Assessment of Personality Functioning: Validity of the Operationalized Psychodynamic Diagnosis Axis IV (Structure)

Abstract

Background: The assessment of personality functioning has recently become a focus of psychiatric diagnostics. The interview-based Operationalized Psychodynamic Diagnosis (OPD-2) provides a ‘structure axis' for the assessment of personality functioning. Methods: One hundred twenty-four psychiatric patients were diagnosed by means of the Structured Clinical Interviews for DSM-IV (SCID-I and SCID-II), underwent OPD-2 interviews, and completed 9 questionnaires. Results: The OPD-2 structure axis shows good interrater reliability (intraclass correlation = 0.793). Correlations between the OPD-2 structure axis domains and a priori selected questionnaire scales were of medium size and significant. Patients with a personality disorder (PD) showed significantly worse personality functioning than those without. In cluster B PD, personality functioning was more severely impaired than in cluster C PD. Discussion: The OPD-2 structure axis shows good reliability as well as concurrent and discriminant validity and can be recommended for clinical use and research purposes.

Levels of Structural Integration Mediate the Impact of Metacognition on Functioning in Non-affective Psychosis: Adding a Psychodynamic Perspective to the Metacognitive Approach

“…There are several limitations to this study: The investigated sample had on average moderate to low integration levels of psychic structure, which were relatively high compared to the only other study of individuals with non-affective psychoses using the OPD (Uzdawinis et al, 2010), and were closer to ratings of personality disorders (Doering et al, 2014). This finding might partly be explained by the observation that patients with psychosis show particular characteristics of psychic structure and that sometimes "disintegrated" as well as better integrated aspects of the same dimension can exist simultaneously at the same time.…”

Is reflective functioning associated with clinical symptoms and long-term course in patients with personality disorders?

“…Like the STIPO methodology, the structure axis of OPD aims to cover a broad set of personality domains such as self and object recognition, regulation, communication, and attachment [58]. In a recent report by Doering et al [60], axis IV of the OPD was used as a measure of the level of personality functioning, and PD patients showed significantly worse results on axis IV outcomes than patients without PD.…”

How Is Our Self Altered in Psychiatric Disorders? A Neurophenomenal Approach to Psychopathological Symptoms

“…This will be the focus in the following. Reasons of space will prevent me from giving a more general overview of the psychopathology of the self in other psychiatric disorders such as in addiction (see for instance de Greck et al [6,7]) and personality disorders (see Doering et al [8]).…”