Structured Clinical Interview For DSM-III-R Personality Disorders Research Articles

Relationship of probable ADHD with novelty seeking, severity of psychopathology and borderline personality disorder in a sample of patients with opioid use disorder

ABSTRACTOBJECTIVEThe aim of the present study was to evaluate the relationship of probable attention-deficit hyperactivity disorder (ADHD) with novelty seeking (NS), the severity of psychopathology and borderline personality disorder (BPD) in a sample of male patients with opioid use disorder (OUD).METHODSParticipants included 229 patients with OUD. Participants were evaluated with the Adult ADHD Self-Report Scale (ASRS-v1.1), the Symptom Checklist-90-Revised (SCL-90-R) and NS subscale of the Temperament and Character Inventory (TCI). In addition, BPD was assessed with the Structured Clinical Interview for DSM-III-R-Personality Disorders (SCID-II).RESULTSAge, duration of education, marital and employment status did not differ between those with probable ADHD (n = 54, 23.1%) and those without (n = 175, 76.9%). The severity of psychopathology, NS and subdimensions (other than NS1, which was lower) were higher among those with the probable ADHD. ADHD scores were midly correlated with NS scores, other than NS...

How do mothers with borderline personality disorder mentalize when interacting with their infants?

Mothers with borderline personality disorder (BPD) have been theorized to have decreased mentalization ability, which is the capacity to perceive and interpret mental states. This could increase the risk for troubled relationships with their infants and therefore have adverse consequences for child social and emotional development. Mind-mindedness (MM), which codes the mother's references to her infant's mental states during an interaction, is one method of indexing mothers' mentalizing ability. However, research has yet to examine MM in mothers with BPD. Our objective was to assess the MM ability of 38 mothers during interactions with their 12-month-old infants, including 10 mothers with BPD and 28 mothers without a psychiatric diagnosis. Trained observers assessed maternal MM from 2 min of videotaped mother-infant free play. BPD was assessed with the Structured Clinical Interview for DSM-III-R-Personality Disorders (SCID-II). Mothers with and without BPD did not differ in the proportion of total comments referring to infant mental states. However, mothers in the BPD group proportionately made 3.6 times more misattuned mind-related comments than control mothers. Thus, mothers with and without BPD appear equally likely to envision mental states in their infants. However, mothers with BPD also appear more likely to misread their infants' mental states. Copyright © 2016 John Wiley & Sons, Ltd.

Pregnancy-Onset Obsessive-Compulsive Disorder: Clinical Features, Comorbidity, and Associated Factors

Objective: The prevalence rate of obsessive-compulsive disorder (OCD) was found to be higher in women during pregnancy and puerperium than that estimated in the general population. Additionally, the symptomatology of OCD shows several variations during the lifetime of women. Objective of the current study was to examine the clinical characteristics and comorbidity with other anxiety and mood disorders of pregnancy-onset obsessive-compulsive disorder (POCD) and to investigate factors related to POCD. Method: The study sample was composed of three groups. The first group (POCD group) included 20 consecutive pregnant women meeting the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) for OCD, showing an onset of OCD during their current pregnancy. The second group (non-OCD group) consisted of 207 consecutive pregnant women without any mood or anxiety disorders to assess factors associated with POCD. In addition, the study included a control group to compare the symptoms of POCD and non-pregnancy-onset OCD. The control group was composed of 40 nonpregnant female outpatients with OCD. Type and severity of obsessive-compulsive symptoms were assessed with the Yale-Brown Obsessive-Compulsive Scale (YBOCS). OCD and other anxiety or mood disorders were determined by means of the Structured Clinical Interview for DSM-IV (SCID-I). Comorbid axis II disorders were diagnosed with the Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II). Results: The mean onset time of OCD in the POCD group was 13.3±6.35 (week5-28) gestational weeks. OCD occurred during the first trimester of pregnancy in 9 women (45%), during the second trimester in 10 (50%) women, and during the third trimester in 1 (5%) woman. The most common obsessions were contamination (n=16, 80%) and symmetry/exactness (n=6, 30%), and the most common compulsions were cleaning/ washing (n=16, 80%) and checking (n=12, 60%) in POCD. Thirteen (65%) of the pregnant OCD patients met the criteria for a mood or anxiety disorder. Generalized anxiety disorder was the most frequently diagnosed axis I disorder (40%, n=8). The independent factors associated with POCD were cigarette smoking (p=0.002), the existence of an anxiety disorder at onset of pregnancy (p=0.000), and obsessive-compulsive personality disorder (p=0.003). Conclusion: The present study suggests that POCD presents similar clinical characteristics with nonpregnancy-onset OCD. Mood or anxiety disorder comorbidity is observed in more than half of the women with POCD. Additionally, pregnant women who have at least one of 3 factors (cigarette smoking, the existence of an anxiety disorder at onset of pregnancy, and obsessive-compulsive personality disorder) seem to be at risk for POCD.

