Slide 1

Monika Marsza Adam Mickiewicz University Pozna , Poland Psychotic, borderline and neurotic personality organization fact or artifact? Slide 2 Over the past few decades, object relation theories have become a central topic in conceptualization of personality disorders. One of them, Otto Kernbergs theory is considered to be the most interesting, but also the most controversial one. When we are analyzing the psychodynamic literature it is hard not to claim that many of its assumptions should have been verified and described in an empirical way, based on well planned research. Slide 3 aim to recognize the etiology and describe the essence of intrapsychic structure, what is believed to be the source of a specific patterns of thinking, behaving and experiencing Slide 4 personality development is based on an intrapsychic transformations of positive and negative self- object- affect representations. It can be inhibited as a consequence of a biological factor (ex. disharmonized temperament) and/or psychological factor connected with the lack of possibility to relate to the object (mother). If the fixation takes place in a symbiotic phase, we observe the psychotic PO when in a self/ object differentiation phase theres borderline PO and when in a consolidation phase- neurotic PO Slide 5 structural model The differences between three levels of POs concerning 3 basic dimensions: 1. level of defense mechanisms maturity 2. level of identity integration 3. capacity to reality testing BPO is similar to PPO in case of domination of primitive defense mechanisms and identity disturbances but is different in case of reality testing, what makes it more similar to NPO. Slide 6 defense mechanisms BPO and PPO are constructed by the primitive defense mechanisms like: splitting, projection and projective identification. The maintenance of those mechanisms results in the lack of integration between libidinal and aggressive aspects of self and object. This integration is achieved in NPO, where splitting is replaced by the more mature mechanisms: repression, denial, reversal. Slide 7 identity In NPO we can observe high level of stability and continuity of self/object representations, what results in identity integration. In PPO and BPO identity is diffused, unstable, or connected with foreclosure identity (Kernberg, 2004, 2004, 1970, 1967). Slide 8 Reality testing A broad deficit in PPO, but individuals with BPO may present some disturbances as well. In general, we can assume that reality testing is seriously impaired only in PPO, when patients suffer from hallucinations, delusions, and confusion about their own existence (Kernberg, 2004b, 1970, 1967; McWilliams, 2009). Reality testing is not disturbed in NPO. Slide 9 Aim of the study Concerning this brief theoretical description, in our research we decided to empirically verify the assumptions about the differences in capacity to reality testing, level of identity integration and predominance of certain defense mechanisms in neurotic, borderline and psychotic PO. Slide 10 Participants 90 individuals: 30 individuals with the BPO, 30 individuals with the PPO and 30 individuals with the NPO. The criteria of selection to the groups were psychiatric and/or psychological evaluation. 18 -64 years old (M=32.9), 46 women and 44 men. 70% of the participants had high school degree, 24.5% of the participants had college/university degree and 5.5% had elementary school degree. Among the participants with the BPO and NPO there were more women than men, but in the case of the participants with the PPO there were considerably more men. Slide 11 Methods Defense Mechanisms Inventory (1969) by C. Gleser and D. Ihilevich. Objective Measure of Ego-Identity Status Bennion i Adams (1986). Ego Strength (Es) F. Barron from MMPI (Barron, 1953). Slide 12 Results Slide 13 Ego strength post hoc T3 Dunnet Ego strength F(2,85)= 16,057; P