Davidson Kate M, Obonsawin Marc C, Seils Maureen, Patience Lynne
Glasgow Institute of Psychosocial Interventions, Department of Psychological Medicine, University of Glasgow, Gartnavel Royal Hospital, Scotland.
J Pers Disord. 2003 Jun;17(3):208-18. doi: 10.1521/pedi.17.3.208.22148.
The Shedler Westen Assessment Procedure (SWAP-200; Westen & Shedler, 1999a) is a clinician-rated assessment providing descriptions of personality disorder prototypes using a Q-sort procedure. This study aims to investigate the degree to which there is agreement between patients' and clinicians' accounts of personality pathology on a modified version of the SWAP-200 using Bland Altman analysis with the data from 23 clinician-patient pairs. Poor agreement was found between clinicians and patients on personality prototypes. Even the best agreement found between patients and clinicians on the avoidant prototype was poor--the patients' ratings were up to 43.5 per cent below and 32.9 per cent above the clinicians' ratings. This is an unacceptable degree of variation. The difference between the clinician and patient ratings are large when expressed as a percentage of the possible scores (as obtained on the clinician rating scale). The patient ratings vary between being 40.8 to 91.1% below the clinician ratings, and 32.9 to 99.7% above the clinician ratings.
谢德勒-韦斯顿评估程序（SWAP-200；韦斯顿和谢德勒，1999a）是一种由临床医生评定的评估方法，它使用Q分类程序来描述人格障碍原型。本研究旨在通过对23对临床医生-患者的数据进行布兰德-奥特曼分析，调查在SWAP-200的修订版中，患者和临床医生对人格病理学描述的一致程度。结果发现，临床医生和患者在人格原型方面的一致性较差。即使在患者和临床医生之间发现的关于回避型原型的最佳一致性也很差——患者的评分比临床医生的评分低43.5%，高32.9%。这是一个不可接受的变异程度。当以可能得分的百分比（如在临床医生评定量表上获得的得分）表示时，临床医生和患者评分之间的差异很大。患者评分比临床医生评分低40.8%至91.1%，高32.9%至99.7%。
