Personality disorder models and their coverage of interpersonal problems

Interpersonal Problem Profiles of Personality and Psychopathology Constructs in Chinese Undergraduates and Offenders

The interpersonal problem circumplex is extensively used in the field as an assessment framework for understanding the interpersonal implications of a range of personality and psychopathology constructs. The vast majority of this large literature has been conducted in Western convenience and clinical samples. We computed interpersonal problem structural summary parameters for a range of personality and psychopathology variables in two Chinese offender samples (N = 424 and N = 555) and one undergraduate sample (N = 511) to test how well findings from Western samples generalize to Chinese undergraduates and offenders. The results showed that findings in Western samples generalized reasonably well to Chinese young adult and forensic contexts, although the interpersonal profiles of external variables were less specific in Chinese samples. Compared with undergraduates, interpersonal distress has stronger associations with the mental health of offenders. This study further elaborates the interpersonal correlates of individual differences in personality and psychopathology across cultures and assessment contexts, and it also extends the literature examining interpersonal problems in forensic settings.

Assessing the relationship between early maladaptive schemas and interpersonal problems using interpersonal scenarios depicting rejection

BACKGROUND

Early maladaptive schemas (EMSs) have been theorised to contribute to reoccurring interpersonal problems. This study developed a novel experimental paradigm that aimed to assess if EMSs moderate the impact of interpersonal situations on interpersonal responses by manipulating the degree of rejection in a series of interpersonal vignettes depicting acceptance, ambiguous rejection and rejection.

METHOD

In a sample of 158 first-year psychology students (27.2% male; 72.2% female; 0.6% other) participant responses to interpersonal scenarios were measured including degree of perceived rejection, emotional distress, conviction in varying cognitive appraisals consistent with attribution theory and behavioural responses to scenarios. Qualitative data was analysed using inductive content analysis and statistical analyses were conducted using multi-level mixed effect linear and logistic regression models using the software Jamovi.

RESULTS

People reporting higher EMSs reported increased emotional distress (F(1, 156) = 24.85, p < .001), perceptions of rejection (F(1, 156) = 34.33, p < .001), self-blame (F(1, 156) = 53.25, p < .001), other-blame (F(1, 156) = 13.16, p < .001) and more intentional (F(1, 156) = 9.24, p = .003), stable (F(1, 156) = 25.22, p < .001) and global (F(1, 156) = 19.55, p < .001) attributions but no differences in reported behavioural responses. The results also supported that EMSs moderate the relationship between interpersonal rejection and perceptions of rejection (F(2, 1252) = 18.43, p < .001), emotional distress (F(2, 1252) = 12.64, p < .001) and self-blame (F(2, 1252) = 14.00, p < .001).

CONCLUSION

Together these findings suggest that people with EMSs experience increased distress and select negative cognitions in situations where there are higher levels of rejection but that distress and negative cognitions are generally higher in people with EMSs irrespective of the situation.

Examining Schizotypal Personality Scales Within and Across Interpersonal Circumplex Surfaces

Differing perspectives on the operationalization of schizotypal personality pathology (STPP) have led to numerous multidimensional assessment measures. The current study applied the interpersonal construct validation approach to self-report data from 856 undergraduate students to formally examine the interpersonal content, similarities, and differences in the subscales of four measures of STPP within and across two interpersonal circumplex surfaces using a bootstrapping methodology for computing confidence intervals around circumplex structural summary method parameters. Results suggested that negative-like expressions of STPP are prototypically and distinctively interpersonal constructs associated with cold and socially avoidant interpersonal problems and hypersensitivity to others' warmth and affection. Positive-like expressions of STPP as assessed by two out of four measures were prototypically and distinctively interpersonal constructs associated with vindictiveness. Across four measures, there was notable overlap in interpersonal correlates among related subscales, suggesting convergent validity. However, subscales containing social anxiety content were associated with more submissive (i.e., socially avoidant) interpersonal problems than subscales without social anxiety content.

Structure of Pathological Personality Traits Through the Lens of the CAT-PD Model

Personality pathology is increasingly conceptualized within hierarchical, dimensional trait models. The Comprehensive Assessment of Traits Relevant to Personality Disorders (CAT-PD) is a pathological-trait measure with potential to improve on currently prevailing instruments because it has wider content coverage; however, its domain-level structure, which is of scientific and clinical interest, is not established. In this study, we investigated the structure and construct validity of the CAT-PD's domain level to facilitate wider use of the measure. We estimated five- and six-factor models with exploratory factor analysis in a pooled sample of eight independent subsamples (N = 3,987) and found that both models fit the data well; each had interpretable factors that were invariant across gender, sample type, and Black/White racial groups; and the factors had good convergent validity with other measures of maladaptive traits, Big Five personality, and interpersonal problems. Our results support the validity of the CAT-PD for assessing multiple levels of the pathological trait hierarchy.

