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Development and Psychometric Properties of the Standardized Assessment of Severity of Personality Disorder (SASPD)

Published Online:https://doi.org/10.1521/pedi_2017_31_285

Personality disorder (PD) is increasingly categorized according to its severity, but there is no simple way to screen for severity according to ICD-11 criteria. We set out to develop the Standardized Assessment of Severity of Personality Disorder (SASPD). A total of 110 patients completed the SASPD together with a clinical assessment of the severity of personality disorder. We examined the predictive ability of the SASPD using the area under the ROC curve (AUC). Two to four weeks later, 43 patients repeated the SASPD to examine reliability. The SASPD had good predictive ability for determining mild (AUC = 0.86) and moderate (AUC = 0.84) PD at cut points of 8 and 10, respectively. Test-retest reliability of the SASPD was high (intraclass correlation coefficient = 0.93, 95% CI [0.88, 0.96]). The SASPD thus provides a simple, brief, and reliable indicator of the presence of mild or moderate PD according to ICD-11 criteria.

References

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. CrossrefGoogle Scholar
  • Arntz A., , van den Hoorn M., , Cornelis J., , Verheul R., , van den Bosch W. M., , & de Bie A. J. (2003). Reliability and validity of the Borderline Personality Disorder Severity Index. Journal of Personality Disorders, 17(1), 45–59. LinkGoogle Scholar
  • Bateman A., , & Fonagy P. (2013). Impact of clinical severity on outcomes of mentalisationbased treatment for borderline personality disorder. British Journal of Psychiatry, 203(3), 221–227. Crossref MedlineGoogle Scholar
  • Bukh J. D., , Bock C., , Vinberg M., , Gether U., , & Kessing L. V. (2010). Clinical utility of Standardised Assessment of Personality – Abbreviated Scale (SAPAS) among patients with first episode depression. Journal of Affective Disorders, 127(1), 199–202. Crossref MedlineGoogle Scholar
  • Coid J., , Yang M., , Tyrer P., , Roberts A., , & Ullrich S. (2006). Prevalence and correlates of personality disorder in Great Britain. British Journal of Psychiatry, 188(5), 423–431. Crossref MedlineGoogle Scholar
  • Crawford M. J., , Koldobsky N., , Mulder R., , & Tyrer P. (2011). Classifying personality disorder according to severity. Journal of Personality Disorders, 25(3), 321–330. LinkGoogle Scholar
  • DeLong E. R., , DeLong D. M., , & Clarke-Pearson D. L. (1988). Comparing the areas under two or more correlated receiver operating characteristic curves: A nonparametric approach. Biometrics, 44(3), 837–845. Crossref MedlineGoogle Scholar
  • First M. B., , Spitzer R. L., , Gibbon M., , Williams J. B. W., , & Benjamin L. (1997). Structured Clinical Interview for DSM-IV Axis II Personality Disorders. Washington, DC: American Psychiatric Press. Google Scholar
  • Giesen-Bloo J. H., , Wachters L. M., , Schouten E., , & Arntz A. (2010). The Borderline Personality Disorder Severity Index-IV: Psychometric evaluation and dimensional structure. Personality and Individual Differences, 49(2), 136–141. CrossrefGoogle Scholar
  • Hopwood C. J., , Malone J. C., , Ansell E. B., , Sanislow C. A., , Grilo C. M., , McGlashan T. H., , … Morey L. C. (2011). Personality assessment in DSM-5: Empirical support for rating severity, style, and traits. Journal of Personality Disorders, 25, 305–320. LinkGoogle Scholar
  • Huang Y., , Kotov R., , De Girolamo G., , Preti A., , Angermeyer M., , Benjet C., , … Kessler R. (2009). DSM-IV personality disorders in the WHO World Mental Health Surveys. British Journal of Psychiatry, 195, 46–53. Crossref MedlineGoogle Scholar
