Changes in Personality Functioning After Inpatient Psychodynamic Therapy: A Dimensional Approach to Personality Disorders

Background and Objectives: Emotional dysfunction is considered a key component in personality disorders; however, only few studies have examined the relationship between the two. In this study, emotional dysfunction was operationalized through the Affect Integration Inventory, and the aim was to examine the relationships between the level of affect integration and the levels of symptom distress, interpersonal problems, and personality functioning in patients diagnosed with personality disorder according to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition. Materials and Methods: Within a hospital-based psychiatric outpatient setting, 87 patients with personality disorder referred for treatment were identified for assessment with the Affect Integration Inventory and other measures (e.g., the Symptom Checklist-90, Revised, the Inventory of Interpersonal Problems 64 circumplex version, and the Severity Indices of Personality Problems). Results: The analyses revealed that problems with affect integration were strongly and statistically significantly correlated with high levels of symptom distress, interpersonal problems, and maladaptive personality functioning. Additionally, low scores on the Affect Integration Inventory regarding discrete affects were associated with distinct and differentiated patterns of interpersonal problems. Conclusion: Taken together, emotional dysfunction, as measured by the Affect Integration Inventory, appeared to be a central component of the pathological self-organization associated with personality disorder. These findings have several implications for the understanding and psychotherapeutic treatment of personality pathology. Furthermore, they highlight the importance of considering the integration of discrete affects and their specific contributions in the conceptualization and treatment of emotional dysfunction in patients with personality disorders.

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Three Dimensional Approaches to Personality Disorders: a Review on Personality Functioning, Personality Structure, and Personality Organization

Current Psychiatry Reports ◽

10.1007/s11920-021-01250-y ◽

2021 ◽

Vol 23 (7) ◽

Author(s):

Susanne Hörz-Sagstetter ◽

Ludwig Ohse ◽

Leonie Kampe

Keyword(s):

Personality Disorders ◽

Empirical Studies ◽

Three Dimensional ◽

Personality Pathology ◽

Personality Structure ◽

Assessment Instruments ◽

Personality Organization ◽

Personality Functioning ◽

Clinical Observations ◽

Categorical Classification

Abstract Purpose of Review The concept of personality functioning (Alternative DSM-5 Model of Personality Disorders) has led to increased interest in dimensional personality disorder diagnosis. While differing markedly from the current categorical classification, it is closely related to the psychodynamic concepts of personality structure and personality organization. In this review, the three dimensional approaches, their underlying models, and common instruments are introduced, and empirical studies on similarities and differences between the concepts and the categorical classification are summarized. Additionally, a case example illustrates the clinical application. Recent Findings Numerous studies demonstrate the broad empirical basis, validated assessment instruments and clinical usefulness of the dimensional concepts. Their advantages compared to the categorical approach, but also the respective differences, have been demonstrated empirically, in line with clinical observations. Summary Evidence supports the three dimensional concepts, which share conceptual overlap, but also entail unique aspects of personality pathology, respectively.

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Early intervention in personality disorders

Early Intervention in Psychiatric Disorders Across Cultures ◽

10.1093/med/9780198820833.003.0014 ◽

2019 ◽

pp. 167-174

Author(s):

John M. Oldham

Keyword(s):

Risk Factors ◽

Early Intervention ◽

Personality Disorders ◽

Early Development ◽

Early Identification ◽

Early Onset ◽

Early Adulthood ◽

Critical Component ◽

Personality Functioning ◽

Attachment Process

Personality disorders have their onset in adolescence or early adulthood. It is now well-established that these conditions emerge in individuals who have heritable risk factors and who experience disruptions in the attachment process, a critical component of early development that, when successful, sets the stage for healthy, stable personality functioning in adulthood. The importance of early identification of, and intervention for, emerging personality disorders is increasingly recognized. A new dimensional model for personality disorders relies on assessing self and interpersonal functioning, impairment of which during adolescence may signal the early onset of potentially disabling personality disorders.

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The DSM-5 Levels of Personality Functioning and Severity of Iranian Patients With Antisocial and Borderline Personality Disorders

Iranian Red Crescent Medical Journal ◽

10.5812/ircmj.17(5)2015.19885 ◽

2015 ◽

Vol 17 (8) ◽

Cited By ~ 4

Author(s):

Mehdi Amini ◽

Abbas Pourshahbaz ◽

Parvaneh Mohammadkhani ◽

Mohammad Reza Khodaie Ardakani ◽

Mozhgan Lotfi

Keyword(s):

Personality Disorders ◽

Borderline Personality ◽

Borderline Personality Disorders ◽

Personality Functioning ◽

Dsm 5 ◽

Iranian Patients

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Biologic markers for personality disorders: A dimensional approach

Biological Psychiatry ◽

10.1016/0006-3223(89)91769-1 ◽

1989 ◽

Vol 25 (7) ◽

pp. A140

Author(s):

Larry J. Siever ◽

Emil F. Coccaro ◽

Jeremy Silverman ◽

Richard Keefe ◽

Howard Klar ◽

...

Keyword(s):

Personality Disorders ◽

Dimensional Approach ◽

Biologic Markers

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Relating DSM-5 section III personality traits to section II personality disorder diagnoses

Psychological Medicine ◽

10.1017/s0033291715002226 ◽

2015 ◽

Vol 46 (3) ◽

pp. 647-655 ◽

Cited By ~ 42

Author(s):

L. C. Morey ◽

K. T. Benson ◽

A. E. Skodol

Keyword(s):

Personality Disorder ◽

Personality Traits ◽

Personality Disorders ◽

Alternative Model ◽

Work Group ◽

Taxonomic Structure ◽

Personality Functioning ◽

Dsm 5 ◽

Criterion A ◽

Dsm Iv

BackgroundThe DSM-5 Personality and Personality Disorders Work Group formulated a hybrid dimensional/categorical model that represented personality disorders as combinations of core impairments in personality functioning with specific configurations of problematic personality traits. Specific clusters of traits were selected to serve as indicators for six DSM categorical diagnoses to be retained in this system – antisocial, avoidant, borderline, narcissistic, obsessive–compulsive and schizotypal personality disorders. The goal of the current study was to describe the empirical relationships between the DSM-5 section III pathological traits and DSM-IV/DSM-5 section II personality disorder diagnoses.MethodData were obtained from a sample of 337 clinicians, each of whom rated one of his or her patients on all aspects of the DSM-IV and DSM-5 proposed alternative model. Regression models were constructed to examine trait–disorder relationships, and the incremental validity of core personality dysfunctions (i.e. criterion A features for each disorder) was examined in combination with the specified trait clusters.ResultsFindings suggested that the trait assignments specified by the Work Group tended to be substantially associated with corresponding DSM-IV concepts, and the criterion A features provided additional diagnostic information in all but one instance.ConclusionsAlthough the DSM-5 section III alternative model provided a substantially different taxonomic structure for personality disorders, the associations between this new approach and the traditional personality disorder concepts in DSM-5 section II make it possible to render traditional personality disorder concepts using alternative model traits in combination with core impairments in personality functioning.

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