Short-interval test-retest interrater reliability of the Dutch version of the Structured Clinical Interview for DSM-IV personality disorders (SCID-II)

This study examined the short-interval test-retest reliability of the Structured Clinical Interview (SCID-II: First, Spitzer, Gibbon, & Williams, 1995) for DSM-IV personality disorders (PDs). The SCID-II was administered to 69 in- and outpatients on two occasions separated by 1 to 6 weeks. The interviews were conducted at three sites by ten raters. Each rater acted as first and as second rater and equal number of times. The test-retest interrater reliability for the presence or absence of any PD was fair to good (kappa = .63) and was higher than values found in previous short-interval test-retest studies with the SCID-II for DSM-III-R. Test-retest reliability coefficients for trait and sumscores were sufficient, except for dependent PD. Values for single criteria were variable, ranging from poor to good agreement. Further large-scale test-retest research is needed to test the interrater reliability of more categorical diagnoses and single traits.     

Psychometric properties of the Spanish version of the self-report Personality Diagnostic Questionnaire -4+ (PDQ-4+) in psychiatric outpatients

We examined the psychometric properties of the Spanish version of the self-report Personality Diagnostic Questionnaire-4+ (PDQ-4+) in a sample of 437 psychiatric outpatients. Psychometric properties were assessed through internal consistency analysis, exploratory factor analysis (EFA) and concurrent validity. Results indicate that the Spanish version of the PDQ-4+ has moderate internal consistency, which was acceptable for 7 of the 12 self-report scales. The factor structure roughly replicated the DSM-IV clusters. The presence of Personality Disorders was associated with the character dimensions of the Temperament and Character Inventory (TCI).     

Diagnostic efficiency of the Iowa personality disorder screen items in a nonclinical sample

The diagnostic efficiency of the 11-item Iowa Personality Disorder Screen (IPDS; Langbehn et al., 1999) was evaluated in a nonclinical sample of young adults, 35% of whom met DSM-III-R criteria for a personality disorder, in a retrospective analysis of SIDP-R data. Results indicated that two IPDS item sets (i.e., combinations of items) produced hit rates of more than 80% along with good sensitivity, specificity, positive predictive power, and negative predictive power. Combined with the findings of Langbehn et al. (1999), these results suggest that the IPDS may be useful as a screening measure for personality disorder in both clinical and nonclinical populations.     

Association among items from the self-report version of the Hamilton Depression Scale (Carroll Rating Scale) and respondents' sex

The association among items of the self-reported version of the Hamilton Depression Scale (Carroll Rating Scale), answered according to a memory of a maximally disturbing event experienced, and respondents' sex was examined in a nonclinical sample of 320 college students, 164 women (M age=21.7 yr., SD=3.6) and 156 men (M age=23.5 yr., SD=5.8). An assessment of sex bias was also evaluated. Multiple regression analysis showed that statements regarding unhappiness, urge to cry, dizziness and faintness, and waking in the middle of the night were significantly associated with women. Removal of these items from the Carroll Rating Scale Total scores eliminated the sex differences in depression rates. Items that displayed significant sex bias were those regarding behavior and emotions commonly attributed to women within the general population.     

Diagnostic validity of the Eppendorf Schizophrenia Inventory (ESI): a self-report screen for ultrahigh risk and acute psychosis

Providers of mental health services need tools to screen for acute psychosis and ultrahigh risk (UHR) for transition to psychosis in help-seeking individuals. In this study, the Eppendorf Schizophrenia Inventory (ESI) was examined as a screening tool and for its ability to correctly predict diagnostic group membership (e.g., help seeking, mild psychiatric complaints, highly symptomatic mood or anxiety disorder, UHR, acute psychosis). Diagnostic evaluation with established instruments was used for diagnosis in 3 research samples. UHR status was assessed with the Structured Interview for Prodromal Symptoms/Scale of Prodromal Symptoms (Miller et al., 1999) and the Bonn Scale for the Assessment of Basic Symptoms Prediction list (Gross, Huber, Klosterk?tter, & Linz, 1987; Klosterk?tter, Hellmich, Steinmeyer, & Schulze-Lutter, 2001). This study showed that members of different diagnostic groups rate themselves significantly differently on the ESI and its subscales. A new subscale was constructed, the UHR-Psychosis scale, that showed good utility in detecting individuals with interview-diagnosed UHR status and acute psychosis. The scale is also sensitive to the threshold between UHR and acute psychosis. Practical applications of the ESI include use as a diagnostic tool within various settings.     

