The objective of this research is to develop and evaluate a patient computer interview for DSM III personality disorders (Axis II). This approach combines the benefits of direct patient interviewing (standardization of question presentation, completeness, and legibility) with DSM III diagnostic criteria and has the potential to overcome some deficiencies associated with human interviewing (unreliable observational and interviewing skills). Comparisons will be made with a structured human interview, clinician diagnoses and a paper-and-pencil questionnaire. Evaluations of reliability, accuracy, patient acceptance, time, cost and limitations of this approach will be made. 1) Interview construction (year one). Content and logic for the interview will follow DSM III. Questions will cover defining characteristics, associated behavior and features, impairment, and distress, with additional items necessary to rule out pre-emptive Axis I disorders drawn from our existing DIS interview. 2) Preliminary trials (year one). Preliminary trials of the interview will be carried out on 48 patients, selected on the basis of probable diagnoses on each of the Axis II disorders. Other evaluation procedures (personal interview, clinical diagnoses, chart review and patient self-report inventory) will also be piloted at this time. 3) Evaluation (years two and three). For formal evaluation the result of the patient-computer interview will be compared with a) structured personal interview, b) clinician diagnosis using the computer DSM III program, c) chart checklist and d) patient self-report inventory. Two subsamples of patients will be selected: a) outpatients with current Axis II chart diagnoses (n = 180) and b) inpatients with selected Axis I disorders (n = 40). In addition to diagnostic results, we will consider patient evaluations and some features of the patient-computer interaction in data analyses.
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