Diagnostic accuracy of DSM-5 borderline personality disorder criteria: Toward an optimized criteria set
| Autor: | Jon G. Allen, J. Christopher Fowler, William H. Orme, Marianne Millen Carlson, John M. Oldham, B. Christopher Frueh, Alok Madan |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Diagnostic accuracy behavioral disciplines and activities DSM-5 03 medical and health sciences 0302 clinical medicine Borderline Personality Disorder mental disorders Humans Mass Screening Medicine Set (psychology) Borderline personality disorder Receiver operating characteristic business.industry Fear medicine.disease Personality disorders 030227 psychiatry Diagnostic and Statistical Manual of Mental Disorders Psychiatry and Mental health Clinical Psychology Impulsive Behavior business 030217 neurology & neurosurgery Clinical psychology |
| Zdroj: | Journal of Affective Disorders. 279:203-207 |
| ISSN: | 0165-0327 |
| Popis: | The polythetic system used by the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) for diagnosing borderline personality disorders (BPD) is far from optimal; however, accumulated research and clinical data are strong enough to warrant ongoing utilization. This study examined diagnostic efficiency of the nine DSM-IV BPD criteria, then explored the feasibility of an optimized criteria set in classifying BPD.Adults (N=1,623) completed the Structured Clinical Interviews for DSM-IV Axis II Disorders resulting in a BPD group (n=352) and an inpatient psychiatric control group (PC) with no personality disorders (n=1,271). Receiver operator characteristics and diagnostic efficiency statistics were calculated to ascertain the relative diagnostic efficiency of each DSM-5 BPD criterion in classifying BPD cases.Affective instability (Criterion 6) evidenced the strongest capacity to differentiate the groups (AUC = .84, SE = .01, p.0001). Abandonment fears (Criterion 1), unstable relationships (Criterion 2), identity disturbance (Criterion 3), impulsivity (Criterion 4), and chronic emptiness (Criterion 7) yielded good-to-moderate discrimination (AUC range = .75-.79). A composite index of these six criteria yielded excellent accuracy (AUC = .98, SE = .002, p.0001), sensitivity (SN=.99), and specificity (SP=.90).The current findings add to evidence that affective instability is a useful gate criterion for screening, and the optimized criteria set evidences equivalent accuracy to the original 9 criteria, with a substantial reduction in estimated heterogeneity (from 256 combinations with the original set to 42 combinations with the optimized set). |
| Databáze: | OpenAIRE |
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