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CHILD AND ADOLESCENTPSYCHIATRIC ASSESSMENT(CAPA)Core Diagnostic Modules for DSM 5(Depression, Anxiety, ODD/CD, ADHD, and Impairment Modules)CHILD INTERVIEWVersion 10.0.0ADRIAN ANGOLD MRCPsychCenter for Developmental EpidemiologyDepartment of Psychiatry and Behavioral SciencesDuke University Medical CenterDurham, North Carolina 27710-3454ANTHONY COX, FRCPsychMICHAEL PRENDERGAST, MRCPsychMICHAEL RUTTER, MD, FRSEMILY SIMONOFF, MRCPsychMRC Child Psychiatry UnitInstitute of PsychiatryLondon SE5 8AF EnglandA Angold, A Cox, M Prendergast, M Rutter, E SimonoffCopyright (1987,1989,1991,1992,1993,1994,1995,1996,1997)
Table of ContentsA. Demographics with EthnicityPage A 1-11B. Family SectionPage B 1-8Please review Food Section to decide if you want to use ARFID.C. Food Preferences and Appetite (Short)Page C 1-2C. Food Preferences and Appetite (Short)Page C 1-10D. School Work Performance and BehaviorPage D 1-11E. School and Separation AnxietyPage E 1-12F. WorriesPage F 1-4G. Anxious AffectPage G 1-24H. Sleep ProblemsPage H 1-4I. Depressed AffectPage I 1-23J. Oppositional and Conduct Disorder SectionPage J 1-47K. Incapacity SectionPage K 1-50L. Ending the InterviewPage L 1-1
Child and Adolescent Psychiatric AssessmentDefinitions and questionsCodesINTERVIEW #CAPAIDINTERVIEWER INITIALSCAA3X01PVIEWERINTERVIEW DATECAA4O01/ /FIRST DAY OF PRIMARY PERIOD3 Months ago from Interview DateCAA5O01/ /TIME AT START OF INTERVIEWCAQ1D01TIME AT END OF INTERVIEW:CQA9X12:LOCATION OF INTERVIEWH Subjects HomeP Project OfficeT Treatment SettingC Custodial InstitutionO OtherCAQ0X01A-1
Child and Adolescent Psychiatric AssessmentDefinitions and questionsCodesQUALITY OF INTERVIEWCQA9X01Code your subjective impression as to the quality of theinformation collected during the interview. The subject mayhave refused to provide adequate descriptions of symptomsor been deliberately misleading on occasion.Quality of interviewAdequacy of InterviewCQA9X02Misleading Answers or Lies0 Adequate2 The interview is inadequate, in relation to the specified area,only in certain parts of the interview. Note the section where datais probably inadequate.CQA9X03Did Not Answer Many QuestionsVerbally3 The whole interview is inadequate.CQA9X04Guarded InformantRefused to ContinueCQA9X05Impaired ConsciousnessCQA9X06Intoxicated with Alcohol or DrugsCQA9X07Unsuitable Interview EnvironmentCQA9X08Interviewer CommentsA-2
Child and Adolescent Psychiatric AssessmentDefinitions and questionsCodesSUBJECTCAA0X01PSEXGENDER1 Male2 FemaleGENDER1 Male2 FemaleCAA1O01DOBDATE OF BIRTHWhat is your birth date?DATE OF BIRTHHISPANICHISPANIC0 Absent2 PresentAre you Spanish, Hispanic, or Latino?ETHNIC ORIGINWhat race are you? You can choose more than one.Are you American Indian or Alaskan Native?Or Asian?African-American or Black American?White, that is, of European, Middle Eastern, or North Africanorigin?Native Hawaiian or other Pacific Islander?Some other race that I have not mentioned?ETHNIC ORIGIN1 African American2 American Indian or AlaskanNative3 Asian or Pacific Islander4 Hispanic5 Other6 White (European or MiddleEastern)CUB5X01CUB5X02CAP7I01LANGUAGE SPOKEN AT HOME1 English2 Spanish3 OtherWhat language do you speak at home?AGE AT ADOPTIONAGE AT ADOPTION (Years andMonths)Are you adopted?How old were you when you were adopted?CAP9X01:CAB0O01FOSTER CAREHave you been in foster care?How long have you been in foster care?When did you first go into foster care?/ /CAB1F01How many foster care homes have you been in?A-3
