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Borges SQ, Camargos EF. Prevalence of and Factors Associated with Hypersexuality in Patients with Dementia: A Retrospective Cross-Sectional Study. J Geriatr Psychiatry Neurol 2024; 37:263-271. [PMID: 38156788 DOI: 10.1177/08919887231225481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
INTRODUCTION The psychological and behavioral symptoms of dementia are frequently observed in clinical practice, and those related to sexuality are particularly challenging. However, few studies have evaluated the prevalence or factors associated with hypersexuality in patients with dementia. OBJECTIVES This study aims to determine the prevalence of hypersexuality in patients with dementia, describe associated factors, and qualitatively report the most common presentations and treatments. METHODS This retrospective cross-sectional study collected data from semi-structured charts of dementia patients who were followed up at a secondary care reference center between 2015 and 2019. Results: Of 552 total patients, 52 (9.3%) were hypersexual, which was associated with male sex (P < .000; OR 2.95, 95% CI 1.73-5.01), frontotemporal dementia (P < .007), alcohol use (P < .015; OR 2.35, 95% CI 1.16-4.73) and tobacco use (P < .000; OR 2.88, 95% CI 1.61-5.13). CONCLUSIONS Although our findings were similar to the literature, their significant variability reflects the limited and low quality of the available evidence and a lack of standardization regarding terminology, definitions, and diagnostic criteria for hypersexuality.
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Affiliation(s)
- Saulo Queiroz Borges
- Medical Sciences Graduate Program, University of Brasília, Brasília, Brazil
- Center for Older Adult Medicine, Brasilia University Hospital, University of Brasília, Brasília, Brazil
| | - Einstein Francisco Camargos
- Medical Sciences Graduate Program, University of Brasília, Brasília, Brazil
- Center for Older Adult Medicine, Brasilia University Hospital, University of Brasília, Brasília, Brazil
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2
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Fodstad EC, Erga AH, Pallesen S, Ushakova A, Erevik EK. Personality traits as predictors of recovery among patients with substance use disorder. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 162:209360. [PMID: 38631658 DOI: 10.1016/j.josat.2024.209360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 02/22/2024] [Accepted: 04/07/2024] [Indexed: 04/19/2024]
Abstract
INTRODUCTION Substance use disorder (SUD) is often considered a chronic illness in which prolonged recovery, in terms of abstinence, is uncommon. Personality has been found to predict recovery, but not much is known about its long-term predictive ability as the majority of previous studies have had short follow-up periods (≥ one year). The current longitudinal cohort study therefore investigated whether personality traits predict short- (STR) as well as long-term recovery (LTR) in SUD patients. METHODS Treatment-seeking patients with SUD (n = 123) completed the NEO Personality Inventory - Revised. STR and LTR categories were defined as scoring <8 on the Alcohol Use Disorders Identification Test - C and <2 on the Drug Use Disorder Identification Test - C at the one-year and 6-8-year follow-up, respectively. Whether personality traits predicted outcome was investigated by two-tailed independent samples t-tests, α < 0.05. Additional analysis was conducted with latent growth curve model. RESULTS Neuroticism (inversely, p = .004, d = 0.55) and Extraversion (p = .04, d = 0.38) predicted STR (n = 114). Although not significant the effect size for Conscientiousness was above the cut-off for a practical significant effect (d = 0.31). No traits predicted LTR category. Still, the effect sizes for LTR regarding Neuroticism (d = 0.36), Extraversion (d = 0.21) and Conscientiousness (d = 0.27) indicated that these traits have relevance for LTR. The latent growth curve model indicated that these traits predicted the short-term use of drugs and long-term use of alcohol in this cohort dominated by patients suffering from severe poly-SUD. CONCLUSION Personality traits predict recovery. The effect sizes indicate that more studies with larger samples on personality traits and LTR are required to understand their possible influences on the recovery process.
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Affiliation(s)
- Elise Constance Fodstad
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway; Centre for Alcohol and Drug Research (KORFOR), Stavanger University Hospital, Stavanger, Norway.
| | - Aleksander Hagen Erga
- Centre for Alcohol and Drug Research (KORFOR), Stavanger University Hospital, Stavanger, Norway; Department of Social Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Anastasia Ushakova
- Department of Research, Section of Biostatistics, Stavanger University Hospital, Stavanger, Norway
| | - Eilin Kristine Erevik
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
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Neo PSH, McNaughton N, Sellbom M. Midfrontal conflict theta and parietal P300 are linked to a latent factor of DSM externalising disorders. PERSONALITY NEUROSCIENCE 2024; 7:e7. [PMID: 38689856 PMCID: PMC11058520 DOI: 10.1017/pen.2023.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 09/13/2023] [Accepted: 09/25/2023] [Indexed: 05/02/2024]
Abstract
Psychiatric illnesses form spectra rather than categories, with symptoms varying continuously across individuals, i.e., there is no clear break between health and disorder. Dimensional measures of behaviour and brain activity are promising targets for studying biological mechanisms that are common across disorders. Here, we assessed the extent to which neural measures of the sensitivity of the three biological systems in the reinforcement sensitivity theory (RST) could account for individual differences in a latent general factor estimated from symptom counts across externalising disorders (EXTs). RST explanatory power was pitted against reduced P300, a reliable indicator of externalising per previous research. We assessed 206 participants for DSM-5 EXTs (antisocial personality disorder, conduct disorder, attention-deficit/hyperactivity disorder, intermittent explosive disorder symptoms, alcohol use disorder, and cannabis use disorder). Of the final sample, 49% met diagnostic criteria for at least one of the EXTs. Electroencephalographic measures of the sensitivities of the behavioural activation system (BAS), the fight/flight/freeze system, and the behavioural inhibition system (BIS), as well as P300 were extracted from the gold bar-lemon and stop-signal tasks. As predicted, we found that low neural BIS sensitivity and low P300 were uniquely and negatively associated with our latent factor of externalising. Contrary to prediction, neural BAS/"dopamine" sensitivity was not associated with externalising. Our results provide empirical support for low BIS sensitivity and P300 as neural mechanisms common to disorders within the externalising spectrum; but, given the low N involved, future studies should seek to assess the replicability of our findings and, in particular, the differential involvement of the three RST systems.
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Affiliation(s)
- Phoebe S.-H. Neo
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Neil McNaughton
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Martin Sellbom
- Department of Psychology, University of Otago, Dunedin, New Zealand
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Brieman CL, McGarrigle WJ, Cope LM, Kiehl KA, Kosson DS. Clarifying Relations Between Core Features of Psychopathy and Substance (Mis)use: A Replication and Extension in Two Large Independent Samples. J Pers Disord 2024; 38:138-156. [PMID: 38592911 DOI: 10.1521/pedi.2024.38.2.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
Two studies examined the consistency of associations between specific components of psychopathy and two indices of drug use: (a) abstinence and (b) severity (i.e., counts) of lifetime substance use disorder (SUD) symptoms. Participants were 418 male county jail inmates in Illinois (Study One) and 354 male state prison inmates in New Mexico (Study Two). Across samples, lifestyle and antisocial trait ratings were associated with a reduced likelihood of abstinence from most substances. Lifestyle traits were also uniquely associated with severity of substance dependence ratings. Consistent with prior research, interpersonal traits were uniquely related to cocaine indices in both samples. Furthermore, analyses revealed negative associations between the affective features of psychopathy and alcohol dependence in one sample (Study Two), and illicit substance use across samples. These findings demonstrate the robustness of the associations between the interpersonal and affective features of psychopathy and specific aspects of substance (mis)use.
