Article2010

The relationship between personality organization, reflective functioning, and psychiatric classification in borderline personality disorder.

Melitta Fischer‐Kern · Anna Buchheim · Susanne Hörz‐Sagstetter · Peter Schuster · Stephan Doering · Nestor D. Kapusta +5 more

130 citations0/0 files storedPsychoanalytic Psychology

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Personality Disorders and Psychopathology Psychoanalysis and Psychopathology Research Personality Traits and Psychology

Abstract

Relationships between personality organization, reflective functioning (RF), and the number of Axis I and Axis II disorders were examined. Ninety-two female patients with Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV-TR) borderline personality disorder (BPD) were administered the Structured Interview of Personality Organization (STIPO), the Adult Attachment Interview for assessment of RF, and the Structured Clinical Interview for DSM Disorders. Significant correlations were found between the level of personality organization and the number of Axis I and Axis II diagnoses. In contrast, no association was found between RF and the severity of Axis I and Axis II pathology. RF and level of personality organization were moderately associated. The results indicate that the concept of personality organization is related to the descriptive approach of the DSM-IV-TR. The STIPO provides a differentiated picture of the severity of personality pathology and allows dimensional ratings of several domains central to personality functioning. The RF findings confirm previous studies indicating impairments of mentalizing capacity in BPD patients. The association between RF and level of personality organization supports both shared and divergent conceptual considerations underlying mentalization and personality organization. Further investigation of the relationship between these structural constructs would shed light on the complex interplay of an individual's capacity to mentalize and the personality structure shaped by identity integration, defense mechanisms, and reality testing. In addition to the psychiatric classification, measurements of RF and personality organization should be considered in psychotherapeutic treatment planning as well as evaluation of therapy response.

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References

2013Diagnostic and Statistical Manual of Mental Disorders 1985Security in Infancy, Childhood, and Adulthood: A Move to the Level of Representation 2018Affect Regulation, Mentalization, and the Development of the Self 1991The capacity for understanding mental states: The reflective self in parent and child and its significance for security of attachment 1984Severe Personality Disorders: Psychotherapeutic Strategies 1996The relation of attachment status, psychiatric classification, and response to psychotherapy.2007Evaluating Three Treatments for Borderline Personality Disorder: A Multiwave Study 2006Change in attachment patterns and reflective function in a randomized control trial of transference-focused psychotherapy for borderline personality disorder.

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