A construct validity study of Kernberg's notion of upper- and lower-level personality organizations (Otto Kernberg) Clinicians have advocated for empirical research to support the use of dimensional models for the classification of personality disorders. Otto Kernberg has proposed three personality organizations that are conceptualized on a continuum of severity, with a neurotic organization representing the higher level of functioning, the psychotic organization representing the lowest level of functioning, and an intermediate borderline organization that encompasses the majority of the personality disorders. Kernberg puts forth an additional distinction within the borderline personality organization, classifying the less severe personality disorders as "upper-level" and the more severe personality disorders as "lower-level," along the continuum between the neurotic and psychotic personality organizations. The purpose of this study was to validate Kernberg's distinction between upper- and lower-level borderline organizations with clinical data. DSM-IV diagnoses, MMPI data, and ratings on the DCS (Diagnostic Conceptual Scheme; an adaptation of Bellak and Goldsmith's Ego Function Assessment [EFA], 1984) were collected from over one thousand clients at Washington University's Psychological Service Center (PSC) over a period of fourteen years. A sample of 208 cases consisted of matching the DSM-IV diagnoses with paired MMPI and DCS data. Patient cases were sorted a priori into two groups based upon DSM-IV diagnosis, according to Kernberg's classification of each DSM diagnosis within either the upper- or lower-level borderline personality organization. Discriminant analyses were conducted. Results indicated that a high percentage of cases were correctly placed in the a priori classification scheme by the discriminant function, which supports Kernberg's notion of borderline personality organization. Overall, Kernberg's distinction between upper-level and lower-level borderline personality organization is validated by the present data, providing support for a dimensional model for classifying personality disorders. The results are likely applicable to outpatient populations in similar mental health settings. (PsycINFO Database Record (c) 2007 APA, all rights reserved) https://www.upress.umn.edu/test-division/bibliography/2000-2009/2006/dolinsky_cahall_construct_2006 https://www.upress.umn.edu/logo.png

Marisa C Dolinsky Cahall (2006)

A construct validity study of Kernberg's notion of upper- and lower-level personality organizations (Otto Kernberg)

PhD thesis.

Keywords

Adaptation
APA
Classification
Classification of personality disorders
Clients
Clinicians
Construct validity
Diagnosis
Discriminant function
DSM IV
Ego
Ego function assessment
Empirical research
Mental health settings
MMPI
Ooutpatient population
Personality
Personality disorder
Psychotic
Rating
Research
Severity
University
Validity

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A construct validity study of Kernberg's notion of upper- and lower-level personality organizations (Otto Kernberg)