Validation of two informant-based screening instruments for personality disorders in  a psychiatric outpatient population

The internal consistency, test-retest reliability, and predictive validity of the Iowa Personality Disorder Screen (IPDS) as a screening instrument for personality disorders (PDs) were studied in 195 Dutch psychiatric outpatients, using the SCID-II as the gold standard. All patients completed a self-administered version of the IPDS. Internal consistency was moderate (0.64), and the test-retest reliability was good (0.87). According to the SCID-II, 97 patients (50%) had at least one personality disorder (PD). The IPDS correctly classified 81.0 percent of all participants in the category PD present/absent. The sensitivity and specificity were 77% and 88%, respectively. Positive and negative predictive values were 83% and 79%. Test-retest reliability after a 2-week interval was 0.87. These results are comparable with those reported in earlier studies with respect to the interview version of the IPDS and more promising than previously reported results obtained with a self-report version of the IPDS. Therefore, it is concluded that a self-report version of the IPDS may be useful as a screening measure for determining the presence/absence of PD in a population of psychiatric outpatients.

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Test-Retest Reliability of a Self-Report Questionnaire for DSM-IV and ICD-10 Personality Disorders

European Journal of Psychological Assessment ◽

10.1027//1015-5759.16.1.53 ◽

2000 ◽

Vol 16 (1) ◽

pp. 53-58 ◽

Cited By ~ 11

Author(s):

Hans Ottosson ◽

Martin Grann ◽

Gunnar Kullgren

Keyword(s):

Personality Disorder ◽

Anxiety Disorders ◽

Personality Disorders ◽

Clinical Sample ◽

Self Report ◽

Anxiety State ◽

Short Term ◽

Retest Reliability ◽

Axis I ◽

Test Retest Reliability

Summary: Short-term stability or test-retest reliability of self-reported personality traits is likely to be biased if the respondent is affected by a depressive or anxiety state. However, in some studies, DSM-oriented self-reported instruments have proved to be reasonably stable in the short term, regardless of co-occurring depressive or anxiety disorders. In the present study, we examined the short-term test-retest reliability of a new self-report questionnaire for personality disorder diagnosis (DIP-Q) on a clinical sample of 30 individuals, having either a depressive, an anxiety, or no axis-I disorder. Test-retest scorings from subjects with depressive disorders were mostly unstable, with a significant change in fulfilled criteria between entry and retest for three out of ten personality disorders: borderline, avoidant and obsessive-compulsive personality disorder. Scorings from subjects with anxiety disorders were unstable only for cluster C and dependent personality disorder items. In the absence of co-morbid depressive or anxiety disorders, mean dimensional scores of DIP-Q showed no significant differences between entry and retest. Overall, the effect from state on trait scorings was moderate, and it is concluded that test-retest reliability for DIP-Q is acceptable.

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Machiavellianism and personality disorder: their relationship in the mirror of interpersonal attitudes

Orvosi Hetilap ◽

10.1556/oh.2014.30004 ◽

2014 ◽

Vol 155 (40) ◽

pp. 1584-1588

Author(s):

András Láng

Keyword(s):

Personality Disorder ◽

Personality Traits ◽

Personality Disorders ◽

Interpersonal Problems ◽

Self Report ◽

Callous Unemotional ◽

Personality Dysfunction ◽

Medium Strength

Introduction: Social and personality psychologists have described Machiavellianism as a pragmatic, callous-unemotional, exploitative and manipulative attitude towards others. Several former studies linked Machiavellian personality traits and interpersonal problems or personality dysfunction. Aim: The aim of this study was to reveal the connection between Machiavellianism and interpersonal problems that are characteristic of personality disorders. Method: 252 participants (146 females and 106 males, aged 32.46±5.39 years, mean±SD) filled out self-report measures of Machiavellianism and personality disorder related interpersonal problems. Results: There was a medium strength relationships between Machiavellianism and several interpersonal problems. Aggression and ambivalence proved to be significant predictors of Machiavellian personality traits. Conclusions: Results are discussed in relation to the patient–therapist bond. Orv. Hetil., 2014, 155(39), 1584–1588.