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Affiliation(s)
| | | | - Lora M Cope
- Department of Psychiatry and Addiction Center, University of Michigan, Ann Arbor, Michigan
| | - Kent A Kiehl
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico
| | - David S Kosson
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois
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Vancappel A, Gillet N, Fouquereau E, Chevalier S, Aubouin-Bonnaventure J, Coillot H, Mangolini A, Jansen E, Dicosimo C, El-Hage W. Development of a revised version of the transdiagnostic skills scale (T2S-R). Front Psychol 2024; 15:1290692. [PMID: 38410398 PMCID: PMC10895014 DOI: 10.3389/fpsyg.2024.1290692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 01/30/2024] [Indexed: 02/28/2024] Open
Abstract
Introduction The transdiagnostic approach has been shown to offer promising prospects in psychopathology, based on the observation that common factors may be involved in different psychiatric disorders. The transdiagnostic skills scale (T2S) was developed recently to assess the skills that are disrupted in these disorders. However, studies have shown that the T2S has lower predictive power for externalizing than internalizing disorders. This may be due to the fact that the skills assessed do not include the control of urges and cravings. The aims of the current study are thus to develop a revised version of the T2S (T2S-R) integrating this dimension, and to assess its factor structure and invariance across employment status (workers vs. students) and the level of psychopathology. Method We recruited 1,298 French participants online through social media. They completed the revised version of the T2S and the symptomatic transdiagnostic test (S2T), which evaluates 11 clusters of psychiatric symptoms. We assessed the factor structure, internal consistency, invariance, and predictive validity of the revised T2S. Results We found a good fit for a bifactor exploratory structural equation modeling (B-ESEM) approach including a global skills factor and seven specific factors. The results also indicate that the new dimension (i.e., control of urges and cravings) has good predictive value, especially for externalizing problems. We also found total invariance of the scale across employment status and partial invariance across the level of psychopathology. Conclusion The revised version of the T2S-R has good psychometric properties. It predicts better externalizing problems than the original version. However, the scale remains more correlated with internalizing than externalizing problems. We discuss the implications of the results on the transdiagnostic conceptualization and the interest of using a mixed approach combining transdiagnostic and diagnostic analyses.
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Affiliation(s)
- Alexis Vancappel
- Département de Psychologie, QualiPsy, Qualité de Vie et santé Psychologique, Université de Tours, Tours, France
- CHRU de Tours, Pôle de Psychiatrie-Addictologie, Tours, France
| | - Nicolas Gillet
- Département de Psychologie, QualiPsy, Qualité de Vie et santé Psychologique, Université de Tours, Tours, France
- Institut Universitaire de France, Paris, France
| | - Evelyne Fouquereau
- Département de Psychologie, QualiPsy, Qualité de Vie et santé Psychologique, Université de Tours, Tours, France
| | - Séverine Chevalier
- Département de Psychologie, QualiPsy, Qualité de Vie et santé Psychologique, Université de Tours, Tours, France
| | - Julia Aubouin-Bonnaventure
- Département de Psychologie, QualiPsy, Qualité de Vie et santé Psychologique, Université de Tours, Tours, France
| | - Hélène Coillot
- Département de Psychologie, QualiPsy, Qualité de Vie et santé Psychologique, Université de Tours, Tours, France
| | - Anna Mangolini
- CHRU de Tours, Pôle de Psychiatrie-Addictologie, Tours, France
| | - Eline Jansen
- CHRU de Tours, Pôle de Psychiatrie-Addictologie, Tours, France
| | - Cinzia Dicosimo
- CHRU de Tours, Pôle de Psychiatrie-Addictologie, Tours, France
| | - Wissam El-Hage
- CHRU de Tours, Pôle de Psychiatrie-Addictologie, Tours, France
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
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Komasi S, Rezaei F, Hemmati A, Nazari A, Nasiri Y, Faridmarandi B, Zakiei A, Saeidi M, Hopwood CJ. Clinical cut scores for the Persian version of the personality inventory for DSM-5. J Clin Psychol 2024; 80:370-390. [PMID: 37864832 DOI: 10.1002/jclp.23614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/27/2023] [Accepted: 10/11/2023] [Indexed: 10/23/2023]
Abstract
BACKGROUND The cut points of psychological tools to diagnose clinical conditions are not universal and depend on the region and prevalence of the disorder. Thus, we aimed to identify the cutoff points of the Persian original version of the personality inventory for DSM-5 (PID-5; 220 items) that would optimally distinguish nonclinical from clinical groups. METHODS Both nonclinical (N = 634, 73% female, 34.0 ± 10.8 years) and clinical (N = 454, 29% female, 29.5 ± 7.4 years) samples from the West of Iran participated in the study. Data were analyzed using receiver operating characteristic (ROC) and Youden's index was used to determine the cutoff scores across the PID-5 domains and facets. The means and standard deviations of both the clinical male and female were compared with the nonclinical group using Cohen's d and independent t-tests. RESULTS All the PID-5 algorithms and facets significantly distinguished clinical from nonclinical samples with some unique findings for male and female samples. The mean score of all the PID-5 algorithms and facets in the clinical male and female samples were respectively 1.0-2.0 SD and 0.5-1.0 SD above the mean for the nonclinical counterparts. A score higher than 1.5 on ranging from 0 to 3 in each domain or facet indicated clinical status. CONCLUSION Raw cutting scores throughout the PID-5 algorithms can be well used to diagnose any pathology of personality and the severity of the disorder in clinical patients. The cut scores provide a useful tool for the clinical use of the original version of PID-5 in Iran.
