Personality Assessment Schedule Research Articles

The recording of personality strengths: An analysis of the impact of positive personality features on the long-term outcome of common mental disorders.

Although personality strengths are assessed frequently in occupational and managerial settings and in children, they have been less used in studies of personality disorder. The aim of this study is to examine the impact of a measure of personality strengths derived from the comprehensive version of the Personality Assessment Schedule (CPAS) (i.e., positive and reinforcing traits) on clinical symptoms and functioning. Eighty‐nine patients with anxiety and depression seen at the 30‐year follow‐up point in a cohort study (Nottingham Study of Neurotic Disorder) were administered the Comprehensive version of the PAS (CPAS). A factor analysis of the results determined the main groupings and their impact on long‐term outcomes as well as their association with change of outcomes over 30 years. Five positive factors (strengths), forceful considerateness, emotional toughness, cautiousness, independence and discernment accounted for 67.2% of the variance using both Varimax and Promax rotations. Low positive scores were strongly associated with suicide attempts, moderate/severe personality disorder, cothymia (mixed anxiety‐depression), greater symptomatology and poor social function. High scores were protective of serious pathology and particularly effective in inhibiting suicidal behaviour. The promotion of personality strengths may be of value in preventing suicidal behaviour and helping pro‐social change in those with personality disturbance.

The influence of personality disorder in predicting suicidal behaviour in common mental disorders: A 30-year study.

Two hundred ten patients with anxiety and depressive disorders were followed up over 30 years. Personality status was assessed at baseline using the Personality Assessment Schedule (PAS), an instrument that classifies personality disorder in a similar way to the new ICD‐11 classification. Assessments of suicidal behaviour were made at 5, 12 and 30 years and suicidal thoughts at 12 and 30 years and analysed by personality status, clinical diagnosis and scores on the General Neurotic Syndrome Scale, a combined diagnosis of mixed anxiety depression and personality dysfunction. Suicide attempts were most frequent in the first 5 years of the study and reduced over time. Baseline personality status was the best predictor of suicide attempts at 5 years (no personality disorder 29.3%, personality disorder 51.6%, p = 0.006), and at 12 years (no personality disorder 11.9%, personality disorder 25.7%, p = 0.042), but no important differences were found at 30 years, when comorbid mental state disorder was the strongest predictor (p < 0.001). Similar but less marked findings were found for the general neurotic syndrome. It is concluded that the presence of personality disorder is a robust predictor of suicidal behaviour in the shorter term but in the long‐term comorbid pathology is a better predictor.

Personality change in the Nottingham Study of Neurotic Disorder: 30-Year cohort study.

Background:Persistence is said to be a feature of personality disorder, but there are few long-term prospective studies of the condition. A total of 200 patients with anxiety and depressive disorders involved in a randomised controlled trial initiated in 1983 had full personality status assessed at baseline. We repeated assessment of personality status on three subsequent occasions over 30 years.Methods:Personality status was recorded using methods derived from the Personality Assessment Schedule, which has algorithms for allocating Diagnostic and Statistical Manual of Mental Disorders (DSM) and the 11th International Classification of Diseases (ICD-11) categories. The category and severity of personality diagnosis were recorded at baseline in the randomised patients with DSM-III anxiety and depressive diagnoses. The same methods of assessing personality status was repeated at 2, 12 and 30 years after baseline.Results:Using the ICD-11 system, 47% of patients, mainly those with no personality disturbance at baseline, retained their personality status; of the others 16.8% improved and 20.4% worsened to more severe disorder. In DSM-III diagnosed patients, those diagnosed as Cluster A and Cluster C increased in frequency (from 14% to 40%, p < 0.001, and 21.5% to 36%, p < 0.001, respectively) over follow-up, while those with Cluster B showed little change in frequency (22% to 18%, p = 0.197).Conclusion:In this population of patients with common mental disorders, personality status showed many changes over time, inconsistent with the view that personality disorder is a persistent or stable condition. The increase in diagnoses within the Cluster A and C groups suggests personality disorder generally increases in frequency as people age.

Is social function a good proxy measure of personality disorder?