Child and Adolescent Psychiatric AssessmentDefinitions and questionsvCodesPARENTAL FIGURESParental figures are adults who have lived in the child's homefor at least one month who assume some responsibility forattempting to control the behavior and discipline of the child.Parental Figures in the Home (Parent #1 and Parent #2) arethose who have lived in the child's home for at least onemonth of the primary period.Parental figures living elsewhere (Other Parents #1 andOther Parent #2) are individuals who now live elsewhere whoeither currently act as parental figures or did so in the past,such as a biological parent who is now separated from thechild.PARENT #1:Name1 Biological parent2 Adoptive parent3 Step parent4 Live-in partner of one parent ( 6months)5 Live-in partner of one parent ( 6months)6 Grandparent7 Other relative10 Foster parent11 Unrelated adult serving as parent12 Deceased biological parent13 Deceased non-biological parentCAB5X01CAB5X02CAB5X03What is your relationship with “Parent #1”?Is s/he your biological parent?Is s/he your adoptive parent?Step parent?Live-in partner of one parent?More than 6 months or less than 6 months?Grandparent?Some other relative like an aunt or uncle?Foster parent?An unrelated adult serving as a parent?GENDERAGE IN YEARSPARENT #2:Name1 Biological parent2 Adoptive parent3 Step parent4 Live-in partner of one parent ( 6months)5 Live-in partner of one parent ( 6months)6 Grandparent7 Other relative10 Foster parent11 Unrelated adult serving as parent12 Deceased biological parent13 Deceased non-biological parentGender1 Male2 FemaleAGEHow old is “Parent #1”?What is your relationship with “Parent #2”?Is s/he your biological parent?Is s/he your adoptive parent?Step parent?Live-in partner of one parent?More than 6 months or less than 6 months?Grandparent?Some other relative like an aunt or uncle?Foster parent?An unrelated adult serving as a parent?CAB6X01CAB6X02GENDER1 Male2 FemaleGender1 Male2 FemaleCAB6X03AGE IN YEARSAGEHow old is “Parent #2”?A-4
Child and Adolescent Psychiatric AssessmentDefinitions and questionsCodesIf child has “Other Parent #1”, continue. Otherwise skipto Siblings Page.OTHER PARENT #1:Name1 Biological parent2 Adoptive parent3 Step parent4 Live-in partner of one parent ( 6months)5 Live-in partner of one parent ( 6months)6 Grandparent7 Other relative10 Foster parent11 Unrelated adult serving as parent12 Deceased biological parent13 Deceased non-biological parentWhat is your relationship with “Other Parent #1”?Is s/he your biological parent?Is s/he your adoptive parent?Step parent?Live-in partner of one parent?More than 6 months or less than 6 months?Grandparent?Some other relative like an aunt or uncle?Foster parent?An unrelated adult serving as a parent?Gender of “Other Parent #1”1 Male2 FemaleAGEHow old is “Other Parent #1”?Gender1 Male2 FemaleIf child has “Other Parent #1”, continue. Otherwise skipto Siblings Page.What is your relationship with “Other Parent #2”?Is s/he your biological parent?Is s/he your adoptive parent?Step parent?Live-in partner of one parent?More than 6 months or less than 6 months?Grandparent?Some other relative like an aunt or uncle?Foster parent?An unrelated adult serving as a parent?CAB7X01CAB7X02CAB7X03AGECAB8X01OTHER PARENT #2:Name1 Biological parent2 Adoptive parent3 Step parent4 Live-in partner of one parent ( 6months)5 Live-in partner of one parent ( 6months)6 Grandparent7 Other relative10 Foster parent11 Unrelated adult serving as parent12 Deceased biological parent13 Deceased non-biological parentGender1 Male2 FemaleCAB8X02Gender1 Male2 FemaleAGEHow old is “Other Parent #2”?CAB8X01AGEA-5
