The OPD conflict questionnaire Background: To date, no self-report measure is available to assess modes of coping with unconscious conflicts according to Operationalized Psychodynamic Diagnosis (OPD). The OPD conflict questionnaire (OPD-CQ) developed here thus intends to close this gap. Methods: To select the items for the OPD-CQ, expert ratings and psychometric criteria based on a sample of 534 persons were combined.
Results:The OPD-CQ comprises 66 items with which active and passive modes of coping with six conflicts as well as defended perception of conflict and emotions can be assessed. Some of the scales had a rather low internal consistency. An investigation of the factor structure of the OPD-CQ scales revealed five factors that could be meaningfully interpreted. The OPD-CQ scales showed expected correlations with other clinically relevant instruments. In addition, we showed the incremental validity of the OPD-CQ scales regarding the prediction of psychological distress and life satisfaction above and beyond structural deficits. Discussion: The results provide important clues toward developing and validating the OPD-CQ. The first version presented here should be considered preliminary.
Personality disorders (PD) are prevalent, underdiagnosed and affect clinical trajectories of psychiatric patients. The SASPD has been developed as a screening tool for PD severity according to the dimensional model of the initial ICD-11 proposal. We show that the SASPD total score might be useful as an indicator for a heterogeneous mixture of PD features, but less as a unidimensional measure of PD severity.
Fragestellung: Angststörungen, insbesondere Panikstörungen und Agoraphobie, sind weitverbreitete psychische Störungen, die eine hohe Komorbidität mit Persönlichkeitsstörungen aufweisen. Randomisierte kontrollierte Studien, die sich mit dieser sehr relevanten Gruppe von Patienten befassen, fehlen bisher. Methode: Die multizentrisch durchgeführte Studie zu Angst-und Persönlichkeitsstörungen (APS) untersucht 200 Patienten mit Panikstörung und/oder Agoraphobie mit komorbiden Persönlichkeitsstörungen in einer randomisierten, kontrollierten Vergleichsstudie zwischen Analytischer Psychotherapie (psychoanalytic therapy, PT) und Kognitiver Verhaltenstherapie (cognitive behavioral therapy, CBT), wobei jede Gruppe 100 Patienten enthält. Jeder Patient wird über einen Zeitraum von sechs Jahren untersucht, unabhängig von der Dauer der individuellen Behandlung. Die wesentlichen Fragestellungen dieser Studie beziehen sich auf den Vergleich der Effektivität von PT und CBT in dieser speziellen Patientenpopulation, auf den Vergleich der Nachhaltigkeit der Effekte von PT und CBT, den Vergleich der langfristigen Kosten-Nutzen-Relation von PT und CBT, sowie die Untersuchung von prädiktiven Patientenmerkmalen für individuelle Therapieempfehlungen (Differenzielle Indikationsstellung). Diskussion: Die APS-Studie vergleicht Effektivität, Nachhaltigkeit und Kosten-Nutzen-Relation von PT und CBT für Angst-plus Persönlichkeitsstörungen in einem randomisierten, kontrollierten Design. Das Studiendesign erfüllt damit die Anforderungen an eine Effektivitätsstudie für PT, die unlängst definiert wurden. Studienregistrierung: Current Controlled Trials ISRCTN12449681.
The Standardized Assessment of Severity of Personality Disorder (SASPD) is a nine-item self-report screening instrument and was developed to assess personality disorder (PD) severity according to the initial proposal of ICD-11. Our aim was to investigate the psychometric properties of the German version of the SASPD in non-clinical and clinical samples. A total of 1,991 participants (N = 888 from non-clinical and N = 1,103 from clinical samples) provided ratings on the SASPD as well as other measures of psychopathology and personality. We examined the SASPD regarding its factor structure, internal consistency, and construct validity. A unidimensional structure of the SASPD provided inadequate model fit, whereas a three-factor solution provided good fit in both the non-clinical and clinical samples. Internal consistency of the SASPD total score was acceptable in the clinical and in the non-clinical sample based on this multi-factorial model. In terms of convergent validity, SASPD scores correlated fairly with other measures of PD severity across samples. Discriminant validity with measures of general symptom distress and measures of (normal) personality traits was mixed. In addition, the SASPD scores predicted levels of PD severity above and beyond a measure of symptom distress. The SASPD captures some theoretically expected features of PD severity. However, the multidimensional structure and limited convergent and discriminant validity may hamper future usage of the SASPD as a short screening tool of PD severity according to ICD-11.
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