The factor structure and the convergent validity of the Personality Inventory for DSM-5 (PID-5), a self-report questionnaire designed to measure personality pathology as advocated in the fifth edition, Section III of Diagnostic and Statistical Manual of Mental Disorders (DSM-5), are already demonstrated in general population samples, but need replication in clinical samples. In 240 Flemish inpatients, we examined the factor structure of the PID-5 by means of exploratory structural equation modeling. Additionally, we investigated differences in PID-5 higher order domain scores according to gender, age and educational level, and explored convergent and discriminant validity by relating the PID-5 with the Dimensional Assessment of Personality Pathology-Basic Questionnaire and by comparing PID-5 scores of inpatients with and without a DSM-IV categorical personality disorder diagnosis. Our results confirmed the original five-factor structure of the PID-5. The reliability and the convergent and discriminant validity of the PID-5 proved to be adequate. Implications for future research are discussed.

This study examined the relationship between the psychotherapeutic process and outcome in 44 patients who completed hospitalization-based psychodynamic treatment for personality disorders. Using self-report and interview ratings, outcome was assessed in terms of symptoms and personality functioning, and the psychotherapeutic process in terms of self and object relations, felt safety, and reflective functioning. Symptom and process measures were administered at intake, every 3 months during treatment, and at 3 and 12 months follow-up. Personality measures were collected at intake, the end of treatment, and at 3 and 12 months follow-up. Using Piecewise Linear Growth Curve Analysis results showed improvement in symptoms, personality functioning, self and object relations and felt safety, but not in reflective functioning. Linear changes in self and object representation and felt safety, but not in reflective functioning, predicted improvement in outcome.

This paper provides a systematic review of extant research concerning the association between level of personality organization (PO) and psychotherapy response. Psychotherapy studies that reported a quantifiable association between level of PO and treatment outcome were examined for eligibility. Based on stringent inclusion and exclusion criteria, we identified 18 studies from 13 original data sources. Participants in these studies had a variety of mental disorders, of which mood, anxiety, and personality disorders were the most common. The results of this systematic review converge to suggest that higher initial levels of PO are moderately to strongly associated with better treatment outcome. Some studies indicate that level of PO may interact with the type of intervention (i.e., interpretive versus supportive) in predicting treatment outcome, which suggests the importance of tailoring the level of interpretive work to the level of PO. Yet, at the same time, the limited number of studies available and the heterogeneity of measures used to assess PO in existing research stress the need for further research. Potential implications for clinical practice and guidelines for future research are discussed.

This study aims to identify different outcome trajectories in a psychoanalytic hospitalization-based treatment in a sample of 70 patients with personality disorders using a naturalistic 12 month follow-up design. Trajectory analysis identified four groups of patients, i.e., patients showing (a) high initial symptom levels and considerable and consistent improvement late in treatment (High-Low group; HL), (b) medium initial symptom levels and a quick and sustained response (Medium-Low group; ML), (c) medium initial symptom levels but without substantial improvement (Medium-Medium group; MM), and (d) low initial symptom levels without substantial further improvement during and after treatment (Low-Low group; LL). Further, data suggested that these four trajectories were related in theoretically meaningful ways to pre-treatment variables, such as anaclitic and introjective personality styles and trauma. Results are discussed in the context of other studies showing the need for differential treatment approaches based on pretreatment characteristics.