K-SADS in Context: Testing Measurement Equivalence Across Race, Ethnicity, and Socioeconomic Factors

Rates of youth mental disorders vary across white, Black and Hispanic youths in the United States. The weak evidence for the generalizability of diagnostic tools significantly challenge the understanding of racial and ethnic differences in mental disorder risks. The Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS) is a widely used diagnostic interview. However, its applicability across racial and ethnic groups is questionable. The current study tested the statistical generalizability, or measurement equivalence, of the K-SADS across Hispanic (n=2,015), non-Hispanic white (n=6,021) and non-Hispanic Black (n=1,420) youths, using data from the Adolescent and Brain Cognitive Development (ABCD) Study. The sample was diverse in terms of child’s sex assigned at birth. Our results indicated that the K-SADS screening interview had a one-factor structure that was scalar equivalent. However, nearly 50% of its items functioned differently across groups, suggesting unequal probabilities of symptom endorsement at equivalent levels of mental disorder risks. Crucially, socioeconomic factors explained many of the measurement differences across groups, implicating their role in the validity of symptom reporting. Findings from this study can help develop clinical screening tools that are generalizable across race, ethnicity and socioeconomic factors, which is important for a contextualized understanding of racial and ethnic differences in youth mental disorders.