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Wyssen A, Lerch S, Reichl C, Mürner-Lavanchy I, Sigrist C, Schär S, Cavelti M, Koenig J, Kaess M. Comparing the new concept of impairment in personality functioning with borderline personality disorder: differential psychosocial and psychopathological correlates in a clinical adolescent sample. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02555-y. [PMID: 39150466 DOI: 10.1007/s00787-024-02555-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 08/05/2024] [Indexed: 08/17/2024]
Abstract
Borderline personality disorder (BPD) is an established diagnosis in adolescence with high comorbidity and psychosocial impairment. With the introduction of the alternative model for personality disorders in DSM-5 (AMPD), personality functioning is operationalized using the Level of Personality Functioning Scale (LPFS), which has been shown to be associated with severity of personality pathology. The present study aimed at examining differential psychopathological and psychosocial correlates of LPFS and BPD. A total of 526 adolescent in- and outpatients were interviewed with the STiP-5.1 (LPFS) and the SCID-II. Mixed linear regression was used to investigate the associations between the two interviews with measures of psychopathology and psychosocial impairment. 11.4% met the diagnostic threshold of both interviews, 16.1% only of the LPFS, and 64.1% were below the diagnostic threshold in both interviews (no PD). The BPD only group was larger than expected-8.4% of patients who met criteria for BPD did not fulfill criteria for significant impairment in the LPFS. The highest burden was found in individuals concurrently showing significant impairment in LPFS and fulfilling BPD diagnosis (LPFS + BPD). Differences between the LPFS only group and the BPD only group were found in risk behavior and traumatic experiences, with higher prevalence in the BPD group. Findings confirm the high psychopathological burden and psychosocial impairment associated with both BPD and LPFS. Those exceeding the diagnostic threshold of LPFS in combination with a BPD diagnosis are characterized by greatest disability. Not all adolescents fulfilling formal BPD diagnosis showed a clinically significant impairment in LPFS, which may refer to a distinct diagnostic group.
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Affiliation(s)
- Andrea Wyssen
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Stefan Lerch
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Corinna Reichl
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Ines Mürner-Lavanchy
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Christine Sigrist
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Selina Schär
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Marialuisa Cavelti
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Julian Koenig
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
- Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany.
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Yalch MM, Stone SN. An Evolutionary Perspective on the DSM-5 Alternative Model for Personality Disorders. J Pers Disord 2024; 38:268-283. [PMID: 38857160 DOI: 10.1521/pedi.2024.38.3.268] [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: 06/12/2024]
Abstract
Recent work has nested the Alternative Model for Personality Disorders (AMPD) within several theoretical paradigms of personality and clinical psychology (e.g., multivariate, psychodynamic). This has both spurred on additional research and aided in practical application. Connecting the model to other theoretical heuristics may lead to further advances. One candidate for such a theory is that of evolutionary psychology, which attempts to provide explanations of human behavior (including personality traits) rooted in adaptation. In this article, we review and integrate the theoretical and empirical literature on the AMPD and evolutionary psychology, providing a synthesis of the two models in the hope of furthering the research and application of both.
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Aluja A, Balada F, Atitsogbe KA, Rossier J, García LF. Convergence of the dimensional assessment of personality pathology (DAPP-BQ) and the five-factor personality inventory for the international classification of diseases 11th edition (FFiCD) in the context of the five-factor model and personality disorders. BMC Psychiatry 2024; 24:386. [PMID: 38773491 PMCID: PMC11110343 DOI: 10.1186/s12888-024-05835-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 05/09/2024] [Indexed: 05/23/2024] Open
Abstract
The current manuscript presents the convergence of the Dimensional Assessment of Personality Pathology (DAPP-BQ), using its short form the DAPP-90, and the Five-Factor Personality Inventory for International Classification of Diseases (ICD-11), the FFiCD, in the context of the five-factor personality model and the categorical approach of personality disorders (PDs). The current manuscript compares the predictive validity of both the FFiCD and the DAPP-90 regarding personality disorder scales and clusters. Results demonstrate a very high and meaningful convergence between the DAPP-90 and the FFiCD personality pathology models and a strong alignment with the FFM. The DAPP-90 and the FFiCD also present an almost identical predictive power of PDs. The DAPP-90 accounts for between 18% and 47%, and the FFiCD between 21% and 47% of PDs adjusted variance. It is concluded that both DAPP-90 and FFiCD questionnaires measure strongly similar pathological personality traits that could be described within the frame of the FFM. Additionally, both questionnaires predict a very similar percentage of the variance of personality disorders.
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Affiliation(s)
- Anton Aluja
- Human Behavior Laboratory, Lleida Institute for Biomedical Research Dr. Pifarré Foundation (IRBLleida), Catalonia, Spain.
- University of Lleida, Catalonia, Spain.
