A comparison of clinical and self-report diagnoses of DSM-III personality disorders in 552 patients

Hyler, Steven E.; Rieder, Ronald O.; Williams, Janet B. W.; Spitzer, Robert L.; Lyons, Michael J.; Hendler, Judith

doi:10.1016/0010-440x(89)90070-9

Cited by 145 publications

(62 citation statements)

References 10 publications

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“…However, in comparing the SHI and the PDQ-R with regard to their ability to predict a DIB diagnosis of BPD, different levels of sensitivity were revealed between the two measures. Using the recommended cutoff score for the PDQ-R (Hyler et al, 1989), the PDQ-R accurately classified 88.7% of those with DIB-diagnosed BPD. This is the same rate of accuracy as the SHI (using a cutoff score of 5).…”

Section: Resultsmentioning

confidence: 99%

The self-harm inventory (SHI): Development of a scale for identifying self-destructive behaviors and borderline personality disorder

Sansone¹,

Wiederman²,

Sansone³

1998

J. Clin. Psychol.

347

233

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Intentional self-harm behavior is an important clinical phenomenon that appears highly related to borderline personality disorder (BPD). Self-harm behavior in the context of borderline personality probably exists along a continuum from graphic, self-harm behavior to milder forms of self-sabotaging behavior that might be viewed as self-defeating Relatively little attention has been paid to developing a self-report measure of intentional self-harm, particularly as a screening device for detecting BPD. In Study 1, an initial list of self-harm behaviors encountered in clinical practice was narrowed to those behaviors related to BPD in a sample comprised of adults from both a mental health and non-mental health setting. All participants (N = 221) underwent a semistructured diagnostic interview for BPD. Using a cut-off score of 5 on the resulting 22-item Self-Harm Inventory (SHI), 83.7% of research participants were correctly classified as having BPD or not. In Study 2, women (N = 285) sampled from an outpatient medical setting completed the SHI and a widely used self-report measure of BPD. The SHI cut-off score resulted in correct classification of 87.9% of the individuals. In Study 3, using a sample of adults involuntarily hospitalized for psychiatric reasons (N = 32), the SHI performed at least as well as another self-report measure of BPD in diagnosing participants (the final diagnosis was based on a semistructured interview). The results are discussed with regard to potential advantages and utility of the SHI and need for further validation.

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Section: Resultsmentioning

confidence: 99%

The self-harm inventory (SHI): Development of a scale for identifying self-destructive behaviors and borderline personality disorder

Sansone¹,

Wiederman²,

Sansone³

1998

J. Clin. Psychol.

347

233

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“…El grado de concordancia entre los autoinformes y las entrevistas clínicas es muy bajo, lo que indica una baja fiabilidad en el diagnóstico de estos trastornos. Todo ello indica la necesidad de interpretar con precaución los datos obtenidos con cuestionarios autoadministrados, que están muy condicionados por la subjetividad del paciente (Hyler et al, 1989;Zimmerman y Coryell, 1990). El tipo de instrumento de evaluación utilizado resulta, por tanto, fundamental a la hora de valorar la presencia de un trastorno de personalidad en el ámbito clínico.…”

Section: Discrepancia Entre Los Cuestionarios Y Las Entrevistasunclassified

Uso y abuso de los autoinformes en la evaluación de los trastornos de personalidad

Montalvo¹,

Echeburúa²

2006

RPPC

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Resumen: En este artículo se lleva a cabo una revisión de las discrepancias observadas en los estudios de comorbilidad entre los trastornos mentales del Eje I y los trastornos de personalidad. Las investigaciones llevadas a cabo hasta la fecha muestran un amplio rango en la tasa de comorbilidad, con variaciones en función del tipo de instrumento de evaluación utilizado. Los estudios que recurren a cuestionarios muestran tasas significativamente más altas de trastornos de personalidad que los llevados a cabo con entrevistas clínicas. Los autoinformes presentan, por tanto, una tendencia a sobrediagnosticar trastornos de personalidad. Las entrevistas clínicas, en cambio, son más estrictas y conservadoras, por lo que las tasas de prevalencia son más bajas y ajustadas, incluso con diferencias significativas cuando se utilizan ambos tipos de instrumentos con una misma muestra clínica. Se ejemplifican estos datos con estudios concretos llevados a cabo en el ámbito del alcoholismo, la ludopatia, la adicción a la cocaína y los trastornos de la conducta alimentaria. Por últi-mo, se comentan las implicaciones de este hecho para la práctica clínica cotidiana y para la investigación futura. Palabras clave: Trastornos de personalidad, autoinformes, entrevistas clínicas, evaluación. Use and abuse ofself-reports in the assessment ofpersonality disorders Abstract:In this paper an analysis of the observed discrepancies in studíes about the comorbidity between mental disorders of Axis I and personality disorders was carried out. Research shows a wide range of the comorbidity rates, with variations in function of the kind of assessment tool used. The studies that use self-reports show significantly higher rates ofpersonality disorders than the ones using clinical interviews. Therefore, self-reports have a tendency to over-diagnose personality disorders. However, clinical interviews are stricter and more conservative and so the prevalence rates are lower, even with significant differences when both types of assessment tools are used with the same clinical sample. These data are illustrated with specific studies carried out in some clinical disorders: alcoholism, pathological gambling, cocaine dependence and eating disorders. Lastly, implications of this study for clinical practice and future research are commented upon.

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“…In a prior study the diagnostic agreement between the SIDP-R and PDQ-R was calculated (De Ruiter and Greeven, 2000). The mean kappa value for diagnostic agreement in our study was 0.34 on a categorical level, whereas other authors found mean kappa values of 0.15 (Hyler et al, 1989) and 0.19 (Trull and Larson, 1994). A dimensional approach led to a somewhat higher diagnostic agreement between the two instruments, though still at a moderate level.…”

Section: Methodsmentioning

confidence: 54%

Personality disorders in a Dutch forensic psychiatric sample: changes with treatment

Greeven¹,

Ruiter

2004

Criminal Behav Ment Health

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The findings of the study are encouraging in terms of reduction of personality disorder psychopathology. Limitations to the study design are acknowledged. Further, it is not known whether this change constitutes substantial reorganization of personality, or whether it reflects a change at a more superficial level. Further follow-up of the patients is necessary to investigate whether the positive changes remain after release from hospital.

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A comparison of clinical and self-report diagnoses of DSM-III personality disorders in 552 patients

Cited by 145 publications

References 10 publications

The self-harm inventory (SHI): Development of a scale for identifying self-destructive behaviors and borderline personality disorder

The self-harm inventory (SHI): Development of a scale for identifying self-destructive behaviors and borderline personality disorder

Uso y abuso de los autoinformes en la evaluación de los trastornos de personalidad

Personality disorders in a Dutch forensic psychiatric sample: changes with treatment

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