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Open Access 01-12-2013 | Research article

Reliability and validity of the German version of the Structured Interview of Personality Organization (STIPO)

Authors: Stephan Doering, Markus Burgmer, Gereon Heuft, Dina Menke, Brigitta Bäumer, Margit Lübking, Marcus Feldmann, Susanne Hörz, Gudrun Schneider

Published in: BMC Psychiatry | Issue 1/2013

Abstract

Background

The assessment of personality organization and its observable behavioral manifestations, i.e. personality functioning, has a long tradition in psychodynamic psychiatry. Recently, the DSM-5 Levels of Personality Functioning Scale has moved it into the focus of psychiatric diagnostics. Based on Kernberg’s concept of personality organization the Structured Interview of Personality Organization (STIPO) was developed for diagnosing personality functioning. The STIPO covers seven dimensions: (1) identity, (2) object relations, (3) primitive defenses, (4) coping/rigidity, (5) aggression, (6) moral values, and (7) reality testing and perceptual distortions. The English version of the STIPO has previously revealed satisfying psychometric properties.

Methods

Validity and reliability of the German version of the 100-item instrument have been evaluated in 122 psychiatric patients. All patients were diagnosed according to the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV) and were assessed by means of the STIPO. Moreover, all patients completed eight questionnaires that served as criteria for external validity of the STIPO.

Results

Interrater reliability varied between intraclass correlations of .89 and 1.0, Crohnbach’s α for the seven dimensions was .69 to .93. All a priori selected questionnaire scales correlated significantly with the corresponding STIPO dimensions. Patients with personality disorder (PD) revealed significantly higher STIPO scores (i.e. worse personality functioning) than patients without PD; patients cluster B PD showed significantly higher STIPO scores than patients with cluster C PD.

Conclusions

Interrater reliability, Crohnbach’s α, concurrent validity, and differential validity of the STIPO are satisfying. The STIPO represents an appropriate instrument for the assessment of personality functioning in clinical and research settings.

Freud S: Die Traumdeutung. Gesammelte Werke Bd. II/III. 1900/1999, Frankfurt am Main: Fischer Taschenbuchverlag

Freud A: Das Ich und die Abwehrmechanismen. 1936, Wien: Internationaler Psychoanalytischer Verlag

Hartmann H: Ich-Psychologie und Anpassungsproblem. Int Z Psychoanal Imago. 1939, 24: 62-135.

Hartmann H: Ego psychology and the problem of adaptation. 1958, New York: International Universities PressCrossRef

Kernberg OF: Borderline Conditions and Pathological Narcissism. 1975, New York: Jason Aronson

Kernberg OF: Severe personality disorders. 1984, New Haven: Yale University Press

Clarkin JF, Yeomans FE, Kernberg OF: Psychotherapy for Borderline Personality Disorder. 2006, Washington, DC: American Psychiatric Publishing

Bowlby J: Attachment and Loss. Vol. 1. Attachment. 1969, London: Hogarth Press

Fonagy P: Thinking about thinking: some clinical and theoretical considerations in the treatment of a borderline patient. Int J Psychoanal. 1991, 72: 639-656.PubMed

10.

Fonagy P: Playing with reality: The development of psychic reality and its malfunction in borderline personalities. Int J Psychoanal. 1995, 76: 39-44.PubMed

11.

Fonagy P, Target M, Steele H, Steele M: Reflecting Functioning Manual, Version 5, for Application to Adult Attachment Interviews. 1998, London: Unpublished manuscript

12.

Fischer-Kern M, Buchheim A, Hörz S, Schuster P, Doering S, Kapusta ND, Taubner S, Tmej A, Rentrop M, Buchheim P, Fonagy P: The Relationship between Personality Organization, Reflective Functioning and Psychiatric Classification in Borderline Personality Disorder. Psychoanal Psychol. 2010, 27: 395-409.CrossRef

13.

Wallerstein RS, DeWitt K, Hartley D, Rosenberg SE, Zilberg N: The Scales of Psychological Capacities. Version 1. Unpublished manual. 1989, San Francisco: University of California

14.

OPD Task Force: Operationalized Psychodynamic Diagnosis – OPD-2. Manual of Diagnosis and Treatment Planning. 2008, Cambridge, MA: Hogrefe & Huber Publishers

15.

Bender DS, Morey LC, Skodol AE: Toward a model for assessing level of personality functioning in DSM-5, part I: a review of theory and methods. J Personal Assess. 2011, 93: 332-346. 10.1080/00223891.2011.583808.CrossRef

16.

