The Severity Indices of Personality Problems (SIPP): The Severity Indices of Personality Problems (SIPP): A new dimensional questionnaire for measuring

The Severity Indices of Personality Problems The Severity Indices of Personality Problems (SIPP)(SIPP)::

A new dimensional questionnaire for measuring (mal)adaptive personality functioning

Helene Andrea (PhD)1

Roel Verheul (PhD)2 Joost Hutsebaut (PhD)2

Dineke Feenstra (MSc)1

Espen Arnevik (PhD)3

1 Viersprong Institute for Studies on Personality Disorders (VISPD), Halsteren, the Netherlands 2 Center for Psychotherapy de Viersprong, Halsteren, the Netherlands 3 Dept Research & Education, Ulleval University Hospital, Oslo, Norway

APA Annual Meeting, San Francisco, 18 May 2009

ContentsContents

Background Why a new questionnaire Psychometrics (factor structure, reliability)

New results Discriminant validity (symptomatic measurements) Convergent validity (personality measurements) Sensitivity to change

Discussion & further research

Why a new questionnaireWhy a new questionnaire

Dimensional measurement that combines:

Broad scope of central elements personality pathology Relating maladaptive to adaptive capacities Developed to measure change Easy to administer (self-report & limited number of items)

Verheul, Andrea et al (2008). Psychol Assessment, 20, 23-34

Overview SIPP-questionnaireOverview SIPP-questionnaire

118 items, 16 facets (subscales), 5 higher-order domains

Lower score = more maladaptive level of functioning Higher score = more adaptive level of functioning

Examples

� � � �

Fully disagree Partly disagree Partly agree Fully agree

Item Facet/subscale Domain

I usually have adequate control over my feelings Emotion regulation

Self-control

I can easily accept people the way they are, even whenthey are different

Respect Social concordance

Website: http://hdl.handle.net/1765/10066

Publication: Verheul, Andrea et al (2008). Psychol Assessment, 20, 23-34

http://hdl.handle.net/1765/10066

Results confirmative factor analysisResults confirmative factor analysisDomainDomain Facet (subscale)Facet (subscale)

Self control Emotion regulation

Effortful control

Identity

integration

Purposefulness

Enjoyment

Self-respect

Stable self-image

Self-reflexive functioning

Relational capacities Enduring relationships

Intimacy

Feeling recognized

Social concordance Aggression regulation

Frustration tolerance

Cooperation

Respect

Responsibility Responsible industry

Trustworthiness



Psychometric qualities final model1. Good model fit among different populations:

2. Good internal consistency facets(median Cronbach’s .77; range .69-.88)

3. Good test-retest reliability (median ICC .92; range .85-.95)

NN Chi-sqChi-sq RMSEARMSEA NNFINNFI CFICFI SRMRSRMR

PD-pts (test sample) 555 218.8 0.056 0.951 0.978 0.030

Additional PD-pts 308 450.6 0.055 0.953 0.963 0.040

Mental health pts 157 504.4 0.067 0.935 0.947 0.064

General population 468 624.1 0.065 0.946 0.956 0.051



New results I:

Validity studiesValidity studies

Study Study

populationpopulation NN SCL-90SCL-90 CIPCIP

NEO-NEO-

PI-RPI-R DAPPDAPP

PD multi-centre

(Netherlands)

1483 X X

PD Viersprong

(Netherlands)

112 X

PD Ulleval Hospital

(Norway)

114 X X

General population

(Netherlands)

468 X

Method: Study samples & Instruments

SCL-90: Symptom Check List (Derogatis, 1983; Arrindell et al, 2003)

CIP: Circumplex of Interpersonal Problems (Pederson, 2000)

NEO-PI-R: NEO Personality Inventory-Revised (Costa & McCrae, 1992)

DAPP: Dimensional Assessment of

Personality Pathology (Livesley & Jackson, 2002)

SIPP & Symptomatic distress (SCL)SIPP & Symptomatic distress (SCL)

SIPPSIPP

SCLSCL

Self-

control

Identity

Integration

Relational capacities

Responsi-bility

Social con-

cordance

Total score(Norway)

