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 Personality Diagnostic Questionnaire

Personality Diagnostic Questionnaire

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Purpose

The Personality Diagnostic Questionnaire – 4th Edition (PDQ-4+) is a 99-item assessment that is used to screen for DSM-IV personality disorders. 

Link to Instrument

Acronym PDQ-4+

Area of Assessment

Assertiveness

Assessment Type

Patient Reported Outcomes

Administration Mode

Paper & Pencil

Cost

Not Free

Actual Cost

$0.00

Cost Description

No longer available for purchase

Key Descriptions

  • Participants respond to 97 true/false self-report items based on criteria for ten personality disorder diagnoses from the Diagnostic and Statistical Manual (DSM)-V and two personality disorders proposed in the DSM-IV.

Number of Items

99

Equipment Required

  • Computer

Time to Administer

20-30 minutes

Required Training

No Training

Required Training Description

Should be performed by a mental health professional.

Age Ranges

Adults

18 - 64

years

Older Adults

+

years

Instrument Reviewers

Sabria Borom

Marie Yaroch

Haley Szalewski

ICF Domain

Participation

Measurement Domain

Cognition

Considerations

  • Most of the research on the PDQ-4+ has been done on undergraduate students, patients with psychiatric illnesses, and incarcerated persons.
  • The PDQ-4+ should not be used as a screening instrument in outpatients.
  • To improve validity, the PDQ-4+ Clinical Significance Scale Interview can be implemented afterwards to provide clarity for the PDQ-4+ assessment results, along with using additional assessments.
  • There is a computer-adapted version of the PDQ-4+ for persons who may not be able to fill out the paper and pencil version. 

Mixed Populations

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Cut-Off Scores

 

People in prison: (Davison et al., 2001; N = 389; median age = 31 years; United Kingdom)

  • Davison et al. found a cut-off score of 25 to be more sensitive and specific than the recommended cut-off score of 50:

 

Cut-off Score

Sensitivity (%)

Specificity (%)

Positive predictive power (%)

Negative predictive power (%)

20

89

72

86

78

25

75

74

85

61

50

26

100

100

41

Persons living in residential substance abuse treatment programs and prisons: (Guy et al., 2008; N = 1,345; Mean Age (SD) = 31.40 [6.69] years; gender = 83% men [n = 1,122], 17% women [n = 223]; race/ethnicity = 66% Caucasian [n = 869], 34% African American [n = 454], 10% Hispanic ethnicity; incarcerated = 50.4% [n = 678], substance use residential facility = 49.6% [n = 667]).

  • For the Antisocial Personality Disorder subscale, participants needed to endorse at least three items that evaluated conduct disorder criteria and four items that evaluated adult criteria. These cut-off scores led to sensitivity of 50% and specificity of 84%.

Normative Data

People in prison: (Green & Browne, 2019; N = 37; mean age [SD] = 33.38 [10.93] years; Men in prison; convicted of domestic violence)

  • 80% of participants had clinically significant scores on at least one portion of the Trauma Symptom Inventory, indicating that the participants experienced posttraumatic symptoms in the previous six months.
  • 65% of participants met PDQ-4+ criteria for Antisocial Personality Disorder or Borderline Personality Disorder.

53% of participants met PDQ-4+ criteria for both Antisocial Personality Disorder and Borderline Personality Disorder.

Persons living in residential substance abuse treatment programs and prisons: (Guy et al., 2008; N = 1,345; Mean Age (SD) = 31.40 [6.69] years; gender = 83% men [n = 1,122], 17% women [n = 223]; race/ethnicity = 66% Caucasian [n = 869], 34% African American [n = 454], 10% Hispanic ethnicity; incarcerated = 50.4% [n = 678], substance use residential facility = 49.6% [n = 667]).

  • Participants reported a mean of 7.98 (SD = 4.65) symptoms on the ASPD portion of the PDQ-4+.
  • 34% of participants (n = 456) were classified with ASPD.
  • Men scored significantly higher than women (t[1343] = 2.12, p = 0.03; Cohen’s d = 0.16).
  • No significant differences were found between race/ethnicity (t[1321] = 1.93, p =  0.05; Cohen’s d = 0.11).
  • The residential sample scored significantly higher than incarcerated sample (t[1343] = 4.00, p < 0.01; Cohen’s d = 0.22).

