Skip to main content
Search
Search
    Quick Search anywhere
    Quick search in Citations
Advanced Search
Skip main navigationClose Drawer MenuOpen Drawer Menu
Previous article
Next article
Originalarbeit

Diagnostik von Persönlichkeitsstörungen im Jugendalter nach SKID-II

Published Online:March 24, 2008https://doi.org/10.1024/1422-4917.36.2.117

Abstract

Zusammenfassung:Fragestellung: Ziel der vorliegenden Untersuchung war eine Überprüfung der Anwendbarkeit des Strukturierten Klinischen Interviews für DSM-IV, Achse II: Persönlichkeitsstörungen (SKID-II) im Jugendalter sowie eine Untersuchung zur Übereinstimmung zwischen SKID-II Diagnosen und klinischem Urteil. Zusätzlich wurde der Frage nachgegangen, welche Faktoren bei Patientinnen einer jugendpsychiatrischen Inanspruchnahmepopulation Persönlichkeitsstörungen (PS) prognostizieren. Methodik: Insgesamt wurden 110 stationär behandelte, jugendpsychiatrische Patienten im Alter von 14-18 Jahren mit dem SKID-II und dem Persönlichkeitsstil- und Störungsinventar (PSSI) untersucht. Ergebnisse: 32.7% der untersuchten Patienten zeigten nach SKID-II die Diagnose einer PS. Die Übereinstimmung zwischen kategorialem Urteil (PS liegt vor versus PS liegt nicht vor) des SKID-II und der klinischen Diagnose erwies sich insgesamt als niedrig. Lediglich für die histrionische PS und für die Borderline-PS ergaben sich annehmbare bis sehr gute Übereinstimmungen. Logistische Regressionsanalysen identifizierten «Anorexia nervosa (bulimisch)», «einfache Aktivitäts- und Aufmerksamkeitsstörung/Störung des Sozialverhaltens (ADHD/SSV)» und «Schicht» als relevante prognostische Faktoren für PS. Schlussfolgerungen: Das SKID-II, das primär für Erwachsene entwickelt wurde, ist für den Gebrauch bei Jugendlichen gut einsetzbar. Im jugendpsychiatrischen Bereich sind die Diagnosen Anorexia nervosa (bulimisch) und ADHD/SSV eng mit der Entwicklung einer PS assoziiert.


Diagnostic of personality disorders in adolescence according to SCID-II

Summary:Objectives: The aim of the present study was to ascertain whether the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II) is applicable for use with adolescents. Furthermore, the diagnostic concordance between SCID-II and the clinicians’ estimations of personality disorders (PD) is assessed. In addition, we identified predicting factors for personality disorders in adolescent psychiatric inpatients. Methods: 110 adolescent psychiatric inpatients aged 14-18 years were assessed by means of SCID-II and a personality and disorder inventory (PSSI). Results: 32.7% of the inpatients met the criteria for PD according to SCID-II. While agreement between the presence of any PD based on SCID-II and that found according to clinicians’ estimations was low, moderate and very good agreement between SCID-II and clinicians’ estimations was found with regard to borderline PD and histrionic PD. Logistic regression analyses identified “anorexia nervosa (binge-purging)”, “attention-deficit/hyperactivity disorder/conduct disorder (ADHD/CD)” and “socioeconomic status” as good predictors for PD. Conclusions: The SCID-II - which was primarily developed for use with adults - is suitable for use among adolescents. Anorexia nervosa (binge-purging type) and ADHD/CD are closely associated with the development of PD in adolescents.

