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The Structured Interview of Personality Organization (STIPO): An Instrument to Assess Severity and Change of Personality Pathology

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Psychodynamic Psychotherapy Research

Part of the book series: Current Clinical Psychiatry ((CCPSY))

Abstract

The assessment and diagnosis of personality disorders for clinical intervention and research purposes is at crossroads. The diagnostic criteria for the personality disorders in DSM-IV TR Axis II are a listing of symptoms in search of a unifying assessment of personality dysfunction. The utilization of the diagnosis of these criteria has resulted in an advance in the reliability of personality disorders, but it has become evident that there are numerous difficulties in the personality disorder diagnoses made by the criterion-based, atheoretical approach of Axis II. The major problem involves the heterogeneity of the patient groups selected by the categorical system without any rating of severity of dysfunction. While a categorical approach to diagnosis focuses on the presence or absence of the disorder, based on a number of fulfilled criteria or symptoms, a dimensional approach also assesses the severity of symptoms or dimensions of personality pathology. As patients seen in clinical practice tend to present with different levels of severity of pathology, a dimensional approach provides the clinician with a diagnosis more reflective of the clinical picture, which also includes an assessment of strengths and deficits on each of the dimensions. The clinical usefulness of the categorical system has been seriously questioned [1]. The proposed changes in DSM-V define personality disorders as a failure to develop self-identity and capacity for adaptive interpersonal functioning, focus on the assessment on personality disorder prototypes, and provide a severity rating of personality disorder functioning. These proposed changes are congruent with the object relations view of personality pathology and call attention to the need for reliable diagnostic instruments based on psychodynamic object relations theory. In this chapter, we describe such an instrument, which provides evaluation of core dimensions of personality functioning emphasized by the DSM V Personality Disorders Task Force (www.dsm5.org)

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Notes

  1. 1.

    The item structure of the STIPO is currently being analyzed. The STIPO version described here and used in the ­following patient examples consists of 100 items and seven domains. A shortened version available for download [6] consists of 87 items and six domains. After examination of the item structure, a final version will be made available online.

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Author information

Authors and Affiliations

  1. Department of Psychology, Ludwig-Maximilians University, Munich, Germany

    Susanne Hörz Ph.D., Dipl-Psych.

  2. Department of Psychiatry, Weill Cornell Medical College, White Plains, New York, USA

    John F. Clarkin Ph.D. (Clinical Professor of Psychology in Psychiatry)

  3. Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA

    Barry L. Stern Ph.D. (Assistant Clinical Professor of Psychology)

  4. Department of Psychiatry, New York University School of Medicine, New York, NY, USA

    Eve Caligor M.D. (Clinical Professor of Psychiatry)

Authors
  1. Susanne Hörz Ph.D., Dipl-Psych.
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  2. John F. Clarkin Ph.D.
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  3. Barry L. Stern Ph.D.
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  4. Eve Caligor M.D.
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Corresponding author

Correspondence to Susanne Hörz Ph.D., Dipl-Psych. .

Editor information

Editors and Affiliations

  1. Massachusetts General Hospital, Harvard Medical School, Department of Psychiatry, Parkman St., Boston, 02114, Massachusetts, USA

    Raymond A. Levy

  2. Massachusetts General Hospital, Harvard Medical School, Department of Psychiatry, Morrimac Street 101, Boston, 02114, Massachusetts, USA

    J. Stuart Ablon

  3. and Psychoanalysis, International Psychoanalytic University, Department of Clinical Psychology, Stromstr. 3, Berlin, 10555, Germany

    Horst Kächele

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Hörz, S., Clarkin, J.F., Stern, B.L., Caligor, E. (2012). The Structured Interview of Personality Organization (STIPO): An Instrument to Assess Severity and Change of Personality Pathology. In: Levy, R., Ablon, J., Kächele, H. (eds) Psychodynamic Psychotherapy Research. Current Clinical Psychiatry. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60761-792-1_32

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  • DOI: https://doi.org/10.1007/978-1-60761-792-1_32

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