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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
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
Website: http://hdl.handle.net/1765/10066
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
Website: http://hdl.handle.net/1765/10066
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
Relational capacities
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
Relational capacities
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
Relational capacities
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)
http://hdl.handle.net/1765/10066
Email:[email protected]