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Standardised Assessment of Personality – Abbreviated Scale (SAPAS): preliminary validation of a brief screen for personality disorder
- Authors:
- MORAN Paul, et al
- Journal article citation:
- British Journal of Psychiatry, 18(9), September 2003, pp.228-232.
- Publisher:
- Cambridge University Press
There is a need for a brief and simple screen for personality disorders that can be used in routine psychiatric assessments. The aim was to test the concurrent validity and test–retest reliability of a brief screen for personality disorder. Sixty psychiatric patients were administered a brief screening interview for personality disorder. On the same day, they were interviewed with an established assessment for DSM–IV personality disorder. Three weeks later, the brief screening interview was repeated in order to examine test–retest reliability. A score of 3 on the screening interview correctly identified the presence of DSM–IV personality disorder in 90% of participants. The sensitivity and specificity were were 0.94 and and 0.85 respectively. The study provides preliminary evidence of the usefulness of the screen in routine clinical settings
Delirium among patients with and without dementia: does the diagnosis according to the DSM-IV differ from the previous classifications?
- Authors:
- LAURILA Jouko V., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(3), March 2004, pp.271-277.
- Publisher:
- Wiley
Different diagnostic criteria differ in their capacity to identify subjects as delirious. It is not known how DSM-IV classification, compared with the DSM-III, DSM-III-R, and ICD-10, identifies delirium among individuals with and without dementia and whether the symptom profiles differ between these two subgroups. A cross-sectional study was performed on patients (age 70 years) in seven acute geriatric wards (n = 230) and in seven nursing-homes (n = 195) in Helsinki, Finland. Delirium was diagnosed according to the operationalized criteria according to the DSM-III, DSM-III-R, DSM-IV, and clinical criteria of ICD-10. Dementia was defined according to consensus judgment among three geriatricians with concise information including: prior dementia diagnoses, Clinical Dementia Rating Scale, operationalized criteria according to the DSM-IV, nurses and/or caregivers interviews, and the results of the brain CT/MRI and prior Mini-Mental State Examination scores, when available. According to the DSM-III, DSM-IIIR, DSM-IV and ICD-10 criteria of delirium 22.7, 23.5, 25.9 and 14.9% of the demented, and 12.9, 13.5, 23.5 and 2.9% of the non-demented, respectively, were diagnosed as delirious. In stepwise logistic regression analysis clouding of consciousness, perceptual disturbances, and disorganized thinking were the most significant contributors to delirium diagnosis according to the DSM-IV among individuals with dementia, whereas perceptual disturbances, motor disturbances, and disorientation were the most significant contributors among those without dementia. DSM-IV criteria of delirium identify new, often non-demented, subjects as being delirious, while ICD-10 is overly restrictive. The symptom profile of delirium was slightly different among individuals with and without dementia.
Using a model to guide data gathering, interpretation, and communication in capital mitigation evaluations
- Authors:
- MARCZYK Geoffrey, et al
- Journal article citation:
- Journal of Forensic Psychology Practice, 3(3), 2003, pp.89-103.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia
The use of a model can have a direct impact on several areas of forensic mental health assessment, and is important in gathering and interpreting data, reasoning about the results and conclusions, and communicating the results of such an assessment. The following report and accompanying discussion illustrates the application of a forensic model in the context of a defense-initiated capital mitigation evaluation under Pennsylvania State law. The first step in employing a model was to identify the relevant legal standard, which required the forensic clinician to assess character traits, contextual circumstances, extreme mental or emotional disturbance, and mental and cognitive deficits that might have had a direct impact on the defendant's ability to conduct or conform his conduct to the requirements of the law at the time of the alleged offense. In the second part of the model, these clinical characteristics were related to the tasks and functional abilities that are part of the relevant legal question. Finally, using the third step of the model, the forensic clinician assesses the strength of the causal connection between the existence of mental and cognitive deficits and the functional abilities related to the relevant legal question. In addition to improving the overall quality and accuracy of the evaluation, the use of this type of model is consistent with the guidelines and substantive criteria for capital mitigation articulated by the United States Supreme Court. (Copies of this article are available from: Haworth Document Delivery Centre Haworth Press Inc., 10 Alice Street Binghamton, NY 13904-1580)
Developing sensitivity to distortion: utility of psychological tests in differentiating malingering and psychopathology in criminal defendants
- Author:
- HEINZE Michaela C.
- Journal article citation:
- Journal of Forensic Psychiatry and Psychology (The), 14(1), April 2003, pp.151-177.