American Psychiatric Association: Diagnostic and Statistical Manual. Fifth edition. DSM-5. 2013, Washington, DC: American Psychiatric Publishing

17.

Tyrer P, Crawford M, Mulder R: Reclassifying personality disorders. Lancet. 2011, 377: 1814-1815. 10.1016/S0140-6736(10)61926-5.CrossRefPubMed

18.

Kernberg OF: The structural interviewing. Psychiatr North Am. 1981, 4: 169-195.

19.

Clarkin JF, Foelsch PA, Kernberg OF: The Inventory of Personality Organization (IPO). 1995, New York: Weill Medical College of Cornell University

20.

Lenzenweger MF, Clarkin JF, Kernberg OF, Foelsch PA: The Inventory of Personality Organization: psychometric properties, factorial composition, and criterion relations with affect, aggressive dyscontrol, psychosis proneness, and self-domains in a nonclinical sample. Psychol Assess. 2001, 13: 577-591.CrossRefPubMed

21.

Clarkin JF, Caligor E, Stern B, Kernberg OF: Structured Interview of Personality Organization (STIPO). 2003, New York: Weill Medical College of Cornell University

22.

Stern BL, Caligor E, Clarkin JF, Critchfield KL, Horz S, MacCornack V, Lenzenweger MF, Kernberg OF: Structured interview of personality organization (STIPO): Preliminary psychometrics in a clinical sample. J Personal Assess. 2010, 92: 35-44. 10.1080/00223890903379308.CrossRef

23.

Clark LA: Schedule of Nonadaptive an Adaptive Personality, SNAP. 1993, Minneapolis: University of Minnesota Press

24.

Hörz S: A Prototype of Borderline Personality Organization – Assessed by the Structured Interview of Personality Organization (STIPO). 2007, Hamburg: Verlag Dr. Kovac

25.

Doering S, Hörz S, Rentrop M, Fischer-Kern M, Schuster P, Benecke C, Buchheim A, Martius P, Buchheim P: Transference-focused psychotherapy v. treatment by community psychotherapists for borderline personality disorder: randomised controlled trial. Br J Psychiatry. 2010, 196: 389-395. 10.1192/bjp.bp.109.070177.CrossRefPubMed

26.

Hörz S, Rentrop M, Fischer-Kern M, Schuster P, Kapusta N, Buchheim P, Doering S: Strukturniveau und klinischer Schweregrad der Borderline-Persönlichkeitsstörung. Z Psychosom Med Psychother. 2010, 56: 136-149.PubMed

27.

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders. Fourth Edition. DSM-IV. 1994, Washington, DC: American Psychiatric Publishing

28.

Fydrich T, Renneberg B, Schmitz B, Wittchen HU: SKID-II: Strukturiertes Klinisches Interview für DSM-IV, Achse II: Persönlichkeitsstörungen. 1997, Göttingen: Hogrefe

29.

Wittchen HU, Zaudig M, Fydrich T: SKID-I: Strukturiertes Klinisches Interview für DSM-IV, Achse I. 1997, Göttingen: Hogrefe

30.

Skre I, Onstad S, Torgersen S, Kringlen E: High interrater reliability for the Structured Clinical Interview for DSM-III-R Axis I (SCID-I). Acta Psychiatr Scand. 1991, 84 (2): 167-173. 10.1111/j.1600-0447.1991.tb03123.x.CrossRefPubMed

31.

Maffei C, Fossati A, Agostoni I, Barraco A, Bagnato M, Deborah D, Mania C, Novella L, Petrachi M: Interrater reliability and internal consistency of the Structured Clinical Interview for DSM-IV axis II personality disorders (SCID-II), version 2.0. J Personal Disord. 1997, 11 (3): 279-284. 10.1521/pedi.1997.11.3.279.CrossRef

32.

World Health Organization: The ICD-10 Classification of Mental and Behavioural Disorders. 1992, Geneva: World Health Organization

33.

Benecke C, Koschier A, Peham D, Bock A, Dahlbender RW, Biebl W, Doering S: Erste Ergebnisse zur Reliabilität und Validität der OPD-2 Strukturachse. Z Psychosom med Psychother. 2009, 55: 84-96.PubMed

34.

Cierpka M, Grande T, Stasch M, Oberbracht C, Schneider W, Schüssler G, Heuft G, Dahlbender R, Schauenburg H, Schneider G: Zur Validität der Operationalisierten Psychodynamischen Diagnostik (OPD). Psychotherapeut. 2001, 46: 122-133. 10.1007/s002780100145.CrossRef

35.

Leichsenring F: Borderline Persönlichkeits-Inventar (BPI). 1997, Göttingen: Hogrefe

36.