Category

 

Mean (SD)

Gender

Male (n = 1,122)

8.10 (4.65)

 

Female (n = 223)

7.38 (4.61)

Race

Caucasian (n = 869)

8.17 (4.70)

 

African American (n = 454)

7.65 (4.55)

Status

Residential (n = 667)

8.49 (4.74)

 

Incarcerated (n = 678)

7.48 (4.51)

Internal Consistency

People in prison: (Green & Browne, 2019; N = 37; mean age [SD] = 33.38 [10.93] years; men in prison; convicted of domestic violence)

  • Excellent internal consistency for overall scale: Cronbach’s alpha = 0.86.
  • Adequate internal consistency for Borderline subscale: Cronbach’s alpha = 0.79.
  • Adequate internal consistency for Antisocial subscale: Cronbach’s alpha = 0.70.
  • Poor internal consistency for remainder of subscales: Cronbach’s alpha < 0.70.

Persons living in residential substance abuse treatment programs and prisons: (Guy et al., 2008; N = 1,345; Mean Age (SD) = 31.40 [6.69] years; gender = 83% men [n = 1,122], 17% women [n = 223]; race/ethnicity = 66% Caucasian [n = 869], 34% African American [n = 454], 10% Hispanic ethnicity; incarcerated = 50.4% [n = 678], substance use residential facility = 49.6% [n = 667]).

  • Excellent internal consistency for Antisocial subscale: Cronbach’s alpha = 0.85, MIC = 0.20.

Content Validity

The PDQ-4+ is composed of scales aimed to measure personality disorder diagnoses by using the diagnostic criteria from the DSM-IV, which contains the information required to meet each specific criterion. The test includes all of the personality disorders within the DSM-IV, the latest DSM when the PDQ-4+ was developed (Green & Browne, 2019).

Mental Health

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Cut-Off Scores

Mixed Psychiatric Sample: (Fossati et al., 1998; N = 300; Mean age [SD] = 30.38 [9.16]; Gender = 59.3% female [n = 178], 40.7% male [n = 122])

  • All scales have provided a significant amount of false-positives other than the Narcissistic Personality Disorder subscale.

Personality Disorder

FP Frequency

FN Frequency

Χ2 (1, N = 300)

Paranoid

92

7

71.273**

Schizotypal

63

8

41.070**

Schizoid

53

3

42.875**

Histrionic

54

15

20.927**

Narcissistic

27

39

1.833

Borderline

111

11

80.336**

Antisocial

19

3

10.227**

Avoidant

141

3

130.340**

Dependent

62

3

51.754**

Obsessive

128

8

104.125**

Passive-Ag.

106

10

77.802**

Depressive

215

0

213.005**

Any

82

9

56.967**

Internal Consistency

Mixed Psychiatric Sample: (Fossati et al., 1998; N = 300; Mean age [SD] = 30.38 [9.16]; Gender = 59.3% female [n = 178], 40.7% male [n = 122])

  • Poor internal consistency (mean KR-20 = .61).

Personality Disorder

Internal Consistency (KR-20)

Paranoid

Poor (0.65)

Schizotypal

Poor (0.67)

Schizoid

Poor (0.53)

Histrionic

Poor (0.54)

Narcissistic

Poor (0.58)

Borderline

Poor (0.70)

Antisocial

Poor (0.63)

Avoidant

Adequate (0.71)

Dependent

Adequate (0.74)

Obsessive-compulsive

Poor (0.46)

Passive-aggressive

Poor (0.51)

Depressive

Poor (0.64)

Construct Validity

Mixed Psychiatric Sample (Fossati et al., 1998; N = 300; Mean age (SD) = 30.38 (9.16); Gender = 59.3% female [n = 178], 40.7% male [n = 122])

  • Correlations between PDQ-4 and SCID-II scores:

Personality disorder

PPM correlation between PDQ-4 and SCID-II score

Paranoid

Adequate (.359)

Schizotypal

Poor (.202)

Schizoid

Poor (.193)

Histrionic

Poor (.292)

Narcissistic

Adequate (.417)

Borderline

Adequate (.404)

Antisocial

Adequate (.372)

Avoidant

Adequate (.359)

Dependent

Adequate (.387)

Obsessive-Compulsive

Poor (.284)

Passive-Aggressive

Poor (.297)

Depressive

Poor (.208)

Content Validity

Hopwood et al. found that there may be some limitations for the PDQ-4’s content validity when assessing Narcissistic Personality Disorder: “The PDQ-4 only includes a single binary item to capture each DSM-IV symptom, potentially limiting the reliability and content validity of the measure” (Hopwood et al., 2012, p. 281).

