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The Child and Adolescent Psychiatric Assessment

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The Child and Adolescent Psychiatric Assessment THE CHILD AND ADOLESCENT PSYCHIATRIC ASSESSMENT (CAPA) Child Interview Version 5.0 ADRIAN ANGOLD, MRCPsych Developmental Epidemiology Program Department of Psychiatry and Behavioral Sciences, Duke University 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 Revised CAPA Mania Section Module Contributors Joan Luby & Melissa Meade Stalets October 2008 A Angold, A Cox, M Prendergast, M Rutter, E Simonoff Copyright (1987,1990,1992,1994,1996,1998) Child and Adolescent Psychiatric Assessment Definitions and questions Codes INTERVIEW # CAA3X01 INTERVIEWER PVIEWER CAP0X01 PINTLOC FIRST DAY OF PRIMARY PERIOD // CAQ1D01 TIME AT BEGINNING OF INTERVIEW TIME AT END OF INTERVIEW : FOR REVIEW ONLY 1 Child and Adolescent Psychiatric Assessment Definitions and questions Codes QUALITY OF INTERVIEW CQA9X01 Quality of interview Code your subjective impression as to the quality of the information collected during the interview. The subject Adequacy of Interview may have refused to provide adequate descriptions of symptoms or been deliberately misleading on occasion. CQA9X02 Misleading Answers or Lies 0= Adequate 2= The interview is inadequate, in relation to the specified area, CQA9X03 only in certain parts of the interview. Note the section where data Did Not Answer Many Questions is probably inadequate. Verbally 3= The whole interview is inadequate. CQA9X04 Guarded Informant Refused to Continue CQA9X05 Impaired Consciousness CQA9X06 Intoxicated with Alcohol or Drugs CQA9X07 Unsuitable Interview Environment CQA9X08 Interviewer Comments ________________________________ ________________________________ ________________________________ ________________________________ FOR REVIEW ONLY 2 Child and Adolescent Psychiatric Assessment Definitions and questions Codes SUBJECT CAA0X01 PSEX GENDER M=Male F= Female CAA1O01 DATE OF BIRTH DOB 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) CEE4X01 / BIRTH WEIGHT ( pounds/ounces) CEE4D01 GESTATIONAL AGE (Weeks) CURRENT WEIGHT CURRENT HEIGHT CAP7I01 LANGUAGE SPOKEN AT HOME 1= English 2= Spanish 3= Other CAP9X01 FOR REVIEW ONLY AGE AT ADOPTION (Years and Months) : 3 Child and Adolescent Psychiatric Assessment Definitions and questions Codes v PARENTAL FIGURES CAB2X01 BIOLOGICAL PARENTS MARITAL STATUS 1= Married 2= Widowed 3= Separated 4= Divorced 5= Cohabited>6 months 6= Cohabited<6 months 7= Never cohabited CAB3F01 YEARS BIOLOGICAL PARENTS LIVED TOGETHER CAB5X01 PARENT #1: Name___________________________ 1= Biological parent 2= Adoptive parent 3= Step parent 4= Live-in partner of one parent (> 6 months) 5= Live-in partner of one parent (<6 months) 6= Grandparent 7= Other relative 10= Foster parent 11= Unrelated adult serving as parent 12= Deceased biological parent 13= Deceased non-biological parent CAB5X02 Gender M= Male F= Female CAB5X03 AGE EDUCATION 1= 0-8 years completed CSA0X01 2= Some high school 3= GED or high school equivalency 4= High school degree 5= Post high-school training (vocational, technical, job training) 6= Some college (0-2 years) 7= 2 year associate degree 8= Some collegeFOR (2-4 years) REVIEW ONLY 9= 4 year college degree 10= Some graduate or professional school training 11= Completed graduate or professional degree 4 Child and Adolescent Psychiatric Assessment Definitions and questions Codes Parental Employment and Occupation Parent #1 CSA1X01 Current Employment Status 1= Employed full-time 2= Employed full-time and part-time 3= Employed part-time (1 or more jobs) 4= Not employed outside of the home 5= Student 6= Retired 7= Disabled 8= Unemployed CSA1X02 Type of Employment (Current or most recent) 1= Employee of private business 2= Government employee 3= Self-employed 4= Working without pay CSA1X03 Occupation (Current or most recent) Enter code from Census Index of Occupations CSA1X04 Industry (Current or most recent) Enter code from Census Index of Occupations CSA2O01 Date Last Employed Code if not employed at the time of the interview / / FOR REVIEW ONLY 5 Child and Adolescent Psychiatric Assessment Definitions and questions Codes v PARENTAL FIGURES CAB6X01 PARENT #2: Name___________________________ 1= Biological parent 2= Adoptive parent 3= Step parent 4= Live-in partner of one parent (> 6 months) 5= Live-in partner of one parent (<6 months) 6= Grandparent 7= Other relative 10= Foster parent 11= Unrelated adult serving as parent CAB6X02 12= Deceased biological parent 13= Deceased non-biological parent Gender M= Male F= Female CAB6X03 AGE EDUCATION 1= 0-8 years completed 2= Some high school CSA0X02 3= GED or high school equivalency 4= High school degree 5= Post