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Abstract
BackgroundBrief screening instruments for co-morbid personality disorders could potentially have great value in substance abuse treatment settings.MethodsWe assessed the psychometric properties of the 8-item Standardised Assessment of Personality – Abbreviated Scale (SAPAS) in a sample of 58 methadone maintenance patients.ResultsInternal consistency was modest, but similar to the original value (alpha = 0.62), and test-retest correlation at four months follow-up was moderately encouraging for a short instrument such as this (n = 31, test retest intraclass correlation = 0.58), and change at the mean level was minimal, but marginally significant (from an average of 3.3 to 3.8, p = 0.06). Analyses of nurse ratings of patients' behaviour at the clinic showed that SAPAS was significantly correlated with nurse ratings of externalizing behaviour (r = 0.42, p = 0.001), and Global Assessment of Functioning (r = -0.36, p = 0.006), but unrelated to intoxication (r = 0.02, NS), or withdrawal (r = 0.20, NS).ConclusionThere is evidence that the SAPAS is a modestly valid and relatively reliable brief screening measure of personality disorders in patients with ongoing substance abuse undergoing methadone maintenance. It can be used in situations where limited resources are available, and researchers or others wish to get an impression of the degree of personality pathology in a clinical population, as well as for screening purposes.
Highlights
Brief screening instruments for co-morbid personality disorders could potentially have great value in substance abuse treatment settings
Evidence is emerging that substance abuse treatment is more effective, if it addresses personality related issues, including personality disorders [8,9,10]
The internal consistency of the Standardised Assessment of Personality – Abbreviated Scale (SAPAS) was slightly lower in this sample than in the psychiatric sample (α = 0.62)
Summary
Brief screening instruments for co-morbid personality disorders could potentially have great value in substance abuse treatment settings. Personality disorders are among the most common comorbidities among patients with substance use disorders [1,2]. Personality disorders complicate treatment in a range of ways, elicit negative emotional reactions in clinicians [3], and are associated with worse outcome in treatment for substance use disorders [4,5,6,7]. Identifying patients with co-morbid personality disorders remain a challenge for substance abuse treatment services. Self-report inventories tend to diagnose most substance abusers with personality disorders [11], and often traits improve rapidly with time [12,13]. Reducing the number of patients who need a full personality disorder examination by screening out patients without personality disorders (page number not for citation purposes)
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