the severity indices for personality problems (sipp) questionnaire: a dimensional measurement for...
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The Severity Indices for Personality Problems (SIPP) questionnaire:
A dimensional measurement for theseverity of personality pathology
Helene Andrea (PhD)
Roel Verheul (PhD)
Viersprong Institute for Studies on Personality Disorders (VISPD), Halsteren, the Netherlands
Borderline Congress, Berlin, July 1 2010
Introduction Introduction
Severity Indices for Personality Problems (SIPP)Verheul, Andrea et al, 2008
Recently developed self-report questionnaire Dimensional measurement for severity of personality functioning ->
relevant towards DSM-V Previous research: concurrent validity when comparing PD patients with a
non-clinical population
Also useful as a dimensional instrument withinwithin a clinical population?
Verheul, Andrea et al, Psychol Assessment 2008, 20, 23-34
Objective & method Objective & method
Dimensional measurementof severity
of personality pathology
Facets (subscales) SIPP
Other Indices of severity of
personality pathology
DSM-IV based measurements:- Presence BPD- Number of PDs
- Number of BPD criteria- Cluster A PDs
Is the dimensional assessment of the severity of personality pathology (SIPP)
associated with
other indices of the severity of personality pathology
in a clinical population?
Study Population
SCEPTRE study: N=2078 patients referred to centers offering psychotherapy for personality problems
Structured Interview for DSM-IV Personality (SIDP-IV):
N=379 patients (18%) with BPD - 79.2% female, mean age 30.47 (sd 7.85)- Dimensional scores 16 SIPP facets
SIPPSIPPFacet (subscale)Facet (subscale) DomainDomain
Emotion regulation
Effortful control
Self control
Purposefulness
Enjoyment
Self-respect
Stable self-image
Self-reflexive functioning
Identity integration
Enduring relationships
Intimacy
Feeling recognized
Relational functioning
Aggression regulation
Frustration tolerance
Cooperation
Respect
Social concordance
Responsible industry
Trustworthiness
Responsibility
Website: Website: http://hdl.handle.net/1765/10066
SIPPSIPP
118 items, 16 facets (subscales), 5 higher-order domains
Dimensional measurement of personality severity: Lower score = more maladaptive level of functioning - higher severity Higher score = more adaptive level of functioning – lower severity
Examples
� � � �
Fully disagree Partly disagree Partly agree Fully agree
Item Facet/subscale Domain
I usually have adequate control over my feelings Emotion regulation
Self-control
I can easily accept people the way they are, even whenthey are different
Respect Social concordance
Website: http://hdl.handle.net/1765/10066
Publication: Verheul, Andrea et al (2008). Psychol Assessment, 20, 23-34
ResultsSIPP facets and BPD diagnosis
1,75
2
2,25
2,5
2,75
3
3,25
Self res
pect
*
Stable
self-
imag
e *
Self-re
fl. Fu
nctio
ning
*
Enjoym
ent *
Purpos
efuln
ess *
Emot
.regu
latio
n *
Effortf
ul co
ntrol *
Intim
acy *
End. R
elatio
nships
*
Feelin
g reco
gnized
*
Resp. in
dustry
*
Trustw
orth
ines
s *
Aggr. R
egula
tion
*
Frustr
. Toler
ance
*
Cooper
ation
*
Respec
t *
No BPD (n=1699; 82%) BPD (n=379; 18%)
BPD diagnosis =BPD diagnosis =
SIPP-scores more SIPP-scores more maladaptivemaladaptive
Within the BPD population: SIPP scores associated with number of PDs?
# BPD criteria
Cluster A PDsComparable pattern
1,75
2
2,25
2,5
2,75
3
Self re
spec
t *
Stable
self-
imag
e *
Self-re
fl. Fun
ction
ing
Enjoym
ent *
Purpo
sefu
lness
*
Emot
.regu
lation
*
Effortf
ul co
ntro
l
Intim
acy *
End. R
elatio
nship
s *
Feelin
g re
cogn
ized
*
Resp.
indu
stry
Trustw
orth
iness
Aggr.
Regula
tion
Frustr
. Tole
ranc
e *
Coope
ratio
n *
Respe
ct
1-3 PDs (n=263; 69%) At least 4 PDs (n=116; 31%)
Associations between SIPPAssociations between SIPPand DSM-IV severity Indices and DSM-IV severity Indices
for 10 (out of 16) facetsfor 10 (out of 16) facets
Results (modestly) in support of the SIPP as a useful instrument for the dimensional assessment of severity among BPD-patients
However…. Contrast within BPD-patients smaller than
between BPD and non-BPD-patients SIPP specific and sensitive enough??
Discussion (1)Discussion (1)
Transition: DSM-IV -> DSM-V
Proposal DSM-V: Indicate level of personality functioning for a patient on the “Self
and Interpersonal Functioning Continuum” “Self”: Identity integration, Integrity of Self concept, Self-directnedness
“Interpersonal”: Empathy, Intimacy, Cooperativeness, Complexity, Integration of representations of others
5 levels: No/Mild/Moderate/Serious/Extreme Impairment
How are SIPP-scores related to this continuum? Dimensional scores and/or cut-off scores? Specificity & sensitivity?
Further researchFurther research
Availability of the SIPPAvailability of the SIPP
Diagnostic version: 118 items, 16 facets, 5 domainsOutcome version (SIPP-SF): 60 items, 5 domains
Available in Dutch, English, Norwegian, Spanish and Italian In exchange for research data
Websites: www.vispd.nl (click on heading sipp-main menu; five subpages)
http://hdl.handle.net/1765/10066
Email:[email protected]