Stability and change in personality and personality disorders

Influence of Betrayal Trauma on Schizotypal Personality Pathology

Schizotypal personality pathology (SZP) is a persistent and debilitating problem for a substantial number of people. Research on SZP has typically emphasized its biological and more specifically genetic origins. However, recent research has highlighted the potential influence of trauma on SZP. This research is promising, although it has thus far focused primarily on type of trauma (e.g., different types of abuse vs. neglect in childhood) rather than who perpetrated the trauma. Previous studies on both personality pathology in general and psychotic-spectrum experiences characteristic of SZP in particular have highlighted the influence of trauma perpetrated by someone with whom the trauma survivor was close (i.e., betrayal trauma), although this has not yet been examined with respect to SZP specifically. In this study we examined this, evaluating the influence of trauma with varying degrees of betrayal on SZP in a sample of adults (N = 364) using structural equation modeling. Results suggest that interpersonal trauma in general was associated with higher levels of SZP. Findings further indicate that for women but not men, trauma with a high degree of betrayal was uniquely associated with SZP. These results underscore the potential role of trauma in SZP and have implications for future research on and intervention with people with high levels of SZP.

Key insights from studies on the stability of personality disorders in different age groups

While for decades, temporal stability has been conceived as a defining feature of personality disorders (PDs), cumulative findings appear to question the stability of PDs and PD symptoms over time. However, stability itself is a complex notion and findings are highly heterogenous. Building upon a literature search from a systematic review and meta-analysis, this narrative review aims to capture key findings in order to provide critical implications, both for clinical practice and future research. Taken together, this narrative review revealed that unlike previous assumptions, stability estimates in adolescence are comparable to stability estimates in adulthood and PDs and PD symptoms are not that stable. The extent of stability itself depends yet on various conceptual, methodological, environmental, and genetic factors. While findings were thus highly heterogenous, they all seem to converge in a notable trend towards symptomatic remission, except for high-risk-samples. This challenges the current understanding of PDs in terms of disorders and symptoms and argues instead in favor of the AMPD and ICD-11 reintroducing the idea of self and interpersonal functioning as the core feature of PDs.

Stability of specific personality network features corresponding to openness trait across different adult age periods: A machine learning analysis

The functional connectivity patterns of the brain during resting state are closely related to an individual's cognition, emotion, behavior, and social interactions, making it an important research method to measure personality traits in an unbiased way, replacing traditional paper-and-pencil tests. However, due to the dynamic nature of the brain, whether the changes in functional connectivity caused by age can stably map onto personality traits has not been previously investigated. This study focuses on whether network features that are significantly related to personality traits can effectively distinguish subjects with different personality traits, and whether these network features vary across different periods of adulthood. The study included 343 healthy adult participants, divided into early adulthood and middle adulthood groups according to the age threshold of 35. Resting-state functional magnetic resonance imaging (fMRI) and the Big Five personality questionnaire were collected. we investigated the relationship between personality traits and intrinsic whole-brain functional connectome. We then used support vector machine (SVM) to evaluate the performance of personality network features in distinguishing subjects with high and low scores in the early-adulthood sample, and cross-validated in the mid-adulthood sample. Additionally, edge-based analysis (NBS) was used to explore the stability of personality networks across the two age samples. Our results show that the network features corresponding to openness personality trait are stable and can effectively differentiate subjects with different scores in both age samples. Furthermore, this study found that these network features vary to some extent across different periods of adulthood. These findings provide new evidence and insights into the application of resting-state functional connectivity patterns in measuring personality traits and help us better understand the dynamic characteristics of the human brain.

