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The reliability and validity of two structured diagnostic interviews for personality disorders
P A Pilkonis1, C L Heape, J M Proietti
1Department of Psychiatry, University of Pittsburgh, School of Medicine, PA, USA.
Archives of General Psychiatry
|December 1, 1995
Summary
This study found that structured interviews for personality disorders (PDs) show good interrater reliability with continuous data but lower reliability with categorical diagnoses. Validity varied, suggesting careful consideration of these diagnostic tools.
Area of Science:
- Psychiatry
- Clinical Psychology
- Psychometrics
Background:
- Investigated the reliability and validity of Axis II diagnoses.
- Focused on 108 patients with nonpsychotic Axis I disorders.
Purpose of the Study:
- To assess the accuracy and consistency of structured interviews for diagnosing personality disorders (PDs).
- To compare the performance of two specific diagnostic tools: the Personality Disorder Examination (PDE) and the Structured Interview for DSM-III-R Personality (SIDP-R).
Main Methods:
- Patients were interviewed using either the PDE or SIDP-R to assess for PDs.
- Interview diagnoses were compared against "best-estimate" consensus diagnoses made by a panel of expert judges to determine validity.
Main Results:
- Interrater reliability was excellent for continuous data (intra-class correlation coefficients: .82–.92) but lower for categorical diagnoses (kappa: 0.55–0.58).
- Validity coefficients for any PD vs. no PD were 0.18 (PDE) and 0.37 (SIDP-R).
- Validity coefficients for "marked" PD were 0.21 (PDE) and 0.24 (SIDP-R).
Conclusions:
- Structured interviews for Axis II diagnoses have advanced but require careful interpretation.
- Continuous data demonstrated advantages over categorical data in diagnostic assessment.
- Further research is needed to refine these diagnostic tools and understand their limitations.