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Screening for personality disorder in incarcerated adolescent boys: preliminary validation of an adolescent version of the standardised assessment of personality – abbreviated scale (SAPAS-AV)
Mickey Kongerslev, Paul Moran, Sune Bo, Erik Simonsen
BMC Psychiatry , 2012, DOI: 10.1186/1471-244x-12-94
Abstract: We adapted a rapid screen for the identification of PD in adults (Standardised Assessment of Personality – Abbreviated Scale; SAPAS) for use with adolescents and then carried out a study of the reliability and validity of the adapted instrument in a sample of 80 adolescent boys in secure institutions. Participants were administered the screen and shortly after an established diagnostic interview for DSM-IV PDs. Nine days later the screen was readministered.A score of 3 or more on the screening interview correctly identified the presence of DSM-IV PD in 86% of participants, yielding a sensitivity and specificity of 0.87 and 0.86 respectively. Internal consistency was modest but comparable to the original instrument. 9-days test-retest reliability for the total score was excellent. Convergent validity correlations with the total number of PD criteria were large.This study provides preliminary evidence of the validity, reliability, and usefulness of the screen in secure institutions for adolescent male offenders. It can be used in juvenile offender institutions with limited resources, as a brief, acceptable, staff-administered routine screen to identify individuals in need of further assessment of PD or by researchers conducting epidemiological surveys.Converging research has demonstrated that there is a disproportionately high prevalence of mental disorders in young offender samples [1,2], when compared with community youth [3] or adult prison populations [4]. Current estimates suggest that up to 75% of incarcerated juvenile offenders meet criteria for one or more mental disorders [5]. Such research findings, combined with reports of a high prevalence of undiagnosed and untreated physical disorders [6,7], high rates of suicide and suicide attempts [8], and elevated mortality rates associated with early death due to unnatural causes [9], have led the American Academy for Child and Adolescent Psychiatry [5], as well as other experts [10-13] to call for the development a
Standardised assessment of personality – a study of validity and reliability in substance abusers
Morten Hesse, Joachim Rasmussen, Mads Pedersen
BMC Psychiatry , 2008, DOI: 10.1186/1471-244x-8-7
Abstract: We assessed the psychometric properties of the 8-item Standardised Assessment of Personality – Abbreviated Scale (SAPAS) in a sample of 58 methadone maintenance patients.Internal 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).There 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.Personality disorders are among the most common co-morbidities among patients with substance use disorders [1,2]. Personality disorders complicate treatment in a range of ways, elicit negative emotional reactions in clinicians [3], and are associated with worse outcome in treatment for substance use disorders [4-7]. Evidence is emerging that substance abuse treatment is more effective, if it addresses personality related issues, including personality disorders [8-10].However, identifying patients with co-morbid personality disorders remain a challenge for substance abuse treatment services. Self-report inventories tend to diagnose nearly all substance abusers with personality disorders [11], and often traits improve rapid
Screening for Personality Disorders: A Comparison of the Dimensional NEO-FFI with the Categorical SAPAS-SR  [PDF]
Sara Germans, Alexander Rath, Guus L. Van Heck, Paul P. G. Hodiamont
Psychology (PSYCH) , 2013, DOI: 10.4236/psych.2013.42016
Abstract:

In psychiatric outpatients, the usefulness of the dimensional NEO-FFI as a screening instrument for personality disorders (PDs) was compared with the categorical screening instrument SAPAS-SR using the SCID-II as the gold standard. Major research questions are: 1) is the NEO-FFI a useful screening instrument for PDs? 2) does the NEO-FFI outperform a categorical screening instrument (SAPAS-SR)? 3) does combining both instruments improve the screening results? Extreme raising on Big Five personality trait domains (NEO-FFI) domain scores were examined in relation to the presence and the number of PDs as diagnosed, with to the SCID-II. Additionally, the NEO-FFI, in conjunction with a short self-report screening instrument (SAPAS-SR), was analysed with respect to sensitivity and specificity for screening of PDs. According to the SCID II, 97 patients (50%) were suffering from a PD. The majority of them had no (35.9%) or only one (40%) extreme score on one of the Big Five personality domains. There were no significant relationships between separate extreme traits on PD or five factor profiles, as proposed in the literature, and the presence of a SCID-II PD. Comparisons of the NEO-FFI with the SAPAS-SR showed no significant relationships. Using both screeners in conjunction resulted in an increase in specificity and the number of correctly classified cases at the expense, however, of the sensitivity. Correlation and regression analyses showed that personality traits are statistically significant predictors for each of the12 PDs. However, the associations between NEO-FFI scores and the DSM-VI-TR PD criteria were rather modest. Support could not be obtained for the view that separate extreme scores on basic personality traits or combinations of such scores in five-factor profiles will provide adequate screening possibilities for PDs. The SAPAS-SR has better screening potential than the NEO-FFI or the SAPAS-SR and the NEO-FFI together.

