Diagnostic Efficiency of Personality Disorder Screening Tool ; The Korean Version of Self-Report Standardized Assessment of Personality-Abbreviated Scale : Preliminary Validation Study

Jisu Choi; Sun-Joo Hwang; Dohee Pai; Soon-Taek Hwang; Youl-Ri Kim

doi:10.4306/jknpa.2015.54.4.534

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Choi, Hwang, Pai, Hwang, and Kim: Diagnostic Efficiency of Personality Disorder Screening Tool ; The Korean Version of Self-Report Standardized Assessment of Personality-Abbreviated Scale : Preliminary Validation Study

Original Article

Journal of Korean Neuropsychiatric Association 2015; 54(4): 534-541.

Published online: 30 November 2015

DOI: https://doi.org/10.4306/jknpa.2015.54.4.534

Diagnostic Efficiency of Personality Disorder Screening Tool ; The Korean Version of Self-Report Standardized Assessment of Personality-Abbreviated Scale : Preliminary Validation Study

Jisu Choi, MD¹, Sun-Joo Hwang, MSc², Dohee Pai, PhD³, Soon-Taek Hwang, PhD⁴, Youl-Ri Kim, MD, PhD^1,^5,⁶

¹Department of Psychiatry, Seoul Paik Hospital, Inje University, Seoul, Korea.

²Korea Psychological Autopsy Center, Seoul, Korea.

³Department of Counseling Psychology, Hanyang Cyber University, Seoul, Korea.

⁴Department of Psychology, Chungbuk National University, Cheongju, Korea.

⁵Institute of Eating Disorders and Mental Health, Inje University, Seoul, Korea.

⁶Institute for Gender Research, Seoul National University, Seoul, Korea.

Address for correspondence: Youl-Ri Kim, MD, PhD. Department of Psychiatry, Seoul Paik Hospital, Inje University, 9 Mareunnae-ro, Jung-gu, Seoul 04551, Korea. Tel +82-2-2270-0063, Fax +82-2-2270-0344, youlri.kim@paik.ac.kr

Received 10 October 2015 Revised 19 October 2015 Accepted 26 October 2015

Abstract

Objectives

The aims of this study were to evaluate acceptability and usefulness of the Korean version of Self-report Standardized Assessment of Personality-Abbreviated Scale (SAPAS-SR) as an instrument for screening patients with a personality disorder.

Methods

The Korean version of the SAPAS-SR was administered to a non-random sample of 186 psychiatric patients (155 patients with a personality disorder and 31 patients with no personality disorder). The International Classification of Diseases 10th version Personality Assessment Schedule was used as a gold standard in diagnosis of personality disorder. Receiver-operant-characteristics and validity indicators were determined. In addition, the SAPAS-SR was administered to 22 healthy men to examine the test-retest reliability.

Results

The area under the curve for the SAPAS-SR was 0.69 (95% confidence interval 0.59-0.79). The SAPAS-SR score of 4 or more correctly classified 67.2% of patients with a personality disorder. Sensitivity (0.67) and specificity (0.68) were slightly lower compared with the original English version.

Conclusion

This study provides preliminary evidence of the usefulness of the Korean version of the SAPAS-SR as a self-administered instrument for screening personality disorders in the clinical population.

Keywords: Personality disorder, Self-report Standardized Assessment of Personality-Abbreviated Scale, Diagnosis, Screening measure, Sensitivity, Specificity, Receiver-operant-characteristics analysis

Figures and Tables

Fig. 1

Sensitivity-specificity plot relating structured clinical interview for International Classification of Diseases 10th version personality disorders positive diagnosis to total score on the Korean version of the Self-report Standardized Assessment of Personality-Abbreviated Scale.

Table 1

Internal consistency of the Korean version of the Self-report Standardized Assessment of Personality-Abbreviated Scale items

The alpha coefficient for the total score is 0.79

Table 2

Sensitivity, specificity, and power to predict personality disorder at different cut-off scores of the Self-report Standardized Assessment of Personality-Abbreviated Scale

* : The score of the maximum J. J : Youden index

Notes

^{Conflicts of Interest} The authors have no financial conflicts of interest.

Appendix

References

1. Grant BF, Hasin DS, Stinson FS, Dawson DA, Chou SP, Ruan WJ, et al. Prevalence, correlates, and disability of personality disorders in the United States: results from the national epidemiologic survey on alcohol and related conditions. J Clin Psychiatry. 2004; 65:948–958.

2. Moran P, Jenkins R, Tylee A, Blizard R, Mann A. The prevalence of personality disorder among UK primary care attenders. Acta Psychiatr Scand. 2000; 102:52–57.

3. Ranger M, Methuen C, Rutter D, Rao B, Tyrer P. Prevalence of personality disorder in the case-load of an inner-city assertive outreach team. Psychiatr Bull. 2004; 28:441–443.

