[Personality disorder]

Differentiating between diagnoses of Asperger's syndrome and personality disorders is difficult because of the symptomatology of these disorders and due to the following methodological problems: 1) Developmental disorders, including Asperger's syndrome, are diagnosed in consideration of the time course, while personality disorders are cross sectional entities: 2) The distinction between both becomes more difficult according to the specific operational diagnosis system used. 3) Differentiating between these diagnoses is difficult because data regarding the developmental problems of adult patients with Asperger's syndrome are rare. In consideration of such problems, differential diagnoses between Asperger's syndrome and some types of personality disorder, namely schizoid, schizotypal, borderline, anankastic and avoidant types are discussed. Furthermore, the antisocial tendencies of Asperger's syndrome are also discussed.

Validation of the Affect Integration Inventory in a sample of patients with personality disorders: A cross-sectional study

Affect integration is defined as the capacity to comprehend emotional experiences as meaningful and to convert this knowledge into well-adjusted motivation, communication and behavior. Thus, affect integration is considered essential for personal adjustment and well-being, and it has been operationalized through the Affect Integration Inventory. However, the validity of this questionnaire has been examined only in non-clinical respondents. Therefore, the purpose of this study was to investigate the psychometric properties of the questionnaire in a sample of patients with personality disorders (n = 87). The internal structure and consistency were addressed using Cronbach's alpha and confirmatory factor analysis. To determine aspects of convergent and discriminant validity, the correlations between the scores on the questionnaire and the scores on content-related questionnaires and scales were examined. Finally, scores from the clinical respondents and existing data from a previously collected non-clinical sample (n = 157) were compared to evaluate the external validity. The overall results demonstrated satisfactory internal consistency, a consistent factor structure, and systematic patterns of convergent and discriminant validity. Additionally, the findings indicated that the instrument clearly differentiated the clinical sample from the non-clinical sample.

Doing justice to the richness of personality: Introduction to the special issue "New Approaches to the Measurement of Personality: Translational Thoughts to Applied, Educational, and Clinical Settings"

Personality and its assessment are growth areas in the psychological literature and are important in applied practice. In the decades since personality reemerged as a viable scientific construct following the person-situation debate, we have learned much about the nature and full breadth of personality traits as well as refined methods for the assessment of personality characteristics. Indeed, the personality assessment literature currently is vibrant and now intersects with numerous other disciplines, including traditional psychometrics, developmental psychology and psychopathology, clinical psychology, neuroscience, industrial-organizational psychology, and educational and social psychology. This growth in the personality assessment literature inspired us to organize an expert meeting on personality assessment. This 2-day event-which was held in Oostduinkerke (Belgium) in September 2016-brought together junior and senior personality assessment researchers as well as a number of methodologists from around the world and focused on sharing modern viewpoints on personality assessment from a wide diversity of perspectives. Following the meeting, we envisioned this special issue, including papers from meeting attendees addressing topics that emerged from the discussion sessions and are the result of fruitful and often new collaborations. Although the papers were invited, all were subjected to critical peer review and underwent revisions prior to their publication here. In what follows, the overall rationale for the present special issue and the connection between the different papers will be outlined from an integrative perspective. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

[Personality variables, psychopathological alterations and personality disorders in alcohol-dependent patients according to Cloninger's typology of alcohol abuse]

In this paper, an evaluation of Cloninger's typology of alcohol abuse in personality, psychopathology and personality disorders is carried out. The sample consisted of 158 alcoholics in treatment (56 Type I alcohol-dependent patients and 102 Type II alcohol-dependent patients). All subjects were assessed with diverse assessment tools related to personality (Impulsiveness Scale, Sensation Seeking Scale and STAI), psychopathology (SCL-90-R, BDI and Inadaptation Scale) and personality disorders (IPDE). The main findings were that Type II alcohol-dependent patients were more impulsive and sensation-seeking and they displayed more hostility and emotional distress than Type I alcohol-dependent patients. Personality disorders were not so prevalent in the case of Type I alcohol-dependent patients. The most specific personality disorders for Type II alcohol-dependent patients were narcissistic and paranoid. The implications of this study for further research are commented on.