The relationship between Nine Types Temperament Model with Psychobiological Personality Model and Affective Temperament Model

Objective: This study aims to determine Nine Types Temperament Model (NTTM), which is a new temperament model, with Psychobiological Personality Model (PPM) and Affective Temperament Model (ATM) and define the possible relations between categories and dimensions and their degrees of predicting each other. Methods: The sample group consists of 206 healthy volunteers who did not receive any psychiatric treatment in their life and do not have any chronic disease. Structured Clinical Interview for DSM-IV (SCID-I), Structured Clinical Interview for DSM-III-R personality disorders (SCID-II), Temperament and Character Inventory (TCI), Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire Version (TEMPS-A) and Nine Type Temperament Scale (NTTS) were used to collect data. Results: Except for NTM3, NTM8 and NTM9 temperament categories, all NTTS categories have significant correlation with various TCI dimensions at a level r=0.40 and above. Except for NTM1, NTM5 and NTM9 temperament categories, all NTTS categories have significant correlation with various TEMPS-A categories at a level r=0.40 and above. According to the results of regression analyses, it is found that TCI dimensions and TEMPS-A categories can explain 29-63% of variance of NTTS temperament categories. Conclusion: This study indicates that although there are consistent and significant correlations between dimensions and categories of NTTS and the two scales widely used in psychiatry, there are conceptual differences between NTTM, PPM and ATM and temperament categories of NTTM have unique features.

Long-term continuation treatment after short-term day treatment of female patients with severe personality disorders: Body awareness group therapy versus psychodynamic group therapy

Objective: To investigate and compare the treatment effects of psychodynamic group therapy (PGT) and body awareness group therapy (BAGT) as outpatient treatment following day treatment for personality disorders. Materials and methods: Twenty-one female patients given PGT were compared with 29 female patients receiving BAGT. The average length of outpatient therapy was 24 and 25 months, respectively. The patients were assessed trough the quality assurance system of the Norwegian Network of Psychotherapeutic Day Hospitals, including the Mini International Neuropsychiatric Interview (M.I.N.I.) and Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II) for diagnostic purposes. Outcome was assessed using the Global Assessment of Functioning (GAF), Symptom Check List 90-R sum score (Global Severity Index, GSI), Circumplex of Interpersonal Problems (CIP), at admission and at discharge from day treatment, and at the end of outpatient group therapy. Results: Patients undertaking BAGT improved significantly on GAF, GSI and CIP, and reported high ratings of satisfaction with therapy and group climate at the end of outpatient treatment. The magnitude of change on GAF and CIP was significantly higher in the BAGT group compared with the PGT patients who displayed only minor changes after outpatient treatment. Conclusions: BAGT is possibly an effective outpatient continuation therapy for women with severe personality disorders, but because of limitations of this study, these results warrant a larger randomized study.

One year follow-up of post-partum-onset depression: the role of depressive symptom severity and personality disorders

Objective. Long-term follow-up and risk factors of persistent post-partum depression (PPD) are fairly unknown compared with its prevalence in the developing countries. In this study, we did a follow-up measure of PPD and examined the factors, which were associated with PPD 1-year post-partum.Method. Our sample comprised of 34 women. Depressive symptoms were assessed by the Edinburgh post-natal depression scale (EPDS) 6 weeks post-partum, and women with scores >12 on this scale was categorised as depressed. Personality disorders were determined at the same occasion by means of the Structured Clinical Interview for DSM-III-R personality disorders (SCID-II). One year post-partum EPDS was completed.Results. The rate of PPD 1-year post-partum was 32.4%, and it was unrelated to age at assessment, primiparity, number of children, employment status, economical status and educational level. Women depressed 1-year post-partum had significantly higher basal scores of EPDS and more often also a diagnosis of any axis II disorder; and specifically dependent and obsessive-compulsive personality disorders. In our sample, the predictors of 1-year post-partum PPD were having higher basal score of EPDS and the existence of a personality disorder.Conclusion. This study suggests that women with PPD, scoring high in the EPDS scale 6 weeks post-partum and having a personality disorder, run a higher risk for depression at 1-year follow-up.