Child and Adolescent Psychiatric AssessmentDefinitions and questionsCodesRELATIONSHIPBETWEEN PARENT 1 AND PARENT 2vMARITAL RELATIONSHIPMARITAL RELATIONSHIPA Marital Relationship is either a legal marriage or anycontinuing relationship that has lasted at least six months. Inboth cases, the relationship must have been ongoing duringthe last 3 months, with the partners living together in thesame home for at least one month of that period.CAB9I010 No2 YesN.B. Include homosexual partnerships if they fulfill the abovecriteria.In the absence of a Marital Relationship, complete the ratingsfor an Exclusive Partnership, if appropriate.Are your “Parents” married?EXCLUSIVE PARTNERSHIPEXCLUSIVE PARTNERSHIPCAC0I010 No2 YesAny exclusive relationship that has been ongoing for at least3 months and has continued for some period during thepreceding 3 months; and that has involved the partner invisiting the child's home for at least 10 hours per week.N.B. Include homosexual partnerships if they fulfill the abovecriteria.In the absence of an Exclusive Partnership, complete theratings for Dating, if appropriate.CAC1I01DATINGDATINGA relationship that fulfills the criteria for an ExclusivePartnership, except that it does not meet the 10 hr. timecriterion.0 No2 YesA-6
Child and Adolescent Psychiatric AssessmentDefinitions and questionsCodesCAA6X01SIBLINGSDo you have any brothers or sisters?1.CAA6X02Siblings1 Full Sib2 Half Sib3 Step Sib4 Adopted Sib5 Unrelated Child6 Other related child (e.g. cousin, aunt)7 Biological parent living in the home but non-functional inthe parental roleCAA6X03CAA6X04Sex of SiblingM MaleF FemaleCAA6X05Age2.Sibling Living In the Home0 Live at home at least 1 month2 Live away from A6X12A-7
Child and Adolescent Psychiatric AssessmentDefinitions and questionsCodesCAA6X13SIBLINGSSiblings1 Full Sib2 Half Sib3 Step Sib4 Adopted Sib5 Unrelated Child6 Other related child (e.g. cousin, aunt)7 Biological parent living in the home but non-functional inthe parental role4.CAA6X14CAA6X15Sex of SiblingM MaleF FemaleCAA6X16AgeCAA6X17Sibling Living In the Home0 Live at home at least 1 month2 Live away from CAA6X24A-8
Child and Adolescent Psychiatric AssessmentDefinitions and questionsCodesCAA6X25SIBLINGSSiblings1 Full Sib2 Half Sib3 Step Sib4 Adopted Sib5 Unrelated Child6 Other related child (e.g. cousin, aunt)7 Biological parent living in the home but non-functional inthe parental role7.CAA6X26CAA6X27CAA6X28Sex of SiblingM MaleF FemaleAgeCAA6X29Sibling Living In the Home0 Live at home at least 1 month2 Live away from CAA6X36A-9
Child and Adolescent Psychiatric AssessmentDefinitions and questionsCodesMULTIPLE BIRTHCAA7X01TwinIDENTICAL/NON-IDENTICAL1 Identical2 Non-identical (fraternal)3 other multipleCAA7X02TripletCAA7X04Other MultipleBIRTH ORDER IN MULTIPLE BIRTH1 First born2 Second born3 Third bornCAA7X03Birth OrderA-10
Child and Adolescent Psychiatric AssessmentDefinitions and questionsCodesList respondent firstOTHERS IN HOUSECAA8X011.Status1 Biological parent2 Adoptive parent3 Step parent4 Live-in partner of one parent ( 6 months)5 Live-in partner of one parent ( 6 months)6 Grandparent7 Other relative8 Paying boarder9 Other10 Foster .CAA8X077.CAA8X088.CAA8X099.CAA8X1010.A-11
