Assessment Tools

The structured clinical interview

The cornerstone for the accurate diagnosis of personality disorders is usually the structured clinical interview.

The most commonly used reference model is the SCID (Structured Clinical Interview for the DSM), designed specifically to assess for the presence of standardized diagnostic criteria.

The main advantage of this method is that it allows the professional a direct observation of the patient "live", capturing not only what he says, but how he says it, his nonverbal language and his immediate emotional reactions.

It is a tool that systematizes the collection of information, reducing variability among different eva luators.

Questionnaires and self-reports (MCMI, MMPI, 16PF)

Psychometric instruments are commonly used to triangulate the information obtained in the interview.

Among the most relevant tests for adults are the 16PF (16 Factor Personality Questionnaire), the MMPI (Minnesota Multiphasic Personality Inventory) and the MCMI (Millon Clinical Multiaxial Inventory), the latter specially designed to detect pathological personality patterns.

In the case of adolescents, where diagnosis requires greater caution, specific adaptations are used.

For example, the Millon Adolescent Clinical Inventory (MACI) or the MMPI-A are calibrated for this population.

Tools such as the Hare Psychopathy Checklist in its juvenile version (PCL:YV) or the NEO-PI-R, which assesses personality traits based on the Big Five Factor Model, are also used.

Diagnostic Challenges: Overlap and comorbidity

Clinical diagnosis faces significant obstacles stemming from the assessor's own cognitive biases.

One of the most frequent risks in the interview is the "halo effect," which is the erroneous generalization of a positive or negative characteristic to the patient's entire personality.

For example, a therapist might unconsciously assume that a patient is emotionally stable and sincere simply because he or she presents well-dressed and has refined manners, overlooking subtle indicators of pathology. Likewise, it is common to fall into the "fundamental attribution error."

This bias leads the clinician to overestimate internal factors (personality, character) to explain the patient's behavior, while underestimating the influence of external situational or environmental factors.

These errors of judgment can lead to incorrect diagnoses or pathologization of normal reactions to