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Bulimia nervosa with co-morbid avoidant personality disorder: behavioural characteristics and serotonergic function

Psychological Medicine ◽

10.1017/s003329170300864x ◽

2004 ◽

Vol 34 (1) ◽

pp. 113-124 ◽

Cited By ~ 22

Author(s):

K. R. BRUCE ◽

H. STEIGER ◽

N. M. KOERNER ◽

M. ISRAEL ◽

S. N. YOUNG

Keyword(s):

Personality Disorder ◽

Bulimia Nervosa ◽

The Other ◽

Self Report ◽

Lower Sensitivity ◽

Social Avoidance ◽

Behavioural Inhibition ◽

Avoidant Personality Disorder ◽

Affective Instability ◽

The Impact

Background. Separate lines of research link lowered serotonin tone to interpersonal submissiveness and bulimia nervosa (BN). We explored the impact of co-morbid avoidant personality disorder (APD), as a proxy for submissiveness, on behavioural inhibition and serotonin function in women with BN.Method. Participants included women with BN with co-morbid APD (BNA+, N=13); women with BN but without APD (BNA−, N=23), and control women with neither BN nor APD (N=23). The women were assessed for psychopathological tendencies and eating disorder symptoms, and participated in a computerized laboratory task that measured behavioural inhibition and disinhibition. Participants also provided blood samples for measurement of serial prolactin responses following oral administration of the partial 5-HT agonist meta-chlorophenylpiperazine (m-CPP).Results. The BNA+ group had higher scores than the other groups on self-report measures of submissiveness, social avoidance, restricted emotional expression, affective instability and self-harming behaviours. Compared with the other groups, the BNA+ group tended to be more inhibited under cues for punishment on the computerized task and to have blunted prolactin response following m-CPP. The bulimic groups did not differ from each other on current eating symptoms or on frequencies of other mental disorders.Conclusions. Findings indicate that women with BN and co-morbid APD may be characterized by interpersonal submissiveness and avoidance, affective instability, self-harm, behavioural inhibition in response to threat and lower sensitivity to serotonergic activation. These findings may indicate common, serotonergic factors, associated with social submissiveness, behavioural inhibition to threat and BN.

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Preliminary Scales for ICD-11 Personality Disorder: Self and Interpersonal Dysfunction Plus Five Personality Disorder Trait Domains

Frontiers in Psychology ◽

10.3389/fpsyg.2021.668724 ◽

2021 ◽

Vol 12 ◽

Author(s):

Lee Anna Clark ◽

Alejandro Corona-Espinosa ◽

Shereen Khoo ◽

Yuliya Kotelnikova ◽

Holly F. Levin-Aspenson ◽

...

Keyword(s):

Personality Disorder ◽

Discriminant Validity ◽

The Other ◽

Self Report ◽

Model Description ◽

Component Level ◽

Convergent And Discriminant Validity ◽

Interpersonal Dysfunction ◽

Two Factors ◽

Clinical Description

The ICD-11 personality disorder model is the first fully dimensional assessment of personality pathology. It consists of a personality disorder (PD) dysfunction-severity dimension, which encompasses both self- and interpersonal dysfunction, and six optional qualifiers for five prominent personality traits—Negative Affectivity (NA), Detachment (DET), Dissociality (DSL), Disinhibition (DSN), and Anankastia (ANK)—plus a borderline pattern that is defined by the criteria of DSM-IV borderline PD. This article reports on the development of a new self-report measure to assess self- and interpersonal dysfunction and the five trait qualifiers. It is the first comprehensive measure of the ICD-11 PD model in that (a) it is the only one to include both PD dysfunction-severity as well as trait scales and because (b) it is based on the Clinical Description and Diagnostic Guidelines, which are more detailed than the “statistical” model description that is currently on the ICD-11 website. The authors wrote 992 items and then reduced the pool to 300 items by eliminating redundancy and selecting the consensus best few items for each subconstruct. Data were collected using an online sample of 383 Prolific workers. Using exploratory factor analysis, seven domain scales were developed, each of which contained two to four scales assessing components of the domain. These preliminary scales’ psychometrics were excellent, as were the domains’ and their components’ convergent and discriminant validity, with a few generally minor exceptions. Structural analyses at the component level revealed a three-factor structure consisting of two moderately correlated Internalizing factors, one centered on Self Dysfunction with two NA components and a DSN component (Distractibility) and the other on Interpersonal Dysfunction with DET and ANK components; as well as an Externalizing factor with DSL and a DSN component (Reckless Impulsivity) that was uncorrelated with the other two factors. Two aspects of the results in particular are striking: (1) ANK was not the opposite end of a DSN dimension, but rather contributed to an Internalizing Interpersonal Dysfunction dimension and (2) DSN had both an Internalizing and an Externalizing component. Implications of the findings and study limitations are discussed.