Literatur

  • Adam, A. , Peters, M. (2003). Störungen der Persönlichkeitsentwicklung bei Kindern und Jugendlichen. Stuttgart: Kohlhammer First citation in articleGoogle Scholar

  • Arntz, A. , van Beijsterveldt, B. , Hoekstra, R. , Hofman, A. , Eussen, M. , Sallaerts, S. (1992). The interrater reliability of a dutch version of the structured clinical interview for DSM-III-R personality disorders. Acta Psychiatrica Scandinavia, 85, 394– 400 First citation in articleCrossref Medline, Google Scholar

  • Bernstein, D. P. , Cohen, P. , Velez, C. N. , Schwab-Stone, M. , Siever, L. J. , Shinsato, L. (1993). revalence and stability of DSM-III-R personality disorder in a community-based survey of adolescents. American Journal of Psychiatry, 150, 1237– 1243 First citation in articleCrossref Medline, Google Scholar

  • Bienvenu, O. J. , Stein, M. B. (2003). Personality and anxiety disorders: a review. Journal of Personality Disorders, 17, 2 139– 151 First citation in articleCrossref, Google Scholar

  • Bradley, R. , Zittel Conklin, C. , Westen, D. (2005). The borderline personality diagnosis in adolescents: gender differences and subtypes. Journal of Child Psycholology and Psychiatry, 46, 9 1006– 1019 First citation in articleCrossref, Google Scholar

  • Braun-Scharm, H. , Kieninger, S. , Wienecke, S. (2000). Persönlichkeitsstörungen im Jugendalter (1). Eine Pilotstudie zur Klassifikation und Frühverlauf. Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie, 28, 1 5– 15 First citation in articleAbstract, Google Scholar

  • Brunner, R. , Parzer, P. , Resch, F. (2001). Dissoziative Symptome und traumatische Lebensereignisse bei Jugendlichen mit einer Borderline-Störung. Persönlichkeitsstörungen, 5, 4– 12 First citation in articleGoogle Scholar

  • Cassin, S. E. , von Ranson, K. M. (2005). Personality and eating disorders: a decade in review. Clinical psychology review, 25, 7 895– 916 First citation in articleCrossref, Google Scholar

  • Chanen, A. M. , Jovev, M. , Jackson, H. J. (2007). Adaptive functioning and psychiatric symptoms in adolescents with borderline personality disorder. Journal of Clinical Psychiatry, 68, 2 297– 306 First citation in articleCrossref, Google Scholar

  • Chanen, A. M. , Jackson, H. J. , McGorry, P. D. , Allot, K. A. , Pan Yuen, H. (2004). Two-year stability of personality disorder in older adolescent outpatients. Journal of Personality Disorder, 18, 526– 541 First citation in articleCrossref, Google Scholar

  • Durret, C. , Westen, D. (2005). The Structure of Axis II disorders in adolescents: a cluster- and factor-analytic investigation of DSM-IV categories and criteria. Journal of Personality Disorders, 19, 4 440– 461 First citation in articleCrossref, Google Scholar

  • Ekselius, L. , Eriksson, M. , von Knorring, L. , Linder, J. (1997). Comorbidity of personality disorders and major depression in patients with somatoform pain disorders or medical illnesses with long-standing work disability. Scandinavian Journal of Rehabilitation Medicine, 29, 2 91– 96 First citation in articleGoogle Scholar

  • First, M. B. , Gibbon, M. , Spitzer, R. L. , Williams, J. B. , Benjamin, L. S. (1997). User’s guide for the structured clinical interview for DSM-IV AXIS II personality disorders. Washington DC: American Psychiatric Press First citation in articleGoogle Scholar

  • First, M. B. , Spitzer, R. L. , Gibbon, M. , Williams, J. B. W. , Davies, M. , Borus, J. , Howes, M. J. , Kane, J. , Pope, H. G. , Rounsaville, B. (1995). The structured clinical interview for DSM-III-R Personality Disorders (SCID-II), Part II: Multi-site test retest reliability disorders. Journal of Personality Disorders, 9, 92– 104 First citation in articleCrossref, Google Scholar

  • Fischer, M. , Barkley, R. A. , Smallish, L. , Fletcher, K. (2002). Young adult follow-up of hyperactive children: self-reported psychiatric disorders, comorbidity, and the role of childhood conduct problems and teen CD. Journal of abnormal child psychology, 64, 22– 81 First citation in articleGoogle Scholar