A community service for high-risk mentally disordered sex offenders: a follow-up study

There is sparse literature on mentally disordered sex offenders, and little is published on treatment participation and outcomes for this group. This article aims to describe the characteristics of a cohort of high-risk mentally disordered-largely personality disordered-sex offenders at risk in the community in southeast London. Drawing on various measures of personality dysfunction-including key developmental variables, a self-report personality disorder questionnaire Millon Clinical Multi-axial Inventory-III (MCMI-III) and psychopathy as measured by the Psychopathy Checklist: Screening Version (PCL:SV)-the researchers describe the characteristics of a cohort of mentally disordered sex offenders referred to the Challenge project. Follow-up data for those placed in treatment are reported and include consideration of treatment completion and reconviction: the relationship between personality dysfunction and a dynamic measure of risk are also explored. Of the 137 participants, 53% were placed in the community treatment project. Seventy five percent completed treatment, and were followed up for an average of 40 months. Eleven percent were sexually reconvicted, 3% violently reconvicted. Community failure was best predicted by a combination of static risk and personality-related variables.

Narcissistic personality disorder: effect on relationships

BACKGROUND

Personality disorders, by definition, affect relationships. Narcissistic Personality Disorder can negatively impact relationships in all areas of life: the workplace, the community, and the family. A clear understanding of the types and extent of interpersonal impairment can assist nurses in establishing therapeutic relationships with those diagnosed with Narcissistic Personality Disorder.

AIM

The purpose of this activity is to examine the negative impact of Narcissistic Personality Disorder on interpersonal relationships.

METHOD

A review of literature connecting Narcissistic Personality Disorder to impairment in relationships.

RESULTS

Research findings show that Narcissistic Personality Disorder symptoms and behaviors will negatively impact interpersonal relationships across all areas of life. CONCLUSIONS AND COMMENT: Nurses interact with diverse populations in a variety of settings. Establishment of a therapeutic relationship with individuals who have Narcissistic Personality Disorder can be aided by a clear understanding of the associated relationship issues.

Relationships Between Psychopathy and DSM Personality Disorders in Men and Women

The current investigation asseses the relationship between DSM personality disorders (PDs) and PCL psychopathy in a community study: the Cambridge Study in Delinquent Development (CSDD). The children (Generation 3) of the original CSDD males (Generation 2) were assessed for PDs and psychopathy in early adulthood. Generation 3 consisted of both males (n = 291) and females (n = 260) and allowed for analyses separately for each gender. Cluster B PDs showed the strongest relationships with psychopathy, especially Borderline and Antisocial PD. Histrionic PD did not appear to have strong relationships with psychopathy, and there were no indications that histrionic PD overlaps with psychopathy in females as past research has hypothesized. There were however some other gender-specific relationships in the analyses, most notably between psychopathy and schizoid and schizotypal PDs for females, and between psychopathy and paranoid PD in males. Implications for the understanding of psychopathy in males and females are discussed.

Translation and cultural adaptation of the DSM-5 Personality Inventory - Brief Form (PID-5-BF)

INTRODUCTION

The Personality Inventory for the DSM-5 - Brief Form (PID-5-BF) - is an instrument for assessment of the five pathological personality traits from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) alternative model of personality disorders.

OBJECTIVES

To determine the psychometric properties of the version of the PID-5-BF translated and adapted to Brazilian Portuguese.

METHODS

The process of translating and cross-culturally adapting the text was carried out by independent translators and the resulting version was administered to 176 patients in two hospitals in Rio Grande do Sul. The internal structure was tested by means of confirmatory factor analysis. Evidence of reliability was tested by examining the internal consistency of the scales and their convergent and concurrent validity with other methods of psychopathology.

RESULTS

The five factors were replicated in the present sample with adequate indicators of fit of the data to the model. Appropriate reliability coefficients for the scales and evidence of validity were observed, indicating the clinical usefulness of the PID-5-BF in the Brazilian context.

CONCLUSION

The psychometric properties of PID-5-BF proved satisfactory in an initial sample of Brazilians.

