Child and Adolescent Psychiatric Hospital, Psychiatric University Hospitals Basel, Basel, Switzerland.
Child Adolesc Psychiatry Ment Health. 2012 Jul 19;6(1):27. doi: 10.1186/1753-2000-6-27.
In the continuing revision of Diagnostic and Statistical Manual (DSM-V) "identity" is integrated as a central diagnostic criterion for personality disorders (self-related personality functioning). According to Kernberg, identity diffusion is one of the core elements of borderline personality organization. As there is no elaborated self-rating inventory to assess identity development in healthy and disturbed adolescents, we developed the AIDA (Assessment of Identity Development in Adolescence) questionnaire to assess this complex dimension, varying from "Identity Integration" to "Identity Diffusion", in a broad and substructured way and evaluated its psychometric properties in a mixed school and clinical sample.
Test construction was deductive, referring to psychodynamic as well as social-cognitive theories, and led to a special item pool, with consideration for clarity and ease of comprehension. Participants were 305 students aged 12-18 attending a public school and 52 adolescent psychiatric inpatients and outpatients with diagnoses of personality disorders (N = 20) or other mental disorders (N = 32). Convergent validity was evaluated by covariations with personality development (JTCI 12-18 R scales), criterion validity by differences in identity development (AIDA scales) between patients and controls.
AIDA showed excellent total score (Diffusion: α = .94), scale (Discontinuity: α = .86; Incoherence: α = .92) and subscale (α = .73-.86) reliabilities. High levels of Discontinuity and Incoherence were associated with low levels in Self Directedness, an indicator of maladaptive personality functioning. Both AIDA scales were significantly different between PD-patients and controls with remarkable effect sizes (d) of 2.17 and 1.94 standard deviations.
AIDA is a reliable and valid instrument to assess normal and disturbed identity in adolescents. Studies for further validation and for obtaining population norms are in progress and may provide insight in the relevant aspects of identity development in differentiating specific psychopathology and therapeutic focus and outcome.
在《精神疾病诊断与统计手册》(DSM-V)的持续修订中,“身份认同”被整合为人格障碍(与自我相关的人格功能)的一个核心诊断标准。根据 Kernberg 的观点,身份认同扩散是边缘型人格组织的核心要素之一。由于目前没有详细的自评量表来评估健康和障碍青少年的身份认同发展,我们开发了 AIDA(青少年身份认同发展评估)问卷,以广泛而细分的方式评估这一复杂维度,从“身份认同整合”到“身份认同扩散”,并在混合学校和临床样本中评估其心理测量学特性。
测试构建是演绎式的,参考了心理动力学和社会认知理论,并产生了一个特殊的项目池,同时考虑了清晰度和易于理解。参与者包括 305 名 12-18 岁的公立学校学生和 52 名青少年精神科门诊和住院患者,其中人格障碍(N=20)或其他精神障碍(N=32)的诊断。通过与人格发展(JTCI 12-18 R 量表)的协变量评估聚合效度,通过患者和对照组之间的身份认同发展(AIDA 量表)差异评估标准效度。
AIDA 的总分(扩散:α=0.94)、量表(不连续性:α=0.86;不连贯性:α=0.92)和子量表(α=0.73-0.86)具有优异的信度。高不连续性和不连贯性水平与自我指导水平低有关,自我指导是一种适应不良的人格功能指标。PD 患者与对照组之间的 AIDA 量表差异显著,具有显著的效应量(d),分别为 2.17 和 1.94 个标准差。
AIDA 是一种可靠有效的评估青少年正常和障碍性身份认同的工具。目前正在进行进一步验证和获得群体常模的研究,这可能为区分特定精神病理学、治疗重点和结果方面的身份认同发展提供深入了解。