The stability of personality disorders and personality disorder criteria: A systematic review and meta-analysis

The aim of this systematic review and meta-analysis was to investigate the diagnostic, the dimensional mean-level, and rank-order stability of personality disorders (PDs) and PD criteria over time. EMBASE, PsycInfo, PubMed, and Web of Science were searched for peer-reviewed studies published in either English, German, or French between the first publication of the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980 and December 20, 2022. Inclusion criteria were a prospective longitudinal study design, assessing the stability of PDs or PD criteria over at least two measurement occasions at least one month apart, and using the same assessment at baseline and follow-up. Effect sizes included proportion of enduring cases (i.e., diagnostic stability), test-retest correlations (i.e., dimensional rank-order stability), and within-group standardized mean differences (i.e., dimensional mean-level stability), based on the first and last available measurement occasion. From an initial pool of 1473 studies, 40 were included in our analyses, covering 38,432 participants. 56.7% maintained the diagnosis of any PD, and 45.2% maintained the diagnosis of borderline PD over time. Findings on the dimensional mean-level stability indicate that most PD criteria significantly decreased from baseline to follow-up, except for antisocial, obsessive-compulsive, and schizoid PD criteria. Findings on the dimensional rank-order stability suggested moderate estimates, except for antisocial PD criteria, which were found to be high. Findings indicated that both PDs and PD criteria were only moderately stable, although between study heterogeneity was high, and stability itself depended on several methodological factors.

The prospective power of personality for childbearing: a longitudinal study based on data from Germany

The link between personality and fertility is relatively underexplored. Moreover, there are only a few studies focusing on the prospective association between personality and childbearing. However, none of these studies considered the Five-Factor Model (FFM), which is the most widely accepted measurement of personality. The present study fills this gap by examining the prospective association between the FFM and the hazard ratio of the first and the second childbirth in Germany. Analyses are based on recent data (2005–2017) from the Socio-economic Panel Study. Cox proportional hazard models are applied. Findings demonstrate that personality traits are associated with fertility. Extraversion is positively linked with the first childbirth, but is negatively associated with the second childbirth. These findings are mainly driven by males. Agreeableness is positively linked with the first childbirth across the total sample. Again, this correlation is mainly based on the findings for men, among whom a positive association between agreeableness and the second childbirth is also found. Among women, personality does not seem to be linked with the first childbirth. However, the risk of having a second child is found to be negatively associated with conscientiousness. My study adds to the current understanding of the personality–fertility association by exploring the impact of personality trait scores from the FFM on subsequent fertility behavior. However, further research is needed on the association between personality and childbearing; on the mechanisms through which personality affects fertility; and on how these links differ across cultures, among higher parities, and for births after re-partnering.

Profile changes in admissions to a psychiatric hospitalisation unit over 15 years (2006-2021), considering the impact of the pandemic caused by SARS-CoV-2

The objective of this current work was to explore whether modification of the diagnostic criteria upon the publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the impact of the COVID-19 pandemic had influenced the diagnostic and sociodemographic profiles of mental health admissions. For that purpose, we designed an observational, longitudinal, and retrospective study of the data recorded in the discharge reports of the Brief Hospitalization Unit at Castellon (Spain), between January 2006 and December 2021. The sample consisted of 7,037 participants, with a mean age of 42.1 years. The mean age of admissions, number of women, and presentation of affective disorders, addictions, and dementias all increased significantly during the DSM-5 period. Beyond diagnoses, the reduction in readmissions before the pandemic could be attributed to the use of long-acting injectable antipsychotics. In contrast, the pandemic did not change the percentage of readmissions or the volume of admissions. Also, during the pandemic period, the significant results obtained indicate that the average stay was reduced, affective disorders decreased, and addictions increased. Therefore, clinicians should consider these diagnostic and sociodemographic fluctuations when adapting clinical care, taking into account gender perspective, ageing of patients and increasing of dual and affective disorders.