Personality assessment may be helped by proxy measures. To examine the assessment of social functioning in relationship to personality disorder. Secondary analysis of data from three clinical studies, following deliberate self-harm (n= 460), cognitive behaviour therapy for health anxiety (n= 444) and a 30-year follow-up of 200 anxious/depressed patients. Social function and personality were assessed using the Social Functioning Questionnaire (SFQ) and the Personality Assessment Schedule, with its ICD-11 modification. A 5-item short version of the SFQ, the Short Social Functioning Questionnaire (SSFQ), was also developed. The SFQ score in the first two studies (area under curve [AUC] 0.64 and 0.65) partly predicted personality status; in the third study, this achieved close agreement (AUC SFQ 0.85 [95% CI 0.8-0.9]; AUC SSFQ 0.84 [95% CI 0.78-0.89]). In all studies, social function deteriorated linearly with increasing personality pathology. Cut-off points of 4 on the SSFQ and 7 on the SFQ had high sensitivity (SSFQ 82%-90%; SFQ 82%-83%) and acceptable specificity (SSFQ 66%-75%; SFQ 69%-75%) in identifying personality disorder in the third study. Social functioning recorded in either a 5-item or 8-item self-rating is a useful proxy measure of personality disturbance and may be the core of disorder.

The prevalence of severe personality disorder in perpetrators of homicide.

Current UK evidence on the prevalence of personality disorder in homicide is lacking. The aims were to estimate the prevalence of personality disorder in homicide perpetrators from court reports and carry out a dimensional assessment in keeping with the new ICD-11 classification of the prevalence of severe personality disorder. Associations between severe personality disorder and sociodemographic, historical and offence-related characteristics were then explored. Six hundred court reports from a national case series of homicide perpetrators in England and Wales were analysed using a document-derived version of the Personality Assessment Schedule (PAS-DOC), providing categorical and dimensional personality assessments. The prevalence of personality disorder and severe personality disorder was estimated. Factors associated with the diagnosis of severe personality disorder were examined. The prevalence of personality disorder using the PAS-DOC was 56.3% (95% confidence interval 52.3%, 60.3%), compared with 16% as diagnosed in reports. Severe personality disorder was present in 62% (n=338) of all those with a personality disorder and was significantly associated with homicides of strangers and previous violence. Severe personality disorder is highly prevalent among perpetrators of homicide, and the finding that it is more prevalent when strangers are the victims stresses both the need for early identification of those at risk of developing severe personality disorder and the development of appropriate early preventive interventions. There is also a need for the development of effective treatment and interventions for those with established severe personality disorder and better identification of this level of disorder by psychiatrists. The forthcoming ICD-11 classification should help in this endeavour. © 2021 The Authors Personality and Mental Health Published by John Wiley & Sons Ltd.

Personality Assessment Questionnaire for ICD-11 personality trait domains: Development and testing.

We aimed to develop a questionnaire suitable for the assessment of trait domains in the forthcoming International Classification of Diseases 11th Revision (ICD-11). This questionnaire, the Personality Assessment Questionnaire for ICD-11 (PAQ-11) personality trait domains, was intended as a short and reliable self-report measure. The initial items were derived from the relevant traits of an established version of the Personality Assessment Schedule. In Phase 1, item selection and scale construction proceeded iteratively using data from 334 female university students and 75 psychiatric patients (combined N=409) in Korea. In Phase 2, a validation study of the scale was conducted in a subset of the sample from Phase 1, who were deemed to be at high risk of personality disorders (N=210). Exploratory and confirmatory factor analyses of the Personality Assessment Schedule items created a 17-item scale. This scale, PAQ-11, demonstrated adequate convergent and discriminant validity with the five-factor model, the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition traits model and emotional difficulties. The results were consistent with its underlying theoretical structure. The PAQ-11 appears to be potentially promising in terms of clinical utility to assess the five domains of ICD-11 personality disorders. More research must be conducted in other cultural backgrounds with gender-balanced populations. © 2020 John Wiley & Sons, Ltd.

Assessment of personality traits in a sample of opioid-dependent patients in comparison with nondependent men

