An Object Relations Model Perspective on the Alternative Model for Personality Disorders (DSM-5)

Clarkin, John F.; Caligor, Eve; Sowislo, Julia F.

doi:10.1159/000508353

Cited by 38 publications

(36 citation statements)

References 20 publications

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“…The potentially negative effect of item reduction on the validity of PID-5 has also been discussed in the case of PID-5-BF ( 44 ). Psychodynamically oriented authors perceive the operationalization of the model of personality traits in ICD-11 and AMPD based on self-assessment as a procedure more suitable for research rather than for daily clinical practice ( 51 ). This somewhat contrasts with the predominance of self-assessment tools that have emerged since the publication of PID-5 in 2012 ( 52 ).…”

Section: Discussionmentioning

confidence: 99%

Psychometric Properties of the Independent 36-Item PID5BF+M for ICD-11 in the Czech-Speaking Community Sample

2021

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Background: Empirical soundness and international robustness of the PID5BF+M, a shortened version of the PID-5 developed for simultaneous evaluation of maladaptive personality traits in the DSM-5 AMPD and ICD-11 models for personality disorders, was recently confirmed in 16 samples from different countries. Because the modified PID5BF+ scale (36 items) was extracted from the complete 220-item PID-5, an independent evaluation of psychometric properties of a stand-alone PID5BF+M is still missing.Objectives: The present study evaluated the validity and reliability of the 36-item PID5BF+M in comparison with the extracted version from the original PID-5. It also assessed associations between the Borderline Pattern qualifier and trait domain qualifiers.Methods: Two non-clinical samples meeting the inclusion criteria were employed in the study. Sample 1 (n = 614) completed the 220-item PID-5; Sample 2 (n = 1,040) completed the independent 36-item PID5BF+M. Participants were from all 14 regions of the Czech Republic. The Borderline Pattern qualifier was evaluated using a shortened IPDEQ screener.Results: The proposed latent structure of the independent PID5BF+M was confirmed, with an exception of the Disinhibition domain. The results confirmed good internal consistency and test-retest reliability of the measure, as well as some support for the measurement invariance of the independent PID5BF+M in comparison with the extracted version from the original PID-5. Significant associations between the Negative affectivity, Disinhibition, and Psychoticism qualifiers and the IPDEQ items for the emotionally unstable personality disorder of both impulsive and borderline types confirmed good predictive validity of the PID5BF+M in pursuing borderline psychopathology within the ICD-11 model.Conclusions: The independent PID5BF+M was found to be a valid and reliable tool for evaluation of the ICD-11 trait model. However, the Disinhibition domain deserves further investigation in clinical samples as well as in international community samples.

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Section: Discussionmentioning

confidence: 99%

Psychometric Properties of the Independent 36-Item PID5BF+M for ICD-11 in the Czech-Speaking Community Sample

2021

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“…One of the key differences between a psychoanalytic approach to personality disorder assessment and the ICD-11 proposal is that the first one is grounded in a comprehensive theoretical system as opposed to the atheoretical, predominantly descriptive ICD-11 system (33,34). Object relations theory incorporates findings from psychoanalytic clinical experience, developmental psychology, as well as neurobiology and integrates them into a complex and unified theoretical model of healthy and pathological personality functioning (17,31).…”

Section: Atheoretical Description Vs Systematic Theoretical Backgroundmentioning

confidence: 99%

“…On the other hand, patients with less severe personality disturbance are able to benefit from less structured treatment modalities and therapists can more readily focus on explorative interventions such as confrontations and interpretations. There is little risk for destructive acting out and treatment goals include a greater depth of experience of self and others as well as more flexible functioning (31,33,45).…”

Section: Clinical Utilitymentioning

confidence: 99%

“…Notably, the assessment of the severity of personality disturbance constitutes only one step of the ICD-11 diagnostic procedure, and careful consideration needs to be given to the aptitude of the supplementing trait model to provide a clinically meaningful picture of the individual personality style or type of a patient (10,47). Many psychodynamically oriented researchers and practitioners are critical of the ability of traitbased models mainly derived from self-report questionnaires to reflect the complexity and functional interrelatedness of psychological characteristics and the crucial importance of the experiential dimension of meaning for an adequate and clinically valuable assessment of an individual patient (20,33,48).…”

Section: Clinical Utilitymentioning

confidence: 99%

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ICD-11 Personality Disorders: A Psychodynamic Perspective on Personality Functioning

