Adolescents were administered a modified version (version 3.0) of the World Health Organization Composite International Diagnostic Interview (CIDI), a fully structured interview administered by trained lay interviewers to generate DSM-IV diagnoses.28 The modifications to the CIDI were conducted following a standard 4-step process of instrument development proposed by experts in survey methods.24 First, diagnostic sections of the adult CIDI were reviewed to determine whether assessment for particular disorders should be removed based on low presumed prevalence in adolescents. Second, the language in the remaining CIDI sections was modified to enhance comprehension with adolescents using an iterative process. Third, CIDI modules were modified in content to make them more germane to the contexts and experiences of adolescents. The most common change of this type required altering references from adult contexts (eg, work life and parenting) to adolescent contexts (eg, school life and peer relationships). Fourth, the finalized revision of each diagnostic module was reviewed for meaning, logic, and comparability to the adult version. Each diagnostic section was then systematically piloted to test the flow and timing among adolescents, with subsequent modifications