Acceptance of Structured Diagnostic Interviews for Mental Disorders in Clinical Practice and Research Settings

The objective of this study was to investigate the acceptance of structured diagnostic interviews in clinical practice, as well as research, settings. Using the Diagnostisches Interview bei Psychischen Störungen (the modified and extended German version of the Anxiety Disorders Interview Schedule for DSM-IV), 10 certified interviewers conducted 183 structured interviews in different inpatient, outpatient, and research settings in Switzerland and Germany. After each interview, patients and interviewers filled out a questionnaire asking for their evaluation of the interview. Patients' and interviewers' reactions to the interview were highly positive. On a scale measuring overall satisfaction with the interview (0 = not at all satisfied, 100 = totally satisfied) the mean patient rating was 86.55 (SD = 13.18), and the mean interviewer rating was 85.82 (SD = 12.84). The procedure used by the interviewer was rated by 142 (78.5%) patients as being helpful, and 176 (96.7%) rated the relationship as being positive. Less than 16% of the interviews were described as exhausting by the patients and interviewers. A majority of the interviewers (92.6%) indicated that during the interview they could respond adequately to the patient. The results of this study indicate that structured diagnostic interviews are highly accepted by interviewers and patients in a variety of settings. These findings, together with the existing evidence of the reliability and validity of structured interviews, should encourage their use in the diagnostic process, in outpatient and inpatient clinical settings as well as in research studies.     

Validity and reliability of the Japanese version of the Emotional Intelligence Scale among college students and psychiatric outpatients

We examined the validity and reliability of the Japanese version of the Emotional Intelligence Scale in two samples of 267 college students and 398 psychiatric outpatients. Suitable validity and reliability of this scale were suggested by high correlations with scores on the NEO Personality Inventory, adequate internal consistency, and relatively high test-retest correlations. The Emotional Intelligence Scale seems suitable for both clinically distressed populations as well as comparative groups such as college students.     

The Spanish version of the Wisconsin Personality Disorders Inventory-IV (WISPI-IV): tests of validity and reliability

Personality disorders (PD) are a prevalent class of mental disorders that interfere with functioning and cause subjective distress while increasing the intensity and duration of Axis I clinical syndromes, and therefore assessing PD is important even when PDs are not the focus of treatment. The purpose of these studies was to develop and test a new Spanish version of a self-report measure of PD, the Wisconsin Personality Inventory-IV (WISPI-IV) that would be psychometrically equivalent to the English version while also maintaining the same interpersonal content, which is based on Benjamin's analysis of the PD criteria using her Structural Analysis of Social Behavior (SASB) model (1974). Study 1 participants completed the WISPI-IV twice over a two-week interval. For Study 2, participants from two sites in Spain and one site in Argentina completed Spanish versions of the WISPI-IV and other personality measures. SASB-analysis of the translated items showed high correspondence between the interpersonal content of the English version and the Spanish version demonstrating theoretical validation in relation to other PD measures. The Spanish WISPI-IV showed satisfactory reliability based on test-retest correlations and alphas for internal consistency. Study 2 showed the Spanish WISPI-IV had good convergent validity with the Spanish versions of the IIP and SCID-II and performed similarly to the English versions of these measures. Our goal in translating the WISPI-IV was to extend this measure to Spanish-speakers in language that would be understood by different Hispanic sub-groups, however research team members and subjects had a variety of suggestions for changes in item wording. This reflects the difficulty with creating a "neutral" Spanish version of any assessment given regional differences.     

The Italian version of the Inventory of Interpersonal Problems Personality Disorders Scales (IIP-47): psychometric properties and clinical usefulness as a screening measure

The Inventory of Interpersonal Problems-47 (IIP-47) is a brief and valid self-report measure for screening Personality Disorders (PDs). This study examined internal consistency, factor structure, criterion validity, temporal stability, and operating characteristics of the Italian version of the IIP-47 in two independent samples: PD subjects (n = 120) and nonclinical subjects (n = 475). Alpha coefficients ranged from .70 to .90. Multiple-Group Confirmatory Factor Analyses showed that the five-correlated-factor model reported in literature had the highest measurement invariance across the two groups. Criterion validity was supported by correlations among IIP-47 scale scores and scores on established measures of personality dimensions and pathology. Test-retest indices ranged from .71 to .95. PD subjects scored significantly higher than nonclinical subjects on all IIP-47 scales and cut-off scores for different levels of specificity and sensibility are reported. It is concluded that the psychometric properties of the original IIP-47 were preserved in its Italian version.     

