DSM-IV Personality Disorders (dsm-iv + personality_disorders)

Distribution by Scientific Domains

Selected Abstracts

Using the SWAP-200 in a personality-disordered forensic population: is it valid, reliable and useful?

Luisa E. Marin-Avellan
Background Treatment and risk management of forensic patients relies heavily on diagnosing psychopathology, yet the reliability of clinical diagnoses of personality disorder has been found to be only fair to low. Structured instruments for the global assessment of personality disorder are infrequently used in clinical assessments possibly due to their limited validity and clinical utility. Aims/methods The Shedler-Westen Assessment Procedure-200 (SWAP-200) was developed in an effort to address these limitations. Although good reliability and validity in relation to clinicians' diagnosis of personality disorder has been reported, to date the validity of this instrument has not been assessed in relation to other standardized instruments or in a personality-disordered, forensic population. This study aims to establish the reliability and validity of the SWAP-200 against other diagnostic instruments and measures of interpersonal functioning in a personality disordered forensic population. Results This paper reports the results of 30 subjects from a high secure hospital in the UK who were assessed with the SWAP-200, the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II), the Adult Attachment Interview (AAI) and the Chart of Interpersonal Reactions in Closed Living Environments (CIRCLE). Preliminary results suggest that the SWAP-200 is a reliable instrument for the diagnosis of personality disorder in forensic patients. Conclusions Although the small sample size allows only preliminary conclusions about the validity of this instrument, early results show a reduction of the diagnosis of comorbidity compared with the SCID-II, together with an increased number of expected associations between independent measures of interpersonal functioning and categories of personality disorder. Copyright 2005 Whurr Publishers Ltd. [source]

New onsets of substance use disorders in borderline personality disorder over 7 years of follow-ups: findings from the Collaborative Longitudinal Personality Disorders Study

ADDICTION, Issue 1 2009
Marc Walter
ABSTRACT Aims The purpose of this study was to examine whether patients with borderline personality disorder (BPD) have a higher rate of new onsets of substance use disorders (SUD) than do patients with other personality disorders (OPD). Design This study uses data from the Collaborative Longitudinal Personality Disorder Study (CLPS), a prospective naturalistic study with reliable repeated measures over 7 years of follow-up. Setting Multiple clinical sites in four northeastern US cities. Participants A total of 175 patients with BPD and 396 patients with OPD (mean age 32.5 years) were assessed at baseline and at 6, 12, 24, 36, 48, 60, 72 and 84 months. Measurements The Structured Clinical Interview for DSM-IV Axis I Disorders and the Diagnostic Interview for DSM-IV Personality Disorders were used at baseline, the Follow-Along version of the DIPD-IV and the Longitudinal Interval Follow-up Evaluation at the follow-up evaluations. Kaplan,Meier analyses were calculated to generate the time to new onsets. Findings BPD patients showed a shorter time to new onsets of SUD. Thirteen per cent of BPD patients developed a new alcohol use disorder and 11% developed a new drug use disorder, compared to rates of 6% and 4%, respectively, for OPD. Non-remitted BPD and remitted BPD patients did not differ significantly in rates of new onsets of SUD. Conclusions BPD patients have a high vulnerability for new onsets of SUDs even when their psychopathology improves. These findings indicate some shared etiological factors between BPD and SUD and underscore the clinical significance of treating SUD when it co-occurs in BPD patients. [source]

Screening for personality disorder: a comparison of personality disorder assessment by patients and informants

Dr Paul Walters
Abstract The Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II Version 2.0) is becoming the most favoured instrument to measure personality disorder but takes up to an hour to complete. The Standardized Assessment of Personality (SAP), an informant-based measure, takes 10 to 15 minutes to complete. Both instruments have been validated independently. This study aimed to determine whether the SAP is a suitable screening instrument for personality disorder as measured by the SCID-II. Fifty-seven psychiatric patients were assessed for personality disorder using both the SAP and the SCID-II. The SAP assessments were conducted blind to the results of the SCID-II assessments. Agreement between the two instruments in this population was low (kappa = 0.3). The level of agreement differed between personality disorder categories, ranging from kappa = 0.4 (antisocial) to ,0.1 (narcissistic). In this population of patients, the SAP proved to be a poor screen for the SCID-II. The study highlights the discrepancy between informant and self-report assessments for personality disorder. Copyright 2004 Whurr Publishers Ltd. [source]

Personality disorders in first-episode psychosis,

Erik Simonsen
The aim of the study was to determine the prevalence of personality disorders in the early course of first-episode psychosis and their likely presence in the premorbid period. Fifty-five patients were enrolled at baseline and premorbid function was evaluated by the Premorbid Adjustment Scale. Thirty-three of these of the patients were assessed at two-year follow-up for comorbid personality disorders by the Structured Clinical Interview for DSM-IV Personality Disorders and by the self-report instrument Millon Clinical Multiaxial Inventory-II. Half of the patients met the criteria of two or more personality disorders, while one-third of the patients did not fulfil the criteria for any personality disorder. The schizoid and the avoidant were the most frequent personality disorders and both were associated with social withdrawal during childhood and adolescence. The limitation of the study is the small sample, the retrospective assessment and a 40% attrition rate. The strengths are that it is a clinical epidemiological sample of first-episode psychotic patients and that different but complimentary measures of the personality disorders were used. Copyright 2008 John Wiley & Sons, Ltd. [source]

The Self-report Standardized Assessment of Personality-abbreviated Scale: Preliminary results of a brief screening test for personality disorders

Sara Germans
Objective,The internal consistency, test,retest reliability and validity of the Self-report Standardized Assessment of Personality-abbreviated Scale (SAPAS-SR) as a screening instrument for personality disorders were studied in a random sample of 195 Dutch psychiatric outpatients, using the Structured Clinical Interviews for DSM-IV Personality Disorders (SCID-II) as a gold standard. Method,All patients completed a self-report version of the SAPAS. One week later, they were interviewed with the SCID-II. Two weeks later, the SAPAS-SR was re-administered. Results,According to the SCID-II, 97 patients (50%) were suffering from a personality disorder. The SAPAS-SR correctly classified 81% of all participants. Sensitivity (0.83) and specificity (0.80) were slightly lower compared with the original English version. This difference may be explained by the lower prevalence and severity of personality disorders in the study population. Conclusion,The results provide evidence for the usefulness of the SAPAS as a self-administered instrument for screening personality disorders in clinical populations. Copyright 2008 John Wiley & Sons, Ltd. [source]