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使用人格组织结构访谈(STIPO-R)建立人格功能水平:潜在剖面分析。

Establishing Levels of Personality Functioning Using the Structured Interview of Personality Organization (STIPO-R): A Latent Profile Analysis.

机构信息

Department of Psychology, Bishop's University, Sherbrooke, QC, Canada.

Personality Disorders Institute and Department of Psychiatry, Weill Medical College of Cornell University, New York, New York.

出版信息

J Pers Assess. 2024 Nov-Dec;106(6):727-739. doi: 10.1080/00223891.2024.2330502. Epub 2024 Apr 2.

Abstract

Both the new ICD-11 and the latest Alternative DSM-5 Model for Personality Disorders focus on self and interpersonal functioning as the central feature of personality pathology, also acknowledging that personality disorders are organized along a dimensional continuum of severity. This revised understanding is in line with long-standing psychodynamic conceptualisations of personality pathology, in particular Kernberg's object relations model of personality organization. Despite existing evidence for the clinical utility of the derived Structured Interview of Personality Organization (STIPO-R), empirical support for the identification of clear cut-points between the different levels of personality functioning is missing. For this purpose, a total of 764 adult participants were recruited across two clinical (outpatient and inpatient) settings ( 250) and two non-clinical (university students and general community) samples ( 514). Results from the mixture modeling suggested the existence of five groups across the clinical and non-clinical samples that covered: healthy personality functioning, maladaptive personality rigidity, and mild, moderate, and severe levels of personality pathology. All five indicators of personality organization were found to be reliable predictors of personality pathology. Of the five STIPO-R indicators, Aggression and Moral Values had the most discriminative power for differentiating between the Mild, Moderate, and Severe personality disorder groups. Implications of these findings are discussed.

摘要

新的 ICD-11 和最新的 DSM-5 人格障碍替代模型都将自我和人际关系功能作为人格病理的核心特征,也承认人格障碍是沿着严重程度的维度连续体组织的。这种修订后的理解与长期存在的精神动力学人格病理概念一致,特别是 Kernberg 的人格组织客体关系模型。尽管已经有证据表明衍生的人格组织结构访谈(STIPO-R)具有临床实用性,但缺乏明确区分不同人格功能水平之间的明确界限的实证支持。为此,共有 764 名成年参与者在两个临床(门诊和住院)环境(250 名)和两个非临床(大学生和普通社区)样本(514 名)中进行了招募。混合模型的结果表明,在临床和非临床样本中存在五个组,涵盖:健康的人格功能、适应不良的人格僵化以及轻度、中度和重度人格病理。人格组织的所有五个指标都被发现是人格病理的可靠预测指标。在五个 STIPO-R 指标中,攻击性和道德价值观对区分轻度、中度和重度人格障碍组最具区分力。讨论了这些发现的意义。

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