Assessing the level of structural integration using operationalized psychodynamic diagnosis (OPD): implications for DSM-5.
A key ingredient in the current proposal of the DSM-5 Work Group on Personality and Personality Disorders is the assessment of overall severity of impairment in personality functioning: the Levels of Personality Functioning Scale (LPFS). The aim of this article is to contribute a conceptual and empirical discussion of the LPFS from the perspective of the Operationalized Psychodynamic Diagnosis (OPD) system (OPD Task Force,  2008 ). First, we introduce the OPD Levels of Structural Integration Axis (OPD-LSIA), a measure of individual differences in severity of personality dysfunction that is rooted in psychodynamic theory. We show that the OPD-LSIA is reliable, valid, and highly associated with observer ratings of personality disorders. In the second part, we present results from an OPD expert consensus study exploring potential limitations of the current LPFS item set from the perspective of the OPD-LSIA. We conclude with highlighting implications for future revisions of the DSM-5 proposal.
Department of Psychology, University of Kassel, Hollaendische Str. 36–38, 34127 Kassel, Germany. johannes.zimmermann@uni-kassel.de
Johannes
J
Zimmermann
Johannes C
JC
Ehrenthal
Manfred
M
Cierpka
Henning
H
Schauenburg
Stephan
S
Doering
Cord
C
Benecke
D039721:Diagnostic and Statistical Manual of Mental Disorders; D006801:Humans; D010551:Personality; D010554:Personality Disorders / Q000175:diagnosis*; D011574:Psychoanalytic Theory; D011575:Psychoanalytic Therapy; D015203:Reproducibility of Results