Standardised Assessment Of Personality-Abbreviated Scale Research Articles

Screening for personality disorder in probationers: Validation of the Standardised Assessment of Personality—Abbreviated Scale (SAPAS)

ABSTRACTPersonality disorder (PD) is an important indicator of future recidivism, and a brief assessment of PD would be of great value to those working in the criminal justice system. There is insufficient research on PD among probation populations. We examined the concurrent validity of a mini‐interview for PD, the Standardised Assessment of Personality—Abbreviated Scale (SAPAS), by comparing its performance with that of the Structured Clinical Interview for DSM‐IV Personality Disorders (SCID‐II) in a sample of 40 individuals on probation in Lincolnshire, UK. The SCID‐II identified 30/40 (75%) of the sample as having a PD. The most common category was antisocial PD, for which 20/40 (50%) were positive. A cut score of 3 on the SAPAS produced a good balance of sensitivity (0.73) and specificity (0.9) for case identification. We conclude that the SAPAS is a valid screening tool for PD among those on probation and is of potential value to those working in the criminal justice system. Copyright © 2011 John Wiley & Sons, Ltd.

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.

Clinical utility of Standardised Assessment of Personality — Abbreviated Scale (SAPAS) among patients with first episode depression

Background Personality disorder frequently co-occurs with depression and seems to be associated with a poorer outcome of treatment and increased risk for recurrences. However, the diagnosing of personality disorder can be lengthy and requires some training. Therefore, a brief screening interview for comorbid personality disorder among patients suffering from depression would be of clinical use. Method The present study aimed to assess the utility of the Standardised Assessment of Personality — Abbreviated Scale (SAPAS) as a screen for personality disorder in a population of patients recently diagnosed with first episode depression. A total number of 394 patients with an ICD-10 diagnosis of a single depressive episode were sampled consecutively via the Danish Psychiatric Central Research Register during a 2 years inclusion period and assessed by the screening interview and, subsequently, by the Structured Clinical Interview for DSM-IV Personality Disorders. Results We found, that a cut-off of 3 on the screen correctly identified the presence of comorbid personality disorder in 73.1% of the patients. The sensitivity and specificity were 0.80 and 0.70, respectively. Limitations The findings cannot be generalized to patients outside hospital settings. Conclusion The study provides evidence for the clinical utility of SAPAS as a screening interview for comorbid personality disorder in a population of patients with a primary diagnosis of depression.

Treatment response in major depression: effects of personality dysfunction and prior depression

The impact of personality dysfunction on the outcome of treatment for depression remains debated. To examine the relationship between the number of prior depressive episodes, personality dysfunction and treatment response for depression. In a large sample (n = 8229) of adult out-patients with a major depressive episode (DSM-IV), personality dysfunction was assessed using the Standardised Assessment of Personality - Abbreviated Scale (SAPAS). Potential predictors of treatment response at 6 weeks were examined via structural equation modelling. The amount of personality dysfunction and number of prior episodes of depression were both associated with poor response to treatment. Once personality dysfunction was controlled for, the number of prior episodes of depression was not associated with treatment response. Personality dysfunction is associated with impaired short-term response to antidepressant treatment in major depression. The apparent detrimental effect of prior depression on treatment response may be accounted for by pre-existing personality dysfunction.

Screening for personality disorder with the Standardised Assessment of Personality: Abbreviated Scale (SAPAS): further evidence of concurrent validity

BackgroundThe assessment of personality disorders (PD) is costly and time-consuming. There is a need for a brief screen for personality disorders that can be used in routine clinical settings and epidemiological surveys. Aims: To test the validity of the Standardised Assessment of Personality: Abbreviated Scale (SAPAS) as a screen for PD in a clinical sample of substance abusers.MethodsConvergent validity of the SAPAS with both categorical and dimensional representations of personality disorders was estimated.ResultsIn this sample, the SAPAS correlated well with dimensional representations of cluster A and C personality disorders, even after controlling for ADHD symptoms, anxiety/depression symptoms and recent substance use. The SAPAS was also significantly associated with total number of PD criteria, although correlation with categorical measures of PD was weak.ConclusionsThe SAPAS is an valid brief screen for PD as assessed dimensionally.

Screening for attention-deficit hyperactivity disorder and co-morbid mental disorders among prison inmates

Attention-deficit hyperactivity disorder (ADHD) is a developmental disorder, which is associated with a number of psychiatric conditions, mostly personality disorder, substance misuse, anxiety and depression. The aim of the present study was to investigate the relationship between ADHD symptoms and associated psychiatric conditions among prisoners. The participants were 90 male prisoners in Iceland who were assessed within 10 days of admission to the prison. The Mini International Neuropsychiatric Interview (MINI) and the Standardised Assessment of Personality-Abbreviated Scale (SAPAS) were administered. Childhood ADHD symptoms were screened by the Wender–Utah Rating Scale and current adult symptoms by the DSM-IV Checklist for ADHD. Half of the prisoners (50%) were found on screening to have met criteria for ADHD in childhood and of those over half (60%) were either fully symptomatic or in partial remission of their symptoms. A logistic regression analysis revealed that the MINI Antisocial Personality Disorder scale was the single best predictor of current ADHD symptoms. Many prisoners are either fully symptomatic or in partial remission of their ADHD symptoms and have serious co-morbid problems, primarily associated with antisocial personality disorder and substance dependence. Prisoners should routinely undergo screening for ADHD in order to identify those who would benefit from a comprehensive assessment to determine who may have ADHD and associated problems.

Standardised assessment of personality – a study of validity and reliability in substance abusers

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.

Standardised Assessment of Personality – Abbreviated Scale (SAPAS): Preliminary validation of a brief screen for personality disorder

There is a need for a brief and simple screen for personality disorders that can be used in routine psychiatric assessments. To test the concurrent validity and test-retest reliability of a brief screen for personality disorder. Sixty psychiatric patients were administered a brief screening interview for personality disorder. On the same day, they were interviewed with an established assessment for DSM-IV personality disorder. Three weeks later, the brief screening interview was repeated in order to examine test-retest reliability. A score of 3 on the screening interview correctly identified the presence of DSM-IV personality disorder in 90% of participants. The sensitivity and specificity were were 0.94 and and 0.85 respectively. The study provides preliminary evidence of the usefulness of the screen in routine clinical settings.