Structured Clinical Interview for Dsmiv Axis II Personality Disorders

The Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II; First, Gibbon, Spitzer, Williams, & Benjamin, 1997) was developed to complement the widely used Axis I version of the SCID (First, Spitzer, Gibbon, & Williams, 1997). The SCID-II has semi-structured format (like the Axis I version) but it covers the 10 standard DSM-IV Axis II personality disorders, as well as Personality Disorder Not Otherwise Specified, and Depressive Personality Disorder and Passive-Aggressive Personality Disorder from DSM-IV Appendix B (see Table 9.2). The Axis I SCID is commonly administered prior to personality disorder assessment so that the patient's mental state can be considered.

In contrast to the SIDP-IV and IPDE, the SCID-II has a modular approach in which the personality disorders are assessed one at a time. This design is a strength of the SCID-II because administration can be customized easily to meet the unique needs of the user. For example, the interview can be shortened or lengthened to include only those disorders of interest and the order of modules can be altered. The format and sequence of the SCID-II was designed to approximate the flow of experienced diagnostic interviewers.

A useful feature of the SCID-II is that it includes a self-report Personality Questionnaire, which is a 119-item self-report, forced choice yes/no screening component that can be administered prior to the interview portion and takes about 20 minutes. The purpose of the Personality Questionnaire is to reduce overall administration time because only those items that are scored in the pathological direction are further evaluated during the structured interview portion. During the structured interview component, the pathologically endorsed screening responses are further pursued to ascertain whether the symptoms are actually experienced at clinically significant levels. The SCID-II has many open-ended prompts that encourage respondents to elaborate freely about their symptoms. At times, open-ended prompts are followed by closed-ended questions to fully clarify a particular personality disorder symptom. Consistent with its strong link to DSM-IV, the formal diagnostic criteria are printed on the interview page permitting interviewers to see the criteria to which SCID-II questions pertain.

During the interview, responses are coded as follows: "?" = inadequate information, "1" = absent or false, "2" = subthreshold, and "3" = threshold or true. Each personality disorder is assessed completely and diagnoses are made before proceeding to the next disorder. Clinicians who administer the SCID-II are expected to use their clinical judgment to clarify responses, gently challenge inconsistencies, and ask for additional information as required to rate accurately each criterion. Collection of diagnostic information from ancillary sources is permitted. Complete administration of the SCID-II typically takes less than 1 hour.

The SCID-II is optimally administered by trained clinicians. Training in administration includes carefully reading the administration booklet and score sheet, viewing videotape training materials that are available from the SCID-II authors, and conducting role-played practice administrations with extensive feedback discussions. The psychometric properties of the SCID-II are strong, and the interested reader is referred to First and Gibbon (2004) for a comprehensive review. For more information on the SCID-I and SCID-II, the interested reader may visit the SCID web site: www.scid4.org.

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Responses

  • Erno
    Is scid more popular in consagenois marriges?
    4 months ago

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