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Journal ArticleDOI: 10.1080/00223891.2019.1705464

Comparative Content Analysis of Self-Report Scales for Level of Personality Functioning.

04 Mar 2021-Journal of Personality Assessment (Routledge)-Vol. 103, Iss: 2, pp 161-173
Abstract: Content validity analyses of eight self-report instruments for assessing severity of personality disorder (PD), also known as Level of Personality Functioning (LPF), were conducted using the conceptual scheme of the Alternative Model for Personality Disorders (AMPD; APA, 2013). The item contents of these eight inventories were characterized for the LPF constructs of Identity (ID), Self-Direction (SD), Empathy (EM), and Intimacy (IN) along with the pathological personality trait domains of Negative Affectivity, Detachment, Antagonism, Disinhibition, and Psychoticism. Severity of pathology (SV) reflected in item content was also rated. Raters demonstrated robust agreement for AMPD and SV constructs across instruments. Similarity between instrument AMPD construct profiles was quantified by intraclass correlations (ICC). Results showed the instruments were generally similar in AMPD-construct coverage, but some important differences emerged. The subscales of the instruments also were characterized for the degree to which they reflect the four LPF (ID, SD, EM, IN) domain constructs. Collectively, these content validity comparisons clarify the equivalence of instruments for AMPD constructs and the relative proportions of construct coverage within instrument subscales. These results can inform future research with LPF self-report instruments and guide clinicians in selecting an LPF-related instrument for use in practice.

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Topics: Content validity (54%), Personality (52%), Psychoticism (51%) ... show more
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Open accessJournal ArticleDOI: 10.1159/000507377
01 Jan 2020-Psychopathology
Abstract: Introduction: Dimensional models of personality disorders (PD) in the DSM-5 and ICD-11 share a focus on impairments in self and interpersonal functioning to represent the general features and severity of PD. This new perspective has led to the development of numerous measures for assessing individual differences in PD severity. While this improves choices for researchers and practitioners, it also poses the challenge of an increasing lack of standardization. Objective: The aim of this study is to establish a common metric across 6 widely used self-report measures of PD severity using item response theory models. Methods: 849 participants completed a survey including the Inventory of Personality Organization – 16-item version (IPO-16), the Level of Personality Functioning Scale – Brief Form 2.0, the Level of Personality Functioning Scale – Self-Report, the Operationalized Psychodynamic Diagnosis – Structure Questionnaire Short Form, the Personality Inventory for DSM-5 – Brief Form Plus and the Standardized Assessment of Severity of Personality Disorder (SASPD). We fitted exploratory multidimensional graded response models and used bifactor rotation to extract a general factor across measures. Factor scores were linked to representative T scores using data from a representative survey of 2,502 participants who completed the IPO-16. Results: When using bifactor rotation in a 7-factor model, all items loaded positively on the general factor, and the general factor explained 65.5% of the common variance. With the exception of the SASPD, all measures provided highly discriminating items (factor loadings >0.70) for measuring the general factor and reached an acceptable reliability (>0.80) across a wide range of the latent continuum. We constructed a crosswalk table linking total scores of the 6 measures to each other and to representative T scores. Conclusions: Our results suggest that 6 different self-report measures of the severity of PD capture a strong common factor and can therefore be scaled along a single latent continuum. Our results may facilitate instrument-independent assessment of severity of PD and increase comparability across studies.

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Topics: Metric (mathematics) (59%), Personality (58%), Item response theory (52%)

18 Citations


Journal ArticleDOI: 10.1080/08039488.2020.1841290
Abstract: Background and objectives Avoidant Personality Disorder (AvPD) is considered a mild to moderate personality disorder. However, few studies have focused on the heterogeneity of AvPD in terms of symptoms and severity. In the current study we set out to replicate and extend earlier findings showing that there is variation among patients with AvPD in terms of alexithymia and, further, that this variation is especially associated with specific facets of personality functioning and is not explained by measures of depression, symptom severity, or co-occurring personality disorder traits. Method We used intake data from a sample of AvPD patients (n = 56) who had been treated in similar outpatient services. Alexithymia was measured using the Toronto Alexithymia Scale (TAS-20). Patients filled out questionnaires that were analysed using linear regression models. Results and conclusions Using well-established cut-off points for low, intermediate and high levels of alexithymia we found an almost equal distribution of alexithymia groups in our sample. Alexithymia was associated with higher personality dysfunction on twelve out of sixteen facets of personality functioning. For eight of these personality facets the alexithymia total score explained significant variance even after controlling for self-reported depression, symptom severity and clinician ratings of personality disorder. Results suggest that AvPD is heterogeneous and that alexithymia may be important as an indicator of severity of specific personality dysfunction.

