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Originalia

Die Skala zur Erfassung der Impulsivität der Borderline-Persönlichkeitsstörung (IS-27)

Ein Beitrag zur Qualitätssicherung in der Psychotherapie

Published Online:June 25, 2010https://doi.org/10.1026/0012-1924/a000022

Abstract

Zusammenfassung. Um im Bereich von Psychotherapie eingesetzt zu werden, sollte die Skala zur Erfassung der Impulsivität (IS-27) bei der Borderline-Persönlichkeitsstörung (BPS) veränderungssensitiv sein und Personen mit BPS identifizieren können. Das Instrument wurde mit anderen Selbstbeurteilungsinstrumenten einer ambulanten Stichprobe (n = 147), einer gesunden Kontrollgruppe (n = 43) sowie einer Stichprobe von stationären Patienten mit BPS vor und nach einer dreimonatigen dialektisch behavioralen Behandlung (n = 62) vorgelegt. Das reliable und valide Instrument diskriminierte Patienten mit BPS von anderen Diagnosegruppen und konnte die Symptomreduktion infolge der Behandlung abbilden. Die „Receiver-Operating-Characteristic” (ROC)-Kurve zeigte eine hohe diskriminatorische Fähigkeit. Unterschiedliche Cut-Off-Werte wurden hinsichtlich ihrer diagnostischen Effizienz bewertet. Aufgrund der Kosten, die die BPD verursacht, wird ein Cut-off-Wert von ≥ 27 bei fast optimalem Youden-Index und hoher Sensitivität favorisiert. Mit der IS-27 liegt ein Verfahren mit guten teststatischen Kennwerten vor, das einen Beitrag zu einer störungsspezifischen Qualitätssicherung leisten kann.


The Impulse Scale of borderline personality disorder (IS-27) – a contribution to a quality management in psychotherapy

Abstract. For its utilization in psychotherapy, the Impulsivity Scale (IS-27) for borderline personality disorder (BPD) should be sensitive to change and identify individuals with BPS. Along with other self-reports, the IS-27 was given to a sample of outpatients (n = 147), a healthy control group (n = 43), and a sample of inpatients with BPD before and after a three month interval of dialectical behaviour treatment (n = 62). The reliable and valid instrument discriminated individuals with BPD from other diagnostic groups and was sensitive to change. Analyses of the area under receiver-operating-characteristic curve revealed a high diagnostical power. Several cut-off scores were evaluated concerning their diagnostical efficiency. Due to the costs caused by the diagnosis of BPD, a cut-off score of ≥ 27 was favoured with a nearly optimal Youden-criterion and high sensitivity. The IS-27 has shown adequate psychometric properties and can make a contribution to a quality management.

Literatur

  • Abel, U. (1993). Die Bewertung diagnostischer Tests. Stuttgart: Hippokrates. First citation in articleGoogle Scholar

  • Alnæs, R. , Torgersen, S. (1988). The relationship between DSM-III symptom disorders (axis I) and personality disorders (axis II) in an outpatient population. Acta Psychiatrica Scandinavica, 78, 485–492. First citation in articleCrossref, Google Scholar

  • American Psychiatric Association (APA) . (2003). Diagnostisches und statistisches Manual psychischer Störungen. Textrevision (DSM-IV-TR). Übersetzt nach der Textrevision der 4. Auflage des Diagnostic and statistical manual of mental disorders der American Psychiatric Association/dt. Bearb. und Einf. von Henning Saß. Göttingen: Hogrefe. First citation in articleGoogle Scholar

  • Arntz, A. , Dietzel, R. , Dreessen, L. (1999). Assumption in borderline personality disorder: specifity, stability and relationship with etiological factors. Behaviour Research and Therapy, 37, 545–557. First citation in articleCrossref, Google Scholar

  • Beaglehole, R. , Bonita, R. , Kjellström, T. (1997). Einführung in die Epidemiologie. Bern: Huber. First citation in articleGoogle Scholar

  • Bender, D. S. , Dolan, R. T. , Skodol, A. E. , Sanislow, C. A. , Dyck, I. R. , McGlashan, T. H. , Shea, M. T. , Zanarini, M. C. , Oldham, J. M. , Gunderson, J. G. (2001). Treatment utilization by patients with personality disorders. American Journal of Psychiatry, 158, 295–302. First citation in articleCrossref, Google Scholar