Does Religiosity Reduce Narcissistic Personality Disorder? Examining the Case of Muslim University Students

The purpose of this study was to examine the influences of religiousness on the prevalence of Narcissistic Personality Disorder (NPD) among young adults. Prevalence of three forms of Allportian religious orientation, three forms of quest religious orientation and seven symptoms of NPD were examined through self-reported measures. 618 randomly selected Muslim students from the four public sector Pakistani universities participated in the study. Three research instruments comprising Religious Orientation Scale developed by Gorsuch and McPherson, Quest Scale developed by Batson and Schoenrade and Narcissistic Personality Inventory developed by Raskin and Terry were used to collect the data. All subscales demonstrated more than .70 Cronbach Alpha Coefficients. The findings demonstrate comparatively higher presence of intrinsic, extrinsic personal and extrinsic social religious orientations among the Pakistani Muslim young adults. The presence of NPD symptoms remains higher among the participants too. The study concludes that the religious orientations significantly explain the variances in the prevalence of NPD symptoms among the Muslim university students with the direct effects of intrinsic and extrinsic personal religious orientations and indirect effects of quest religious orientations.

[Premorbid border-line mental disorders in adolescents and young-aged people]

The aim of the study was to determine the predictive value of some types of premorbid state for the development of border-line mental diseases (neurotic disorders and personality disorders). We examined 579 school students and 523 university students. The study comprised two stages: primary examination and follow-up (2 years). Some forms of premorbid mental disorders and their impact on the development of border-line mental diseases were described. The predictive value of different premorbid disorders was estimated.

[Personality disorders and aging]

Personality disorder can be defined as an enduring pattern of inner experience and behavior that markedly deviates from the expectations of the individual's culture. With aging, personality disorders may improve or worsen. Their prevalence in the elderly is slightly lower than the prevalence in young adult. Furthermore, their comorbidity and co-occurrence are the rule with an increased risk of late decompensation. Categorical approach used in the current international classifications (ICD-10 and DSM-5) is not adapted to the specificities of the elderly with consequent overrepresentation of "unspecified personality disorder". However, a pathological personality tends to complicate all interventions for somatic or psychological care in the elderly. Thus, this review describes changes in personality disorders related to aging in order to help the clinician to better identify these disorders. Indeed, recognizing a pathological personality in the elderly improves its management both in the field of mental health and in somatic disorders in which the role of personality must be evaluated. Personality and its disorders should therefore be taken into account in all geriatric practices, in particular in the context of cognitive disorders.

[Spanish validation of the Iowa Rating Scale for Personality Change (IRSPC) for the appraisal of changes in personality in patients with acquired brain injury]

INTRODUCTION

The Iowa Rating Scale for Personality Change (IRSPC) presents some features (puts an emphasis on the motivational and emotional functions; evaluates the 'cognitive' executive functions in the daily life; estimates the premorbid personality; values the informant reliability) that make it use really interesting for both clinical and research.

AIM

The aim of this study was the Spanish validation of the IRSPC, which evaluates the 'personality changes' secondary to prefrontal cortex brain injury and particularly those located in the ventromedial area.

PATIENTS AND METHODS

After the translation and the Spanish adaptation of the scale guide, we carried out a validation study with 31 patients suffering from traumatic brain injury, getting good reliability.

RESULTS

The data obtained by measuring the internal consistency of the IRSPC and the inter rater and test-retest reliability support this statement. The instrument validity is confirmed by the results of the concurrent validity (comparing IRSPC and Neuropsychiatric Inventory) and the construct validity (scores before and after the trauma).

CONCLUSIONS

The IRSPC is a valid and reliable instrument for clinical examination in the context of a comprehensive evaluation of the symptoms resulting from neurological diseases and particularly from the ventromedial prefrontal cortex injury.