Developing and Validating a Facial Emotion Recognition Task With Graded Intensity

Facial emotion recognition (FER) tasks are often digitally altered to vary expression intensity; however, such tasks have unknown psychometric properties. In these studies, an FER task was developed and validated-the Graded Emotional Face Task (GEFT)-which provided an opportunity to examine the psychometric properties of such tasks. Facial expressions were altered to produce five intensity levels for six emotions (e.g., 40% anger). In Study 1, 224 undergraduates viewed subsets of these faces and labeled the expressions. An item selection algorithm was used to maximize internal consistency and balance gender and ethnicity. In Study 2, 219 undergraduates completed the final GEFT and a multimethod battery of validity measures. Finally, in Study 3, 407 undergraduates oversampled for borderline personality disorder (BPD) completed the GEFT and a self-report BPD measure. Broad FER scales (e.g., overall anger) demonstrated evidence of reliability and validity; however, more specific subscales (e.g., 40% anger) had more variable psychometric properties. Notably, ceiling/floor effects appeared to decrease both internal consistency and limit external validity correlations. The findings are discussed from the perspective of measurement issues in the social cognition literature.

The Relationship Between Patients' Personality Traits, the Alliance, and Change in Interpersonal Distress in Intensive Group Treatment for Personality Dysfunction

This study examined patients' personality traits as operationalized by the five-factor model in relation to early alliance and reduction of interpersonal distress through an intensive group treatment program for personality dysfunction. A sample of 79 consecutively admitted psychiatric outpatients with personality dysfunction who attended an 18-week intensive group treatment program completed the NEO Five-Factor Inventory at pretreatment, the Inventory of Interpersonal Problems at pre- and posttreatment, and the Edmonton Therapeutic Alliance Scale, a measure of the therapeutic alliance with the program therapist, at Session 5. Results indicated that patients who were relatively extraverted tended to rate the alliance with their program therapist higher and subsequently reported more improvement of interpersonal distress. The presence of a personality disorder did not moderate this mediation. Patients' extraversion likely promotes a bonding with the therapist and facilitates the interpersonal group work necessary for improvement. Assessing patients' level of extraversion before starting intensive group treatment might indicate which intervention strategies could be useful with that patient within the program frame.

Development and Validation of a German Interpersonal Sensitivities Circumplex (ISC-G)

Abstract. The Interpersonal Sensitivities Circumplex (ISC) assesses individual differences in sensitivities to aversive interpersonal behaviors. In this research (total N = 1,519), we developed and validated a German adaptation of the ISC (ISC-G) and extended the nomological net of interpersonal sensitivity as a construct. Using the structural summary method, we investigated associations with self- and informant reports of adaptive (interpersonal) personality traits as well as self-reported personality functioning, maladaptive personality traits, childhood trauma, and hypersensitivity. Replicating and extending previous findings with the ISC, the present research sheds light on the interplay between different personality traits and the perception of others’ interpersonal behavior. Results suggested that individuals report experiencing interpersonal behavior opposite to their own self-description in terms of agency and communion as aversive. This oppositional pattern was most pronounced for antagonistic vs. agreeable traits/behaviors. We discuss these results in the context of research on personality pathology.

Psychometric study of the brazilian version of the personality inventory for DSM-5-paper-and-pencil version

The Personality Inventory for DSM-5 - Self Reported Form (PID-5-SRF) operationalizes Criterion B of the personality alternative model of DSM-5 Section III and has already been cross-culturally adapted to many countries. The objective is to present evidence of validity and reliability of the Brazilian version of PID-5 (pencil-and-paper) in a Brazilian community sample. The sample was composed of 730 individuals from the general population [67.8% women, aged 33.84 (SD = ±15.2), 69.5% ≥ 12 years of schooling]. The participants were recruited in academic, organizational, healthcare, and business facilities in three Brazilian states. The snowball method was used. The PID-5 Brazilian version and the Revised NEO-Five Factor Inventory (NEO-FFI-R) were individually applied, and the retest was applied 30 days after. Satisfactory internal consistency (facets α ≥0.51; domains α ≥0.82) and test-retest reliability (facets ICC ≥ 0.45; domains ICC ≥0.76) were found, but a floor effect was verified in 97.7% of the items. Regarding convergent validity, strong correlations were found between the PID-5 and the NEO-FFI-R domains (r = -0.44 to 0.70). Ten facets did not fit the unidemensional structure. Confirmatory Factor Analyses did not present adequate goodness of fit, and Exploratory Analyses indicated that a five-factor model is more appropriate, though it presents some peculiarities concerning the original model. PID-5 also presented satisfactory goodness of fit to the personality hierarchical model. Generally, the instrument's psychometric indicators favor its use in the Brazilian context. However, some aspects demand attention, and more specific studies should be conducted to verify the impact of reverse-scored items, floor effect, and peculiarities of its internal structure (some facets' multidimensionality and interstitiality) concerning the original model.

