Inventory Of Personality Organization Research Articles

Insecure attachment strategies are associated with cognitive alexithymia in patients with severe somatoform disorder.

In light of interpersonal difficulties and their relation to alexithymia in patients with somatoform disorder, the primary aim of this study was to explore the association between two insecure attachment strategies (deactivation and hyperactivation strategies), and affective and cognitive alexithymia in a sample of 128 patients with severe somatoform disorder, over and above the levels of negative affectivity and personality pathology. In a cross-sectional study among patients with somatoform disorder, self-report data were obtained using measures for alexithymia (Bermond-Vorst Alexithymia Questionnaire), attachment (Experiences in Close Relationships Questionnaire), personality pathology (Inventory of Personality Organization), and negative affectivity (Dutch Short Form of the MMPI). We used hierarchical regression analyses to test main effects of attachment deactivation and hyperactivation strategies in the prediction of both cognitive and affective alexithymia, while controlling for the levels of negative affectivity and personality pathology. Only cognitive alexithymia, i.e., the inability to analyze, identify, and verbalize emotions, was associated with personality dysfunction, in particular insecure attachment strategies. Affective alexithymia, i.e., the inability to fantasize and to experience emotions, was associated (negatively) with negative affectivity but not with the personality variables. This study, therefore, indicates that both types of alexithymia are relevant for the assessment and treatment of severe somatoform disorder, yet each type may tap into different features of somatoform disorder.

A Validation Study of the Korean Version of the Inventory of Personality Organization

본 연구는 성격조직화 척도(Inventory of Personality Organization: IPO)(Kernberg & Clarkin, 1995; Clarkin, Foelsch, & Kernberg, 2001)의 주요 3개 하위 척도(원시적 방어기제, 정체감 혼란, 현실검증력 손상)에 대한 심리측정적 속성을 검토하였다. 대학생 477명을 대상으로 하였으며, IPO와 함께, 정적 정서 및 부적 정서 척도(PANAS), 공격성 척도(AQ-K), 한국판 역학연구센터 우울 척도(CES-D), 상태-특성 불안 척도(STAI), 정서곤란 척도(DERS-K) 등의 정서 관련 척도와 대상관계와 애착의 질을 반영하는 성인애착 척도(ASS), 그리고 각 하위 척도와 관련이 있는 개념을 측정하는 세 가지 척도, 즉 방어유형 측정 척도(DSQ), 자기개념 명료성 척도(SCS) 및 자기안정성 척도(SSS), 분열형 성격장애 척도 단축형(SPQ-B)을 실시하였다. 또한 검사-재검사 신뢰도를 측정하기 위해 4주 간의 간격을 두고 일부 참가자에게 IPO를 재실시하였다. 분석 결과는 다음과 같다. 첫째, IPO는 양호한 내적 합치도와 높은 검사-재검사 신뢰도를 보였다. 둘째, 확인적 요인분석을 통해 IPO 주요 척도의 요인구조를 알아본 결과, 원시적 방어기제, 정체감 혼란, 현실검증력 손상의 3요인 모델이 가장 적합한 것으로 나타났다. 셋째, IPO와 관련 척도 간의 상관분석에서 IPO의 수렴타당도와 준거타당도를 지지하는 결론이 도출되었다. 넷째, IPO의 각 하위척도 점수를 기준으로 신경증적 성격조직화 집단, 경계선적 성격조직화 집단, 정신증적 성격조직화 집단의 심리정서적 특성을 비교한 결과, 심리정서적 특성에 있어서 유의미한 집단 간 차이가 나타났다. 이러한 결과를 종합해 볼 때, IPO는 양호한 신뢰도와 타당도를 가진 척도인 것으로 판단된다.

The facets of identity: personality pathology assessment through the Inventory of Personality Organization.

