Problems in developing an instrument for the rapid assessment of personality status

Purpose: To assess the validity of a quick assessment instrument (10 minute s) for assessing status, the Rapid Personality Assessment Schedule (PAS-R). Subjects and methods: The PAS-R was evaluated in psychotic patients recruit ed in one of the centres involved in multicentre randomised controlled tria l of intensive vs standard case management (the UK700 case management Patie nts were assessed using both a full version of the PAS (PAS-I - ICD version ) and the PAS-R. The weighted statistic was used to gauge the (criterion-re lated) validity of the PAS-R using the PAS-I as the gold standard. measure code personality status using a four-point rating of severity in addition t o recording individual categories personality disorder. Results: One hundred fifty-five (77%) of 201 patients recruited were assess ed with both instruments. The kappa statistic was 0.31, suggesting only mod erate agreement between the PAS-I and PAS-R instruments under four-point ra ting format, and 0.39 for the dichotomous personality disorder/no disorder separation. The (64%) and specificity (82%) of the PAS-R in predicting PAS- I personality disorder were as satisfactory as for screening instruments bu t still somewhat disappointing, and the PAS-R had an overall diagnostic acc uracy of 78%. Conclusion: The PAS-R is a quick and rough method of detecting personality abnormality but is not a substitute for fuller assessment. (C) 2000 Edition s scientifiques et medicales Elsevier SAS.