Background Drug-taking behavior and drug dependence is a multifactorial disorder. Of them, specific gene or an early established trait may act as a predisposing factor. Different environmental factors may act as precipitating and perpetuating factors, whereas individual temperament, personality, and constitutional characteristics act as the vulnerability factors. These vulnerability factors act as the causal determinants of whether or not the predispositions are expressed. Thus, personality is a very important determining factor of drug involvement. Aim of the work The aim of this study was to compare the personality profile of synthetic opioid-dependent male patients with the personality profile of non-substance-dependent male participants. Patients and methods Groups I and II were selected consecutively and were recruited from Kasr El-Aini Hospital as well as private hospitals in greater Cairo during the period from November 2012 to March 2013. Group I included 30 substance-dependent male patients and group II included 30 non-substance-dependent male participants who were subjected to personality assessment schedule; the addiction severity index was applied only to group I. Results The sociodemographic findings of the study found that 80.0% of patients in group I were not working due to substance dependence and only 20% were working, whereas in group II 90% of participants were working and only 10% were not working. An overall 66.7% of patients in group I were divorced and only 26.7% were married, whereas in group II one was divorced and 86.7% were married. As regards the personality test, 73.3% of patients in group I had severe degree of the sociopathic trait, 20% has sociopathic trait difficulty, and only 6.6% did not have sociopathic trait. Conclusion Our study showed the effect of opioid dependence in changing behavior and personality traits, emphasizing that diverse maladaptive personality traits and these negative traits are the familial risk factors for substance use disorders. They act as a predisposing vulnerability and predict the onset or age of expression of substance-related problems and tendency to relapse. Impulsive–aggressive personality traits in childhood and adolescence predict early onset of substance abuse.

A Validation Study of Korean Version of Personality Beliefs Questionnaire-Short Form (PBQ-SF)

MethodsZZThe Korean version of PBQ-SF was examined in 115 participants (50 patients with personality disorder and 65 patients without personality disorder). All participants were assessed for personality disorder using the semi-structured clinical interview of the Personality Assessment Schedule. The construction validity was examined by correlation with Beck Depression Inventory, Spielberger State-Trait Anxiety Inventory, and Neuroticism-Extraversion-Openness Five-Factor Inventory neuroticism scales. Twenty four randomly sampled patients were examined for the test-retest reliability.

Preliminary field trial of a putative research algorithm for diagnosing ICD-11 personality disorders in psychiatric patients: 2. Proposed trait domains

This field trial examines the discriminant validity of five trait domains of the originally proposed research algorithm for diagnosing International Classification of Diseases (ICD)-11 personality disorders. This trial was carried out in South Korea where a total of 124 patients with personality disorder participated in the study. Participants were assessed using originally proposed monothetic trait domains of asocial-schizoid, antisocial-dissocial, anxious-dependent, emotionally unstable and anankastic-obsessional groups of the research algorithm in ICD-11. Their assessments were compared to those from the Personality Assessment Schedule interview, and the five-factor model (FFM). A total of 48.4% of patients were found to have pathology in two or more domains. In the discriminant analysis, 64.2% of the grouped cases of the originally proposed ICD-11 domains were correctly classified by the five domain categories using the Personality Assessment Schedule, with the highest accuracy in the anankastic-obsessional domain and the lowest accuracy in the emotionally unstable domain. In comparison, the asocial-schizoid, anxious-dependent and the emotionally unstable domains were moderately correlated with the FFM, whereas the anankastic-obsessional or antisocial-dissocial domains were not significantly correlated with the FFM. In this field trial, we demonstrated the limited discriminant and the convergent validities of the originally proposed trait domains of the research algorithm for diagnosing ICD-11 personality disorder. The results suggest that the anankastic, asocial and dissocial domains show good discrimination, whereas the anxious-dependent and emotionally unstable ones overlap too much and have been subsequently revised.

Profiling for Alcohol Addiction

Introduction 4.4% of the global burden of diseases are due to alcohol consumption. Ethanol addiction is caused by multiple factors like personal and environmental vulnerability. Objectives To analyze the provenience, the educational level, the most frequent personality trades and the genetic load for psychiatric disorders in a sample of subjects with ethanol addiction. Aims To demonstrate that a specific profile for a person with high risk for ethanol addiction exists. Methods A sample of 46 subjects, admitted between November 2013 and January 2014 in Timisoara's Psychiatric Clinic with Ethanol Addiction was analyzed. We evaluated the following: provenience, personality trades, genetic load for psychiatric disorders and occupational status. Personality trades were evaluated using the Personality Assessment Schedule – ICD-10 version. Results Most of the subjects were males (86.95%), unemployed (39.13%), have finished high school (47.82%) and had one of the parents with chronic consumption of ethanol. The sample was equally distributed between urban and rural. The most frequent personality trades were: the need to be liked and accepted, sensitivity to critique and rejection; intrapsychic tension and anxiety; the sense of inferiority, submission, excessive docility and a lack of assuming responsibility. Conclusions The profile of a person predisposed for alcohol addiction is: an unemployed male, without a higher education, with a chronic ethanol consumer father, and with certain personality trades like the need to be liked and accepted, sensitivity to critique and rejection; intrapsychic tension and anxiety; the sense of inferiority, submission, excessive docility and a lack of assuming responsibility.

