AUTHOR=Unoka Zsolt , Csáky-Pallavicini Krisztina , Horváth Zsolt , Demetrovics Zsolt , Maraz Aniko 

TITLE=The Inventory of Personality Organization: A valid instrument to detect the severity of personality dysfunction

JOURNAL=Frontiers in Psychiatry

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2022.995726

DOI=10.3389/fpsyt.2022.995726

ISSN=1664-0640

ABSTRACT=Background and aims: In the eleventh revision of the International Classification of Diseases (ICD-11), the severity of personality dysfunction became the central dimension of personality disorder's definition, besides the trait domain qualifiers. Personality functioning, also known as personality organization, is becoming an increasingly important concept in administering, predicting, and measuring severity and nature of personality disturbance. The Inventory of Personality Organization (IPO) is a self-report rating scale for the measurement of personality organization. Aim of this study was to identify severity groups according to the level of personality organization and to explore their validity. Methods: A clinical sample of 118 patients were recruited from a four-week in-patient cognitive psychotherapy program. Besides the IPO, Structured Clinical Interview for the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders, (DSM-IV.) Axis I and II, Symptom Check List-90, State-Trait Anger Expression Inventory and Dissociative Experience scale. Two types of analyses were conducted: a person-centered (latent profile) analysis and various variable-centered tests to confirm the factor structure of IPO and calculate group differences. Results: The three-factor (CFI=0.990, TLI=0.990, RMSEA=0.022, SRMR=0.089) and the five-factor (CFI=0.995, TLI=0.995, RMSEA=0.014, SRMR=0.090) models of the IPO was supported. Latent class analysis identified three subgroups of personality organization: "Well-integrated", "Moderately integrated" and "Disintegrated" classes. There were no significant differences between the three classes in the number of Axis 1 diagnoses (p=0.354; η2=0.01). Group differences in the number of personality disorders, the number of personality disorder symptoms as well as in the presence of borderline and depressive personality disorder were significant (all p<0.001; V=0.35-0.42; η2=0.15-0.26). Persons with more severe personality organization problem level had higher rates of psychopathological symptoms, state and trait anger, and dissociative characteristics (all p<0.001; η2=0.13-0.36). Conclusions: The IPO can be an appropriate instrument to measure the severity of personality disorganization and to classify participants along a continuum of severity in this regard. Our results present further evidence that the severity of personality dysfunction, the central dimension of the ICD-11 and the Alternative Model for Personality Disorders is detectable with an instrument, the IPO, that was initially developed to detect the disturbances in personality organization.