Department of Child and Adolescent Psychiatry, Region Zealand, Roskilde, Denmark.
BMC Psychiatry. 2012 Jul 30;12:94. doi: 10.1186/1471-244X-12-94.
Personality disorder (PD) is associated with significant functional impairment and an elevated risk of violent and suicidal behaviour. The prevalence of PD in populations of young offenders is likely to be high. However, because the assessment of PD is time-consuming, it is not routinely assessed in this population. A brief screen for the identification of young people who might warrant further detailed assessment of PD could be particularly valuable for clinicians and researchers working in juvenile justice settings.
We adapted a rapid screen for the identification of PD in adults (Standardised Assessment of Personality - Abbreviated Scale; SAPAS) for use with adolescents and then carried out a study of the reliability and validity of the adapted instrument in a sample of 80 adolescent boys in secure institutions. Participants were administered the screen and shortly after an established diagnostic interview for DSM-IV PDs. Nine days later the screen was readministered.
A score of 3 or more on the screening interview correctly identified the presence of DSM-IV PD in 86% of participants, yielding a sensitivity and specificity of 0.87 and 0.86 respectively. Internal consistency was modest but comparable to the original instrument. 9-days test-retest reliability for the total score was excellent. Convergent validity correlations with the total number of PD criteria were large.
This study provides preliminary evidence of the validity, reliability, and usefulness of the screen in secure institutions for adolescent male offenders. It can be used in juvenile offender institutions with limited resources, as a brief, acceptable, staff-administered routine screen to identify individuals in need of further assessment of PD or by researchers conducting epidemiological surveys.
人格障碍（PD）与显著的功能障碍和暴力及自杀行为风险增加有关。在年轻罪犯人群中，PD 的患病率可能很高。然而，由于 PD 的评估耗时，因此在该人群中通常不会进行评估。对于在青少年司法环境中工作的临床医生和研究人员来说，对可能需要进一步详细评估 PD 的年轻人进行 PD 快速筛查可能特别有价值。
我们改编了成人 PD 快速筛查工具（简化人格评估-缩写量表；SAPAS），用于青少年，并在安全机构的 80 名青少年男孩样本中进行了该改编工具的信度和效度研究。参与者接受了筛查，并在不久后接受了 DSM-IV PD 诊断访谈。9 天后再次进行了筛查。
筛查访谈得分为 3 分或以上正确识别了 86%参与者的 DSM-IV PD，敏感性和特异性分别为 0.87 和 0.86。内部一致性适中，但与原始工具相当。总分的 9 天测试-重测信度极好。与 PD 标准总数的聚合效度相关性较大。
本研究初步证明了该筛查在安全机构中对男性青少年罪犯的有效性、可靠性和实用性。它可以在资源有限的青少年罪犯机构中使用，作为一种简短、可接受、由工作人员管理的常规筛查，以识别需要进一步 PD 评估的个体，也可以由进行流行病学调查的研究人员使用。