Body dysmorphic disorder in patients with borderline personality disorder: prevalence, clinical characteristics, and role of childhood trauma.

The prevalence of body dysmorphic disorder (BDD) in patients with borderline personality disorder (BPD) is unidentified. We hypothesised that BDD would be more common than realised in patients with BPD and comorbidity with BDD would result in a more severe clinical profile. Also, childhood trauma may play a predictive role in this association. The study included 70 BPD in-patients and 70 matched healthy controls. The subjects were evaluated with a comprehensive assessment battery using Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II) diagnostic tool for BDD, Global Assessment of Functioning, Traumatic Experiences Checklist and Hamilton Depression Rating Scale. The prevalence of BDD was 54.3% in the borderline sample. The BPD patients with BDD had significantly lower overall functioning and higher levels of BPD pathology, childhood traumatic experiences, suicide attempts, substance abuse and self-mutilation than those without BDD. Traumatic experiences were significant predictor of comorbid BDD diagnosis in BPD patients. Our results suggest a relatively high prevalence of BDD among patients with BPD, and co-occurrence of BDD and BPD remains to be clarified. The additional diagnosis of BDD in patients with BPD may cause a more severe global illness, and these two disorders may share, at least partly, a common psychopathologic mechanism.

Associations between patient characteristics and ratings of treatment milieu

The objective of the study was to investigate associations between patients ratings of their treatment milieu and personal characteristics such as gender, age, educational level, personality disorders, symptom distress, interpersonal problems, global level of functioning, as well as treatment outcome. Data was taken from 908 patients (with mainly personality, mood and anxiety disorders) consecutively admitted to eight day-treatment units. Treatment milieu was measured by Ward Atmosphere Scale for Therapeutic Programs (WAS-TP). Overall level of psychosocial functioning was measured by Global Assessment of Functioning (GAF). Diagnoses and personality traits was measured by the Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II), according to DSM-IV. Symptom distress and interpersonal problems was measured by Symptom Checklist 90-R and the Circumplex of Interpersonal Problems, respectively. No substantial associations were found between individual personal characteristics and ratings of the treatment milieu, and no substantial associations were found between ratings of the treatment milieu and treatment outcome or the likelihood of treatment completion. There seems to be no support as to making general inferences about or from individual ratings of the treatment milieu. Possible uses of individual evaluations of treatment milieu are discussed.

Prevalence of dissociative disorders among women in the general population

This study sought to determine the prevalence of dissociative disorders among women in the general population, as assessed in a representative sample of a city in central Turkey. The Dissociative Disorders Interview Schedule (DDIS), the Borderline Personality Disorder section of the Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II), and the PTSD-Module of the Structured Clinical Interview for DSM-III-R (SCID) were administered to 628 women in 500 homes. The mean age of participants was 34.8 (S.D. = 11.5, range: 18–65); 18.3% of participants ( n = 115) had a lifetime diagnosis of a dissociative disorder. Dissociative disorder not otherwise specified (DDNOS) was the most prevalent diagnosis (8.3%); 1.1% of the population was diagnosed as having dissociative identity disorder (DID). Participants with a dissociative disorder had borderline personality disorder, somatization disorder, major depression, PTSD, and history of suicide attempt more frequently than did participants without a dissociative disorder. Childhood sexual abuse, physical neglect, and emotional abuse were significant predictors of a dissociative disorder diagnosis. Only 28.7% of the dissociative participants had received psychiatric treatment previously. Because dissociative disorders are trauma-related, significant part of the adult clinical consequences of childhood trauma remains obscure in the minds of mental health professionals and of the overall community. Revisions in diagnostic criteria of dissociative disorders in the DSM-IV are recommended.

