Investigation of changes in the level of personality functioning in different therapy settings and the importance of defense and countertransference in the therapy process

Prof. Leonie Kampe

The dimensional diagnostic approach of the DSM-5's Alternative Model of Personality Disorders (APA, 2013) offers a diagnostic model that prioritizes severity-oriented functional diagnostics instead of symptom-oriented diagnostics. While this diagnostic model is innovative in international classification systems, it is also highly dependent on the decades-old psychoanalytic models of personality structure and organization. In previous comparative therapy efficacy studies, psychodynamic methods have proven to be superior, particularly in terms of changing personality structure. The introduction of the Structured Clinical Interview for the DSM-5-Alternative Model for Personality Disorders (SCID-5-AMPD-I, First et al., 2018; German version Hörz-Sagstetter et al., in preparation) is now available, which captures these structural changes beyond the symptoms and, due to its postulated atheoretical construction, is available to all therapeutic schools for comparative procedural studies independently.

The SCID-AMPD-I change study investigates several fundamental diagnostic and psychotherapy process issues:

1. For the first time in a naturalistic psychotherapy study, the SCID-AMPD-I, which will soon be published in German, the inventory of personality organization (IPO-30; Hörz-S agstetter et al., 2020) and a new questionnaire for the Empirical Study of Defense Mechanisms (FEUA; Kampe, 2020/2024) were used and the change sensitivity of the instruments was determined.
2. Psychodynamic long-term therapies are compared with behavioral therapy and day-clinic psychiatric treatment to examine whether there are differences in the change in the level of functioning and other variables between the procedures.
3. Particular attention is paid to the investigation of those structural dimensions that were not included in the AMPD due to its atheoretical conception (e.g. defense, aggression), and which operationalize inherently psychoanalytic constructs.
4. Relevant thresholds for measuring clinically significant change are to be determined.
5. The structured clinical interviews of modules II and III of the alternative model (SCID-AMPD-II and -III, Hörz-Sagstetter et al. (in preparation)) are validated.
6. In the therapy process, further variables such as therapeutic countertransference, clinical follow-up data, external severity criteria are collected and linked.
    

Reference
Hörz-Sagstetter, S., Mokros, A., & Zimmermann, J. (in preperation). Strukturiertes Klinisches Interview für das alternative DSM–5-Modell für Persönlichkeitsstörungen (SCID-5-AMPD). Deutsche Bearbeitung des Structured Clinical Interview for the DSM–5 Alternative Model for Personality Disorders von Michael B. First, Andrew E. Skodol, Donna S. Bender, & John M. Oldham. Göttingen: Hogrefe.

Original language: German

Prof. Johannes Zimmerann (University of Kassel)
Prof. Cord Benecke (University of Kassel)

Projekt Start: 08/2021
Projekt End: 09/2025