Transdiagnostic Associations With Interpersonal and Affective Variability in Borderline Personality Pathology

Emotional and behavioral variability are unifying characteristics of borderline personality disorder (BPD). Ambulatory assessment (AA) has been used to quantify this variability in terms of the categorical BPD diagnosis, but evidence suggests that BPD instead reflects general personality pathology. This study aimed to clarify the conceptualization of BPD by mapping indices of variability in affect, interpersonal behavior, and perceptions of others onto general and specific dimensions of personality pathology. A sample of participants who met diagnostic criteria for BPD (n = 129) and healthy controls (n = 47) reported on their daily interactions during a 21-day AA protocol. Multilevel SEM was used to examine associations between shared and specific variance in maladaptive traits with dynamic patterns of functioning. The authors found that variability is an indicator of shared trait variance and Negative Affectivity, not any other specific traits, reinforcing the idea that BPD is best understood as general personality pathology.

Early Maladaptive Schemas and the Accuracy of Facial Emotion Recognition: A Preliminary Investigation

Different developmental experiences related to deep-rooted beliefs about oneself and others may significantly affect individual social emotional competencies, such as the accuracy of facial emotion recognition and detection. This study presents a preliminary examination of the relationship between early maladaptive schemas (EMSs) and the accuracy of recognizing facial expressions showing basic emotions, neutral faces, and discrimination between neutral and emotional faces. The sample consisted of 138 psychology students (M = 20.33; SD = 1.33, 27 of the respondents were male). JACFEE and JACNeuF (Matsumoto & Ekman, 1988) were used as stimulus material for assessing the facial emotion recognition of seven basic emotions (anger, contempt, disgust, fear, sadness, happiness, and surprise) and neutral faces. The Young Schema Questionnaire - Short Form 3 (YSQ-S3; Young, 2005) was administered as a measure of EMSs. The findings demonstrate that all schema domains affect the accuracy of recognizing facial expressions showing negative emotions (anger, contempt, disgust, fear, and sadness). The Dependence/Incompetence, Entitlement/Grandiosity schemas were significant predictors for detecting neutral faces and discriminating between faces with and without emotion, while the Abandonment/Instability schema additionally proved significant for recognizing neutral faces. Limitations and suggestions for future elaboration are acknowledged.

Employing Contemporary Integrative Interpersonal Theory to Understand Dysfunction in Those at Clinical High Risk for Psychosis

Poor social functioning is related to the development of psychosis; however, our current understanding of social functioning in those at-risk for psychosis is limited by (a) poor conceptual models of interpersonal behavior and (b) a reliance on comparisons to healthy controls (e.g., vs. clinical controls). In this study, we introduce Contemporary Integrated Interpersonal Theory (CIIT) and use its Interpersonal Circumplex (IPC) model to compare interpersonal behavior traits in those at clinical high-risk (CHR) for psychosis, clinical controls, and healthy controls. A community sample (N = 3460) was used to derive estimates of IPC dimensions (i.e., affiliation and dominance), which were then compared among a large subsample that completed diagnostic interviews (N = 337), which included a CHR group, as well as several control groups ranging on degree of psychosis vulnerability and internalizing disorders. CHR individuals were distinguished from healthy controls by low affiliation (d = –1.31), and from internalizing disorder groups by higher dominance (d = 0.64). Negative symptoms were consistently associated with low affiliation and low dominance, whereas positive symptoms were related primarily to coldness. These results connect social functioning in psychosis risk to a rich theoretical framework and suggest a potentially distinct interpersonal signature for CHR individuals. More broadly, this study suggests that CIIT and the IPC may have utility for informing diagnostics and treatment development in psychosis risk research.

Pathological personality, situations, and their joint influences on daily emotional symptoms

OBJECTIVE

The present research aims to advance current understanding on how individuals with pathological personality traits construe their day-to-day situational experiences.

METHOD

College students (N = 231) completed a measure of personality pathology, followed by six assessments of everyday situations and anxiety/depression symptoms over two weeks.