The Relationship between Concurrent Substance Use Disorders and Eating Disorders with Personality Disorders  [PDF]
Christine Courbasson,Jacqueline M. Brunshaw
International Journal of Environmental Research and Public Health , 2009, DOI: 10.3390/ijerph6072076
Abstract: Objective: The current pilot study investigated whether patients with concurrent substance use disorders and eating disorders (SUD and ED) who experienced a reduction in SUD and ED symptoms following treatment for SUD and ED also experienced a reduction in personality disorder (PD) symptoms. Method: Twenty patients with SUD and ED and PD were assessed pre and post treatment using clinical interviews, self-report questionnaires, and a therapist questionnaire on DSM-IV-TR symptoms for PD. Results: Symptoms for the personality disorders were reduced following treatment. This reduction was correlated with a decrease in the number of symptoms of ED at post treatment. Discussion: Chronic concurrent SUD and ED may make it difficult to separate PD symptoms from co-occurring disorders. Many features attributed to PDs may be reduced when problematic substance use and disordered eating are addressed, a fact that may increase clinician and patients’optimism about therapeutic change.
The addition of a goal-based motivational interview to standardised treatment as usual to reduce dropouts in a service for patients with personality disorder: a feasibility study
Mary McMurran, W Miles Cox, Stephen Coupe, Diane Whitham, Lucy Hedges
Trials , 2010, DOI: 10.1186/1745-6215-11-98
Abstract: All referrals accepted to the psychological service of Nottinghamshire Healthcare NHS Trust's outpatient service for people with personality disorder are eligible for inclusion. Consenting participants are randomised to receive the Personal Concerns Inventory interview plus treatment as usual or treatment as usual only. We aim to recruit 100 participants over 11/2 years. A randomised controlled trial will be considered feasible if [1] the recruitment rate to the project is 54% of all referrals (95% CI 54-64), [2] 80% of clients find the intervention acceptable in terms of its practicability and usefulness (95% CI 80-91), and [3] 80% of therapists report finding the intervention helpful (95% CI 80-100). In a full-scale randomised controlled trial, the primary outcome measure will be completion of treatment i.e., entry into and completion of ≥ 75% of sessions offered. Therefore, information will be collected on recruitment rates, attendance at therapy sessions, and completion of treatment. The feasibility of examining the processes of engagement will be tested by assessing the value, coherence, and attainability of goals pre-treatment, and engagement in treatment. The costs associated with the intervention will be calculated, and the feasibility of calculating the cost-benefits of the intervention will be tested. The views of clients and therapists on the intervention, collected using semi-structured interviews, will be analysed using thematic analysis.The Personal Concerns Interview as a preparation for treatment of people with personality has the potential to maximise treatment uptake, reduce unfilled places in treatment programmes, and prevent group treatments faltering through non-attendance. Most importantly, it has the potential to improve patient outcomes, helping them to function better and reduce hospitalisation.ClinicalTrials.Gov.UK Identifier - NCT01132976In the UK in recent years, there has been recognition that people with personality disorders have been
Validation of two informant-based screening instruments for personality disorders in a psychiatric outpatient population
Sara Germans,Guus L.Van Heck,Paul PG Hodiamont,Danielle Elshoff
Journal of Hospital Administration , 2012, DOI: 10.5430/jha.v2n2p133
Abstract: Purpose: The predictive validity of two informant-based screening instruments for personality disorders (PDs), the Standardized Assessment of Personality (SAP) and a short eight-item version (SAPAS-INF), were studied in 103 Dutch psychiatric outpatients, using the SCID-II as the ‘gold standard’. Methods: All patients and their informants were interviewed separately and independently by different interviewers who were unaware of the results in the other conditions. Results: According to the SCID-II, 66 patients had at least one personality disorder (PD). The SAP correctly classified 72% of all participants in the category PD present/absent. The sensitivity and specificity were 69% and 76%, respectively. The positive and negative predictive values were 84% and 58%. The SAPAS-INF, using a cut-off score of 3, correctly classified 70%; the sensitivity and specificity were 76% and 58%, respectively. The positive and the negative predictive values were 77% and 57%. Conclusion: These results show that the informant-based SAP as well as the shorter informant-based SAPAS-INF are adequate; though rather moderate screening instruments for identifying PD. The SAP and the SAPAS-INF, however, both performed worse than the SAPAS-SR, which is based on the patient’s self-report. Therefore, it is concluded that the SAP or the SAPAS-INF can be used as a satisfactory screening instruments for the presence/absence of PD in those cases where patients themselves are unable to provide the required information.
