Obbarius Alexander, Obbarius Nina, Fischer Felix, Liegl Gregor, Rose Matthias
Medizinische Klinik mit Schwerpunkt Psychosomatik, Charité - Universitätsmedizin Berlin.
Psychother Psychosom Med Psychol. 2019 Jan;69(1):38-48. doi: 10.1055/s-0043-125394. Epub 2018 Feb 15.
Screening for personality dysfunction is regarded as increasingly important for treatment planning in clinical settings as this allows to determine specific clinical pathways in an early stage. Recently, the 12-item OPD Structure Questionnaire (OPD-SQS) was developed for this purpose and initial results of the factor structure and validity have been published. This study aimed to investigate and validate the OPD-SQS in further patient samples beyond the team of developers and to provide reference values.
Data was assessed in psychosomatic outpatients (N=565) and inpatients (N=670) at Charité - Universitätsmedizin Berlin between 2012 and 2016. To examine the factor structure of the OPD-SQS confirmatory factor analyses (CFA) were applied in both samples. To evaluate construct validity, a SKID-II-Interview was performed in N=105 patients and narcissism inventory (NI-90) was completed by N=160 patients. In addition, a range of instruments reflecting emotional, social and physical health were assessed. Bivariate correlations were performed to analyze relations between these instruments and the OPD-SQS.
CFAs indicated a good to satisfying fit for the proposed model including 3 factors. A Bifactormodel resulted in very good modelfit. Analyses of construct validity resulted in high positive correlations of OPD-SQS with dimensional SCID-II scores, SKID-II interviews, and NI-90 confirming convergent validity. Results for discriminant validity were heterogeneous. Medium to high correlations were found with a range of instruments including D-CAT (depression), A-CAT (anxiety), S-CAT (stress), and PHQ-15 (somatic symptoms). Subsequent analyses revealed, that the factor self-perception is potentially being influenced by current depression and anxiety. Analyses showed only minor differences of correlations between OPD-SQS subscales and other instruments.
The OPD-SQS seems to be appropriate for screening of personality dysfunction. However, other aspects of psychopathology are gathered in addition. Therefore, further investigation of the patients' personality structure such as an OPD interview may be added in clinical settings.
在临床环境中，人格功能障碍筛查对于治疗规划日益重要，因为这有助于在早期确定具体的临床路径。最近，为此目的开发了12项OPD结构问卷（OPD-SQS），并已发表了关于其因子结构和效度的初步结果。本研究旨在对开发者团队之外的更多患者样本进行调查和验证OPD-SQS，并提供参考值。
2012年至2016年期间，在柏林夏里特大学医学中心对心身门诊患者（N = 565）和住院患者（N = 670）的数据进行了评估。为了检验OPD-SQS的因子结构，在两个样本中均应用了验证性因子分析（CFA）。为了评估结构效度，对105例患者进行了SKID-II访谈，160例患者完成了自恋量表（NI-90）。此外，还评估了一系列反映情绪、社会和身体健康的工具。进行双变量相关分析以分析这些工具与OPD-SQS之间的关系。
CFA表明，包含3个因子的提议模型拟合良好至令人满意。双因子模型的模型拟合非常好。结构效度分析显示，OPD-SQS与维度性SCID-II评分、SKID-II访谈和NI-90呈高度正相关，证实了聚合效度。区分效度的结果参差不齐。发现与一系列工具存在中度至高度相关性，包括D-CAT（抑郁）、A-CAT（焦虑）、S-CAT（压力）和PHQ-15（躯体症状）。随后的分析表明，自我认知因子可能受到当前抑郁和焦虑的影响。分析显示，OPD-SQS子量表与其他工具之间的相关性差异很小。
OPD-SQS似乎适用于人格功能障碍的筛查。然而，此外还收集了精神病理学的其他方面。因此，在临床环境中可能需要增加对患者人格结构的进一步调查，如进行OPD访谈。
