Problems in developing an instrument for the rapid assessment of personality status.
OBJECTIVE
To assess the validity of a quick assessment instrument (10 minutes) for assessing personality status, the Rapid Personality Assessment Schedule (PAS-R).


METHODS
The PAS-R was evaluated in psychotic patients recruited in one of the centres involved in a multicentre randomised controlled trial of intensive vs standard case management (the UK700 case management trial). Patients were assessed using both a full version of the PAS (PAS-I - ICD version) and the PAS-R. The weighted kappa statistic was used to gauge the (criterion-related) validity of the PAS-R using the PAS-I as the gold standard. Both measure code personality status using a four-point rating of severity in addition to recording individual categories of personality disorder.


RESULTS
One hundred fifty-five (77%) of 201 patients recruited were assessed with both instruments. The weighted kappa statistic was 0.31, suggesting only moderate agreement between the PAS-I and PAS-R instruments under the four-point rating format, and 0.39 for the dichotomous personality disorder/no disorder separation. The sensitivity (64%) and specificity (82%) of the PAS-R in predicting PAS-I personality disorder were as satisfactory as for other screening instruments but still somewhat disappointing, and the PAS-R had an overall diagnostic accuracy of 78%.


CONCLUSIONS
The PAS-R is a quick and rough method of detecting personality abnormality but is not a substitute for a fuller assessment.
Van Horn
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E
Department of Public Mental Health, Division of Neuroscience and Psychological Medicine, Imperial College School of Medicine, Paterson Centre, 20 South Whart Road, London W2 1PD, UK.
Manley
C
C
Leddy
D
D
Cicchetti
D
D
Tyrer
P
P
D000328:Adult; D019090:Case Management; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010552:Personality Assessment / Q000706:statistics & numerical data*; D010554:Personality Disorders / Q000175:diagnosis* / Q000523:psychology / Q000534:rehabilitation; D011594:Psychometrics; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000523:psychology / Q000534:rehabilitation; D015203:Reproducibility of Results; D012559:Schizophrenia / Q000175:diagnosis* / Q000534:rehabilitation; D012565:Schizophrenic Psychology