Transference-focused psychotherapy was developed by Otto F. Kernberg and is based on his model of borderline personality disorder.1,2 The efficacy of transference-focused psychotherapy has been evaluated in two randomised controlled trials (RCTs) to date. A 1-year RCT 3 with 90 participants with borderline personality disorder compared transference-focused psychotherapy with dialectical behaviour therapy 4 and psychodynamic supportive therapy. All three groups showed significant positive change in depression, anxiety, global functioning and social adjustment in a multiwave design. Transference-focused psychotherapy and dialectical behaviour therapy were associated with a significant improvement in suicidality, transference-focused psychotherapy and supportive therapy improved facets of impulsivity and only the former yielded a significant improvement in anger, irritability and verbal and direct assault. Moreover, only those individuals in the transference-focused psychotherapy group improved significantly in their reflective function and their attachment style. compared transference-focused psychotherapy to schema-focused therapy 8 in a 3-year RCT with 88 participants with borderline personality disorder. The transference-focused psychotherapy revealed a significantly higher drop-out rate (51.2% v. 26.7%) and -despite improvements in all domains of outcome -significantly smaller treatment effects. The American Psychological Association (Division 12) evaluated transference-focused psychotherapy as having controversial research support. Thus, more research is needed before transference-focused psychotherapy can be considered to have modest or strong research support. 9 The present study aims to bring clarity to the field and to determine whether transference-focused psychotherapy can be regarded as empirically supported treatment according to the American Psychological Association (Division 12) criteria.10 This investigation examines the efficacy of transference-focused psychotherapy for borderline personality disorder in an RCT comparing those randomised to transference-focused psychotherapy with those randomised to a group treated by experienced psychotherapists in the community. Method Study designThe study was approved by the ethics commission of the Medical University Innsbruck, Austria, on 24 March 2004 (ID: UN1950) and was registered at Clinicaltrials.gov (NCT00714311). Participants were recruited at the out-patient units of the Departments of Psychiatry and Psychotherapy, Technical University of Munich, Germany, and the Psychoanalysis and Psychotherapy Department, Medical University Vienna, Austria. People who fulfilled the inclusion criteria were given a complete description of the study. Those who gave written informed consent were assessed by trained local research assistants. The results of the first assessments were sent to a researcher outside the two study centres who performed the randomisation. Participants were randomly assigned to either transferencefocused psychotherapy or experienced community...

The authors investigated the structure and correlates of DSM-5 maladaptive personality traits in two samples of 577 students and 212 inpatients using the German self-report form of the Personality Inventory for DSM-5. They found that (a) the factor structure of DSM-5 trait facets is largely in line with the proposed trait domains of Negative Affectivity, Detachment, Antagonism, Disinhibition, and Psychoticism; (b) all DSM-5 trait domains except Psychoticism are highly related to the respective domains of the Five-Factor Model of personality; (c) the trait facets are positively associated with a self-report measure of general personality dysfunction; and (d) the DSM-5 trait facets show differential associations with a range of self-reported DSM-IV Axis I disorders. These findings give further support to the new DSM-5 trait model and suggest that it may generalize to other languages and cultures.

A key ingredient in the current proposal of the DSM-5 Work Group on Personality and Personality Disorders is the assessment of overall severity of impairment in personality functioning: the Levels of Personality Functioning Scale (LPFS). The aim of this article is to contribute a conceptual and empirical discussion of the LPFS from the perspective of the Operationalized Psychodynamic Diagnosis (OPD) system (OPD Task Force, 2008 ). First, we introduce the OPD Levels of Structural Integration Axis (OPD-LSIA), a measure of individual differences in severity of personality dysfunction that is rooted in psychodynamic theory. We show that the OPD-LSIA is reliable, valid, and highly associated with observer ratings of personality disorders. In the second part, we present results from an OPD expert consensus study exploring potential limitations of the current LPFS item set from the perspective of the OPD-LSIA. We conclude with highlighting implications for future revisions of the DSM-5 proposal.

Several authors have raised the concern that the DSM-5 Level of Personality Functioning Scale (LPFS) is relatively complex and theory laden, and thus might put high requirements on raters. We addressed this concern by having 22 untrained and clinically inexperienced students assess the personality functioning of 10 female psychotherapy inpatients from videotaped clinical interviews, using a multi-item version of the LPFS. Individual raters' LPFS total scores showed acceptable interrater reliability, and were significantly associated with 2 distinct expert-rated measures of the severity of personality pathology. These findings suggest that, contrary to the previously mentioned concerns, successfully applying the LPFS to clinical cases might require neither extensive clinical experience nor training.

In diesem Artikel wird eine deutschsprachige Kurzskala des Inventars der Persönlichkeitsorganisation (IPO-16) vorgestellt und in drei klinischen Stichproben mit insgesamt 1300 Personen validiert. Das IPO ist ein international verbreitetes Selbsteinschätzungsinstrument, das in mehreren Versionen vorliegt und zur Erfassung von struktureller Beeinträchtigung in den Bereichen Identität, Abwehr und Realitätsprüfung eingesetzt wird. Die Kurzskala basiert auf 16 versionsübergreifenden IPO-Items und misst den Schweregrad der strukturellen Beeinträchtigung. In den Studien konnte gezeigt werden, dass das IPO-16 (1) intern konsistent ist, (2) eine modellkonforme Faktorenstruktur hat, (3) eine sehr hohe Überlappung zur IPO-Vollversion aufweist, (4) in der Selbsteinschätzung über konvergente und diskriminante Validität verfügt, (5) den Schweregrad der Persönlichkeitsstörung aus Expertensicht unabhängig vom aktuellen Leidensdruck vorhersagt und (6) eine diagnostische Effizienz erreicht, die mit anderen Screening-Instrumenten im Bereich der Persönlichkeitsstörungsdiagnostik vergleichbar ist. Mit dem IPO-16 liegt für den deutschsprachigen Raum erstmals ein ökonomisches und gut validiertes Selbsteinschätzungsinstrument zur Erfassung von struktureller Beeinträchtigung vor.