Feasibility, reliability and validity of the Spanish version of Psychiatric Assessment Schedule for Adults with Developmental Disability: a structured psychiatric interview for intellectual disability.
The Spanish PAS-ADD interview works fine for collecting psychiatric data in adults with ID, yet its computer algorithm gives shaky diagnoses—so override the auto-score for now.
01Research in Context
What this study did
Aman et al. (2002) translated the full PAS-ADD-10 interview into Spanish. They wanted to know if clinicians could give it to adults with intellectual disability and get trustworthy psychiatric diagnoses.
The team checked three things: Can the interview be finished without problems? Do two raters agree on the answers? Does the built-in CATEGO computer algorithm give correct diagnoses?
What they found
Most adults with ID could finish the interview, so feasibility was good. Two raters usually agreed on the answers, showing solid reliability.
The CATEGO algorithm, however, often gave the wrong psychiatric label. It missed real illness or called healthy people sick. The tool is usable, but the computer scoring needs fixing.
How this fits with other research
Freeman et al. (2015) tested the shorter Mini-PASADD against another checklist and also found good agreement between raters. Together, the two studies show the PAS-ADD family is reliable, but the shorter form avoids the faulty CATEGO step.
Dudley et al. (2019) uncovered a different Spanish ID scale that undervalues clients with severe disability. Like Aman et al. (2002), they warn that scores can mislead if the tool is used straight out of the box.
Sappok et al. (2013) tried the ADOS and ADI-R for autism in adults with ID. They hit the same wall: good rater agreement, but the built-in rules over-diagnose. The pattern is clear—check the algorithm before you trust it.
Why it matters
If you screen Spanish-speaking adults with ID, you can use the PAS-ADD interview questions, but ignore the CATEGO print-out for now. Score the items yourself or with a clinician until better cut-offs are published. This keeps the good parts of the tool and drops the faulty ones.
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Join Free →Use the Spanish PAS-ADD questions, but hand-score the results or use clinical judgment instead of the CATEGO algorithm until fixed cut-offs arrive.
02At a glance
03Original abstract
BACKGROUND: Over 30% of people with intellectual disability (ID) have a comorbid psychiatric disorder. However, there are few assessment instruments available for international use and cross-cultural validation studies of these instruments are rare. The aim of the present study was to standardize the Spanish version of the Psychiatric Assessment Schedule for Adults with Developmental Disability (PAS-ADD-10), a semi-structured interview for people with ID. METHODS: After a conceptual translation, feasibility (i.e. applicability, acceptability and practicality) and reliability analyses were carried out. The predictive validity of the PAS-ADD-10 CATEGO-5 codings was also examined (i.e. positive and negative predictive values). Four independent raters with wide-ranging experience in quantitative evaluation and psychiatric assessment of ID evaluated a sample of 80 subjects with ID and borderline intellectual functioning at the AFANAS occupational centre in Jerez, Southern Spain. The ICD-10 codes were used for psychiatric diagnosis. RESULTS: The practicality of the PAS-ADD-10 is limited because of the need for previous standardization of SCAN interviews. Nevertheless, its overall feasibility was judged adequate by raters and the PAS-ADD-10 was considered extremely useful for training. Test-retest and inter-rater reliability kappa values were moderate to high. The CATEGO coding showed limited validity because of overdiagnosis of anxiety disorders and underdiagnosis of mood and psychotic disorders (positive predictive value = 74%, negative predictive value = 76%). CONCLUSIONS: The PAS-ADD-10 is a useful tool for standard psychiatric assessment of people with ID; however, CATEGO codings show low validity and a series of modifications should be considered before this instrument is used extensively in Spain. In this regard, a study on the clinical usefulness of the PAS-ADD-10 in patients with ID and severe mental disorders has been undertaken.
Journal of intellectual disability research : JIDR, 2002 · doi:10.1046/j.1365-2788.2002.00402.x