SCREENING FOR PERSONALITY DISORDERS

描述(申请人摘要)： 已有越来越多的人认识到 精神和医学样本中的人格障碍(PD)和 开展相关工作，开发更好的病例鉴定方法。 已经取得了足够的进展，可以提议对筛查者进行比较测试 目前可用：爱荷华州人格障碍屏幕， 自我导向量表来自于气质和性格问卷(TCI)， PDS的量表是从人际关系问卷发展而来的 问题(LIP)。为了最大化它们的科学价值，这些测试应该 包括精神病学样本的交叉验证和对 它们在PDS基本速率为 可能会更低。我们提出了两个阶段的评估方法 目的。第一阶段是完成所有三种筛查仪器和 阶段2是一项更密集的临床评估，采用分层、随机 由不同筛查者确定的受试者的精选子样本。这个 这项工作的具体目标是：(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学样本和 现在调查其他筛查工具的比较效用 可用；(2)将工作扩展到PD基本费率较低的样品： 一份糖尿病患者的医学样本和一份从 匹兹堡大学来源；以及(3)检验预测效度 或在6个月的随访期内采用不同方法诊断帕金森病。 感兴趣的结果将是个人结果(精神状态， 医疗状况、症状学、角色功能)和社会结果(使用 治疗服务)。我们的假设是，将有相同的等级 三个样本在两个领域的结果排序：受试者 B组(戏剧性、表现力强、外在的)PD将是最差的 个人结果和需要最多的治疗服务，其次是 患有C组(焦虑、恐惧、内在化)PD的受试者，其次是 没有PDS的受试者，谁会有最好的个人结果 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.