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Topics: Alexithymia (74%), Toronto Alexithymia Scale (66%), Avoidant personality disorder (65%) ... show more

8 Citations


Journal ArticleDOI: 10.1002/PMH.1510
Bo Bach1, Tiffany A. Brown2, Roger T. Mulder2, Giles Newton-Howes2  +3 moreInstitutions (3)
Abstract: Aim No measure has formally been developed to assess the published ICD-11 model of Personality Disorder (PD) severity. We therefore set out to develop and evaluate the 14-item Personality Disorder Severity ICD-11 (PDS-ICD-11) scale. Method A representative U.S. community sample (N = 428; 50.9% women) and a New Zealand mental health sample (N = 87; 61.5% women) completed the PDS-ICD-11 scale along with a series of established PD and impairment measures. Results Item response theory supported the unidimensionality of PDS-ICD-11 (median item loading of 0.68) and indicated that a PDS-ICD-11 score of 17.5 may serve as a benchmark for pronounced dysfunction. Correlation and regression analyses supported both criterion validity and incremental validity in predicting impairment and PD symptoms. The PDS-ICD-11 was particularly associated with measures of Level of Personality Functioning Scale (LPFS), Global PD severity, and Borderline PD symptom score. A comparison between clinical individuals diagnosed with an ICD-11 PD vs. no PD supported diagnostic validity. Conclusion This initial construction study suggests that the PDS-ICD-11 constitutes a promising instrument that provides a quick impression of the severity of personality dysfunction according to the official ICD-11 PD guidelines. Clearly, more research is needed to corroborate its validity and utility. The PDS-ICD-11 scale is provided as online supporting information.

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Topics: Incremental validity (57%), Criterion validity (57%), Personality (52%)

5 Citations


Open accessJournal ArticleDOI: 10.1016/J.COPSYC.2020.09.009
Abstract: The diagnostic concept of Personality Disorder (PD) is changing. A dimensional PD concept that focuses on severity of impairment of personality functioning was introduced in the DSM 5 Section III in 2013 and is adopted by the upcoming ICD-11 in a similar manner. Several reliable, valid and useful instruments to assess personality functioning (Criterion A) either as self-report, expert rating or clinical interview were developed in the past years. This article gives a latest state-of-the-art overview of these measures. It underlines the importance of multi-informant multi-method assessment of, and a longitudinal perspective on PD pathology and the importance of standardized inclusion of PD individuals in studies to increase the significance of research findings.

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Topics: Personality (54%), DSM-5 (52%)

3 Citations


Open accessJournal ArticleDOI: 10.3390/IJERPH17124610
Abstract: Borderline Personality Disorder (BPD) significantly impairs functioning Fortunately, effective treatments are available for borderline symptoms but their effect on functioning should be assessed The objective of this meta-analysis is to assess the effect of specifically-designed versus non-specifically designed psychotherapies on function in adult patients with BPD The reference list of Cristea et al 2017 was used to identify the randomized controlled trials (RCTs) assessing the BPD-specifically-designed psychotherapy versus non-specific psychotherapies in adult BPD patients Among those, RCTs assessing post-treatment functioning using the Global Assessment of Functioning, Social Adjustment Scale-Self-Report and Inventory of Interpersonal Problems were included Ten trials (880 participants) were included Summary effect size was calculated using the measured Hedge's g The results indicate the BPD patients in the intervention group had a significantly higher (g = 041; 95% CI, 009-073) level of psychosocial functioning after receiving the specifically-designed psychotherapies in comparison with BPD patients in control groups after receiving non-specific psychotherapies Specifically-designed psychotherapies can improve psychosocial functioning although improvement in measurement of function (ie, more objective and universal tools) and improvement in psychotherapies (ie, more focused on general functioning) will be helpful

