Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.1590/2237-6089-2017-0038
Trends in Psychiatry and Psychotherapy
Original Article

Investigation of the clinical functioning of the Dimensional Clinical Personality Inventory 2 criticism avoidance dimension

Investigação do funcionamento clínico da dimensão evitação a críticas do Inventário Dimensional Clínico da Personalidade 2

Lucas de Francisco Carvalho; Catarina Possenti Sette; Fabiano Koich Miguel

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Abstract

Abstract Objective: To investigate the clinical functioning of the criticism avoidance dimension from the Dimensional Clinical Personality Inventory 2 (Inventário Dimensional Clínico da Personalidade 2 [IDCP-2]), establishing a clinically relevant cut-off for the typical traits of avoidant personality disorder (AvPD) for screening purposes. Methods: We administered the IDCP-2 to a sample of 2,276 subjects aged 18 to 90 years (mean = 26.95, standard deviation = 9.71). Of the total sample, 1,650 were women (67%) and most were college students (72.7%). The sample was divided into psychiatric patients diagnosed with other personality disorders (PDs) (n = 53), patients diagnosed with AvPD without comorbidities (n = 10), patients with AvPD with comorbidities (n=42) and those without a known diagnosis of PD (nonpsychiatric patients; n=2,171). Results: We checked for psychometric properties, assessed the adequacy of psychometric assumptions, and proceeded to focus analyses. The Wright item-person map showed the predominance of patients with AvPD in high levels of the scale. Analysis of variance (ANOVA) post hoc comparisons pointed to significant and expressive differences for almost all the comparisons; in the receiver operating characteristic (ROC) curve, we observed a sensitivity of 79% and a specificity of 87%. Conclusion: We found a suitable cut-off for the dimension, and results suggest that the dimension may help clinicians discriminate between patients with and without high levels in the symptoms of AvPD.

Keywords

Personality assessment, personality disorders, DSM, mental disorders

Resumo

Resumo Objetivo: Investigar o funcionamento clínico da dimensão evitação a críticas do Inventário Dimensional Clínico da Personalidade 2 (IDCP-2), estabelecendo um ponto de corte relevante para traços típicos do transtorno da personalidade evitativa (avoidant personality disorder - AvPD), para finalidade de triagem. Métodos: Nós aplicamos o IDCP-2 em uma amostra de 2.276 pessoas com idade entre 18 e 90 anos (média=26,95; desvio padrão=9,71). Dessa amostra, 1.650 eram mulheres (67%) e a maioria era de universitários (72,7%). A amostra foi dividida em pacientes psiquiátricos com outros transtornos de personalidade (PD; n = 53), pacientes com AvPD sem comorbidades (n = 10), pacientes com AvPD com comorbidades (n=42) e aqueles sem diagnóstico conhecido de PD (pacientes não psiquiátricos; n=2.171). Resultados: Foram verificadas as propriedades psicométricas, investigando a adequação dos pressupostos psicométricos, e então procedemos às análises principais. O mapa Wright de itens-pessoas mostrou a predominância de pacientes com AvPD nos níveis mais altos da escala. Análises post hoc, pela análise de variância (ANOVA), apontou para diferenças significativas e expressivas para quase todas as comparações; na curva ROC, nós observamos sensibilidade de 79% e especificidade de 87%. Conclusão: Foi encontrado um ponto de corte adequado para a dimensão, e os resultados sugerem que a dimensão pode auxiliar clínicos a discriminar pacientes com elevação nos traços do AvPD de pacientes sem elevação nesses traços.

Palavras-chave

Avaliação da personalidade, transtornos da personalidade, DSM, transtornos mentais

References

Torgersen S. Prevalence, sociodemographics, and functional impairment. Essentials of personality disorders. 2009:83-102.

Stuart S, Pfohl B, Battaglia M, Bellodi L, Grove W, Cadoret R. The co-occurrence of DSM-III-R personality disorders. J Pers Disord. 1998;12:302-15.

McGlashan TH, Grilo CM, Skodol AE, Gunderson JG, Shea MT, Morey LC. The Collaborative Longitudinal Personality Disorders Study: baseline Axis I/II and II/II diagnostic cooccurrence. Acta Psychiatr Scand. 2000;102:256-64.

Zimmerman M, Rothchild L, Chelminski I. The prevalence of DSM-IV personality disorders in psychiatric outpatients. Am J Psychiatry. 2005;162:1911-8.

Hummelen B, Wilberg T, Pedersen G, Karterud S. An investigation of the validity of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition avoidant personality disorder construct as a prototype category and the psychometric properties of the diagnostic criteria. Compr Psychiatry. 2006;47:376-83.

Torgersen S, Kringlen E, Cramer V. The prevalence of personality disorders in a community sample. Arch Gen Psychiatry. 2001;58:590-6.

Widiger TA. A shaky future for personality disorders. Personal Disord. 2011;2:54-7.