  • Bishop, Y. M. M. , Fienberg, S. E. , Holland, P. W. (1975). Discrete multivariate analysis: Theory and practice. Cambridge: MIT Press. First citation in articleGoogle Scholar

  • Black, D. W. , Blum, N. , Pfohl, B. , Hale, N. (2004). Suicidal behavior in borderline personality disorder: Prevalence, risk factors, prediction, and prevention. Journal of Personality Disorders, 18, 226–239. First citation in articleCrossref, Google Scholar

  • Bohus, M. , Haaf, B. , Simms, T. , Limberger, M. F. , Schmahl, C. , Unckel, C. et al. (2004). Effectiveness of inpatient dialectical behavioral therapy for borderline personality disorder: a controlled trial. Behavior Research and Therapy, 42, 487–499. First citation in articleCrossref, Google Scholar

  • Bohus, M. , Limberger, M. F. , Frank, U. , Chapman, A. L. , Kühler, T. , Stieglitz, R.-D. (2007). Psychometric properties of the Borderline Symptom List (BSL). Psychopathology, 40, 126–132. First citation in articleCrossref, Google Scholar

  • Bohus, M. , Swenson, C. , Sender, I. , Kern, I. , Berger, M. (1996). Die Anwendung der ’Dialektisch-Behavioralen Therapie’ für Borderline-Störungen im stationären Bereich. Psychotherapie in Psychiatrie, Psychotherapeutischer Medizin und Klinischer Psychologie, 1, 32–43. First citation in articleGoogle Scholar

  • Bornovalova, M. A. , Lejuez, C. W. , Daughters, S. B. , Rosenthal, M. Z. , Lynch, T. R. (2005). Impulsivity as a common process across borderline personality and substance use disorders. Clinical Psychology Review, 25, 790–812. First citation in articleCrossref, Google Scholar

  • Buss, A. H. , Durkee, A. (1957). An inventory for assessing different kinds of hostility. Journal of Consulting Psychology, 21, 343–349. First citation in articleCrossref, Google Scholar

  • Buss, A. H. , Perry, M. (1992). The Aggression Questionnaire. Journal of Personality and Social Psychology, 63, 452– 459. First citation in articleCrossref, Google Scholar

  • Butler, A. C. , Brown, G. K. , Beck, A. T. , Grisham, J. R. (2002). Assessment of dysfunctional beliefs in Borderline Personality Disorder. Behaviour Research and Therapy, 40, 1231–1240. First citation in articleCrossref, Google Scholar

  • Cassin, S. E. , von Ranson, K. M. (2005). Personality and eating disorders: A decade in review. Clinical Psychology Review, 25, 895–916. First citation in articleCrossref, Google Scholar

  • Clarkin, J. F. , Yeomans, F. E. , Kernberg, O. F. (1999). Psychotherapy for Borderline Personality Disorder. New York: Wiley & Sons. First citation in articleGoogle Scholar

  • Coles, E. M. (1997). Impulsivity in major mental disorders. In C. D. Webster, M. A. Jackson (Eds.), Impulsivity: Theory, Assessment, and Treatment (pp. 180–194). New York, London: Guilford Press. First citation in articleGoogle Scholar

  • Dickman, S. J. (1990). Functional and dysfunctional impulsivity: personality and cognitive correlates. Journal of Personality and Social Psychology, 58, 95–102. First citation in articleCrossref, Google Scholar

  • Evenden, J. L. (1999). Varieties of impulsivity. Psychopharmacology, 146, 348– 361. First citation in articleCrossref, Google Scholar

  • Franke, G. H. (2002). Brief Symptom Inventory (BSI). Göttingen: Beltz. First citation in articleGoogle Scholar

  • Fydrich, T. , Renneberg, B. , Schmitz, B. , Wittchen, H.-U. (1997). Strukturiertes Klinisches Interview für DSM-IV, Achse II (SKID-II). Göttingen: Hogrefe. First citation in articleGoogle Scholar