Healthy Adults

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Normative Data

 Undergraduate Students: (Fossati et al., 2004; N = 747; mean age = 22.96 [SD = 2.63] years; mean university education = 3.89 [SD = 1.97] years; gender = 64.5% female [n = 482], 35.5% male [n = 265]; Italy)

  • Mean number of Borderline Personality Disorder symptoms = 3.08; SD = 1.95
  • Mean number of Antisocial Personality Disorder symptoms = 1.32; SD = 1.45
  • Female participants scored significantly higher on the BPD scale than male participants; t(745) = 3.20, p < 0.005.
  • Female participants scored significantly lower on the ASPD scale than male participants; t(745) = -3.94, p < 0.001.

Test/Retest Reliability

Undergraduate Students (Okada & Oltmanns, 2009; N = 203; mean age [SD] = 20 [1.1] years; 31% male [n = 63]; United States):

Personality Disorder

 

ICC (Time 1 and Time 2)

ICC (Time 2 and Time 3)

ICC (Time 1 and Time 3)

Paranoid

0.61

0.84

0.58

Schizoid

0.54

0.80

0.59

Schizotypal

0.64

0.82

0.63

Antisocial

0.56

0.85

0.58

Borderline

0.58

0.87

0.47

Histrionic

0.65

0.85

0.62

Narcissistic

0.65

0.79

0.66

Avoidant

0.56

0.81

0.66

Dependent

0.60

0.84

0.57

Obsessive-Compulsive

0.59

0.82

0.56

Median

0.60

0.83

0.59

 

 

 

 

 

Undergraduate students (Ling et al., 2010; N = 4,811; China)

 

Personality Disorder

Test-Retest Reliability (ICC)

Borderline

0.83

Antisocial

0.79

Paranoid

0.66

Schizoid

0.57

Internal Consistency

Undergraduate students (Ling et al., 2010; N = 4,811; China)

Personality Disorder

Cronbach’s alpha

Antisocial

Adequate (0.74)

Paranoid

Adequate (0.70)

Borderline

Excellent (0.83)

Community residents (Ling et al., 2010; age range = 18-80 years; general community residents, China)

 

Personality Disorder

Cronbach’s alpha

Borderline

Adequate (0.78)

Schizotypal

Poor (0.56)

 

Criterion Validity (Predictive/Concurrent)

Predictive Validity:

 

Undergraduate students, China  (Ling et al., 2010; N = 313):

  • Poor PPM correlations between personality disorder scores, as measured by the PDQ-4+, and parental relationships in childhood, as measured by the CECA.Q.
  • Adequate correlations between total score for PDQ and antipathy toward mother and total score for PDQ and antipathy toward father.

Personality Disorder

Antipathy toward mother

Neglect by mother

Antipathy toward father

Neglect by father

Paranoid

.155**

.010

.169**

.022

Schizotypal

.242**

.214**

.227**

.240**

Schizoid

.176**

.094**

.205**

.104**

Antisocial

.209**

.244**

.295**

.202**

Borderline

.268**

.156**

.269**

.185**

Histrionic

.107**

.063

.091**

.042

Narcissistic

.142**

.023

.136**

.020

Avoidant

.240**

.161**

.242**

.207**

Dependent

.204**

.152**

.211**

.162**

Obsessive-Compulsive

.151**

.029

.126**

.082*

Passive-Aggressive

.185**

.087**

.185**

.102**

Depressive

.230**

.145**

.239**

.192**

Total score for PDQ

.332**

.200**

.339**

.214**

Construct Validity

Convergent Validity:

Undergraduate students (Okada & Oltmanns, 2009; N = 203; 69% female; mean age [SD] = 20 [1.1]; United States):

Personality Disorder

Pearson Correlation for agreement between SCID-IIQ and PDQ-4

Paranoid

Excellent (0.82)