Child and Adolescent Psychiatric Assessment DSM 5 10.0.0Definitions and questionsCoding rulesCodesFAMILY SECTIONLIVING AT HOMEChild lives at home for at least 4 weeks of the last 3months.LIVING AT HOME0 Child has lived at home for at least 4weeks in last 3 months.Have you lived at home for at LEAST 4 weeks of thelast 3 months?CAC2I01Intensity2 Child HAS NOT lived at home for atLEAST 4 weeks in the last 3 months.WEEKS LIVING AT HOMENumber of weeks living at home with Parent #1/(Parent#2).WEEKS LIVING AT HOMECAC2F01FrequencySECONDARY PERIOD: BEGINNINGDATE OF LAST MONTH LIVING ATHOMECAC3O01REASON(S) NOT LIVING AT HOME 4WEEKSCAR0X01In the last 3 months, how many weeks have you livedat home?IF NOT AT HOME ALL 12 WEEKS IN LAST 3 MONTHS,ASK:Where else have you lived in the past 3 months?LIVING ELSEWHERE IN LAST 3 MONTHSCODE AS PRESENT AND CONTINUE.When did you live at home for at least 4 weeks?IF CHILD NOT LIVING AT HOME FOR AT LEAST 4WEEKS IN LAST 3 MONTHS, CODE DATE WHEN LASTLIVED AT HOME FOR 4 WEEKS.Where have you been living?1 Time spent away from home andparental figures while attending specialprogram or camp, traveling, vacationing,visiting relatives or friends./ /CAR0X022 In hospital.3 In treatment facility(ies)CAR0X034 Living with other parent.5 Foster careCAR0X046 OtherCAR0X05CAR0X06Family Structure and FunctionB-1
Child and Adolescent Psychiatric Assessment DSM 5 10.0.0Definitions and questionsCoding rulesCodesARGUMENTS WITH PARENT #1CAD1I01IntensityARGUMENTS WITH PARENT #1An argument is defined as a disagreement, lasting at least5 minutes, that results in a dispute involving raised voices,shouting, verbal abuse, or physical aggression or fights.0 No2 YesDo you have arguments with "Parent #1"?CAD1F01FrequencyHow long do these arguments last?Do either one of you raise your voice?CAD1O01OnsetHow many arguments have you had with "Parent #1" in thelast 3 months?/ /When was the first time you had an argument with "Parent#1?"In the last 3 months, did you get physical during theargument?PHYSICAL ARGUMENTS WITH PARENT#1CAD2I01Intensity0 NoDid you hit "Parent #1" while arguing?2 YesIn the last 3 months, how often have you had an argumentwith "Parent #1" that has gotten physical?CAD2F01FrequencyWhen was the first time you had an argument with “Parent#1” that got physical?CAD2O01Onset/ /OTHER PHYSICAL VIOLENCE AGAINSTPARENT #1 BY CHILD (WITHOUTARGUMENTS)In the last 3 months, have you hit “Parent #1” withouthaving an argument?OTHER PHYSICAL VIOLENCE BY CHILD(WITHOUT ARGUMENTS)CAD3I01Intensity0 NoIn the last 3 months, how often have you hit “Parent #1”without an argument?2 YesCAD3F01FrequencyWhen was the first time this happened?CAD3O01Onset/ /Family Structure and FunctionB-2
Child and Adolescent Psychiatric Assessment DSM 5 10.0.0Definitions and questionsCoding rulesCodesARGUMENTS WITH PARENT #2CAD4I01IntensityARGUMENTS WITH PARENT #2An argument is defined as a disagreement, lasting at least5 minutes, that results in a dispute involving raised voices,shouting, verbal abuse, or physical aggression or fights.0 No2 YesIn the last 3 months, have you had arguments withyour “Parent #2”?CAD4F01FrequencyHow long do these arguments last?Do either one of you raise your voice?CAD4O01OnsetHow many arguments have you had with “Parent #2” in thelast 3 months?/ /When was the first time you had an argument like this?In the last 3 months, did the arguments get physical?PHYSICAL ARGUMENTS WITH PARENT#2Did you hit "Parent #2" while arguing?CAD5I01Intensity0 NoIn the last 3 months, how many arguments have you hadwith “Parent #2” that got physical?2 YesCAD5F01FrequencyWhen was the first time this happened?CAD5O01Onset/ /OTHER PHYSICAL VIOLENCE AGAINSTPARENT #2 BY CHILD (WITHOUTARGUMENTS)In the last 3 months, have you hit "Parent #2" withouthaving an argument?OTHER PHYSICAL VIOLENCE AGAINSTPARENT #2 BY CHILD (WITHOUTARGUMENTS)In the last 3 months, how often has this happened?0 NoWhen was the first time this happened?2 YesCAD6I01IntensityCAD6F01FrequencyCAD6O01Onset/ /Family Structure and FunctionB-3
