Neurotic Personality Organization Research Articles

An integrated approach in the treatment of a patient with pulmonary tuberculosis and tracheobronchial tree with psychological support

One of the complications of the tuberculosis process is tuberculosis of the tracheobronchial tree, which tends to grow in recent years. Many studies indicate the incidence of bronchial tuberculosis from 10% to 40%, taking into account the level of diagnostic measures to detect tuberculosis and the availability of endoscopic services. An important problem in the treatment of tuberculosis is psychological problems in patients, including those with drug-resistant tuberculosis. In phthisiology, attention is drawn to the widespread history of stress in patients with tuberculosis and the complexity of psychological rehabilitation against the background of treatment. In relation to such patients, it is advisable to use a comprehensive medical and psychological approach, including specialized care based on the developed models of psychological rehabilitation. A large number of studies show that among patients with tuberculosis of the trachea and bronchi, young women, non-smokers with a high level of education and income are about 2 times more likely. An important problem is also unstable compliance and low stress tolerance in patients with neurotic personality organization, prone to actualization of maladaptive stereotypes of responding to the difficulties of the treatment process. This clinical example demonstrates the high efficiency of complex treatment of the tuberculosis process, which included anti-tuberculosis therapy, inhalation therapy, surgical treatment and psychological correction. Despite the late diagnosis of the tuberculosis process, relief of intoxication syndrome, cessation of bacte excretion and improvement of the clinical condition were achieved by 2 months of treatment. This approach in the complex treatment of the tuberculosis process is extremely important and relevant to achieve high treatment results.

The effects of online art therapy on ego functions, emotion regulation, and interpersonal relationship styles in neurotic personality organization

Art therapy, as an effective therapeutic intervention, is used to improve positive self-image and self-awareness, promote insight, and enhance therapeutic communication. This study aimed to evaluate the efficacy of art psychotherapy on ego functions, emotion regulation, and interpersonal relationship styles of individuals with neurotic personality organization. Using a quasi-experimental pretest-posttest design, 60 participants were assigned to intervention and control groups, each further divided into three subgroups (n = 10 per subgroup). The intervention group engaged in online art therapy sessions twice weekly over nine weeks, while the control group received no intervention. Data analysis involved descriptive statistics, paired samples t-tests, and independent t-tests. There was a significant decrease in the intervention group's judgmental subdimensions of the Ego Function Assessment Scale. A significant decrease was found in the intervention group in “awareness” (p < 0.01), “clarity” (p < 0.05), and “impulse” (p < 0.001) subdimensions and total scores of the Difficulties in Emotion Regulation Scale. There was no statistical difference between the intervention and control groups' mean pretests and posttests and comparing those groups with each other concerning IRSQ scores. The online group art therapy led to successful improvements in participants' ego functions and emotion regulations.

Investigating the Lived Experience of Religion in People with Neurotic and Borderline Personality Organization: A Phenomenological Study

Investigating the Lived Experience of Religion in People with Neurotic and Borderline Personality Organization: A Phenomenological Study

Personality Disorders in Adult Female Child Sexual Abuse Survivors: Dimensions of Personality Pathology and Characteristics of Abuse

The relationship between child sexual abuse (CSA) and later personality disorders (PDs) has been established in numerous studies. However, there are still a number of uncertainties about the specifics of this association. This study further explored the child sexual abuse survivors' (CSASs) vulnerability to PDs by introducing the variable of personality organization (PO) and dimensions of personality pathology as conceptualized by Kernberg, and by including additional variables of CSA characteristics. It was hypothesized that in the CSA group, the occurrence of borderline personality organization (BPO) would be significantly higher than in the non-CSA group and that characteristics of abuse associated with its higher severity would prevail in individuals with BPO. The study group consisted of 329 women who completed measures of PO and experiences of CSA. The results were consistent with formulated hypotheses. Significantly more CSASs than those who did not experience CSA were characterized by close to BPO (cBPO). Moreover, CSASs group differed from the group without the CSA experience with regard to all BPO dimensions. The biggest difference between the CSA and the control group concerned the dimension referring to the difficulties in creating close, intimate relationships. With regard to CSA features, women characterized by cBPO, in contrast to those characterized by neurotic personality organization (NPO), significantly more often reported having experienced CSA more than once, involving physical contact, from more than one offender and from the offender they previously known. The findings of the study support the idea that the optimal treatment approach for CSASs should address both the personality structure and the specificity of the impact of CSA along with its characteristics.