  • Fleiss, J. L. (1981). Statistical methods for rates and proportions. New York: Wiley First citation in articleGoogle Scholar

  • Franke, G. H. (1995). Die Symptom-Checkliste von Derogatis. Göttingen: Beltz First citation in articleGoogle Scholar

  • Fridell, M. , Hesse, M. (2006). Clinical Diagnosis and SCID-II Assessment of DSM-III-R Personality Disorders. European Journal of Psychological Assessment, 22, 2 104– 108 First citation in articleLink, Google Scholar

  • Fydrich, T. , Renneberg, B. , Schmitz, B. , Wittchen, H. U. (1997). Strukturiertes Klinisches Interview für DSM-IV Achse II: Persönlichkeitsstörungen. Göttingen: Hogrefe First citation in articleGoogle Scholar

  • Fydrich, T. , Schmitz, B. , Hennsch, C. , Bodem, M. (1996). Zuverlässigkeit und Gültigkeit diagnostischer Verfahren zur Erfassung von Persönlichkeitsstörungen. In: B. Schmitz, T. Fydrich, K. Limbacher. Persönlichkeitsstörungen: Diagnostik und Psychotherapie (S. 91-113). Weinheim: Psychologie Verlags Union First citation in articleGoogle Scholar

  • Fydrich, T. , Schmitz, B. , Dietrich, G. , Heinicke, S. , König, J. (1996). Prävalenz und Komorbidität von Persönlichkeitsstörungen. In: B. Schmitz, T. Fydrich, K. Limbacher. Persönlichkeitsstörungen: Diagnostik und Psychotherapie (S.50-90). Weinheim: Psychologie Verlags Union (S. 56-90) First citation in articleGoogle Scholar

  • Garnet, K. E. , Levy, K. N. , Mattanah, J. F. , Edell, W.S. , McGlashan, T. H. (1994). Borderline personality disorder in adolescents: Ubiquitous or specific?. American Journal of Psychiatry, 151, 1380– 1382 First citation in articleCrossref Medline, Google Scholar

  • Grant, B. F. (2004). Prevalence, correlates and disability of personality disorder in the United States: results from the national epidemiologic survey on alcohol and related conditions. Journal of Clinical Psychiatry, 65, 7 948– 958 First citation in articleCrossref, Google Scholar

  • Grilo, C. M. , McGlashan, T. H. , Quinlan, D. M. , Greenfield, D. , Edell, W. S. (1998). American Journal of Psychiatry, 155, 140– 142 First citation in articleCrossref Medline, Google Scholar

  • Grilo, C. M. (1996). Comorbidity of DSM-III-R axis I and II disorders among female inpatients with eating disorders. Psychiatric Services, 47, 426– 429 First citation in articleCrossref Medline, Google Scholar

  • Grilo, C. M. , Becker, D. F. , Walker, M. L. , Levy, K. N. , Edell, W.S. , McGlashan, T. H. (1995). Comorbidity of adolescent substance users. Journal of American Academy of Child and Adolescent Psychiatry, 34, 1085– 1091 First citation in articleCrossref Medline, Google Scholar

  • Herkov, M. J. , Blashfield, R. K. (1995). Clinician diagnoses of personality disorders: evidence of a hierarchical structure. Journal of Personality Assessment, 65, 313– 321 First citation in articleCrossref Medline, Google Scholar

  • Herpertz, S. C. , Herpertz-Dahlmann, B. (2003). Temperament und Persönlichkeit. In: B. Herpertz-Dahlmann, F. Resch, M. Schulte-Markwort, A. Warnke, (Ed.), Entwicklungspsychiatrie, 151-162. Stuttgart: Schattauer First citation in articleGoogle Scholar

  • Herpertz, S. , Steinmeyer, E. M. , Saß, H. (1994). «Patterns of comorbidity» among DSM-III-R and ICD-10 personality disorder as observed with a new inventory for the assessment of personality disorders. European Archives of Psychiatry and Clinical Neuroscience, 244, 161– 169 First citation in articleCrossref Medline, Google Scholar