Influence of Personality Traits on Post-Traumatic Cognitions of Sexual Assault

Sexual assault is a common form of trauma that is associated with psychological distress for many people who experience it. One factor that influences the degree to which sexual assault survivors exhibit distress is the cognitions they form related to the assault in its aftermath. The more times the assault happens, the more disruptive are the post-traumatic cognitions, although both the frequency of sexual assault and nature of post-traumatic cognitions differ by gender. Another factor that may influence post-traumatic cognitions is personality, which emerging research suggests has an influence on post-traumatic response in general and post-traumatic cognitions in particular. However, there is little research on the influence of personality on post-traumatic cognitions related to sexual assault specifically. In this study, we examine the association between personality traits (Agreeableness, Conscientiousness, Extraversion, Neuroticism, and Openness) and post-traumatic cognitions of sexual assault in a sample of sexual assault survivors recruited from Amazon's Mechanical Turk (N = 303) using a Bayesian approach to multiple regression. Results suggest that although the influence of traits varied depending on the post-traumatic cognition under analysis and the sex of the sexual assault survivor, Neuroticism was the primary predictor of post-traumatic cognitions over and above sexual assault frequency, although this applied more for men than for women. Study findings clarify previous research on the role of personality traits in post-traumatic response and suggest directions for future research and clinical intervention.

Mental Disorders Into Adulthood Among Adolescents Placed in Residential Care: A Prospective 10-Year Follow-up Study

Background

Child welfare and juvenile justice placed youths show high levels of psychosocial burden and high rates of mental disorders. It remains unclear how mental disorders develop into adulthood in these populations. The aim was to present the rates of mental disorders in adolescence and adulthood in child welfare and juvenile justice samples and to examine their mental health trajectories from adolescence into adulthood.

Methods

Seventy adolescents in shared residential care, placed by child welfare (n = 52, mean age = 15 years) or juvenile justice (n = 18, mean age = 17 years) authorities, were followed up into adulthood (child welfare: mean age = 25 years; juvenile justice: mean age = 27 years). Mental disorders were assessed based on the International Classification of Diseases 10th Revision diagnoses at baseline and at follow-up. Epidemiological information on mental disorders was presented for each group. Bivariate correlations and structural equation modeling for the relationship of mental disorders were performed.

Results

In the total sample, prevalence rates of 73% and 86% for any mental disorder were found in adolescence (child welfare: 70%; juvenile justice: 83%) and adulthood (child welfare: 83%; juvenile justice: 94%) respectively. General psychopathology was found to be stable from adolescence into adulthood in both samples.

Conclusions

Our findings showed high prevalence rates and a high stability of general psychopathology into adulthood among child welfare and juvenile justice adolescents in Swiss residential care. Therefore, continuity of mental health care and well-prepared transitions into adulthood for such individuals is highly warranted.

Risikofaktoren für und Stabilität einer Persönlichkeitsstörung vom Jugendalter bis ins junge Erwachsenenalter in einer Hochrisikopopulation

Zusammenfassung. Theoretischer Hintergrund: Studien zeigen, dass Persönlichkeitsstörungen (PS) weniger stabil und bei einer frühzeitigen Erkennung gut behandelbar sind. Fragestellung: Ziel dieser Studie ist, 1) die Prävalenz von PS bei ehemalig fremdplatzierten jungen Erwachsenen zu beschreiben, 2) die kategoriale Stabilität von PS vom Jugendalter bis ins junge Erwachsenenalter zu bestimmen und 3) prospektive Risikofaktoren für eine PS im Erwachsenenalter zu identifizieren. Methoden: 180 ehemalig fremdplatzierte junge Erwachsene ( M = 26.3 Jahre) aus einer schweizweiten Längsschnittstudie wurden untersucht. Ergebnisse: 35 % der Teilnehmenden wiesen eine PS auf. Die kategoriale Stabilität belief sich auf 47 %. Folgende Risikofaktoren für eine PS im Erwachsenenalter wurden identifiziert: vorangehende PS, psychopathische Persönlichkeitszüge, Substanzmissbrauch, emotionale Vernachlässigung, kumulierte Misshandlungserfahrungen und Deliktschwere. Diskussion und Schlussfolgerung: Die kategoriale Stabilität irgendeiner PS in dieser Stichprobe gilt als mittelgradig. Dies unterstreicht die Notwendigkeit, PS nicht mehr mit einem lebenslangen, unveränderbaren Schicksal gleichzusetzen. Das Erkennen möglicher Risikofaktoren ist eine wichtige Voraussetzung, um individuelle Behandlungsmöglichkeiten zu gewährleisten und einer Chronifizierung entgegenzuwirken.

