IPDE - Extranet Systems - World Health Organization

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120 Manual data. If examiners have access to information from family, friends, mental health professionals, records, etc., that clearly contradicts a subject's responses regarding a particular criterion, then they may score the criterion in the informant column provided two requirements are met. Firstly, they should have more confidence in that information than they do in the subject; and secondly, the other source must satisfy the identical scoring guidelines that apply to the subject's response. Later, in entering ratings in the computer or transcribing them from the interview to the scoresheet, the scores based on the subject's report are bypassed in favour of those derived from the informant. While it is necessary to administer the PDE with knowledge of a subject's psychiatric history and current mental state, the examiner should avoid making detailed inquiries about the subject's personality prior to the interview. It is probably not advisable to confront subjects during the interview with discrepancies between their accounts and information obtained from others. Making them aware of the discrepancies could adversely affect rapport, and also create discord between the subject and informant. Examiner qualifications and training The IPDE ICD-l0 Module presupposes a thorough familiarity with the ICD-10 classification system of mental disorders, and considerable training and experience in making psychiatric diagnoses. Like any semistructured clinical interview, its reliability and validity are inseparable from the qualifications and training of the person using it. It is designed for experienced psychiatrists, clinical psychologists, and those with comparable training, who are capable of making independent psychiatric diagnoses without a semistructured inte~ew. It is not intended for use by clinicians in the early phase of their training, or by research assistants, nurses, and medical or graduate students. The first step in training to use the PDE is to study the interview and manual very thoroughly. Before the basics are mastered. the interview should be administered to several subjects primarily to get a 'feel' for it, and to make the instructions in this manual and the scoring guidelines more meaningful. Then the neophyte should examine a series of patients, following the instructions and scoring guidelines as closely as possible. This is best done with a colleague, someone who has already mastered the instrument or is also learning how to use it. These practice interviews should be followed by a critique, and a discussion of any problems in administration and scoring. Most clinicians will feel comfortable with
121 Administration of the IPDE the IPDE and have achieved a basic proficiency after having given about 10 interviews. As they examine more patients, they will find themselves making less use of the guides for questioning and scoring, but occasional reference to them is to be expected even by the seasoned examiner. We strongly recommend that those who wish to obtain the optimal training in the use of the IPDE, enrol1 in the course offered at one of the worldwide WHO training centres. Administration of the IPDE If the interview should take more than one to one and a half hours, there is danger that the examiner will not pursue responses with the same alertness and thomugbness, and that the subject's replies will become briefer and more perfunctory. In those circumstances the interview should be given on more than one occasion, if possible. However, interruptions in the middle of a section should be avoided. The IPDE can only be administered properly when the examiner conducts an adequate clinical examination of the subject with appropriate probing to solicit examples, anecdotes, and additional details. This requires a thorough knowledge of the scope and meaning of each criterion and a corn application of the scoring guidelines. Ultimately. many of these become familiar to examiners, and there is no need townstantly refer to them during the interview. Initial replies of the subject that suggest a positive rating are m ly sufficient for scoring a criterion. They must be supplemented and supposed by convincing descriptions or examples. Examiners must use their clinical judgement to determine the length of the descriptions and the number of examples that are required. When in doubt, they should always ask for more rather than less. However, they should avoid 'leading the witness,' or being influenced by a 'halo' effect. For example, if the subject has already met three of the required four criteria for a diagnosis, the examples regarding a possible fourtb criterion should not be viewed any differently than if the subject had previously not met any criterion. Interviewers should not hesitate to tactfully inquire about apparent contradictions in responses. Although the examiners should score the interview as they go along, they should comt the scoring of an earlier item, when subsequent information elicited during the interview requires it. Recording the subject's responses verbatim is not required, but it can pmvide a permanent record of a considerable amount of useful information, that is not conveyed by diagnoses or dimensional scores alone.