Comparison of treatment responses and clinical characteristics of early-onset and late-onset obsessive-compulsive disorder

Objective. The clinical characteristics and response to pharmacotherapy of adult patients with early-onset and late-onset obsessive-compulsive disorder (OCD) were compared in this study. Methods. A total of 50 outpatients with OCD diagnosed according to DSM-IV criteria (early-onset: 20; late-onset: 30) were included in the study. After initial clinical evaluation with The Structured Clinical Interview for DSM-IV/Clinical Version (SCID-I/CV), The Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II) and Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), all patients were treated with fluvoxamine, sertraline or paroxetine for 12 weeks. Treatment response was defined as a ≥35% reduction in the Y-BOCS-total scores from baseline in a 12-week follow-up period. Results. Forty-three patients (early-onset: 16; late-onset: 27) completed the study. The early-onset group had higher frequencies of symmetry/exactness obsessions and ordering/arranging compulsions, and the late-onset group had higher mean age at assessment. Nine (56.3%) patients with early-onset and 18 (66.7%) with late-onset responded to pharmacotherapy. The difference between response rates was not statistically significant. Conclusions. Our study suggests that although there are some phenomenological differences between patients with early-onset OCD and late-onset OCD, these patients have similar responses to pharmacotherapy.

Alexithymia After Traumatic Brain Injury: Its Relation to Magnetic Resonance Imaging Findings and Psychiatric Disorders

People with traumatic brain injury (TBI) were studied to assess the prevalence of alexithymia and its relationship to magnetic resonance imaging (MRI) findings and psychiatric disorders. Fifty-four participants, 67% men, were evaluated after a median of 30 years since TBI. A control group was matched for age, gender, and severity of depression. Alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20). In patients with TBI, axis I psychiatric disorders were assessed with the Schedules for Clinical Assessment in Neuropsychiatry (SCAN, version 2.1), and axis II disorders with the Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II). MRI examinations were carried out with a 1.5 T MRI scanner. Alexithymia was significantly more common in patients with TBI than in controls (31.5% versus 14.8%; odds ratio 2.64, 95% confidence interval 1.03-6.80). None of the variables representing TBI, ie, severity of TBI or the presence, laterality, or location of contusions on MRI, was associated with the TAS-20 total scores. Several current axis I and II psychiatric disorders, particularly organic personality syndrome, were connected to higher TAS-20 scores. Alexithymia is common, along with psychiatric disorders, in patients with TBI. Both of them may reflect dysfunction of the injured brain. In clinical practice, alexithymic features should be taken into consideration in psychosocial rehabilitation after TBI.

Validity of the family history method for diagnosing schizophrenia, schizophrenia-related psychoses, and schizophrenia-spectrum personality disorders in first-degree relatives of schizophrenia probands

This study examined the validity of the family history method for diagnosing schizophrenia, schizophrenia-related psychoses, and schizophrenia-spectrum personality disorders in first-degree relatives of schizophrenia probands. This is the first large-scale study that examined the validity of the family history method for diagnosing DSM-III-R personality disorders. The best estimate DSM-III-R diagnoses of 264 first-degree relatives of 117 adult-onset schizophrenia probands based on direct structured diagnostic interviews, family history interview, and medical records were compared to Family History Research Diagnostic Criteria (FH-RDC) diagnoses based on the NIMH Relative Psychiatric History Interview and to family history Structured Clinical Interview for DSM-III-R: Personality Disorders (SCID-II) diagnoses based on the SCID-II adapted to a third person format. Diagnoses of relatives were made blind to proband diagnostic status. The median sensitivity for schizophrenia and the related psychoses was 29% (range 0–50%), the median specificity 99% (range 98–100%), and the median positive predictive value (PPV) 67% (range 20–80%). The median sensitivity for the personality diagnoses was 25% (range 14–71%), the median specificity 100% (range 99–100%), and the median PPV 100% (range 67–100%). The family history method has low sensitivity but has excellent specificity and PPV for schizophrenia, schizophrenia-related psychoses, and schizophrenia-spectrum personality disorders. The κ coefficient for the family history method was moderately good for the psychoses (0.598) and for paranoid and schizotypal personality disorder (0.576). Using the family history method, the validity of making schizophrenia-related personality disorder diagnoses was comparable to that of making psychotic disorder diagnoses.