  • Hyler, S. E. , Skodol, A. E. , Kellmann, H. D. , Oldham, J. M. , Rosnik, L. (1990). Validity of the Personality Disorder Questionnaire - Revised: Comparison with two structured interviews. American Journal of Psychiatry, 147, 1043– 1048 First citation in articleCrossref Medline, Google Scholar

  • Johnson, J. G. , Cohen, P. , Kasen, S. , Skodol, A. E. (1999). Personality disorders in adolescence and risk of major mental disorders and suicidality during adulthood. Archieves of General Psychiatry, 56, 805– 822 First citation in articleCrossref Medline, Google Scholar

  • Krischer, M. , Sevecke, K. , Döpfner, M. , Lehmkuhl, G. (2006). Persönlichkeitsstörungsmerkmale im Kindes- und Jugendalter: Konzepte, methodische Ansätze und empirische Ergebnisse. Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie, 34, 87– 100 First citation in articleLink, Google Scholar

  • Kuhl, J. , Kazén, M. (1997). Persönlichkeits-, Stil- und Störungs-Inventar (PSSI). Göttingen: Hogrefe First citation in articleGoogle Scholar

  • Kutcher, S. P. , Marton, P. , Korenblum, M. (1990). Adolescent bipolar illness and personality disorder. Journal of American Academy of Child and Adolescent Psychiatry, 29, 355– 358 First citation in articleCrossref Medline, Google Scholar

  • Leibling, E. , Doering, S. (2006). Diagnostik von Persönlichkeitsstörungen. Schulen übergreifende, praxisorientierte Perspektive. Psychotherapeut, 51, 229– 244 First citation in articleCrossref, Google Scholar

  • Levy, K. N. (1999). Concurrent and predictive validity of the personality disorder diagnosis in adolescent patients. American Journal of Psychiatry, 156, 1522– 1528 First citation in articleCrossref Medline, Google Scholar

  • Loeber, R. , Farrington, D. P. , Stouthammer-Loeber, M. , Moffitt, T. E. , Caspi, A. , Lynam, D. (2001). Male mental health problems, psychopathy, and personality traits: key findings from the first 14 years of the Pittsburgh Youth Study. Clinical Child and Family Psychological Review, 4, 273– 297 First citation in articleCrossref Medline, Google Scholar

  • Loranger, A. , Sartorius, N. , Andreoli, A. , Berner, W. , Buchheim, P. , Channabasavanna, S. M. , Coid, B. , Dahl, A. et al. (1994). IPDE. The International Personality Disorder Examination: The WHO/ADAMHA International Pilot Study of Personality Disorders. Archives of General Psychiatry, 51, 215– 224– First citation in articleCrossref Medline, Google Scholar

  • Matsunaga, H. , Kiriike, N. , Nagata, T. A. , Yamagami, S. (1998). Personality disorder in patients with eating disorders in Japan. International Journal of Eating Disorder, 23, 399– 408 First citation in articleCrossref Medline, Google Scholar

  • Nigg, J. T. , John, O. P. , Blaskey, L. G. , Huang-Pollock, C. L. , Willcutt, E. G. , Hinshaw, S. P. , Pennington, B. (2002). Big five dimensions and ADHD Symptoms links between personality traits and clinical symptoms. Journal of Personality and Social Psychology, 8, 451– 469 First citation in articleCrossref, Google Scholar

  • Renneberg, B. , Chambless, D. L. , Dowdall, D. J. , Fauerbach, J. A. , Gracely, E. J. (1992). The Structured Clinical Interview for DSM-III-R Axis II and the Millon Clinical Multiaxial Inventory: A concurrent validity study of personality disorder among agoraphobic outpatients. Journal of Personality Disorders, 6, 117– 124 First citation in articleCrossref, Google Scholar