  • Fyer, M. R. , Frances, A. J. , Sullivan, T. , Hurt, S. W. , Clarkin, J. (1988). Suicide attempts in patients with borderline personality disorder. American Journal of Psychiatry, 145, 737–739. First citation in articleCrossref, Google Scholar

  • Geisheim, C. , Hahlweg, K. , Fiegenbaum, W. , Frank, M. , Schröder, B. , von Witzleben, I. (2002). Das Brief Symptom Inventory (BSI) als Instrument zur Qualitätssicherung in der Psychotherapie. Diagnostica, 48, 28–36. First citation in articleLink, Google Scholar

  • Herpertz, S. (2001). Impulsivität und Persönlichkeit: Zum Problem der Impulskontrollstörungen. Stuttgart: Kohlhammer. First citation in articleGoogle Scholar

  • Herpertz, S. , Saß, H. (1997). Impulsivität und Impulskontrolle. Zur psychologischen und pathologischen Konzeptionalisierung. Nervenarzt, 68, 171– 183. First citation in articleCrossref, Google Scholar

  • Hopwood, C. J. , Morey, L. C. , Edelen, M. O. , Shea, M. T. , Grilo, C. M. , Sanislow, C. A. et al. (2008). A comparison of interview and self-report methods for the assessment of borderline personality disorder criteria. Psychological Assessment, 20, 81–85. First citation in articleCrossref, Google Scholar

  • Horn, N. R. , Dolan, M. , Elliott, R. , Deakin, J. F. W. , Woodruff, P. W. R. (2003). Response inhibition and impulsivity: An fMRI study. Neuropsychologia, 41, 1959–1966. First citation in articleCrossref, Google Scholar

  • Igl, W. , Zwingmann, C. , Faller, H. (2005). Änderungssensitivität. Rehabilitation, 44, 100–106. First citation in articleCrossref, Google Scholar

  • Jacobson, N. S. , Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy. Journal of Consulting and Clinical Psychology, 59, 12–19. First citation in articleCrossref, Google Scholar

  • Jerschke, S. , Meixner, K. , Richter, K. H. , Bohus, M. (1998). Zur Behandlungsgeschichte und Versorgungssituation von Patientinnen mit Borderline-Persönlichkeitsstörung. Fortschritte der Neurologie und Psychiatrie, 66, 545–552. First citation in articleCrossref, Google Scholar

  • Koons, C. R. , Robins, C. J. , Tweed, J. L. , Lynch, T. R. , Gonzalez, A. M. , Morse, J. Q. et al. (2001). Efficacy of dialectical behavior therapy in women veterans with borderline personality disorder. Behavior Therapy, 32, 371–390. First citation in articleCrossref, Google Scholar

  • Kröger, C. , Freese, S. (2003). Borderline Personality Disorder Severity Index (BPDSI). Unveröffentlichtes Manuskript. Christoph-Dornier-Stiftung Braunschweig. First citation in articleGoogle Scholar

  • Kröger, C. , Holdstein, D. , Lombe, A. , Schweiger, U. , Kosfelder, J. (2007). Konstruktion eines störungsspezifischen Instruments zur Erfassung der Impulsivität der Borderline-Persönlichkeitsstörung. Zeitschrift für Klinische Psychologie und Psychotherapie, 36, 290–297. First citation in articleLink, Google Scholar

  • Kröger, C. , Kosfelder, J. (2007). Eine Meta-Analyse zur Wirksamkeit der dialektisch behavioralen Therapie bei Borderline-Persönlichkeitsstörungen. Zeitschrift für Klinische Psychologie und Psychotherapie, 36, 11–17. First citation in articleLink, Google Scholar

  • Leichsenring, F. (1999). Development and first results of the borderline personality inventory: A self-report instrument for assessing borderline personality organization. Journal of Personality Assessment, 73, 45–63. First citation in articleCrossref, Google Scholar

  • Linehan, M. M. (1993a). Cognitive-behavioral treatment of Borderline Personality Disorder. New York: Guilford Press. First citation in articleGoogle Scholar

  • Linehan, M. M. (1993b). Skill training manual for treatment Borderline Personality Disorder. New York: Guilford Press. First citation in articleGoogle Scholar

