Sellbom Martin, Brown Tiffany A, Bach Bo
Department of Psychology, University of Otago, Dunedin, New Zealand.
Psychiatric Research Unit, Center for Personality Disorder Research, Region Zealand, Slagelse, Denmark.
Personal Ment Health. 2024 Feb;18(1):60-68. doi: 10.1002/pmh.1596. Epub 2023 Nov 9.
No clinician-rating tool has formally been developed to assess the ICD-11 model of personality disorder (PD) severity. We therefore developed and evaluated the 14-item personality disorder Severity ICD-11 (PDS-ICD-11) Clinician-Rating Form. A combined sample of 195 patients was rated by mental health professionals or clinical research assistants in New Zealand using the PDS-ICD-11 Clinician-Rating Form. Responses were subjected to item-response theory analysis and confirmatory factor analysis. In a subsample, we examined interrater reliability and convergence with self- and informant-reported measures of personality impairment, dysfunction in various psychopathology domains, and traditional PD symptoms. Item-response theory and confirmatory factor analyses supported the item functioning and unidimensionality, respectively, of the PDS-ICD-11 Clinician-Rating Form. The interrater reliability was very promising (intraclass correlation coefficient = 0.94, p < 0.001). PDS-ICD-11 Clinician-Rating Form scores were associated with established measures of personality dysfunction at large effect sizes. This initial development study suggests that the PDS-ICD-11 Clinician-Rating Form constitutes a psychometrically sound instrument that provides a clinically based impression of the severity of personality dysfunction according to the official ICD-11 description. More research is needed to corroborate its validity and utility, and a structured interview is warranted for diagnostic purposes. The final PDS-ICD-11 Clinician-Rating Form is included as online supporting information.
尚未正式开发出用于评估国际疾病分类第11版（ICD - 11）人格障碍（PD）严重程度的临床医生评定工具。因此，我们开发并评估了包含14个条目的人格障碍严重程度ICD - 11（PDS - ICD - 11）临床医生评定表。195名患者的合并样本由新西兰的心理健康专业人员或临床研究助理使用PDS - ICD - 11临床医生评定表进行评分。对回答进行了项目反应理论分析和验证性因素分析。在一个子样本中，我们检验了评分者间信度以及与自我报告和知情者报告的人格损害、各精神病理学领域功能障碍及传统PD症状测量指标的一致性。项目反应理论和验证性因素分析分别支持了PDS - ICD - 11临床医生评定表的项目功能和单维度性。评分者间信度非常可观（组内相关系数 = 0.94，p < 0.001）。PDS - ICD - 11临床医生评定表得分与已确立的人格功能障碍测量指标相关，效应量较大。这项初步的开发研究表明，PDS - ICD - 11临床医生评定表是一种心理测量学上可靠的工具，可根据ICD - 11官方描述提供基于临床的人格功能障碍严重程度印象。需要更多研究来证实其有效性和实用性，并且为了诊断目的有必要进行结构化访谈。最终的PDS - ICD - 11临床医生评定表作为在线支持信息包含在内。