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The Clinical Utility of Personality Profiles of High-Risk Offenders in Rehabilitation

10.26686/wgtn.17006152.v1 ◽

2021 ◽

Author(s):

◽

Morgan K.A. Sissons

Keyword(s):

Cluster Analysis ◽

High Risk ◽

Personality Disorders ◽

Predictive Validity ◽

Clinical Relevance ◽

Clinical Utility ◽

Self Report ◽

Offender Rehabilitation ◽

Criminal Recidivism ◽

Self Presentation

<p>Personality disorders are common among high-risk offenders. These disorders may have relevance for their risk of offending, and they are likely to present barriers to their engagement in rehabilitation programmes. Co-morbidity between personality disorders - and the high frequency of clinical disorders in general - in offender samples complicate research on personality disorder in offender rehabilitation. One approach to understanding this heterogeneity is to use cluster analysis (CA). CA is an empirical strategy which is used to identify subgroups (clusters) of individuals who have similar scores on the variables used in the analysis. It has been used to empirically identify different patterns of personality and clinical psychopathology among incarcerated offenders. Two profiles frequently emerge in cluster analytic research on offender psychopathology profiles: an antisocial/narcissistic profile and a high-psychopathology profile. However, previous research has not empirically examined whether the identification of these profiles has clinical relevance for offender rehabilitation; that is, whether the profiles are simply descriptive, or whether they can provide useful information for the management and rehabilitation of offenders. In the current research, I used data collected from high risk offenders entering prison-based rehabilitation programmes to investigate the clinical utility of psychopathology clusters. Using a self-report measure of personality and clinical psychopathology - the Millon Clinical Multiaxial Inventory III - I identified three clusters: a low-psychopathology cluster (26% of the sample), a high-psychopathology cluster (35% of the sample), and an antisocial/narcissistic cluster (39% of the sample). The high-psychopathology and antisocial/narcissistic clusters in particular resembled high risk clusters found in previous research. To determine whether the three clusters had clinical relevance, I investigated cluster differences in criminal risk, treatment responsivity, and self-report predictive validity. I found evidence for cluster differences in criminal risk: men in the high-psychopathology and antisocial/narcissistic clusters had higher rates of criminal recidivism after release compared to men in the low-psychopathology cluster. However, I found that regardless of psychopathology, men in all three clusters made progress in treatment, and there was little evidence that clusters that reported more psychopathology were less engaged, or made less progress. In the final study I examined cluster differences in self-presentation style and the predictive validity of self-report. Results indicated that offenders who reported high levels of psychopathology had a more general tendency for negative self-presentation, and their self-report on risk-related measures was highly predictive of criminal recidivism. Combined, the results of this research show that cluster analysis of self-reported psychopathology can generate a parsimonious model of heterogeneity in offender samples. Importantly, the resulting clusters can also provide information for some of the most important tasks in offender management: assessment and treatment. The results suggest the highest risk offenders tend to report higher levels of psychopathology, and that offenders who report extensive psychopathology also have highly predictive risk-related self-report. Perhaps one of the most reassuring findings of the current research is that even offenders who report high levels of psychopathology appear to benefit from rehabilitation.</p>

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COGNITIVE BEHAVIOUR THERAPY AND ASSERTION TRAINING GROUPS FOR PATIENTS WITH DEPRESSION AND COMORBID PERSONALITY DISORDERS

