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Related Experiment Videos

Revising and assessing axis II, Part I: developing a clinically and empirically valid assessment method

D Westen1, J Shedler

  • 1Department of Psychiatry, Harvard Medical School, Boston, USA. dw@wjh.harvard.edu

The American Journal of Psychiatry
|February 16, 1999
PubMed
Summary

The Shedler-Westen Assessment Procedure (SWAP-200) offers a valid, clinician-based method for assessing personality disorders. This tool aids in refining diagnostic categories and criteria for improved clinical utility.

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Area of Science:

  • Psychiatry and Clinical Psychology
  • Psychometrics and Assessment

Background:

  • Current personality disorder assessment tools face challenges with validity and rely on self-report, limiting their clinical utility.
  • Existing instruments are often tied to specific diagnostic criteria (e.g., DSM-IV), hindering empirical revision of these categories.

Purpose of the Study:

  • To develop and validate a novel assessment tool, the Shedler-Westen Assessment Procedure (SWAP-200), for systematic and quantifiable personality disorder assessment.
  • To provide clinicians with a method for generating detailed, clinically rich personality descriptions.

Main Methods:

  • The SWAP-200 was developed and validated using data from 797 psychiatrists and psychologists.
  • Participants described actual or prototypical patients with personality disorders or healthy individuals using the SWAP-200.

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Main Results:

  • Aggregated SWAP-200 descriptions demonstrated high convergent and discriminant validity for personality disorder categories.
  • The procedure supports both categorical and dimensional diagnoses of personality disorders.
  • SWAP-200 profiles showed similarities to MMPI profiles but were based on clinician observation.

Conclusions:

  • The SWAP-200 offers a promising approach for empirically refining personality disorder classification.
  • This method has the potential to enhance the psychometric and clinical soundness of diagnostic categories and criteria.