The Axis-I Dissociative Disorder Comorbidity of Borderline Personality Disorder Among Psychiatric Outpatients

ABSTRACT The aim of this study was to determine the frequency of dissociative disorders among psychiatric outpatients with borderline personality disorder (BPD). In order to ascertain the extent of the overlap between two diagnostic groups, the overall prevalence of both disorders were evaluated. Two hundred and forty (240) consecutive patients who presented to a university outpatient psychiatry unit were screened using the self-report questionnaire version of the BPD section of Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II), the Dissociative Experiences Scale (DES) and the Somatoform Dissociation Questionnaire (SDQ). One hundred and twenty-nine (129) participants who had a score above the cut-off point on at least one of these instruments were evaluated using the interview version of the BPD section of the SCID-II, the Dissociative Disorders Interview Schedule (DDIS), and the PTSD module of the Structured Clinical Interview for DSM-III-R (SCID-I). All participants who were diagnosed as having BPD or a dissociative disorder were evaluated then with the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D). Twenty-five (25; 10.4%) participants had BPD and 33 participants (13.8%) had dissociative disorder in the final evaluation. Sixteen participants (64.0%) with BPD had the Axis I diagnosis of a dissociative disorder; all six participants (2.5%) with dissociative identity disorder were among them. The findings demonstrate that a significant part of psychiatric outpatients who fit the criteria of BPD have a DSM-IV dissociative disorder on Axis I. The presence of dissociative symptoms as a part of BPD should not lead to overlooking the possibility of a co-occurring dissociative disorder.

Personality disorder comorbidity in panic disorder patients with or without current major depression.

To investigate the relationship between current or past major depressive disorder (MDD) on comorbid personality disorders in patients with panic disorder, we compared the comorbidity of personality disorders using the Structured Clinical Interview for DSM-III-R personality disorders (SCID-II) in 34 panic disorder patients with current MDD (current-MD group), 21 with a history of MDD but not current MDD (past-MD group), and 32 without lifetime MDD comorbidity (non-MD group). With regard to personality disorders, patients in the current-MD group met criteria for at least one personality disorder significantly more often than patients in the past-MD group or the non-MD group (82.4% vs. 52.4% and 56.3%, respectively). The current-MD group showed statistically significantly more borderline, dependent, and obsessive-compulsive personality disorders than the past-MD group or non-MD group. With stepwise regression analyses, number of MDD episodes emerged as an indicator of the comorbidity of cluster C personality disorder and any personality disorders. Future studies should determine whether aggressive treatment of comorbid personality disorders improves the outcome (e.g., lowers the likelihood of comorbid MDD) of patients with panic disorder.

Personality disorders have no excessively negative impact on therapist-rated therapy process in the cognitive and behavioural treatment of Axis I anxiety disorders

The impact of DSM-III-R personality pathology on the Axis I therapy process was studied in 70 outpatients who received cognitive and/or behavioural therapy for an Axis I anxiety disorder. The Axis I therapy process was evaluated by the therapist. DSM-III-R personality pathology was assessed first by an independent rater using a semi-structured interview (Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II)) and second by the therapist in the course of treatment. Results showed poor diagnostic agreement between SCID- and therapist-derived personality pathology. SCID-derived personality pathology was only weakly related to a dysfunctional Axis I therapy process, as reported by the therapist. Therapist-derived personality pathology, on the contrary, was strongly related to a dysfunctional Axis I therapy process, as reported by the therapist. Possibly, therapists erroneously attributed Axis I therapy failure to assumed personality pathology. This is the first study on the impact of personality pathology, as assessed by an independent semi-structured interview, on the process of cognitive-behavioural therapy for Axis I anxiety disorders. The findings are consistent with studies that show no negative impact of personality pathology, as assessed by independent semi-structured interviews, on therapy outcome of Axis I anxiety disorders. Copyright © 1999 John Wiley & Sons, Ltd.

The factor structure of schizophrenia spectrum personality disorders: signs and symptoms in relatives of psychotic patients from the UCLA family members study

The dimensions and limits of the concept of schizotypy are examined using an exploratory factor analysis of the 36 signs and symptoms in the Cluster A DSM-III-R personality disorders as well as those in Borderline Personality Disorder and Avoidant Personality Disorder in the 307 first-degree relatives and half-siblings of 123 probands with schizophrenia/schizoaffective disorder. The personality disorders examined were assessed using sections of the Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II) and hospital and clinic records. Interviewers were blind to the proband diagnosis. The resulting six-factor solution accounted for 40% of the variance. The results of the six-factor solution accounted for the greatest variance and gave the most easily interpretable simple structure of all the solutions examined. The six factors are labeled as (1) Borderline Symptoms, (2) Schizoid Symptoms, (3) Paranoid Symptoms, (4) Avoidant Symptoms, (5) Positive Schizotypy Symptoms, and (6) Disorganized Symptoms. The Schizotypal Personality items are spread across all but the ‘Borderline Symptoms’ factor. We conclude schizotypy is a multidimensional construct that is not adequately characterized by any one DSM-III-R personality disorder. It appears to consist of six distinct dimensions, which, interestingly, parallel current thinking on dimensions in schizophrenia.

