David Shaffer

David Percy Shaffer (April 20, 1936 – October 15, 2023) was a South African-born British-American physician and pediatrician.

He was the Irving Philips Professor of Child Psychiatry in the Departments of Psychiatry and Pediatrics, at Columbia University's College of Physicians and Surgeons in New York City, now the Columbia University Vagelos College of Physicians and Surgeons.

Shaffer was also the chief of pediatric psychiatry at New York–Presbyterian Hospital and chief of the Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute.

He was the former spouse of renowned British-American journalist Anna Wintour.

Shaffer was born in Johannesburg, South Africa, on April 20, 1936, In the late 1940s and early 1950s he attended the International School of Geneva as a boarder, since his father did not want him to be educated in the racist society of South Africa.

He subsequently pursued his medical studies in London, England.

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

At the Maudsley, Shaffer conducted the first epidemiological study of child and early adolescent suicide using the psychological autopsy method.

He found that there was a short delay between experiencing a stressor and the act of suicide, youth tended to show elevated levels of aggressive behavior prior to committing suicide, and imitation appeared to play a role in youth suicide.

These findings would later be confirmed in his much larger controlled study in New York City and the surrounding area.

Other important findings from the New York study included the very high prevalence of alcohol and substance abuse in older male teens who committed suicide and the occurrence of a prior suicide attempt as a predictor of suicide in males, but not females.

In females, major depression was especially important predictor of suicide.

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 case-finding, suicide-awareness educational programs, was found to offer few benefits and potentially increased risk.

This stimulated the development of a screening strategy instead.

Ultimately, Shaffer led a team of colleagues in creating the Columbia TeenScreen.

The scoring algorithm had a sensitivity of 0.75, specificity 0.83, and positive predictive value 16% with suicidal ideation as the criterion.

Other research interests included the development of diagnostic instruments.

He was charged by the National Institutes of Health (NIMH) to develop a child version of the Diagnostic Interview Schedule (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 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 Multimodal Treatment Study of Children with ADHD; federally administered regular surveys, such as National Health and Nutrition Examination Survey; and a number of other longitudinal studies.

The availability of the instrument allowed, for the first time, careful examination of patterns of psychiatric comorbidity and how this emerges over time, a matter of great importance for the DSM.

The American Psychiatric Association funded a grant to Shaffer's group to reexamine DISC data on 26,000 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 Michael Rutter to explore the benefits of a multi-axial system for the ICD-9.

The multi-axial modifications of the ICD-9 subsequently influenced the development of the 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.

Building on data collected as part of the Columbia Presbyterian Hospital chapter of the multi-center Collaborative Perinatal Project, Shaffer led a study of the sequelae of age-7 neurological soft signs.

In that study, Shaffer and his colleagues found that neurological soft signs diagnosed at age 7 were related to mood and anxiety disorders ten years later.

Shaffer retired as director of the Division of Child and Adolescent Psychiatry at the New York State Psychiatric Institute (NYSPI) /Columbia University (CU) in May 2008, but retained his academic position and was actively engaged in research on DSM-5, the determinants and triggers of suicidal ideation, and the categorization of suicidal ideation and behavior in adolescents.

He thus maintained 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 35,000; 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.

Shaffer served as a consultant on suicide prevention for the U.S. Department of Defense, the Indian Health Service, and the New York State Office of Mental Health.

He was a member of the Surgeon General’s Advisory Task Force on Suicide Prevention.

He was a past president of the American Foundation for Suicide Prevention and of the Society for Research in Child and Adolescent Psychopathology.

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.

Shaffer was married and divorced twice.