Subtypes of borderline personality disorder in a day-clinic setting-Clinical and therapeutic differences

This preliminary study aims at extending existing empirical evidence on subtypes of borderline personality disorders (BPDs) by identifying subtypes among patients with BPD, comparing their characteristics to the trait domains of the dimensional model of the International Classification of Diseases, 11th Revision (ICD-11; World Health Organization [WHO], 2022), and examining differences in sociodemographic, clinical, and therapeutic outcome variables. Data of N = 109 patients were subjected to cluster analysis based on the International Personality Disorder Examination variables for BPD and analyzed regarding differences in clinical and therapeutic variables. Clustering suggested a three-cluster solution, namely, internalizing (n = 35), externalizing (n = 28), and mixed subtype (n = 46). Subtypes showed differences in clinical variables and therapeutic outcomes with the internalizing showing more affective disorders and the mixed subtype showing the lowest therapeutic change in borderline-specific symptoms. Together, the present results correspond to the model of the ICD-11 (WHO, 2022). Clinical and treatment implications are being discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Two-year retest reliability and predictive validity of the Self- and Informant-Personality Inventory for ICD-11 in older adults

The International Classification of Diseases, 11th edition (ICD-11) adopted a fully dimensional model of personality disorder. The Personality Inventory for ICD-11 (PiCD) and Informant-Personality Inventory for ICD-11 (IPiC) were developed to assess the ICD-11 trait model, and the PiCD has since received significant validation support. However, there has only been one prior study of longitudinal predictive validity of the PiCD, two relatively short test-retest reliability studies of the PiCD, and no prior longitudinal tests of the IPiC. Longitudinal psychometric support for psychological assessment measures is essential. The present study provides a longer, larger, 2-year psychometric validation test of the PiCD and IPiC. Participants (N = 711) and their informants (N = 569) were recruited in the St. Louis Personality and Aging Network. The results demonstrated strong 2-year retest reliability for the PiCD and IPiC, as well as mean-level stability. Additionally, we explored the relationships between the PiCD and IPiC and important life outcome measures (depressive symptoms, satisfaction with life, and health status). The analysis revealed several significant associations between PiCD and IPiC scales and the outcome variables across time. Further, the PiCD Negative Affectivity and IPiC Detachment scales demonstrated incremental validity over each other and the outcome variables at Wave 1 in the prediction of depressive symptoms and satisfaction with life, respectively. The findings provide essential longitudinal test-retest reliability and predictive validity support for the PiCD and IPiC. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Self-Reported ICD-11 Personality Disorder Severity in Peruvian Adolescents: Structure, Validity, and Tentative Cutoffs

Personality disorder (PD) is particularly common in adolescents, which underscores the significance of early screening, diagnosis, and intervention. To date, the definition of PD in the new ICD-11 has not yet been investigated in adolescents. This study therefore aimed to investigate the unidimensionality and criterion validity of self-reported ICD-11 PD features in Peruvian adolescents using the Personality Disorder Severity ICD-11 (PDS-ICD-11) scale. A total of 1,073 students (63% female; age range 12-16 years) were administered the PDS-ICD-11 scale along with criterion measures of personality pathology and symptom distress. The PDS-ICD-11 score showed adequate unidimensionality and conceptually meaningful associations with external criterion variables. The findings indicate that ICD-11 PD features, as measured with the PDS-ICD-11 scale, are structurally and conceptually sound when employed with adolescents. Norm-based cutoffs derived from the present study may be used for clinical interpretation. The PDS-ICD-11 may be employed as an efficient screening tool for personality dysfunction in adolescents.

Recognizing and Responding to Patients with Personality Disorders

Caring for patients with personality disorders and traits presents unique challenges for physicians and other providers. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, recognizes 10 personality disorders, which are organized into 3 clusters (A, B, and C) based on shared diagnostic features. Personality disorders or traits create difficulty in clinical and interpersonal interactions, promoting missed diagnosis or underdiagnosis, nonadherence to medical recommendations, or other dangerous outcomes. It is important to recognize patients with potential personality disorders and understand strategies to achieve optimal patient interactions and best possible medical outcomes.

