scholarly journals The Construct Validity of the ICD-11 Severity of Personality Dysfunction Under Scrutiny of Object-Relations Theory

2021 ◽  
Vol 12 ◽  
Author(s):  
Amin Nazari ◽  
Steven K. Huprich ◽  
Azad Hemmati ◽  
Farzin Rezaei
Keyword(s):  
Personality Disorder ◽  
Object Relations ◽  
International Classification Of Diseases ◽  
Structured Interview ◽  
Self Report ◽  
Clinical Group ◽  
Object Relations Theory ◽  
Personality Functioning ◽  
Personality Dysfunction

The current classification of personality disorder in ICD-11 includes a description of personality functioning, derived from a number of theoretical paradigms, but most notably consistent with the psychodynamic approach. Concurrently, an object-relations model of personality functioning in a dimensional assessment of severity is provided in the Structured Interview of Personality Organization-Revised (STIPO-R). To date, there are no published measures of International Classification of Diseases-11 (ICD-11) personality severity, though the construct is very comparable to the concepts assessed in the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) levels of personality functioning concept, which is measured by the Level of Personality Functioning Scale-Self-Report (LPFS-SR). This study examined the validity of ICD-11 personality functioning, as measured by the LPFS-SR, by evaluating its associations with the STIPO-R in Kurdistan region. The samples included 231 University students and 419 inpatient participants across four hospitals (267 with a diagnosed personality disorder). All the components of LPFS-SR and STIPO-R were positively and significantly intercorrelated. The components of each measure discriminated PD and non-PD patients from a University, non-clinical group adequately. Despite slightly better performance of the STIPO-R in this discrimination, the measures had a high congruence in predicting personality dysfunction. Overall, the findings of the present study support the validity of ICD-11 construct for evaluating personality functioning.

Use of the ICD-10 version of the Standardized Assessment of Personality to determine the prevalence of personality disorder in psychiatric in-patients

1990 ◽  
Vol 20 (4) ◽  
pp. 985-992 ◽  
Author(s):  
John Pilgrim ◽  
Anthony Mann
Keyword(s):  
Personality Disorder ◽  
Total Sample ◽  
International Classification Of Diseases ◽  
Structured Interview ◽  
Standardized Assessment ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
One Year ◽  
First Admission

SynopsisThe Standardized Assessment of Personality (SAP) involves a short semi-structured interview with an informant. It was modified to accord with the 1987 draft of the tenth revision of the International Classification of Diseases (ICD-10) and used to assess the pre-morbid personality of first-admission patients in one London area over the period of one year. Of the 120 (84% of the total sample of first-admissions) patients included, 43 (36%) were found to satisfy the ICD-10 criteria for personality disorder and a further 17 (14%) to satisfy the criteria for personality trait accentuation.

scholarly journals ICD-11 Personality Disorders: A Psychodynamic Perspective on Personality Functioning

2021 ◽  
Vol 12 ◽  
Author(s):  
Victor Blüml ◽  
Stephan Doering
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Conceptual Analysis ◽  
Common Ground ◽  
Personality Pathology ◽  
Object Relations Theory ◽  
Personality Functioning ◽  
Dimensional Classification ◽  
Data Points

The new ICD-11 introduces a fully dimensional classification of personality disorders representing a fundamental change in personality disorder diagnosis with major implications for clinical practice and research. The new system centers on the evaluation of the severity of impairment in the areas of self and interpersonal functioning. This focus on personality functioning converges with long-standing psychoanalytic/psychodynamic conceptualizations of personality pathology. In a detailed conceptual analysis and review of existing empirical data, points of convergence and notable differences between major exponents of the psychodynamic tradition—object relations theory as developed by Kernberg et al. and the Operationalized Psychodynamic Diagnosis—and the ICD-11 system are critically discussed. Personality functioning can be considered to be the current “common ground” for the assessment of personality disorders and constitutes a considerable step forward in making personality disorder diagnosis both clinically meaningful and suitable for research purposes.

scholarly journals Assessing Personality Disorders in Adolescence: A Validation Study of the IPOP-A

2020 ◽  
Vol 9 (3) ◽  
pp. 194-205
Author(s):  
Isabel Leal ◽  
Sara Bailote Silva ◽  
Maria Meireles Ramos ◽  
Marta Pedreira ◽  
Vera Santos Ramos ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Discriminant Validity ◽  
Personality Development ◽  
Total Sample ◽  
Structured Interview ◽  
Clinical Group ◽  
Personality Functioning ◽  
Valid Instrument ◽  
Coding Manual ◽  
Acceptable Internal Consistency