Levels of personality organization and internal relational patterns

BackgroundThis study aimed to determine whether level of personality organization is associated with a relational pattern present in an autobiographical narrative about an important interpersonal relationship. The main goals were to explore whether and how the components of the internal relationship pattern, and whether and how the configurations of the components, are related to personality organization, when integrated personality organization (IPO) is taken into account.Participants and procedureAssessment of the relational patterns was based on the Core Conflictual Relationship Theme (CCRT) – wishes (WS), responses from others (RO), and responses of the self (RS) – as identified from participants’ self-narratives about important relationships (N = 90).ResultsOne-way analysis of variance revealed significant differences between groups with different levels of personality organization, according to one wish of self (WS2 To oppose, hurt, control), five responses of others (RO4 Bad; RO5 Rejecting; RO6 Helpful; RO7 Likes me; RO8 Understanding), and three responses of self (RS1 Helpful; RS4 Oppose and hurt others; RS8 Anxious). Considering the configurations of WS + RO + RS, the results indicate that in the borderline personality organization (BPO) group, the WS Libidinal + RO Frustrating + RS Negative pattern is most prevalent, while in the neurotic personality organization (NPO) and IPO groups, the WS Libidinal + RO Fulfilling + RS Negative and the WS Libidinal + RO Fulfilling + RS Positive configurations are most frequent.ConclusionsThe study supports the thesis that component relationship patterns and their configurations might be related to personality organization. The main differences were found between BPO and IPO with NPO placed between them, in a way congruent with Kernberg’s theory.

Cosa Nostra and the Camorra: Assessment of personality, alexithymic traits, and attachment styles

The Mafia (Cosa Nostra) and the Camorra are criminal organizations deeply rooted in an immoral familyism in which group interests are protected to the detriment of the individual. The aim of this study was to investigate the presence of personality disorders, alexithymic traits and specific attachment styles in a sample of members belonging to these two different organized crime groups. We carried out two studies adopting two different perspectives. In the first study, we recruited 20 participants (10 members of Cosa Nostra and 10 members of the Camorra) who were serving time in the Augusta (Sicily) prison for crimes they had committed as members of the two Mafia-type organizations. The age of the Cosa Nostra members ranged from 28 to 62 years (M = 47.40, SD = 10.25); the age of the Camorra members ranged from 45 to 68 (M = 55.30, SD = 7.06). We tested personality profiles, attachment styles, alexithymia, and psychopathy and compared the results between the two groups. In this study while we did not find significant differences between the two groups, we were able to identify some discrepancies in a few of the variables analysed. In the second study, we used the Structured Interview of Personality Organization (STIPO) to analyse the personality organization of 10 of 20 participants (5 members of Cosa Nostra and 5 members of Camorra). Analysing the results at the STIPO we found a significant presence of borderline personality organization in both groups. As regards attachment style, we found that Camorra-members' scores high (75°) on the Discomfort with Closeness (related to Avoidant Attachment Style) and Relationship as Secondary factors of the Attachment Style Questionnaire. The Data collected in our study were not sufficient to identify a specific personality disorder or a specific serious psychological condition in the two groups of participants. Nonetheless, thanks to use of the STIPO we were able to determine that in the sample analysed there was not one subject with a psychotic personality organization; we did however find the presence of borderline personality organization and neurotic personality organization in some of the subjects.

The Level of Personality Organization and Revictimization in Lives of Child Sexual Abuse Survivors.

Previous research has documented that women who were sexually abused in childhood are also often victims of sexual abuse in adulthood. In the current study, we investigated the relationship between the phenomenon of sexual revictimization and personality organization (PO) conceptualized in accordance with the Otto Kernberg's theory. The central hypothesis was that women with borderline personality organization (BPO) and neurotic personality organization (NPO) differ in terms of the occurrence of revictimization and its features. We predicted that women with BPO would experience revictimization more often, and that it would be characterized by features determining its higher severity than in women with NPO. In our study, 119 Polish adult women completed measures of PO and experiences of sexual violence in childhood and adulthood. The results supported the predicted relationships. After controlling for participants' age, we showed that women with a close to borderline level of personality organization (cBPO) are at the greater risk of experiencing revictimization than those with NPO, in particular the revictimization involving penetration and by the previously known offender. Moreover, specific structural features related to BPO were found to have particular associations: Fear of Fusion (FF) was associated with the experience of revictimization; Identity Diffusion (ID), Primitive Defense Mechanism (PDM), FF, and Impaired Reality Testing (IRT) with penetration during revictimization; and PDM and IRT with revictimization by the previously known offender. Our findings suggest the importance of taking into account PO in estimating the risk of revictimization, as well as in therapy programs aimed at reducing this risk.