Behavioural and Cognitive Psychotherapy ◽

10.1017/s1352465800000072 ◽

2000 ◽

Vol 28 (1) ◽

pp. 71-85 ◽

Cited By ~ 7

Author(s):

Jillian Ball ◽

Brian Kearney ◽

Kay Wilhelm ◽

Jodie Dewhurst-Savellis ◽

Belinda Barton

Keyword(s):

Personality Disorder ◽

Personality Disorders ◽

Depressive Symptomatology ◽

Therapy Group ◽

Self Report ◽

Cognitive Behaviour ◽

Long Term Follow Up ◽

Assertion Training

Longitudinal evaluations were conducted on 61 adults who were referred to a Mood Disorders Unit with a history of depression (all index episodes reached criteria for DSM-III-R major depression or dysthymia) and who had completed a cognitive behavioural therapy group either on its own or in combination with an assertion training group. Assessment of personality was made using DSM-III-R Axis II personality disorder categories. These categories were aggregated to form three groups: (i) no personality disorder; (ii) Cluster B (dramatic-erratic); and (iii) Cluster C (anxious-fearful), and were used to identify responsiveness to treatment and outcome at long-term follow-up. A battery of self-report measures were administered pretreatment, posttreatment and at long-term follow-up (1–3 years later). Both groups showed significant improvements in mean scores during treatment and these gains were maintained over the follow-up period. However, improvement in those patients without personality disorders was greater at posttreatment and at long-term follow-up, both in level of depressive symptomatology and proportion of cases meeting criteria for recovery. The treatment implications of these results are discussed.

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Self-report assessment of the DSM-IV personality disorders. Measurement of trait and distress characteristics: the ADP-IV

Psychological Medicine ◽

10.1017/s0033291798007041 ◽

1998 ◽

Vol 28 (5) ◽

pp. 1179-1188 ◽

Cited By ~ 98

Author(s):

C. K. W. SCHOTTE ◽

D. de DONCKER ◽

C. VANKERCKHOVEN ◽

H. VERTOMMEN ◽

P. COSYNS

Keyword(s):

Factor Analysis ◽

Personality Disorder ◽

Personality Disorders ◽

Alternative Assessment ◽

Assessment Method ◽

Self Report ◽

Clinical Samples ◽

Item Level ◽

Dsm Iv ◽

Scoring Algorithms

Background. Self-report instruments assessing the DSM personality disorders are characterized by overdiagnosis due to their emphasis on the measurement of personality traits rather than the impairment and distress associated with the criteria.Methods. The ADP-IV, a Dutch questionnaire, introduces an alternative assessment method: each test item assesses ‘Trait’ as well as ‘Distress/impairment’ characteristics of a DSM-IV criterion. This item format allows dimensional as well as categorical diagnostic evaluations. The present study explores the validity of the ADP-IV in a sample of 659 subjects of the Flemish population.Results. The dimensional personality disorder subscales, measuring Trait characteristics, are internally consistent and display a good concurrent validity with the Wisconsin Personality Disorders Inventory. Factor analysis at the item-level resulted in 11 orthogonal factors, describing personality dimensions such as psychopathy, social anxiety and avoidance, negative affect and self-image. Factor analysis at the subscale-level identified two basic dimensions, reflecting hostile (DSM-IV Cluster B) and anxious (DSM-IV Cluster C) interpersonal attitudes. Categorical ADP-IV diagnoses are obtained using scoring algorithms, which emphasize the Trait or the Distress concepts in the diagnostic evaluation. Prevalences of ADP-IV diagnoses of any personality disorder according to these algorithms vary between 2·28 and 20·64%.Conclusions. Although further research in clinical samples is required, the present results support the validity of the ADP-IV and the potential of the measurement of trait and distress characteristics as a method for assessing personality pathology.