Background: The need to develop clinical and empirically-based tools for assessing personality development in adolescence led to the proposal of the IPOP-A (Ammaniti, Fontana, Kernberg, Clarkin, & Clarkin, 2011), a semi-structured interview for adolescents that aims to differentiate personality organization processes from characteristics that may reflect a personality disorder. Objective and Methods: This research aimed to evaluate the adaptation of the IPOP-A to the Portuguese population, attending to its diagnostic properties and its discriminant validity by comparing a clinical group with a nonclinical one. A total sample of 44 adolescents from 13 to 18 years old has taken part in this study, 22 of whom had a previous personality disorder diagnosis. The content of the interviews was transcribed and codified according to the coding manual. Results: Acceptable internal consistency values across the dimensions of the IPOP-A are found and statistically significant differences are revealed between the clinical group and nonclinical group, with the clinical group revealing values that suggest higher impairment in the dimensions of the personality functioning in comparison with the nonclinical one. Conclusion: Our study supports that the Portuguese version of the IPOP-A can be considered a valid instrument to identify adolescents with a personality disorder.

DSM‐IV personality disorders and the Five‐Factor Model of personality: a multi‐method examination of domain‐ and facet‐level predictions

2005 ◽  
Vol 19 (4) ◽  
pp. 307-324 ◽  
Author(s):  
R. Michael Bagby ◽  
Paul T. Costa ◽  
Thomas A. Widiger ◽  
Andrew G. Ryder ◽  
Margarita Marshall
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Factor Model ◽  
Psychiatric Patients ◽  
Five Factor Model ◽  
Structured Interview ◽  
Self Report ◽  
Neo Personality Inventory ◽  
Personality Functioning ◽  
Personality Psychopathology

The personality disorder classification system (Axis II) in the various versions of the Diagnostic and Statistical Manuals of Mental Disorders (DSM) has been the target of repeated criticism, with conceptual analysis and empirical evidence documenting its flaws. In response, many have proposed alternative approaches for the assessment of personality psychopathology, including the application of the Five‐Factor Model of personality (FFM). Many remain sceptical, however, as to whether domain and facet traits from a model of general personality functioning can be successfully applied to clinical patients with personality disorders (PDs). In this study, with a sample of psychiatric patients (n = 115), personality disorder symptoms corresponding to each of the 10 PDs were successfully predicted by the facet and domain traits of the FFM, as measured by a semi‐structured interview, the Structured Interview for the Five Factor Model (SIFFM; Trull & Widiger, 1997) and a self‐report questionnaire, the Revised NEO Personality Inventory (NEO PI‐R; Costa and McCrae, 1992). These results provide support for the perspective that personality psychopathology can be captured by general personality dimensions. The FFM has the potential to provide a valid and scientifically sound framework from which to assess personality psychopathology, in a way that covers most of the domains conceptualized in DSM while transcending the limitations of the current categorical approach to these disorders. Copyright © 2005 John Wiley & Sons, Ltd.

Machiavellianism and personality disorder: their relationship in the mirror of interpersonal attitudes

2014 ◽  
Vol 155 (40) ◽  
pp. 1584-1588
Author(s):  
András Láng
Keyword(s):  
Personality Disorder ◽  
Personality Traits ◽  
Personality Disorders ◽  
Interpersonal Problems ◽  
Self Report ◽  
Callous Unemotional ◽  
Personality Dysfunction ◽  
Medium Strength

Introduction: Social and personality psychologists have described Machiavellianism as a pragmatic, callous-unemotional, exploitative and manipulative attitude towards others. Several former studies linked Machiavellian personality traits and interpersonal problems or personality dysfunction. Aim: The aim of this study was to reveal the connection between Machiavellianism and interpersonal problems that are characteristic of personality disorders. Method: 252 participants (146 females and 106 males, aged 32.46±5.39 years, mean±SD) filled out self-report measures of Machiavellianism and personality disorder related interpersonal problems. Results: There was a medium strength relationships between Machiavellianism and several interpersonal problems. Aggression and ambivalence proved to be significant predictors of Machiavellian personality traits. Conclusions: Results are discussed in relation to the patient–therapist bond. Orv. Hetil., 2014, 155(39), 1584–1588.