Blüml

Doering

2021

Front. Psychiatry

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The new ICD-11 introduces a fully dimensional classification of personality disorders representing a fundamental change in personality disorder diagnosis with major implications for clinical practice and research. The new system centers on the evaluation of the severity of impairment in the areas of self and interpersonal functioning. This focus on personality functioning converges with long-standing psychoanalytic/psychodynamic conceptualizations of personality pathology. In a detailed conceptual analysis and review of existing empirical data, points of convergence and notable differences between major exponents of the psychodynamic tradition—object relations theory as developed by Kernberg et al. and the Operationalized Psychodynamic Diagnosis—and the ICD-11 system are critically discussed. Personality functioning can be considered to be the current “common ground” for the assessment of personality disorders and constitutes a considerable step forward in making personality disorder diagnosis both clinically meaningful and suitable for research purposes.

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“…Tai ne tik duoda nuorodą į DSM-5 ir psichodinaminės paradigmos jungtį, bet ir "sugrąžina psichoanalitinę teoriją į DSM klasifikaciją" (Natoli, 2019(Natoli, , p. 1025. Kaip vienas svarbiausių šios krypties teorinių modelių išskiriama Otto Kernbergo asmenybės sąrangos lygių koncepcija (Bender et al, 2011), ji netgi iš dalies inkorporuojama į AMPD (Clarkin et al, 2020), nes asmenybės funkcionavimo lygio vertinimas neatsiejamas nuo asmenybės struktūros sąvokos (Schmeck et al, 2013), kuri paties O. Kernbergo įvardijama kaip asmenybės organizacijos lygis (nuo neurotinio iki psichotinio). Jo vertinimas remiasi tapatumo (nuo integracijos iki difuzijos), gynybų naudojimo (nuo brandžių iki primityvių) ir tikrovės tyrimo (nuo nepažeisto iki silpno ir nepastovaus) kriterijais.…”

Section: Teorinis Asmenybės Funkcionavimo Lygio Konstrukto Pagrindimas Ir Empiriniai Tyrinėjimai: žVilgsnis Iš Klinikinės Perspektyvosunclassified

Change in the Definition of Personality Disorder in Transition to ICD-11: A Look from Clinical and Developmental Perspectives

Barkauskienė

Gaudiešiūtė

Skabeikytė

2021

PSY

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The recent body of research reveals fundamental limitations to the categorical concept of a personality disorder that has led researchers to adopt a new personality disorder concept. During the last decade DSM-5 and ICD-11 diagnostic classifications have accepted the dimensional view towards personality pathology. Despite the differences between the two classifications, the joint aspect of both models is the construct of Levels of personality functioning. The construct of personality functioning involves personality (dys)function in the self and interpersonal domains. This two-step conceptualization includes (a) impairments of self and interpersonal functioning, indicating general signs and severity of personality disorder, and (b) pathological personality traits, reflecting ‘stylistic’ differences in the expression of personality disorder. The new conceptualization of personality disorder reflects the innovative multi-theoretical integration of known, empirically-based personality assessment paradigms. The relationship between personality functioning and interpersonal, psychodynamic, and personological paradigms provides the theoretical integrity and empirically-based structure necessary to understand the overall severity of personality pathology. Many methods (interviews, self-assessment scales, and questionnaires) have already been developed for the assessment of personality functioning, and their development will be encouraged by the ICD-11 classification established in 2022. At present, only one instrument has been developed in Lithuania for assessing the level of personality functioning in young people aged 12–18 (Barkauskienė & Skabeikytė, 2020). The empirical data about the validity of this construct and its capability to differentiate between the normal and impaired personality in adults and adolescents provide promising results, but are still accumulating. Research suggests that adolescence is a stage in development when personality pathology can fully unfold and be validly confirmed, which opens up opportunities for early intervention. Although the dimensional personality disorder model needs to further prove its importance, there is already evidence that it is less stigmatizing and returns psychology and personality into the concept of a personality disorder. This review presents changes in the conceptualization of personality disorders by discussing them from both clinical and developmental perspectives and highlighting the results of key research in recent years.

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An Object Relations Model Perspective on the Alternative Model for Personality Disorders (DSM-5)

Cited by 38 publications

References 20 publications

Psychometric Properties of the Independent 36-Item PID5BF+M for ICD-11 in the Czech-Speaking Community Sample

Psychometric Properties of the Independent 36-Item PID5BF+M for ICD-11 in the Czech-Speaking Community Sample

ICD-11 Personality Disorders: A Psychodynamic Perspective on Personality Functioning

Change in the Definition of Personality Disorder in Transition to ICD-11: A Look from Clinical and Developmental Perspectives

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