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Structured interviews for borderline personality disorder.

R J Kavoussi1, E F Coccaro, H M Klar

  • 1Department of Psychiatry, Mount Sinai School of Medicine, New York.

The American Journal of Psychiatry
|November 1, 1990
PubMed
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Three instruments for diagnosing borderline personality disorder (BPD) showed low agreement. This variability impacts research reliability and suggests a need for improved diagnostic criteria or dimensional approaches for BPD.

Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Mental Health Diagnostics

Background:

  • Borderline personality disorder (BPD) diagnosis relies on various assessment tools.
  • Variability in diagnostic instruments can affect patient classification and research validity.

Purpose of the Study:

  • To compare the diagnostic agreement of three instruments for borderline personality disorder.
  • To assess the implications of diagnostic variability on research generalizability.

Main Methods:

  • The study evaluated 56 patients with personality disorders.
  • Three diagnostic instruments were used: Diagnostic Interview for Borderline Patients (DIB), Schedule for Interviewing Borderlines, and Structured Interview for DSM-III Personality Disorders.

Main Results:

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  • Borderline diagnosis rates varied significantly across instruments: DIB (30%), Structured Interview for DSM-III Personality Disorders (48%), and Schedule for Interviewing Borderlines (55%).
  • Overall diagnostic agreement among the three instruments was low at 52%.

Conclusions:

  • Low diagnostic agreement among instruments challenges the generalizability of borderline personality disorder research.
  • Enhancing diagnostic consistency may require revising current criteria or adopting dimensional models for BPD assessment.