SCREENING FOR PERSONALITY DISORDERS

描述（申请人摘要）： 越来越多的人认识到， 精神病学和医学样本中的人格障碍（PD）， 开展相关努力，以制定更好的病例识别方法。 已经取得足够的进展，可以提议进行筛选器的比较试验 目前可用：爱荷华州人格障碍筛查， 气质与性格量表（TCI）中的自我导向量表， 以及根据人际关系量表（Inventory of Interpersonal 问题（IIP）。 为了最大限度地发挥其科学价值，这些测试应该 包括精神病样本交叉验证和对 在PD基本率为 可能会更低。 我们建议采用两阶段评估方法， 目的 第一阶段是完成所有三个筛选工具， 第2阶段是一个更密集的临床评估， 由不同筛选人员确定的选定受试者子样本。 的 具体的工作目标是：（1）交叉验证初步结果 从我们的IIP PD筛查量表在一个新的精神病样本， 现在调查其他筛选工具的比较效用 （2）将工作扩展到PD基本率较低的样本中： 患有糖尿病的医学样本和从以下确定的社区样本： 匹兹堡大学资料来源;（3）检验预测效度 或在6个月的随访期内通过不同方法进行PD诊断。 感兴趣的结果将是个人结果（精神状态， 医疗状况、疾病学、角色功能）和社会结果（使用 治疗服务）。 我们的假设是， 所有三个样本中两个领域的结果排序： 集群B（戏剧性、表达性、外化）PD的表现最差 个人结果，需要最多的治疗服务，其次是 C组（焦虑、恐惧、内化）PD受试者，其次是 没有PD的受试者，他们将有最好的个人结果， 需要最少的服务。

DESCRIPTION (Applicant's Abstract): There has been increased recognition of the clinical importance of personality disorders (PDs) in both psychiatric and medical samples and related efforts to develop better methods of case identification. Sufficient progress has been made to propose a comparative test of screeners currently available: the Iowa Personality Disorder Screen, the self-directedness scale from the Temperament and Character Inventory (TCI), and the scales for PDs developed from the Inventory of Interpersonal Problems (lIP). To maximize their scientific value, these tests should include both crossvalidation in psychiatric samples and an examination of their operating characteristics in samples where the base rate of PDs is likely to be lower. We propose a 2- stage assessment methodology for these purposes. Stage I is the completion of all three screening instruments and stage 2 is a more intensive clinical assessment with stratified, randomly selected subsamples of subjects identified by the different screeners. The specific aims of the work are: (1) To crossvalidate the initial results from our IIP PD screening scales in a new psychiatric sample and to investigate the comparative utility of the other screening tools now available; (2) To extend the work into samples with lower base rates of PDs: a medical sample with diabetes and a community sample ascertained from University of Pittsburgh sources; and (3) To examine the predictive validity or PD diagnosis by the different methods over a 6- month follow-up period. The outcomes of interest will be both personal outcomes (psychiatric status, medical status, symptomatology, role functioning) and social outcomes (use of treatment services). Our hypothesis is that there will be the same rank ordering of outcomes in both areas in all three samples: subjects with cluster B (dramatic, expressive, externalizing) PDs will have the poorest personal outcomes and require the most treatment services, followed by subjects with cluster C (anxious, fearful, internalizing) PDs, followed by subjects without PDs, who will have the best personal outcomes while requiring the fewest services.