" consensus diagnoses and ratings. For the SIPS, SOPS, BPRS, SANS, SAPS, and SUMD-R, we will require that the trainee obtain a minimum Intraclass Correlation Coefficient (ICC) of .80 across all items and all six training videotapes. These requirements must be met or the trainee will attend remediation sessions before "graduating" to Phase II of training, which requires conducting 4 "live" assessments for each measure. The DSAC will also formally evaluate interviewer style, e.g., ability to probe for symptoms. All interviewers will enter a quality assurance program aimed at preventing rater "drift." Each interviewer will be required to demonstrate, as evaluated with kappa and ICC statistics, high levels of interrater reliability by continuing to conduct "live" interviews and co-rating assessments conducted by a senior Center diagnostician. The DSAC will collaborate with other Cores for Clinical Samples and Center Projects around research questions such as instrument development, method development, and improving interrater reliability.