Diagnostic and Statistical Manual of Mental Disorders 5. 2013.

Krueger RF, Derringer J, Markon KE, Watson D, Skodol AE. Initial construction of a maladaptive personality trait model and inventory for DSM-5. Psychol Med. 2011;8:1-12.

Carvalho LF, Primi R. Manual técnico do Inventário Dimensional Clínico da Personalidade-2 (IDCP-2) e versão triagem. 2018.

Diagnostic and Statistical Manual of Mental Disorders. 2003.

Millon T, Davis RD. Disorders of personality: DSM-IV and beyond. 1996.

Millon T, Grossman S. Moderating severe personality disorders. 2007.

Millon T, Grossman S. Overcoming resistant personality disorders. 2007.

Millon T, Grossman S, Tringone R. The Millon Personality Spectrometer: a tool for personality spectrum analyses, diagnoses, and treatments. Disorders of Personality: introducing a DSM/ICD spectrum from normal to abnormal. 2010:391-416.

Carvalho LF, Primi R. Development and internal structure investigation of the Dimensional Clinical Personality Inventory (IDCP). Psicol Reflex Crit. 2015;28:322-30.

Carvalho LF, Primi R, Stone GE. Psychometric properties of the Dimensional Clinical Personality Inventory (IDCP) using the Rating Scale Model. Av Piscol Clin Latinonot. 2014;32:433-46.

Abela RK, Carvalho LDF, Cho SJM, Yazigi L. Validity evidences for the Dimensional Clinical Personality Inventory in outpatient psychiatric sample. Paideia (Ribeirão Preto). 2015;25:221-8.

Carvalho LF, Sette CP. Revision of the criticism avoidance dimension of the Dimensional Clinical Personality Inventory. Estud Psicol (Campinas). 2017;34:219-31.

Millon T. Disorders of personality: Introducing a DSM/ICD spectrum from normal to abnormal. 2011.

Westen D, Shedler J. Revising and assessing Axis II, part I: developing a clinically and empirically valid assessment method. Am J Psychiatry. 1999;156:258-72.

Clark LA. Toward a consensual set of symptom clusters for assessment of personality disorder. Advances in personality assessment. 1990.

Carvalho LF, Arruda W. Revisão da dimensão isolamento do Inventário Dimensional Clínico da Personalidade. Temas Psicol. 2016;24:47-61.

Carvalho LF, Pianowski G. Revision of the dependency dimension of the Dimensional Clinical Personality Inventory. Paideia (Ribeirão Preto). 2015;25:57-65.

Carvalho LF, Pianowski G, Miguel FK. Revision of the aggressiveness dimension of Dimensional Clinical Personality Inventory. Psicol Teor Prat. 2015;17:146-63.

Carvalho LF, Sette CP, Capitão CG, Primi R. Propriedades psicométricas da versão revisada da dimensão necessidade de atenção do Inventário Dimensional Clínico da Personalidade. Temas Psicol. 2014;22:147-60.

Carvalho LF, Silva GC. Review of the self-sacrifice dimension of the Clinical Dimensional Personality Inventory. Psicol Reflex Crit. 2016;29:2-6.

Wolfe EW. Equating and item banking with the Rasch model. J Appl Meas. 2000;1:409-34.

Wright BD, Masters GN. Rating scale analysis. 1982.

Linacre JM. Winsteps® version 3.72.3 [computer software]. 2011.

Wright BD, Linacre JM. Reasonable mean-square fit values. Rasch Meas Trans. 1994;8:370.

Daniel MH. Behind the scenes: using new measurement methods on the DAS and KAIT. The new rules of measurement: What every psychologist and educator should know. 1999:37-63.

Elliot R, Fox CM, Beltyukova SA, Stone GE, Gunderson J, Zhang X. Deconstructing therapy outcome measurement with Rasch analysis of a measure of general clinical distress: The SCL-90-R. Psychol Assess. 2006;18:359-72.

Linacre JM. Winsteps Rasch measurement computer program. 2009.

Thissen D. Reliability and measurement precision. Computerized adaptive testing: A primer. 2000:159-84.

Skodol AE, Clark LA, Bender DS, Krueger RF, Morey LC, Verheul R. Proposed changes in personality and personality disorder assessment and diagnosis for DSM-5 part I: description and rationale. Personal Disord. 2011;2:4-22.

Braga ACS. Curvas ROC: aspectos funcionais e aplicações [dissertation]. 2000.

Andreoli SB, Blay SL, Mari JJ. Escalas de rastreamento de psicopatologia. Psiquiatr Clin. 1998;25:229-32.

Fletcher RH, Fletcher SW, Wagner EH. Epidemiología clínica: elementos essenciais. 1996.

Carvalho LF, Primi R, Meyer GJ. Application of the Rasch model in measuring personality disorders. Trends Psychiatry Psychother. 2012;34:101-9.

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