Screening for borderline personality disorder in outpatient youth
Screening for borderline personality disorder in outpatient youth
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DOI：
10.1521/pedi.2008.22.4.353
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发表时间：
2008-08-01
影响因子：
2.3
通讯作者：
Jackson, Henry J.
中科院分区：
文献类型：
--
作者：
Chanen, Andrew M.;Jovev, Martina;Jackson, Henry J.
患有边缘型人格障碍（BPD）的年轻人通常会寻求帮助，但往往得不到承认。筛查提供了一种识别个人的手段，以便进行更详细的评估，以便进行早期干预和研究。目的：本研究比较了姆克林边缘性人格障碍筛查量表（MSI-BPD）、边缘性人格问卷（BPQ）、国际人格障碍筛查问卷（International Personality Disorder Examination Screening Questionnaire）中的BPD项目和DSM-IV轴II障碍结构化临床访谈（SCID-II）人格问卷中的BPD项目。方法：101名门诊青年（15-25岁）完成了筛查措施，并接受了采访，不知道筛查状态，与SCID-II BPD模块。两周后再次进行筛查，以评估重测信度。结果如下：所有四种仪器的表现相似，但BPQ具有最佳的特征组合，具有中等灵敏度（0.68），最高特异性（0.90），高阴性预测值（0.91）和中等阳性预测值（0.65）。与其他三个工具相比，BPQ具有最高的总体诊断准确性（0.85），显著较高的Kappa值（0.57）与标准诊断，最高的重测信度（ICC = 0.92）和最高的内部一致性（a = 0.92）。接受者操作曲线（ROC）分析中出现的唯一明显差异是BPQ显著优于MSI（p = 0.05）。结论：在门诊青年中筛查BPD是可行的，但不能取代临床诊断。
Young people with borderline personality disorder (BPD) commonly seek help but often go unrecognized. Screening offers a means of identifying individuals for more detailed assessment for early intervention and for research. Aims: This study compared the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD), Borderline Personality Questionnaire (BPQ), the BPD items from the International Personality Disorder Examination Screening Questionnaire and the BPD items from the Structured Clinical Interview for DSM-IV Axis II disorders (SCID-II) Personality Questionnaire. Method: 101 outpatient youth (aged 15-25 years) completed the screening measures and were interviewed, blind to screening status, with the SCID-II BPD module. The screening measures were readministered two weeks later to assess test-retest reliability. Results: All four instruments performed similarly but the BPQ had the best mix of characteristics, with moderate sensitivity (0.68), the highest specificity (0.90), high negative predictive value (0.91) and moderate positive predictive value (0.65). Compared to the other three instruments, the BPQ had the highest overall diagnostic accuracy (0.85), a substantially higher kappa (0.57) with the criterion diagnosis, the highest test-retest reliability (ICC = 0.92) and the highest internal consistency (a = 0.92). The only clear difference to emerge in the Receiver Operator Curve (ROC) analysis was that the BPQ significantly outperformed the MSI (p = 0.05). Conclusion: Screening for BPD in outpatient youth is feasible but is not a replacement for clinical diagnosis.