University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern.
Department of Population Health Sciences, Centre for Academic Mental Health, Bristol Medical School, University of Bristol.
Personal Disord. 2023 May;14(3):300-308. doi: 10.1037/per0000583. Epub 2022 Jun 9.
The Standardized Assessment of Personality-Abbreviated Scale (SAPAS) has been used extensively to screen for personality disorders (PD), including adolescents. Yet, it is unclear how well the SAPAS performs in screening for impairment in personality functioning (IPF), Criterion A of the alternative model for PD (AMPD) in adolescent samples. We examined the performance of the SAPAS in detecting IPF at a diagnostic threshold for PD in the AMPD. A consecutive clinical sample of adolescents in Bern, Switzerland ( = 293), were first administered the SAPAS, then the Semistructured Interview for Personality Functioning (STiP-5.1). A receiver operating characteristic (ROC) analysis was used to determine the diagnostic accuracy of the SAPAS in relation to the STiP-5.1. ROC regression analyses were conducted to determine if other variables moderated the discriminant performance of the SAPAS. Internal consistency of the SAPAS was low (α = .54) and overall discriminatory accuracy was moderate (area under the curve = .73). The optimum cut-off point was 5, with the best balance of sensitivity and specificity (63.22 and 69.90, respectively), correctly classifying 67.92% of participants. Agreement between the SAPAS and the STiP-5.1 using this cut-off was low (κ = .30). Age yielded statistically significant effects on the discriminant performance of the SAPAS-performance improving among older adolescents. Findings suggest that the SAPAS may not be the optimal method of screening for Criterion A IPF among adolescents in clinical settings but might also be more suited to Criterion B. Our findings call for a developmentally adapted screener for early detection of PD represented by IPF in adolescents. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
人格简明评定量表（SAPAS）已广泛用于筛查人格障碍（PD），包括青少年。然而，SAPAS 在筛查人格功能障碍（PD 的替代模型中的标准 A）方面的表现如何，在青少年样本中尚不清楚。我们研究了 SAPAS 在 PD 的替代模型（AMPD）诊断阈值下检测人格功能障碍的性能。瑞士伯尔尼的连续临床青少年样本（n = 293）首先接受 SAPAS 测试，然后接受人格功能半结构化访谈（STiP-5.1）。采用接收者操作特征（ROC）分析确定 SAPAS 与 STiP-5.1 相关的诊断准确性。进行 ROC 回归分析，以确定其他变量是否调节 SAPAS 的判别性能。SAPAS 的内部一致性较低（α =.54），整体判别准确性中等（曲线下面积 =.73）。最佳截断点为 5，具有最佳的敏感性和特异性平衡（分别为 63.22 和 69.90），正确分类 67.92%的参与者。使用此截断值，SAPAS 与 STiP-5.1 之间的一致性较低（κ =.30）。年龄对 SAPAS 的判别性能有统计学意义的影响——年龄较大的青少年的表现有所提高。研究结果表明，SAPAS 可能不是临床环境中筛查人格障碍标准 A 人格功能障碍的最佳方法，但可能更适合标准 B。我们的研究结果呼吁为青少年的 PD 代表人格功能障碍的早期检测开发一个适应发展的筛查器。（PsycInfo 数据库记录（c）2023 APA，保留所有权利）。