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Affiliation(s)
- Saeid Komasi
- Department of Neuroscience and Psychopathology Research, Mind GPS Institute, Kermanshah, Iran
| | - Farzin Rezaei
- Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Azad Hemmati
- Department of Psychology, University of Kurdistan, Sanandaj, Iran
| | - Amin Nazari
- Department of Psychology, University of Kurdistan, Sanandaj, Iran
| | - Yeganeh Nasiri
- Department of Neuroscience and Psychopathology Research, Mind GPS Institute, Kermanshah, Iran
| | - Behrooz Faridmarandi
- Department of Neuroscience and Psychopathology Research, Mind GPS Institute, Kermanshah, Iran
| | - Ali Zakiei
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mozhgan Saeidi
- Department of Neuroscience and Psychopathology Research, Mind GPS Institute, Kermanshah, Iran
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7
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Ruchensky JR, Kelley SE, Massey C, Richardson LA, Blais MA, Stein MB. Using the Personality Assessment Inventory to Assess the Alternative Model for Personality Disorders: Criterion Validity in a Clinical Sample. J Pers Assess 2024; 106:72-82. [PMID: 37220386 DOI: 10.1080/00223891.2023.2203240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 02/06/2023] [Accepted: 03/31/2023] [Indexed: 05/25/2023]
Abstract
The Personality Assessment Inventory (PAI) is a broadband measure of psychopathology that is widely used in applied settings. Researchers developed regression-based estimates that use the PAI to measure constructs of the Alternative Model for Personality Disorders (AMPD) - a hybrid dimensional and categorical approach to conceptualizing personality disorders. Although prior work has linked these estimates to formal measures of the AMPD, there is little work investigating the clinical correlates of this scoring approach of the PAI. The current study examines associations between these PAI-based AMPD estimates and life data in a large, archival dataset of psychiatric outpatients and inpatients. We found general support for the criterion validity of AMPD estimate scores, such that a theoretically consistent pattern of associations emerged with indicators such as prior academic achievement, antisocial behavior, psychiatric history, and substance abuse. These results provide preliminary support to this scoring approach for use in clinical samples.
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Affiliation(s)
- Jared R Ruchensky
- Department of Psychology & Philosophy, Sam Houston State University, Huntsville, Texas
| | - Shannon E Kelley
- Clinical Psychology Department, William James College, Newton, Massachusetts
| | - Christina Massey
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Laura A Richardson
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Mark A Blais
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Michelle B Stein
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
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Oot EN, Sawyer KS, Oscar-Berman M, Luhar RB, Jensen JE, Silveri MM. Anterior cingulate metabolite levels, memory, and inhibitory control in abstinent men and women with alcohol use disorder. Alcohol Alcohol 2023; 58:578-588. [PMID: 37738108 PMCID: PMC10642606 DOI: 10.1093/alcalc/agad059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 08/09/2023] [Accepted: 08/11/2023] [Indexed: 09/24/2023] Open
Abstract
Alcohol use disorder (AUD) has been shown to have harmful cognitive and physiological effects, including altered brain chemistry. Further, although men and women may differ in vulnerability to the neurobiological effects of AUD, the results of existing studies have been conflicting. We examined brain metabolite levels and cognitive functions in a cross-section of men with AUD (AUDm) and women with AUD (AUDw) to determine the degree of abnormalities after extended periods of abstinence (mean, 6 years) and to evaluate gender differences in neuropsychological and metabolite measures. Participants were 40 abstinent individuals with AUD (22 AUDw, 18 AUDm) and 50 age-equivalent non-AUD comparison participants (26 NCw, 24 NCm). Proton magnetic resonance spectroscopy (MRS) was employed at 3 Tesla to acquire metabolite spectra from the dorsal anterior cingulate cortex (dACC). Brain metabolites N-acetyl aspartate (NAA), choline (Cho), myo-Inositol (mI), and glutamate & glutamine (Glx) were examined relative to measures of memory and inhibitory control. Metabolite levels did not differ significantly between AUD and NC groups. Memory and inhibitory-control impairments were observed in the AUD group. There also were significant group-specific associations between metabolite ratios and measures of inhibitory control. There were no group-by-gender interactions for the four metabolite ratios. These findings demonstrate that brain metabolite levels in men and women with AUD, following long-term abstinence, do not differ from individuals without AUD. The data also provide preliminary evidence of sustained associations between metabolite levels and measures of inhibitory control, a functional domain important for curtailing harmful drinking.
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Affiliation(s)
- Emily N Oot
- McLean Hospital, 115 Mill St., Belmont, MA 02478, United States
- Boston University Chobanian & Avedisian School of Medicine, 72 E. Concord St., Boston, MA 02118, United States
| | - Kayle S Sawyer
- Boston University Chobanian & Avedisian School of Medicine, 72 E. Concord St., Boston, MA 02118, United States
- VA Boston Healthcare System, 150 So. Huntington Ave., 151B, Boston, MA 02130, United States
- Massachusetts General Hospital, Boston, MA, United States
- Sawyer Scientific, LLC, Boston, MA, United States
| | - Marlene Oscar-Berman
- Boston University Chobanian & Avedisian School of Medicine, 72 E. Concord St., Boston, MA 02118, United States
- VA Boston Healthcare System, 150 So. Huntington Ave., 151B, Boston, MA 02130, United States
- Massachusetts General Hospital, Boston, MA, United States
| | - Riya B Luhar
- Boston University Chobanian & Avedisian School of Medicine, 72 E. Concord St., Boston, MA 02118, United States
- VA Boston Healthcare System, 150 So. Huntington Ave., 151B, Boston, MA 02130, United States
| | - J E Jensen
- McLean Hospital, 115 Mill St., Belmont, MA 02478, United States
| | - Marisa M Silveri
- McLean Hospital, 115 Mill St., Belmont, MA 02478, United States
- Harvard Medical School, Boston, MA, United States
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Letkiewicz AM, Spring JD, Li LY, Weinberg A, Shankman SA. Childhood trauma predicts blunted error monitoring in adulthood: An event-related potential study. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2023; 23:427-439. [PMID: 36653556 PMCID: PMC10065923 DOI: 10.3758/s13415-023-01061-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/02/2023] [Indexed: 01/20/2023]
Abstract
Abuse and neglect have detrimental consequences on emotional and cognitive functioning during childhood and adolescence, including error monitoring, which is a critical aspect of cognition that has been implicated in certain internalizing and externalizing psychopathologies. It is unclear, however, whether (a) childhood trauma has effects on error monitoring and, furthermore whether, (b) error monitoring mediates the relation between childhood trauma and psychopathology in adulthood. To this end, in a large sample of young adults (ages 18-30) who were oversampled for psychopathology (N = 390), the present study assessed relations between childhood trauma and error-related negativity (ERN), which is a widely used neurophysiological indicator of error monitoring. Cumulative childhood trauma predicted ERN blunting, as did two specific types of traumas: sexual abuse and emotional neglect. Furthermore, the ERN partially mediated the effects of cumulative childhood trauma and emotional neglect on externalizing-related symptoms. Future studies should further examine the relations between childhood trauma and error monitoring in adulthood, which can help to inform intervention approaches.
