Biomedical subjects

P Pilkonis

Publications and source records attributed to P Pilkonis.

6 recordsLinked to original sources

PubMed2000

Inventory of Interpersonal Problems Personality Disorder scales: operating characteristics and confirmatory factor analysis in nonclinical samples.

Research involving clinical samples has demonstrated the utility of a 28-item personality disorder (PD) screening measure (Inventory of Interpersonal Problems--Personality Disorder scale [IIP-PD]) culled from the IIP in the prediction of the presence or absence of a PD (Pilkonis, Kim, Proietti, & Barkham, 1996). This article extends these diagnostic efficiency findings to nonclinical samples and presents additional data regarding the factor structure of the 28 IIP-PD items. Diagnostic efficiency statistics for the IIP-PD scale, calculated using both interview and self-report methods, support the utility of the IIP-PD scale as a screening tool for the presence or absence of a PD. High specificity estimates indicate that individuals who do not exceed Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) symptom thresholds rarely exceed the IIP-PD cutoff. Furthermore, a high negative predictive power (NPP) estimate derived using an interview-based diagnostic standard suggests that the IIP-PD scale accurately screens out individuals who do not have a PD. Finally, cross-validated confirmatory factor-analytic results involving items composing the 5 IIP PD subscales identified in previous research (Kim, Pilkonis, & Barkham, 1997) suggest that a measurement model with a single second-order factor (general PD) and 5 first-order factors (one representing each PD subscale) provided the best fit to the observed data compared to 2 other competing models.

Adult↗

PubMed1999

The Iowa Personality Disorder Screen: development and preliminary validation of a brief screening interview.

The length and expense of comprehensive personality disorder interviews makes them unwieldy for routine use. A brief but sensitive screen could eliminate administration of longer instruments in many instances. We describe the development of the Iowa Personality Disorder Screen (IPDS)--a mini-structured interview which can be completed in less than 5 minutes. Retrospective analyses using 1,203 SIDP-R interviews suggested that the IPDS items should provide good sensitivity and specificity. We present results from a prospective validation study, using a mixed group of 52 nonpsychotic inpatients and outpatients who were diagnosed using the SIDP-IV. Blind administration of the IPDS yielded excellent sensitivity (92%) and good specificity (79%), using a subset of five screening items. Addition of two more items leads to an estimated sensitivity of 79% and specificity of 86%. The IPDS shows promise as a quick personality disorder screen for use in research settings or standard clinical interviews.

Adult↗

PubMed1993

Personality disorders diagnosed at intake at a public psychiatric facility.

OBJECTIVE: The purpose of the study was to determine the prevalence of personality disorders among a large population of persons seeking treatment in a public psychiatric facility and to examine the role of personality disorders in the clinical conditions of persons frequenting such facilities. METHODS: Clinical and demographic data were retrospectively examined for 18,179 adults who visited a walk-in clinic of a public psychiatric facility between 1983 and 1989. Patients who received a diagnosis of personality disorder were compared with those who did not. RESULTS: A total of 2,344 patients (12.9 percent) were diagnosed as having a personality disorder, a lower prevalence rate than generally found in treatment populations. The most frequent diagnoses were atypical, antisocial, and borderline personality disorders. Compared with other subjects, those with a personality disorder were significantly more likely to be men, to be 35 years old or younger, to have a higher level of social impairment, and to have more symptoms and more severe symptoms. CONCLUSIONS: The relatively low prevalence rate was attributed in part to underdiagnosis, largely due to the need for making rapid assessments in a public intake setting. The authors conclude that clinicians in such facilities may be likely to diagnose personality disorders when patients with certain axis I disorders such as substance use, affective, and adjustment disorders present with an overall greater level of symptomatology and social impairment.

Adult↗

PubMed1992

Are personality assessments valid in acute major depression?

A number of recent studies indicate that identification of Axis II comorbidity in depressed patients may influence both the initial treatment plan and subsequent prognosis. Nevertheless, the validity of personality disorder diagnoses may be compromised by the effects of the patients' depression on historical recall, which distort presentation of their premorbid strengths and liabilities. These problems are illustrated in this study of 53 acutely depressed unipolar outpatients, with (N = 14) or without (N = 39) personality disorder diagnoses as defined by the Personality Disorder Examination (PDE). We found that: 1) pretreatment PDE diagnoses had no significant associations with any measure of demography, symptomatic status, illness course, or treatment response; and 2) pretreatment PDE diagnoses typically were not confirmed when patients were reassessed following effective treatment with cognitive behavior therapy. These findings provide strong empirical support for the wisdom of deferring definitive assessment of Axis II until an acute depressive disorder has been optimally treated.

Acute Disease↗

PubMedDate not supplied

Explaining diagnostic complexity in an intake setting.

A one patient-one illness paradigm is implicit in the history and theory of psychiatry, and in basic research. Yet, in clinical practice and treatment populations in general, more than one diagnosis per patient is frequently encountered. How clinicians formulate comorbidity by means of DSM-III has rarely been investigated. In this study, the ideas of clinical condition and that of its diagnostic complexity are used to analyze descriptive features of a large number of patients seen in an intake setting. Axis I of DSM-III is used to measure diagnostic complexity. Complexity is analyzed in relation to demographic variables, to ratings entered in the remaining axes of DSM-III formulations, to symptom levels of patients, and to decisions involving disposition. Results indicate that analysis of diagnostic complexity by means of DSM-III yields a definable structure and that it can be related meaningfully to clinical factors. The idea of information uncertainty in diagnosis, i.e., the opacity versus transparency of a clinical condition, is also used to explain results. The ideas introduced and studied are shown to have value for social psychiatric research.

Adaptation, Psychological↗

PubMedDate not supplied

On the homogeneity of personality disorder clusters.

This study was conducted using as subjects persons seeking psychiatric care in a public intake facility. Patients who received a diagnosis of a personality disorder (PD) on axis II constituted the study sample. The study is unique in that it attempts to analyze in a treatment population the relationships between all of the personality disorders (PD) stipulated in DSM-III with emphasis on their relationships to the associated features recorded in the remaining axes of DSM-III. The specific aim of the study was to determine the variation that exists with respect to clinical and demographic variables across the PD clusters categorized in DSM-III and across the PD types of each of the DSM-III PD clusters. In general, considerable inhomogeneity was shown within and across clusters in both demographic and clinical variables, although differences among clusters were noted as well. Cluster B differs prominently from its cohorts with respect to demographic and clinical characteristics. Some of the limitations of these results are emphasized.

Adult↗