(PS8-C67) Psychometric Properties of a Five-item Screening Scale for Impairment in Personality Functioning in Dutch-speaking Community and Clinical Samples

In section III of the Diagnostic and Statistical Manual of Mental Disorder – fifth edition (DSM-5; APA, 2013), an Alternative Model for Personality Disorders (AMPD) is proposed, including a criterion to assess the level of personality functioning impairment (Criterion A). According to the AMPD, impairment in personality functioning (Criterion A) manifests itself by impairment in two domains: self and interpersonal functioning. Each domain consists of two subdomains: identity and self-direction for self-functioning; and empathy and intimacy for interpersonal functioning. Since the publication of the DSM-5, several self-report questionnaires and interviews were developed to assess Criterion A of the AMPD. Most of these measures – although useful for detailed assessment – are time-consuming for patients and/or clinicians. Therefore, clinical research could benefit from a short screening instrument to assess impairments in personality functioning. The present study examined the structure, reliability, and validity of the Dutch version of a five-item screening scale for Criterion A - the Five-Item Screening Scale for Personality Disorder (FISSPD; Skodol et al., 2011) - in a community sample of 1,477 (59% female) adolescents and 546 adults (63% female) and a clinical sample of 820 adults (59% female). In the combined sample, we aimed to examined whether screening cut-off scores could be determined by using Receiver Operating Characteristic (ROC) curve analyses.  To assess convergent and discriminant validity, identity and personality (pathology) questionnaires were completed. Confirmatory factor analysis yielded a single factor structure for the FISSPD, which proved to be (partially) invariant across age and gender, and invariant across patients with or without a personality disorder (PD). Adequate reliability coefficients were obtained for the FISSPD total scores in all samples. Additionally, significant correlations were found between the FISSPD and consolidated identity (negative) and identity disturbance/lack of identity (positive). Significant correlations were found with several personality disorders (and especially with borderline personality disorder), maladaptive personality traits (Criterion B of the AMPD), and severity of personality problems. In the adolescent sample, FISSPD was positively correlated with borderline personality disorder characteristics. Finally, cut-off scores were determined in order to distinguish between healthy controls and patients, healthy controls and patients with a PD, and patients with and without a PD. In sum, the present study underscores the reliability and validity of the FISSPD to screen for (severity of) personality pathology in Dutch-speaking community and clinical samples.