RESULTS

Multilevel analyses indicated that personality pathology was meaningfully associated with situational experiences. Major findings suggested that situations that entailed aggravations and interpersonal confrontations were associated with negative affectivity, antagonism, and psychoticism. Detached individuals were less likely to experience pleasant and social situations. Exploratory analyses suggested an amplification effect where individuals high on personality pathology were more anxious or depressed when they perceived certain situational features, compared to their low trait counterparts. However, such cross-level interactions constituted a small minority; most personality traits and situations exerted additive effects on symptoms.

CONCLUSION

Situational experiences appear to be driven in part by personality pathology. The exacerbation of daily negative symptoms can be attributed to the joint (largely additive) influence of the trigger situations and pathological personality traits.

Loneliness and problematic internet use: testing the role of interpersonal problems and motivation for internet use

BACKGROUND

A number of factors have been demonstrated to be associated with Problematic Internet Use (PIU); otherwise known as Internet Addiction), which is mostly concerned with psychological problems such as loneliness. This study aimed to examine how and in what way loneliness influenced PIU.

METHODS

A self-report measurement on loneliness, the Internet addiction test (IAT) and instruments on interpersonal problems were administered to 318 medical students (57% females); mean age totaled 20.88 years (SD = 1.8). We performed a mediation analysis to evaluate direct effects of loneliness on IAT, as well as indirect effects mediated by interpersonal problems. In addition, motivation for internet use was added to the mediation model and tested whether it acted as the second mediator (serial mediation model) or a moderator (moderated mediation model).

RESULTS

After controlling for sex and age, socially inhibited problems exhibited full mediation whereas the remainder showed partial mediation effects, with the exception that intrusive and cold interpersonal problems indicated no mediating role. Negative motivation and motivation for being accepted had mediation effects for all types of interpersonal problems. Motivation for working was found to be a significant mediator and moderator of the most interpersonal problems. Intrusive and cold styles became a mediator only when some motivation variables were added to the model, implying that not only psychological problems should be included when analyzing PIU, but also other variables such motivation for internet use. The percent of variance explained, by IAT score, increased from 13% in the mediation model to 33% by the moderated mediation model, and 43% using the serial mediation model.

CONCLUSION

The study suggested the crucial role of loneliness and interpersonal problems on PIU, for which motivation for internet use explained how each interpersonal problem would be associated. This may provide some insight regarding the pathological characteristics of those using the internet as a coping strategy.

Comparing English-Language and Chinese-Language Assessment of DSM-5 Personality Disorders and Interpersonal Problems in Chinese Bilingual Speakers

A review of the literature on Chinese translations of Western self-report personality disorder assessment measures indicates the need to empirically evaluate the validity of assessing Western personality disorder constructs in Chinese language and culture. The current study presents a novel approach to examining this critical question in cross-cultural clinical assessment science and practice. One hundred and ninety-nine (199) Mandarin Chinese and English bilingual participants (92 males and 107 females) provided both English and Chinese self-report ratings on the Inventory of Interpersonal Problems - Short Circumplex (IIP-SC) and The Personality Diagnostic Questionnaire - 4+ (PDQ-4+). The similarities and differences in associations between Diagnostic and Statistical Manual of Mental Disorders-5th edition (DSM-5) personality disorders and interpersonal problems assessed across languages were examined. The structural summary method (SSM) for circumplex data and a bootstrapping methodology were used to compute confidence intervals around SSM parameters to analyze and compare the interpersonal problems profiles for each personality disorder scale (e.g. narcissistic) derived from English-language and Chinese-language data. The current study found highly similar interpersonal profiles for personality disorder scales assessed in English and Chinese, suggesting Western DSM-5 personality disorder constructs generally emphasize the same interpersonal problems in Chinese language and culture. The method employed in this study also has implications for understanding whether translated measures capture the same personality constructs.

Moving in together, marriage, and motherhood: A follow up study of relationships in psychiatric patients with personality disorders

BACKGROUND

Personality disorders (PDs) are related to poor psychosocial function, including fewer relationships with friends and romantic partners.

METHODS

One-hundred eighty-six psychiatric patients were included in a study cohort in 2002-2003. In 2017, data regarding living arrangements and marital status between 2003 and 2016 were collected for these participants and from a matched control group. Data on birth of first child during the study period were collected for women. The former patients were divided into two groups based on occurrence of PD or not. Groups were compared with each other and with the controls.

RESULTS

The proportion of participants with PD who lived together with someone did not increase at the same rate as in the other groups. PD was associated with a reduced likelihood of getting married during the study period. Women in the PD group had children to a lower extent than females in the other groups.

CONCLUSION

Personality disorder was associated with an increased likelihood of living alone and being unmarried. Female participants with PD had a decreased likelihood of having children compared with controls. © 2021 The Authors Personality and Mental Health Published by John Wiley & Sons Ltd.