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2 Citations


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80 results found


Open accessJournal ArticleDOI: 10.1016/J.PSYCHRES.2011.06.006
Vijay A. Mittal1, Elaine F. Walker2Institutions (2)
Abstract: Given the recent attention to movement abnormalities in psychosis spectrum disorders (e.g., prodromal/high-risk syndromes, schizophrenia) (Mittal et al., 2008; Pappa and Dazzan, 2009), and an ongoing discussion pertaining to revisions of the Diagnostic and Statistical Manuel of Mental Disorders (DSM) for the upcoming 5th edition, we would like to take this opportunity to highlight an issue concerning the criteria for tic disorders, and how this might affect classification of dyskinesias in psychotic spectrum disorders. Rapid, non-rhythmic, abnormal movements can appear in psychosis spectrum disorders, as well as in a host of commonly co-occurring conditions, including Tourette’s Syndrome and Transient Tic Disorder (Kerbeshian et al., 2009). Confusion can arise when it becomes necessary to determine whether an observed movement (e.g., a sudden head jerk) represents a spontaneous dyskinesia (i.e., spontaneous transient chorea, athetosis, dystonia, ballismus involving muscle groups of the arms, legs, trunk, face, and/or neck) or a tic (i.e., stereotypic or patterned movements defined by the relationship to voluntary movement, acute and chronic time course, and sensory urges). Indeed, dyskinetic movements such as dystonia (i.e., sustained muscle contractions, usually producing twisting and repetitive movements or abnormal postures or positions) closely resemble tics in a patterned appearance, and may only be visually discernable by attending to timing differences (Gilbert, 2006). When turning to the current DSM-IV TR for clarification, the description reads: “Tic Disorders must be distinguished from other types of abnormal movements that may accompany general medical conditions (e.g., Huntington’s disease, stroke, Lesch-Nyhan syndrome, Wilson’s disease, Sydenham’s chorea, multiple sclerosis, postviral encephalitis, head injury) and from abnormal movements that are due to the direct effects of a substance (e.g., a neuroleptic medication)”. However, as it is written, it is unclear if psychosis falls under one such exclusionary medical disorder. The “direct effects of a substance” criteria, referencing neuroleptic medications, further contributes to the uncertainty around this issue. As a result, ruling-out or differentiating tics in psychosis spectrum disorders is at best, a murky endeavor. Historically, the advent of antipsychotic medication in the 1950s has contributed to the confusion about movement signs in psychiatric populations. Because neuroleptic medications produce characteristic movement disorder in some patients (i.e. extrapyramidal side effects), drug-induced movement disturbances have been the focus of research attention in psychotic disorders. However, accumulating data have documented that spontaneous dyskinesias, including choreoathetodic movements, can occur in medication naive adults with schizophrenia spectrum disorders (Pappa and Dazzan, 2009), as well as healthy first-degree relatives of chronically ill schizophrenia patients (McCreadie et al., 2003). Taken together, this suggests that movement abnormalities may reflect pathogenic processes underlying some psychotic disorders (Mittal et al., 2008; Pappa and Dazzan, 2009). More specifically, because spontaneous hyperkinetic movements are believed to reflect abnormal striatal dopamine activity (DeLong and Wichmann, 2007), and dysfunction in this same circuit is also proposed to contribute to psychosis, it is possible that spontaneous dyskinesias serve as an outward manifestation of circuit dysfunction underlying some schizophrenia-spectrum symptoms (Walker, 1994). Further, because these movements precede the clinical onset of psychotic symptoms, sometimes occurring in early childhood (Walker, 1994), and may steadily increase during adolescence among populations at high-risk for schizophrenia (Mittal et al., 2008), observable dyskinesias could reflect a susceptibility that later interacts with environmental and neurodevelopmental factors, in the genesis of psychosis. In adolescents who meet criteria for a prodromal syndrome (i.e., the period preceding formal onset of psychotic disorders characterized by subtle attenuated positive symptoms coupled with a decline in functioning), there is sometimes a history of childhood conditions which are also characterized by suppressible tics or tic like movements (Niendam et al., 2009). On the other hand, differentiating between tics and dyskinesias has also complicated research on childhood disorders such as Tourette syndrome (Kompoliti and Goetz, 1998; Gilbert, 2006). We propose consideration of more explicit and operationalized criteria for differentiating tics and dyskinesias, based on empirically derived understanding of neural mechanisms. Further, revisions of the DSM should allow for the possibility that movement abnormalities might reflect neuropathologic processes underlying the etiology of psychosis for a subgroup of patients. Psychotic disorders might also be included among the medical disorders that are considered a rule-out for tics. Related to this, the reliability of movement assessment needs to be improved, and this may require more training for mental health professionals in movement symptoms. Although standardized assessment of movement and neurological abnormalities is common in research settings, it has been proposed that an examination of neuromotor signs should figure in the assessment of any patient, and be as much a part of the patient assessment as the mental state examination (Picchioni and Dazzan, 2009). To this end it is important for researchers and clinicians to be aware of differentiating characteristics for these two classes of abnormal movement. For example, tics tend to be more complex than myoclonic twitches, and less flowing than choreoathetodic movements (Kompoliti and Goetz, 1998). Patients with tics often describe a sensory premonition or urge to perform a tic, and the ability to postpone tics at the cost of rising inner tension (Gilbert, 2006). For example, one study showed that patients with tic disorders could accurately distinguish tics from other movement abnormalities based on the subjective experience of some voluntary control of tics (Lang, 1991). Another differentiating factor derives from the relationship of the movement in question to other voluntary movements. Tics in one body area rarely occur during purposeful and voluntary movements in that same body area whereas dyskinesia are often exacerbated by voluntary movement (Gilbert, 2006). Finally, it is noteworthy that tics wax and wane in frequency and intensity and migrate in location over time, often becoming more complex and peaking between the ages of 9 and 14 years (Gilbert, 2006). In the case of dyskinesias among youth at-risk for psychosis, there is evidence that the movements tend to increase in severity and frequency as the individual approaches the mean age of conversion to schizophrenia spectrum disorders (Mittal et al., 2008). As revisions to the DSM are currently underway in preparation for the new edition (DSM V), we encourage greater attention to the important, though often subtle, distinctions among subtypes of movement abnormalities and their association with psychiatric syndromes.