Personality Organization and Paraphilic Interests in Women

Objective: According to Kernberg’s psychodynamic model of personality organization (2012), identity integration, defense mechanisms and reality testing allow the classification of personality functioning in three main organizations lying on a continuum of severity. A specific relation is hypothesized to exist between the continuum of personality organization and the spectrum of sexual pathology, ranging from some degree of sexual inhibition in the presence of the capacity for a stable love relationship (neurotic personality organization), to inordinate and chaotic sexual life combined with paraphilic features (borderline personality organization). The aim of the present study is to assess the relationship between features of BPO and the clinical relevance of paraphilic interests in a sample of women from the community. Design and Method: We sampled 224 women voluntarily recruited through adds posted on different websites. Volunteers were invited to participate in a research project on the “relationship between personality characteristics and sexual life”. After providing consent, all participants were invited to fill in a set of questionnaires including: - the Inventory of Personality Organization (Lenzenweger et al., 2001), to assess the main domains of personality structure according to Kernberg’s model; - a modified version of the Paraphilia Scale (Dawson et al., 2014). Results: We found that the presence of three markers of borderline personality organization (Instability of self/others, Instability of behaviour and Psychosis) is associated, in a linear fashion, to the presence and clinical relevance of paraphilic interests. Conclusions: Results support the importance of an accurate assessment of sexual life in order to obtain essential clinical information on personality functioning in clinical settings.

Application of the Rorschach test in psychological diagnosis of personality disorders

&lt;b&gt;Background&lt;/b&gt;&lt;br /&gt; The paper presents the authors’ own research, which points to the possibility of applying the Rorschach test in the clinical diagnosis of personality disorders.&lt;br /&gt; &lt;br /&gt; &lt;b&gt;Participants and procedure&lt;/b&gt;&lt;br /&gt; The clinical research was conducted in the years 2010-2013 in the Neurosis Treatment Center and in the Mental Health Outpatient Clinic. The study population comprised individuals with a medical diagnosis of neurotic personality organization as well as patients with more severely disorganized personality structure. The research participants had never undergone psychological evaluation for personality disorders (for instance, they had never taken the Rorschach test), and therefore it seemed rather difficult to verify the accuracy of the medical diagnoses which they had received, concerning the level of personality destabilization. Eighty Polish individuals participated in the research. The study population comprised 38 males (47.50%) and 42 females (52.50%). The mean age of women was 30.40 (SD = 7.67). The men’s mean age was 35.10 (SD = 8.73). The examined females were somewhat younger than the male subjects. Methods: Rorschach test, clinical interview.&lt;br /&gt; &lt;b&gt;Results&lt;/b&gt;&lt;br /&gt; The statistical procedures applied in the present study allowed us to conduct empirical examination of the indicators of the investigated variables constituting the major psychological criteria for describing psychological functioning of personality, and thus to identify the main characteristics of neurotic as well as borderline level of personality organization. Analysis of the data obtained as a result of this research allowed us to distinguish two significantly different clusters in the group of 80 examined individuals.&lt;br /&gt; &lt;br /&gt; &lt;b&gt;Conclusions&lt;/b&gt;&lt;br /&gt; The results of the present investigation indicate that despite the fact that the examined individuals displayed symptoms of different medical diagnoses (F40 and F60), the subjects comprising cluster 1 exhibited a higher level of personality structure compared with the study participants belonging to cluster 2.

Interpretation in the Treatment of Borderline Pathology

After integrating and elaborating on the corresponding definitions of interpretation in major standing psychoanalytic dictionaries, I highlight the differences between the interpretative process and its objectives for patients with neurotic personality organization and those with severe personality disorders. To illustrate the interpretative process within the Transference Focused Psychoanalytic Psychotherapy for patients with borderline personality organization, the clinical vignette, depicting the interpretation of projective mechanisms as part of interpretation of primitive object relations activated in transference, is presented verbatim.

