Inter-rater Reliability and Construct Validity of the Lerner Defense Scale in Clinical and Non-clinical Groups

The current study investigated the inter-rater reliability and the construct validity of the Rorschach Lerner Defense Scale (LDS). In particular, it aimed to explore the inter-rater reliability, analyzing the most frequent coding mistakes in an attempt to improve the coding guidelines, and to investigate the ability of the scale to distinguish between individuals with neurotic-level and borderline-level personality organization, according to the Psychodynamic Diagnostic Manual-2 (PDM-2), and non-clinical subjects. Eighty clinical subjects and 80 non-clinical ones participated in the study. Among the clinical subjects, 40 have borderline-level personality organization and 40 have neurotic-level personality organization. Non-clinical subjects were drawn from an archival dataset of non-clinical individuals who previously participated in a Rorschach normative study. The LDS showed substantial inter-rater reliability; however, guidelines could be improved, specifically with regard to the threshold for coding Devaluation and Idealization at level 1. Furthermore, more examples should be included in the manual about the coding of Projective Identification and Denial. The LDS distinguished borderline-level subjects from both the non-clinical and neurotic groups with regard to Devaluation and Projective Identification, with borderline-level personality organization subjects reporting higher scores than either of the two other groups. Only the Denial scale discriminated between the non-clinical and neurotic group, with the latter reporting higher scores of high-level Denial.

Defense Mechanisms and Borderline Personality Organization Among COVID-19 Believers and Non-believers During Complete Lock-Down

The aim of the current study was to investigate whether a specific social perception of the pandemic—believing or not in COVID-19—predicts borderline personality organizations and whether this relationship is mediated by more primitive maladaptive mechanisms—splitting, denial, and dissociation. The online study included 720 organization aged 25–45. Participants were diverse in terms of place of residence, being in a relationship, and education level. Approximately 30% of the general population reported not believing in the COVID-19 pandemic. Non-believers scored slightly higher on borderline symptoms and used more maladaptive defense mechanisms than believers. Individuals who deny COVID-19 are more likely to show characteristics of borderline personality organization. Splitting is an important mechanism in this relationship.

Three Dimensional Approaches to Personality Disorders: a Review on Personality Functioning, Personality Structure, and Personality Organization

Purpose of Review The concept of personality functioning (Alternative DSM-5 Model of Personality Disorders) has led to increased interest in dimensional personality disorder diagnosis. While differing markedly from the current categorical classification, it is closely related to the psychodynamic concepts of personality structure and personality organization. In this review, the three dimensional approaches, their underlying models, and common instruments are introduced, and empirical studies on similarities and differences between the concepts and the categorical classification are summarized. Additionally, a case example illustrates the clinical application. Recent Findings Numerous studies demonstrate the broad empirical basis, validated assessment instruments and clinical usefulness of the dimensional concepts. Their advantages compared to the categorical approach, but also the respective differences, have been demonstrated empirically, in line with clinical observations. Summary Evidence supports the three dimensional concepts, which share conceptual overlap, but also entail unique aspects of personality pathology, respectively.