Child and Adolescent Psychiatric Assessment DSM 5 10.0.0Definitions and questionsCoding rulesCodesCode here any relationship that the child has with OtherParent #1 who no longer lives in the home.CHILD HAS "OTHER PARENT #1"CAD8I01IntensityCODE QUALITY OF RELATIONSHIPS EVEN IF NOCONTACT IN THE LAST 3 MONTHS.2 PresentIF CHILD HAS “OTHER PARENT #1”,CONTINUE. OTHERWISE SKIPT TOARGUMENTS WITH OTHER ADULTS (PAGE 8)OTHER PARENTING - OTHER PARENT #10 AbsentDo you see or have any contact with "Other Parent#1"?Do you want to?OTHER PARENT #1: NUMBER OF VISITSCAD8F01OTHER PARENT #1: DURATION OFVISITSCAD8D010 1 weekHow long are the visits to "Other Parent #1"?1 1 day- 1 week2 1 day3 5 hoursIn the last 3 months, have you received any phonecalls, letters, texts, or emails from "Other Parent #1?"How many calls, texts, letters, or emails?CAD9F01OTHER PARENT #1: QUALITY OFRELATIONSHIPCAE0I010 No evidence of relationship problemswith absent parent.1 No relationship and child grieves or isangry over this.CODE QUALITY OF RELATIONSHIP WITH "OTHERPARENT #1" EVEN IF NO CONTACT IN THE LAST 3MONTHS.How would you describe your relationship with "OtherParent #1"?Are there any problems?Do you like visiting "Other Parent #1"?Family Structure and FunctionNUMBER OF PHONECALLS/LETTERS/EMAILS TO OR FROMOTHER PARENT #1 IN LAST 3 MONTHSB-42 Relationship has negative aspects (e.g.child argues with absent parent, or resentsthat parent's new partner).3 Relationship with absent parent almostcompletely negative (e.g. child veryunhappy until visit ends, or persistentlydifficult during visits to or from absentparent).
Child and Adolescent Psychiatric Assessment DSM 5 10.0.0Definitions and questionsCoding rulesCodesCode here any relationship that the child has with OtherParent #2 who no longer lives in the home.CHILD HAS "OTHER PARENT #2"CAE1I01IntensityCODE QUALITY OF RELATIONSHIPS EVEN IF NOCONTACT IN THE LAST 3 MONTHS.2 PresentIF CHILD HAS “OTHER PARENT #2”,CONTINUE. OTHERWISE SKIPT TOARGUMENTS WITH OTHER ADULTS (PAGE 8)OTHER PARENTING - OTHER PARENT #20 AbsentDo you see or have any contact with "Other Parent#2"?Do you want to?OTHER PARENT #2: NUMBER OF VISITSCAE1F01DURATION OF VISITS: OTHER PARENT#2CAE1D010 1 weekHow long are the visits to "Other Parent #2"?1 1 day- 1 week2 1 day3 5 hoursIn the last 3 months, have you received any phonecalls, texts, letters, or emails from "Other Parent #2"?How many calls, texts, letters, or emails?NUMBER OF PHONECALLS/TEXTS/LETTERS/EMAILS TO ORFROM OTHER PARENT #2 IN LAST 3MONTHSCAE2F01OTHER PARENT #2: QUALITY OFRELATIONSHIPCAE3I010 No evidence of relationship problemswith absent parent.1 No relationship and child grieves or isangry over this.CODE QUALITY OF RELATIONSHIP WITH OTHERPARENT #2 EVEN IF NO CONTACT IN THE LAST 3MONTHS2 Relationship has negative aspects (e.g.child argues with absent parent, or resentsthat parent's new partner).How would you describe your relationship with "OtherParent #2?"Are there any problems?Do you like visiting "Other Parent #2?"Family Structure and FunctionB-53 Relationship with absent parent almostcompletely negative (e.g. child veryunhappy until visit ends, or persistentlydifficult during visits to or from absentparent).
