IPDE - Extranet Systems - World Health Organization

11 Review of diagnostic instruments
Personality Disorder Interviews
Diagnostic lntewiew for Borderlines (DIE)
In the years immediately preceding the appearance of DSM-111,
Gunderson and his colleagues developed an interview for the diagnosis
of borderline personality disorder? The DIB was based on criteria quite
similar to those ultimately adopted by the DSM-111. In its revised form
(DELR)~ it consists of 186 questions divided into four sections: afFect.
cognition, impulse action patterns, and interpersonal relationships. The
information obtained fmm the questions is used to rate 22 statements
that describe important features of borderline personality disorder. The
scores are then algorithmically scaled to yield a total score of 0 to 10,
with a recommended cutoff score of 8 required for the diagnosis.
Typically, the interview takes between 45 minutes and 1 hour to complete.
In the 1980s the original DIB was used in a large number of
research investigations of borderline disorder. There is now a considerable
literature and, not surprisingly, it shows varying agreement with
clinical and other methods of diagnosing borderline disorder.
Structured Interview for DSM-Ill-R Personality Disorders (SIDP-RJ
The revised form of the SIDP-R, developed by Pfohl and colleagues at
the University of Iowa, is organized into 17 topically oriented sections,
each containing about 10 questions.' At the end of every section there is
a list of those DSM-111-R criteria that are to be rated as: not present (0).
moderately present (l), or severely present (2). on the basis of the suhject's
responses to the questions in the section. Brief descriptors serve as
anchors in rating, and a score of either 1 or 2 is considered evidence that
the criterion has been met. At the end of the interview there is a summary
rating form with the criteria listed by PD. The interview usually takes
between one and a half and two hours.
When feasible the interviewer is expected to use information fmm
other sources, including an informant interview based on some of the
same questions. The authors have reported poor agreement between
patient and informant regarding whether or not a PD is present
(kap~a=.13).~ Other than the judgement of the interviewer. there are no
specific guidelines for dealing with such conflicting information.
Published data on interrater agreement in scoring the original version of
the SDP indicate that, in general, the reliability is quite satisfactory and
comparable to that obtained with similar interviews?