  • Linehan, M. M. , Armstrong, H. E. , Suarez, A. , Allmon, D. J. , Heard, H. L. (1991). Cognitiv-behavioral treatment of chronically parasuicidal borderline patients. Archives of General Psychiatry, 48, 1060–1064. First citation in articleCrossref, Google Scholar

  • Linehan, M. M. , Heard, H. L. (1999). Borderline personality disorder: Costs, course, and treatment outcomes. In N. Miller, K. Magruder (Eds.), The cost-effectiveness of psychotherapy: A guide for practitioners, researchers and policy-makers (pp. 291–305). New York: Oxford University Press. First citation in articleGoogle Scholar

  • Linehan, M. M. , Schmidt, H. , Dimeff, L. A. , Craft, J. C. , Kanter, B. S. J. , Comtois, K. A. (1999). Dialectical behavior therapy with borderline personality disorder and drug-dependence. American Journal on Addictions, 8, 279–292. First citation in articleCrossref, Google Scholar

  • Links, P. S. , Heslegrave, R. J. , Mitton, J. E. , van Reekum, R. , Patrick, J. (1995). Borderline Personality Disorder and substance abuse: consequences of comorbidity. Canadian Journal of Psychiatry, 40, 9–14. First citation in articleCrossref, Google Scholar

  • Loranger, A. W. , Sartorius, N. , Andreoli, A. , Berger, P. , Buchheim, P. , Channabasavanna, S. M. et al. (1994). The International Personality Disorder Examination. Archives of General Psychiatry, 51, 215–224. First citation in articleCrossref, Google Scholar

  • Lusted, L. B. (1971). Signal detectability and medical decision – making. Science, 171, 1217–1219. First citation in articleCrossref, Google Scholar

  • Maier, W. , Lichtermann, D. , Klinger, T. , Heun, R. , Hallmayer, J. (1992). Prevalence of personality disorders (DSM-III-R) in the community. Journal of Personality Disorders, 6, 187–196. First citation in articleCrossref, Google Scholar

  • Moeller, F. G. , Barratt, E. S. , Dougherty, D. M. , Schmitz, J. M. , Swann, A. C. (2001). Psychiatric aspects of impulsivity. American Journal of Psychiatry, 158, 1783–1793. First citation in articleCrossref, Google Scholar

  • Paris, J. (2002). Implications of long-term outcome research for the management of patients with Borderline Personality Disorder. Harvard Review of Psychiatry, 10, 315–323. First citation in articleCrossref, Google Scholar

  • Patton, J. H. , Stanfort, M. S. , Barrat, E. S. (1995). Factor structure of the Barratt Impulsiveness Scale. Journal of Clinical Psychology, 51, 768–774. First citation in articleCrossref, Google Scholar

  • Pérez, V. , Barrachina, J. , Soler, J. , Pascual, J. C. , Campins, M. J. , Puigdemont, D. et al. (2007). The clincal global impression scale for borderline personality disorder patients (CGI-BPD): A scale sensible to detect changes. Actas espaòolas de Psiquiatría, 35, 229–235. First citation in articleGoogle Scholar

  • Plutchik, R. , van Praag, H. (1995). The natur of impulsivity: Definitions, ontology, genetics, and relations to aggression. In E. Hollander, D. J. Stein (Eds.), Impulsivity and Aggression (pp. 7–24). Chichester: John Wiley & Sons. First citation in articleGoogle Scholar

  • Preuss, U. W. , Rujescu, D. , Giegling, I. , Watzke, S. , Koller, G. , Zetzsche, T. et al. (2008). Psychometrische Evaluation der deutschsprachigen Version der Barratt Impulsiveness Skala. Nervenarzt, 79, 305–319. First citation in articleCrossref, Google Scholar

  • Renneberg, B. , Schmidt-Rathjens, C. , Hippin, R. , Backenstrass, M. , Fydrich, T. (2005). Cognitive characteristics of patients with Borderline Personality Disorder: Development and validation of a self-report inventory. Journal of Behavior Therapy and Experimental Psychiatry, 36, 173–182. First citation in articleCrossref, Google Scholar