Child and Adolescent Psychiatric Assessment DSM 5 10.0.0Definitions and questionsCoding rulesCodesARGUMENTS WITH OTHER PARENT #1CAE4I01IntensityARGUMENTS WITH OTHER PARENT #1An argument is defined as a disagreement, lasting at least5 minutes, that results in a dispute involving raised voices,shouting, verbal abuse, or physical aggression or fights.0 No2 YesDo you have arguments with "other parent #1"?CAE4F01FrequencyHow long do these arguments last?Do either one of you raise your voice?How many arguments have you had with “Other Parent #1”in the last 3 months?CAE4O01Onset/ /When was the first time this happened?In the last 3 months, did the arguments get physical?PHYSICAL ARGUMENTS WITH OTHERPARENT #1Did you hit "Other Parent #1" while arguing?CAE5I01Intensity0 NoIn the last 3 months, how many arguments have you hadwith “Other Parent #1" that got physical?2 YesCAE5F01FrequencyWhen was the first time this happened?CAE5O01Onset/ /OTHER PHYSICAL VIOLENCE AGAINST OTHERPARENT #1 BY CHILD (WITHOUTARGUMENTS)In the last 3 months, have you hit "Other Parent #1"without having an argument?OTHER PHYSICAL VIOLENCE AGAINSTOTHER PARENT #1 BY CHILD(WITHOUT ARGUMENTS)In the last 3 months, how often has this happened?0 NoWhen was the first time this happened?2 YesCAE6I01IntensityCAE6F01FrequencyCAE6O01Onset/ /Family Structure and FunctionB-6
Child and Adolescent Psychiatric Assessment DSM 5 10.0.0Definitions and questionsCoding rulesCodesARGUMENTS WITH OTHER PARENT #2CAE7I01IntensityARGUMENTS WITH OTHER PARENT #2An argument is defined as a disagreement, lasting at least5 minutes, that results in a dispute involving raised voices,shouting, verbal abuse, or physical aggression or fights.0 No2 YesDo you have arguments with "Other Parent #2"?CAE7F01FrequencyHow long do these arguments last?Do either one of you raise your voice?How many arguments have you had with “Other Parent #2”in the last 3 months?CAE7O01Onset/ /When was the first time this happened?In the last 3 months, did the arguments get physical?PHYSICAL ARGUMENTS WITH OTHERPARENT #2Did you hit "Other Parent #2" while arguing?CAE8I01Intensity0 NoIn the last 3 months, how many arguments have you hadwith “Other Parent #2” that got physical?2 YesCAE8F01FrequencyWhen was the first time this happened?CAE8O01Onset/ /OTHER PHYSICAL VIOLENCE AGAINST OTHERPARENT #2 BY CHILD (WITHOUTARGUMENTS)In the last 3 months, have you hit "Other Parent #2"without having an argument?OTHER PHYSICAL VIOLENCE AGAINSTOTHER PARENT #2 BY CHILD(WITHOUT ARGUMENTS)In the last 3 months, how often has this happened?0 NoWhen was the first time this happened?2 YesCAE9I01IntensityCAE9F01FrequencyCAE9O01Onset/ /Family Structure and FunctionB-7
Child and Adolescent Psychiatric Assessment DSM 5 10.0.0Definitions and questionsCoding rulesCodesARGUMENTS WITH OTHER ADULTSCAL1I01IntensityARGUMENTS WITH OTHER ADULTSAn argument is defined as a disagreement, lasting at least5 minutes, that results in a dispute involving raised voices,shouting, verbal abuse, or physical aggression or fights.0 No2 YesIn the last 3 months, have you had arguments withother adults?CAL1F01FrequencyLike adults in the neighborhood or adults at thestore/mall?CAL1O01OnsetHow long do these arguments last?Do either one of you raise your voice?/ /How many arguments have you had with other adults in thelast 3 months?When was the first time this happened?In the last 3 months, did the arguments get physical?PHYSICAL ARGUMENTS WITH OTHERADULTSDid you hit the "Other Adult" while arguing?CAL2I01Intensity0 NoIn the last 3 months, how many arguments have you hadwith the "other adult" that got physical?2 YesCAL2F01FrequencyWhen was the first time this happened?CAL2O01Onset/ /OTHER PHYSICAL VIOLENCE AGAINST OTHERADULT BY CHILD (WITHOUT ARGUMENTS)In the last 3 months, have you hit another adult withouthaving an argument?OTHER PHYSICAL VIOLENCE AGAINSTOTHER ADULT BY CHILD (WITHOUTARGUMENTS)In the last 3 months, how often has this happened?0 NoWhen was the first time this happened?2 YesCAL3I01IntensityCAL3F01FrequencyCAL3O01Onset/ /Family Structure and FunctionB-8
