Staff and Researcher Publications
Language
English
Publication Date
1-1-2018
Journal
Comprehensive Psychiatry
DOI
10.1016/j.comppsych.2017.09.003
PMID
29069625
Abstract
Background: With the publication of DSM 5 alternative model for personality disorders it is critical to assess the components of the model against evidence-based models such as the five factor model and the DSM-IV-TR categorical model. This study explored the relative clinical utility of these models in screening for borderline personality disorder (BPD).
Methods: Receiver operator characteristics and diagnostic efficiency statistics were calculated for three personality measures to ascertain the relative diagnostic efficiency of each measure. A total of 1653 adult inpatients at a specialist psychiatric hospital completed SCID-II interviews. Sample 1 (n=653) completed the SCID-II interviews, SCID-II Questionnaire (SCID-II-PQ) and the Big Five Inventory (BFI), while Sample 2 (n=1,000) completed the SCID-II interviews, Personality Inventory for DSM5 (PID-5) and the BFI.
Results: BFI measure evidenced moderate accuracy for two composites: High Neuroticism+ low agreeableness composite (AUC=0.72, SE=0.01, p< 0.001) and High Neuroticism+ Low+Low Conscientiousness (AUC=0.73, SE=0.01, p< 0.0001). The SCID-II-PQ evidenced moderate-to-excellent accuracy (AUC=0.86, SE=0.02, p< 0.0001) with a good balance of specificity (SP=0.80) and sensitivity (SN=0.78). The PID-5 BPD algorithm (consisting of elevated emotional lability, anxiousness, separation insecurity, hostility, depressivity, impulsivity, and risk taking) evidenced moderate-to-excellent accuracy (AUC=0.87, SE=0.01, p< 0.0001) with a good balance of specificity (SP=0.76) and sensitivity (SN=0.81).
Conclusions: Findings generally support the use of SCID-II-PQ and PID-5 BPD algorithm for screening purposes. Furthermore, findings support the accuracy of the DSM 5 alternative model Criteria B trait constellation for diagnosing BPD. Limitations of the study include the single inpatient setting and use of two discrete samples to assess PID-5 and SCID-II-PQ.
Keywords
Adult, Borderline Personality Disorder, Diagnosis, Differential, Diagnostic and Statistical Manual of Mental Disorders, Female, Humans, Male, Middle Aged, Personality Inventory, Surveys and Questionnaires
Published Open-Access
yes
Recommended Citation
Fowler, J Christopher; Madan, Alok; Allen, Jon G; et al., "Clinical Utility of the DSM-5 Alternative Model for Borderline Personality Disorder: Differential Diagnostic Accuracy of the Bfi, Scid-II-Pq, and Pid-5" (2018). Staff and Researcher Publications. 72.
https://digitalcommons.library.tmc.edu/clinic_pub/72
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