  • Rentrop, M. , Backenstrass, M. , Jaentsch, B. , Kaiser, S. , Roth, A. , Unger, J. et al. (2008). Response inhibition in borderline personality disorder: Performance in a go/nogo task. Psychopathology, 41, 50–57. First citation in articleCrossref, Google Scholar

  • Rohde-Dachser, C. (1995, 5. Aufl.). Das Borderline-Syndrom. Bern: Huber. First citation in articleGoogle Scholar

  • Safer, D. , Telch, C. F. , Agras, W. S. (2001). Dialectical behavior therapy for bulimia nervosa. American Journal of Psychiatry, 158, 632–634. First citation in articleCrossref, Google Scholar

  • Samuels, J. , Eaton, W. W. , Bienvenu, O. J. , Brown, C. H. , Costa, P. T. , Nestadt, G. (2002). Prevalence and correlates of personality disorders in a community sample. British Journal of Psychiatry, 180, 536–542. First citation in articleCrossref, Google Scholar

  • Sansone, R. A. , Levitt, J. L. (2005). Borderline personality and eating disorders. Eating Disorders, 13, 71–83. First citation in articleCrossref, Google Scholar

  • Shearer, S. L. , Peters, C. P. , Quaytman, S. , Wadman, B. E. (1988). Intent and lethality of suicide attempts among female borderline inpatients. American Journal of Psychiatry, 133, 299–305. First citation in articleGoogle Scholar

  • Skodol, A. E. , Gunderson, J. G. , Pfohl, B. , Widinger, T. A. , Livesley, J. W. , Siever, L. J. (2002a). The borderline diagnosis I: Psychopathology, comorbidity, and personality structure. British Journal of Psychiatry, 51, 936–950. First citation in articleCrossref, Google Scholar

  • Skodol, A. E. , Siever, L. J. , Livesley, W. J. , Gunderson, J. G. , Pfohl, B. , Widiger, T. (2002b). The borderline diagnosis II: Biology, genetics, and clinical course. British Journal of Psychiatry, 51, 951–963. First citation in articleCrossref, Google Scholar

  • Soeteman, D. I. , Hakkaart-van Roijen, L. , Verheul, R. , Busschbach, J. J. V. (2008). The economic burden of personality disorders in mental health care. Journal of Clinical Psychology, 69, 259–265. First citation in articleGoogle Scholar

  • Soloff, P. H. , Lis, J. A. , Kelly, T. , Cornelius, J. , Ulrich, R. (1994a). Risk factors for suicidal behavior in borderline personality disorder. American Journal of Psychiatry, 151, 1316–1323. First citation in articleCrossref, Google Scholar

  • Soloff, P. H. , Lis, J. A. , Kelly, T. , Cornelius, J. , Ulrich, R. (1994b). Self-mutilation and suicidal behaviour in Borderline Personality Disorder. Journal of Personality Disorders, 8, 257–267. First citation in articleCrossref, Google Scholar

  • Soloff, P. H. , Lynch, K. G. , Kelly, T. M. , Malone, K. M. , Mann, J. J. (2000). Characteristics of Suicide Attempts of patients with major depressive episode and borderline personality disorder: A comparative study. American Journal of Psychiatry, 157, 601–608. First citation in articleCrossref, Google Scholar

  • Stieglitz, R.-D. (2000). Diagnostik und Klassifikation psychischer Störungen. Göttingen: Hogrefe. First citation in articleGoogle Scholar

  • Swets, J. A. (1988). Measuring the accuracy of diagnostic systems. Science, 240, 1285–1293. First citation in articleCrossref, Google Scholar

  • Telch, C. , Agras, W. S. , Linehan, M. M. (2001). Dialectical behavior therapy for binge eating disorder. Journal of Consulting and Clinical Psychology, 69, 1061–1065. First citation in articleCrossref, Google Scholar

  • Torgersen, S. , Kringlen, E. , Cramer, V. (2001). The prevalence of personality disorders in a community sample. Archives of General Psychiatry, 58, 590–596. First citation in articleCrossref, Google Scholar

