The Severity Indices for Personality Problems (SIPP)
questionnaire:
A dimensional measurement for the
severity of personality pathology
Helene Andrea (PhD)
Roel Verheul (PhD)
Viersprong Institute for Studies on Personality Disorders (VISPD), Halsteren, the Netherlands
Borderline Congress, Berlin, July 1 2010
Introduction
Severity Indices for Personality Problems (SIPP)
Verheul, Andrea et al, 2008
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Recently developed self-report questionnaire
Dimensional measurement for severity of personality functioning ->
relevant towards DSM-V
Previous research: concurrent validity when comparing PD patients with a
non-clinical population
Also useful as a dimensional instrument within a clinical population?
Verheul, Andrea et al, Psychol Assessment 2008, 20, 23-34
Objective & method
Is the dimensional assessment of the severity of
personality pathology (SIPP)
associated with
other indices of the severity of personality pathology
in a clinical population?
Dimensional measurement
of severity
of personality pathology
Facets (subscales) SIPP
Other Indices
of severity of
personality pathology
DSM-IV based measurements:
- Presence BPD
- Number of PDs
- Number of BPD criteria
- Cluster A PDs
Study Population
 SCEPTRE study: N=2078 patients referred to
centers offering psychotherapy for personality
problems
 Structured Interview for DSM-IV Personality (SIDP-IV):
N=379 patients (18%) with BPD
- 79.2% female, mean age 30.47 (sd 7.85)
- Dimensional scores 16 SIPP facets
SIPP
Facet (subscale)
Domain
Emotion regulation
Effortful control
Self control
Purposefulness
Enjoyment
Self-respect
Stable self-image
Self-reflexive functioning
Identity integration
Enduring relationships
Intimacy
Feeling recognized
Relational functioning
Aggression regulation
Frustration tolerance
Cooperation
Respect
Social concordance
Responsible industry
Trustworthiness
Responsibility
Website: http://hdl.handle.net/1765/10066
SIPP
118 items, 16 facets (subscales), 5 higher-order domains
Dimensional measurement of personality severity:
 Lower score = more maladaptive level of functioning - higher severity
 Higher score = more adaptive level of functioning – lower severity
Examples
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 when
they are different
Respect
Social concordance
•
Fully disagree
•
Partly disagree
•
Partly agree
•
Fully agree
Website: http://hdl.handle.net/1765/10066
Publication: Verheul, Andrea et al (2008). Psychol Assessment, 20, 23-34
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Results
SIPP facets and BPD diagnosis
BPD diagnosis =
3,25
SIPP-scores
more
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maladaptive
2,75
2,5
2,25
2
1,75
No BPD (n=1699; 82%)
BPD (n=379; 18%)
Within the BPD population:
SIPP scores associated with number of PDs?
3
Associations between SIPP
and DSM-IV severity Indices
2,75
for 10 (out of 16) facets
2,5
2,25
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1-3 PDs (n=263; 69%)
# BPD criteria
Cluster A PDs
Comparable pattern
At least 4 PDs (n=116; 31%)
Discussion (1)
 Results (modestly) in support of the SIPP as
a useful instrument for the dimensional
assessment of severity among BPD-patients
However….
 Contrast within BPD-patients smaller than
between BPD and non-BPD-patients
 SIPP specific and sensitive enough??
Further research
 Transition: DSM-IV -> DSM-V
Proposal DSM-V:
 Indicate level of personality functioning for a patient on the
“Self and Interpersonal Functioning Continuum”
 “Self”: Identity integration, Integrity of Self concept, Self-directnedness
“Interpersonal”: Empathy, Intimacy, Cooperativeness, Complexity,
Integration of representations of others
 5 levels: No/Mild/Moderate/Serious/Extreme Impairment
 How are SIPP-scores related to this continuum?
 Dimensional scores and/or cut-off scores? Specificity &
sensitivity?
Availability of the SIPP
 Diagnostic version: 118 items, 16 facets, 5 domains
Outcome 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:
Helene.andrea@deviersprong.nl