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SUPPLEMENT $1;,(7< 2%6(66,9( &2038/6,9( $1' … , dp jrlqj wr dvn \rx pruh derxw zkhq \rx kdyh wkrvh...
Transcript of SUPPLEMENT $1;,(7< 2%6(66,9( &2038/6,9( $1' … , dp jrlqj wr dvn \rx pruh derxw zkhq \rx kdyh wkrvh...
KSADS-PL :
SUPPLEMENT
TABLE OF CONTENTS
2 0
ParentCE
ParentMSP
ChildCE
ChildMSP
SummaryCE
SummaryMSP
0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3
0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3
0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3
0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3
0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3
0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3
Panic Disorder
0 1 2 3 Criteria:
20
ParentCE
ParentMSP
ChildCE
ChildMSP
SummaryCE
SummaryMSP
0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3
0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3
0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3
0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3
0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3
0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3
0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3
0 1 2 3 Criteria:
Panic Disorder
20
ParentCE
ParentMSP
ChildCE
ChildMSP
SummaryCE
SummaryMSP
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2
Criteria
Record the maximum number of attacksin a given month.
Record number of attacks in past week.
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
Codes for Remaining Items:
Panic Disorder20
ParentCE
ParentMSP
ChildCE
ChildMSP
SummaryCE
SummaryMSP
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
Criteria
0 1 2Codes for Remaining Items:
Panic Disorder20
SummaryCE
SummaryMSP
0 1 2 0 1 2
0 1 2Codes for Remaining Items:
Panic Disorder
20
ParentCE
ParentMSP
ChildCE
ChildMSP
SummaryCE
SummaryMSP
NOTE: GET INFORMATION ABOUT WHAT CHILD FEARS WILL HAPPEN. FOR INSTANCE, "CROWDS" CAN BE A SOCIAL OR SPECIFIC PHOBIA,DEPENDING ON IF THE CHILD IS AFRAID OF OTHERS SCRUTINIZING HIM/HER (SOCIAL PHOBIA) OR AFRAID OF NOT BEING ABLE TO GETENOUGH AIR (USUALLY SPECIFIC/SIMPLE PHOBIA). LIKEWISE AN ELEVATOR CAN BE FEAR OF GETTING TRAPPED (USUALLYSPECIFIC/SIMPLE PHOIBA).
Criteria0123
0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3
2 0
20
ParentCE
ParentMSP
ChildCE
ChildMSP
SummaryCE
SummaryMSP
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2
20
0 1 2Codes for the following items:
0 0 0 0 0 0
0 -
1 -
2 -
3 -
PAST:
0 -
1 -
2 -
3 -
PAST:
0 -
1 -
2 -
3 -
PAST:
Separation Anxiety Disorder20
P C S
P C S
P C S
Record approximate duration of symptomsin weeks.
0 -
1 -
2 -
3 -
PAST:
ParentCE
ParentMSP
ChildCE
0 1 2 0 1 2 0 1 2
ChildMSP
0 1 2
SummaryCE
SummaryMSP
0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
Separation Anxiety Disorder
20
Criteria
0 1 2Codes for Remaining Items:
P C S
SummaryCE
SummaryMSP
0 1 2 0 1 2
Separation Anxiety Disorder20
0 1 2Codes for Remaining Items:
IF SIGNIFICANT ANXIETY SYMPTOMS ARE PRESENT BUT DOES NOT MEET FULL CRITERIA FOR SEPARATIONANXIETY DISORDER, GO TO PAGE 2 FOR CONSIDERATION OF POSSIBLE DIAGNOSIS OF ANXIETY DISORDER AFTER COMPLETING ALL OTHER RELEVANT ANXIETY DISORDER SUPPLEMENTS.
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
ParentCE
ParentMSP
ChildCE
ChildMSP
SummaryCE
SummaryMSP
Social
20
0 1 2Codes for Items:
ParentCE
ParentMSP
ChildCE
ChildMSP
SummaryCE
SummaryMSP
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
Social
20
0 1 2Codes for Items:
Criteria
SummaryCE
SummaryMSP
0 1 2 0 1 2
Social 20
0 1 2Codes for Items:
IF SIGNIFICANT ANXIETY SYMPTOMS ARE PRESENT BUT DOES NOT MEET FULL CRITERIA FOR SOCIALPHOBIA, GO TO PAGE 2 FOR CONSIDERATION OF POSSIBLE DIAGNOSIS OF ANXIETY DISORDER AFTER COMPLETING ALL OTHER RELEVANT ANXIETY DISORDER SUPPLEMENTS.
0 1 2 0 1 2
ParentCE
ParentMSP
ChildCE
ChildMSP
SummaryCE
SummaryMSP
CURRENT EPISODE
NOTE: GET INFORMATION ABOUT WHAT CHILD FEARS WILL HAPPEN. FOR INSTANCE, "CROWDS" CAN BE A SOCIAL OR SPECIFIC PHOBIA,DEPENDING ON IF THE CHILD IS AFRAID OF OTHERS SCRUTINIZING HIM/HER (SOCIAL PHOBIA) OR AFRAID OF NOT BEING ABLE TO GETENOUGH AIR (USUALLY SPECIFIC/SIMPLE PHOBIA). LIKEWISE AN ELEVATOR CAN BE FEAR OF GETTING TRAPPED (USUALLYSPECIFIC/SIMPLE PHOIBA - CLAUSTROPHOBIA) OR FEAR OF HAVING A PANIC ATTACK (AGORAPHOBIA).
Criteria0123
NOTE: STARRED (*) ITEMS REPRESENT TYPICAL AGORAPHOBIA FEARS.
