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The structural interview method for diagnosing borderline disorders: a critique.

J Reich, A Frances

    The Psychiatric Quarterly
    |January 1, 1984
    PubMed
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    This study critiques Kernberg's Structural Interview for diagnosing borderline personality organization, finding it equivalent to general personality disorder diagnoses in the studied population. A predictive formula was developed using logistic regression.

    Area of Science:

    • Psychiatry
    • Psychological Assessment
    • Personality Disorders

    Background:

    • Kernberg's Structural Interview is a diagnostic tool for borderline personality organization.
    • Previous studies using the method have reported results with noted limitations.
    • Assumptions underlying the interview method present challenges for accurate diagnosis.

    Purpose of the Study:

    • To evaluate the diagnostic assumptions and methodological limitations of Kernberg's Structural Interview.
    • To compare the Structural Interview diagnosis of borderline personality organization with general personality disorder diagnoses.
    • To develop a predictive model for identifying personality disorders.

    Main Methods:

    • Critical analysis of the assumptions of Kernberg's Structural Interview.

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  • Review and analysis of existing study data reporting results from the Structural Interview.
  • Application of logistic regression to derive a predictive formula for personality disorder diagnosis.

    • Main Results:

    • Methodological limitations were identified in studies utilizing Kernberg's Structural Interview.
    • The diagnosis of borderline personality disorder via the Structural Interview was found to be equivalent to the clinical diagnosis of any personality disorder in the studied group.
    • A predictive formula was successfully derived to ascertain the presence or absence of clinically diagnosed personality disorder.

    Conclusions:

    • Kernberg's Structural Interview may not reliably differentiate borderline personality organization from other personality disorders.
    • The diagnostic utility of the Structural Interview requires further investigation, particularly regarding its underlying assumptions.
    • Logistic regression provides a viable method for developing predictive diagnostic tools for personality disorders.