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Affiliation(s)
- Allison M Letkiewicz
- Department of Psychiatry and Behavioral Sciences, Northwestern University, 680 N. Lakeshore Drive, Suite 1520, Chicago, IL, 60611, USA.
| | - Justin D Spring
- Department of Psychiatry and Behavioral Sciences, Northwestern University, 680 N. Lakeshore Drive, Suite 1520, Chicago, IL, 60611, USA
| | - Lilian Y Li
- Department of Psychiatry and Behavioral Sciences, Northwestern University, 680 N. Lakeshore Drive, Suite 1520, Chicago, IL, 60611, USA
| | - Anna Weinberg
- Department of Psychology, McGill University, Montreal, QC, Canada
| | - Stewart A Shankman
- Department of Psychiatry and Behavioral Sciences, Northwestern University, 680 N. Lakeshore Drive, Suite 1520, Chicago, IL, 60611, USA
- Department of Psychology, Northwestern University, Chicago, IL, USA
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10
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Berlin J, Wallinius M, Nilsson T, Karlén MH, Delfin C. Exploring the psychometric properties of the externalizing spectrum inventory-brief form in a Swedish forensic psychiatric inpatient sample. BMC Psychiatry 2023; 23:184. [PMID: 36944949 PMCID: PMC10031895 DOI: 10.1186/s12888-023-04609-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 02/13/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND The Externalizing Spectrum Inventory-Brief Form (ESI-BF) [1] is a 160-item self-report instrument designed for the assessment of externalizing psychopathology, yet few studies to date have evaluated its psychometric properties, structural fit, and criterion validity in forensic psychiatric settings. METHODS Here, we investigated these aspects in a sample of forensic psychiatric inpatients (n = 77) from a maximum-security forensic psychiatric hospital in Sweden. We firstly investigated the reliability. Secondly, using confirmatory factor analysis, the structure of the ESI-BF. And thirdly, using a Bayesian approach, assessed how the three ESI-BF subfactors relate to criterion measures of antisocial behaviors, substance use, and lifetime externalizing spectrum diagnoses. RESULTS The ESI-BF demonstrated good to adequate reliability and internal consistency, with all but four facet scales exhibiting α and ω values ≥ 0.80. Average inter-item correlations for the facet scales ranged from 0.31 to 0.74. However, all structural models exhibited poor to mediocre fit, with model fit values for the CFI being 0.66, 0.79 and 0.87 and RMSEA values of 0.14, 0.12 and 0.09. for the unidimensional correlated factors and bifactor model, respectively. Regarding criterion validity, all subscales of the item-based ESI-BF three-factor model exhibited robust correlations with the Life History of Aggression total, aggression and antisocial/consequences subscales, with correlations ranging from 0.29 to 0.55. All ESI-BF subfactors demonstrated robust associations, yet with different externalizing outcomes, lending tentative support to its criterion validity. CONCLUSION Despite remaining ambiguities regarding its structural fit, the ESI-BF may be promising for assessing externalizing psychopathology in forensic psychiatric populations. However, further investigation of the ESI-BF is needed before any firm conclusions can be drawn about its appropriateness in forensic psychiatric settings.
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Affiliation(s)
- Johan Berlin
- Lund Clinical Research on Externalizing and Developmental Psychopathology (LU-CRED), Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Lund University, Lund, Sweden.
- Centre of Ethics, Law and Mental Health (CELAM), Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
- Research Department, Regional Forensic Psychiatric Clinic, Växjö, Sweden.
- Rättspsykiatriska regionkliniken, Box 1223, 351 12, Växjö, Sweden.
| | - Märta Wallinius
- Lund Clinical Research on Externalizing and Developmental Psychopathology (LU-CRED), Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Lund University, Lund, Sweden
- Centre of Ethics, Law and Mental Health (CELAM), Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Research Department, Regional Forensic Psychiatric Clinic, Växjö, Sweden
| | - Thomas Nilsson
- Centre of Ethics, Law and Mental Health (CELAM), Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Department for Forensic Psychiatry, The National Board of Forensic Medicine, Gothenburg, Sweden
- Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
| | - Malin Hildebrand Karlén
- Centre of Ethics, Law and Mental Health (CELAM), Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Department for Forensic Psychiatry, The National Board of Forensic Medicine, Gothenburg, Sweden
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
- Institute for Globally Distributed Open Research and Education (IGDORE), Gothenburg, Sweden
| | - Carl Delfin
- Lund Clinical Research on Externalizing and Developmental Psychopathology (LU-CRED), Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Lund University, Lund, Sweden
- Centre of Ethics, Law and Mental Health (CELAM), Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Research Department, Regional Forensic Psychiatric Clinic, Växjö, Sweden
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Gutiérrez F, Peri JM, Aluja A, Baillés E, Sureda B, Gutiérrez-Zotes A, Vall G, Calvo N, Ferrer M, Cavero M, Mallorquí A, Villamón SE, de Alba AM, Rodríguez MÁR. Differentiating Abnormal, Normal, and Ideal Personality Profiles in Multidimensional Spaces. JOURNAL OF INDIVIDUAL DIFFERENCES 2023. [DOI: 10.1027/1614-0001/a000395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
Abstract: Current dimensional taxonomies of personality disorder (PD) establish that intense traits do not suffice to diagnose a disorder, and additional constructs reflecting dysfunction are required. However, traits appear able to predict maladaptation by themselves, which might avoid duplications and simplify diagnosis. On the other hand, if trait-based diagnoses are feasible, it is the whole personality profile that should be considered, rather than individual traits. This takes us into multidimensional spaces, which have their own particular – but poorly understood – logic. The present study examines how profile-level differences between normal and disordered subjects can be used for diagnosis. The Dimensional Assessment of Personality Pathology – Basic Questionnaire (DAPP-BQ) and the Personality Inventory for DSM-5 (PID-5) were administered to a community and a clinical sample each (total n = 1,925 and 3,543 respectively). Intense traits proved to be common in the general population, so empirically-based thresholds are indispensable not to take as abnormal what is at most unideal. Profile-level parameters such as Euclidean and Mahalanobis distances outperformed individual traits in predicting mental problems and equaled the performance of published measures of dysfunction or severity. Personality profiles can play a more central role in identifying disorders than is currently acknowledged, provided that adequate metrics are used.
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Affiliation(s)
- Fernando Gutiérrez
- Institute of Neuroscience, Hospital Clínic, Barcelona, Spain
- IDIBAPS, Barcelona, Spain
| | | | - Anton Aluja
- Department of Psychology, University of Lleida, Spain
- Biomedical Research Institute of Lleida, Spain
| | - Eva Baillés
- Department of Experimental and Health Sciences, Pompeu Fabra University, Spain
| | - Bárbara Sureda
- Institute of Neuroscience, Hospital Clínic, Barcelona, Spain
| | | | - Gemma Vall
- Biomedical Research Institute of Lleida, Spain
- Department of Psychiatry, Mental Health and Addiction, GSS – Hospital Santa María, Lleida, Spain
| | - Natalia Calvo
- CIBERSAM, Madrid, Spain
- Department of Psychiatry, Vall d’Hebron University Hospital, Barcelona, Spain
| | - Marc Ferrer
- CIBERSAM, Madrid, Spain
- Department of Psychiatry, Vall d’Hebron University Hospital, Barcelona, Spain
| | - Myriam Cavero
- Institute of Neuroscience, Hospital Clínic, Barcelona, Spain
| | - Aida Mallorquí
- Institute of Neuroscience, Hospital Clínic, Barcelona, Spain
| | - Silvia Edo Villamón
- Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Spain
- Provincial Hospital Consortium, Castellón, Spain
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12
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Amini M, Abdolahpur MA, Bach B, Darharaj M, Hamraz I, Javaheri A, Lotfi M. The Relationship between Traumatic Life Events and Polysubstance Use: Examining the Mediating Role of DSM-5 Level of Personality Functioning and Maladaptive Personality Traits. THE JOURNAL OF PSYCHOLOGY 2023; 157:227-241. [PMID: 36919464 DOI: 10.1080/00223980.2023.2182265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
The experience of traumatic events in childhood is an important risk factor for the initiation and continuation of polysubstance use. This study aimed to examine the mediating role of DSM-5 level of personality functioning and maladaptive personality traits in the relationship between traumatic life events and polysubstance use. We used a mixed sample (N = 290; Mage = 40; SDage = 12.26; 75.2% males) of patients with substance use disorder (SUD; including 90 mono-drug users and 113 polysubstance users) and non-users (including 87 university students) recruited using convenience sampling method from harm reduction-oriented drug treatment centers and universities respectively in Tehran, Iran. Participants completed the Level of Personality Functioning Scale-Brief Form, the Personality Inventory for DSM 5-Brief Form, and the Life Events Checklist-Revised. The results of structural equation modeling showed that DSM-5 level of personality functioning and maladaptive personality traits partially mediated the relationship between traumatic life events and polysubstance use. Experiencing traumatic events may contribute to the risk of polysubstance use through the effect of global personality dysfunction and specific personality traits. This proposed mediational model must be replicated using a longitudinal design across different populations.
