Hostname: page-component-8448b6f56d-m8qmq Total loading time: 0 Render date: 2024-04-18T23:37:38.926Z Has data issue: false hasContentIssue false

Adult Personality Functioning Assessment (APFA)

An Investigator-Based Standardised Interview

Published online by Cambridge University Press:  02 January 2018

J. Hill*
Affiliation:
Institute of Psychiatry
R. Harrington
Affiliation:
Institute of Psychiatry
H. Fudge
Affiliation:
Institute of Psychiatry
M. Rutter
Affiliation:
MRC Child Psychiatry Unit
A. Pickles
Affiliation:
MRC Child Psychiatry Unit
*
Department of Child and Adolescent Psychiatry, Royal Liverpool Children's Hospital, Alder Hey, Eaton Road, Liverpool L12 2AP

Abstract

The development of an investigator-based standardised interview to assess patterns of specific and general social dysfunction is described. It covers six domains of functioning: work; love relationships; friendships; non-intimate social contacts; negotiations; and everyday coping. Inter-rater reliability was tested by three investigators rating 21 audiotaped interviews, and was shown to be high, with an intraclass correlation of 0.87 for the total score. The pattern of associations between specific and general social dysfunction was examined through determination of sensitivities and specificities and through LISREL modelling. The findings varied across social domains but it was concluded that the total APFA score provided a reasonable measure of general social dysfunction.