Personality Psychology

Personality psychology, which seeks to study individual differences in thoughts, feelings, and behaviors that persist over time and place, has experienced a renaissance in the last few decades. It has also not been reviewed as a field in the Annual Review of Psychology since 2001. In this article, we seek to provide an update as well as a meta-organizational structure to the field. In particular, personality psychology has a prescribed set of four responsibilities that it implicitly or explicitly tackles as a field: (a) describing what personality is-i.e., what the units of analysis in the field are; (b) documenting how it develops; (c) explaining the processes of personality and why they affect functioning; and (d) providing a framework for understanding individuals and explaining their actions, feelings, and motivations. We review progress made over the last 20 years to address these four agendas and conclude by highlighting future directions and ongoing challenges to the field. Expected final online publication date for the Annual Review of Psychology, Volume 73 is January 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Stability in Personality After Physical Trauma

Personality trait stability may be influenced by several factors, there among different life events such as psychological trauma. However, little is known regarding trait stability after physical trauma. Therefore, our primary aim was to assess the extent of stability in personality in burn patients during the first year after injury. Eighty-four burn patients, admitted to a national burn center, were assessed with the Swedish universities Scales of Personality during acute care and 12 months postburn. Personality domain scores remained stable between acute care and 12 months postburn. On the trait level, the only change was seen in personality trait Stress Susceptibility, where burn patients' scores were lower compared with norm scores during acute care but then increased, and normalized, at 12 months postburn. To conclude, personality scores remained relatively stable during the first year after burn trauma.

Dimensions of pathological narcissism and intention to vote for Donald Trump

Pathological narcissism is a term often applied to former President Donald Trump, but it has been less examined as a potential predictor of voting for him. Trump projects a grandiose and omnipotent self-image during press conferences and rallies, and his followers at these events often respond with both effusive admiration and an inflated sense of their own self-regard, all of which are aspects of narcissism. However, while Trump's personal narcissism has been well documented, there is little research on the narcissism of his supporters. In this study we conducted an exploratory analysis examining the hierarchical structure of pathological narcissism and which aspects of narcissism within that structure were associated with intended voting for Trump in the 2020 U.S. presidential election in a sample of U.S. residents collected online (N = 495) using Amazon's Mechanical Turk. Results indicated that an eight-echelon hierarchy best fit the data. Within this hierarchy, antagonistic and indifferent aspects of narcissism within the fifth echelon best predicted intended voting for Trump over and above relevant demographic variables. These results have implications for the study of narcissism and, especially given the results of the 2020 election, the degree to which one can make use of narcissistic aspects of personality in political contests.

The dynamics, processes, mechanisms, and functioning of personality: An overview of the field

Personality psychology has long focused on structural trait models, but it can also offer a rich understanding of the dynamics, processes, mechanisms, and functioning of individual differences or entire persons. The field of personality dynamics, which works towards such an understanding, has experienced a renaissance in the last two decades. This review article seeks to act as a primer of that field. It covers its historical roots, summarizes current research strands - along with their theoretical backbones and methodologies - in an accessible way, and sketches some considerations for the future. In doing so, we introduce relevant concepts, give an overview of different topics and phenomena subsumed under the broad umbrella term 'dynamics', and highlight the interdisciplinarity as well as applied relevance of the field. We hope this article can serve as a useful overview for scholars within and outside of personality psychology who are interested in the dynamic nature of human behaviour and experience.

Is neuroticism relevant for old cancer survivors? A controlled, population-based study (the Norwegian HUNT-3 survey)

Purpose

Personality traits, particularly neuroticism, have an impact on people’s health and lifestyle. Due to lack of previous studies, we examined old cancer survivors (OCSs) versus cancer-free age-matched controls aged ≥ 70 years, regarding prevalence of high neuroticism, health problems in those with high and low neuroticism, and sociodemographic and clinical variables that were significantly associated with high neuroticism.

