DIAGNOSTIC AGREEMENT BETWEEN CLINICIANS AND CLIENTS: THE CONVERGENT AND DISCRIMINANT VALIDITY OF THE SWAP-200 AND MCMI-III PERSONALITY DISORDER SCALES

A particularly controversial aspect in the field of personality assessment is the use of self-report measures, versus clinicians' evaluations, for diagnosing personality disorder (PD). No studies have systematically documented the agreement between these sources for the entire array of DSM-S PDs using comprehensive measures and experienced clinicians' judgments. The present work fills this gap by indexing the agreement between patients' self-descriptions and clinicians' judgments, relying on standardized and thorough PD instruments. The Shedler-Westen Assessment Procedure-200 (SWAP-200; Westen & Shedler, 1999a, 1999b) and the Millon Clinical Multiaxial Inventory-III (Millon, Davis, & Millon, 1997) were both completed in a clinical series of 56 adult outpatients. Analyses highlighted moderate correlations between the two measures for the 10 DSM-S PDs (Mdn = .35). Agreement was highest for psychological features that are more easily observable by the clinicians. Furthermore, results revealed problematic discriminant validity between the two instruments.