Abstract
BackgroundThe assessment of personality organization and its observable behavioral manifestations, i.e. personality functioning, has a long tradition in psychodynamic psychiatry. Recently, the DSM-5 Levels of Personality Functioning Scale has moved it into the focus of psychiatric diagnostics. Based on Kernberg’s concept of personality organization the Structured Interview of Personality Organization (STIPO) was developed for diagnosing personality functioning. The STIPO covers seven dimensions: (1) identity, (2) object relations, (3) primitive defenses, (4) coping/rigidity, (5) aggression, (6) moral values, and (7) reality testing and perceptual distortions. The English version of the STIPO has previously revealed satisfying psychometric properties.MethodsValidity and reliability of the German version of the 100-item instrument have been evaluated in 122 psychiatric patients. All patients were diagnosed according to the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV) and were assessed by means of the STIPO. Moreover, all patients completed eight questionnaires that served as criteria for external validity of the STIPO.ResultsInterrater reliability varied between intraclass correlations of .89 and 1.0, Crohnbach’s α for the seven dimensions was .69 to .93. All a priori selected questionnaire scales correlated significantly with the corresponding STIPO dimensions. Patients with personality disorder (PD) revealed significantly higher STIPO scores (i.e. worse personality functioning) than patients without PD; patients cluster B PD showed significantly higher STIPO scores than patients with cluster C PD.ConclusionsInterrater reliability, Crohnbach’s α, concurrent validity, and differential validity of the STIPO are satisfying. The STIPO represents an appropriate instrument for the assessment of personality functioning in clinical and research settings.
Highlights
The assessment of personality organization and its observable behavioral manifestations, i.e. personality functioning, has a long tradition in psychodynamic psychiatry
Sample characteristics Three patients had to be excluded from the study, because they did not complete the Structured Interview of Personality Organization (STIPO) interview, 122 patients were included into the analyses
Interrater reliability was determined by calculating intraclass correlation (ICC) of the interviewers’ assessments of six video-taped STIPO interviews
Summary
The assessment of personality organization and its observable behavioral manifestations, i.e. personality functioning, has a long tradition in psychodynamic psychiatry. Based on Kernberg’s concept of personality organization the Structured Interview of Personality Organization (STIPO) was developed for diagnosing personality functioning. The basic assumption in Kernberg’s model is that the internal world of individuals on a borderline or psychotic level consists of split-off aspects of the self and others, which means that there are no integrated internal images of the self and significant others. This deficit leads to numerous problems in personality functioning in the realm of identity, interpersonal relations, coping with stress and aggression, as well as moral values. Kernberg presented a theoretical model that assigns the different personality disorders to different levels of personality organization [7], p
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