- Publisher:
- Taylor and Francis
In a retrospective study, the accuracy of various psychological tests in distinguishing between those who were diagnosed as malingerers and those who were diagnosed as mentally ill was examined. Speci cally, information about the utility of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), Structured Interview of Reported Symptoms (SIRS), M Test, the Atypical Presentation Scale (AP) and the Rey 15-Item Memory Test (RMT) was examined in 66 men who had been hospitalized as incompetent to stand trial. Overall, results support the use of psychological testing in the detection of malingering of psychotic symptoms. Practical guidance on how to utilize psychological tests within the overall evaluation is provided.
Clinically significant religious impairment
- Author:
- HATHAWAY William L.
- Journal article citation:
- Mental Health Religion and Culture, 6(2), July 2003, pp.113-129.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Recent psychodiagnostic practice, as embodied in the DSM IV, requires that psychopathological features result in a ‘‘clinically significant impairment’’ to qualify as a ‘‘mental disorder’’ in many cases. The impairment must be in social, occupational, or other important areas of functioning. The current proposal is that clinicians should consider the potential impairment in religious functioning arising from mental disorders in diagnostic process. It is suggested that psychopathology may result in a clinically significant religious impairment that is defined as a reduced ability to perform religious activities, achieve religious goals, or to experience religious states, due to a psychological disorder. Various existing approaches to studying the relationship between religious functioning and psychopathology are briefly reviewed and oughly categorized as either focused on ‘symptomatic religiosity’ or reflecting a ‘religiously sympathetic’ posture. Yet, in both of these approaches, religion has predominantly been construed as an exogenous variable contributing to mental health in some fashion (for good, for ill, or for both). The current proposal suggests that clinicians should also consider religion in endogenous perspective. So construed, religion is a significant domain of adaptive functioning, which may be adversely impacted by psychopathology. A discussion of various clinical, research and ethical issues involved in realizing the proposal is provided.
Personality disorder: temperament or trauma?: an account of an emancipatory research study carried out by service users diagnosed with personality disorder
- Author:
- CASTILLO Heather
- Publisher:
- Jessica Kingsley
- Publication year:
- 2003
- Pagination:
- 176p.,bibliog.
- Place of publication:
- London
Personality Disorder (PD) is one of the most difficult psychological conditions to classify and treat and in the past literature on the subject has tended to neglect the invaluable viewpoint of sufferers themselves. Drawing on research carried out in conjunction with service users, the author seeks to emphasise the need for health professionals to reassess their approach to the condition and allows those with PD to effectively define themselves and their illness.
Utility of the brief symptom inventory in the assessment of psychological distress
- Authors:
- KELLETT Stephen, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 16(2), June 2003, pp.127-134.
- Publisher:
- Wiley
People with intellectual disabilities are now acknowledged to be susceptible to the full range of mental health disorders. This acknowledgement has resulted in the need to develop and evaluate instruments for the assessment and detection of mental health problems. This research evaluates the use of the Brief Symptom Inventory (BSI) with 200 people with mild intellectual disabilities representing community, clinical and forensic populations.
Psychiatric disorder and personality factors associated with suicide in older people: a descriptive and case-control study
- Authors:
- HARWOOD Daniel, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 16(2), February 2001, pp.155-165.
- Publisher:
- Wiley
Reports on a study to determine the rates of psychiatric disorder and personality variables in a sample of older people who had committed suicide and to compare the rates in a subgroup of this sample with those in a control group of people who died from natural causes. The sample covered four counties and one large urban area in central England. Results found seventy-seven per cent of the suicide sample had a psychiatric disorder at the time of death, most often depression. Personality disorder or personality trait accentuation was present in 44 percent. Depression, personality disorder, and personality trait accentuation emerged as predictors of suicide in the case-control analysis. Concludes that personality factors, as well as depression, are important risk factors for suicide in older people.
Social work with the impossible client
- Author:
- THOMPSON Paul
- Journal article citation:
- Practice: Social Work in Action, 8(3), 1996, pp.45-52.
- Publisher:
- Taylor and Francis
This paper explores some of the problems encountered in social work practice with clients who are difficult to engage. It is suggested that change is not always possible and that what can be more important than seeking change can be the continuance of a responsive and consistent social work relationship. A consideration is given to psychiatric definitions of personality disorder and the helpfulness, or not, of this diagnosis.
Mental disorders, medications and clinical social work
- Author:
- AUSTRIAN Sonia G
- Publisher:
- Columbia University Press
- Publication year:
- 1995
- Pagination:
- 317p.,bibliog.
- Place of publication:
- New York
Practical guide, aimed at social workers, to mental health problems. Includes chapters on: anxiety disorders; mood disorders; somatoform and factitious disorders; dissociative disorders; schizophrenia; disorders arising from substance abuse; eating disorders; personality disorders; dementia; psychological and neuropsychological assessment; and psychotropic medications.