Is a brief screen for personality disorder clinically useful for the detection of impairment in personality functioning in adolescents?

Thomson, Madelyn; Cavelti, Marialuisa; Lerch, Stefan; Reichl, Corinna; Mürner-Lavanchy, Ines; Moran, Paul; Koenig, Julian; Kaess, Michael (2023). Is a brief screen for personality disorder clinically useful for the detection of impairment in personality functioning in adolescents? Personality disorders: theory, research, and treatment, 14(3), pp. 300-308. American Psychological Association 10.1037/per0000583

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The Standardized Assessment of Personality-Abbreviated Scale (SAPAS) has been used extensively to screen for personality disorders (PD), including adolescents. Yet, it is unclear how well the SAPAS performs in screening for impairment in personality functioning (IPF), Criterion A of the alternative Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition model for PD (AMPD) in adolescent samples. We examined the performance of the SAPAS in detecting IPF at a diagnostic threshold for PD in the AMPD. A consecutive clinical sample of adolescents in Bern, Switzerland (N = 293), were first administered the SAPAS, then the Semistructured Interview for Personality Functioning Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (STiP-5.1). A receiver operating characteristic (ROC) analysis was used to determine the diagnostic accuracy of the SAPAS in relation to the STiP-5.1. ROC regression analyses were conducted to determine if other variables moderated the discriminant performance of the SAPAS. Internal consistency of the SAPAS was low (α = .54) and overall discriminatory accuracy was moderate (area under the curve = .73). The optimum cut-off point was 5, with the best balance of sensitivity and specificity (63.22 and 69.90, respectively), correctly classifying 67.92% of participants. Agreement between the SAPAS and the STiP-5.1 using this cut-off was low (κ = .30). Age yielded statistically significant effects on the discriminant performance of the SAPAS-performance improving among older adolescents. Findings suggest that the SAPAS may not be the optimal method of screening for Criterion A IPF among adolescents in clinical settings but might also be more suited to Criterion B. Our findings call for a developmentally adapted screener for early detection of PD represented by IPF in adolescents. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > University Psychiatric Services > University Hospital of Child and Adolescent Psychiatry and Psychotherapy 04 Faculty of Medicine > University Psychiatric Services > University Hospital of Child and Adolescent Psychiatry and Psychotherapy > Research Division
UniBE Contributor:	Thomson, Madelyn Brooke, Cavelti, Marialuisa (A), Lerch, Stefan, Reichl, Corinna, Mürner-Lavanchy, Ines Mirjam, Koenig, Julian, Kaess, Michael
Subjects:	600 Technology > 610 Medicine & health
ISSN:	1949-2715
Publisher:	American Psychological Association
Language:	English
Submitter:	Chantal Michel
Date Deposited:	10 Jun 2022 14:50
Last Modified:	06 May 2023 00:11
Publisher DOI:	10.1037/per0000583
PubMed ID:	35679218
URI:	https://boris.unibe.ch/id/eprint/170551