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This article presents a guide for conceptualizing psychological difficulties across the broad spectrum of personality and symptom disorders. A psychodynamic model is used to organize these disorders along a structural continuum of severity. The authors propose that seven key indices of personality functioning be evaluated: cognition, affect, self-object relations, interpersonal relations, defenses, superego functioning, and primary dynamics. The results are then employed to determine where the patient should be placed along a continuum of nine diagnostic categories of ego development and their associated disorders. These include "normal," neurotic trait, and neurotic symptom organization; high-, mid-, and low-level borderline organization; and affective, cognitive-affective, and cognitive psychotic organization. An accurate evaluation of the seven variables will permit a more precise formulation of the nature and severity of the patient's difficulties, which will hopefully result in more accurate and appropriate treatment planning. Examples of the application of this model to a common symptom complaint are provided.

This article presents a model for conceptualizing psychopathology designed to assist practitioners in evaluating patients and applying effective treatment plans. The model describes psychopathology as a function of (a) level of ego organization and (b) character style. Two adjunctive variables are discussed that augment treatment planning through (a) evaluation of the individual's current level of adaptive functioning and (b) confirmation of the diagnostic conceptualization and treatment approach by evaluation of the primary dynamic or conflict. These 2 major dimensions and 2 adjunctive variables are examined in relation to theoretical description of psychological functioning and procedures for assessment and treatment considerations, respectively. Key guidelines for the treatment of prototypical disorders are presented.

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An interpretive approach to the Minnesota Multiphasic Personality Inventory (MMPI), based on a psychodynamic conceptual system, is presented. Scale elevations and configurations on the MMPI are viewed as reflecting the following dimensions of personality: (a) characteristic security and defense operations, (b) capacity to manage or tolerate anxiety, c) characteristic ways of dealing with aggression and hostility, d) stability of reality contact, e) quality of object relations, and f) level of psychopathology. Various MMPI profile configurations, and empirical research findings where applicable, are related to variations in personality functioning and psychopathology within each of these six dimensions. The interpretive approach described is consistent with the authors' belief that psychological assessment should go beyond the level of description and attempt to understand the individual in a more comprehensive and integrated manner.