Et Kort Til Grænselandet - Foruden Det På Begge Sider - En Teoretisk Specialeafhandling Om Otto Kernbergs Borderline-Personlighedsorganisering I Relation til Personligheds(dys)funktion: En Teoretisk Specialeafhandling Om Otto Kernbergs Borderline-Personlighedsorganisering I Relation til Personligheds(dys)funktion

Abstract

Consisting of 6 chapters, the thesis presented intends to elaborate upon the meaning of Level of Personality Functioning (LPF) contained within Criterion A of the Alternate Model of Personality Disorders (AMPD) described by Section III of the DSM-5-TR (APA, 2022). In this effort Otto Kernberg’s (1928-) Object Relations Theory, and his concept of Borderline Personality Organization is utilized. Hopefully this might contribute the insights needed to fill the theoretical gaps currently casting this valuable diagnostic addition into the realm of uncertainty. Chapter 1 presents fundamental concepts within the field of nosology, regarding the diagnosis of Personality Disorders. Focusing on the AMPD the thesis argues in favour of maintaining the concept of LPF defined by Criterion A, while also acknowledging the need for revision. To this end, Kernberg’s theory regarding Borderline Personality Organization (BPO) is employed. Thus, the primary objective of the thesis is concerned with answering how the concept of Personality Functioning may be expanded upon by use of Kernberg’s Theory of Borderline Personality Organization, as well as outlining implications this might have for the continued relevancy of the personality functioning-concept. Chapter 2 delineates the contentious history of personality disorder diagnostics, particularly emphasizing the development of the term ‘borderline’ and its introduction into the DSM-III. Simultaneously, it is argued that the revitalization of Kraepelinian nosology immersed the Psychiatric community pertaining to personality pathology in a discussion informed by opposing positions within the field of Philosophy of Science, that to this day is still ongoing. By means of heuristics, Chapter 3 organizes these differing perspectives into Team A and B, denominated so due to their respective support of either the AMPD’s Criterion A or B. Considering the thesis’ sentiment, arguments opposing continued inclusion of Criterion A are presented. Chapter 4 examines the Object Relations Theory of Otto Kernberg, presenting the developmental logic and core concepts, as they pertain to the theory of Borderline Personality Organization (BPO). In turn, the commonalities and differences between BPO and LPF are discussed, indicating that whilst a fundamental theoretical and empirical overlap exists between the two, substantial differences are equally abundant. Predominantly, differences are concerned with divergent intent and practical usage of the concepts in addition to their coverage and assumptions regarding psychological processes. Furthermore, theoretical and empirical studies suggest that the terminology underlying BPO is distributed among Criterion A and B. Chapter 5 discusses how these differences might be resolved, the implications of doing so as well as the limitations of the thesis. It is argued that whilst adopting a theoretical framework analogous to Kernberg’s, such an approach might be unfit for diagnostic systems, like the DSM. Instead, Mentalization-theory might prove a better alternative due to its ostensibly more limited scope. Moreover, the notion that trait domains and psychological processes – and by extension Criterion A and B – are conceptually different is supported both theoretically and empirically, whereby intrapsychic processes seem the premier theoretical, diagnostic and clinical concept. Thus, Criterion A appears to capture the core of personality pathology, the value of which has prompted the ICD-11 to all but abandon maladaptive trait domains. Indeed, Criterion B might be more in need of theoretical expansion than Criterion A. Cybernetic Big-5 Theory is suggested as a potential aid in this regard. Finally, Chapter 6 summarizes the contributions of each preceding chapter, the interrelationship between these and what conclusions might be drawn from them.

A master thesis from Aalborg University

[A Map for The Borderline - Excluding Either Side - A Theoretical Thesis Regarding Otto Kernberg's Borderline-Personalityorganization in Relation to Personality(dys)function: A Theoretical Thesis Regarding Otto Kernberg's Borderline-Personalityorganization in Relation to Personality(dys)function]