Clinical Validity of a Personality Inventory for Children (PIC) Profile Typology

We evaluated the validity of a profile typology for the Personality Inventory for Children (PIC), a parent-informant measure of child psychiatric status. For referred children, we studied (a) the convergence of PIC profile types with diagnoses according to the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., American Psychiatric Association, 1980) and (b)the incremental validity of the PIC over diagnoses in the prediction of symptom ratings completed by teachers and clinicians. We found a high diagnosis-PIC correspondence only for developmentally disordered children: the overlap for children with emotional-conduct problems was poor. For the latter group, however, the correlation of diagnoses with symptom ratings was low, but the incremental validity of the PIC over diagnoses was high. We discuss the use of this profile typology in the clinical evaluation of children and present a case example.     

External Validity of Conduct and Oppositional Defiant Disorders Determined by the NIMH Diagnostic Interview Schedule for Children

We administered the Diagnostic Interview Schedule for Children (DISC) two times to a group of youth (222 boys, 147 girls) entering residential care, once at their time of entry and once 1 year later. We then compared their DISC outcomes on Conduct Disorder (CD) and Oppositional Defiant Disorder (ODD) against changes in independent direct observations of diagnostically relevant behavior obtained over the course of that year. Results from hierarchical linear modeling analyses showed significant discriminative relationships between results from the DISC and the independent observations. Specifically, observations of symptomatic behaviors (CD or ODD) decreased for youth who met diagnostic criteria at the first administration of the DISC but not at the second, increased for youth who did not meet criteria at the first administration but did at the second, and did not change for youth who met criteria at both administrations. These results extend the data on the validity of the DISC and support continued research efforts to determine its clinical utility.     

Test-Retest Reliability of the Spanish Version of the Diagnostic Interview Schedule for Children (DISC-IV)

The test-retest reliability of the Spanish Diagnostic Interview Schedule for Children (DISC-IV) is presented. This version was developed in Puerto Rico in consultation with an international bilingual committee, sponsored by NIMH. The sample (N = 146) consisted of children recruited from outpatient mental health clinics and a drug residential treatment facility. Two different pairs of nonclinicians administered the DISC twice to the parent and child respondents. Results indicated fair to moderate agreement for parent reports on most diagnoses. Relatively similar agreement levels were observed for last month and last year time frames. Surprisingly, the inclusion of impairment as a criterion for diagnosis did not substantially change the pattern of results for specific disorders. Parents were more reliable when reporting on diagnoses of younger (4–10) than older children. Children 11–17 years old were reliable informants on disruptive and substance abuse/dependence disorders, but unreliable for anxiety and depressive disorders. Hence, parents were more reliable when reporting about anxiety and depressive disorders whereas children were more reliable than their parents when reporting about disruptive and substance disorders.     

Psychometric qualities of the German version of the Posttraumatic Diagnostic Scale (PTDS)

In the present study, the psychometric properties of the German version of the Posttraumatic Diagnostic Scale (PTDS; A. Ehlers, R. Steil, H. Winter, & E. B. Foa, 1996) were evaluated in a sample of 143 trauma survivors. To investigate convergent and discriminant validity of this questionnaire, the authors assessed posttraumatic stress disorder (PTSD), anxiety, depression symptoms, and social phobia. Internal consistencies of the PTDS and its subscales as well as their association with related measures show that the German PTDS is a reliable and valid instrument for the assessment of posttraumatic stress symptoms. A 3-factor structure was found that is, however, not exactly in concordance with the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000) formulation (Reexperiencing, Avoidance, and Hyperarousal) but rather comprises a Reexperiencing/Avoidance factor; an Emotional Numbing/Hyperarousal factor; and a 3rd factor, consisting of Hypervigilance and an Exaggerated Startle Response. The findings are discussed with respect to their equivalency to the original PTDS, core symptoms of PTSD, and desirable future research.     

