Personality disorders and Ego States - the mediating role of mentalization

• Piotr Przybylski

  1. Uniwersytet Zielonogórski, 2. Centrum Analizy Transakcyjnej w Poznaniu

  https://orcid.org/0000-0003-3543-2009

• Lidia Cierpiałkowska

  1. Uniwersytet im. Adama Mickiewicza, 2. Uniwersytet Zielonogórski

• Dominika Rusnak

Purpose of the study
Transactional Analysis has faced an important theoretical and empirical challenge as a result of the change in the approach to personality disorders in the DSM-5 and ICD-11 medical classifications of mental and behavioral disorders. The purpose of this study was to determine whether there are relationships between positively and negatively used Ego States and personality functioning and mentalization, and to test whether mentalization is a mediator between the severity of personality disorder and the severity of used Ego States.

Methods
Personality disorder was examined using the Self-Descriptive Brief Scale for Assessing Level of Personality Functioning for Personality Disorders: Self and Interpersonal Functioning Scale (SIFS, Gamache et al., 2019; Polish adaptation Cieciuch and Strus, 2021), mentalization ability with the Mentalization Scale (MentS, Dimitrijević et al., 2018; Polish adaptation Jańczak, 2021), positive and negative Ego States the Ego States Questionnaire (Matkowski, Więcławski, 2016).

Respondents
A total of 106 individuals aged 18 to 65 were examined. The average age of the study participants was 25.8 years, with the largest group consisting of women with incomplete higher education. Nearly half of the group had a psychiatric diagnosis of various mental disorders or were undergoing diagnostic assessments for personality disorders.

Results
Significant correlations were found between the overall level of personality functioning and its two domains - self-functioning and interpersonal functioning - and the intensity of positively used Ego States, and only a few negatively used ones. Significant associations emerged between the general capacity for mentalization, self-mentalization, and mentalization about others, and the Adult Ego State. However, the assumption of the mediating role of mentalization ability between personality functioning and the Adult Ego State was not confirmed.

Keywords: Ego States, personality disorder, mentalization

Allen, J.G., Fonagy, P., Bateman, A. (2008). Mentalizing in Clinical Practice. Washington DC: American Psychiatric Publishing.

APA (2013). Diagnostic and Statistical Manual of Mental Disorders, DSM-5. Washington: American Psychiatric Association

Bach, B., Simonsen, S. (2021). How does level of personality functioning inform clinical management and treatment? Implications for ICD-11 classification of personality disorder severity. Current Opinion in Psychiatry, 34(1), 54. https://doi.org/10.1097/YCO.0000000000000658

Bach, B., Kramer, U., Doering, S., di Giacomo, E., Hutsebaut, J., Kaera, A., De Panfilis, C., Schmahl, C., Swales, M., Taubner, S., & Renneberg, B. (2022). The ICD-11 classification of personality disorders: A European perspective on challenges and opportunities. Borderline Personality Disorder and Emotion Dysregulation, 9(1), 12. https://doi.org/10.1186/s40479-022-00182-0

Cierpiałkowska, L., Frączek, A. (2017). Przymierze terapeutyczne w terapii zaburzeń osobowości z perspektywy analizy transakcyjnej. Edukacyjna Analiza Transakcyjna, 6, Article 6. https://doi.org/10.16926/eat.2017.06.08

Cierpiałkowska, L., Soroko, E., (2020). Zaburzenia osobowości. Problemy diagnozy klinicznej. Poznań: Wydawnictwo Naukowe UAM

Cierpiałkowska, L., Soroko, E., Sęk, H. (2016). Modele diagnozy klinicznej a problemy diagnostyczne. W: L. Cierpiałkowska, H. Sęk (Red.). Psychologia Kliniczna (s. 195-214). Warszawa: Wydawnictwo Naukowe PWN SA.

Cornell, W. F. (2018). Into TA: A Comprehensive Textbook on Transactional Analysis. Routledge.

Craig, R. J., & Olson, R. E. (1988). Changes in Functional Ego States following Treatment for Drug Abuse. Transactional Analysis Journal, 18(1), 68–72. https://doi.org/10.1177/036215378801800111

Dimitrijević, A., Hanak, N., Altaras Dimitrijević, A., & Jolić Marjanović, Z. (2018). The Mentalization Scale (MentS): A Self-Report Measure for the Assessment of Mentalizing Capacity. Journal of Personality Assessment, 100(3), 268–280. https://doi.org/10.1080/00223891.2017.1310730

Eaton, N.R.,Krueger, R.F., Keyes, K.M., Skodol, A.E., Markon, K.E., Grant, B.F., Hasin, D.S. (2011). Borderline personality disorder co-morbidity: relationship to the internalizing-externalizing structure of common mental disorders. Psychological Medicine, 41(5), 1041-1050.

