Sensitivity, Specificity and Interrater Reliability of a Clinical Staging Model for Personality Disorders in Older Adults: A Case Series Study.

IF 2.8 3区心理学 Q2 PSYCHOLOGY, CLINICAL

Journal of personality assessment Pub Date : 2025-06-04 DOI:10.1080/00223891.2025.2509491

Roel J Schepman, Jeroen A P Conjaerts, Sebastiaan P J van Alphen, Jelle de Jong, Samantha Bouwmeester, Arjan C Videler

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引用次数: 0

Abstract

A recent Delphi study found expert-consensus that clinical staging (CS) could provide a valid framework in the assessment of personality disorders (PDs) in older adults (Conjaerts et al., 2025). The categorical models used currently to assess PDs are poorly suited for treatment selection, in older adults even more so as age-specific factors were not considered in the development. The aim of this study was to investigate the interrater reliability, sensitivity and specificity of the recently proposed CS model, using the level of personality functioning and the lifetime course of personality pathology as profilers. Clinical vignettes were composed to reflect various stages of PD. 35 international expert clinicians in the field of PDs in older adults were presented three vignettes and asked to assign the PD to a clinical stage. Interrater reliability was good (κ = .86; 95% CI: 0.79-0.94). Overall sensitivity (0.80) and specificity (0.93) rates of the model were good. Sensitivity for stages 2, 3 and 4 was very good (0.92, 0.85, and 0.85, respectively), whereas sensitivity for stage 1 was insufficient (0.60). The overall satisfactory interrater reliability, sensitivity and specificity rates indicate that CS might be a valid and reliable new approach of assessing PDs in older adults.

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老年人人格障碍临床分期模型的敏感性、特异性和可信度：一项病例系列研究。

最近的一项德尔福研究发现，专家一致认为，临床分期（CS）可以为老年人人格障碍（pd）的评估提供一个有效的框架（Conjaerts et al., 2025）。目前用于评估pd的分类模型不太适合治疗选择，在老年人中更是如此，因为在开发过程中没有考虑到年龄特异性因素。本研究以人格功能水平和人格病理终生病程作为分析指标，探讨了最近提出的CS模型的互译信度、敏感性和特异性。临床影像反映PD的不同阶段。35名国际专家临床医生在老年PD领域提出了三个小插曲，并要求分配PD的临床阶段。信度较好(κ = 0.86；95% ci: 0.79-0.94)。模型的总灵敏度（0.80）和特异度（0.93）较好。第2、3和4期的敏感性非常好（分别为0.92、0.85和0.85），而第1期的敏感性不足（0.60）。总体上令人满意的信度、敏感性和特异性表明CS可能是一种有效可靠的评估老年人pd的新方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of personality assessment Multiple-

CiteScore

7.20

自引率

8.80%

发文量

期刊介绍： The Journal of Personality Assessment (JPA) primarily publishes articles dealing with the development, evaluation, refinement, and application of personality assessment methods. Desirable articles address empirical, theoretical, instructional, or professional aspects of using psychological tests, interview data, or the applied clinical assessment process. They also advance the measurement, description, or understanding of personality, psychopathology, and human behavior. JPA is broadly concerned with developing and using personality assessment methods in clinical, counseling, forensic, and health psychology settings; with the assessment process in applied clinical practice; with the assessment of people of all ages and cultures; and with both normal and abnormal personality functioning.