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Affiliation(s)
| | | | - Bo Bach
- Center for Personality Disorder Research, Psychiatric Research Unit
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13
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Stephens R, Dowber H, Barrie A, Almeida S, Atkins K. Effect of swearing on strength: Disinhibition as a potential mediator. Q J Exp Psychol (Hove) 2023; 76:305-318. [PMID: 35135411 DOI: 10.1177/17470218221082657] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Swearing fulfils positive functions, including benefitting pain relief and physical strength. Here we present two experiments assessing a possible psychological mechanism, increased state disinhibition, for the effect of swearing on physical strength. Two repeated measures experiments were carried out with sample sizes N = 56 and N = 118. Both included the measures of physical performance assessing, respectively, grip and arm strength, and both included the Balloon Analogue Risk Task (BART) to measure risky behaviour. Experiment 2, which was pre-registered, additionally assessed flow, emotion including humour, distraction including novelty, self-confidence, and anxiety. Experiments 1 and 2 found that repeating a swear word benefitted physical strength and increased risky behaviour, but risky behaviour did not mediate the strength effect. Experiment 2 found that repeating a swear word increased flow, positive emotion, humour, distraction, and self-confidence. Humour mediated the effect of swearing on physical strength. Consistent effects of swearing on physical strength indicate that this is a reliable effect. Swearing influenced several constructs related to state disinhibition, including increased self-confidence. Humour appeared to mediate the effect of swearing on physical strength, consistent with a hot cognitions explanation of swearing-induced state disinhibition. However, as this mediation effect was part of an exploratory analysis, further pre-registered experimental research, including validated measures of humour, is required.
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Affiliation(s)
| | - Harry Dowber
- School of Psychology, Keele University, Staffs, UK
| | - Amber Barrie
- School of Psychology, Keele University, Staffs, UK
| | | | - Katie Atkins
- School of Psychology, Keele University, Staffs, UK
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14
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Gori A, Topino E, Cacioppo M, Craparo G, Schimmenti A, Caretti V. An addictive disorders severity model: a chained mediation analysis using structural equation modeling. J Addict Dis 2023; 41:98-109. [PMID: 35616192 DOI: 10.1080/10550887.2022.2074762] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND The clinical relevance of the degree of severity in addiction disorders supports the need to investigate the variables underlying this aspect of the phenomenon. OBJECTIVE This study aimed to explore the relationships between factors that may influence the severity of addiction disorder, with a particular focus on temperamental disinhibition, emotion dysregulation, interpersonal vulnerability, and their interactions. METHODS A clinical sample of 502 (77% males and 22% females) was involved. All participants received a DSM-5 clinical diagnosis of "Substance-Related and Addictive Disorders" and were recruited from the Italian National Health System. The collected data were analyzed by implementing a chained mediation model using structural equation modeling. RESULTS The statistical appropriateness of the hypothesized latent 4- factors model was confirmed. Specifically, temperamental disinhibition (composed of impulsiveness, compulsiveness, and obsessiveness), emotion dysregulation (composed of affect dysregulation, alexithymia, and dissociation), interpersonal vulnerability (composed of traumatic experiences, preoccupied, avoidant and unresolved attachment), and Addictive Disorders Severity (composed by substance use severity, alcohol use severity, gambling severity, and Internet use severity) were the four factors which have been identified. Furthermore, a total chained mediation model emerged, where emotion dysregulation and interpersonal vulnerability mediated the relationship between temperamental disinhibition and Addictive Disorders Severity. CONCLUSIONS Our findings offer a better understanding of the variables associated with addictive disorder severity, providing important indications for therapeutic interventions.
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Affiliation(s)
- Alessio Gori
- Department of Health Sciences, University of Florence, Florence, Italy.,Integrated Psychodynamic Psychotherapy Institute (IPPI), Florence, Italy
| | - Eleonora Topino
- Department of Human Sciences, LUMSA University of Rome, Rome, Italy
| | - Marco Cacioppo
- Department of Human Sciences, LUMSA University of Rome, Rome, Italy
| | - Giuseppe Craparo
- Faculty of Human and Social Sciences, UKE-Kore University of Enna, Enna, Italy
| | - Adriano Schimmenti
- Faculty of Human and Social Sciences, UKE-Kore University of Enna, Enna, Italy
| | - Vincenzo Caretti
- Department of Human Sciences, LUMSA University of Rome, Rome, Italy
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15
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Draheim C, Pak R, Draheim AA, Engle RW. The role of attention control in complex real-world tasks. Psychon Bull Rev 2022; 29:1143-1197. [PMID: 35167106 PMCID: PMC8853083 DOI: 10.3758/s13423-021-02052-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2021] [Indexed: 11/15/2022]
Abstract
Working memory capacity is an important psychological construct, and many real-world phenomena are strongly associated with individual differences in working memory functioning. Although working memory and attention are intertwined, several studies have recently shown that individual differences in the general ability to control attention is more strongly predictive of human behavior than working memory capacity. In this review, we argue that researchers would therefore generally be better suited to studying the role of attention control rather than memory-based abilities in explaining real-world behavior and performance in humans. The review begins with a discussion of relevant literature on the nature and measurement of both working memory capacity and attention control, including recent developments in the study of individual differences of attention control. We then selectively review existing literature on the role of both working memory and attention in various applied settings and explain, in each case, why a switch in emphasis to attention control is warranted. Topics covered include psychological testing, cognitive training, education, sports, police decision-making, human factors, and disorders within clinical psychology. The review concludes with general recommendations and best practices for researchers interested in conducting studies of individual differences in attention control.
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Affiliation(s)
- Christopher Draheim
- Department of Psychology, Lawrence University, Appleton, WI, USA.