Screening for personality disorder in drug and alcohol dependence

Comorbidity of personality disorders in addiction is common, and there is a need for efficient detection methods. This study describes the use of two quick screening instruments: the self-reported versions of the Iowa Personality Disorder Screen (IPDS-SR) and the Standardised Assessment of Personality Abbreviated Scale (SAPAS-SR). The sample included 53 inpatients dependent on alcohol and/or drugs, with a 42% prevalence of any DSM-IV personality disorder. The Personality Assessment Schedule (PAS) was used as gold standard. Receiver-Operant-Characteristic (ROC) was used for analysis. The Area Under the Curve for the IPDS-SR was 0.84 (95% CI 0.72–0.93) and for the SAPAS-SR was 0.82 (95% CI 0.70–0.93). An IPDS-SR score of 5 or more correctly classified 77.4% of patients, with a sensitivity of 86.4% and a specificity of 71%. A SAPAS-SR score of 4 or more correctly classified 73.6% of patients, with a sensitivity of 81.8% and a specificity of 67.7%. Both instruments were quick, easy to administer, and acceptable to use by this population. They can be implemented in routine clinical practice in busy substance misuse departments. However further research into the implications of positive screenings is required.

Field trial of a putative research algorithm for diagnosing ICD‐11 personality disorders in psychiatric patients: 1. Severity of personality disturbance

This preliminary field trial examines the reliability and validity of a proposed research algorithm for diagnosing International Classification of Diseases (ICD)-11 personality disorders and its association with other psychiatric assessments for the primary classification of a single dimension of the five severity levels of personality dysfunction. In total, 137 psychiatric patients (119 with personality disorders and 18 without personality disorders) in Korea were assessed. In the first part of the study, inter-rater reliability was evaluated with an independent assessment of personality (personality assessment schedule). In the second part of the study, (1) the algorithm that identified any personality disturbance was compared with the ICD-10 and DSM-IV personality disorder diagnostic equivalents, and (ii) the four levels of severity were examined for their associations with clinical pathology and social functioning. The results showed good agreement between the algorithm and the test instruments for identifying a personality disorder. A graded increase in clinical pathology and social dysfunction was observed with increasing severity of personality disorder. These findings suggest that a simple algorithm for recording severity of a personality disturbance had both construct validity and was useful in practice, which supports severity classification as a valuable concept. These findings need to be confirmed in other cultures and ethnic groups.

Influence of dependent personality status on the outcome and health service costs of health anxiety

To assess the effect of dependent personality disturbance as an influence on the cost and clinical outcome of health anxiety. In the course of a randomized trial of treatments for patients with high health anxiety over 12 months, we also recorded dependent personality status by two methods: the Personality Assessment Schedule (an observer-rated instrument) and the self-rated Dependent Personality Questionnaire (DPQ), the latter being administered at baseline, six months and 12 months. The two main hypotheses tested were that patients with dependent personality features would have a worse outcome and attract greater health service costs. Forty-nine patients took part in the trial; all had baseline dependent personality data, 44 provided health service costs, and 38 had observer-rated personality assessments. At baseline patients with any personality disorder had higher clinical ratings for health anxiety, and dependent personality disturbance, mainly in the form of personality difficulty, was associated with a worse outcome than those without dependent personalities after correction for baseline differences. The DPQ at a score of 15 successfully identified all patients with dependent personality disorder in both ICD and DSM classifications and showed a significant but relatively modest reduction in scores of 1.5 (13%) during the course of the 12-month trial. Costs in those separated by personality status showed those with dependent personality incurred 45% more health service costs than those without these personality characteristics (p = .10). No patient with dependent personality disorder dropped out of treatment compared with 6 out of 38 (16%) of those with no dependence. The DPQ is probably a reliable instrument for assessing dependent personality characteristics without the need for interview and its scores, unlike many ratings of personality, are stable over time. The findings may have been influenced by different responses to those treated in the trial with cognitive behaviour therapy compared with control treatment.