Validity of the NIMH Diagnostic Interview Schedule for Children: A comparison between psychiatric and pediatric referrals

The NIMH Diagnostic Interview Schedule for Children (DISC) was used to evaluate 40 psychiatric referrals aged 7–11 and 40 pediatric referrals matched for age, sex, race, and socioeconomic status. Each parent and child was interviewed separately using parallel versions of the interview, DISC-P and DISC-C, and parents completed the Child Behavior Checklist (CBCL). The psychiatric referrals had more psychiatric diagnoses and higher symptom scores than the pediatric referrals. Parent reports discriminated better between the criterion groups than child reports. In both groups, mild oppositional behavior and fears were commonly reported by parents, whereas mild separation anxiety, fears, and dysthymia were commonly reported by children. Attention deficit disorder, conduct disorder, and affective disorders were much more common among psychiatrically referred children. There was an association (x²=37.1, p < 001) between abnormally high CBCL scores and diagnoses derived from the interview with the parent, but the association between the CBCL and the child interview was not significant. Over all, the results support the validity of the DISC-P, and to a lesser extent that of the DISC-C, in discriminating psychiatric from pediatric referrals, at the level of both symptoms and severe diagnoses, but not at the mild/moderate level of diagnosis.This work was supported in part by NIMH Clinical Research Center Grant No. MH30915 and by NIMH Contract No. RFP-DB-81-0027. The second author is supported by an NIMH Research Scientist Development Award No. MH00403 and by a Faculty Scholar's Award from the William T. Grant Foundation. The authors are most grateful to Noelle Conover for her assistance in data analysis.     

Clinical validity of a Personality Inventory for Children (PIC) profile typology.

We evaluated the validity of a profile typology for the Personality Inventory for Children (PIC), a parent-informant measure of child psychiatric status. For referred children, we studied (a) the convergence of PIC profile types with diagnoses according to the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., American Psychiatric Association, 1980) and (b) the incremental validity of the PIC over diagnoses in the prediction of symptom ratings completed by teachers and clinicians. We found a high diagnosis-PIC correspondence only for developmentally disordered children; the overlap for children with emotional-conduct problems was poor. For the latter group, however, the correlation of diagnoses with symptom ratings was low, but the incremental validity of the PIC over diagnoses was high. We discuss the use of this profile typology in the clinical evaluation of children and present a case example.     

Reliability and validity of the Spanish version of the Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A)

The aim of this study was to determine the test-retest reliability and internal consistency of the scales of the Spanish version of the Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A; Butcher et al., 1992). Two samples of 939 and 109 Spanish adolescents ages 14 to 18 years were assessed with the MMPI-A in their school environment. The first sample responded to the inventory once, whereas the second sample responded to it on 2 occasions with a 2-week interval between sessions. Results showed no significant differences in means or variances between the first and the second test administration for most MMPI-A scales. Test-retest reliability ranged between .62 (Amorality, Ma(1)) and .92 (Immaturity, IMM); most correlations exceeded .70. Internal consistency values for the MMPI-A scales in the pretest and posttest were very similar overall. External validity of the MMPI-A was demonstrated through several significant correlations between its scales and YSR/11-18 syndromes and social interaction measures. The highest correlations were established between the Anxious/Depressed YSR/11-18 scale and other MMPI-A scales such as Schizophrenia (Sc), Welsh's Anxiety (A), Adolescent-Anxiety (A-anx) and Adolescent-Alienation (A-aln), and between the Social Avoidance and Distress Scale and the MMPI-A Adolescent-Social Discomfort (A-sod) scale.     

Psychometric properties of the Brief Symptoms Inventory-18 (Bsi-18) in a Spanish sample of outpatients with psychiatric disorders

This study analyzes the psychometric and structural properties of the BSI-18 in a sample of Spanish outpatients with psychiatric disorders (N = 200), with three basic objectives: (a) to study the structural validity of the instrument; (b) to analyse reliability (internal consistency and test-retest stability) and validity (convergent and discriminant) of the instrument, and (c) to evaluate sensitivity to change in a therapeutic context. Using confirmatory factor analysis, two models were tested: the three-dimensional theoretical model proposed by its authors, and the empirical four-factor model obtained by the same authors through exploratory factor analysis. Our results showed that the best structure was a four-dimensional model, with the General Distress index and Somatization, Depression, General Anxiety and Panic scores. These four scales showed good internal consistency, test-retest reliability, validity and sensitivity to therapeutic change. The BSI-18 has been shown to be a reliable and useful tool for psychiatric assessment of patients, with the added advantage provided by its simplicity and ease of application.