Case Report: Pathological Personality Traits Through the Lens of the ICD-11 Trait Qualifiers and the DSM-5 Section III Trait Model: Two Patients Illustrating the Clinical Utility of a Combined View

We report on two individuals presenting for treatment as part of everyday clinical practice, comparing their pathological personality traits through the lens of the ICD-11 trait qualifiers and the DSM-5 Section III personality trait model. We compare higher order pathological personality domains and lower order pathological personality trait facets of patient M (diagnosed with borderline personality traits according to DSM-5 Section II), and patient L (diagnosed with obsessive-compulsive personality traits according to DSM-5 Section II) with normative data and with each other. Findings highlight the clinical utility of a ICD-11/DSM-5 combined view, including: (1) the Disinhibition/Anankastia personality domain distinction as advocated in the ICD-11 model, (2) the Psychoticism personality domain as conceptualized in the DSM-5 Section III personality trait model, as well as (3) the use of lower order personality trait facets within each higher order personality domain.

Comparative Content Analysis of Self-Report Scales for Level of Personality Functioning

Content validity analyses of eight self-report instruments for assessing severity of personality disorder (PD), also known as Level of Personality Functioning (LPF), were conducted using the conceptual scheme of the Alternative Model for Personality Disorders (AMPD; APA, 2013). The item contents of these eight inventories were characterized for the LPF constructs of Identity (ID), Self-Direction (SD), Empathy (EM), and Intimacy (IN) along with the pathological personality trait domains of Negative Affectivity, Detachment, Antagonism, Disinhibition, and Psychoticism. Severity of pathology (SV) reflected in item content was also rated. Raters demonstrated robust agreement for AMPD and SV constructs across instruments. Similarity between instrument AMPD construct profiles was quantified by intraclass correlations (ICC). Results showed the instruments were generally similar in AMPD-construct coverage, but some important differences emerged. The subscales of the instruments also were characterized for the degree to which they reflect the four LPF (ID, SD, EM, IN) domain constructs. Collectively, these content validity comparisons clarify the equivalence of instruments for AMPD constructs and the relative proportions of construct coverage within instrument subscales. These results can inform future research with LPF self-report instruments and guide clinicians in selecting an LPF-related instrument for use in practice.

Convergent and Discriminant Validity of Personality Inventory for DSM-5-BF in a Primary Care Sample

A growing body of research supports the validity of the Personality Inventory for DSM-5 (PID-5) in evaluating community and psychiatric samples. Although maladaptive personality also has significant relevance in primary care settings, research on the PID-5 in primary care samples is limited. In this study, the authors examined the intercorrelations, convergent validity, and discriminant validity of the brief form of the PID-5 (PID-5-BF) in 100 primary care outpatients. Results are consistent with findings in other samples in suggesting that PID-5 domains are moderately intercorrelated and associated with a variety of mental health variables. Smaller associations with physical health variables support the discriminant validity of the instrument. Overall, results suggest that the PID-5-BF can provide a useful psychiatric screening tool in primary care settings.

The Multidimensional Behavioral Health Screen 1.0: A Translational Tool for Primary Medical Care

The Multidimensional Behavioral Health Screen (MBHS) is a brief, 27-item questionnaire designed for screening every patient in primary medical care settings. It measures nine psychopathology constructs that represent the major distinctive core dimensions of the types of behavioral health symptoms most commonly encountered in primary care (anxiety-related, depressive, and attention/cognitive symptoms). The underlying design of the MBHS is based on the major paradigm shift that has occurred in the field of theoretical psychopathology, replacing categorical syndromes, or "disorders," with hierarchical-dimensional constructs. Existing screening tests such as the PHQ-9 and GAD-7 are based explicitly on the categorical paradigm and thus suffer from the same (numerous) shortcomings as the categorical model itself. The dimensional paradigm supports enhanced measurement precision with very short scales. The goals of the MBHS are threefold: (1) to provide accurate, treatment-relevant behavioral health information to the medical provider; (2) to provide clear referral cut-points; (3) to contribute nine psychometrically sound behavioral health variables to the "healthcare big data cloud" to support future scholarship of discovery. Presented here are the basic psychometric properties of the MBHS, including reliability, convergent and discriminant validity, and classification accuracy, as well as implementation considerations.