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The Clinical Utility of Personality Profiles of High-Risk Offenders in Rehabilitation

10.26686/wgtn.17006152 ◽

2021 ◽

Author(s):

◽

Morgan K.A. Sissons

Keyword(s):

Cluster Analysis ◽

High Risk ◽

Personality Disorders ◽

Predictive Validity ◽

Clinical Relevance ◽

Clinical Utility ◽

Self Report ◽

Offender Rehabilitation ◽

Criminal Recidivism ◽

Self Presentation

<p>Personality disorders are common among high-risk offenders. These disorders may have relevance for their risk of offending, and they are likely to present barriers to their engagement in rehabilitation programmes. Co-morbidity between personality disorders - and the high frequency of clinical disorders in general - in offender samples complicate research on personality disorder in offender rehabilitation. One approach to understanding this heterogeneity is to use cluster analysis (CA). CA is an empirical strategy which is used to identify subgroups (clusters) of individuals who have similar scores on the variables used in the analysis. It has been used to empirically identify different patterns of personality and clinical psychopathology among incarcerated offenders. Two profiles frequently emerge in cluster analytic research on offender psychopathology profiles: an antisocial/narcissistic profile and a high-psychopathology profile. However, previous research has not empirically examined whether the identification of these profiles has clinical relevance for offender rehabilitation; that is, whether the profiles are simply descriptive, or whether they can provide useful information for the management and rehabilitation of offenders. In the current research, I used data collected from high risk offenders entering prison-based rehabilitation programmes to investigate the clinical utility of psychopathology clusters. Using a self-report measure of personality and clinical psychopathology - the Millon Clinical Multiaxial Inventory III - I identified three clusters: a low-psychopathology cluster (26% of the sample), a high-psychopathology cluster (35% of the sample), and an antisocial/narcissistic cluster (39% of the sample). The high-psychopathology and antisocial/narcissistic clusters in particular resembled high risk clusters found in previous research. To determine whether the three clusters had clinical relevance, I investigated cluster differences in criminal risk, treatment responsivity, and self-report predictive validity. I found evidence for cluster differences in criminal risk: men in the high-psychopathology and antisocial/narcissistic clusters had higher rates of criminal recidivism after release compared to men in the low-psychopathology cluster. However, I found that regardless of psychopathology, men in all three clusters made progress in treatment, and there was little evidence that clusters that reported more psychopathology were less engaged, or made less progress. In the final study I examined cluster differences in self-presentation style and the predictive validity of self-report. Results indicated that offenders who reported high levels of psychopathology had a more general tendency for negative self-presentation, and their self-report on risk-related measures was highly predictive of criminal recidivism. Combined, the results of this research show that cluster analysis of self-reported psychopathology can generate a parsimonious model of heterogeneity in offender samples. Importantly, the resulting clusters can also provide information for some of the most important tasks in offender management: assessment and treatment. The results suggest the highest risk offenders tend to report higher levels of psychopathology, and that offenders who report extensive psychopathology also have highly predictive risk-related self-report. Perhaps one of the most reassuring findings of the current research is that even offenders who report high levels of psychopathology appear to benefit from rehabilitation.</p>

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Assessment of Personality Disorders and Related Traits: Bridging DSM-IV-TR and DSM-5

The Oxford Handbook of Personality Disorders ◽

10.1093/oxfordhb/9780199735013.013.0006 ◽

2012 ◽

pp. 107-140 ◽

Cited By ~ 1

Author(s):

Joshua D. Miller ◽

Lauren R. Few ◽

Thomas A. Widiger

Keyword(s):

Personality Disorder ◽

Personality Disorders ◽

Self Report ◽

Dsm 5 ◽

Prototype Matching ◽

Semistructured Interviews ◽

Assessment Techniques ◽

Dsm Iv ◽

The Many ◽

Diagnostic Criterion

The assessment of personality disorders and related traits is at an important crossroads with the imminent release of DSM-5. In this chapter we first review assessment techniques and measures as they pertain to the DSM-IV-TR personality disorders and pathological personality traits, focusing in particular on the many self-report inventories and semistructured interviews that have been developed. Second, we discuss the proposed changes to the diagnosis of personality disorder in DSM-5, which are substantial, and their ramifications for the assessment of personality disorder, including the (now abandoned) proposal to replace explicit diagnostic criterion sets with a prototype matching technique, the proposal to delete and/or shift a number of diagnoses from the personality disorders section, the provision of a new dimensional trait model of personality pathology, and the provision of new rating of impairment pertaining to self and interpersonal functioning.

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