Axis II comorbidity of substance use disorders among patients referred for treatment of personality disorders.

The purpose of this study was to determine the extent of comorbid substance use disorders in patients referred for treatment of personality disorders. Two hundred inpatients and outpatients were assessed by semistructured interviews for substance use and personality disorders. Univariate odds ratios were calculated for groups of substance use disorders and each DSM-III-R axis II disorder; comorbidity among axis II disorders was controlled in multivariate models predicting current or lifetime substance use disorder groups. The impact of personality disorder on chronicity and overall impairment associated with substance use disorders was evaluated. Close to 60% of subjects with substance use disorders had personality disorders. Borderline personality disorder was significantly associated with current substance use disorders, excluding alcohol and cannabis, and with lifetime alcohol, stimulant, and other substance use disorders, excluding cannabis. Antisocial personality disorder was associated with lifetime substance use disorders other than alcohol, cannabis, and stimulants. These relationships remained significant after controlling for the presence of all other personality disorders. There was no evidence that personality disorders increased the chronicity of substance use disorders, but comorbid personality disorders were associated with greater global impairment. Borderline personality disorder may be associated with a wide variety of substance use disorders, especially among patients seeking treatment for personality problems.

Childhood antisocial behaviors as predictors of psychotic symptoms and DSM-III-R borderline criteria among inpatients with borderline personality disorder.

Structured clinical interviews of 107 female inpatients diagnosed with borderline personality disorder (BPD) were used to determine whether antisocial personality disorder (APD) diagnostic criteria evident prior to age 15 could be used to predict current Axis I and Axis II psychopathology. Diagnostic information was gathered using the Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II) and the Structured Clinical Interview for DSM-III-R-Patient Version (SCID-P). Childhood APD criteria were subjected to principal-components analysis, and three factors--rule-breaking, assault, and sadism--emerged. The severity of the childhood APD criteria was related to psychotic symptoms, as well as to the unstable relationships and labile affect BPD criteria and the current overall severity of BPD criteria. Sadism predicted psychotic symptoms and BPD severity, while rule-breaking predicted unstable relationships and BPD severity. Childhood APD severity also had a larger effect on BPD severity than on psychotic symptoms. Possible explanations for these findings are explored and discussed.

Short-interval test-retest interrater reliability of the Structured Clinical Interview for DSM-III-R personality disorders (SCID-II) in outpatients.

The short-interval test-retest interrater reliability of the Structured Clinical Interview for DSM-III-R personality disorders (SCID-II) was studied in a psychotherapy outpatient group whose main complaint was mostly an Axis I anxiety disorder. Using a test-retest approach to assess interrater reliability, three sources of variance were taken into account (rater variance in the elicitation and interpretation of information and patient variance across interviews). Base rate requirements were established before calculating reliability coefficients. On the whole, interrater agreement on the SCID-II was found to be satisfactory, except for the histrionic personality traits. This is the first study that has estimated short-interval test-retest interrater reliability of the SCID-II in outpatients, and also the first that has studied single SCID-II traits and dimensional diagnoses. The results found support the use of the SCID-II as a diagnostic instrument for clinical and research purposes.

Patient-informant concordance on the Structured Clinical Interview for DSM-III-R personality disorders (SCID-II).

In the assessment of personality disorders, patients reports can be questioned for several reasons, such as lack of insight, shame, and acute psychiatric state. High concordance between patient-based and informant-based diagnoses would be an indication of the validity of patient reports (convergent validity). The present study examined the concordance between 42 psychotherapy outpatients and their informants (intimates) on the Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II). Similar to prior studies, low or only modest levels of agreement were found. In comparison with evaluations of the personality of the patient by the therapist, patient interviews seemed to be more valid than informant interviews. Furthermore, couples with high intensity and intimacy in the contact generally showed higher agreement than couples with low intensity and intimacy. In conclusion, the data slightly suggest that patient reports are more valid than informant reports. However, the lack of a golden standard forces us to find more evidence before concluding that patient reports on personality result in valid diagnoses.