Methods

We merged data from a Norwegian population–based health study (the HUNT-3) and from the Cancer Registry of Norway identifying OCSs. Three cancer-free controls were drawn at random for each OCS. Neuroticism was self-rated on a brief version of Eysenck Personality Questionnaire. Between-group statistical comparisons were made between OCS and controls, and among their subgroups with high and low neuroticism. Logistic regression analyses were used to investigate independent variables significantly associated with high neuroticism.

Results

Twenty-nine percent of OCSs reported high neuroticism while controls reported 30%. OCSs showed significantly lower rate of good life satisfaction than controls. All other between-group comparisons were nonsignificant. Being OCSs was not significantly related to high neuroticism in the regression analyses. Sociodemographic, general health, and lifestyle issues, lack of energy, and low life satisfaction remained significantly associated with high neuroticism in the multivariable analysis.

Conclusions

The prevalence of high neuroticism was similar in OCSs and controls. High neuroticism was associated with negative health and lifestyle issues in both groups.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00520-020-05870-7.

Personalized models of personality disorders: using a temporal network method to understand symptomatology and daily functioning in a clinical sample

BACKGROUND

An ongoing challenge in understanding and treating personality disorders (PDs) is a significant heterogeneity in disorder expression, stemming from variability in underlying dynamic processes. These processes are commonly discussed in clinical settings, but are rarely empirically studied due to their personalized, temporal nature. The goal of the current study was to combine intensive longitudinal data collection with person-specific temporal network models to produce individualized symptom-level structures of personality pathology. These structures were then linked to traditional PD diagnoses and stress (to index daily functioning).

METHODS

Using about 100 daily assessments of internalizing and externalizing domains underlying PDs (i.e. negative affect, detachment, impulsivity, hostility), a temporal network mapping approach (i.e. group iterative multiple model estimation) was used to create person-specific networks of the temporal relations among domains for 91 individuals (62.6% female) with a PD. Network characteristics were then associated with traditional PD symptomatology (controlling for mean domain levels) and with daily variation in clinically-relevant phenomena (i.e. stress).

RESULTS

Features of the person-specific networks predicted paranoid, borderline, narcissistic, and obsessive-PD symptom counts above average levels of the domains, in ways that align with clinical conceptualizations. They also predicted between-person variation in stress across days.

CONCLUSIONS

Relations among behavioral domains thought to underlie heterogeneity in PDs were indeed associated with traditional diagnostic constructs and with daily functioning (i.e. stress) in person-specific networks. Findings highlight the importance of leveraging data and models that capture person-specific, dynamic processes, and suggest that person-specific networks may have implications for precision medicine.

Robustness of the Maladaptive Personality Plaster: An Investigation of Stability of the PSY-5-r in Adults over 20 Years

The long-term stability of maladaptive personality traits in the general population has been under-investigated. The current study examined the longitudinal 20-year mean-level stability and rank-order consistency of five maladaptive personality traits-as measured with the Personality Psychopathology-5-r scales. Correlations and regression analysis were conducted to test both types of stability comparing raw scores of scale administrations in a general population sample in both 1992 and 2012 (N = 65). Repeated measures analysis of variance demonstrated significant mean-level stability of the PSY-5-r traits over 20 years. The PSY-5-r scales demonstrated significant rank-order consistency as evidenced by correlational analyses and reliability coefficients. The scales Aggressiveness-r (r = .73), Neuroticism/Negative Emotionality-r (r = .65), Introversion/Low Positive Emotionality-r (r = .63), and Disconstraint-r (r = .56), evidenced strong rank-order stability, whereas Psychoticism-r (r = .3) showed moderate rank-order consistency. The results of the present study indicate that maladaptive personality traits as measured with the PSY-5-r scales are relatively stable over 20 years in an adult community population.