- School of Psychology, Georgia Institute of Technology, Atlanta, GA, USA.
| | - Richard Pak
- Department of Psychology, Clemson University, Clemson, SC, USA
| | - Amanda A Draheim
- Department of Psychology, Lawrence University, Appleton, WI, USA
| | - Randall W Engle
- School of Psychology, Georgia Institute of Technology, Atlanta, GA, USA
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16
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Burley CV, Burns K, Brodaty H. Pharmacological and nonpharmacological approaches to reduce disinhibited behaviors in dementia: a systematic review. Int Psychogeriatr 2022; 34:1-17. [PMID: 35331345 DOI: 10.1017/s1041610222000151] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Disinhibited behaviors in dementia are associated with multiple negative outcomes. However, effective interventions are under-researched. This systematic review aims to provide an overview of intervention studies that report outcome measures of disinhibited behaviors in dementia. DESIGN Systematic searches of the databases MEDLINE, EMBASE, and PsychINFO, Social Work Abstracts and Cochrane Central Register of Controlled Trial databases were conducted for publications published between 2002 and March 2020. We included hand-searched reviews, original articles, case reports, cohort studies, and randomized controlled trials (RCTs). All studies were rated for research quality. Statistical and clinical significance were considered for individual studies. Effect sizes were included where provided or calculated where possible. Mean effect sizes were calculated for RCTs only. PARTICIPANTS The systematic review included studies involving people living with dementia. MEASUREMENTS The Neuropsychiatric Inventory disinhibition subscale was used most often. RESULTS Nine pharmacological and 21 nonpharmacological intervention studies utilized different theoretical/clinical approaches. These included pain management, antidepressants, models of care, education and/or training, music-based approaches, and physical activity. The quality of research in RCTs was strong with a greater effect size in nonpharmacological compared to pharmacological approaches (mean Cohen's d = 0.49 and 0.27, respectively). Disinhibition was a secondary outcome in all studies. CONCLUSION Pharmacological (including pain management and antidepressants) and, more so, nonpharmacological (models of care, education/training, physical activity, and music) approaches were effective in reducing disinhibition.
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Affiliation(s)
- Claire V Burley
- Dementia Centre for Research Collaboration, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Kim Burns
- Dementia Centre for Research Collaboration, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Henry Brodaty
- Dementia Centre for Research Collaboration, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
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17
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Zajenkowska A, Nowakowska I, Kaźmierczak I, Rajchert J, Bodecka-Zych M, Jakubowska A, Anderson JL, Sellbom M. The interplay between disinhibition and Present-Hedonistic time perspective in the relation between Borderline Personality Organization and depressive symptoms. PERSONALITY AND INDIVIDUAL DIFFERENCES 2022. [DOI: 10.1016/j.paid.2021.111317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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18
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Early and late signals of unexpected reward contribute to low extraversion and high disinhibition, respectively. PERSONALITY NEUROSCIENCE 2021; 4:e5. [PMID: 34909564 PMCID: PMC8645529 DOI: 10.1017/pen.2021.4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/29/2021] [Accepted: 06/05/2021] [Indexed: 12/23/2022]
Abstract
Like socio-economic status and cognitive abilities, personality traits predict important life outcomes. Traits that reflect unusually low or high approach motivations, such as low extraversion and high disinhibition, are linked to various forms of mental disorder. Similarly, the dopamine system is theoretically linked to approach motivation traits and to various forms of mental disorder. Identifying neural contributions to extremes of such traits should map to neural sources of psychopathology, with dopamine a prime candidate. Notably, dopamine cells fire in response to unexpected reward, which suggests that the size of non-invasive, scalp-recorded potentials evoked by unexpected reward could reflect sensitivity in approach motivation traits. Here, we evaluated the validity of evoked electroencephalography (EEG) responses to unexpected reward in a monetary gain/loss task to assess approach motivation traits in 137 participants, oversampled for externalizing psychopathology symptoms. We demonstrated that over the 0–400 ms period in which feedback on the outcome was presented, responses evoked by unexpected reward contributed to all theoretically relevant approach motivation trait domains (disinhibition, extraversion and the behavioural activation system); and did so only at times when dopamine responses normally peak and reportedly code salience (70–100 ms) and valuation (200–300 ms). In particular, we linked “dopaminergic” salience and valuation to the psychopathology-related constructs of low extraversion (social anxiety) and high disinhibition (impulsivity) respectively, making the evoked potential components biomarker candidates for indexing aberrant processing of unexpected reward.
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19
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Hanegraaf L, Hohwy J, Verdejo-Garcia A. Latent classes of maladaptive personality traits exhibit differences in social processing. J Pers 2021; 90:615-630. [PMID: 34714935 PMCID: PMC9545362 DOI: 10.1111/jopy.12686] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 10/22/2021] [Accepted: 10/24/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Social processing (SP) deficits manifest across numerous mental disorders. However, this research has been plagued by heterogeneity and a piecemeal approach whereby skills are examined in isolation rather than as part of an integrated cognitive system. Here, we combined two dimensional frameworks of psychopathology to address these limitations. METHOD We utilized the Alternative Model for Personality Disorders (AMPD) to distill trait-related heterogeneity within a community sample (n = 200), and the Research Domain Criteria (RDoC) 'Systems for Social Processes' to comprehensively assess SP. We first applied latent class analyses (LCA) to derive AMPD-based groups and subsequently contrasted the performance of these groups on a SP test battery that we developed to align with the RDoC SP constructs. RESULTS Our LCA yielded four distinct subgroups. The recognizable trait profiles and psychopathological symptoms of these classes suggested they were clinically meaningful. The subgroups differed in their SP profiles: one displayed deficits regarding the self, a second displayed deficits in understanding others, a third displayed more severe deficits including affiliation problems, whilst the fourth showed normal performance. CONCLUSIONS Our results support the link between clusters of maladaptive personality traits and distinctive profiles of SP deficits, which may inform research on disorders involving SP dysfunctions.
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Affiliation(s)
- Lauren Hanegraaf
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Jakob Hohwy
- Cognition and Philosophy Lab, Philosophy Department, Monash University, Clayton, Victoria, Australia
| | - Antonio Verdejo-Garcia
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
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20
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Krueger RF, Hobbs KA, Conway CC, Dick DM, Dretsch MN, Eaton NR, Forbes MK, Forbush KT, Keyes KM, Latzman RD, Michelini G, Patrick CJ, Sellbom M, Slade T, South S, Sunderland M, Tackett J, Waldman I, Waszczuk MA, Wright AG, Zald DH, Watson D, Kotov R. Validity and utility of Hierarchical Taxonomy of Psychopathology (HiTOP): II. Externalizing superspectrum. World Psychiatry 2021; 20:171-193. [PMID: 34002506 PMCID: PMC8129870 DOI: 10.1002/wps.20844] [Citation(s) in RCA: 94] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The Hierarchical Taxonomy of Psychopathology (HiTOP) is an empirical effort to address limitations of traditional mental disorder diagnoses. These include arbitrary boundaries between disorder and normality, disorder co-occurrence in the modal case, heterogeneity of presentation within dis-orders, and instability of diagnosis within patients. This paper reviews the evidence on the validity and utility of the disinhibited externalizing and antagonistic externalizing spectra of HiTOP, which together constitute a broad externalizing superspectrum. These spectra are composed of elements subsumed within a variety of mental disorders described in recent DSM nosologies, including most notably substance use disorders and "Cluster B" personality disorders. The externalizing superspectrum ranges from normative levels of impulse control and self-assertion, to maladaptive disinhibition and antagonism, to extensive polysubstance involvement and personality psychopathology. A rich literature supports the validity of the externalizing superspectrum, and the disinhibited and antagonistic spectra. This evidence encompasses common genetic influences, environmental risk factors, childhood antecedents, cognitive abnormalities, neural alterations, and treatment response. The structure of these validators mirrors the structure of the phenotypic externalizing superspectrum, with some correlates more specific to disinhibited or antagonistic spectra, and others relevant to the entire externalizing superspectrum, underlining the hierarchical structure of the domain. Compared with traditional diagnostic categories, the externalizing superspectrum conceptualization shows improved utility, reliability, explanatory capacity, and clinical applicability. The externalizing superspectrum is one aspect of the general approach to psychopathology offered by HiTOP and can make diagnostic classification more useful in both research and the clinic.
