David Shaffer

Training

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.

Study of suicide

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.

Study of diagnosis

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 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 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 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 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.

Shaffer’s contribution to psychiatric classification dates back to 1966, when he collaborated with Sir Michael Rutter to explore the benefits of a multi-axial system for ICD-9. This would subsequently be adapted for DSM-III. He served on the Child and Adolescent Work Group for DSM-III and DSM-IIIR and was co-chair of that group for DSM-IV. He was a member of the Child and Adolescent Work Group and the Mood Disorders Work Group for DSM-V and was co-chair of the Disruptive Behaviors Disorder Workgroup for DSM-V.

Later years

Shaffer retired as director of the Division of Child Psychiatry at the New York State Psychiatric Institute/Columbia University (CU) in May 2008, but retains his academic position and was actively engaged in research on DSM-V, on the determinants and triggers of suicide ideation, and on the categorization of suicide ideation and behavior in adolescents. He thus maintains his ties with the Division of Child Psychiatry at NYSPI/CU, which, under his leadership, grew from a small department with seven hundred visits a year to one with over thirty five thousand; from one without research grants to one that holds a portfolio of over $30 million per annum; and from one with four child psychiatrists in training to one that is now the largest in the country, with five endowed chairs, over twenty-four clinical trainees, eight research trainees, and junior researchers from all continents.

He served as a consultant on suicide prevention for the U.S. Department of Defense, the Indian Health Service, and the York State Office of Mental Health. He was a member of the Surgeon General’s Advisory Task Force on Suicide Prevention. He is a past president of the American Foundation for Suicide Prevention and of the Society for Research in Child and Adolescent Psychopathology.

Awards and honors

Offices held

In addition to these research studies, he contributed to the debate about the relationship between SSRI antidepressants and suicidal behavior for the American Academy of Child and Adolescent Psychiatry, the American Psychiatric Association, and both the American College of Neuropsychopharmacology and the European College of Neuropsychopharmacology.

Family life

He was married and divorced twice. His first wife was the caterer Serena Bass, by whom he had two sons. His second wife, by whom he had a daughter and a son, was Vogue editor in chief Anna Wintour.