Leichsenring F: Development and First Results of the Borderline Personality Inventory: A Self-Report Instrument for Assessing Borderline Personality Organization. J Personal Assess. 1999, 73: 45-63. 10.1207/S15327752JPA730104.CrossRef

37.

Janke W, Erdmann G: Streßverarbeitungsfragebogen (SVF-120). 1997, Göttingen: Hogrefe Verlag

38.

Spielberger CD: State-Trait-Anger-Expression-Inventory (STAXI). 1988, Odessa, FL: Psychological Assessment Resources, Research

39.

Schwenkmerger P, Hodapp V, Spielberger CD: Das State-Trait-Ärgerausdrucks-Inventar – STAXI. 1992, Bern: Verlag Hans Huber

40.

Freyberger HJ, Spitzer C, Stieglitz RD: Fragebogen zu Dissoziativen Symptomen. 2005, Bern: Hans Huber Verlag, 2

41.

Bernstein EM, Putnam FW: Development, reliability, and validity of a dissociation scale. J Nerv Ment Dis. 1986, 174: 727-735. 10.1097/00005053-198612000-00004.CrossRefPubMed

42.

Hentschel U, Kießling M, Wiemers M: Fragebogen zu Konfliktbewältigungsstrategien – FKBS. 1998, Göttingen: Beltz

43.

Gleser GC, Ihilevich D: An objective instrument for measuring defense mechanisms. J Consult Clin Psychol. 1969, 1969 (33): 51-60.CrossRef

44.

Deusinger IM: Die Frankfurter Selbstkonzeptskalen (FSKN). 1986, Göttingen: Hogrefe

45.

Brennan KA, Clark CL, Shaver PR: Self-report measurement of adult attachment: An integrative overview. Attachment theory and close relationships. Edited by: Simpson JA, Rholes WS. 1998, New York, NY: Guilford, 46-76.

46.

Neumann E, Rohmann E, Bierhoff HW: Entwicklung und Validierung von Skalen zur Erfassung von Vermeidung und Angst in Partnerschaften – Der Bochumer Bindungsfragebogen (BoBi). Diagnostica. 2007, 53: 33-47. 10.1026/0012-1924.53.1.33.CrossRef

47.

Schotte CKW, De Doncker D, Vankerckhoven C, Vertommen H, Cosyns P: Self-report assessment of the DSM-IV personality disorders. Measurement of trait and distress characteristics: the ADP-IV. Psychol Med. 1998, 28: 1179-1188. 10.1017/S0033291798007041.CrossRefPubMed

48.

Doering S, Renn D, Höfer S, Smrekar U, Janecke N, Schatz DS, Schatz DS, Schotte C, DeDoncker D, Schüssler G: Validierung der deutschen Version des Fragebogens zur Erfassung von DSM-IV Persönlichkeitsstörungen (ADP-IV). Z Psychosom Med Psychother. 2007, 53: 111-128.PubMed

49.

Renn D, Höfer S, Schüßler G, Rumpold G, Smrekar U, Janecke N, Doering S: Dimensionale Diagnostik mit dem Fragebogen zur Erfassung von DSM-IV Persönlichkeitsstörungen (ADP-IV). Z Psychosom Med Psychother. 2008, 54: 214-226.PubMed

50.

Huber D, Klug G, Henrich G, Marten-Mittag B, Wallerstein RS: Die Skalen Psychischer Kompetenzen (SPK). Handbuch der Strukturdiagnostik. Konzepte, Instrumente, Praxis. Edited by: Doering S, Hörz S. 2012, Stuttgart: Schattauer, 122-151.

51.

Zimmermann J, Ehrenthal JC, Cierpka M, Schauenburg H, Doering S, Benecke C: Assessing the Level of Structural Integration using Operationalized Psychodynamic Diagnosis (OPD): Implications for DSM-5. J Personal Assess. 2012, 94: 522-532. 10.1080/00223891.2012.700664.CrossRef

The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-244X/13/210/prepub

Title: Reliability and validity of the German version of the Structured Interview of Personality Organization (STIPO)
Authors: Stephan Doering
Markus Burgmer
Gereon Heuft
Dina Menke
Brigitta Bäumer
Margit Lübking
Marcus Feldmann
Susanne Hörz
Gudrun Schneider
Publication date: 01-12-2013
Publisher: BioMed Central
Published in: BMC Psychiatry / Issue 1/2013
Electronic ISSN: 1471-244X
DOI: https://doi.org/10.1186/1471-244X-13-210

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Reliability and validity of the German version of the Structured Interview of Personality Organization (STIPO)

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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