The latent structure of interpersonal problems: Validity of dimensional, categorical, and hybrid models

Interpersonal problems are key transdiagnostic constructs in psychopathology. In the past, investigators have neglected the importance of operationalizing interpersonal problems according to their latent structure by using divergent representations of the construct: (a) computing scores for severity, agency, and communion (“dimensional approach”), (b) classifying persons into subgroups with respect to their interpersonal profile (“categorical approach”). This hinders cumulative research on interpersonal problems, because findings cannot be integrated both from a conceptual and a statistical point of view. We provide a comprehensive evaluation of interpersonal problems by enlisting several large samples (Ns = 5,400, 491, 656, and 712) to estimate a set of latent variable candidate models, covering the spectrum of purely dimensional (i.e., confirmatory factor analysis using Gaussian and nonnormal latent t-distributions), hybrid (i.e., semiparametric factor analysis), and purely categorical approaches (latent class analysis). Statistical models were compared with regard to their structural validity, as evaluated by model fit (corrected Akaike’s information criterion and the Bayesian information criterion), and their concurrent validity, as defined by the models’ ability to predict relevant external variables. Across samples, the fully dimensional model performed best in terms of model fit, prediction, robustness, and parsimony. We found scant evidence that categorical and hybrid models provide incremental value for understanding interpersonal problems. Our results indicate that the latent structure of interpersonal problems is best represented by continuous dimensions, especially when one allows for nonnormal latent distributions.

This study suggests that interpersonal problems are best characterized by continuous differences in severity and interpersonal style (i.e., agency and communion), and not by “types” of people.

A Brief but Comprehensive Review of Research on the Alternative DSM-5 Model for Personality Disorders

PURPOSE OF REVIEW

Both the Alternative DSM-5 Model for Personality Disorders (AMPD) and the chapter on personality disorders (PD) in the recent version of ICD-11 embody a shift from a categorical to a dimensional paradigm for the classification of PD. We describe these new models, summarize available measures, and provide a comprehensive review of research on the AMPD.

RECENT FINDINGS

A total of 237 publications on severity (criterion A) and maladaptive traits (criterion B) of the AMPD indicate (a) acceptable interrater reliability, (b) largely consistent latent structures, (c) substantial convergence with a range of theoretically and clinically relevant external measures, and (d) some evidence for incremental validity when controlling for categorical PD diagnoses. However, measures of criterion A and B are highly correlated, which poses conceptual challenges. The AMPD has stimulated extensive research with promising findings. We highlight open questions and provide recommendations for future research.

Construction and Validation of the Interpersonal Influence Tactics Circumplex (IIT-C) Scales

Assessment of interpersonal dispositions (e.g., traits, problems) commonly employs self- and informant-report measures that conform to the two-dimensional interpersonal circumplex (IPC) model. Here, we adopted the IPC and interpersonal theory as a framework for mapping the universe of content of interpersonal influence. Although there are existing measures of influence tactics used in influence research, this literature is divided among disciplines with varying construct definitions and no unifying theory. Here, we define interpersonal influence as the conscious maneuvering of one's behavior to engender desired responses from others in interpersonal situations. The current article details the construction and validation of the Interpersonal Influence Tactics Circumplex (IIT-C) Scales in two samples (Ns = 862, 608). The 64-item IIT-C assesses a comprehensive taxonomy of interpersonal influence tactics conforming to the structure of the IPC. Circumplex structure of the IIT-C was confirmed and replicated. Using the structural summary method for circumplex data, associations with other IPC measures, existing measures of influence, normal personality traits, and pathological personality traits supported the validity of IIT-C scores. The IIT-C assesses a theoretically based and empirically derived set of interpersonal influence tactics and provides a common language for integrating distinct streams of influence research by conforming to the IPC.

Improving self-esteem through integrative group therapy for personality dysfunction: Investigating the role of the therapeutic alliance and quality of object relations

OBJECTIVE

We aimed to investigate change in self-esteem through intensive group treatment for personality dysfunction, by exploring: (a) the relationship between patients' experience of therapeutic alliance and improvement in self-esteem during treatment, including patients' quality of object-relations (QOR) as a possible moderator; and (b) the association between improvement in self-esteem during treatment, and depressive symptoms 9 months later.

METHOD

Eighty patients with personality dysfunction, consecutively enrolled in a group-oriented treatment program, were assessed at pretreatment, posttreatment, and 9 months follow-up.

RESULTS

Especially for patients with lower QOR, alliance predicted self-esteem change during treatment. In addition, change in self-esteem during treatment predicted follow-up depression severity, even when controlling for within-treatment symptom change.

CONCLUSIONS

Patients with impoverished inner relational representations may benefit more from a secure alliance in terms of improving their self-esteem. Change in self-esteem may also be important in preventing relapse of depressive symptoms in people with personality dysfunction.