-0.23 -0.49 -0.38 -0.28 -0.12

Total score(Netherlands)

-0.44 -0.60-0.60 -0.39 -0.26 -0.32

Correlation

SCL-subscale

>.50

Hostility

(-0.60)Depression

(-0.68)Interpers.

sensitivity

(-0.52)

- - Hostility

(-0.56)

Overall median correlation: -0.28

Discriminative validity (partially) present

Comparison with other personality measures Comparison with other personality measures (I): (I):

SIPP – NEO / CIPSIPP – NEO / CIP SIPP

NEO

Self-control Identity

Integration


Responsi-

bility

Social

concordance

Neuroticism -0.55 -0.53 -0.24 -0.17 -0.25

Extraversion -0.17 0.30 0.48 -0.30 -0.05

Openness toexperiences

-0.00 0.25 0.31 -0.10 -0.01

Agreeable-

ness 0.43 0.09 0.22 0.37 0.62

Conscien-tiousness

0.44 0.28 0.03 0.77 0.15

CIP-totalN=114 PD

(Norway)

-0.17 -0.34 -0.41 -0.27 -0.17

Higher correlations refer to plausible associations

SIPP

DAPP

higher order

Self-control Identity

Integration


Responsi-

bility

Social

concordance

Emotional dysregulation

-.68 -.76 -.57 -.51 -.54

Dissocial

behavior-.53 -.34 -.34 -.54 -.58

Inhibition -.13 -.38 -.38 -.09 -.14

Compulsivity -.06 -.06 -.06 .26 -.14

Overall median correlation: -0.36

Partially convergent, partially discriminative validity

Verheul, Andrea et al (2008). Psychol Assessment, 20, 23-34

Comparison with other personality measures (II): Comparison with other personality measures (II): SIPP – DAPPSIPP – DAPP

Evidence for meaningful associations with other personality measurements (convergent validity)

Also evidence for lower associations with symptomatic measurements (discriminative validity)

Summary Validity StudiesSummary Validity Studies

New results II:

Sensitivity to changeSensitivity to change

Method Method

Setting

PD patients

% (n)

Average treatment

duration

Outpatient 26% (n=156) 13.8 (sd 7.3) months

Day hospital 35% (n=214) 9.1 (sd 4.0) months

Inpatient 39% (n=238) 7.6 (sd 3.5) months

Follow ups: 1 year and 3 years after start treatment

SIPP domains at baseline and follow-upsSelf-control

31

33

35

37

39

41

More adaptive scores

after treatment

Identity integration

25

27

29

31

33

35


28

30

32

34

36

38

Baseli

ne

1 ye

ar

3 ye

ar

Social concordance

36

38

40

42

44

46

Responsibility

35

37

39

41

43

45

Effect

sizes:

0.73 &

1.02

Effect

sizes:

0.95 &

1.17

Effect

sizes:

0.57 &

0.69

Effect

sizes:

0.18 &

0.58

Effect

sizes:

0.18 &

0.40

DiscussionDiscussionValues of the SIPP

Dimensional measurement core components personality pathology Self-control, identity integration, relational capacities, social concordance, responsibility

Promising psychometric resultsFactorial model, reliability, validity

More adaptive scores after treatment

Further researchFurther research

SIPP as outcome instrument in effectiveness studies

Predictive validity: - Symptomatic improvement necessary for improvement on SIPP?- Improvement on SIPP necessary for functional improvement?

SIPP part of studies DSM-V personality disorders workgroup

Availability of the SIPPAvailability of the SIPP

Diagnostic version: 118 items, 16 facets, 5 domainsOutcome version (SIPP-SF): 60 items, 5 domains

Available in Dutch, English, Norwegian, Spanish and Italian In exchange for research data

Websites: www.vispd.nl (click on heading sipp-main menu; five subpages)


Email:[email protected]

Documents

The Severity Indices of Personality Problems (SIPP): The Severity Indices of Personality Problems (SIPP): A new dimensional questionnaire for measuring