The Comparison Between Personality Characteristics and Family Relations Of The Subjects With Neurotic Level Of Personality Organization With Control Group

Studies to explain neurotic personality organization is no more. Studies emphasize the early family relationships are important in formation of this structure. Our study aims to assess personality traits and family relations of individuals with neurotic personality organization. 31 patients assessed in neurotic personality organization according to SCID-I and SCID-II followed by social psychiatry unit (Structured Clinical Interview for DSM Disorders), 31 control groups not taking diagnostic in the same tests were included in study. Socio-demographic data form was filled by interviewer, Beck Depression Inventory, MMPI (Minnesota Multiphasic Personality Inventory), State-Trait Anxiety Inventory, Family Assessment Scale, Sheehan Disability Scale by the participants. Control group was created from, of volunteers, subjects not taking any psychiatric diagnosis. Compared to neurotic patient group with control group; Shehan Disability Scale for Beck Depression Inventory scores; Family Assessment Scale for social life and family environment, business subscale and household responsibilities, for State-Trait Anxiety Inventory; hypochondria, depression, hysteria, and social introversion subscales for problem solving and behavior control subscale scores between groups and Minnesota Multiphasic Personality Inventory. Neurotic group was taking significantly diagnosis compared to control group for depressive disorder, anxiety disorders and avoidant personality disorder. Considered that avoidant personality structuring of neurotic individuals are at the forefront, the secondary anxiety and depressive symptoms progress. Said all these processes impair domestic problem-solving, behavior control skills of these individuals. Supports this process that the average score of neurotic patients are higher than control group for hypochondria, depression, hysteria, and social introversion subscales as results of MMPI.

The diagnostic usability of selected narrativity indices in stories about close relationships in the assessment of personality organization

The aim of this study was to test the usability of selected narrativity indices identified from autobiographical accounts of important relationships in an assessment of neurotic (NPO) and borderline personality organization (BPO). Narrativity indices, both particular and generalized, were used to predict personality organization levels. Indices were derived from two separate layers of analysis: 1) lexical indices were counted with computer assistance; 2) evocative/reception indices dealing with coherence of the story were assessed using the competent judges method. It was found that the lexical narrativity index-the active "I"-was a good predictor of both BPO and NPO, while the human factor was a good predictor of BPO when low. Moreover, a generalized index was used to describe how stories are saturated with the narrativity indices of intentionality, concreteness, and active "I", but simultaneously deprived of human factor, and was found to be the best predictor of BPO. Furthermore, where the coherence of the story and of its subdimension (integration) rise, the probability of BPO diagnosis decreases. This research provides support for the thesis that surface narrativity indices may predict deeper personality structure. Its results are justified in the light of Kernberg's theory, and have the potential to become a useful tool in clinical practice as a supplementary source of information in diagnostic and psychotherapeutic processes.

Internal relationship patterns in borderline and neurotic personality organization: An analysis of self-narratives

Abstract The main goals of this study are 1) to explore whether internal relationship patterns are related to personality organization, and 2) to recognize the role that selected relationship patterns play in diagnosing personality organization levels. Internal relationship patterns were assessed according to the core conflictual relationship theme (CCRT) - about wishes (WS), responses from others (RO), and responses of the self (RS) - as identified from participants’ self-narratives about important relationships. Significant differences in the frequencies of patterns were found among participants with borderline personality organization (BPO), neurotic personality organization (NPO), and integrated personality (IPO). For example, the majority of negative RS responses were detected in the BPO sample. The study supports the thesis that relationship patterns might be related to personality organization, and that object representation complexity may be a good predictor of integrated personality organization.

Association between level of personality organization as assessed with theory-driven profiles of the Dutch Short Form of the MMPI and outcome of inpatient treatment for personality disorder

The association between level of personality organization as assessed by theory-driven profile interpretation of the MMPI (Hathaway & McKinley, 1943) Dutch Short Form and treatment outcome was investigated in a naturalistic follow-up study among 121 psychotherapy inpatients who had been treated for their severe personality pathology. Treatment outcome was measured with the Brief Symptom Inventory (De Beurs & Zitman, 2006). Personality organization was associated with severity of psychopathology at baseline, the end of treatment, and 36 months after baseline. At 36 months after baseline, all patients except those with the high-level borderline organization profile and the psychotic borderline profile maintained their improvement. Contrary to expectations, (a) personality organization did not differentiate between patients with successful and unsuccessful out-comes, and (b) patients with a neurotic personality organization did not respond better than those with a borderline personality organization. Because of the small N, conclusions are tentative.