Maladaptive personality traits and romantic relationship satisfaction: A monozygotic co-twin control analysis

The recent inclusion of an alternative model for personality disorders in the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5; American Psychiatric Association, 2013a) highlights the importance of extreme variants of personality for psychopathology. The maladaptive personality traits described in the alternative model comprise 5 higher-order domains and 25 lower-order facets that capture pathological levels of personality. The present report adds to a growing body of research on the implications of maladaptive personality traits for functioning by demonstrating significant associations between each of the higher-order domains (Negative Affect, Detachment, Antagonism, Disinhibition, and Psychoticism) and most of the lower-order facets and lower romantic relationship satisfaction in a population-based sample of 284 monozygotic (MZ) adult twins. We further capitalized upon co-twin differences in levels of personality pathology in a causally informative approach, the MZ co-twin control study design. Co-twin control analyses indicated that higher levels of Negative Affect, Detachment, Disinhibition, and Psychoticism, as well as several lower-order facets, were associated with lower romantic relationship satisfaction even after accounting for the genetic and environmental factors shared by twins that confer liability toward personality pathology and psychosocial dysfunction. The present results lend support to the potentially causal implications of personality pathology for interpersonal functioning, even in a community sample unlikely to be evidencing clinical levels of pathology, by suggesting that extreme variants of personality, manifested by comparably extreme deviations in thinking, feeling, behaving, and interacting with others, may lead to impaired functioning in important domains. (PsycINFO Database Record

A framework for treating DSM-5 alternative model for personality disorder features

Despite its demonstrated empirical superiority over the DSM-5 Section 2 categorical model of personality disorders for organizing the features of personality pathology, limitations remain with regard to the translation of the DSM-5 Section 3 alternative model of personality disorders (AMPD) to clinical practice. The goal of this paper is to outline a general and preliminary framework for approaching treatment from the perspective of the AMPD. Specific techniques are discussed for the assessment and treatment of both Criterion A personality dysfunction and Criterion B maladaptive traits. A concise and step-by-step model is presented for clinical decision making with the AMPD, in the hopes of offering clinicians a framework for treating personality pathology and promoting further research on the clinical utility of the AMPD. Copyright © 2018 John Wiley & Sons, Ltd.

The construct validity of general and specific dimensions of personality pathology

BACKGROUND

Modern personality disorder (PD) theory and research attempt to distinguish transdiagnostic impairments common to all PDs from constructs that explain varied PD expression. Bifactor modeling tests such distinctions; however, the only published PD criteria bifactor analysis focused on only 6 PDs and did not examine the model's construct validity.

METHODS

We examined the structure and construct validity of competing PD criteria models using confirmatory and exploratory factor analytic methods in 628 patients who completed structured diagnostic interviews and self-reports of personality traits and impairment.

RESULTS

Relative to alternative models, two bifactor models - one confirmatory model with 10 specific factors for each PD (acceptable fit) and one exploratory model with four specific factors resembling broad personality domains (excellent fit) - fit best and were compared via connections with external criteria. General and specific factors related meaningfully and differentially to personality traits, internalizing symptoms, substance use, and multiple indices of psychosocial impairment. As hypothesized, the general factor predicted interpersonal dysfunction above and beyond other psychopathology. The general factor also correlated strongly with many pathological personality traits.

CONCLUSIONS

The present study supported the validity of a model with both a general PD impairment dimension and separate individual difference dimensions; however, it also indicated that currently prominent models, which assume general PD impairments and personality traits are non-overlapping, may be misspecified.

Personality traits and maladaptivity: Unipolarity versus bipolarity

OBJECTIVE

Dimensional personality trait models have gained favor as an alternative to categorical personality disorder (PD) diagnosis; however, debate persists regarding whether these traits should be conceptualized as maladaptive at both extremes (i.e., maladaptively bipolar) or just one trait pole (i.e., unipolar).

METHOD

To inform the debate on maladaptive bipolarity, linear and nonlinear relations between personality traits and dysfunction were examined in a large psychiatric patient sample (N = 365). Participants self-reported on normal-range and pathological personality domains, life satisfaction, specific interpersonal problems, and broad psychosocial functioning. In addition, participants were interviewed regarding specific psychiatric symptoms and broad psychosocial functioning.

RESULTS

All traits related moderately to strongly with at least one dysfunction variable. All traits were predominantly correlated with dysfunction at one pole; however, several small linear relations provided some evidence for maladaptively high Extraversion and Agreeableness. None of the significant nonlinear effects provided clear evidence for maladaptivity at both ends of any trait.

CONCLUSIONS

Taken together, these results suggest that broad personality traits are predominantly maladaptive at one extreme; however, in limited cases, the opposite extreme may also be maladaptive.