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Topics: Tics (65%), Tourette syndrome (62%), Dyskinesia (59%) ... show more

52,117 Citations


Open accessJournal ArticleDOI: 10.1037/H0040957
Lee J. Cronbach1, Paul E. MeehlInstitutions (1)
Abstract: Validation of psychological tests has not yet been adequately conceptualized, as the APA Committee on Psychological Tests learned when it undertook (1950-54) to specify what qualities should be investigated before a test is published. In order to make coherent recommendations the Committee found it necessary to distinguish four types of validity, established by different types of research and requiring different interpretation. The chief innovation in the Committee's report was the term construct validity.[2] This idea was first formulated by a subcommittee (Meehl and R. C. Challman) studying how proposed recommendations would apply to projective techniques, and later modified and clarified by the entire Committee (Bordin, Challman, Conrad, Humphreys, Super, and the present writers). The statements agreed upon by the Committee (and by committees of two other associations) were published in the Technical Recommendations (59). The present interpretation of construct validity is not "official" and deals with some areas where the Committee would probably not be unanimous. The present writers are solely responsible for this attempt to explain the concept and elaborate its implications.

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Topics: Construct validity (57%), Nomological network (54%), Test validity (54%) ... show more

9,262 Citations


Journal ArticleDOI: 10.1037/1040-3590.6.4.284
Domenic V. Cicchetti1Institutions (1)
Abstract: In the context of the development of prototypic assessment instruments in the areas of cognition, personality, and adaptive functioning, the issues of standardization, norming procedures, and the important psychometrics of test reliability and validity are evaluated critically. Criteria, guidelines, and simple rules of thumb are provided to assist the clinician faced with the challenge of choosing an appropriate test instrument for a given psychological assessment. Clinicians are often faced with the critical challenge of choosing the most appropriate available test instrument for a given psychological assessment of a child, adolescent, or adult of a particular age, gender, and class of disability. It is the purpose of this report to provide some criteria, guidelines, or simple rules of thumb to aid in this complex scientific decision. As such, it draws upon my experience with issues of test development, standardization, norming procedures, and important psychometrics, namely, test reliability and validity. As I and my colleagues noted in an earlier publication, the major areas of psychological functioning, in the normal development of infants, children, adolescents, adults, and elderly people, include cognitive, academic, personality, and adaptive behaviors (Sparrow, Fletcher, & Cicchetti, 1985). As such, the major examples or applications discussed in this article derive primarily, although not exclusively, from these several areas of human functioning.