0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3
2 0
Phobic Disorders
20
a
b
c
d
e
f
*g
*h
*i
*j
*k
*l
*m
*n
ParentCE
ParentMSP
ChildCE
ChildMSP
SummaryCE
SummaryMSP
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
Criteria:
0 1 2 0 1 2
Phobic Disorders
20
0 1 2Codes for the following items:
SummaryCE
SummaryMSP
0 1 2 0 1 2
0 1 2 0 1 2
0 1 2 0 1 2
0 1 2 0 1 2
0 1 2 0 1 2
Phobic Disorders
20
0 1 2Codes for the following items:
IF SIGNIFICANT ANXIETY SYMPTOMS ARE PRESENT BUT DOES NOT MEET FULL CRITERIA FOR PHOBICDISORDERS, GO TO PAGE 2 FOR CONSIDERATION OF POSSIBLE DIAGNOSIS OF ANXIETY DISORDER AFTER COMPLETING ALL OTHER RELEVANT ANXIETY DISORDER SUPPLEMENTS.
0 -
1 -
2 -
3 -
PAST:
0 -
1 -
2 -
3 -
PAST:
0 -
1 -
2 -
3 -
PAST:
NOTE: IN ORDER TO RATE POSITIVELY, CHILD MUST WORRYABOVE AND BEYOND OTHER CHILDREN OF THE SAME AGE.WORRIES MUST BE EXAGGERATED AND OUT OF CONTEXT.
NOTE: IN ORDER TO RATE POSITIVELY, CHILD MUST WORRYABOVE AND BEYOND OTHER CHILDREN OF THE SAME AGE.WORRIES MUST BE EXAGGERATED AND OUT OF CONTEXT.
NOTE: IN ORDER TO RATE POSITIVELY, CHILD MUST WORRY ABOVE AND BEYOND OTHER CHILDREN OF THE SAME AGE. WORRIES MUST BE EXAGGERATED AND OUT OF CONTEXT.
0 -
1 -
2 -
3 -
PAST:
Generalized Anxiety Disorder
20
P C S
P C S
P C S
P C S
ParentCE
ParentMSP
ChildCE
ChildMSP
SummaryCE
SummaryMSP
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
ParentCE
ParentMSP
ChildCE
ChildMSP
SummaryCE
SummaryMSP
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
Generalized Anxiety Disorder
20
0 1 2Codes for Remaining Items:
Notes:
SummaryCE
SummaryMSP
0 1 2 0 1 2
Generalized Anxiety Disorder
20
0 1 2Codes for Remaining Items:
IF SIGNIFICANT ANXIETY SYMPTOMS ARE PRESENT BUT DOES NOT MEET FULL CRITERIA FOR GENERALANXIETY DISORDER, GO TO PAGE 2 FOR CONSIDERATION OF POSSIBLE DIAGNOSIS OF ANXIETY DISOREDER AFTER COMPLETEING ALL OTHER RELEVANT ANXIETY DISORDER SUPPLEMENTS.
OBSESSIONS:
ParentCE
ParentMSP
ChildCE
ChildMSP
SummaryCE
SummaryMSP
0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3
Obsessive-Compulsive Disorder
20
Notes
Criteria:0 -1 -2 -
3 -
ParentCE
ParentMSP
ChildCE
ChildMSP
SummaryCE
SummaryMSP
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
Criteria
0 1 2Codes for Remaining Items:
Obsessive-Compulsive Disorder
20
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
SummaryCE
SummaryMSP
0 1 2 0 1 2
0 1 2 0 1 2
0 1 2 0 1 2
0 1 2 0 1 2
ParentCE
ParentMSP
ChildCE
ChildMSP
0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 20 1 2
0 1 2 0 1 2 0 1 20 1 2
0 1 20 1 20 1 20 1 2
0 1 2Codes for Remaining Items:
Obsessive-Compulsive Disorder
20
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
COMPULSIONS:
ParentCE
ParentMSP
ChildCE
ChildMSP
SummaryCE
SummaryMSP
0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3
Obsessive-Compulsive Disorder
20
Notes:
Criteria:0 -1 -2 -
3 -
ParentCE
ParentMSP
ChildCE
ChildMSP
SummaryCE
SummaryMSP
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
Criteria
Obsessive-Compulsive Disorder
20
0 1 2Codes for Remaining Items:
0 1 2 0 1 2
Obsessive-Compulsive Disorder
20
0 1 2Codes for Remaining Items:
SummaryCE
SummaryMSP
0 1 20 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 20 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 20 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2Codes for Following Items:
ParentCE
ParentMSP
ChildCE
ChildMSP
SummaryCE
SummaryMSP
Post-Traumatic Stress Disorder20
0 1 20 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 20 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 20 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 20 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 20 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2Codes for Following Items:
ParentCE
ParentMSP
ChildCE
ChildMSP
SummaryCE
SummaryMSP
Post-Traumatic Stress Disorder20
0 1 20 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 20 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 20 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 20 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 20 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 20 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 20 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2Codes for Following Items:
ParentCE
ParentMSP
ChildCE
ChildMSP
SummaryCE
SummaryMSP
Post-Traumatic Stress Disorder20
0 1 20 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 20 1 2 0 1 2 0 1 2 0 1 2 0 1 2
0 1 2 0 1 2
0 1 2 0 1 2
0 1 2 0 1 2
SummaryCE
SummaryMSP
0 1 2Codes for Following Items:Post-Traumatic Stress Disorder
20
If subject meets for any anxiety disorder diagnosis check here and stop.