Interpersonal problems across levels of the psychopathology hierarchy

We examined the relationship between psychopathology and interpersonal problems in a sample of 825 clinical and community participants. Sixteen psychiatric diagnoses and five transdiagnostic dimensions were examined in relation to self-reported interpersonal problems. The structural summary method was used with the Inventory of Interpersonal Problems Circumplex Scales to examine interpersonal problem profiles for each diagnosis and dimension. We built a structural model of mental disorders including factors corresponding to detachment (avoidant personality, social phobia, major depression), internalizing (dependent personality, borderline personality, panic disorder, posttraumatic stress, major depression), disinhibition (antisocial personality, drug dependence, alcohol dependence, borderline personality), dominance (histrionic personality, narcissistic personality, paranoid personality), and compulsivity (obsessive-compulsive personality). All dimensions showed good interpersonal prototypicality (e.g., detachment was defined by a socially avoidant/nonassertive interpersonal profile) except for internalizing, which was diffusely associated with elevated interpersonal distress. The findings for individual disorders were largely consistent with the dimension that each disorder loaded on, with the exception of the internalizing and dominance disorders, which were interpersonally heterogeneous. These results replicate previous findings and provide novel insights into social dysfunction in psychopathology by wedding the power of hierarchical (i.e., dimensional) modeling and interpersonal circumplex assessment.

Interpersonal dysfunction in personality disorders: A meta-analytic review

Personality disorders are defined in the current psychiatric diagnostic system as pervasive, inflexible, and stable patterns of thinking, feeling, behaving, and interacting with others. Questions regarding the validity and reliability of the current personality disorder diagnoses prompted a reconceptualization of personality pathology in the most recent edition of the psychiatric diagnostic manual, in an appendix of emerging models for future study. To evaluate the construct and discriminant validity of the current personality disorder diagnoses, we conducted a quantitative synthesis of the existing empirical research on associations between personality disorders and interpersonal functioning, defined using the interpersonal circumplex model (comprising orthogonal dimensions of agency and communion), as well as functioning in specific relationship domains (parent-child, family, peer, romantic). A comprehensive literature search yielded 127 published and unpublished studies, comprising 2,579 effect sizes. Average effect sizes from 120 separate meta-analyses, corrected for sampling error and measurement unreliability, and aggregated using a random-effects model, indicated that each personality disorder showed a distinct profile of interpersonal style consistent with its characteristic pattern of symptomatic dysfunction; specific relationship domains affected and strength of associations varied for each personality disorder. Overall, results support the construct and discriminant validity of the personality disorders in the current diagnostic manual, as well as the proposed conceptualization that disturbances in self and interpersonal functioning constitute the core of personality pathology. Importantly, however, contradicting both the current and proposed conceptualizations, there was not evidence for pervasive dysfunction across interpersonal situations and relationships. (PsycINFO Database Record

Differentiating Dark Triad Traits Within and Across Interpersonal Circumplex Surfaces

Recent discussions surrounding the Dark Triad (narcissism, psychopathy, and Machiavellianism) have centered on areas of distinctiveness and overlap. Given that interpersonal dysfunction is a core feature of Dark Triad traits, the current study uses self-report data from 562 undergraduate students to examine the interpersonal characteristics associated with narcissism, psychopathy, and Machiavellianism on four interpersonal circumplex (IPC) surfaces. The distinctiveness of these characteristics was examined using a novel bootstrapping methodology for computing confidence intervals around circumplex structural summary method parameters. Results suggest that Dark Triad traits exhibit distinct structural summary method parameters with narcissism characterized by high dominance, psychopathy characterized by a blend of high dominance and low affiliation, and Machiavellianism characterized by low affiliation on the problems, values, and efficacies IPC surfaces. Additionally, there was some heterogeneity in findings for different measures of psychopathy. Gender differences in structural summary parameters were examined, finding similar parameter values despite mean-level differences in Dark Triad traits. Finally, interpersonal information was integrated across different IPC surfaces to create profiles associated with each Dark Triad trait and to provide a more in-depth portrait of associated interpersonal dynamics.

Beyond Description in Interpersonal Construct Validation: Methodological Advances in the Circumplex Structural Summary Approach

The interpersonal circumplex is a well-established structural model that organizes interpersonal functioning within the two-dimensional space marked by dominance and affiliation. The structural summary method (SSM) was developed to evaluate the interpersonal nature of other constructs and measures outside the interpersonal circumplex. To date, this method has been primarily descriptive, providing no way to draw inferences when comparing SSM parameters across constructs or groups. We describe a newly developed resampling-based method for deriving confidence intervals, which allows for SSM parameter comparisons. In a series of five studies, we evaluated the accuracy of the approach across a wide range of possible sample sizes and parameter values, and demonstrated its utility for posing theoretical questions on the interpersonal nature of relevant constructs (e.g., personality disorders) using real-world data. As a result, the SSM is strengthened for its intended purpose of construct evaluation and theory building.