比较《精神疾病诊断与统计手册》第四版人格障碍访谈量表(PDI-IV)与《精神障碍诊断统计手册》第二版边缘型人格障碍量表:一项项目反应理论分析
Comparing the Personality Disorder Interview for DSM-IV (PDI-IV) and SCID-II borderline personality disorder scales: an item-response theory analysis.
作者信息
Huprich Steven K, Paggeot Amy V, Samuel Douglas B
机构信息
a Department of Psychology , Eastern Michigan University.
出版信息
J Pers Assess. 2015;97(1):13-21. doi: 10.1080/00223891.2014.946606. Epub 2014 Sep 9.
One-hundred sixty-nine psychiatric outpatients and 171 undergraduate students were assessed with the Personality Disorder Interview-IV (PDI-IV; Widiger, Mangine, Corbitt, Ellis, & Thomas, 1995) and the Structured Clinical Interview for DSM-IV Axis II disorders (SCID-II; First, Gibbon, Spitzer, Williams, & Benjamin, 1997) for borderline personality disorder (BPD). Eighty individuals met PDI-IV BPD criteria, whereas 34 met SCID-II BPD criteria. Dimensional ratings of both measures were highly intercorrelated (rs = .78, .75), and item-level interrater reliability fell in the good to excellent range. An item-response theory analysis was performed to investigate whether properties of the items from each interview could help understand these differences. The limited agreement seemed to be explained by differences in the response options across the two interviews. We found that suicidal behavior was among the most discriminating criteria on both instruments, whereas dissociation and difficulty controlling anger had the 2 lowest alpha parameter values. Finally, those meeting BPD criteria on both interviews had higher levels of anxiety, depression, and more impairments in object relations than those meeting criteria on just the PDI-IV. These findings suggest that the choice of measure has a notable effect on the obtained diagnostic prevalence and the level of BPD severity that is detected.
对169名精神科门诊患者和171名本科生使用《人格障碍访谈第四版》(PDI-IV;Widiger、Mangine、Corbitt、Ellis和Thomas,1995年)以及《精神疾病诊断与统计手册第四版》轴II障碍的结构化临床访谈(SCID-II;First、Gibbon、Spitzer、Williams和Benjamin,1997年)评估边缘型人格障碍(BPD)。80人符合PDI-IV的BPD标准,而34人符合SCID-II的BPD标准。两种测量方法的维度评分高度相关(rs = 0.78、0.75),项目层面的评分者间信度处于良好到优秀范围。进行了项目反应理论分析,以研究每次访谈中项目的属性是否有助于理解这些差异。有限的一致性似乎可以通过两次访谈中反应选项的差异来解释。我们发现自杀行为是两种工具中最具区分性的标准之一,而解离和难以控制愤怒的alpha参数值最低。最后,在两次访谈中都符合BPD标准的人比仅符合PDI-IV标准的人有更高水平的焦虑、抑郁,并且在客体关系方面有更多损害。这些发现表明测量方法的选择对获得的诊断患病率和检测到的BPD严重程度水平有显著影响。