Clinical assessment of individuals with personality disorder in the secure hospital

2006 ◽  
pp. 39-57
Author(s):  
Estelle Moore
Keyword(s):  
Personality Disorder ◽  
Clinical Assessment

scholarly journals Development and Psychometric Properties of the Standardized Assessment of Severity of Personality Disorder (SASPD)

2018 ◽  
Vol 32 (1) ◽  
pp. 44-56 ◽  
Author(s):  
Kike Olajide ◽  
Jasna Munjiza ◽  
Paul Moran ◽  
Lesley O'Connell ◽  
Giles Newton-Howes ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Psychometric Properties ◽  
Clinical Assessment ◽  
Roc Curve ◽  
Intraclass Correlation ◽  
Predictive Ability ◽  
Standardized Assessment ◽  
Cut Points ◽  
Test Retest Reliability ◽  
High Intraclass Correlation Coefficient

Personality disorder (PD) is increasingly categorized according to its severity, but there is no simple way to screen for severity according to ICD-11 criteria. We set out to develop the Standardized Assessment of Severity of Personality Disorder (SASPD). A total of 110 patients completed the SASPD together with a clinical assessment of the severity of personality disorder. We examined the predictive ability of the SASPD using the area under the ROC curve (AUC). Two to four weeks later, 43 patients repeated the SASPD to examine reliability. The SASPD had good predictive ability for determining mild (AUC = 0.86) and moderate (AUC = 0.84) PD at cut points of 8 and 10, respectively. Test-retest reliability of the SASPD was high (intraclass correlation coefficient = 0.93, 95% CI [0.88, 0.96]). The SASPD thus provides a simple, brief, and reliable indicator of the presence of mild or moderate PD according to ICD-11 criteria.

Personality Disorder and Its Clinical Assessment in Aviation

2019 ◽  
pp. 183-196
Author(s):  
Peter Scragg ◽  
Robert Bor ◽  
Carina Eriksen ◽  
Margaret Oakes
Keyword(s):  
Personality Disorder ◽  
Clinical Assessment

Personalized Models of Psychopathology as Contextualized Dynamic Processes: An Example from Individuals with Borderline Personality Disorder

2018 ◽  
Author(s):  
William C. Woods ◽  
Cara Arizmendi ◽  
Kathleen Gates ◽  
Stephanie Stepp ◽  
Paul A. Pilkonis ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Clinical Assessment ◽  
Borderline Personality ◽  
Dynamic Processes ◽  
Model Estimation ◽  
Case Formulation ◽  
Multiple Model ◽  
Behavioral Regulation ◽  
The Individual

Objective: Psychopathology research has relied on discrete diagnoses, which neglects the unique manifestations of each individual’s pathology. Borderline personality disorder combines interpersonal, affective, and behavioral regulation impairments making it particularly ill-suited to a “one size fits all” diagnosis. Clinical assessment and case formulation involve understanding and developing a personalized model for each patient’s contextualized dynamic processes, and research would benefit from a similar focus on the individual. Method: We use group iterative multiple model estimation, which estimates a model for each individual and identifies general or shared features across individuals, in both a mixed-diagnosis sample (N=78) and a subsample with a single diagnosis (n=24). Results: We found that individuals vary widely in their dynamic processes in affective and interpersonal domains both within and across diagnoses. However, there was some evidence that dynamic patterns relate to transdiagnostic baseline measures. We conclude with descriptions of two person-specific models as an example of the heterogeneity of dynamic processes. Conclusions: The idiographic models presented here join a growing literature showing that the individuals differ dramatically in the total patterning of these processes, even as key processes are shared across individuals. We argue that these processes are best estimated in the context of person-specific models, and that so doing may advance our understanding of the contextualized dynamic processes that could identify maintenance mechanisms and treatment targets.

scholarly journals Challenges assessing personality disorders with the SCID-5-PD in psychiatric patients

2020 ◽  
Author(s):  
Mateo Boberg ◽  
Simon Felding ◽  
Lennart Bertil Jansson ◽  
Julie Nordgaard
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Clinical Diagnosis ◽  
Clinical Assessment ◽  
Psychiatric Patients ◽  
Borderline Personality ◽  
Schizophrenia Spectrum ◽  
Icd 10 ◽  
Schizotypal Disorder ◽  
Diagnostic Outcomes

