David Shaffer

David Shaffer F.R.C.P., F.R.C.Psych., (born April 20, 1936) is the Irving Philips Professor of Child Psychiatry in the Departments of Psychiatry and Pediatrics, at the Columbia University College of Physicians and Surgeons at Columbia University in New York City. He is also the chief of pediatric psychiatry at New York–Presbyterian Hospital.

Shaffer obtained his medical training in London, England. He qualified as a physician at University College London, undertook his training in pediatrics at Great Ormond Street Hospital for children in London, and trained at the Maudsley Hospital.

At Maudsley, Shaffer conducted the first epidemiological study of child and early adolescent suicide using the psychological autopsy method. Findings included the short delay between experiencing a stressor and the act of suicide, the frequency of aggressive behavior, and the suggestions that imitation played a role in youth suicide. These findings would later be confirmed by his much larger controlled study in New York. Important findings from the New York Study were the very high prevalence of alcohol and substance abuse in older male teens who committed suicide, and the significance of a prior suicide attempt as a predictor in males, but not females, for whom major depression was especially important.

The finding of specific profiles and the almost universal presence of treatable psychiatric disorders among suicide victims suggested that case finding would be a viable method for preventing suicide. However, one approach to this—suicide-awareness educational programs—was found to offer few benefits and potential risks . This stimulated the development of a screening strategy instead. Ultimately, Shaffer led a team of colleagues in creating the now-discredited Columbia TeenScreen Program. Although Shaffer's own evaluation of TeenScreen found that the instrument had a positive predictive value of merely 16%, his organization was able for some years to promote the instrument in schools on a national level.

Other research interests have included the development of diagnostic instruments. He was charged by the National Institutes of Health (NIMH) to develop a child version of the DIS for use in large field studies. The NIMH DISC "is a highly structured diagnostic interview, designed to assess more than 30 psychiatric disorders occurring in children and adolescents, and can be administered by "lay" interviewers after a minimal training period." Shaffer has led the development of several editions of the DISC, including the current version (NIMH DISC-IV), which is based closely on DSM-IV. DISC-IV includes a computerized version of the interview that incorporates voice technology. This has greatly reduced the cost of administration, and allowed for self-completion by youth unable to read, obviating the constraining presence of an adult interviewer. The DISC has been translated into nine languages and has been used in approximately two hundred child research projects. Elements of the DISC have been employed by large, multi-site studies, such as the MTA; federally administered regular surveys, such as NHANES; and a number of other longitudinal studies. The availability of the instrument has, for the first time, allowed careful examination of patterns of psychiatric comorbidity and how this emerges over time, a matter of great importance for DSM. The American Psychiatric Association has just funded a grant to Shaffer’s group to reexamine DISC data on twenty-six thousand subjects for the purpose of identifying critical questions for DSM-V.

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