Assessment tools for affect regulation and quality of object relations in personality disorders: The predictive impact on initial treatment engagement.

On the road to DSM-V, instruments are demanded that provide clinically meaningful information, for example, predictions about psychotherapy utilization. Comparison of five different instruments in a sample of 297 patients with personality disorders showed that the Structured Clinical Interviews for DSM-IV (SCID), SWAP-200, and the Inventory of Interpersonal Problems (IIP) lead to predictive models concerning initial therapy engagement. The Affect Experience and Affect Regulation Q-sort (AREQ) provided information concerning therapy rejection.

Exploration of personality factors and their predictive impact on therapy utilization: the externalizing mode of functioning.

The aim of this study was to identify personality factors predicting psychotherapy utilization on the basis of personality pathology, affect regulation and interpersonal functioning. The authors assessed affectivity (using the Affect Experience and Affect Regulation Q-Sort), interpersonal context (using the Quality of Object Relations Scale), and character pathology (using the Shedler-Westen Assessment Procedure-200). Combination of instruments showed one stable factor predictive for nonengagement in psychotherapy, revealing an externalizing personality dimension, dominated by externalizing defenses, acting out, deficient superego functions, and impairment in reflective functioning and in relating to others.