Abstract Background: The SCID-5-PD is frequently used to diagnose personality disorders. The aim of this study is to compare the diagnostic outcomes of the SCID-5-PD with expert clinical assessment in an ICD-10 setting. Methods: A random sample of a total of 30 psychiatric in- and outpatients (mean age = 34 ± 16, 17 males and 13 females) went through a comprehensive clinical assessment conducted by experts. Subsequently, the patients were assessed with the SCID-5-PD by specifically trained novice raters. Results: 55% (n=11) of patients with clinical diagnosis within the schizophrenia spectrum were allocated one or more diagnoses of personality disorder according to the SCID-5-PD, primarily borderline personality disorder (n=6). In contrast, of all patients with a clinical diagnosis outside the schizophrenia spectrum, only one patient qualified for a diagnosis of personality disorder with the SCID-5-PD. Meanwhile, 70% (n=7) of patients with a clinical diagnosis of ICD-10 schizotypal disorder did not meet the criteria for this disorder when assessed with the SCID-5-PD. Conclusions: When considering a differential diagnosis within the schizophrenia spectrum, outcomes from the SCID-5-PD should be interpreted cautiously.

Dynamic Nosology and Clinical Assessment of Fragmented Personality

2018 ◽  
pp. 159-196
Author(s):  
Dragan M. Svrakic ◽  
Mirjana Divac-Jovanovic
Keyword(s):  
Personality Disorder ◽  
Clinical Diagnosis ◽  
Clinical Assessment ◽  
Psychological Testing ◽  
Personality Pathology ◽  
Mental Functioning ◽  
Adaptive Style ◽  
The Individual ◽  
The Mind ◽  
Healthy Personality

This chapter introduces a dynamic, personalized, context- and time-sensitive diagnosis of personality in health and disorder. Adaptive flexibility of the mind implies that its component subsystems and functions must also be flexible and semistable, including healthy personality and personality disorder. The model defines a 3D diagnostic space, in which each individual is uniquely and flexibly positioned. “Vertical diagnosis” is based on the duration, pervasiveness, and frequency of periods of fragmented functioning. It is cross-matched with “horizontal diagnosis,” based on the predominant adaptive style. Such dynamic nosology accounts for fluctuations in mental functioning as the individual “moves” in the diagnostic space. The approach captures the flexibility of the mind, self-reorganizing to adapt to changing conditions, and champions the positive connotation of change, challenging the widespread therapeutic nihilism about severe personality pathology. Clinical diagnosis of personality disorder, notably interpersonal (relational), behavioral, and intrapersonal approaches, together with psychological testing are discussed in detail.

Tools & Resources: Impairment and Disability Web Sites

1999 ◽  
Vol 4 (6) ◽  
pp. 5-6
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Interpersonal Relationships ◽  
Web Sites ◽  
Outpatient Psychotherapy ◽  
Obsessive Compulsive ◽  
Not Otherwise Specified ◽  
Cluster B Personality Disorders ◽  
Clinically Significant ◽  
And Behavior

Abstract Personality disorders are enduring patterns of inner experience and behavior that deviate markedly from those expected by the individual's culture; these inflexible and pervasive patterns reflect issues with cognition, affectivity, interpersonal functioning and impulse control, and lead to clinically significant distress or impairment in social, occupational, or other important areas of functioning. The AMA Guides to the Evaluation of Permanent Impairment, Fourth Edition, defines two specific personality disorders, in addition to an eleventh condition, Personality Disorder Not Otherwise Specified. Cluster A personality disorders include paranoid, schizoid, and schizotypal personalities; of these, Paranoid Personality Disorder probably is most common in the legal arena. Cluster B personality disorders include antisocial, borderline, histrionic, and narcissistic personality. Such people may suffer from frantic efforts to avoid perceived abandonment, patterns of unstable and intense interpersonal relationships, an identity disturbance, and impulsivity. Legal issues that involve individuals with cluster B personality disorders often involve determination of causation of the person's problems, assessment of claims of harassment, and assessment of the person's fitness for employment. Cluster C personality disorders include avoidant, dependent, and obsessive-compulsive personality. Two case histories illustrate some of the complexities of assessing impairment in workers with personality disorders, including drug abuse, hospitalizations, and inpatient and outpatient psychotherapy.

597: How Accurate is the Clinical Assessment of the Inguinal Region in Patients with Squamous Cell Carcinoma of the Penis

2006 ◽  
Vol 175 (4S) ◽  
pp. 193-193 ◽  
Author(s):  
Paul Hadway ◽  
Cathy M. Corbishley ◽  
Matthew Perry ◽  
Nicholas A. Watkin
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Clinical Assessment ◽  
Inguinal Region
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