Transference-Focused Psychotherapy for Pathological Narcissism and Narcissistic Personality Disorder (TFP-N)

2021 ◽  
Vol 49 (2) ◽  
pp. 244-272
Author(s):  
Diana Diamond ◽  
Frank Yeomans ◽  
John R. Keefe
Keyword(s):  
Personality Disorder ◽  
Sense Of Self ◽  
Assessment Process ◽  
Narcissistic Personality Disorder ◽  
Object Relations Theory ◽  
Pathological Narcissism ◽  
Personality Functioning ◽  
Therapeutic Interaction ◽  
Narcissistic Personality ◽  
Transference Focused Psychotherapy

In this article, we provide an overview of transference-focused psychotherapy for patients with pathological narcissism and narcissistic personality disorder (TFP-N). In TFP-N we have modified and refined the tactics and techniques of TFP, an evidence-based treatment for borderline personality disorder, to meet the specific challenges of working with patients with narcissistic personality pathology whose retreat from reality into an illusory grandiosity makes them particularly difficult to engage in treatment. We first describe a model of narcissistic pathology based on considerations of psychological structure stemming from object relations theory. This model provides a unifying understanding of the core structure of narcissistic pathology, the pathological grandiose self, that underlies the impairments in self and interpersonal functioning of those with narcissistic pathology across the levels of personality organization (from high functioning to borderline to malignant). We then delineate the clinical process of working with patients with pathological narcissism and narcissistic personality disorder. Starting with the assessment process, using a detailed clinical example, we guide the reader through the progression of TFP-N as it helps the patient move from the distorted, unintegrated sense of self underlying the narcissistic presentation to the more integrated, realistic sense of self that characterizes healthier personality functioning. In TFP-N the focus on the disturbed interpersonal patterns of relating in the here and now of the therapeutic interaction is the vehicle to diminish grandiosity and improve relatedness, thereby effecting enduring changes in mental representation and real-world functioning.

ICD-11 and DSM-5 personality trait domains capture categorical personality disorders: Finding a common ground

2017 ◽  
Vol 52 (5) ◽  
pp. 425-434 ◽  
Author(s):  
Bo Bach ◽  
Martin Sellbom ◽  
Mathias Skjernov ◽  
Erik Simonsen
Keyword(s):  
Personality Disorder ◽  
Mental Disorders ◽  
Personality Disorders ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Classification Of Diseases ◽  
Domain Models

Objective: The five personality disorder trait domains in the proposed International Classification of Diseases, 11th edition and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition are comparable in terms of Negative Affectivity, Detachment, Antagonism/Dissociality and Disinhibition. However, the International Classification of Diseases, 11th edition model includes a separate domain of Anankastia, whereas the Diagnostic and Statistical Manual of Mental Disorders, 5th edition model includes an additional domain of Psychoticism. This study examined associations of International Classification of Diseases, 11th edition and Diagnostic and Statistical Manual of Mental Disorders, 5th edition trait domains, simultaneously, with categorical personality disorders. Method: Psychiatric outpatients ( N = 226) were administered the Structured Clinical Interview for DSM-IV Axis II Personality Disorders Interview and the Personality Inventory for DSM-5. International Classification of Diseases, 11th edition and Diagnostic and Statistical Manual of Mental Disorders, 5th edition trait domain scores were obtained using pertinent scoring algorithms for the Personality Inventory for DSM-5. Associations between categorical personality disorders and trait domains were examined using correlation and multiple regression analyses. Results: Both the International Classification of Diseases, 11th edition and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition domain models showed relevant continuity with categorical personality disorders and captured a substantial amount of their information. As expected, the International Classification of Diseases, 11th edition model was superior in capturing obsessive–compulsive personality disorder, whereas the Diagnostic and Statistical Manual of Mental Disorders, 5th edition model was superior in capturing schizotypal personality disorder. Conclusion: These preliminary findings suggest that little information is ‘lost’ in a transition to trait domain models and potentially adds to narrowing the gap between Diagnostic and Statistical Manual of Mental Disorders, 5th edition and the proposed International Classification of Diseases, 11th edition model. Accordingly, the International Classification of Diseases, 11th edition and Diagnostic and Statistical Manual of Mental Disorders, 5th edition domain models may be used to delineate one another as well as features of familiar categorical personality disorder types. A preliminary category-to-domain ‘cross walk’ is provided in the article.

