A Psychoanalytic Theory of Personality Disorders

Structured Interview of Personality Organization (STIPO): Preliminary Psychometrics in a Clinical Sample

“…We hypothesized that individuals characterized by significant identity pathology and the extensive use of primitive defenses (i.e., probable cases of BPO), would exhibit higher levels of negative affect and aggression, high levels of interpersonal distress, and lower levels of positive affect. Consistent with the view that impairments in reality testing in the borderline spectrum occur principally under conditions of what has been termed "peak affect activation or aggression" (Kernberg & Caligor, 2005; as opposed to being trait-like, enduring impairments such as those seen in schizotypic pathology), we did not anticipate that reality testing would contribute significantly to the prediction of measures of affect, aggression, or personality disorder traits above and beyond what is accounted for by the identity and primitive defenses domains. We did anticipate that after controlling for the independent effects of identity and primitive defenses, reality testing would be significantly associated with measures of cognitive impairment.…”

“…In this report, we present preliminary data on the psychometric development of the Structured Interview of Personality Organization (STIPO), a semi-structured interview developed to assess dimensions of personality pathology within Kernberg's (1984) particular psychodynamic frame of reference. Informed by contemporary object relations theory, Kernberg (1984;Kernberg & Caligor, 2005) has described what is essentially a dimensional model of personality centered on the assessment of three key domains: identity disturbance, primitive psychological defenses, and reality testing (1984; Kernberg & Caligor, 2005). In his clinical writing and teaching, Kernberg characterized the clinical psychopathology of personality disorder according to the individual's standing on these three dimensions as falling into two primary regions: the borderline (BPO) and neurotic (NPO) levels of "personality organization."…”

“…Normal identity is based on the individual's ability to shift flexibly across various self-representations, resulting in an appraisal of the self that is realistic and integrated, with an ability to tolerate both the positively and negatively imbued qualities of the self and a correspondingly realistic and stable experience of others. In contrast, identity pathology is characterized by inflexible and unstable, poorly integrated, black and white (i.e., "all good" or "all bad") experiences of self and other, with a resulting incoherence in the experience of self and others and a predominance of negative affects as well as instability and conflict in the interpersonal sphere (Kernberg & Caligor, 2005).…”

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In this article, we describe the development and preliminary psychometric properties of the Structured Interview of Personality Organization (STIPO), a semistructured interview designed for the dimensional assessment of identity, primitive defenses, and reality testing, the three primary content domains in the model of personality health and disorder elaborated by Kernberg (1984;Kernberg & Caligor, 2005). Results of this investigation, conducted in a clinical sample representing a broad range of personality pathology, indicate that identity and primitive defenses as operationalized in the STIPO are internally consistent and that interrater reliability for all 3 content domains is adequate.

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Mindfulness skills in individuals with borderline personality features: Roles of impulsivity and rejection sensitivity

“…Previous research suggests that a disrupted (Black, 2010;Lowmaster, 2013;Rizvi, 2004) and disintegrated sense of self (Bateman & Fonagy, 2004;Kernberg, 1996) distorted perceptions of both self and others (Arntz, Dietzel & Dreessen, 1999;Clarkin, Yeomans & Kernberg, 2006) negative emotional attributions (Beck, Freeman & Davis, 2004;Feliu-Soler et al, 2013) biased thinking (Renneberg et al, 2012;Tragesser, Lippman, Trull & Barrett 2008) emotion regulation difficulties (Linehan, 1993;van Dijke et al, 2010) and emotion recognition problems (Farrell, 1994) are among the important problems in individuals with borderline personality features. These problems may contribute to mood shifts, relationship problems and negative attitudes about self (Cheavens, Strunk & Chriki, 2012) which may cause impulsive behaviours, feelings of emptiness and perceived rejection (Linehan, 1993).…”