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Structured interviews and borderline personality disorder.

A W Loranger, J M Oldham, L M Russakoff

    Archives of General Psychiatry
    |June 1, 1984
    PubMed
    Summary
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    The Diagnostic Interview for Borderlines (DIB) and Schedule for Affective Disorders and Schizophrenia (SADS) show substantial agreement in diagnosing borderline personality disorder. However, differences in diagnostic criteria limit generalizing findings between the two systems.

    Area of Science:

    • Psychiatry
    • Clinical Psychology

    Background:

    • Borderline personality disorder (BPD) diagnosis relies on specific criteria.
    • The Diagnostic Interview for Borderlines (DIB) and Schedule for Affective Disorders and Schizophrenia (SADS) are diagnostic tools.
    • Assessing concordance between diagnostic instruments is crucial for research reliability.

    Purpose of the Study:

    • To evaluate if the Diagnostic Interview for Borderlines (DIB) could be scored from the Schedule for Affective Disorders and Schizophrenia (SADS).
    • To determine if DIB scores predict the DSM-III diagnosis of borderline personality disorder.
    • To assess the concordance and potential discrepancies between the DIB and DSM-III criteria.

    Main Methods:

    • Clinicians conducted separate interviews using the DIB and a modified SADS on the same patient cohort.

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  • Patients were diagnosed based on Gunderson and Singer's criteria for borderline personality disorder.
  • Statistical analysis included sensitivity, specificity, and intraclass correlation coefficient (ICC).
  • Main Results:

    • Both interviews identified similar patient groups as borderline.
    • DIB scores demonstrated 70% sensitivity and 90% specificity in predicting DSM-III borderline personality disorder.
    • An intraclass correlation coefficient of .75 indicated substantial agreement between the measures.

    Conclusions:

    • There is significant concordance between the DIB and SADS in diagnosing borderline personality disorder.
    • Disparities between DSM-III and DIB diagnostic systems may hinder the generalization of research findings.
    • Researchers should be mindful of the specific diagnostic criteria used in studies involving borderline personality disorder.