This work aims to further validate the object-relations-based model of personality pathology assessment, evaluating the psychometric properties of the Italian version of the Inventory of Personality Organization (IPO), a self-report instrument for the assessment of personality organization according to O. Kernberg's model of personality pathology. Six hundred ninety-six nonclinical volunteers and 121 psychiatric patients completed a set of questionnaires including the IPO, the Severity Indices of Personality Problems, the Borderline Personality Disorder Checklist, the Response Evaluation Measure 71, and the Symptom Checklist 90-Revised. Confirmatory factor-analyses on the IPO items supported the 1-, 2-, 3-, and 4-factor solutions. The last (Instability of sense of self/others, Instability of goals, Instability of behaviors, Psychosis) resulted in relatively better fit indexes. Invariance across samples (nonclinical, clinical) and gender was confirmed. The 4 IPO subscales showed good levels of internal coherence and, in the nonclinical sample, good test-retest reliability. Associations with the convergent measures were in line with theoretical expectations and supported the benefit of adopting a 4-factor solution. The 4 factors showed the expected criterion relations: All the dimensions discriminated between clinical and nonclinical subjects, whereas only Instability of self/others and Instability of goals discriminated patients with borderline personality disorder from patients with other diagnoses. Our results suggest that the Italian version of the IPO is a reliable and valid tool for the assessment of personality organization according to Kernberg's model. Results are discussed in the context of the current directions in the evaluation of personality disorders proposed by the Diagnostic and Statistical Manual of Mental Disorders, 5th edition.

Levels of Personality Functioning and Their Association With Clinical Features and Interpersonal Functioning in Patients With Personality Disorders

Recently, the DSM-5 Personality and Personality Disorders Work Group has proposed a multiple level approach toward the classification and diagnosis of personality disorders (PDs), with the first level entailing a rating of impairments in levels of personality functioning. Although a number of measures that assess levels of personality functioning have been validated, given its prominent status in the DSM-5 proposal and contemporary theories of personality pathology, the Work Group has called for more research in this area (e.g., Bender, Morey, & Skodol, 2011). In response to this call, this study investigates the relationship between two major, well-validated dimensional measures of levels of personality functioning, that is, the Differentiation-Relatedness Scale (DR-S; Diamond, Blatt, Stayner, & Kaslow, 1991), as scored on the Object Relations Inventory (ORI; Blatt, Wein, Chevron, & Quinlan, 1979), and the Inventory of Personality Organization (IPO; Lenzenweger, Clarkin, Kernberg, & Foelsch, 2001), a self-report instrument, and their relationship with different measures of clinical and interpersonal functioning in 70 patients with a PD. First, results showed that higher levels of differentiation and relatedness of descriptions of self and significant others, and of the self in particular, were negatively related to indices of personality functioning as assessed by the IPO. Lower levels of personality functioning, as measured with both the DR-S and the IPO, were positively related to severity of depression, symptomatic distress, self-harm, and interpersonal problems. Finally, results showed that the DR-S and the IPO independently predicted clinical features and interpersonal functioning. Hence, this study lends further support for the concurrent and predictive validity of the DR-S and the IPO in assessing levels of personality functioning. However, more research concerning the validity of these measures in assessing levels of personality functioning is needed. Suggestions for further research are formulated.

The Influence of Borderline Personality Organization on Trait Depressive Affects and the Generation of Negative Life Events

The Influence of Borderline Personality Organization on Trait Depressive Affects and the Generation of Negative Life Events This study sought to assess whether borderline personality organization (BPO) influenced trait depressive affect, the generation of negative life events (NLEs), and state depressive affect, which includes the depressive affect component caused by the NLEs. The study population was 350 university students in Japan. They were solicited to complete questionnaires on three occasions over a six-week period. The Inventory of Personality Organization and Self-Rating Depression Scale (SDS) were used to assess BPO and depressive affect, respectively. Structural equation modeling and simultaneous analysis of multi-groups were used for statistical analysis.

Assessment of Personality Organization in Couple Relationships: Factorial Structure of the Inventory of Personality Organization and Incremental Validity Over Neuroticism

Drawing on a sample of 372 French-Canadian couples, this study examined the factorial structure of a 20-item abbreviated version of the Inventory of Personality Organization (IPO) across a sample of couples and tested if identity diffusion, primitive defenses, and reality testing explain additional variance in couple distress when controlling for neuroticism. The IPO is based on Kernberg's conceptualization of personality organization (Kernberg, 1976). Gender differences were also studied through an examination of the value of both self-reported and partner-reported personality in the prediction of each partner's couple satisfaction. Results of confirmatory factor analyses indicated that the tripartite model of the short version of the IPO provided an acceptable fit and proved invariant when tested on couples. Actor–Partner Interdependence Model analyses (Kenny, Kashy, & Cook, 2006) showed that elevated neuroticism predicted higher endorsement of primitive defenses, which in turn predict couple dissatisfaction. There was also a direct, negative path from neuroticism to dyadic adjustment. Finally, self-reported neuroticism scores predicted high utilization of primitive defenses by the partner, and low partner-reported couple satisfaction. Furthermore, high self-reported utilization of primitive defenses predicted low couple satisfaction.

