Neurotic disorders

Personality disorder
3.1 Assessment covering each type of personality disorder (plus a
'not otherwise specified'):
Personality disorder was assessed as part of the Avoidant
second-stage clinical interview. The Structured Dependant
Clinical Interview for DSM-IV (SCID-II) was Obsessive - compulsive
chosen for the clinical assessment of personality Paranoid
disorder. In the SCID-II interview, each of the Schizotypal
twelve personality disorder categories is covered in Schizoid
turn and, within each category, each component Histrionic
criterion is evaluated by a specified question (or Narcissistic
questions) and subsequent specified probes. It has Borderline
120 items and the clinician rates each item on a Anti-social
i four point scale: 'inadequate information; 'negative' Passive-aggressive
'sub-threshold', and 'threshold'. Depressive
The SCID-II has many favourable characteristics, In the present survey, it was decided to use lay
one of which is that it can usually be completed in interviewers to administer the self-completion
under 60 minutes, compared to other instruments (screening) questionnaire of the SCiD-II and to
which take considerably longer, and requires 1-2 omit two categories of personality disorder,
days training for dinicians. This is an important depressive and passive-aggressive, which are
consideration for a survey covering many disorders omitted from the formal version of the DSM-IV. It
and several other topics, e.g. physical illness,
was decided to use the clinicians who were
medication, Services, lifestyle behaviours etc. undertaking a SCAN interview on the I in 5 subsample
to carry out a SCID-II interview on the
Other favourable characteristics of the SCID-II same sample. Although it would have been
were included in Zimmerman's (1994) review:, desirable for someone else who knew the prisoner
well to have been interviewed also, there were too
• Developed to assess DSM criteria, many practical and ethical difficulties in adopting
• Results on the screening ability of the this strategy.
additional screen questionnaire were
•,) encouraging. In the DSM-IV classification one criterion for the
• Questions in the SCID-II are organised by assessment of anti-social personality disorder is that
diagnosis and diagnosis orientated
a person must be aged 18 or over. Rather than
interviews can be shortened by omitting
exdude the possibility of an assessment of antiquestions
of remaining criteria after it is social personality disorder for many young offenders
determined that the diagnosis cannot be who otherwise displayed both conduct disorder
present, before age 15 and anti-social behaviour after the age
• The SCID-II evaluates attitudes and of 15, this criterion was waived in this study.
behaviours for 5 years prior to the interview.
, The SCID-II is one of only three instruments While the main estimate of the prevalence of
which have been used in published studies personality disorder in this survey was based on the
by researchers outside of the centre in which second-stage clinical assessment, the small
they were developed, numbers in the sub-sample which took part in a
clinical interview limits the possibility for further
Another advantage of the SCID-II is that it is in analysis. The relationship between the screening
modular form. The latest version has 12 modules instrument, which was completed by all
20 PsychiatricMorbidity amongYoungOffenders in EnglandandWales
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