Psychometric properties of the Spanish structured interview of personality organization revised (STIPO-R) in a clinical and community sample

The diagnosis of personality disorders (PD) remains challenging in clinical practice. The Diagnostic and Statistical Manual of Mental Disorders reviewed (DSM-5-TR) proposes an alternative diagnostic hybrid model (AMPD), that emphasizes dimensional assessment of personality pathology, particularly severity of impairment in personality functioning (Criterion A), a construct conceptually derived from Kernberg’s model of personality organization (PO) but operationalized in a highly simplified form. However, few structured diagnostic interviews aligned with this framework are available in Spanish. The Structured Interview of Personality Organization–Revised (STIPO-R) provides a dimensional assessment of the original PO construct and may offer clinically valuable information beyond current Criterion A measures. The aim of the present study was to validate the Spanish version of the STIPO-R and to examine its reliability (internal consistency) and construct validity. A cross-sectional study was carried out with a sample of 206 subjects distributed into two groups: a clinical group comprised 134 outpatient psychiatric patients diagnosed with PD who were administered both the SCID-II and the Spanish version of the STIPO-R. The control group comprised 72 subjects without a PD diagnosis in the preceding ten years to whom the Spanish STIPO-R was administered. Reliability (internal consistency) and four types of validity evidence were examined: criterion, content, structural and concurrent with the SCID-II. The results confirmed that the Spanish STIPO-R has adequate reliability (internal consistency), and content, structural, criterion and concurrent validity. The CFA confirmed a six-factor solution consistent with the domain structure proposed in the original English version: (1) Identity, (2) Object relations, (3) Primitive defenses, (4) Advanced defenses, (5) Aggression and (6) Moral values. The Spanish STIPO-R is empirically confirmed to be valid and reliable for assessing normal and pathological personality organization according to Kernberg’s full theoretical model; including Defense Mechanisms, absent from the AMPD, and Aggression and Moral values, only partially represented within its trait domains - thereby offering clinicians a more comprehensive assessment of personality pathology.