Irritable bowel syndrome: The incidence of concurrent psychopathology
Margie H Wilson,Anita D Stuart,H Gertie Pretorius
Health SA Gesondheid , 1999, DOI: 10.4102/hsag.v4i1.4
Abstract: The goal of this study was to improve understanding of the association between physiology and psychology in Functional Gastrointestinal disorders by considering the co-morbidity of lrritable Bowel Syndrome and psychopathology in a sector of the South African population. A comparison was made between the incidence of concurrent psychopathology in a sample of 48 white female patients, aged 25 to 55 years and diagnosed with lrritable Bowel Syndrome and the incidence of psychopathology in a control group that consisted of 39 white women, aged 25 to 55 years, who did not meet the criteria for lrritable Bowel Syndrome. The Personality Assessment Inventory was used to determine the incidence of psychopathological personality traits and symptoms in the lrritable Bowel Syndrome group and the control group. This is a selfadministered, objective measuring instrument of adult personality that was developed to provide information about 18 critical clinical variables. The instrument was developed and standardised for use in the clinical assessment of individuals aged 18 years and older. Earlier studies showed a high incidence of associated psychiatric disorder in patients with lrritable Bowel Syndrome. This study confirmed this trend and it seems as if age and level of education has no influence on the incidence of psychopathology in patients with lrritable Bowel Syndrome. Opsomming Dit was die doel van die studie om 'n verbeterde begrip van die assosiasie tussen fisiologie en sielkunde in Funksionele Maagderm Versteurings te bewerkstellig deur die komorbiditeit van Prikkelbare Dermsindroom en psigopatalogie binne 'n sektor van die Suid Afrikaanse populasie te oorweeg. 'n Vergelyking is getref tussen die voorkoms van konkurrente psigopatalogie in 'n steekproef van 48 wit, vroulike pasiente wat wissel in ouderdomme van 25 tot 55 jaar en gediagnoseer is met Prikkelbare Dermsindroom, en die voorkoms van psigopatalogie in 'n kontrolegroep wat bestaan het uit 39 wit vrouens wat nie aan Prikkelbare Dermsindroom ly nie en wie se ouderdomme gewissel het van 25 tot 55 jaar. Die "Personality Assessment Inventory" is gebruik om die voorkoms van psigopatalogiese persoonlikheidtrekke en simptome in die Prikkelbare Dermsindroomgroep en die kontrolegroep te bepaal. Hierdie is 'n self-geadministreerde, objektiewe meetinstrument van volwasse persoonlikheid wat ontwerp is om inligting oor 18 kritiese kliniese veranderlikes te verskaf. Die instrument is ontwikkel en gestandaardiseer vir gebruik in die kliniese taksering van individue vanaf die ouderdom van 18 jaar. Vroesre studies het
The Relationship of Personality to Eating Disorders
Mohammad Ali Besharat
Iranian Journal of Psychiatry , 2008,
Abstract: This paper highlights a variety of personality disorders in individuals with eating disorder and also emphasizes the importance of identifying clinically meaningful eating disorders subtypes based on concurrent personality disorder. The relationship between personality disorders and eating disorders is an important issue as this association has implications for assessment and treatment. Different hypotheses concerning the relationship between personality disorders and eating disorders will be reviewed. The prevalence rates of concomitant personality disorder diagnoses in eating disorder patients is highlighted to illustrate some of the pertinent conceptual issues concerning the meaning of the co-occurrence of separately defined diagnostic entities. The literature review reveals a robust finding that patients with ersonality pathology have a poorer response to treatment of Axis I disorders than those without such pathology. It is also argued that therapeutic relationship deserves more attention in the assessment and treatment of eating disorder patients with a co morbid personality disorder.
Standardised Parenteral Nutrition  [PDF]
Karen Simmer,Abhijeet Rakshasbhuvankar,Girish Deshpande
Nutrients , 2013, DOI: 10.3390/nu5041058
Abstract: Parenteral nutrition (PN) has become an integral part of clinical management of very low birth weight premature neonates. Traditionally different components of PN are prescribed individually considering requirements of an individual neonate (IPN). More recently, standardised PN formulations (SPN) for preterm neonates have been assessed and may have advantages including better provision of nutrients, less prescription and administration errors, decreased risk of infection, and cost savings. The recent introduction of triple-chamber bag that provides total nutrient admixture for neonates may have additional advantage of decreased risk of contamination and ease of administration.
Personality and Performance in Eventing  [PDF]
Jennifer Hart, Adrian Furnham
Psychology (PSYCH) , 2016, DOI: 10.4236/psych.2016.710129
Abstract: This study examined the effects of personality on performance in the sport of Eventing. A questionnaire consisting of the abbreviated Big Five and Core-Self Evaluations (CSE) was administered to 155 participants who were split into three groups: Amateurs (n = 48), Progressive Amateurs (n = 62) and Professionals (n = 45). The criteria were self and other rated performance. The results showed that CSE, Conscientiousness and Extraversion were significant predictors of actual and rated performance. Implications and limitations were discussed.
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