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National Comorbidity Survey Replication Adolescent Supplement (NCS-A): II. Overview and Design

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Abstract

Objective

To present an overview of the design and field procedures of the National Comorbidity Survey Replication Adolescent Supplement (NCS-A).

Method

The NCS-A is a nationally representative face-to-face household survey of the prevalence and correlates of DSM-IV mental disorders among U.S. adolescents (aged 13–17 years) that was performed between February 2001 and January 2004 by the Survey Research Center of the Institute for Social Research at the University of Michigan. The sample was based on a dual-frame design that included 904 adolescent residents of the households that participated in the National Comorbidity Survey Replication (response rate 85.9%) and 9,244 adolescent students selected from a representative sample of 320 schools in the same nationally representative sample of counties as the National Comorbidity Survey Replication (response rate 74.7%).

Results

Comparisons of sample and population distributions on census sociodemographic variables and, in the school sample, school characteristics documented only minor differences that were corrected with poststratification weighting. Comparisons of DSM-IV disorder prevalence estimates among household versus school sample respondents in counties that differed in the use of replacement schools for originally selected schools that refused to participate showed that the use of replacement schools did not introduce bias into prevalence estimates.

Conclusions

The NCS-A is a rich nationally representative dataset that will substantially increase understanding of the mental health and well-being of adolescents in the United States.

Section snippets

Fieldwork Organization and Procedures

The NCS-A fieldwork was performed by the same professional national field interview staff from the Survey Research Center (SRC) at the University of Michigan that performed the NCS-R. There were 197 interviewers supervised by a team of 18 experienced regional supervisors. A study manager located at the central SRC facility in Michigan oversaw the work of the supervisors and their staff. Upon making in-person contact, the interviewer answered questions before obtaining written informed consent

Sample Disposition

The NCS-A sample disposition is reported in Table 1. The overall adolescent response rate was 75.6%, for a total of 10,148 completed interviews. This is made up of response rates of 85.9% (n = 904) in the household sample, 81.8% (n = 8,912) in the unblinded school sample, and 22.3% (n = 332) in the blinded school sample. Nonresponse was largely due to refusal (21.3%), which, in the household and unblinded school samples, came largely from parents rather than adolescents (72.3% and 81.0%,

Discussion

This article presented an overview of the NCS-A survey design and field procedures. The design allowed us to gather data from a nationally representative sample of adolescents and schools. An important limitation of the NCS-A is the relatively low response rate of schools in the school sample, but we were able to show in analyses reported here that this seems not to have introduced bias into estimates of the prevalence of mental disorders or estimates of treatment rates. Nonetheless, because of

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The National Comorbidity Survey Replication Adolescent Supplement (NCS-A) is supported by the National Institute of Mental Health (NIMH; Grant U01-MH60220) with supplemental support from the National Institute on Drug Abuse, the Substance Abuse and Mental Health Services Administration, the Robert Wood Johnson Foundation (Grant 044780), and the John W. Alden Trust. The work of Dr. Merikangas and her staff on the NCS-A is supported by the NIMH Intramural Research Program, whereas the work of Dr. Zaslavsky and his staff on the validity of the NCS-A measures is supported by NIMH Grant R01-MH66627. The views and opinions expressed in this article are those of the authors and should not be construed to represent the views of any of the sponsoring organizations, agencies, or U.S. Government. A complete list of NCS-A publications can be found at http://www.hcp.med.harvard.edu/ncs.

The NCS-A is performed in conjunction with the World Health Organization World Mental Health (WMH) Survey Initiative. The authors thank the staff of the WMH Data Collection and Data Analysis Coordination Centers for assistance with instrumentation, fieldwork, and consultation on data analysis. The WMH Data Coordination Centers have received support from NIMH (Grants R01-MH070884, R13-MH066849, R01-MH069864, and R01-MH077883), NIDA (Grant R01-DA016558), the Fogarty International Center of the National Institutes of Health (FIRCA R03-TW006481), the John D. and Catherine T MacArthur Foundation, the Pfizer Foundation, and the Pan American Health Organization. The WMH Data Coordination Centers have also received unrestricted educational grants from Astra Zeneca, Bristol-Myers Squibb, Eli Lilly and Company, GlaxoSmithKline, Ortho-McNeil, Pfizer, Sanofi-Aventis, and Wyeth. A complete list of WMH publications can be found at http://www.hcp.med.harvard.edu/wmh/.

The authors thank Steven Heeringa, Ph.D., and Alan Zaslavsky, Ph.D., for statistical expertise.

This article is the subject of an editorial by Dr. Peter Szatmari in this issue.

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