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Abstract
BackgroundPersonality disorder (PD) is associated with important health outcomes in the general population. However, the length of diagnostic interviews poses a significant barrier to obtaining large scale, population‐based data on PD. A brief screen for the identification of people at high risk of PD in the general population could be extremely valuable for both clinicians and researchers.AimWe set out to validate the Standardised Assessment of Personality – Abbreviated Scale (SAPAS), in a general population sample, using the Structured Clinical Interviews for DSM‐IV Personality Disorders (SCID‐II) as a gold standard.MethodOne hundred and ten randomly selected, community‐dwelling adults were administered the SAPAS screening interview. The SCID‐II was subsequently administered by a clinical interviewer blind to the initial SAPAS score. Receiver operating characteristic analysis was used to assess the discriminatory performance of the SAPAS, relative to the SCID‐II.ResultsArea under the curve for the SAPAS was 0.70 (95% CI = 0.60 to 0.80; p < 0.001), indicating moderate overall discriminatory accuracy. A cut point score of 4 on the SAPAS correctly classified 58% of participants. At this cut point, the sensitivity and specificity were 0.69 and 0.53 respectively.ConclusionThe SAPAS operates less efficiently as a screen in general population samples and is probably most usefully applied in clinical populations. © 2015 The Authors Personality and Mental Health published by John Wiley & Sons Ltd
Highlights
Personality disorder (PD) is a global health problem (Tyrer et al, 2010)
In the World Health Organization World Mental Health Surveys of DSMIV Personality Disorder, approximately 6% of community participants from 13 high-income, middle-income and low-income countries met the criteria for a PD (Huang et al, 2009), other surveys have found higher prevalence figures of the order of 10–13% (Samuels, 2011; Torgersen, Kringlen, & Cramer, 2001)
The alpha coefficient for the total Standardised Assessment of Personality – Abbreviated Scale (SAPAS) score was 0.51, with ‘Generally a perfectionist’ being the item that was least consistent with the remaining items. This is the first attempt at validating a PD screening tool in a general population sample
Summary
People with PD are more likely to be separated or divorced, unemployed, living in urban locations and are more likely to have concurrent health problems in the form of mood, anxiety and substance use disorders (Coid, Yang, Tyrer, Roberts, & Ullrich, 2006). They report a greater number of physical health problems and are at elevated risk of cardiovascular disease (Moran et al, 2007). An efficient screening interview might be usefully applied, perhaps as part of a two-stage procedure for case identification (Lenzenweger, Loranger, Korfine, & Neff, 1997)
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