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Affiliation(s)
| | - Kelsey A. Hobbs
- Department of PsychologyUniversity of MinnesotaMinneapolisMNUSA
| | | | - Danielle M. Dick
- Department of PsychologyVirginia Commonwealth UniversityRichmondVAUSA
| | - Michael N. Dretsch
- US Army Medical Research Directorate ‐ WestWalter Reed Army Institute of Research, Joint Base Lewis‐McChordWAUSA
| | | | - Miriam K. Forbes
- Centre for Emotional Health, Department of PsychologyMacquarie UniversitySydneyNSWAustralia
| | | | | | | | - Giorgia Michelini
- Semel Institute for Neuroscience and Human BehaviorUniversity of California Los AngelesLos AngelesCAUSA
| | | | - Martin Sellbom
- Department of PsychologyUniversity of OtagoDunedinNew Zealand
| | - Tim Slade
- Matilda Centre for Research in Mental Health and Substance UseUniversity of SydneySydneyNSWAustralia
| | - Susan C. South
- Department of Psychological SciencesPurdue UniversityWest LafayetteINUSA
| | - Matthew Sunderland
- Matilda Centre for Research in Mental Health and Substance UseUniversity of SydneySydneyNSWAustralia
| | | | - Irwin Waldman
- Department of PsychologyEmory UniversityAtlantaGAUSA
| | | | | | - David H. Zald
- Department of PsychologyVanderbilt UniversityNashvilleTNUSA
| | - David Watson
- Department of PsychologyUniversity of Notre DameNotre DameINUSA
| | - Roman Kotov
- Department of PsychiatryStony Brook UniversityStony BrookNYUSA
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21
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Kotov R, Krueger RF, Watson D, Cicero DC, Conway CC, DeYoung CG, Eaton NR, Forbes MK, Hallquist MN, Latzman RD, Mullins-Sweatt SN, Ruggero CJ, Simms LJ, Waldman ID, Waszczuk MA, Wright AGC. The Hierarchical Taxonomy of Psychopathology (HiTOP): A Quantitative Nosology Based on Consensus of Evidence. Annu Rev Clin Psychol 2021; 17:83-108. [PMID: 33577350 DOI: 10.1146/annurev-clinpsy-081219-093304] [Citation(s) in RCA: 168] [Impact Index Per Article: 56.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Traditional diagnostic systems went beyond empirical evidence on the structure of mental health. Consequently, these diagnoses do not depict psychopathology accurately, and their validity in research and utility in clinicalpractice are therefore limited. The Hierarchical Taxonomy of Psychopathology (HiTOP) consortium proposed a model based on structural evidence. It addresses problems of diagnostic heterogeneity, comorbidity, and unreliability. We review the HiTOP model, supporting evidence, and conceptualization of psychopathology in this hierarchical dimensional framework. The system is not yet comprehensive, and we describe the processes for improving and expanding it. We summarize data on the ability of HiTOP to predict and explain etiology (genetic, environmental, and neurobiological), risk factors, outcomes, and treatment response. We describe progress in the development of HiTOP-based measures and in clinical implementation of the system. Finally, we review outstanding challenges and the research agenda. HiTOP is of practical utility already, and its ongoing development will produce a transformative map of psychopathology.
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Affiliation(s)
- Roman Kotov
- Departments of Psychiatry and Psychology, Stony Brook University, Stony Brook, New York 11794, USA;
| | - Robert F Krueger
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - David Watson
- Department of Psychology, University of Notre Dame, Notre Dame, Indiana 46556, USA
| | - David C Cicero
- Department of Psychology, University of North Texas, Denton, Texas 76203, USA
| | | | - Colin G DeYoung
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - Nicholas R Eaton
- Departments of Psychiatry and Psychology, Stony Brook University, Stony Brook, New York 11794, USA;
| | - Miriam K Forbes
- Centre for Emotional Health, Department of Psychology, Macquarie University, Macquarie Park, New South Wales 2109, Australia
| | - Michael N Hallquist
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
| | - Robert D Latzman
- Department of Psychology, Georgia State University, Atlanta, Georgia 30303, USA
| | | | - Camilo J Ruggero
- Department of Psychology, University of North Texas, Denton, Texas 76203, USA
| | - Leonard J Simms
- Department of Psychology, University at Buffalo, State University of New York, Buffalo, New York 14260, USA
| | - Irwin D Waldman
- Department of Psychology, Emory University, Atlanta, Georgia 30322, USA
| | - Monika A Waszczuk
- Department of Psychology, Rosalind Franklin University, North Chicago, Illinois 60064, USA
| | - Aidan G C Wright
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
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22
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Wilson S, Olino TM. A developmental perspective on personality and psychopathology across the life span. J Pers 2021; 89:915-932. [PMID: 33550639 PMCID: PMC10142293 DOI: 10.1111/jopy.12623] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 01/28/2021] [Accepted: 01/29/2021] [Indexed: 12/16/2022]
Abstract
Taking a developmental perspective, guided by core principles of developmental science and developmental psychopathology, is necessary to move the fields of personality science and psychopathology forward. Personality and psychopathology can be delineated using hierarchical models of individual differences, as evidenced by decades of converging evidence across community and psychiatric samples, countries and cultures, and ages and developmental periods. A large body of empirical research likewise documents associations between personality and various forms of psychopathology. Cross-sectional investigations of personality-psychopathology links in samples of adults now yield diminishing returns. Prospective, longitudinal investigations that assess personality, psychopathology, and their co-development across the life span are needed to determine their temporal ordering, capture dynamic associations over time and development, and elucidate causal origins and underlying mechanisms. We lay out a developmental framework that integrates across the developmental, personality, and psychopathology literatures in order to further understanding and guide future investigations of the nature of personality-psychopathology links.
