Measurement of Personality Structure by the OPD Structure Questionnaire Can Help to Discriminate Between Subtypes of Eating-Disorders

Abstract

BackgroundDifferentiation between purging type (AN-P) and restricting type (AN-R) is common in anorexia nervosa (AN) and relevant for clinical practice. However, differences of personality pathology in eating disorders (ED) and their subtypes, which can be captured by the operationalized psychodynamic diagnosis (OPD) system, have not been systematically investigated to date.ObjectivesThe aim of this study was to explore differences in personality structure between the subtypes of AN and bulimia nervosa (BN) using the OPD structure questionnaire (OPD-SQ). In addition, the ability of the instrument to support the classification of eating disorders was examined.Materials and MethodsWe conducted a retrospective, exploratory study in a subset sample of a larger validation study. The OPD-SQ had been collected from n = 60 patients with AN or BN. Patients were assigned to the ED groups by clinical assessment. Statistical analyses included multivariate analysis of variance (MANOVA) and discriminant analysis.ResultsDifferences between ED groups were observed on 5 OPD-SQ main scales and 9 subscales, as well as on the global scale. AN-P patients demonstrated the lowest personality structure on most of the main scales and subscales, whereas AN-R patients showed a higher personality structure level as compared to both BN and AN-P patients. The OPD-SQ scales with the largest differences include self-perception, object perception, and attachment to internal objects. Discriminant analysis resulted in satisfactory assignment to ED groups by OPD-SQ subscales.ConclusionsPersonality structure was found to be less developed in patients with BN and AN-P as compared to patients with AN-R. Although the results have to be proven in larger prospective studies, these results suggest that the OPD-SQ may be used to support the clinical assessment and classification in patients with EDs.

Three Dimensional Approaches to Personality Disorders: a Review on Personality Functioning, Personality Structure, and Personality Organization

“…Convergent validity of the OPD-LSIA was confirmed in studies comparing it to other self-report and observer informed instruments focusing on related constructs like the Reflective Functioning Scale [ 77 ] or the psychodiagnostic chart of the Psychodynamic Diagnostic Manual (PDM) [ 78 ]. The approach of the OPD-LSIA, using a dimensional profile of individual structural impairments, also shows added value in the diagnosis of other mental disorders, e.g., eating disorders [ 79 ], chronic pelvic pain syndrome [ 80 ], or anxiety [ 81 ].…”

Chilean Validation of the Operationalized Psychodynamic Diagnosis - Structure Questionnaire (OPD-SQ) for Personality Structure

“…A 12 item screening version 20 was also related (r = .78) to LPFS expert-ratings and re ective functioning 21 . From a clinical perspective, OPD-SQ scores showed relevant associations with slopes of plasma glucose in type 2 diabetes patients 22 , eating disorder pro les 23 , bipolar disorder 24 , trauma symptom severity 25 , to name some areas of research. A preliminary study on the Chilean version 26 also reported good to excellent internal consistencies in all scales (Cronbach α between 0,71 and 0,93), and was able to discriminate between healthy and patient samples (d = 1.05).…”

Selbstberichtete anorektische Essstörungssymptomatik und psychische Struktur

“…Zu dem Zusammenhang zwischen Essstörungen, deren Ausprägung und OPD-Struktur liegen bisher allerdings sehr wenige empirische Befunde vor. In einer Studie an 60 erwachsenen Patienten mit Essstörungen wurden die Werte einer Kontrollgruppe deutlich übertroffen (Rohde et al 2019;Ehrenthal et al 2012). Einige Studien belegen den Zusammen-hang zwischen psychischen Störungen und strukturellen Funktionen -auch bei Adoleszenten, wobei davon ausgegangen wird, dass Einschränkungen der strukturellen Funktionen das Risiko für die Entwicklung von psychischen Störungen erhöht (Huber et al 2017).…”

“…Die Ergebnisse dieser Studie bestätigen nur in Teilen die bisherigen Forschungsbefunde, da die Werte aller Gruppen deutlich über den Vergleichswerten lagen. So gaben beispielsweise Probandinnen der A-AN-Gruppe auf allen OPD-Skalen höhere Werte an als Patienten in der Studie von Rohde et al (2019). Auf einigen OPD-SF-Skalen fanden sich sogar höhere Werte bei Probandinnen der G-AN-Gruppe als bei den Patienten mit manifester Essstörung in der Untersuchung von Rohde et al (2019).…”

“…So gaben beispielsweise Probandinnen der A-AN-Gruppe auf allen OPD-Skalen höhere Werte an als Patienten in der Studie von Rohde et al (2019). Auf einigen OPD-SF-Skalen fanden sich sogar höhere Werte bei Probandinnen der G-AN-Gruppe als bei den Patienten mit manifester Essstörung in der Untersuchung von Rohde et al (2019). Im Vergleich zu den Kontrollgruppen der Studien von Ehrenthal et al (2012) sowie Bock et al (2018) zeigten sich ebenfalls in allen hier erhobenen Gruppen deutlich höhere Werte.…”