Jacobsberg L, Perry S, Frances A
Department of Psychiatry, Cornell University Medical College, USA.
J Pers Assess. 1995 Dec;65(3):428-33. doi: 10.1207/s15327752jpa6503_4.
Instruments to assess personality disorders offer reliability, but at the cost of large amounts of a skilled clinician's time to make assessments. The Structured Clinical Interview for DSM-III Axis II (SCID-II; Spitzer, Williams, Gibbon, & First, 1990), incorporates a self-report screening questionnaire, reducing the number of items needing evaluation by the interviewer. However, false negative responses may cause clinically important areas to be overlooked. To establish the rate of false negative responses, we compared participant self-report on the SCID-II with Axis II diagnostic assessment done by clinicians using the Personality Disorder Examination (Loranger, Susman, Oldham, & Russakoff, 1987). The false negative rate was low for every diagnosis, supporting validity of following up with clinician questioning only those diagnostic elements endorsed in the self-report. Avoidant and dependent personality disorders were accurately self-reported. This, an efficient assessment instrument for personality disorders might combine self-report of those disorders where self-report is reliable, with clinician assessment where needed.
评估人格障碍的工具具有可靠性,但代价是需要经验丰富的临床医生花费大量时间进行评估。《精神疾病诊断与统计手册》第三版轴II障碍的结构化临床访谈(SCID-II;斯皮策、威廉姆斯、吉本和弗斯特,1990年)纳入了一份自我报告筛查问卷,减少了访谈者需要评估的项目数量。然而,假阴性反应可能会导致临床上重要的领域被忽视。为了确定假阴性反应的发生率,我们将参与者在SCID-II上的自我报告与临床医生使用人格障碍检查(洛兰杰、苏斯曼、奥尔德姆和鲁萨科夫,1987年)进行的轴II诊断评估进行了比较。每种诊断的假阴性率都很低,这支持了仅对自我报告中认可的诊断要素进行临床医生询问跟进的有效性。回避型和依赖型人格障碍能够被准确地自我报告。因此,一种有效的人格障碍评估工具可能会将自我报告可靠的那些障碍的自我报告与必要时的临床医生评估结合起来。