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-5 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 and Shedler, 1999a, 1999b) and the Millon Clinical Multiaxial Inventory-III (Millon, Davis, and 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-5 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.