Validation of the mood and anxiety semi-structured (MASS) interview for patients with intellectual disabilities.
The MASS Interview gives BCBAs a quick, behavior-based way to spot mood and anxiety disorders in adults with ID.
01Research in Context
What this study did
Kleinert et al. (2007) built a new interview for adults with intellectual disability.
The tool is called the MASS: Mood and Anxiety Semi-Structured Interview.
They compared MASS answers to long hospital evaluations to see if both give the same diagnosis.
What they found
The MASS matched the hospital team most of the time.
Agreement ranged from fair to good across mood and anxiety disorders.
The tool turns DSM-IV words into plain, watchable behaviors so clients who speak little can still be assessed.
How this fits with other research
Singh et al. (1991) first said we need many ways to separate true mental illness from plain behavior problems in ID.
Kleinert et al. (2007) now give one ready-made way, so the new study extends the old idea into daily practice.
Windsor et al. (2025) later checked every communication questionnaire for people with ID and found none fully sound; MASS, which uses observable signs, fills that gap.
Ganz et al. (2004) warned that classic psychiatric labels lose meaning as ID severity rises; MASS tackles this by staying close to what you can see, not abstract traits.
Why it matters
You now have a free, 45-minute interview that yields reliable mood or anxiety labels for adults with ID.
Use it before writing behavior plans to be sure you are not treating depression as plain avoidance, or anxiety as attention-maintained behavior.
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02At a glance
03Original abstract
BACKGROUND: When assessing people with intellectual disabilities (ID), using the DSM-IV-TR can be challenging. Frequently, significant clinical data must be obtained from interviews with key informants. A new semi-structured interview tool was developed including behavioural descriptions of each DSM-IV-TR symptom criterion for a number of mood and anxiety disorders. A goal was to provide mental health clinicians with an instrument easy to use in clinical practice that would increase reliable identification of diagnostically important mood and anxiety symptoms. This is especially important given the fact that many experts believe these 'internalizing' clinical syndromes may often be missed in this population, because of characteristic limitations in expressive language skills. METHOD: To establish validity, the Mood and Anxiety Semi-structured (MASS) Interview-derived diagnoses were compared with clinical DSM-IV diagnoses derived from an extensive inpatient evaluation and classifications based on the Hamilton Depression Rating Scale for 93 psychiatric inpatients served on a specialized unit for people with ID and major mental health disorders. RESULTS: Agreement with the MASS Interview was high yielding significant kappa coefficients ranging from 0.42 to 0.78. CONCLUSIONS: The MASS Interview, a semi-structured interview containing behavioural descriptions of DSM-IV symptom criteria, shows promise as a potentially helpful tool in the psychiatric diagnostic evaluation of persons with ID and limited expressive language skills, in the detection of mood and anxiety disorders. The tool also yields a wide breadth of clinical information and is easy for mental health clinicians to use.
Journal of intellectual disability research : JIDR, 2007 · doi:10.1111/j.1365-2788.2007.00972.x