I. Somatic symptoms Mild or greater Level 2—Somatic Symptoms—Parent/Guard- ian of Child Age 6—17 (Patient Health 11. Sleep problems Mild or greater Level 2—Sleep Disturbance—Parent/Guard- ian of Child Age 6—17 (PROMIS Sleep
III. Inattention Slight or greater Level 2—Inattention—Parent/Guardian of
Child Age 6—17(Swanson, Nolan, and Pel- ham, Version IV [SNAP-IV])
IV. Depression Mild or greater bevel 2—Depression—Parent/Guardian of
V. Anger Mild or greater Level 2—Anger—Parent/Guardian of Child
VI. Irritability Mild or greater Level 2—Irritability—Parent/Guardian of
VII. Mania Mild or greater Level 2—Mania—Parent/Guardic'1 of Child
VIII. Anxiety Mild or greater Level 2—Anxiety—Parent/Guardian of Child
IX. Psychosis Slight or greater None
X. Repetitive thoughts Mild or greater None
XI. Substance use Yes Level 2—Substance Use—Parent/Guardian of
Child (adapted from the NIDA-modified
XII. Suicidal ideation/ Yes None
Note. NIDA=National Institute on Drug Abuse.
aAvailable at www.psychiatry.org/dsm5.
used as an indicator for additional inquiry. A parent or guardian’s rating of "Don’t Know” on the suicidal ideation, suicide attempt, and any of the substance use items, especially for chil- dren ages 11—17 years, may result in additional probing of the issues with the child, including using the child-rated Level 2 Cross-Cutting Symptom Measure for the relevant domain. Be- cause additional inquiry is made on the basis of the highest score on any item within a do- main, clinicians should indicate that score in the ”Highest Domain Score” column. Table 2 outlines threshold scores that may guide further inquiry for the remaining domains.
Any threshold scores on the Level 1 Cross-Cutting Symptom Measure (as noted in Tables clinical inquiry. Level 2 Cross-Cutting Symptom Measures provide one method of obtain- ing more in-depth information on potentially significant symptoms to inform diagnosis, treatment planning, and follow-up. They are available online at www.psychiatry.org/ dsm5. Tables 1 and 2 outline each Level 1 domain and identify the domains for which
DSM-S Leve12 Cross-Cutting Symptom Measures are available for more detailed assess- ments. Adult and pediatric (parent and child) versions are available online for most Level 1 symptom domains at www.psychiatry.org/dsm5.
Frequency of Use of the Cross-CUuing
To track change in the individual’s symptom presentation over time, the Level 1 and rel- clinically indicated, depending on the stability of the individual’s symptoms and treat- ment status. For individuals with impaired capacity and for children ages 6—17 years, it is preferable for the measures to be completed at follow-up appointments by the same knowledgeable informant and by the same parent or guardian. Consistently high scores on a particular domain may indicate significant and problematic symptoms for the indi- vidual that might warrant further assessment, treatment, and follow-up. Clinical judg— ment should guide decision making.
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