Fonagy, P. (1991). Thinking about thinking: Some clinical and theoretical considerations in the treatment of a borderline patient. International Journal of Psycho-Analysis, 72, 639-656.

Frączek, A. (2020). Psychoterapia indywidualna adolescentów w analizie transakcyjnej. W I. Grzegorzewska, L. Cierpiałkowska, & A. R. Borkowska (Red.), Psychologia Kliniczna dzieci i młodzieży (s. 879–898). Warszawa: Wydawnictwo Naukowe PWN S.A.

Frączek, A., Smelkowska, A., Bobrowska, I., Cierpiałkowska, L., Przybylski, P., Zaręba, F. (2022). Dymensjonalny model diagnozy zaburzeń osobowości w perspektywie koncepcji Analizy Transakcyjnej. Materiały szkoleniowe Centrum Analizy Transakcyjnej. Materiały niepublikowane, Poznań

Gamache, D., Savard, C., Leclerc, P., & Côté, A. (2019). Introducing a short self-report for the assessment of DSM–5 level of personality functioning for personality disorders: The Self and Interpersonal Functioning Scale. Personality Disorders: Theory, Research, and Treatment, 10(5), 438–447. https://doi.org/10.1037/per0000335

Górska, D., Cierpiałkowska, L. (2016). Mentalizacja jako stan i jako cecha – perspektywa strukturalno-procesualna. W: L. Cierpiałkowska & D. Górska (red.). Mentalizacja z perspektywy rozwojowej i klinicznej (s. 13-41). Poznań: Wydawnictwo Naukowe UAM.

Gutiérrez, F., Aluja, A., Rodríguez, C., Gárriz, M., Peri, J. M., Gallart, S., Calvo, N., Ferrer, M., Gutiérrez-Zotes, A., Soler, J., & Pascual, J. C. (2023). Severity in the ICD-11 personality disorder model: Evaluation in a Spanish mixed sample. Frontiers in Psychiatry, 13. https://www.frontiersin.org/articles/10.3389/fpsyt.2022.1015489

Jańczak, M. O. (2021). Polish adaptation and validation of the Mentalization Scale (MentS) – a self-report measure of mentalizing. Psychiatria Polska, 55(6), 1257–1274. https://doi.org/10.12740/PP/125383

Matkowski, M., Więcławski, W. (2016) Kwestionariusz stanów Ja. Wersja eksperymentalna.

Morey, L. C., McCredie, M. N., Bender, D. S., & Skodol, A. E. (2022). Criterion A: Level of personality functioning in the alternative DSM–5 model for personality disorders. Personality Disorders: Theory, Research, and Treatment, 13, 305–315. https://doi.org/10.1037/per0000551

Mulder, R. T. (2021). ICD-11 Personality Disorders: Utility and Implications of the New Model. Frontiers in Psychiatry, 12. https://www.frontiersin.org/articles/10.3389/fpsyt.2021.655548

Stewart, I., & Joines, V. (2021). Analiza transakcyjna dzisiaj: Nowe wprowadzenie. Dom Wydawniczy Rebis.

Widdowson, M. (2011). Depression: A Literature Review on Diagnosis, Subtypes, Patterns of Recovery, and Psychotherapeutic Models. Transactional Analysis Journal, 41(4), 351–364. https://doi.org/10.1177/036215371104100411

World Health Organization (WHO). ICD-11 for Mortality and Morbidity Statistics (dostęp z dnia: 24.08.2023 r.). https://icd.who.int/browse11/l-m/en

Wouters, A., & Smale, G. (1990). Diagnosis with Millon’s Personality System: Implications for Transactional Analysis Therapy. Transactional Analysis Journal, 20(2), 118–127. https://doi.org/10.1177/036215379002000204

Zettl, M., Volkert, J., Vögele, C., Herpertz, S. C., Kubera, K. M., & Taubner, S. (2020). Mentalization and criterion a of the alternative model for personality disorders: Results from a clinical and nonclinical sample. Personality Disorders: Theory, Research, and Treatment, 11(3), 191–201. https://doi.org/10.1037/per0000356

• PDF

Copyright (c) 2023 Piotr Przybylski, Lidia Cierpiałkowska, Dominika Rusnak

This work is licensed under a Creative Commons Attribution 4.0 International License.

AUTHOR'S STATEMENT

I am aware that the Educational Transactional Analysis journal is published under a Creative Commons license - Attribution (https://creativecommons.org/licenses/by/4.0/legalcode).

By submitting the article, I agree to make it available under this license