8 Introduction
variety of patient populations; the latter su pplied valuable information about how proposed
revisions performed in everyday clinical settings among a diverse sample of DSM users. It is
anticipated that future clinical and basic research  studies will focus on the validity of the re-
vised categorical diagnostic criteria and the underlying dimensional features of these disor-
ders (including those now being explored by th e NIMH Research Domain  Criteria initiative).
The medical-academic field trials were cond ucted at 11 North American medical-academic
sites and assessed the reliability, feasibility, and clinical utility of select revisions, with priority
given to those that represented the greatest degree of change from DSM-IV or those potentially
having the greatest public health impact. The fu ll clinical patient populations coming to each
site were screened for DSM-IV diagnoses or qu alifying symptoms likely to predict several spe-
cific DSM-5 disorders of interest. Stratified sample s of four to seven specific disorders, plus a
stratum containing a representative sample of all other diagnoses, were id entified for each site.
Patients consented to the study and were randomly assigned for a clinical interview by a cli-
nician blind to the diagnosis, followed by a se cond interview with a clinician blind to previous
diagnoses. Patients first filled out a computer-assisted inventory of cross-cutting symptoms in
more than a dozen psychological domains. These inventories were scored  by a central server,
and results were provided to clinicians before they conducted a typical clinical interview (with
no structured protocol). Clinicians were required to score the presence of qualifying criteria on
a computer-assisted DSM-5 diagnostic checklist, de termine diagnoses, score the severity of the
diagnosis, and submit all data to the central Web-based server. This study design allowed the
calculation of the degree to wh ich two independent clinicians could agree on a diagnosis (us-