荷兰全科医疗中老年人格障碍量表（GPS）的诊断准确性

Diagnostic accuracy of the Gerontological Personality Disorder Scale (GPS) in Dutch general practice.

作者信息

Penders Krystle A P, Rossi Gina, Metsemakers Job F M, Duimel-Peeters Inge G P, van Alphen Sebastiaan P J

机构信息

a Department of Family Medicine , School for Public Health and Primary Care, Maastricht University (UM) , Maastricht , The Netherlands.

b Faculty of Psychology & Educational Sciences, Department of Clinical & Lifespan Psychology , Vrije Universiteit Brussel (VUB) , Brussels , Belgium.

出版信息

Aging Ment Health. 2016;20(3):318-28. doi: 10.1080/13607863.2015.1008989. Epub 2015 Feb 16.

DOI:10.1080/13607863.2015.1008989

PMID:25683874

Abstract

OBJECTIVE

Personality disorders (PDs) often remain unrecognized in older adults by doctors in general practice. Therefore, this study evaluated the diagnostic accuracy of a screening instrument, the Gerontological Personality Disorder Scale (GPS), in a Dutch general-practice population of older adults.

METHOD

The psychometric properties of the GPS patient (GPS-pv) and informant (GPS-iv) versions were assessed in a sample of 302 (144 male) patients (average age: 69.9 years) and 302 (124 male) informants (average age: 64.7 years), respectively, using an informant-based personality questionnaire (the Hetero-Anamnestische Persoonlijkheidsvragenlijst ) as a reference criterion.

RESULTS

The internal consistency (average item correlation) of the subscale and total scores of the GPS-pv and GPS-iv were .12 (HAB), .16 (BIO), and .10 (total); and .16 (HAB), .15 (BIO), and .12 (total), respectively. The test--retest reliability was strong for both the GPS-pv (rs = .56 [HAB], rs = .67 [BIO], rs = .66 [total]) and the GPS-iv (rs = .52 [HAB], rs = .65 [BIO], rs = .68 [total]) versions. The sensitivity and specificity of the GPS-pv were .83 and .27, respectively, with a cutoff score of ≥1. Raising the cutoff score to ≥2, the sensitivity dropped to .59, whereas the specificity rose to .57. For the GPS-iv, a cutoff score of ≥3 maximized the sensitivity (.78) and specificity (.65).

CONCLUSION

The diagnostic accuracy of the GPS-iv was preferable to that of the GPS-pv. This is the first psychometric study to use the GPS as an age-specific screening instrument for PDs.

摘要

目的

在老年人群中，人格障碍（PDs）通常难以被全科医生识别。因此，本研究评估了一种筛查工具——老年人格障碍量表（GPS），在荷兰老年全科医疗人群中的诊断准确性。

方法

分别在302名（144名男性）患者（平均年龄：69.9岁）和302名（124名男性）信息提供者（平均年龄：64.7岁）的样本中，使用基于信息提供者的人格问卷（Hetero - Anamnestische Persoonlijkheidsvragenlijst）作为参考标准，评估GPS患者版（GPS - pv）和信息提供者版（GPS - iv）的心理测量特性。

结果

GPS - pv和GPS - iv子量表及总分的内部一致性（平均项目相关性）分别为：.12（HAB）、.16（BIO）和.10（总分）；以及.16（HAB）、.15（BIO）和.12（总分）。GPS - pv（rs =.56 [HAB]，rs =.67 [BIO]，rs =.66 [总分]）和GPS - iv（rs =.52 [HAB]，rs =.65 [BIO]，rs =.68 [总分]）版本的重测信度都很强。GPS - pv的敏感性和特异性分别为.83和.27，临界值≥1。将临界值提高到≥2，敏感性降至.59，而特异性升至.57。对于GPS - iv，临界值≥3时敏感性（.78）和特异性（.65）达到最大化。