Department of Psychiatry, Columbia University College of Physicians and Surgeons.
Psychodyn Psychiatry. 2020 Winter;48(4):407-421. doi: 10.1521/pdps.2020.48.4.407.
Kernberg's structural interview integrates exploration of elements of personality organization into the standard initial psychiatric evaluation. The structural interview approach, while essential to transference-focused psychotherapy for patients with borderline personality disorder, is not limited to use in that context. Following the model of the structural interview, clinicians ask a series of questions, which elucidate elements of personality pathology, thereby facilitating comprehensive diagnosis, guiding treatment, and informing prognosis. Direct questioning about finances and the clinician's general curiosity about issues related to money, in the context of the structural interview, can be high-yield lines of inquiry. Patients' history with their finances, attitudes about money, and ways questions about finance emerge in the transference around fees and related concerns, can add an important, often overlooked, dimension to the assessment of personality organization and personality disorder pathology. This article proposes the utility of prioritizing questions regarding money, as might be integrated into the structural interview, as a template for a broader recognition of the value of this line of inquiry in a diagnostic assessment process.
克恩伯格的结构性访谈将人格组织元素的探索纳入到标准的初始精神评估中。结构性访谈方法对于边缘型人格障碍患者的移情焦点心理治疗至关重要，但不仅限于该治疗环境中使用。按照结构性访谈的模式，临床医生会提出一系列问题，这些问题阐明了人格病理学的要素，从而促进全面诊断、指导治疗，并告知预后。在结构性访谈中，直接询问财务状况以及临床医生对与金钱相关问题的普遍好奇心，可能是高收益的探究线索。患者的财务历史、他们对金钱的态度，以及在与费用和相关问题相关的移情中出现的有关财务问题的方式，可以为评估人格组织和人格障碍病理学增加一个重要的、通常被忽视的维度。本文提出将有关金钱的问题作为优先事项纳入结构性访谈，作为更广泛认识这一探究线索在诊断评估过程中的价值的模板。
