Standardised Assessment of Personality - Abbreviated Scale (SAPAS): preliminary validation of a brief screen for personality disorder (original) (raw)
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Classification, assessment, prevalence, and effect of personality disorder
The Lancet, 2015
Personality disorders are common and ubiquitous in all medical settings, so every medical practitioner will encounter them frequently. People with personality disorder have problems in interpersonal relationships but often attribute them wrongly to others. No clear threshold exists between types and degrees of personality dysfunction and its pathology is best classifi ed by a single dimension, ranging from normal personality at one extreme through to severe personality disorder at the other. The description of personality disorders has been complicated over the years by undue adherence to overlapping and unvalidated categories that represent specifi c characteristics rather than the core components of personality disorder. Many people with personality disorder remain undetected in clinical practice and might be given treatments that are ineff ective or harmful as a result. Comorbidity with other mental disorders is common, and the presence of personality disorder often has a negative eff ect on course and treatment outcome. Personality disorder is also associated with premature mortality and suicide, and needs to be identifi ed more often in clinical practice than it is at present. which were relevant to recent developments in the specialty.
Personality and Mental Health, 2008
Objective The internal consistency, test-retest reliability and validity of the Self-report Standardized Assessment of Personality-abbreviated Scale (SAPAS-SR) as a screening instrument for personality disorders were studied in a random sample of 195 Dutch psychiatric outpatients, using the Structured Clinical Interviews for DSM-IV Personality Disorders (SCID-II) as a gold standard. Method All patients completed a self-report version of the SAPAS. One week later, they were interviewed with the SCID-II. Two weeks later, the SAPAS-SR was re-administered. Results According to the SCID-II, 97 patients (50%) were suffering from a personality disorder. The SAPAS-SR correctly classifi ed 81% of all participants. Sensitivity (0.83) and specifi city (0.80) were slightly lower compared with the original English version. This difference may be explained by the lower prevalence and severity of personality disorders in the study population. Conclusion The results provide evidence for the usefulness of the SAPAS as a self-administered instrument for screening personality disorders in clinical populations.
Classification, assesment, prevalence, and effect of personality disorder.
Personality disorders are common and ubiquitous in all medical settings, so every medical practitioner will encounter them frequently. People with personality disorder have problems in interpersonal relationships but often attribute them wrongly to others. No clear threshold exists between types and degrees of personality dysfunction and its pathology is best classifi ed by a single dimension, ranging from normal personality at one extreme through to severe personality disorder at the other. The description of personality disorders has been complicated over the years by undue adherence to overlapping and unvalidated categories that represent specifi c characteristics rather than the core components of personality disorder. Many people with personality disorder remain undetected in clinical practice and might be given treatments that are ineff ective or harmful as a result. Comorbidity with other mental disorders is common, and the presence of personality disorder often has a negative eff ect on course and treatment outcome. Personality disorder is also associated with premature mortality and suicide, and needs to be identifi ed more often in clinical practice than it is at present.
Personality Disorders: A Review of the Current State of Knowledge
Personality disorders are the most common serious mental illness. People suffering from these disorders tend to exhibit emotional patterns and behaviors that seem troubling to the majority of people and are not necessarily explicable by immediate environmental stimuli. Nevertheless, many clinicians are unfamiliar with the most recent research on these disorders and the latest approaches to treatment. This study will review the current diagnostic conceptualization of personality disorders, their clinical treatment, and their relationship to cultural characteristics and culture-specific disorders.
Delineating the Interplay of Personality Disorders and Health
Behavioral Medicine, 2017
The nexus of personality and health is a challenging and, at times, vexing issue in behavioral medicine. While the integration of psychiatric, psychological and psychosocial factors into healthcare delivery systems is becoming normative, the incorporation of personality factors into these system is often overlooked or poorly integrated into conceptualization in our examinations of health behaviors. Understanding and predicting health promoting and risky health behaviors has long been the province of public health, behavioral medicine, and health psychology. However, personality factors are rarely incorporated into health behavior paradigms. Personality can be dismissed as the "noise" in these equations, due to the relatively immutable nature of personality and the greater challenges in addressing personality variables in large-scale behavioral health interventions. Personality factors, conceptualized by models such as the five-factor model of personality or Millon's personality taxonomy, 1-2 have been found to be associated with a wide range of health behaviors, including alcohol and tobacco use, risky sexual behaviors, and cardiovascular risk indices. 3-9 The Millon Behavioral Medicine Diagnostic (MBMD) specifically, assesses personality and behavioral patterns associated with health-related outcomes and attempts to systematically address the association between personality factors and health. Research using the MBMD has documented associations between personality factors and pain treatment outcomes, sensitivity to anesthesia, health related quality of life, and medication adherence. 10-13 With regard to personality disorders, there has been stringent clinical debate about measurement of this construct. Some support the use of dimensional systems which assess personality pathology on a continuum, 14 while others uphold categorical classifications which are congruent with traditional diagnostic conceptualizations of personality disorders. The traditional Diagnostic and Statistical Manual of Mental Disorders taxonomy of personality disorders typically clusters personality disorders into 3 groups (1) odd and unusual (Cluster A: disorders characterized by perceptual distortions, interpersonal behavior characterized by bizarre or unusual conduct, poor self-reflection, insight and judgment); (2) dramatic and erratic (Cluster B: disorders characterized by emotional lability, limited empathy and insight, behavioral dysregulation); and (3) anxious and fearful (Cluster C: disorders characterized by interpersonal reticence and anxiety, rigidity, and diminished social efficacy). 15 Regardless of the assessment system employed, these differential patterns
Personality Disorders: Theory, Research, and Treatment, 2011
A major reconceptualization of personality psychopathology has been proposed for DSM-5 that identifies core impairments in personality functioning, pathological personality traits, and prominent pathological personality types. A comprehensive personality assessment consists of four components: levels of personality functioning, personality disorder types, pathological personality trait domains and facets, and general criteria for personality disorder. This four-part assessment focuses attention on identifying personality psychopathology with increasing degrees of specificity, based on a clinician's available time, information, and expertise. In Part I of this two-part article, we describe the components of the new model and present brief theoretical and empirical rationales for each. In Part II, we will illustrate the clinical application of the model with vignettes of patients with varying degrees of personality psychopathology, to show how assessments might be conducted and diagnoses reached.
Psychopathology Review, 2015
The alternative dimensional model for personality disorder (PD) in DSM-5, Section III (DSM-5–III) includes two main criteria: (A) personality-functioning impairment, and (B) personality-trait pathology; provides specific functioning-and-trait criteria for six PD-type diagnoses; and introduces PD-trait specified (PD-TS), which requires meeting the general PD criteria and not meeting criteria for any specific PD type. We termed this Simple PD-TS and developed two additional definitions: Mixed PD-TS, meeting criteria for one or two PD types and having five or more additional pathological traits; and Complex PD-TS, meeting criteria for three or more PD types. In a mixed sample of 165 outpatients and 215 community adults screened to be at highrisk for PD, we investigated the effect of these additional definitions on coverage, prevalence, comorbidity, and within-diagnosis heterogeneity, and conclude that eliminating the PD-type diagnoses and thus having PD-TS as the only PD diagnosis woul...