Linguistic and cultural adaptation of the Inventory of Personality Organization (IPO) for the Brazilian culture

The Inventory of Personality Organization (IPO) is a self-report instrument to access psychological functions for the structural diagnosis according to the Model of Personality Organization. Objective: The aim was to translate and adapt the IPO for use in the Brazilian language and culture. Method: The synthesized version of the translations was examined by a committee of three experts to evaluate the clarity, appropriateness and semantic equivalence to the Brazilian culture. The resulting version was evaluated by a focal group, composed of four adults with secondary education, which analyzed the familiarity of items. Next, a pilot testing to a 10 subject group was performed to identify possible difficulties in understanding and filling the inventory. A back-translation of the adjusted instrument was submitted to the authors of the original IPO for validation. Results:From 83 items translated, 48 were modified by the committee of experts, 12 by the focal group, 2 after the pilot testing and 2 after the back-translation procedure. In total, 50 (60.2%) items were modified. Conclusions: Herein we have structured the trial version of IPO-Br. The resulting instrument is adjusted to the Brazilian sociocultural reality and maintain equivalence with the original version.

Associations between Identity Diffusion, Axis II Disorder, and Psychopathology in Inpatients with Borderline Personality Disorder

Background: Patients with borderline personality disorder (BPD) suffer from instability in their relationships, their affectivity, and their identity. However, the associations between these dimensions are not clear. The purpose of the present study was to investigate the relation between identity diffusion and psychopathology in BPD. Methods: In the second week of inpatient treatment, 52 patients with BPD were assessed with the Inventory of Personality Organization (IPO) and questionnaires measuring general psychiatric symptoms, mood states, and negative affects (SCL-90-R, BDI, STAI, and STAXI). A median split was examined to differentiate BPD patients with high identity diffusion from those with low identity diffusion. Results: BPD patients with high identity diffusion did not differ in their social data from BPD patients with low identity diffusion. However, BPD patients with high identity diffusion showed significantly higher levels of psychiatric symptoms, as well as higher anxiety, anger, and depression scores (p < 0.01). Moreover, they suffered more frequently from concurrent personality disorders (p < 0.05). Conclusions: These findings indicate an association of identity diffusion with psychopathological symptoms and features of personality disorder and emphasize the clinical significance of identity diffusion for patients with BPD.

The Relationship Between Personality Organization as Assessed by Theory-Driven Profiles of the Dutch Short Form of the MMPI and Self-Reported Features of Personality Organization

In this study, we investigated the relationships between features of personality organization (PO) as assessed by theory driven profiles of the Dutch Short Form of the MMPI (DSFM; Luteijn & Kok, 1985) and 2 self-report measures of personality pathology, that is, the Dutch Inventory of Personality Organization (Berghuis, Kamphuis, Boedijn, & Verheul, 2009) and the Dutch Schizotypy Personality Questionnaire–Revised (Vollema & Hoijtink, 2000), in a sample of 190 outpatient psychiatric patients. Results showed that the single scales of all 3 measures segregated into 2 theoretically expected and meaningful dimensions, that is, a dimension assessing severity of personality pathology and an introversion/extraversion dimension. Theory-driven combinations of single DSFM subscales as a measure of level of PO distinguished characteristics of patients at various levels of PO in theoretically predicted ways. Results also suggest that structural personality pathology may not be fully captured by self-report measures.

The Lack of Negative Affects as an Indicator for Identity Disturbance in Borderline Personality Disorder: A Preliminary Report

Background: Patients with borderline personality disorder (BPD) suffer from instability of their relationships, their affectivity and their identity. The purpose of the study was to investigate negative affects and identity disturbance in patients with BPD and in patients without personality disorder using questionnaire data and interview data. Sampling and Methods: Twelve patients with BPD and 12 patients with major depressive disorder without any personality disorder were assessed with the Structured Interview of Personality Organization (STIPO) and questionnaires (Inventory of Personality Organization, Beck Depression Inventory, State-Trait Anxiety Inventory). They were compared with respect to the frequency of negative affective verbal expressions using computerized content analysis methods. Results: BPD patients showed higher levels of anxiety, depression and identity diffusion in the questionnaires than major depressive disorder patients without personality disorder. However, they did not report more negative affective expressions in the interview. Patients with identity disturbance of both groups showed higher values of negative mood in the questionnaires, but less anger, less anxiety and less affective intensity in the interview. Conclusion: The preliminary findings indicate that patients with identity disturbance show high levels of negative affects in questionnaires but only few negative affects in the interview situation. More studies are needed to enhance the understanding of negative affects and identity disturbance in BPD.