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Affiliation(s)
- Sylia Wilson
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
| | - Thomas M Olino
- Department of Psychology, Temple University, Philadelphia, PA, USA
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23
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Zufferey V, Gunten AV, Kherif F. Interactions between Personality, Depression, Anxiety and Cognition to Understand Early Stage of Alzheimer's Disease. Curr Top Med Chem 2021; 20:782-791. [PMID: 32066361 DOI: 10.2174/1568026620666200211110545] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 11/25/2019] [Accepted: 12/06/2019] [Indexed: 01/18/2023]
Abstract
The multifaceted nature of Alzheimer's disease (AD) and Mild cognitive impairment (MCI) can lead to wide inter-individual differences in disease manifestation in terms of brain pathology and cognition. The lack of understanding of phenotypic diversity in AD arises from a difficulty in understanding the integration of different levels of network organization (i.e. genes, neurons, synapses, anatomical regions, functions) and in inclusion of other information such as neuropsychiatric characteristics, personal history, information regarding general health or subjective cognitive complaints in a coherent model. Non-cognitive factors, such as personality traits and behavioral and psychiatric symptoms, can be informative markers of early disease stage. It is known that personality can affect cognition and behavioral symptoms. The aim of the paper is to review the different types of interactions existing between personality, depression/anxiety, and cognition and cognitive disorders at behavioral and brain/genetic levels.
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Affiliation(s)
- Valérie Zufferey
- Laboratoire de Recherche en Neuroimagerie (LREN), Departement des Neurosciences Cliniques, Centre Hospitalier Universitaire Vaudois, Universite de Lausanne, 1011 Lausanne, Switzerland.,Service Universitaire de Psychiatrie de l'Age Avance (SUPAA), Centre Hospitalier Universitaire Vaudois, 1008 Prilly-Lausanne, Switzerland.,Ecole Polytechnique Fédérale de Lausanne (EPFL Valais), Clinique Romande de Réadaptation, 1951 Sion, Switzerland
| | - Armin von Gunten
- Service Universitaire de Psychiatrie de l'Age Avance (SUPAA), Centre Hospitalier Universitaire Vaudois, 1008 Prilly-Lausanne, Switzerland
| | - Ferath Kherif
- Laboratoire de Recherche en Neuroimagerie (LREN), Departement des Neurosciences Cliniques, Centre Hospitalier Universitaire Vaudois, Universite de Lausanne, 1011 Lausanne, Switzerland
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24
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Allen KJD, Johnson SL, Burke TA, Sammon MM, Wu C, Kramer MA, Wu J, Schatten HT, Armey MF, Hooley JM. Validation of an emotional stop-signal task to probe individual differences in emotional response inhibition: Relationships with positive and negative urgency. Brain Neurosci Adv 2021; 5:23982128211058269. [PMID: 34841088 PMCID: PMC8619735 DOI: 10.1177/23982128211058269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 10/08/2021] [Indexed: 11/17/2022] Open
Abstract
Performance on an emotional stop-signal task designed to assess emotional response inhibition has been associated with Negative Urgency and psychopathology, particularly self-injurious behaviors. Indeed, difficulty inhibiting prepotent negative responses to aversive stimuli on the emotional stop-signal task (i.e. poor negative emotional response inhibition) partially explains the association between Negative Urgency and non-suicidal self-injury. Here, we combine existing data sets from clinical (hospitalised psychiatric inpatients) and non-clinical (community/student participants) samples aged 18-65 years (N = 450) to examine the psychometric properties of this behavioural task and evaluate hypotheses that emotional stop-signal task metrics relate to distinct impulsive traits among participants who also completed the UPPS-P (n = 223). We specifically predicted associations between worse negative emotional response inhibition (i.e. commission errors during stop-signal trials representing negative reactions to unpleasant images) and Negative Urgency, whereas commission errors to positive stimuli - reflecting worse positive emotional response inhibition - would relate to Positive Urgency. Results support the emotional stop-signal task's convergent and discriminant validity: as hypothesised, poor negative emotional response inhibition was specifically associated with Negative Urgency and no other impulsive traits on the UPPS-P. However, we did not find the hypothesised association between positive emotional response inhibition and Positive Urgency. Correlations between emotional stop-signal task performance and self-report measures were the modest, similar to other behavioural tasks. Participants who completed the emotional stop-signal task twice (n = 61) additionally provide preliminary evidence for test-retest reliability. Together, findings suggest adequate reliability and validity of the emotional stop-signal task to derive candidate behavioural markers of neurocognitive functioning associated with Negative Urgency and psychopathology.
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Affiliation(s)
- Kenneth J D Allen
- Department of Psychology, University of California, Berkeley, Berkeley, CA, USA
- Department of Psychology, Oberlin College and Conservatory, Oberlin, OH, USA
| | - Sheri L Johnson
- Department of Psychology, University of California, Berkeley, Berkeley, CA, USA
| | - Taylor A Burke
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - M McLean Sammon
- Department of Psychology, Oberlin College and Conservatory, Oberlin, OH, USA
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Christina Wu
- Department of Psychology, Oberlin College and Conservatory, Oberlin, OH, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, McLean Hospital, Belmont, MA, USA
| | - Max A Kramer
- Department of Psychology, Oberlin College and Conservatory, Oberlin, OH, USA
- Division of the Social Sciences, The University of Chicago, Chicago, IL, USA
| | - Jinhan Wu
- Department of Psychology, Oberlin College and Conservatory, Oberlin, OH, USA
| | - Heather T Schatten
- Psychosocial Research Program, Butler Hospital, Providence, RI, USA
- Department of Psychiatry & Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Michael F Armey
- Psychosocial Research Program, Butler Hospital, Providence, RI, USA
- Department of Psychiatry & Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Jill M Hooley
- Department of Psychology, Harvard University, Cambridge, MA, USA
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Helle AC, Sher KJ, Trull TJ. Individual symptoms or categorical diagnoses? An epidemiological examination of the association between alcohol use, personality disorders, and psychological symptoms. Personal Disord 2020; 12:484-490. [PMID: 33030953 DOI: 10.1037/per0000459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Given the high comorbidity among psychological disorders, and in particular, personality disorders (PDs) and alcohol use disorder, screening and intervention efforts may benefit from the inclusion of transdiagnostic symptoms. Extant symptoms can improve the ability to efficiently gather important information about an individual that relates to a number of conditions, behaviors, and potential problems. Further, less time is needed to assess these symptoms, as compared with full diagnostic criteria sets, which have limitations of their own. This study examined the utility of two PD symptoms, affective instability and impulsivity, as compared with relevant categorical diagnoses (antisocial and borderline PDs), to provide useful information about alcohol use disorder and heaviness of alcohol consumption. Individual symptoms were comparable to the categorical diagnoses in predicting important treatment targets. In an effort to identify and treat comorbidities in a more efficient way, future research should investigate the applicability of these individual symptoms, and other transdiagnostic targets, to screening and brief intervention protocols. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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The vibrant intersection of personality and psychopathology research: A special issue of the Journal of Research in Personality. JOURNAL OF RESEARCH IN PERSONALITY 2020. [DOI: 10.1016/j.jrp.2019.103890] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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