Schizoid

Excellent (0.73)

Schizotypal

Excellent (0.67)

Borderline

Excellent (0.78)

Histrionic

Adequate (0.58)

Narcissistic

Excellent (0.74)

Avoidant

Excellent (0.76)

Dependent

Excellent (0.68)

Obsessive-Compulsive

Excellent (0.65)

Median

Excellent (0.73)

Bibliography

Abdin, E., Koh, K. G., Subramaniam, M., Guo, M.-E., Leo, T., Teo, C., … Chong, S. A. (2011). Validity of the Personality Diagnostic Questionnaire—4 (PDQ-4) among Mentally Ill Prison Inmates in Singapore. Journal of Personality Disorders, 25(6), 834–841. doi: 10.1521/pedi.2011.25.6.834

Davison, S., Leese, M., & Taylor, P. J. (2001). Examination of the Screening Properties of the Personality Diagnostic Questionnaire 4 (PDQ-4 ) in a Prison Population. Journal of Personality Disorders, 15(2), 180–194. doi: 10.1521/pedi.15.2.180.19212

Fossati, A., Barratt, E. S., Carretta, I., Leonardi, B., Grazioli, F., & Maffei, C. (2004). Predicting borderline and antisocial personality disorder features in nonclinical subjects using measures of impulsivity and aggressiveness. Psychiatry Research, 125, 161–170. doi: 10.1016/j.psychres.2003.12.001

Fossati, A., Maffei, C., Bagnato, M., Donati, D., Donini, M., Fiorilli, M., … Ansoldi, M. (1998). Brief Communication: Criterion Validity of the Personality Diagnostic Questionnaire-4 (PDQ-4 ) in a Mixed Psychiatric Sample. Journal of Personality Disorders, 12(2), 172–178. doi: 10.1521/pedi.1998.12.2.172

Green, K., & Browne, K. (2019). Personality Disorder Traits, Trauma, and Risk in Perpetrators of Domestic Violence. International Journal of Offender Therapy and Comparative Criminology, 64(2-3), 147–166. doi: 10.1177/0306624x19826516

Guy, L. S., Poythress, N. G., Douglas, K. S., Skeem, J. L., & Edens, J. F. (2008). Correspondence between self-report and interview-based assessments of antisocial personality disorder. Psychological Assessment, 20(1), 47–54. doi: 10.1037/1040-3590.20.1.47

Hopwood, C. J., Donnellan, M. B., Ackerman, R. A., Thomas, K. M., Morey, L. C., & Skodol, A. E. (2013). The validity of the personality diagnostic questionnaire–4 narcissistic personality disorder scale for assessing pathological grandiosity. Journal of Personality Assessment, 95(3), 274–283. doi: 10.1080/00223891.2012.732637

Hyler, S. E. (1994). Personality Diagnostic Questionnaire-4+ (PDQ-4+) [Database record]. APA PsycTests.

Ling, H., Qian, M.-Y., & Yang, B.-J. (2010). Reliability and validity of the Chinese version of the personality diagnostic questionnaire-4 : A study with Chinese college students. Social Behavior and Personality, 38(3), 311–320. doi: 10.2224/sbp.2010.38.3.311

Okada, M., & Oltmanns, T. F. (2009). Comparison of Three Self-Report Measures of Personality Pathology. Journal of Psychopathology and Behavioral Assessment, 31(4), 358–367. doi: 10.1007/s10862-009-9130-8

Order the PDQ-4. (n.d.) The official website of the PDQ-4. http://www.pdq4.com/Order.html

PDQ Computer Assisted. (n.d.). Steven E. Hyler’s home page.

Pilkonis, P. (2019, January 3). Personality Diagnostic Questionnaire-IV (PDQ-IV) - Personality Studies. Retrieved April 27, 2020, from

Reus, R. J. M. D., Berg, J. F. V. D., & Emmelkamp, P. M. G. (2011). Personality Diagnostic Questionnaire 4 is not Useful as a Screener in Clinical Practice. Clinical Psychology & Psychotherapy, 20(1), 49–54. doi: 10.1002/cpp.766

The Personality Diagnostic Questionnaire. (n.d.). Retrieved April 27, 2020, from