Child and Adolescent Psychiatric Assessment DSM 5 10.0.0Definitions and questionsCoding rulesCodesREDUCED APPETITECFA0I01IntensityFOOD RELATED BEHAVIORREDUCED APPETITEReduction of normal appetite, or reduced interest in, orenthusiasm for food. Include change in appetite due tosubstance use or side effects of medication.0 Absent2 Food intake has been definitely reducedbelow normal level because of lack ofappetite for at least 1 week.How has your appetite been in the last 3 months?Has it been less than usual?3 Subject can only be induced to eat bymarked parental or other persuasion.Has the amount you eat changed at all?IF REDUCED APPETITE, ASK:CFA0O01Onset/ /Has your appetite been reduced for at least 1 week?How much less have you been eating?When did your appetite start to fall off?WEIGHT LOSSHave you lost weight during the last 3 months?WEIGHT LOSS0 AbsentAre you happy with your weight?CFA1I01Intensity2 PresentHow much weight have you lost?WEIGHT LOSS: 3 MONTHSCFA1X01When did you start losing weight?CFA1O01Onset/ /Food Related BehaviorC-1
Child and Adolescent Psychiatric Assessment DSM 5 10.0.0Definitions and questionsCoding rulesCodesEXCESSIVE APPETITECFA2I01IntensityEXCESSIVE APPETITEAn increase in appetite outside the normal range of thesubject, including eating for comfort. Include change inappetite due to substance due or side effects ofmedication.0 Absent2 Food consumption has been definitelyincreased above the subject's usual levelfor at least 1 week.In the last 3 months, have you had a bigger appetitethan usual?CFA2O01OnsetHave you actually eaten more than usual?/ /How much more are you eating?Why are you eating more?IF INCREASE APPETITE, ASK:In the last 3 months, have you been eating more than usualfor at least 1 week?When did you start eating more?WEIGHT GAINDo not include normal developmental weight gain,premenstrual weight gain, or weight gain because ofpregnancy.WEIGHT GAIN0 AbsentCFA3I01Intensity2 PresentHave you gained weight in the last 3 months?WEIGHT GAIN IN KILOGRAMS: 3MONTHSCFA3X01Are you trying to gain weight?CFA3O01OnsetHow much weight have you gained?How long have you been putting on weight?Food Related Behavior/ /C-2
Child and Adolescent Psychiatric Assessment DSM 5 10.0.0Definitions and questionsCoding rulesCodesFOOD RELATED BEHAVIORREDUCED APPETITEReduction of normal appetite, or reduced interest in, orenthusiasm for food. Include change in appetite due tosubstance use or side effects of medication.REDUCED APPETITE0 AbsentCFA0I01Intensity2 Food intake has been definitely reducedbelow normal level because of lack ofappetite for at least 1 week.How has your appetite been in the last 3 months?Has it been less than usual?3 Subject can only be induced to eat bymarked parental or other persuasion.Has the amount you eat changed at all?IF REDUCED APPETITE, ASK:CFA0O01Onset/ /Has your appetite been reduced for at least 1 week?How much less have you been eating?When did your appetite start to fall off?WEIGHT LOSSHave you lost weight during the last 3 months?WEIGHT LOSS0 AbsentAre you happy with your weight?CFA1I01Intensity2 PresentHow much weight have you lost?WEIGHT LOSS: 3 MONTHSCFA1X01When did you start losing weight?CFA1O01Onset/ /Food Related BehaviorC-1
Child and Adolescent Psychiatric Assessment DSM 5 10.0.0Definitions and questionsCoding rulesCodesEXCESSIVE APPETITECFA2I01IntensityEXCESSIVE APPETITEAn increase in appetite outside the normal range of thesubject, including eating for comfort. Include change inappetite due to substance due or side effects ofmedication.0 Absent2 Food consumption has been definitelyincreased above the subject's usual levelfor at least 1 week.In the last 3 months, have you had a bigger appetitethan usual?CFA2O01OnsetHave you actually eaten more than usual?/ /How much more are you eating?Why are you eating more?IF INCREASE APPETITE, ASK:In the last 3 months, have you been eating more than usualfor at least 1 week?When did you start eating more?WEIGHT GAINDo not include normal developmental weight gain,premenstrual weight gain, or weight gain because ofpregnancy.WEIGHT GAIN0 AbsentCFA3I01Intensity2 PresentHave you gained weight in the last 3 months?WEIGHT GAIN IN KILOGRAMS: 3MONTHSCFA3X01Are you trying to gain weight?CFA3O01OnsetHow much weight have you gained?How long have you been putting on weight?Food Related Behavior/ /C-2