high-school training (vocational, technical, job training) 6= Some college (0-2 years) 7= 2 year associate degree 8= Some college (2-4 years) 9= 4 year college degree 10= Some graduate or professional school training 11= Completed graduate or professional degree FOR REVIEW ONLY 6 Child and Adolescent Psychiatric Assessment Definitions and questions Codes Parental Employment and Occupation Parent #2 CSA3X01 Current Employment Status 1= Employed full-time 2= Employed full-time and part-time 3= Employed part-time (1 or more jobs) 4= Not employed outside of the home 5= Student 6= Retired 7= Disabled 8= Unemployed CSA3X02 Type of Employment (Current or most recent) 1= Employee of private business 2= Government employee 3= Self-employed 4= Working without pay CSA3X03 Occupation (Current or most recent) Enter code from Census Index of Occupations CSA3X04 Industry (Current or most recent) Enter code from Census Index of Occupations CSA4O01 Date Last Employed Code if not employed at the time of the interview // FOR REVIEW ONLY 7 Child and Adolescent Psychiatric Assessment Definitions and questions Codes v PARENTAL FIGURES CAB7X01 OTHER PARENT #1: Name___________________________ 1= Biological parent 2= Adoptive parent 3= Step parent 4= Live-in partner of one parent (> 6 months) 5= Live-in partner of one parent (<6 months) 6= Grandparent 7= Other relative 10= Foster parent 11= Unrelated adult serving as parent CAB7X02 12= Deceased biological parent 13= Deceased non-biological parent Gender M= Male CAB7X03 F= Female AGE EDUCATION CSA0X03 1= 0-8 years completed 2= Some high school 3= GED or high school equivalency 4= High school degree 5= Post high-school training (vocational, technical, job training) 6= Some college (0-2 years) 7= 2 year associate degree 8= Some college (2-4 years) 9= 4 year college degree 10= Some graduate or professional school training 11= Completed graduate or professional degree FOR REVIEW ONLY 8 Child and Adolescent Psychiatric Assessment Definitions and questions Codes Parental Employment and Occupation Other Parent #1 CSA5X01 Current Employment Status 1= Employed full-time 2= Employed full-time and part-time 3= Employed part-time (1 or more jobs) 4= Not employed outside of the home 5= Student 6= Retired 7= Disabled 8= Unemployed CSA5X02 Type of Employment (Current or most recent) 1= Employee of private business 2= Government employee 3= Self-employed 4= Working without pay CSA5X03 Occupation (Current or most recent) Enter code from Census Index of Occupations CSA5X04 Industry (Current or most recent) Enter code from Census Index of Occupations CSA6O01 Date Last Employed Code if not employed at the time of the interview / / FOR REVIEW ONLY 9 Child and Adolescent Psychiatric Assessment Definitions and questions Codes v PARENTAL FIGURES CAB8X01 OTHER PARENT #2: Name___________________________ 1= Biological parent 2= Adoptive parent 3= Step parent 4= Live-in partner of one parent (> 6 months) 5= Live-in partner of one parent (<6 months) 6= Grandparent 7= Other relative 10= Foster parent 11= Unrelated adult serving as parent 12= Deceased biological parent CAB8X02 13= Deceased non-biological parent Gender M= Male F= Female CAB8X03 AGE EDUCATION 1= 0-8 years completed CSA0X04 2= Some high school 3= GED or high school equivalency 4= High school degree 5= Post high-school training (vocational, technical, job training) 6= Some college (0-2 years) 7= 2 year associate degree 8= Some college (2-4 years) 9= 4 year college degree 10= Some graduate or professional school training 11= Completed graduate or professional degree FOR REVIEW ONLY 10 Child and Adolescent Psychiatric Assessment Definitions and questions Codes Parental Employment and Occupation Other Parent #2 CSA7X01 Current Employment Status 1= Employed full-time 2= Employed full-time and part-time 3= Employed part-time (1 or more jobs) 4= Not employed outside of the home 5= Student 6= Retired 7= Disabled 8= Unemployed CSA7X02 Type of Employment (Current or most recent) 1= Employee of private business 2= Government employee 3= Self-employed 4= Working without pay CSA7X03 Occupation (Current or most recent) Enter code from Census Index of Occupations CSA7X04 Industry (Current or most recent) Enter code from Census Index of Occupations CSA8O01 Date Last Employed Code if not employed at the time of the interview / / FOR REVIEW ONLY 11 Child and Adolescent Psychiatric Assessment Definitions and questions Codes CAA6X01 SIBLINGS 1.______________________________ Siblings CAA6X02 1= Full Sib 2= Half Sib 3= Step Sib 4= Adopted Sib 5= Unrelated Child CAA6X03 6= Other related child (e.g. cousin, aunt) 7= Biological parent living in the home but non- functional in the parental role CAA6X04 Sex of Sibling M= Male F=
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