Transcript Dia 1 - de Viersprong

Severity Indices of Personality
Problems (SIPP-118) as a clinical
instrument
Dineke Feenstra, Helene Andrea and Joost
Hutsebaut
APA Annual Meeting, 2009
San Francisco
Introduction
 Personality development includes the development
of adaptive capacities
 Link between adaptational level and severity of
personality problems
 Lack of instruments measuring adaptive capacities
and change
 SIPP developed and tested in both an adult as an
adolescent population
How to use the SIPP-118?
 Some guidelines for the assessment of personality
pathology:
– Screening for symptoms (SCL-90)
– Semi-structured interviews for axis I and axis II disorders
(SCID I and SCID II)
– Use personality questionnaires (SIPP-118)
– Use if necessary projective tests, like the TAT, Rorschach
etc.
Structure of the SIPP
 Self-report questionnaire;
 Patients are asked to fill in 118 statements about
themselves, referring to the last 3 months
 Example:
I know exactly who I am and what I am worth.
□
□
□
□
Fully
disagree
Partly
disagree
Partly
agree
Fully
agree
Structure of the SIPP
Domains
Facets
Self-control
Emotion regulation
Effortful control
Identity integration
Self respect
Stable self image
Self-reflexive functioning
Enjoyment
Purposefulness
Relational capacities
Intimacy
Enduring relationships
Feeling recognized
Social concordance
Aggression regulation
Frustration tolerance
Cooperation
Respect
Responsibility
Responsible industry
Trustworthiness
Case I
 16-year old adolescent;
 Further information has been omitted because of
privacy reasons.
Case I
 Screening of symptoms:
– Brief symptom inventory (BSI):
• Very high level of symptomatic distress
• Especially fear and depressive symptoms
– Child behavior Checklist (CBCL):
• Parents report both internalizing as well as externalizing problems
Case I
 Semi-structured interviews:
– SCID I:
• Dysthymic disorder
• Panic attacks
• Flashbacks, no PTSD
– SCID II:
• Borderline personality disorder
• Some dependent characteristics
Case I
Domain
Facet
Norm clinical population
Norm general population
Self-control
Emotion regulation
Low
Very low
Effortful control
Low
Very low
Self respect
Low
Very low
Stable self image
Mediate
Very low
Self-reflexive functioning
Mediate
Very low
Enjoyment
Mediate
Very low
Purposefulness
Low
Very low
Intimacy
Low
Very low
Enduring relationships
Mediate
Low
Feeling recognized
Low
Very low
Aggression regulation
Mediate
Very low
Frustration tolerance
Mediate
Low
Cooperation
Mediate
Mediate
Respect
Mediate
Low
Responsible industry
Mediate
Mediate
Trustworthiness
Mediate
Low
Identity integration
Relational functioning
Social concordance
Responsibility
Case I
Domainscores SIPP
Slfc.
100
80
60
40
Resp.
Id.
20
norm patiënt
norm general
0
Soc.
Rel.
Case I
 Conclusion:
– high level of symptoms, not unusual for the classifications
that were found with the interviews;
– very low to low scores on the SIPP, indicating severe
maladaptive personality functioning.
– Further information has been omitted, because of privacy
reasons.
Case II
 24-year old woman;
 Further information has been omitted because of
privacy reasons.
Case II
 Screening of symptoms:
– Brief symptom inventory (BSI):
• High level of symptomatic distress
• Especially obsessive-compulsive symptoms
Case II
 Semi-structured interviews:
– SCID I:
• PTSD
• Symptoms of general anxiety
– SCID II:
• No diagnosis
• But the interviewer is not sure…
Case II
Domain
Facet
Norm clinical population
Norm general population
Self-control
Emotion regulation
High
Mediate
Effortful control
Mediate
Mediate
Self respect
High
Mediate
Stable self image
High
Mediate
Self-reflexive functioning
Mediate
Low
Enjoyment
High
Mediate
Purposefulness
Mediate
Mediate
Intimacy
Mediate
Mediate
Enduring relationships
Mediate
Mediate
Feeling recognized
Mediate
Mediate
Aggression regulation
High
Mediate
Frustration tolerance
Mediate
Mediate
Cooperation
Mediate
Mediate
Respect
Mediate
Mediate
Responsible industry
Mediate
Mediate
Trustworthiness
Mediate
Mediate
Identity integration
Relational functioning
Social concordance
Responsibility
Case II
Domainscores SIPP
Slfc.
100
80
60
40
Resp.
Id.
20
norm patiënt
0
Soc.
norm general
Rel.
Case II
 Conclusion:
– high level of distress.
– the SIPP shows a good profile, suggesting that the
complaints are best explained by the PTSD.
– Further information has been omitted because of privacy
reasons.
Conclusions SIPP
 The SIPP seems to be a promising instrument that
can be used as an outcome tool, but certainly also
as an assessment tool
 The SIPP can be used for adults as well as
adolescents
 The SIPP is best used in combination with other
instruments
 The SIPP can give information about the more
structural characteristics of personality, and
especially about the severity of a disorder.
Contact
 Website:
– www.vispd.nl
– www.deviersprong.nl
 Email:
– [email protected]
– [email protected]
– [email protected]