Personality Disorders and Attachment Trauma in Adolescent Patients with Psychiatric Disorders

This study examined how personality disorders (PD) differ with respect to gender, attachment status and traumatic childhood experiences in adolescent psychiatric inpatients. In particular, we investigated attachment-related traumatic material underlying adolescent PD. Our sample consisted of 175 inpatient adolescents aged 14 to 18 years (77% female, Mage = 15.13, SD = 1.35; 23% male, Mage =14.85, SD = 1.41). Thirty-nine patients (22%) fulfilled the diagnostic criteria for a PD according to the SCID-II PD: 51% avoidant, 13% obsessive-compulsive, 13% antisocial, 19% borderline, 2% paranoid and 2% histrionic. In the total sample, eighty-three (47%) of our inpatients were classified with an unresolved attachment status using the Adult Attachment Projective Picture System (AAP). We did not find any significant gender differences for patients with and without a PD. Our results revealed a higher percentage of unresolved attachment status in patients with a PD. The in-depth analysis of the total sample showed that patients with a PD demonstrated more traumatic material in their attachment interviews indicating a greater severity of attachment trauma. Furthermore, patients with a PD reported higher scores on emotional and physical neglect. Intervention strategies targeting traumatic attachment-related themes might be useful to treat adolescents with PD.

Clinical heterogeneity of feeding and eating disorders: using personality psychopathology to differentiate "simplex" and "complex" phenotypes

BACKGROUND

To investigate Feeding and Eating Disorders (FED) heterogeneity based on the co-occurrence of FED symptoms and personality psychopathology, on the hypothesis that empirical profiles would not confirm current FED categories but identify unique phenotypes carrying different levels of clinical complexity.

METHODS

Latent Profile Analysis profiled FED patients based on the assessment of both FED symptoms, through the Eating Disorders Inventory, third version (EDI-3), and personality characteristics, through the Minnesota Multiphasic Personality Inventory-2. Then, profiles were compared across socio-demographic and clinical characteristics.

RESULTS

Among 109 eligible patients, three FED profiles were identified: (i) FED simplex (low eating symptoms, absence of dysfunctional personality); (ii) FED simplex-severe (high eating symptoms only); and (iii) FED complex-severe (high eating symptoms and dysfunctional personality). Despite an uneven distribution (χ2(6) = 15.20, adjusted-p = 0.029), FED profiles did not unequivocally confirm clinical diagnoses (e.g., Anorexia Nervosa). A difference in Body Mass Index (BMI) was observed (K(2) = 15.06, adjusted-p = 0.001), but lower BMI did not identify the most severe group. Profiles differed in EDI-3 overall scores (e.g., Eating Disorder Risk Composite: K(2) = 43.08, adjusted-p < 0.001), Body Uneasiness Test Global Severity Index (GSI: K(2) = 29.33, adjusted-p < 0.001), Binge Eating Scale severity (K(2) = 25.49, adjusted-p < 0.001), number of psychiatric (K(2) = 8.79, adjusted-p = 0.021) and personality diagnoses (K(2) = 11.86, adjusted-p = 0.005), and Symptom Checklist-90-Revised GSI (F(2,103) = 37.68, adjusted-p < 0.001), with FED complex-severe patients being generally the most severely impaired in terms of FED symptoms, body concerns, depersonalization, and psychiatric comorbidities.

CONCLUSIONS

Findings support the hypothesis of distinguishing FED simplex and complex phenotypes, based on the co-occurrence of dysfunctional personality, with implications for FED severity and clinical practice.

Broader Issues in Test Translation and Validation: A Commentary Inspired by Macina et al. (2023)

Macina et al. (2023) recently reported mixed results on the German translation of the Self and Interpersonal Functioning Scale (SIFS). By focusing on suboptimal indices of structural validity, they recommended choosing other available instruments over the SIFS in future research on personality impairment. Reflecting on Macina et al.'s overall conclusions inspired us to consider broader issues in the field of personality impairment assessment. In this commentary, we discuss some issues regarding test translation and validity raised by Macina et al.'s article. We advise against assuming equivalence between original and translated versions of a test and discuss some caveats regarding comparison between different instruments based on structural validity. We also call into question whether the latter should be the litmus test for judging the quality of a measure. Finally, we discuss how the proliferation of personality impairment measures can benefit the broader field. Notably, this would allow moving toward a "what works for whom" approach that considers the match between psychometric property, desired use of the instrument, and characteristics of the target population.