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Topics: Psychological testing (58%), Test validity (54%), Standardized test (54%) ... show more

6,001 Citations


Journal ArticleDOI: 10.2466/PR0.1957.3.3.635
Jane Loevinger1Institutions (1)
Abstract: CHAPTER I. EXTENSION OF THE CONCEPT OF VALIDITY A. Critique of classical validity concept B. Construct validity : elucidation of terms -------------______----------------.---.-----------CHAPTER 11. RELATION OF TEST BEHAVIOR TO THEORY A. Test responses as signs and as samples B. The problem of homogeneity ___._____.____.------------.---------------------------------------C. Observation prior to measurement D. The psychology of objective test behavior CHAPTER 111. COMPONENTS OF CONSTRUCT VALIDITY -_.----------------------------------------A. Substantive component --_._.________--------------.-------------------------------------.----------1. Use of content in item selection . . a. Content valldlty b. Empirical keying ----_-____--_-.------------------------------------------------2. The universe and the pool _.__._______-------------------------------------------------3. The concept of substantive validity ----------___-_-_---------------7--------------B. Structural component __.__.___---_-_____--------.---------------------------------------------------1. The concept of structural validity 2. Some kinds of structure -

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1,272 Citations


Journal ArticleDOI: 10.1037/H0056029
Abstract: As the thinking of behavior theorists has become more sophisticated and selfconscious, there has been considerable discussion of the value and logical status of so-called ‘intervening variables.’ Hull speaks of “symbolic constructs, intervening variables, or hypothetical entities” (5, p. 22) and deals with them in his theoretical discussion as being roughly equivalent notions. At least, his exposition does not distinguish among them explicitly. In his presidential address on behavior at a choice point, Tolman inserts one of Hull’s serial conditioning diagrams (11, p. 13) between the independent variables (maintenance schedule, goal object, etc.) and the dependent variable (‘behavior ratio’) to illustrate his concept of the intervening variable. This would seem to imply that Tolman views his ‘intervening variables’ as of the same character as Hull’s. In view of this, it is somewhat surprising to discover that Skinner apparently feels that his formulations have a close affinity to those of Tolman, but are basically dissimilar to those of Hull (10, p. 436, 437). In advocating a theoretical structure which is ‘descriptive’ and ‘positivistic,’ he suggests that the model chosen by Hull (Newtonian mechanics) is not the most suitable model for purposes of behavior theory; and in general is critical of the whole postulate-deductive approach. Simultaneously with these trends, one can still observe among ‘tough-minded’ psychologists the use of words such as ‘unobservable’ and ‘hypothetical’ in an essentially derogatory manner, and an almost compulsive fear of passing beyond the direct colligation of observable data. ‘Fictions’ and ‘hypothetical entities’ are sometimes introduced into a discussion of theory with a degree of trepidation and apology quite unlike the freedom with which physicists talk about atoms, mesons, fields, and the like. There also seems to be a tendency to treat all hypothetical constructs as on the same footing merely because they are hypothetical; so that we find people arguing that if neutrons are admissible in physics, it must be admissible for us to talk about, e.g., the damming up of libido and its reversion to earlier channels. The view which theoretical psychologists take toward intervening variables and hypothetical constructs will of course profoundly influence the direction of theoretical thought. Furthermore, what kinds of hypothetical constructs we become accustomed to thinking about will have a considerable impact upon theory creation. The present paper aims to present what seems to us a major problem in the conceptualization of intervening variables, without claiming to offer a wholly satisfactory solution. Chiefly, it is our aim here to make a distinction between two subclasses of intervening variables, or we prefer to say, between ‘intervening variables’ and ‘hypothetical constructs’ which we feel is fundamental but is currently being neglected. We shall begin with a common-sense distinction, and proceed later to formulations of this distinction which we hope will be more rigorous. Naively, it would seem that there is a difference in logical status between constructs which involve the hypothesization of an entity, proc-

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916 Citations