Abstract
The relationship between the dimensions of personality organization and the quality of mentalization is an important object of study in contemporary psychodynamic theory and it also contributes to the understanding of heroin addiction with comorbid personality disorders. The current study aims to assess levels of personality organization and its main domains (Identity, Object relations, Defense Mechanisms) in patients with opiate addiction, as well as the quality of affect mentalization and possible connections between them. In order to do so we have adopted quantitative text-analysis method of affect mentalization to parts of а interview, trying to show that the language which participants use could be in itself a psychodiagnostic means. A group of 30 heroin addicted patients in a methadone treatment programme and a control group of 30 healthy participants were assessed with the Structured Interview of Personality Organization (STIPO), VEA (Verbal Elaboration of Affect Scale) and The Measure of Affect Contents (MAC). Results show significant differences between the two groups, concerning all dimensions of personality organization as well as some core areas of affect mentalization. The capacity for affect mentalization is significantly correlated to the level of personality organization. The results are discussed from the point of view of the adopted theoretical models and the implications for psychotherapeutic work in the bio-psycho-social model.
Highlights
The onset of drug addiction is determined by a complex combination of constitutional, social and psychological factors
We interviewed all the patients individually with the Structured Interview of Personality Organization 1.07 (STIPO) (Clarkin et al, 2006), after which we evaluated the transcribed narratives with the Verbal Elaboration of Affect Scale (VEA) (Lecours, 2013) and The Measure of Affect Contents (MAC) (Lecours, 2002)
The inter-rater reliability of the STIPO was assessed by calculation of inter-class correlations of the ‘clinical’ (1-5) ratings, put by two independent raters who have either conducted the interview or listened to an audio recording
Summary
The onset of drug addiction is determined by a complex combination of constitutional, social and psychological factors. Psychodynamic thinking has from the very beginning associated addiction with experiences of early childhood trauma. It has been demonstrated that psychic trauma in childhood leads to a disturbance in the capabilities for mentalization and affect regulation. Mentalization theories see childhood trauma as a consequence of failure of the environment to provide the conditions necessary for the development of self and identity. Clinical data relate psychic trauma to the basic characteristics of the personality organization in patients with drug addiction, most often described as borderline (suffering from identity diffusion, partial object relations, predominance of primitive defense mechanisms), but extensive research is still lacking. After a brief review of the some important trends in the development of the Atanassov, N.
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