Results of the Search for Personality Disorder Screening Tools

To examine the characteristics, validity, posttest probabilities, and screening capabilities of 8 different instruments used to predict personality disorders. Screening instruments were examined in 3 prospective, observational, test-development studies in 3 random samples of Dutch psychiatric outpatients, using the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II) as the "gold standard." The studies were performed from March 2004 to March 2005 (study 1: N = 195, mean age = 32.7 years), October 2006 to January 2007 (study 2: N = 79, mean age = 34.3 years), and January 2008 to October 2009 (study 3: N = 102, mean age = 33.7 years). The following 8 assessment instruments were examined: 3 short questionnaires (a self-report form of the Standardized Assessment of Personality-Abbreviated Scale [SAPAS-SR], the self-report Iowa Personality Disorder Screen [IPDS], and a short self-report version of the SCID-II [S-SCID-II]); 2 longer questionnaires (the self-report SCID-II Personality Questionnaire [SCID-II-PQ] and the NEO Five-Factor Inventory [NEO-FFI]); 1 short semistructured interview (the Quick Personality Assessment Schedule [PAS-Q]); and 2 informant-based interviews (the Standardized Assessment of Personality [SAP] and the Standardized Assessment of Personality-Abbreviated Scale for Informants [SAPAS-INF]). The SCID-II rate of identification of personality disorders in the 3 studies was between 48.1% and 64.1%. The SAPAS-SR, the IPDS, and the PAS-Q had the best sensitivity (83%, 77%, and 80%, respectively) and specificity (80%, 85%, and 82%, respectively). Moreover, these 3 instruments correctly classified the largest number of patients. Using the SAPAS-SR, the IPDS, or the PAS-Q raises the odds from 50% to between 80% and 84% that a patient in a psychiatric outpatient population will receive a personality disorder diagnosis. The results provide evidence for the usefulness of the SAPAS-SR, IPDS, and PAS-Q instruments for personality disorder screening. Because the PAS-Q takes a longer time and requires qualified personnel to administer it, we recommend use of the SAPAS-SR or the self-report version of the IPDS.

Quick Personality Assessment Schedule (PAS-Q): Validation of a Brief Screening Test for Personality Disorders in a Population of Psychiatric Outpatients

The internal consistency, test-retest reliability, and validity of the Quick Personality Assessment Schedule (PAS-Q), as a screening instrument for personality disorders were studied in a random sample of 195 Dutch psychiatric outpatients, using the SCID-II as a gold standard. All patients were interviewed with the PAS-Q. With an interval of 1 to 2 weeks, they were interviewed with the SCID-II. Three weeks later the PAS-Q was re-administered. According to the SCID-II, 97 patients (50%) were suffering from a personality disorder. The PAS-Q correctly classified 81% of all participants. Sensitivity and specificity were 0.80 and 0.82, respectively. The results provide evidence for the usefulness of the PAS-Q as a screening instrument for personality disorders in clinical populations.

P02-423 - How to choose the best screening instrument for personality disorder for your specific practice

IntroductionPersonality disorders (PD) are common in psychiatric services and can adversely affect the management and outcome of mental illnesses. Therefore assessment of the personality is an essential part of initial psychiatric examination. To diagnose a PD takes time and competence. A screening instrument in the diagnostic phase can be a solution.AimThe goal of the study was to provide clinicians a powerful screening tool for personality disorders that is ‘quick and dirty’.MethodNine screening instruments were studied in a prospective, observational, test development study with a random sample of Dutch psychiatric outpatients, using the SCID-II as the gold standard. There were three short questionnaires (Standardized Assessment of Personality- Abbreviated Scale (SAPAS), Iowa Personality Disorder Screen (IPDS), Short version of the SCID-II), three longer questionnaires (the SCID-II Personality Questionnaire, the NEO Five-Factor Inventory (NEO-FFI), Inventory of Interpersonal Problems (IIP-PD/C;) one short semi structured interview (Quick Personality Assessment Schedule (PAS-Q.) and two informant interviews (Standardised Assessment of personality (SAP), the Standardized Assessment of Personality- Abbreviated Scale for informants (SAPAS-INF)) involved.ResultsThe three short questionnaires and the semi structured interview were very useful for determining the presence/absence of PD. The other instruments can be used in particular situations for example to determine a specific PD or if the patient is not able to accomplish the test.ConclusionBefore deciding which screening instrument for PD is the best for your practice, you have to consider psychometric values as well as practical circumstances.