4. Fazel S, Danesh J. Serious mental disorder in 23000 prisoners: a systematic review of 62 surveys. Lancet. 2002; 359:545–550.

5. Reich J, Yates W, Nduaguba M. Prevalence of DSM-III personality disorders in the community. Soc Psychiatry Psychiatr Epidemiol. 1989; 24:12–16.

6. Nakao K, Gunderson JG, Phillips KA, Tanaka N, Yorifuji K, Takaishi J, et al. Functional impairment in personality-disorders. J Personal Disord. 1992; 6:24–33.

7. Ellison JM, Blum NR, Barsky AJ. Frequent repeaters in a psychiatric emergency service. Hosp Community Psychiatry. 1989; 40:958–960.

8. Black DW, Warrack G, Winokur G. The Iowa record-linkage study. I. Suicides and accidental deaths among psychiatric patients. Arch Gen Psychiatry. 1985; 42:71–75.

9. Martin RL, Cloninger CR, Guze SB, Clayton PJ. Mortality in a follow-up of 500 psychiatric outpatients. II. Cause-specific mortality. Arch Gen Psychiatry. 1985; 42:58–66.

10. Bulik CM, Sullivan PF, Joyce PR, Carter FA. Temperament, character, and personality disorder in bulimia nervosa. J Nerv Ment Dis. 1995; 183:593–598.

11. Steiger H, Thibaudeau J, Ghadirian AM, Houle L. Psychopathological features in bulimics as a function of Axis-II comorbidity: isolation of mood-independent differences. Int J Eat Disord. 1992; 12:383–395.

12. O'Brien KM, Vincent NK. Psychiatric comorbidity in anorexia and bulimia nervosa: nature, prevalence, and causal relationships. Clin Psychol Rev. 2003; 23:57–74.

13. Skodol AE, Oldham JM, Gallaher PE. Axis II comorbidity of substance use disorders among patients referred for treatment of personality disorders. Am J Psychiatry. 1999; 156:733–738.

14. Lewis KL, Grenyer BF. Borderline personality or complex posttraumatic stress disorder? An update on the controversy. Harv Rev Psychiatry. 2009; 17:322–328.

15. Crawford TN, Cohen P, First MB, Skodol AE, Johnson JG, Kasen S. Comorbid Axis I and Axis II disorders in early adolescence: outcomes 20 years later. Arch Gen Psychiatry. 2008; 65:641–648.

16. Seivewright H, Tyrer P, Johnson T. Persistent social dysfunction in anxious and depressed patients with personality disorder. Acta Psychiatr Scand. 2004; 109:104–109.

17. Söchtig A, Kliem S, Kröger C. Diagnostic efficiency of the German version of the Standardized Assessment of Personality--Abbreviated Scale. Psychopathology. 2012; 45:381–389.

18. Widiger TA, Samuel DB. Evidence-based assessment of personality disorders. Psychol Assess. 2005; 17:278–287.

19. Herpertz SC, Zanarini M, Schulz CS, Siever L, Lieb K, Möller HJ, et al. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of personality disorders. World J Biol Psychiatry. 2007; 8:212–244.

20. Ekselius L, Lindström E, von Knorring L, Bodlund O, Kullgren G. SCID II interviews and the SCID screen questionnaire as diagnostic tools for personality disorders in DSM-III-R. Acta Psychiatr Scand. 1994; 90:120–123.

21. de Reus RJ, van den Berg JF, Emmelkamp PM. Personality diagnostic questionnaire 4+ is not useful as a screener in clinical practice. Clin Psychol Psychother. 2013; 20:49–54.

22. Schotte C, de Doncker D, Cosyns P. ADP-IV questionnaire: assessment of DSM-IV personality disorders. Eur Psychiatry. 2000; 15:73–74.

23. Smith TL, Klein MH, Benjamin LS. Validation of the Wisconsin Personality Disorders Inventory-IV with the SCID-II. J Pers Disord. 2003; 17:173–187.

24. Moran P, Leese M, Lee T, Walters P, Thornicroft G, Mann A. Standardised Assessment of Personality - Abbreviated Scale (SAPAS): preliminary validation of a brief screen for personality disorder. Br J Psychiatry. 2003; 183:228–232.

25. Mann AH, Jenkins R, Cutting JC, Cowen PJ. The development and use of standardized assessment of abnormal personality. Psychol Med. 1981; 11:839–847.

26. Tyrer P, Reed GM, Crawford MJ. Classification, assessment, prevalence, and effect of personality disorder. Lancet. 2015; 385:717–726.

27. Germans S, Van Heck GL, Moran P, Hodiamont PPG. The self-report Standardized Assessment of Personality-Abbreviated Scale: preliminary results of a brief screening test for personality disorders. Personality and Mental Health. 2005; 2:70–76.

