Borderline personality organization, structural diagnosis and the structural interview. A pilot study of interview analysis

Abstract

Kernberg has related the level of integration of the personality to the level of integration (and "structuring") of internalized object relations. He has designated three levels of personality organization: neurotic, borderline, and psychotic, and has developed a specially focused clinical interview designed to reveal intrapsychic structural characteristics--a "structural interview"--as a diagnostic instrument to differentiate the three types of personality organization. This study presents a method of analysis of the structural interview. Interviews of ten hospitalized psychiatric patients were studied to determine whether indicators could be retrieved from the typescripts of the interviews consonant with the diagnoses made by clinicians utilizing Kernberg's structural theory. Results indicate that scores generated from the typescripts are consistent with the hypothesis that the interviews did contain the indicators called for by structural theory and differentiate borderline from psychotic structures better than chance. In addition, this method of analysis of contingencies of interaction in the interview may have broader application to the study of psychotherapy and psychoanalysis.