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Until recently, the standardization
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Assessment and diagnosis of persona
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Contents Contributors Preface Annan
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Contributors Dr Antonio Andreoli Ho
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Preface One of the major goals of t
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... Xlll Acknowledgements The IPDE
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Problems in the field of personalit
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5 Problems in the field of PD perso
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7 Problems in the field of PD In DS
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9 Problems in the field of PD cultu
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11 Review of diagnostic instruments
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19 Epidemiology of DSM-Ill PDs in c
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Table l. Prevalence rates of specif
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24 1. H. Reich and G. de Girolamo (
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26 .- 5 2 0 W C .- 0 P g F ? g e Q
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28 J. H. Reich and G. de Girolarno
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Table 3. Prevalence rates ofpersona
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Pfohl etal.. l986 (67) Pilgrim & Ma
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35 Epidemiology of DSM-Ill PDs were
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37 Epidemiology of DSM-Ill PDs migh
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39 Epidemiology of DSM-Ill PDs 23 R
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4 1 Epidemiology of DSM-Ill PDs 55
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43 International personality disord
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I 45 IPDE iner what he is actually
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47 IPDE Sample of IPDE item The que
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49 IPDE dimensional scores are not
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1 9 IPDE considerable training and
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53 Experiences with IPDE The invest
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55 Experiences with IPDE passive ag
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57 Field Trial
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59 Sampling, inte~iewers, interview
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Description of centres participatin
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63 Centres participating in IPDE fi
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Page 80 and 81: 69 Centres participating in IPDE fi
Page 82 and 83: P- P Table 1. Sample sizes and IPDE
Page 84 and 85: 73 Results Table 3. ICD-I0 Disorder
Page 86 and 87: 75 Results Table 5. Frequency of CO
Page 88 and 89: 77 Results Table 8. Interrater reli
Page 90 and 91: Discussion and conclusions Armand W
Page 92 and 93: 8 1 Discussion and Conclusions stab
Page 94 and 95: 83 Discussion and Conclusions Repet
Page 96 and 97: Discussion and Conclusions of princ
Page 98 and 99: 87 Discussion and Conclusions Frequ
Page 100 and 101: 89 Discussion and Conclusions emoti
Page 102 and 103: 9 1 Discussion and Conclusions inte
Page 104 and 105: 93 Appendix Table A2 Persomlity dis
Page 106 and 107: 95 Appendix Table A4 Personality di
Page 108 and 109: 97 Appendix Table A6 Personaliry di
Page 110 and 111: 99 Appendix Table SA Personaliry di
Page 112 and 113: Table A10 Personality disorder diag
Page 114 and 115: 103 Appendix Table A12 Personality
Page 116 and 117: Table A13 (con?) Criterion B7 B8 1
Page 118 and 119: 107 Appendix Table A13 (cont) Frequ
Page 120 and 121: 109 Appendix Table A14 (cont.) Freq
Page 122 and 123: Acknowledgements 113 Manual History
Page 124 and 125: Manual History of the IPDE One of t
Page 126 and 127: 116 Manual Struchlre of the IPDE Th
Page 128 and 129: 118 Manual that is likely to enhanc
Page 132 and 133: 122 Manual Scoring conventions Much
Page 134 and 135: 124 Manual Recording the scores Req
Page 136 and 137: 126 Manual Q. What do you do when s
Page 138 and 139: 128 Manual section, if there are qu
Page 140 and 141: ICD-10 criteria and corresponding I
Page 142 and 143: 132 ICD-10 criteria and correspondi
Page 144 and 145: 134 IPDE ICD-10 module screening qu
Page 146 and 147: 136 Screening questionnaire 47 1 lo
Page 148 and 149: I 138 IPDE ICD-10 module* interview
Page 150 and 151: 140 Interview schedule 2. 0 1 2 7 0
Page 152 and 153: 142 Inte~iew schedule 4. O 1 2 I N
Page 154 and 155: 144 Interview schedule 6. O l Z ? 0
Page 156 and 157: 146 Interview schedule 8. 0 1 2 1 0
Page 158 and 159: 148 Interview schedule .10. 0 1 2 ?
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170 lnte~iew schedule 32. O 1 2 7 N
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172 Interview schedule *34. 0 1 2 ?
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174 lntewiew schedule 36. 0 1 2 ? 0
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176 lnterv~ew schedule 38. 0 1 2 ?
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178 Interview schedule 40. 0 1 2 ?
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184 lnte~iew schedule 46. 0 1 2 7 0
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~ 186 Interview schedule 48. 0 1 2
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194 Interview schedule 56. 0 1 2 1
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196 Interview schedule VI. IMPULSE
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198 Interview schedule *60. 0 1 2 ?
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200 Interview schedule Have you eve
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202 Interview schedule 1 63. 0 1 2
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204 Intewiew schedule Rate the foll
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206 IPDE ICD-10 module handscoring
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+ 39+44=4, 208 Handscoring algorith
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210 Handscoring algorithms and summ
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IPDE ICD-10 module summary scoreshe
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224 Index paranoid 108 schizoid 108
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226 Index Personalily Assessment Sc
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IPDE - Extranet Systems - World Health Organization

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