  • Rey, J. M. , Morris-Yates, A. , Singh, M. , Andrews, G. , Stewart, G. W. (1995). Continuities between psychiatric disorders in adolescents and personality disorders in young adults. American Journal of Psychiatry, 152, 895– 900 First citation in articleCrossref Medline, Google Scholar

  • Rogers, R. (2003). DSM-IV diagnoses: The clinical applications of structured interviews. Journal of Personality Assessment, 81, 220– 225 First citation in articleCrossref Medline, Google Scholar

  • Rossi, A. , Marinageli, M. G. , Butti, G. , Scito, A. , Di Cicco, L. , Kalyvoka, A. , Petruzzi, C. (2001). Personality disorders in bipolar and depressive disorders. Journal of Affective Disorders, 65, 1 3– 8 First citation in articleCrossref, Google Scholar

  • Schiavone, P. , Dorz, S. , Conforti, D. , Scarso, C. , Borgherini, G. (2004). Comorbidity of DSM-IV Personality Disorders in unipolar and bipolar affective disorders. Psychological Reports, 95, 1 121– 128 First citation in articleGoogle Scholar

  • Serman, N. , Johnson, J. G. , Geller, P. A. , Kanost, R. E. , Zacharapoulou, H. (2002). Personality disorders associated with substance use among American and greek adolescents. Adolescence, 37, 841– 854 First citation in articleMedline, Google Scholar

  • Sourander, A. , Aromaa, M. , Philakoski, L. , Haavisto, A. , Rautava, P. , Helenius, H. , Sikkanpä, M. (2006). Early predictors of deliberate self-harm among adolescents. A prospective follow-up study from age 3 to age 15. Journal of Affective Disorders, 93, 86– 96 First citation in articleCrossref, Google Scholar

  • Tewes, U. , Rossmann, P. , Schallberger, U. (2000). HAWIK-III. Hamburg-Wechsler Intelligenztest für Kinder, 3. ed.. Bern: Huber First citation in articleGoogle Scholar

  • Weiß, R. H. (2006). CFT 20-R. Grundintelligenztest Skala 2 - Revision - 1. Auflage. Göttingen: Hogrefe First citation in articleGoogle Scholar

  • Weiß, R. H. (1996). CFT 20. Grundintelligenztest Skala 2, 4. ed.. Bern: Huber First citation in articleGoogle Scholar

  • Westen, D. , Shedler, J. , Durrett, C. , Glass, S. , Martens, A. (2003). Personality diagnoses in adolescence: DSM-IV Axis II diagnosis and an empirically derived alternative. American Journal of Psychiatry, 160, 952– 966 First citation in articleCrossref Medline, Google Scholar

  • Westen, D. , Chang, C. M. (2000). Adolescent personality pathology: A review. Adolescent Psychiatry, 25, 61– 100 First citation in articleGoogle Scholar

  • Westen, D. , Shedler, J. (1999). Revising and assessing axis II, Part II: toward an empirically based and clinically useful classification of personality disorders. American Journal of Psychiatry, 156, 2 273– 285 First citation in articleGoogle Scholar

  • Westen, S. , Arkowitz-Westen, L. (1998). Limitations of Axis II in diagnosing personality pathology in clinical practice. American Journal of Psychiatry, 155, 1767– 1771 First citation in articleCrossref Medline, Google Scholar

  • Wewetzer, C. , Herpertz, S. , Herpertz-Dahlmann, B. (2003). Persönlichkeitsstörungen. Dt. Ges. f. Kinder- und Jugendpsychiatrie und Psychotherapie u. a. (Hrsg.): Leitlinien zur Diagnostik und Therapie von psychischen Störungen im Säuglings-, Kindes- und Jugendalter. Deutscher Ärzte Verlag First citation in articleGoogle Scholar

  • Widinger, T. G. , Sanderson, C. J. (1995). Toward a dimensional model of personality disorders. In: Livesley W. J. (Hrsg.): The DSM-IV personality disorders. Guilford Press, New York First citation in articleGoogle Scholar