Validity & Clinical Utility of 2-Part System for Personality Disorder Diagnosis

有效性

• 批准号: 8465273
• 负责人: Lee Anna Clark
• 金额: $ 54.92万
• 依托单位: UNIVERSITY OF NOTRE DAME
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-08-09 至 2015-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8465273
• 关键词: Address; Behavioral; Categories; Characteristics; Client; Clinic; Clinical; Clinical assessments; Clinics and Hospitals; Communication; Communities; Complex; Consensus; DSM-V; Data; Development; Diagnosis; Diagnostic; Dimensions; Disease; Distress; Drug Formulations; Ensure; Evaluation; Family; Foundations; Friends; Functional disorder; Goals; Health Personnel; Impairment; Individual; Intake; Intervention; Interview; Iowa; Knowledge; Measures; Mental Health; Mental disorders; Methods; Modeling; Occupational; Outcome; Participant; Patient Self-Report; Patients; Personality; Personality Disorders; Personality Traits; Phase; Psychiatric Hospitals; Reporting; Research; Research Personnel; Sampling; Staging; Structure; Surveys; System; Teaching Hospitals; Techniques; Testing; Therapeutic; Time; Treatment outcome; Universities; Validity and Reliability; Work; base; experience; follow-up; functional disability; high risk; improved; innovation; instrument; longitudinal course; psychosocial; public health relevance; sound; tool; trait; treatment planning; treatment strategy

DESCRIPTION (provided by applicant): Personality disorder (PD) diagnosis is at a crossroads: There is broad acknowledgment of the significant, negative impact that PD has on individuals and on the course and outcome of comorbid disorders, as well as relatively widespread dissatisfaction with the current categorical system of PD diagnosis. Nonetheless, there also is reluctance to implement an alternative trait dimensional system because: (1) there is no consensus on which set of traits to assess, (2) current trait assessment methods do not reflect either dysfunction or the full range of clinical variability, and (3) the clinical utility of a trait-based system is unknown. The proposed research is significant because it will draw from the full spectrum of the personality trait domain to identify a comprehensive set of specific traits for PD diagnosis, demonstrate how PD characteristics are manifest in both stable and clinical-state-dependent forms, and provide a clinically useful PD diagnostic system that integrates assessment of trait dimensions and psychosocial functioning. The long-term goal of this research is to develop a trait-plus-dysfunction-based clinical assessment system for the reliable and valid diagnosis of personality disorder on which to base the development of effective, more specifically targeted interventions. The specific aims of the current proposal are (1) to establish a set of specific traits that collectively define the trait dimensions of individuals with PD, (2) to establish a set of psychosocial functioning dimensions that collectively define the functional impairment of individuals with PD, and (3) to evaluate prospectively the clinical utility of this two-pronged PD diagnostic system. We plan to do this in three stages: (1) Assessing a large sample on a wide range of measures of both traits and psychosocial function to determine the structure of each domain and ensure that we have identified all components needed to assess personality disorder comprehensively; (2) testing the identified components on another large sample of patients and high-risk individuals, including information provided by family and/or friends, and Axis I symptomatology, and (3) testing the clinical utility of the developed system by assessing a sample of new patients, providing the information to their mental health-care providers, surveying the clinicians for the usefulness and acceptability of the diagnostic system, and examining its predictive validity over 6 months post-intake. We expect that the newly developed system will have high predictive validity and be judged clinically useful; specifically, to be comprehensive and accurate, and useful for communication purposes, for formulating general and specific treatment plans, and for predicting general and specific treatment difficulties.

描述（由申请人提供）：人格障碍（PD）的诊断正处于十字路口：人们广泛认识到PD对个体以及共病疾病的病程和结果产生了重大的负面影响，同时对当前PD诊断的分类系统也存在相对广泛的不满。尽管如此，人们也不愿意实施另一种特征维度系统，因为：(1)对于评估哪一组特征没有达成共识；(2)目前的特征评估方法既不能反映功能障碍，也不能反映临床变异性的全部范围；(3)基于特征的系统的临床实用性尚不清楚。这项研究具有重要意义，因为它将从人格特质领域的全谱中提取，以确定PD诊断的一套全面的特定特征，展示PD特征如何以稳定和临床状态依赖的形式表现出来，并提供一个临床有用的PD诊断系统，该系统集成了特征维度和社会心理功能的评估。本研究的长期目标是开发一个基于特征加功能障碍的临床评估系统，以可靠和有效地诊断人格障碍，并以此为基础制定有效的、更有针对性的干预措施。当前提案的具体目标是：(1)建立一组特定的特征，共同定义PD患者的特征维度；(2)建立一组社会心理功能维度，共同定义PD患者的功能障碍；(3)前瞻性评估这种双管齐下的PD诊断系统的临床实用性。我们计划分三个阶段完成这项工作：(1)对一个大样本进行广泛的特征和心理社会功能测量，以确定每个领域的结构，并确保我们已经确定了全面评估人格障碍所需的所有组成部分；(2)在另一个大的患者和高危人群样本上测试确定的成分，包括家庭和/或朋友提供的信息，以及轴I症状学；(3)通过评估新患者样本来测试开发的系统的临床效用，向他们的精神卫生保健提供者提供信息，调查临床医生诊断系统的有用性和可接受性；并在摄入后6个月内检验其预测有效性。我们期望新开发的系统具有较高的预测效度和临床应用价值；具体而言，要全面准确，便于沟通，便于制定一般和具体的治疗方案，便于预测一般和具体的治疗困难。