Hutsebaut Joost, Weekers Laura C, Tuin Nynke, Apeldoorn Jessica S P, Bulten Erik
Viersprong Institute for Studies on Personality Disorders, Halsteren, Netherlands.
GGZ Noord-Holland-Noord, Heerhugowaard, Netherlands.
Front Psychiatry. 2021 Apr 16;12:617702. doi: 10.3389/fpsyt.2021.617702. eCollection 2021.
In forensic settings, several challenges may affect reliability of assessment of personality pathology, specifically when based upon self-report. This study investigates the Semi-Structured Interview for DSM-5 Personality Functioning (STiP-5.1) to assess level of severity of personality functioning in incarcerated patients. Thirty inpatients of three forensic psychiatric facilities completed the STiP 5.1 and additionally completed self-report questionnaires assessing symptom severity, personality functioning and traits. Staff members completed informant versions of personality functioning questionnaires. Previously assessed community ( = 18) and clinical samples ( = 80) were used as a reference. Interrater reliability and internal consistency of the STiP 5.1 were good. As expected, no associations were found between self-report and expert-ratings (STiP 5.1) of personality functioning. Remarkably, no associations were found between informant rated personality functioning and the STiP 5.1. This study confirms the discrepancies between self-report and expert-ratings in forensic settings and identifies the need to design and test assessment instruments within this context instead of generalizing findings obtained in regular mental health care samples. The STiP-5.1 may be a candidate for use in forensic samples, particularly to guide treatment planning and individual patient policy, although it remains unclear what specific information it offers above and beyond self-report and informant-report.
在法医环境中，有几个挑战可能会影响人格病理学评估的可靠性，特别是基于自我报告的评估。本研究调查了用于《精神疾病诊断与统计手册》第5版人格功能的半结构化访谈（STiP - 5.1），以评估被监禁患者的人格功能严重程度。三个法医精神病设施的30名住院患者完成了STiP 5.1，并额外完成了评估症状严重程度、人格功能和特质的自我报告问卷。工作人员完成了人格功能问卷的知情者版本。先前评估的社区样本（n = 18）和临床样本（n = 80）用作参考。STiP 5.1的评分者间信度和内部一致性良好。正如预期的那样，在人格功能的自我报告和专家评分（STiP 5.1）之间未发现关联。值得注意的是，在知情者评定的人格功能与STiP 5.1之间也未发现关联。本研究证实了法医环境中自我报告与专家评分之间的差异，并确定了在此背景下设计和测试评估工具的必要性，而不是将常规精神卫生保健样本中获得的结果进行推广。STiP - 5.1可能是用于法医样本的候选工具，特别是用于指导治疗计划和个体患者策略，尽管尚不清楚它除了自我报告和知情者报告之外还提供了哪些具体信息。
