Computerized Adaptive Assessment of Personality Disorder: Introducing the CAT–PD Project (original) (raw)
Related papers
Identifying personality disorders: Towards the development of a clinical screening instrument
Comprehensive Psychiatry, 2000
gain is used to determine the diagnostic threshold (DT). Initially, 15 of 45 criteria are identified. At the 0.43 PD prevalence, a DT of 2 or more of the 15 PD criteria across samples is optimal. The maximum information gain (MIG) is .42 bits, and the AUR is 0.94 + .007. Other performance indices at this cutoff are .90 sensitivity, 64 specificity, .81 positive predictive power (PPP), .91 negative predictive power (NPP), and .86 hit rate (HR). Taken collectively, the 15 PD criteria selected by the data reduction techniques suggest a narrowed set to be assessed in screening for the presence or absence of any PD with comparable or better psychometric properties than other tests routinely used for diagnosing medical and psychiatric disorders. If specific PD categorization is needed, a second-step comprehensive assessment should follow.
Critical developments in the assessment of personality disorder
British Journal of Psychiatry, 2007
BackgroundThe assessment of personality disorder is currently inaccurate, largely unreliable, frequently wrong and in need of improvement.AimsTo describe the errors inherent in the current systems and to indicate recent ways of improving personality assessment.MethodHistorical review, description of recent developments, including temporal stability, and of studies using document-derived assessment.ResultsStudies of interrater agreement and accuracy of diagnosis in complex patients with independently established personality status using document-derived assessment (PAS–DOC) with a four personality cluster classification, showed very good agreement between raters for the flamboyant cluster B group of personalities, generally good agreement for the anxious/dependent cluster C group and inhibited (obsessional) cluster D group, but only fair agreement for the withdrawn cluster A group. Overall diagnostic accuracy was 71%.ConclusionsPersonality function or diathesis, a fluctuating state, ...
Modeling and Measuring the Personality Disorders
Journal of Personality Disorders, 2000
Archives of General Psychia try, 55, 941-948) reported that personality disorders (PDs) are quantitatively extreme expressions of normal personality func tioning. A similarly designed study attempts to replicate those findings for both selfand observer-rated reports of patients judged clinically to have a PD. Analyses of data sets generated by 758 selfreports (SRs) and 5 1 5 reports from corroborative witnesses (CWs) refined the set of 266 descriptors to 142 items assessing 30 constructs. Intercorrelation of the constructs re vealed considerable interdependence. Principal components analyses identified four factors, consistent across the SR and CW databases, and consistent with the Livesley et al. (1998) analyses where they were labeled Emotional Dysregulation, Dissocial, Inhibition, and Compulsivity. Replication and exten sion of findings to CW-rated data offer additional support for the argument that higher-order PD traits strongly resemble normal personality dimensions. While there are multiple models for conceptualizing and measuring the per sonality disorders (PDs), the keenest debate is over categorical versus di mensional approaches. Previous and current Diagnostic and Statistical Manual of Mental Disorders (DSM; American Psychiatric Association, 1980, 1987, 1994) and International Classification of Diseases (ICD-10; World Health Organization, 1992) classifications impute a number of distinct, in dependent and categorical PDs and, at least in the last three DSM editions, three higher-order PD "clusters." Such a categorical approach reflects the historical preference by psychiatrists to assign patients to classes, or at least to diagnostic groups, rather than adopting a dimensional approach
Psicologia: Ciência e Profissão, 2017
The assessment of personality disorders assumes unquestioned clinical relevance when considering the prevalence rates in the general population. Tests assessing the typical pathological traits of these disorders has been adapted to and developed in Brazil. However, there is a gap in the country of screening tools for personality disorders. Screening tools are designed to allow a fast and informative application on the likelihood of a positive diagnosis, where the consequence should be conveyed to a diagnostic assessment. Using as a base the Dimensional Clinical Personality Inventory (IDCP), developed at the national level, the objective of this research was to develop a screening tool for personality disorders, as well as investigate its diagnostic accuracy. The study included 1,196 people, aging between 18 and 73 years (M = 26.32, SD = 8.69), and 64.1% female. The sample was divided into clinical and non-clinical group. We used an empirical approach based on criteria for selection of items similar to those adopted in the development of Minnesota Multiphasic Personality Inventory was used (MMPI). The logistic regression analysis and also the calculation of Cohen´s d indicated the items that best discriminate against people with personality disorders and those without this diagnosis. We achieved a final set of 15 items with satisfactory sensitivity and specificity for screening test. We discusses the strengths and limitations of screening version of the IDCP and guidelines for further study.
Psychological Assessment, 2003
This study examined the relationships of the Schedule for Nonadaptive and Adaptive Personality (SNAP) model of personality to 4 targeted personality disorders (PDs) in a large multisite sample of patients. Data were examined from 529 patients, who were assigned 1 of 5 primary diagnoses: borderline, schizotypal, avoidant, and obsessive-compulsive PDs and major depression without PD. Patients were administered the SNAP questionnaire and results were compared among diagnostic groups and between patient groups and nonclinical norms. Results indicated that the dimensions of the model appear to have considerable promise in differentiating normal from abnormal personality, particularly in the propensity of individuals with PDs to manifest negative affects and interpersonal detachment. Furthermore, the model appeared to successfully distinguish specific PDs, a property that represents a particular challenge for dimensional models of personality.