Type
Papers
Copyright
Copyright © The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM-III). Washington DC: APA.Google Scholar
Barkto, J. J. & Carpenter, W. T. (1976) On the methods and theory of reliability. Journal of Nervous and Mental Disease, 163, 307317.Google Scholar
Breslau, N. (1987) Inquiring about the bizarre: false positives in diagnostic interview schedule for children (DISC): ascertainment of obsessions, compulsions and psychotic symptoms. Journal of the American Academy of Child Psychology, 26, 639644.CrossRefGoogle ScholarPubMed
Brown, G. W. & Rutter, M. L. (1966) The measurement of family activities and relationships: a methodological study. Human Relations, 19, 241263.CrossRefGoogle Scholar
Clarkin, J., Widiger, T., Frances, A. J., et al (1983) Prototypic typology and the borderline personality disorder. Journal of Abnormal Psychology, 92, 263275 Google Scholar
Cohen, J. (1968) Weighted kappa: nominal scale agreement with provision for scaled disagreement of partial credit. Psychological Bulletin, 70, 213230.Google Scholar
Docherty, J. P., Fibster, S. J. & Shea, T. (1986) Syndrome diagnosis and personality disorder. In American Psychiatric Association Annual Review, Vol. 5 (eds Frances A. J. & Hales R. E.). Washington DC: American Psychiatric Association.Google Scholar
Frances, A. J. & Widiger, T. (1986) The classification of personality disorders: an overview of problems and solutions. In American Pyschiatric Association Annual Review, Vol. 5 (eds Frances A. J. & Hales R. E.). Washington DC: American Psychiatric Association.Google Scholar
Graham, P. & Rutter, M. (1968) The reliability and validity of the psychiatric assessment of the child. II. Interview with the parent. British Journal of Psychiatry, 114, 581592.Google Scholar
Grayson, D. A. (1987) Can categorical and dimensional views of psychiatric illness be distinguished? British Journal of Psychiatry, 151, 355361.Google Scholar
Harrington, R., Hill, J., Rutter, M., et al (1988) The assessment of lifetime psychopathology: a comparison of two interviewing styles. Psychological Medicine, 18, 487493.CrossRefGoogle ScholarPubMed
John, K. & Weissman, M. M. (1987) The measurement of psychosocial and familial aspects of depression. In The Measurement of Depression: Clinical, Biological, Psychological and Psychosocial Perspectives (eds Marsella A. J., Hirschfdd R. M. A. & Ratz M.), pp. 344375. New York: Guilford Press.Google Scholar
Joreskog, K. G. & Sorbum, D. (1981) LISREL V: Analysis of linear structural relationships by maximum likelihood and least squares methods. Research Report 81–88. University of Uppsala.Google Scholar
Katschnig, H. (1983) Methods for measuring social adjustment. In Methodology in Evaluation of Psychiatric Treatment (ed. Helgason T.), pp. 205218. New York: Cambridge University Press.Google Scholar
Le Couteur, M., Rutter, M., Lord, C., et al (1989) Autism diagnostic interview: a standardized investigator-based instrument. Journal of Autism and Developmental Disorders (in press).Google Scholar
Lewis, A. J. (1953) Health as a social concept. British Journal of Sociology, 4, 109124.Google Scholar
Mann, A. H., Jenkins, R., Cutting, J. C., et al (1981) The development and use of a standardized assessment of abnormal personality. Psychological Medicine, 11, 839847.Google Scholar
Mellsop, G., Varghese, F., Joshua, S., et al (1982) The reliability of axis 2 of DSM-III. American Journal of Psychiatry, 139, 13601361.Google Scholar
Merikangas, K. & Weissman, M. M. (1986) Epidemiology of DSM-III Axis II: personality disorders. In American Psychiatric Association Annual Review, Vol. 5. (eds Frances A. J. & Hales R. E.), pp. 258278. Washington DC: American Psychiatric Association.Google Scholar
Quinton, D. & Rutter, M. (1988) Parenting Breakdown: The Making or Breaking of Intergenerational Links. Aldershot: Gower Publishing.Google Scholar
Quinton, D., Rutter, M. & Gulliver, L. (1989) The social functioning in early adulthood of the children of psychiatric patients. In Straight and Devious Pathways From Childhood to Adulthood (eds Robins L. N. & Rutter M.). New York: Cambridge University Press (in press).Google Scholar
Reich, J. (1985) Measurement of DSM–III, Axis II. Comprehensive Psychiatry, 26, 352363.CrossRefGoogle ScholarPubMed
Robins, L. N. (1966) Deviant Children Grown Up. Baltimore: Williams and Wilkins.Google Scholar
Robins, L. N. (1978) Sturdy childhood predictors of adult antisocial behaviour: replications from longitudinal studies. Psychological Medicine, 8, 611622.CrossRefGoogle ScholarPubMed
Robins, L. N. (1986) The consequences of conduct disorder in girls. In Development of Antisocial and Prosocial Behavior: Research, Theories and Issues (eds Olweus D., Block J. & Radke-Yarrow M.), pp. 385414. New York: Academic Press.Google Scholar
Rutter, M. (1966) Children of Sick Parents: An Environmental and Psychiatric Study. Institute of Psychiatry Maudsley Monograph No 16. London: Oxford University Press.Google Scholar
Rutter, M. (1977) Prospective studies to investigate behavioural change. In The Origins and Course of Psychopathology (eds Strauss J. S., Babigian H. M. & Roff M.), pp. 223247. New York: Plenum Publishing.CrossRefGoogle Scholar
Rutter, M. (1984) Psychopathology and development. I. Childhood antecedents of adult psychiatric disorder. Australian and New Zealand Journal of Psychiatry, 18, 225234.CrossRefGoogle ScholarPubMed
Rutter, M. (1987a) Temperament personality and personality disorder. British Journal of Psychiatry, 150, 443458.Google Scholar
Rutter, M. (1987b) Parental mental disorder as a psychiatric risk factor. In American Psychiatric Association Annual Review, Vol. 6 (eds Hales R. E. & Frances A. J.). Washington DC: American Psychiatric Association.Google Scholar
Rutter, M. & Brown, G. W. (1966) The reliability and validity of measures of family life and relationships in families containing a psychiatric patient. Social Psychiatry, 1, 3853.Google Scholar
Rutter, M. & Quinton, D. (1984a) Parental psychiatric disorder: Effect on children. Psychological Medicine, 14, 853880.CrossRefGoogle ScholarPubMed
Rutter, M. & Quinton, D. (1984b) Long-term follow-up of women institutionalized in childhood: factors promoting good functioning in adult life. British Journal of Developmental Psychology, 2, 191204.Google Scholar
Rutter, M. & Gould, M. (1985) Classification. In Child and Adolescent Psychiatry: Modern Approaches (2nd edn) (eds Rutter M. & Hersov L.) pp. 304321. Oxford: Blackwell Scientific.Google Scholar
Rutter, M. & Pickles, A. (1989) Improving the quality of psychiatric data: classification, cause and course. In Methodological Issues in Longitudinal Research I: Data and General Designs (ed Magnusson D.). Cambridge: Cambridge University Press (in press).Google Scholar
Rutter, M., Quinton, D. & Hill, J. (1989) The effects of an institutional rearing on social functioning in early adult life in men and women. In Straight and Devious Pathways from Childhood to Adulthood (eds Robins L. N. and Rutter M.). Cambridge: Cambridge University Press (in press).Google Scholar
Siever, L. J. & Klar, H. (1986) A review of DSM-III criteria for the personality disorders. In American Psychiatric Association Annual Review, Vol. 5 (eds Frances A. J. & Hales R. E.), pp. 279314. Washington DC: American Psychiatric Association.Google Scholar
Stangl, D., Pfohl, B., Zimmerman, M., et al (1985) A structured interview for the DSM–III personality disorders: a preliminary report. Archives of General Psychiatry, 42, 591596.Google Scholar
Sturt, E. & Wykes, T. (1987) Assessment schedules for chronic psychiatric patients. Psychological Medicine, 17, 485494.Google Scholar
Tarnopolsky, A. & Berelowitz, M. (1967) Borderline personality: a review of recent research. British Journal of Psychiatry, 151, 724734.Google Scholar
Tyrer, P. & Ferguson, B. (1987) Problems in the classification of personality disorder. Psychological Medicine, 17, 1520.Google Scholar
Tyrer, P., Alexander, M. S., Cicchetti, D., et al (1979) Reliability of a schedule for rating personality disorder. British Journal of Psychiatry, 135, 168174.Google Scholar
Tyrer, P., Cicchetti, D. V., Casey, R. R., et al (1984) Cross-national reliability study of a schedule for assessing personality disorders. Journal of Nervous and Mental Disease, 172, 718721.Google Scholar
Weissman, M. M. (1975) The assessment of social adjustment: a review of techniques. Archives of General Psychiatry, 32, 357365.Google Scholar
Weissman, M. M., Sholomskas, D. & John, K. (1981) The assessment of social adjustment: an update. Archives of General Psychiatry, 38, 12501258.CrossRefGoogle ScholarPubMed
World Health Organization (1978) International Classification of Diseases (9th revision). Geneva: WHO.Google Scholar
Zeitlin, H. (1986) The Natural History of Disorder in Childhood. Institute of Psychiatry Maudsley Monograph No 29. London: Oxford University Press.Google Scholar
Zoccolillo, M., Rutter, M., Quinton, D., et al (1989) The outcome of conduct disorder: implications for defining adult personality disorders (in preparation).Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.