Child and Adolescent Psychiatric Assessment DSM 5 10.0.0Definitions and questionsCoding rulesCodesFOOD SELECTIVITYCFA6I09IntensityFOOD SELECTIVITYChild extremely limit the range of foods consumed resultingin impairment in functioning or need for nutritionalsupplementation.Note: Do not include instances of avoidance or restrictionof food intake due to the lack of availability of food orcultural practices such as religious fasting or normaldieting.Do you consider yourself a picky eater?2 The subject eats only within the rangeof his/her fads.3 Eating with others difficult because ofextreme fads.CFA6O09Onset/ /Would others describe you as a picky eater?Do you get nervous at the thought of having to try anew food?Is it hard for you to try new foods?What makes it difficult for you to eat a wider range offoods?What sort of things won't you eat?What do your parents do about it?IF PRESENT, ASK:Do your "parent(s)" have to fix special meals just for you?Do these food preferences interfere with family meals?Does it make it difficult to go out to eat?When did you start to get choosy about the food you willeat?IF FOOD SELECTIVITY, CONTINUE.OTHERWISE, SKIP TO "INDIFFERENCETO FOOD", (PAGE 7).Food Related Behavior0 AbsentC-3
Child and Adolescent Psychiatric Assessment DSM 5 10.0.0Definitions and questionsCoding rulesCodesFOOD SELECTIVITY DUE TOAPPEARANCECFA6I12IntensityFOOD SELECTIVITY DUE TO APPEARANCESubject avoids eating certain foods due to appearance.Subject may avoid eating food based on the color (i.e. red,green, etc.) or the appearance, that is, food looks "gross" or"disgusting" to subject.0 No2 YesAre you picky about eating because of the way foodlooks?Are you disgusted or "grossed out" by the appearanceof some foods?Is that with most food or just some foods?Do you avoid certain foods because of the color?For example, red foods or green foods, etc.?Does the appearance of a new food sometimes make yougag?FOOD SELECTIVITY DUE TO TEXTUREChild refuses to eat certain types of food (e.g., crunchyfood; hard food; soft food) because of its texture. Itsignificantly limits his/her food choices.FOOD SELECTIVITY DUE TO TEXTURE0 No2 YesAre you picky about eating because of the texture ofsome foods?Do you refuse to each certain foods because of theway it "feels" in your mouth?Do you avoid certain foods because the texture is toosoft?Or the texture is too hard?Do you avoid food because it is crunchy?Food Related BehaviorC-4CFA6I20Intensity
Child and Adolescent Psychiatric Assessment DSM 5 10.0.0Definitions and questionsCoding rulesCodesFOOD SELECTIVITY DUE TO TASTECFA6I13IntensityFOOD SELECTIVITY DUE TO TASTEChild avoids certain foods based on taste.0 NoDo not include simple dislike of vegetables, etc.2 YesAre you picky about eating because of the way foodtastes?Are you disgusted or "grossed out" by the taste ofsome foods?Does the taste of new food sometimes make you gag?What happens?DO NOT INCLUDE SIMPLE DISLIKE OF VEGETABLES,ETC.FOOD SELECTIVITY DUE TO SMELLChild avoids certain foods based on the smell. Subject maynot be able to tolerate being in the same room because ofthe smell of certain foods.FOOD SELECTIVITY DUE TO SMELL0 No2 YesAre you picky about eating because of the way foodsmells?Are you disgusted or "grossed ou
2 The interview is inadequate, in relation to the specified area, only in certain parts of the interview. Note the section where data is probably inadequate. Did Not Answer Many Questions Verbally 3 The whole interview is inadequate. CQ Guarded Informant Quality of interview Adequacy of Interview Refused to Continue Impaired Consciousness