Premorbid Personality and Insight in First-Episode Psychosis

Insight in psychosis and schizophrenia is considered a complex biopsychosocial phenomenon. Premorbid personality is regarded by some authors as part of the substrate to many psychiatric phenomena, but it is not clear if this applies to insight. To examine longitudinal relationships between personality traits and insight dimensions in first-episode psychosis. One hundred consecutive antipsychotic-naïve first-episode nonaffective psychotic patients admitted to hospital were included in the study. Eighty-one patients completed at 1 month a premorbid personality evaluation, plus baseline, and 6-month insight assessments. We used the Assessment and Documentation of Psychopathology inventory for assessing insight dimensions (not feeling ill, lack of insight, and refusal of treatment) and the Personality Assessment Schedule for ascertaining 5 dimensions of premorbid personality (schizoid, passive-dependent, anancastic, sociopathic, and schizotypy). At baseline, personality dimensions did not show any association with insight dimensions, with the exception of schizotypy traits. At 6 months, schizoid and sociopathic personality showed a significant association with not feeling ill (r = .30, P ≤ .007; r = .27, P = .01) and lack of insight (r = .36, P = .001; r = .41, P < .001), respectively. When we calculated insight change, schizoid and sociopathic personality had moderate correlation with the lack of insight dimension (r = -.34, P = .002; r = .38, P < .001, respectively). After applying partial correlations for potential confounders and Bonferroni correction, the associations remained significant. Moreover, using a regression model, sociopathic and schizoid personality significantly predicted lack of insight at 6 months and change from baseline to the 6 months assessment. Sociopathic and schizoid personality dimensions were not only significantly associated with lack of insight at 6 months but also predicted change on lack of insight over 6 months. Therefore, exploring premorbid personality traits at the beginning of a psychotic episode may be helpful in identifying patients at high risk for lack of insight during the initial course of the illness.

Impact of severity of personality disorder on the outcome of depression

The influence of severity of personality disorder on outcome of depression is unclear. Four hundred and ten patients with depression in 9 urban and rural communities in Finland, Ireland, Norway, Spain and the United Kingdom, were randomised to individual problem-solving treatment ( n = 121), group sessions on depression prevention ( n = 106) or treatment as usual ( n = 183). Depressive symptoms were recorded at baseline, 6 and 12 months. Personality assessment was performed using the Personality Assessment Schedule and analysed by severity (no personality disorder, personality difficulty, simple personality disorder, complex personality disorder). Complete personality assessments were performed on 301 individuals of whom 49.8% had no personality disorder; 19.3% had personality difficulties; 13.0% had simple personality disorder; and 17.9% had complex personality disorder. Severity of personality disorder was correlated with Beck Depression Inventory (BDI) scores at baseline (Spearman's r = 0.21; p < 0.001), 6 months ( r = 0.14; p = 0.02) and 12 months ( r = 0.21; p = 0.001). On multi-variable analysis, BDI at baseline ( p < 0.001) and type of treatment offered (individual therapy, group therapy, treatment as usual) ( p = 0.01) were significant independent predictors of BDI at 6 months. BDI at baseline was the sole significant independent predictor of BDI at 12 months ( p < 0.001). There was no interaction between personality disorder and treatment type for depression. While multi-variable analyses indicate that depressive symptoms at baseline are the strongest predictor of depressive symptoms at 6 and 12 months, the strong correlations between severity of personality disorder and depressive symptoms make it difficult to establish the independent effect of personality disorder on outcome of depression.

Social Functioning of Patients With Personality Disorder in Secondary Care

Patients with personality disorder are often viewed as falling outside the primary therapeutic role of specialist care. This focus on axis I disorders can lead to overlooking patients' personality function. This study explored the social dysfunction associated with personality function and its severity within secondary care. A cross-sectional survey using census data, face-to-face interviews, and audit of case notes was used to collect information from secondary care populations in four urban settings in the United Kingdom. The Quick Personality Assessment Schedule, the Comprehensive Psychopathology Rating Scale, and operational criteria for diagnosis were used to confirm axis I and axis II disorders. Social functioning was assessed with the Camberwell Assessment of Need and the Social Functioning Questionnaire. Because this was a secondary analysis, a priori hypotheses were tested to the p=.01 level to minimize the possibility of type I error. A total of 2,528 key workers completed questionnaires (99%), and 282 randomly selected patients were interviewed (71%). Severity of personality disorder accounted for 14% of the variance in objective measure of social dysfunction and for 19% of the variance in subjective measure of social dysfunction. Of other mental disorders, only depression interacted significantly with either measure, according to multiple stepwise linear regression. Personality disturbance led to social dysfunction to a greater extent than most other pathology. In order to address the issue of social dysfunction, a variety of approaches are needed to turnattention toward personality pathology.

Social Functioning of Patients With Personality Disorder in Secondary Care

Social Functioning of Patients With Personality Disorder in Secondary Care