  • Trull, T. J. , Sher, K. J. , Minks-Brown, C. , Durbin, J. , Burr, R. (2000). Borderline personality disorder and substance use disorders: A review and integration. Clinical Psychology Review, 20, 235–253. First citation in articleCrossref, Google Scholar

  • Van Asselt, A. D. I. , Dirksen, C. D. , Arntz, A. , Severens, J. L. (2007). The cost of borderline personality disorder: Societal cost of illness in BPD-patients. European Psychiatry, 22, 354–361. First citation in articleCrossref, Google Scholar

  • Van Reekum, R. , Links, P. S. , Fedorov, C. (1994). Impulsivity in borderline personality disorder. In K. R. Silk (Ed.), Biological and neurobehavioral studies of Borderline Personality Disorder (pp. 1–21). Washington, DC: American Psychiatric Press. First citation in articleGoogle Scholar

  • Verheul, R. , van den Bosch, L. M. C. , Koeter, M. W. J. , de Ridder, M. A. J. , Stijnen, T. , van den Brink, W. (2003). Dialectical behaviour therapy for women with borderline personality disorder. 12-month, randomised clinical trail in The Netherlands. British Journal of Psychiatry, 182, 135–140. First citation in articleCrossref, Google Scholar

  • Webster, C. D. , Jackson, M. A. (Eds.) (1997). Impulsivity: Theory, Assessment, and Treatment. New York, London: Guilford Press. First citation in articleGoogle Scholar

  • Weltgesundheitsorganisation (WHO) . (2000). Internationale Klassifikation psychischer Störungen. ICD-10 Kapitel V (F). Diagnostische Kriterien für Forschung und Praxis. Hrsg. von H. Dilling, W. Mombour, M. H. Schmidt, E. Schulte-Markwort (2. korrigiert und ergänzte Auflage). Bern: Huber. First citation in articleGoogle Scholar

  • Wittchen, H.-U. , Wunderlich, U. , Gruschitz, S. , Zaudig, M. (1997). Strukturiertes Klinisches Interview für DSM-IV, Achse I (SKID-I). Göttingen: Hogrefe. First citation in articleGoogle Scholar

  • Young, J. E. , Klosko, J. S. , Weishaar, M. E. (2005). Schematherapie. Ein praxisorientiertes Handbuch. Paderborn: Junfermann. First citation in articleGoogle Scholar

  • Zanarini, M. C. (1993). Borderline personality disorder as an impulsive spectrum disorder. In J. Paris (Ed.), Borderline personality disorder: Etiology and treatment (pp. 67–85). Washington, DC: American Psychiatric Press. First citation in articleGoogle Scholar

  • Zanarini, M. C. , Frankenburg, F. R. , Dubo, E. D. , Sickel, A. E. , Trikha, A. , Levin, A. , Reynolds, V. (1998). Axis I comorbidity of borderline personality disorder. American Journal of Pychiatry, 155, 1733–1739. First citation in articleCrossref, Google Scholar

  • Zanarini, M. C. , Vujanovic, A. A. , Parachini, E. A. , Boulanger, J. L. , Frankenburg, F. R. , Hennen, J. (2003). A screening measures for BPD: The McLean screening instrument for borderline personality disorder (MSI-BPD). Journal of Personality Disorders, 17, 568–573. First citation in articleCrossref, Google Scholar

  • Zanarini, M. C. , Weinberg, E. (1996). Borderline Personality Disorder: Impulsive and compulsive features. In J. M. Oldham, E. Hollander (Eds.), Impulsivity and compulsivity (pp. 37–58). Washington, DC: American Psychiatric Press. First citation in articleGoogle Scholar

  • Zimmerman, M. (1994). Diagnosing personality disorders: A review of issues and research methods. Archives of General Psychiatry, 51, 225–245. First citation in articleCrossref, Google Scholar

  • Zimmerman, M. , Mattia, J. I. (1999). Axis I diagnostic comorbidity and borderline personality disorder. Comprehensive Psychiatry, 40, 245–252. First citation in articleCrossref, Google Scholar

  • Zweig, M. H. , Campbell, G. (1993). Reciever-Operating Characteristic (ROC) plots: A fundamental evaluation tool in clinical medicine. Clinical Chemistry, 39, 561–577. First citation in articleGoogle Scholar