VALIDITY IN THE DIAGNOSIS OF PERSONALITY DISORDERS

人格障碍诊断的有效性

• 批准号: 3384054
• 负责人: Paul A Pilkonis
• 金额: $ 22.48万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 1990
• 资助国家: 美国
• 起止时间: 1990-04-01 至 1994-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3384054
• 关键词: diagnosis quality /standard; human middle age (35-64); human subject; interview; longitudinal human study; mental disorder diagnosis; personality disorders; personality tests; psychological tests; young adult human (21-34)

Research on personality disorders is plagued by methodological difficulties. The development of structured interviews for personality disorders has addressed concerns regarding interrater reliability, but even with structured interviews, there is relatively little evidence of the clinical and predictive validity of the diagnoses made. The most pressing scientific issue at present is documenting the validity of diagnoses derived from such measures, and the primary goal of the present proposal is to collect data necessary to address the validity question. The first specific aim is to conduct a study of the clinical and predictive validity of the Personality Disorder Examination (PDE) and the Structured Interview for the DSM-III Personality Disorders (SIDP) in a sample of 200 patients with nonpsychotic diagnoses on Axis I of DSM-III-R. The method for establishing validity has been pretested in a pilot study and relies heavily on Spitzer's recommendations for the use of the "LEAD standard." The acronym LEAD refers to three key concepts: the use of Longitudinal information, ratings of Expert clinicians, and the collection of All Data available. The second aim is to compare the diagnoses derived from clinical consensus and the structured interviews (PDE and SIDP) with those generated by the Wisconsin Personality Inventory (WISPI), the most promising self-report instrument currently available for Axis II disorders. The third aim is to investigate the influence of symptomatic state on what are assumed to be trait assessments done by these different methods (clinical consensus, structured interview, and self-report). The "state vs. trait" issue (especially as it influences the concordance between informants and among evaluation methods) is a thorny but fundamental problem in the attempt to establish valid assessment procedures. A longitudinal design will allow us to measure the stability of trait assessments (done using different methods and relying on different informants) as the patient's symptomatology varies over a 12-month period.

人格障碍的研究受到方法论的困扰 困难。结构化人格访谈的研究进展 混乱已经解决了对评委间可靠性的担忧，但即使 在结构化面试中，几乎没有证据表明 诊断结果的临床和预测效度。最紧迫的 目前的科学问题是记录诊断的有效性 产生于这些措施，本提案的主要目标是 收集解决有效性问题所需的数据。 第一个具体目标是进行临床和预测性研究 人格障碍测验(PDE)与结构型人格测验的效度 DSM-III人格障碍问卷(SIDP)的访谈 在DSM-III-R轴I上诊断为非精神病患者。方法 已经在一项试点研究中进行了预先测试，并依赖于 很大程度上依赖于斯皮策关于使用“铅标准”的建议。 缩写Lead指的是三个关键概念：纵向的使用 信息、专家临床医生的评级和所有数据的收集 可用。第二个目标是比较从 临床共识和结构化访谈(PDE和SIDP) 由威斯康星州人格问卷(WISPI)产生的，最 前景看好的自我报告工具目前可用于治疗Axis II疾病。 第三个目标是调查症状状态对什么的影响 被认为是通过这些不同的方法进行的性状评估 (临床共识、结构化访谈和自我报告)。“国家” VS特征“问题(尤其是它影响 告密者和评价方法)是一个棘手但基本的问题 在试图建立有效的评估程序方面存在问题。一个 纵向设计将使我们能够测量性状的稳定性 评估(使用不同的方法并依赖于不同的 告密者)，因为患者的症状在12个月期间有所不同。