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 the severity 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

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Page 1: The Severity Indices for Personality Problems (SIPP) questionnaire: A dimensional measurement for the severity of personality pathology Helene Andrea (PhD)

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

Page 2: The Severity Indices for Personality Problems (SIPP) questionnaire: A dimensional measurement for the severity of personality pathology Helene Andrea (PhD)

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

Page 3: The Severity Indices for Personality Problems (SIPP) questionnaire: A dimensional measurement for the severity of personality pathology Helene Andrea (PhD)

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?

Page 4: The Severity Indices for Personality Problems (SIPP) questionnaire: A dimensional measurement for the severity of personality pathology Helene Andrea (PhD)

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

Page 5: The Severity Indices for Personality Problems (SIPP) questionnaire: A dimensional measurement for the severity of personality pathology Helene Andrea (PhD)

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

Page 6: The Severity Indices for Personality Problems (SIPP) questionnaire: A dimensional measurement for the severity of personality pathology Helene Andrea (PhD)

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

Page 7: The Severity Indices for Personality Problems (SIPP) questionnaire: A dimensional measurement for the severity of personality pathology Helene Andrea (PhD)

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

Page 8: The Severity Indices for Personality Problems (SIPP) questionnaire: A dimensional measurement for the severity of personality pathology Helene Andrea (PhD)

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

Page 9: The Severity Indices for Personality Problems (SIPP) questionnaire: A dimensional measurement for the severity of personality pathology Helene Andrea (PhD)

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)

Page 10: The Severity Indices for Personality Problems (SIPP) questionnaire: A dimensional measurement for the severity of personality pathology Helene Andrea (PhD)

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

Page 11: The Severity Indices for Personality Problems (SIPP) questionnaire: A dimensional measurement for the severity of personality pathology Helene Andrea (PhD)

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]