Personality Profiles and the Prediction of Categorical Personality Disorders
Journal of Personality, 2001
Personality disorders (PDs) are usually construed as psychiatric categories characterized by a unique configuration of traits and behaviors. To generate clinical hypotheses from normal personality trait scores, profile agreement statistics can be calculated using a prototypical personality profile for each PD. Multimethod data from 1,909 psychiatric patients in the People's Republic of China were used to examine the accuracy of such hypotheses in the Interpretive Report of the Revised NEO Personality Inventory. Profile agreement indices from both self-reports and spouse ratings were significantly related to PD symptom scores derived from questionnaires and clinical interviews. However, accuracy of diagnostic classification was only modest to moderate, probably because PDs are not discrete categorical entities. Together with other literature, these data suggest that the current categorical system should be replaced by a more comprehensive system of personality traits and personality-related problems.
Psychometric properties of a brief inventory for the screening of personality disorders: The SCATI
Psychology and Psychotherapy: Theory, Research and Practice, 2010
The purpose of the present study was to report on the psychometric properties of a revised version of abrief inventorydesigned to screenand assess personality disorders. The shortform of the Coolidge Axis II Inventory(SCATI) is a70-item, self-report, form of the 250-item Coolidge Axis II Inventory(CATI). On ac ommunity sample of 588 adults (range ¼ 16-88years), the median internal scale reliability for the 14 personality disorder scales was .66, and the median test-retest reliability (1 week) was .83. Principal components analysis (PCA) revealed afour-component structure, essentially similar to previous PCAstudies of the SCATIand CATI. Good convergent validity was obtained between afive-factor model of psychopathologyand the 14 SCATIpersonality disorder scales. Gender differences wereo btained on some scales, although the effect sizes wereg enerally small. These preliminaryp sychometric properties establish that the SCATIh as sufficient reliability and validity to warrant further research, particularly in clinical samples. Personality disordersa re among the most debilitating yet poorly understood forms of mental illness (e.g., Millon, Grossman, Millon, Meagher, &R amnath, 2004; Segal, Coolidge,&Rosowsky,2006), yettheir assessment is critically important forclinicalcase formulation and treatment planning, and critically important to prognoses of other comorbidd isorders(e.g., Coolidge&Segal, 1998).T he 250-item,s elf-reportC oolidge Axis II Inventory(CATI) wasd esigned to measure personality disorders strictly according to the specific criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR ;A mericanP sychiatric Association, 2000). The CATI also measures several Axis Isyndromes and neuropsychological dysfunction (e.g., Coolidge, 2005; Coolidge&Merwin, 1992).The purpose of the present study is to report on the psychometric properties of arevised, shortf ormofthe CATI (SCATI) with the specific purposeofscreening forand assessing only personality disorders, 10 from DSM-IV-TR,2 from Appendix Bo ft he DSM-IV-TR (depressive and passive-aggressive), and 2f rom DSM-III-R (American Psychiatric Association, 1987; sadistic and self-defeating) and to
Clinical Psychology & Psychotherapy, 2013
This study presents a psychometric evaluation of the General Assessment of Personality Disorder (GAPD), a self-report questionnaire for assessing the core components of personality dysfunction on the basis of Livesley's (2003) adaptive failure model. Analysis of samples from a general (n = 196) and a clinical population (n = 280) from Canada and the Netherlands, respectively, found a very similar two-component structure consistent with the two core components of personality dysfunction proposed by the model, namely, self-pathology and interpersonal dysfunction. Moreover, the GAPD discriminated between patients diagnosed with and without Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-TR) personality disorder(s) and demonstrated discriminative power in detecting the severity of personality pathology. Correlations with a DSM-IV symptom measure and a pathological traits model suggest partial conceptual overlap. Although further testing is indicated, the present findings suggest the GAPD is suitable for assessing the core components of personality dysfunction. It may contribute to a two-step integrated assessment of personality pathology that assesses both personality dysfunction and personality traits.
Annu. Rev. Psychol., 2007
This chapter reviews recent (2000-2005) personality disorder (PD) research, focusing on three major domains: assessment, comorbidity, and stability. (a) Substantial evidence has accrued favoring dimensional over categorical conceptualization of PD, and the five-factor model of personality is prominent as an integrating framework. Future directions include assessing dysfunction separately from traits and learning to utilize collateral information. (b) To address the pervasiveness and extent of comorbidity, researchers have begun to move beyond studying overlapping pairs or small sets of disorders and are developing broader, more integrated common-factor models that cross the Axis I-Axis II boundary. (c) Studies of PD stability have converged on the finding that PD features include both more acute, dysfunctional behaviors that resolve in relatively short periods, and maladaptive temperamental traits that are relatively more stable-similar to normal-range personality traits-with increa...