Incremental validity of the Structured Interview for the Five‐Factor Model of Personality (SIFFM)

2005 ◽  
Vol 19 (4) ◽  
pp. 343-357 ◽  
Author(s):  
Stephanie D. Stepp ◽  
Timothy J. Trull ◽  
Rachel M. Burr ◽  
Mimi Wolfenstein ◽  
Angela Z. Vieth
Keyword(s):  
Personality Disorder ◽  
Personality Traits ◽  
Clinical Utility ◽  
Factor Model ◽  
Five Factor Model ◽  
Structured Interview ◽  
Incremental Validity ◽  
Self Report ◽  
Histrionic Personality Disorder

This study examined the incremental validity of the Structured Interview for the Five‐Factor Model (SIFFM; Trull & Widiger, 1997) scores in the prediction of borderline, antisocial, and histrionic personality disorder symptoms above and beyond variance accounted for by scores from the Schedule for Nonadaptive and Adaptive Personality (SNAP; Clark, 1993), a self‐report questionnaire that includes items relevant to both normal (i.e. Big Three) and abnormal personality traits. Approximately 200 participants (52 clinical outpatients, and 149 nonclinical individuals from a borderline‐features‐enriched sample) completed the SIFFM, the SNAP, and select sections of the Personality Disorder Interview—IV (PDI‐IV; Widiger, Mangine, Corbitt, Ellis, & Thomas, 1995). We found support for the incremental validity of SIFFM scores, further indicating the clinical utility of this instrument. However, results also supported the incremental validity of SNAP scores in many cases. We discuss the implications of the findings in terms of dimensional approaches to personality disorder assessment. Copyright © 2005 John Wiley & Sons, Ltd.

MCMI-II Personality Traits Associated with the MMPI-2 Masculinity-Femininity Scale

Assessment ◽  
1995 ◽  
Vol 2 (2) ◽  
pp. 131-136
Author(s):  
Mark A. Blais
Keyword(s):  
Personality Disorder ◽  
Minnesota Multiphasic Personality Inventory ◽  
Self Report ◽  
Behavioral Correlates ◽  
Personality Functioning ◽  
T Score ◽  
Millon Clinical Multiaxial Inventory ◽  
Paranoid Personality Disorder ◽  
Personality Disorder Scales ◽  
Report Measure

There has been limited research into the behavioral correlates associated with the Masculinity-Femininity ( Mf) scale of the MMPI (and the MMPI-2). In this study, both the Millon Clinical Multiaxial Inventory—II (MCMI-II), a frequently used self-report measure of personality functioning, and the Minnesota Multiphasic Personality Inventory–2 (MMPI-2) were administered to a group of 76 female psychiatric inpatients. The sample was divided based upon MMPI-2 Mf scale T scores. Subjects with a T score >50 were assigned to the high- Mf group ( n = 28), whereas subjects with a T score >50 were assigned to the low- Mf group ( n = 48). The two groups were compared across the 13 personality disorder scales of the MCMI-II. The results showed that subjects in the high- Mf group had significantly higher scores on the MCMI-II Narcissistic, Antisocial, Aggressive/Sadistic, and Paranoid personality disorder scales. A correlational analysis revealed that the MMPI-2 Mf scale was significantly correlated with these four MCMI-II personality disorder scales. These results are discussed in light of their clinical implications and the limitations of the study.

Is antisocial personality disorder continuous or categorical? A taxometric analysis

2006 ◽  
Vol 36 (11) ◽  
pp. 1571-1581 ◽  
Author(s):  
DAVID K. MARCUS ◽  
SCOTT O. LILIENFELD ◽  
JOHN F. EDENS ◽  
NORMAN G. POYTHRESS
Keyword(s):  
Personality Disorder ◽  
Antisocial Personality Disorder ◽  
Statistical Power ◽  
Structured Interview ◽  
Self Report ◽  
Latent Structure ◽  
Antisocial Personality ◽  
Taxometric Analysis ◽  
Dsm Iv ◽  
State Prisons

Background. Although the DSM-IV-TR is organized into discrete disorders, the question of whether a given disorder possesses a dimensional or a categorical latent structure is an empirical one that can be examined using taxometric methods. The objective of this study was to ascertain the latent structure of antisocial personality disorder (ASPD).Method. Participants were 1146 male offenders incarcerated in state prisons (n=569), or court-ordered to residential drug treatment (n=577). Participants were interviewed using the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II) to assess ASPD symptoms; they also completed the Personality Diagnostic Questionnaire-4 (PDQ-4) ASPD scale. Taxometric analyses were performed to examine whether ASPD is underpinned by a discrete category or a dimensional construct.Results. Multiple taxometric procedures using two different sets of indicators provided no evidence that ASPD has a taxonic latent structure. Instead, the results were far more consistent with the proposition that ASPD exists on a continuum, regardless of whether it is assessed using a structured interview or a self-report measure.Conclusions. Evidence that ASPD is dimensional suggests that it is best studied using continuous measures and that dichotomizing individuals into ASPD versus non-ASPD groups will typically result in decreased statistical power. The findings are also consistent with a multifactorial etiology for ASPD and with recent attempts to conceptualize ASPD within the framework of extant dimensional models of personality.

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