Borderline Personality Organization and Dissociation

The relationship between Kernberg's psychodynamic model of personality organization (PO) and dissociation has not yet been explored. Seventy-two nonclinical subjects and 222 psychiatric patients completed the Dissociative Experiences Scale and the Inventory of Personality Organization. Its Reality Testing subscale emerged as the most important predictor for all facets of dissociation. Discussing our results in the framework of Fonagy and coworkers' model of mentalization, we suggest that dissociation may reflect the preoedipal "pretend" mode of psychic functioning while impaired reality testing and psychotic experiences might be indicative of the "psychic equivalent" mode.

Trauma infanto juvenil y psicopatología adulta: un estudio empírico

Childhood trauma and battering have been associated with adult psychopathology. To explore the relationship between childhood trauma, somatization, post traumatic stress disorder (PTSD), affective disorder and borderline personality disorder in hospitalized patients of four Chilean hospitals. Five hundred five patients were screened by a short seven item trauma recollection scale (70 from San Bernardo Hospital, 193 from Salvador Hospital, 97 from El Trabajador Hospital and 147 from Curico Hospital). A random sample of 85 cases was studied in depth using the CIDI 2.1, depression, PTSD and somatization scales, Inventory of Personality Organization (IPO) and the OQ 45.2 scale. Forty five percent of patients did not report traumatic experiences, 38.4% recalled one or two events and 16.3% three or more traumatic experiences. The most remembered event was physical punishment (28.7%), followed by traumatic separation from parents (27.1%), alcohol and drug use by an adult at home (22%) and presence of family violence (22%). Thirty two percent of the 85 selected cases met CIDI criteria for affective disorder, 20% for post traumatic stress disorder and 11.8% for somatization disorder. There were statistically significant correlations between the frequence of trauma and post traumatic stress disorder (p <0.001), as well as somatization and depressive disorder (p <0.007 and 0.008). This study supports the concept that traumatic psychosocial environments during childhood are a risk factor for diverse psychiatric syndromes during adulthood.

The Inventory of Personality Organization: Psychometric properties, factorial composition, and criterion relations with affect, aggressive dyscontrol, psychosis proneness, and self-domains in a nonclinical sample.

The Inventory of Personality Organization: Psychometric properties, factorial composition, and criterion relations with affect, aggressive dyscontrol, psychosis proneness, and self-domains in a nonclinical sample.

Defense mechanisms and personality in depression

There is a longstanding belief that personality represents a structure that is stable over time, and changes, if at all, very slowly. Nonetheless, clinical and empirical evidence suggests that in patients with some Axis I disorders, the rate of personality disorders using DSM criteria decreases after treatment, suggesting that personality as assessed by phenomenological systems is state-dependent. An alternative to the DSM phenomenological system of conceptualizing personality is the dynamic concept of character, that is, a predictable pattern of both adaptive and pathological defense mechanisms, and personality organization comprised of object relations, ego strengths, and superego development. Data from this study address the hypothesis that defense mechanisms and personality organization remain relatively stable in patients treated for Axis I disorders, irrespective of clinical improvement. Patients meeting DSM-IV criteria for major depressive disorder (MDD) entered randomized, controlled medication trials. Defensive functioning was evaluated with the Defense Style Questionnaire (DSQ) [Bond et al., 1983: Arch Gen Psychiatry 40:333-338], and personality organization was assessed with the Inventory of Personality Organization (IPO; Clarkin et al., unpublished), both at baseline and at the completion of the clinical trial. Data were analyzed for whether an individual's pattern of defense mechanisms and personality organization were stable over time regardless of response to treatment of MDD. The question was also asked whether a predominant pattern of defense mechanisms or level of personality organization predicts response to treatment or dropout rate. Among treatment responders, nonresponders and drop-outs, baseline DSQ scores were similar except for "image-distorting" defenses, which were significantly more prevalent among drop-outs compared to responders (P = .016). Post-treatment DSQ values revealed a significant decrease in "maladaptive" defenses (P = .01) in the entire sample, while intermediate and "adaptive" defenses remained unchanged. This same pattern was found to hold true in treatment responders. When comparing treatment responders and nonresponders at the end of the trial, medication responders used significantly less "maladaptive" defenses than did nonresponders (P = .003), and had a significantly higher, or healthier level of "overall defensive functioning" (P = .04). Baseline and post-treatment IPO values did not show significant differences. Results of the study address the question of whether there are personality characteristics that are enduring and that can be appreciated irrespective of an Axis I disorder.