  • Hutsebaut J., , Feenstra D. J., , & Kamphuis J. H. (2015). Development and preliminary psychometric evaluation of a brief self-report questionnaire for the assessment of the DSM-5 Level of Personality Functioning Scale: The LPFS Brief Form (LPFS-BF). Personality Disorders: Theory, Research, and Treatment, 7, 192–197. CrossrefGoogle Scholar
  • Killaspy H., , Bebbington P., , Blizard R., , Johnson S., , Nolan F., , Pilling S., , & King M. (2006). The REACT study: Random evaluation of assertive community treatment in North London. British Medical Journal, 332, 815–820. Crossref MedlineGoogle Scholar
  • Kongerslev M., , Moran P., , Bo S., , & Simonsen E. (2012). 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, 12, 94. Crossref MedlineGoogle Scholar
  • Livesley W. J. (2006). General assessment of personality disorder (GAPD). Vancouver, BC: Department of Psychiatry, University of British Columbia. Google Scholar
  • Moran P., , Leese M., , Lee T., , Walters P., , Thornicroft G., , & Mann A. (2003). Standardised Assessment of Personality – Abbreviated Scale (SAPAS): Preliminary validation of a brief screen for personality disorder. British Journal of Psychiatry, 183, 228–232. Crossref MedlineGoogle Scholar
  • Morey L. C., , Skodol A. E., & Oldham J. M. (2014). Clinician judgments of clinical utility: A comparison of DSM-IV-TR personality disorders and the alternative model for DSM-5 personality disorders. Journal of Abnormal Psychology, 123, 398–405. Crossref MedlineGoogle Scholar
  • Newton-Howes G., , Tyrer P., , Anagnostakis K., , Cooper S., , Bowden-Jones O., , & Weaver T. (2010). The prevalence of personality disorder, its comorbidity with mental state disorders, and its clinical significance in community mental health teams. Social Psychiatry and Psychiatric Epidemiology, 45(4), 453–460. Crossref MedlineGoogle Scholar
  • Reich J. H., , & Green A. I. (1991). Effect of personality disorders on outcome of treatment. Journal of Nervous and Mental Disease, 179(2), 74–82. Crossref MedlineGoogle Scholar
  • Sato T., , Sakado K., , Uehara T., , Narita T., , & Hirano S. (1999). Personality disorder comorbidity in early-onset versus late-onset major depression in Japan. Journal of Nervous and Mental Disease, 187(4), 237–242. Crossref MedlineGoogle Scholar
  • Tyrer P., , Crawford M. J., , Mulder R., , Blashfield R., , Farnam A., , & Fossati A. (2011). The rationale for the reclassification of personality disorder in the 11th revision of the International Classification of Diseases (ICD11). Personality and Mental Health, 5(4), 246–259. CrossrefGoogle Scholar
  • Tyrer P., , & Johnson T. (1996). Establishing the severity of personality disorder. American Journal of Psychiatry, 153, 1593–1597. Crossref MedlineGoogle Scholar
  • Tyrer P., , Nur U., , Crawford M., , Karlsen S., , Mclean C., , Rao B., , & Johnson T. (2005). The Social Functioning Questionnaire: A rapid and robust measure of perceived functioning. International Journal of Social Psychology, 51(3), 265–275. Crossref MedlineGoogle Scholar
  • Tyrer P., , Reed G., , & Crawford M. J. (2015). Classification, assessment, prevalence, and effect of personality disorder. Lancet, 385, 717–726. doi: 10.1016/S01406736(14)61995-4 Crossref MedlineGoogle Scholar
  • Verheul R., , Andrea H., , Berghout C. C., , Dolan C., , Busschbach J. J. V., , van der Kroft P. J., , … Fonagy P. (2008). Severity Indices of Personality Problems (SIPP-118): Development, factor structure, reliability, and validity. Psychological Assessment, 20, 23–34. Crossref MedlineGoogle Scholar
  • Yonkers K., , Dyck I., , Warshaw M., , & Keller M. (2000). Factors predicting the clinical course of generalised anxiety disorder. British Journal of Psychiatry, 176, 544–549. Crossref MedlineGoogle Scholar