The Impact of Level of Personality Organization and Somatization on Psychological Distress, Worrying, and Coping among Patients with Sleep Disorders

The Impact of Level of Personality Organization and Somatization on Psychological Distress, Worrying, and Coping among Patients with Sleep Disorders Study background: Sleep disorders have a significant impact on daily functioning and show a high degree of overlap with mental disorders and other kinds of mental distress, such as impaired coping and worrying. More insight into factors influencing mental distress in patients with sleep disorders is needed. Methods: Two transdiagnostic factors, i.e., level of personality organization and affect regulation through somatization, and their impact on psychological distress, worrying, and coping was examined among 259 patients with sleep disorders. Results: Patients with the most severe structural personality pathology, i.e., with psychotic personality organization, showed the highest levels of symptoms and passive coping in comparison with patients with borderline and with neurotic personality organization. However, sleep-disordered patients with psychotic personality organization who use somatization as affect regulation reported less psychological distress and less passive coping relative to psychotic personality organization patients without this affect regulation mechanism.

Zaburzenia z pogranicza nerwicy i psychozy a zdolność do podjęcia istotnych obowiązków małżeńskich

The borderline personality disorders may significantly affect the capacity to perform important marital obligations, which should be appropriately reflected by canonical procedures. Psychological models and concepts of mental disorders describe them on three levels: 1) clinically significant symptoms; 2) structures and pathological mechanisms maintaining personality organization; 3) origins, i.e. The interaction of biological, psychological and social factors. The articles aims at the presentation of borderline disorders on the descriptive level according to ICD-10 and DSM-IV-R criteria, and on the explanatory level based on Kernberg’s object relations theory. Due to this conception and clinical and scientific research conducted with the application of its assumptions, the functioning of persons with psychotic, borderline and neurotic personality organization becomes more and more understandable. The conceptions has been widely used to describe and explain the phenomena that occur in marital relationships.

Brief Communications: Interrater Reliability for Kernberg's Structural Interview for Assessing Personality Organization

Interrater reliability is considered a precondition for the validity of theoretical models and their corresponding diagnostic instruments. Studies have documented good interrater reliability for structured interviews measuring personality characteristics on a descriptive-phenomenological level but there is little research on reliability of assessment procedures on a structural level. The current study investigated the interrater reliability of the structural interview (SI) designed to assess neurotic, borderline, and psychotic personality organization according to Kernberg. Videotaped SIs of 69 psychiatric patients were randomly and independently rated by two out of three trained psychologists. Agreement between rater pairs was expressed as square weighted kappa (K(sw), 95% CI). Results indicate satisfactory interrater reliability with respect to Kernberg's tripartite classification (K(sw) = 0.42, 95% CI 0.07 to 0.77). Subdivision of the borderline category or introduction of intermediate subcategories to the tripartite system did not significantly affect reliability (K(sw) = 0.55, 95% CI 0.30 to 0.80; K(sw) = 0.59, 95% CI 0.34 to 0.84, respectively). The conclusion is that trained clinicians can reliably assess structural personality organization using the SI. Refining the nosological system adding subcategories did not reduce reliability.

Major Theories of Personality Disorder, Second Editionedited by Mark F. Lenzenweger and John F. Clarkin. New York, Guilford Press, 2004, 464 pp., $55.00.

Major Theories of Personality Disorder, Second Editionedited by Mark F. Lenzenweger and John F. Clarkin. New York, Guilford Press, 2004, 464 pp., $55.00.

Change of self‐image in patients with neurotic, borderline and psychotic disturbances

AbstractChanges in the self‐image of severely disturbed psychiatric patients diagnosed with Kernberg's (1981) structural interview as having neurotic, borderline and psychotic personality organization (NPO, BPO and PPO) were studied in a naturalistic 5‐year follow‐up programme of milieu treatment. Self‐image was measured with Structural Analysis of Social Behavior (Benjamin, 1974) introject ratings. After treatment all patients had changed in the affiliation dimension of the self‐image, while there was almost no change in the interdependence dimension. A more detailed analysis showed that for the NPO and PPO patients the higher overall affiliation was due to a less attacking self‐image, while for the BPO patients it was due to more self‐love. Both at intake and follow‐up the PPO patients' ratings showed a positive self‐image and those of the BPO patients showed high self‐control. These ratings contrast with the diagnostic descriptions of such patients. It is suggested that these differences in perspective might lead to interpersonal problems. Copyright © 2003 John Wiley &amp; Sons, Ltd.

The significance of structural dynamics for a theory of neurosis and personality disorders

Following the psychopathological approach of Janzarik (structural dynamics), this paper develops a two-dimensional theory for the understanding of neuroses and personality disorders. The dynamic dimension serves to describe the symptomatology between the two poles of anxiety and depression. The structural dimension differs according to the maturity of the personal identity between mature neurotic personality organization on the one hand and severe personality disorder on the other.