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Complementary approaches to the assessment of personality disorder

The Personality Assessment Schedule and Adult Personality Functioning Assessment compared

Department of Psychiatry, Liverpool University

HAZEL FUDGE, BA

MRC Child Psychiatry Unit, Institute of Psychiatry, London

RICHARD HARRINGTON, FRCPsych

Department of Psychiatry, Manchester University

ANDREW PICKLES, PhD

MRC Child Psychiatry Unit, Institute of Psychiatry, London

MICHAEL RUTTER, FRCPsych

Social, Genetic and Developmental Research Centre, Institute of Psychiatry, London

Declaration of interest J.H. was funded by the Medical Research Council, and R.H. and H.F. by the MacArthur Foundation.

Correspondence: Jonathan Hill, University Child Mental Health, Alder Hey Hospital, Eaton Road, Liverpool L12 2AP

Background Current concepts and measures of personality disorder are in many respects unsatisfactory.

Aims To establish agreement between two contrasting measures of personality disorder, and to compare subject-informant agreement on each. To examine the extent to which trait abnormality can be separated from interpersonal and social role dysfunction.

Method Fifty-six subjects and their closest informants were interviewed and rated independently. Personality functioning was assessed using a modified Personality Assessment Schedule (M-PAS), and the Adult Personality Functioning Assessment (APFA).

Results Subject-informant agreement on the M-PAS was moderately good, and agreement between the M-PAS and the APFA, across and within subjects and informants, was comparable to that for the M-PAS. This was equally the case when M-PAS trait plus impairment scores and trait abnormality scores were used.

Conclusions The M-PAS and the APFA are probably assessing similar constructs. Trait abnormalities occur predominantly in an interpersonal context and could be assessed within that context.

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