28. Kim YR, Hwang ST, Kim SG, Lee HS. Social function in patients with personality disorder diagnosed by single dimensional severity using Korean version of Social Functioning Questionnaire. J Korean Neuropsychiatr Assoc. 2015; 54:523–533.

29. Kim YR, Blashfield R, Tyrer P, Hwang ST, Lee HS. Field trial of a putative research algorithm for diagnosing ICD-11 personality disorders in psychiatric patients: 1. Severity of personality disturbance. Personal Ment Health. 2014; 8:67–78.

30. Kim YR, Tyrer P, Lee HS, Kim SG, Hwang ST, Lee GY, et al. Preliminary field trial of a putative research algorithm for diagnosing ICD-11 personality disorders in psychiatric patients: 2. Proposed trait domains. Personal Ment Health. 2015; 9:298–307.

31. Bukh JD, Bock C, Vinberg M, Gether U, Kessing LV. Clinical utility of Standardised Assessment of Personality-Abbreviated Scale (SAPAS) among patients with first episode depression. J Affect Disord. 2010; 127:199–202.

32. Einarsson E, Sigurdsson JF, Gudjonsson GH, Newton AK, Bragason OO. Screening for attention-deficit hyperactivity disorder and co-morbid mental disorders among prison inmates. Nord J Psychiatry. 2009; 63:361–367.

33. Gorwood P, Rouillon F, Even C, Falissard B, Corruble E, Moran P. Treatment response in major depression: effects of personality dysfunction and prior depression. Br J Psychiatry. 2010; 196:139–142.

34. Hesse M, Moran P. Screening for personality disorder with the Standardised Assessment of Personality: Abbreviated Scale (SAPAS): further evidence of concurrent validity. BMC Psychiatry. 2010; 10:10.

35. Hesse M, Rasmussen J, Pedersen MK. Standardised assessment of personality - a study of validity and reliability in substance abusers. BMC Psychiatry. 2008; 8:7.

36. Shaw J, Minoudis P, Craissati J. A comparison of the standardised assessment of personality-abbreviated scale and the offender assessment system personality disorder screen in a probation community sample. J Forens Psychiatry Psychol. 2012; 23:156–167.

37. Germans S, Van Heck GL, Hodiamont PP. Results of the search for personality disorder screening tools: clinical implications. J Clin Psychiatry. 2012; 73:165–173.

38. Gonzalez C. Screening for personality disorder in drug and alcohol dependence. Psychiatry Res. 2014; 217:121–123.

39. Jansen BP, Damen KF, Hoffman TO, Vellema SL. The Standardized Assessment of Personality-Abbreviated Scale as a screening instrument for personality disorders in substance-dependent criminal offenders. Personal Ment Health. 2013; 7:122–132.

40. Kongerslev M, Moran P, Bo S, Simonsen E. Screening for personality disorder in incarcerated adolescent boys: preliminary validation of an adolescent version of the standardised assessment of personality - abbreviated scale (SAPAS-AV). BMC Psychiatry. 2012; 12:94.

41. Newton-Howes G. The impact of mental state disorder and personality on social functioning in patients engaged in community mental health care. Australas Psychiatry. 2014; 22:19–22.

42. Pluck G, Sirdifield C, Brooker C, Moran P. Screening for personality disorder in probationers: Validation of the Standardised Assessment of Personality-Abbreviated Scale (SAPAS). Personal Ment Health. 2012; 6:61–68.

43. Tyrer P, Alexander J. Classification of personality disorder. Br J Psychiatry. 1979; 135:163–167.

44. Tyrer P, Strauss J, Cicchetti D. Temporal reliability of personality in psychiatric patients. Psychol Med. 1983; 13:393–398.

45. Waller NG. Commingled samples: a neglected source of bias in reliability analysis. Appl Psychol Meas. 2008; 32:211–223.

46. Lusted LB. Signal detectability and medical decision-making. Science. 1971; 171:1217–1219.

47. Swets JA. Measuring the accuracy of diagnostic systems. Science. 1988; 240:1285–1293.

48. Youden WJ. Index for rating diagnostic tests. Cancer. 1950; 3:32–35.

49. Zweig MH, Campbell G. Receiver-operating characteristic (ROC) plots: a fundamental evaluation tool in clinical medicine. Clin Chem. 1993; 39:561–577.

50. Metz CE. Basic principles of ROC analysis. Semin Nucl Med. 1978; 8:283–298.

51. Zimmerman M, Rothschild L, Chelminski I. The prevalence of DSM-IV personality disorders in psychiatric outpatients. Am J Psychiatry. 2005; 162:1911–1918.

52. Mellsop G, Varghese F, Joshua S, Hicks A. The reliability of axis II of DSM-III. Am J Psychiatry. 1982; 139:1360–1361.

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