| | - Ferran Balada
- Human Behavior Laboratory, Lleida Institute for Biomedical Research Dr. Pifarré Foundation (IRBLleida), Catalonia, Spain
- Deparment of Psychobiology, Autonomous University of Barcelona, Catalonia, Spain
| | - Kokou A Atitsogbe
- Institute of Psychology, Faculty of Social and Political Sciences, University of Lausanne, Lausanne, Switzerland
| | - Jérôme Rossier
- Institute of Psychology, Faculty of Social and Political Sciences, University of Lausanne, Lausanne, Switzerland
| | - Luis F García
- Human Behavior Laboratory, Lleida Institute for Biomedical Research Dr. Pifarré Foundation (IRBLleida), Catalonia, Spain
- Department of Biological and Health Psychology, Autonomous University of Madrid, Madrid, Spain
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Hopwood CJ. Personality Functioning, Problems in Living, and Personality Traits. J Pers Assess 2024:1-16. [PMID: 38700238 DOI: 10.1080/00223891.2024.2345880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 04/12/2024] [Indexed: 05/05/2024]
Abstract
The publication of the Alternative Model of Personality Disorder (AMPD) was a signpost achievement in the personality assessment. However, research on the AMPD has generally not led to either a deeper understanding of personality disorder or personality assessment or new ideas about how to provide better care for people with personality disorder diagnoses. A significant portion of research has focused on narrow issues and appears to be driven in part by ideological differences between scholars who prefer Criterion A (personality functioning) or Criterion B (maladaptive traits). I trace these issues to ambiguity about the concept of personality functioning as defined in the AMPD and its conceptual distinction from personality traits and problems in living. In this paper, I reground these concepts in coherent and distinct definitions, elaborate upon the implications of their differences, and show how these differences can help clarify and reorient AMPD research to focus on generating clinically useful models for personality pathology and personality assessment.
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Kotov R, Carpenter WT, Cicero DC, Correll CU, Martin EA, Young JW, Zald DH, Jonas KG. Psychosis superspectrum II: neurobiology, treatment, and implications. Mol Psychiatry 2024; 29:1293-1309. [PMID: 38351173 DOI: 10.1038/s41380-024-02410-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 12/24/2023] [Accepted: 01/04/2024] [Indexed: 02/16/2024]
Abstract
Alternatives to traditional categorical diagnoses have been proposed to improve the validity and utility of psychiatric nosology. This paper continues the companion review of an alternative model, the psychosis superspectrum of the Hierarchical Taxonomy of Psychopathology (HiTOP). The superspectrum model aims to describe psychosis-related psychopathology according to data on distributions and associations among signs and symptoms. The superspectrum includes psychoticism and detachment spectra as well as narrow subdimensions within them. Auxiliary domains of cognitive deficit and functional impairment complete the psychopathology profile. The current paper reviews evidence on this model from neurobiology, treatment response, clinical utility, and measure development. Neurobiology research suggests that psychopathology included in the superspectrum shows similar patterns of neural alterations. Treatment response often mirrors the hierarchy of the superspectrum with some treatments being efficacious for psychoticism, others for detachment, and others for a specific subdimension. Compared to traditional diagnostic systems, the quantitative nosology shows an approximately 2-fold increase in reliability, explanatory power, and prognostic accuracy. Clinicians consistently report that the quantitative nosology has more utility than traditional diagnoses, but studies of patients with frank psychosis are currently lacking. Validated measures are available to implement the superspectrum model in practice. The dimensional conceptualization of psychosis-related psychopathology has implications for research, clinical practice, and public health programs. For example, it encourages use of the cohort study design (rather than case-control), transdiagnostic treatment strategies, and selective prevention based on subclinical symptoms. These approaches are already used in the field, and the superspectrum provides further impetus and guidance for their implementation. Existing knowledge on this model is substantial, but significant gaps remain. We identify outstanding questions and propose testable hypotheses to guide further research. Overall, we predict that the more informative, reliable, and valid characterization of psychopathology offered by the superspectrum model will facilitate progress in research and clinical care.
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Affiliation(s)
- Roman Kotov
- Department of Psychiatry and Behavioral Health, Stony Brook University, Stony Brook, NY, USA.
| | | | - David C Cicero
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Christoph U Correll
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Child and Adolescent Psychiatry, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Elizabeth A Martin
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Jared W Young
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - David H Zald
- Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA
| | - Katherine G Jonas
- Department of Psychiatry and Behavioral Health, Stony Brook University, Stony Brook, NY, USA
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Babinski DE, Kujawa A, Pegg S, Leslie JM, Pothoven C, Waschbusch DA, Sharp C. Social and Monetary Reward Processing in Youth with Early Emerging Personality Pathology: An RDoC-Informed Study. Res Child Adolesc Psychopathol 2024; 52:567-578. [PMID: 38008786 PMCID: PMC10963144 DOI: 10.1007/s10802-023-01147-9] [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] [Accepted: 10/23/2023] [Indexed: 11/28/2023]
Abstract
Very little is known about the mechanisms underlying the development of personality disorders, hindering efforts to address early risk for these costly and stigmatized disorders. In this study, we examined associations between social and monetary reward processing, measured at the neurophysiological level, and personality pathology, operationalized through the Level of Personality Functioning (LPF), in a sample of early adolescent females (Mage = 12.21 years old, SD = 1.21). Female youth with (n = 80) and without (n = 30) a mental health history completed laboratory tasks assessing social and monetary reward responsiveness using electroencephalogram (EEG) and completed ratings of personality pathology. Commonly co-occurring psychopathology, including depression, anxiety, attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD) were also assessed. At the bivariate level, significant associations did not emerge between psychopathology and reward processing variables. When covarying symptoms of depression, anxiety, ADHD, ODD, and CD, an enhanced reward positivity (RewP) component to social reward feedback (accounting for response to social rejection) was associated with higher levels of personality impairment. Results were specific to social rather than monetary reward processing. Depression, anxiety, and ODD also explained unique variance in LPF. These findings suggest that alterations in social reward processing may be a key marker for early emerging personality pathology. Future work examining the role of social reward processing on the development of LPF across adolescence may guide efforts to prevent the profound social dysfunction associated with personality pathology.
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Affiliation(s)
- Dara E Babinski
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, PA, USA.
| | - Autumn Kujawa
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
| | - Samantha Pegg
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
| | - Julia M Leslie
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, PA, USA
| | - Cameron Pothoven
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, PA, USA
| | - Daniel A Waschbusch
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, PA, USA
| | - Carla Sharp
- Department of Psychology, University of Houston, Houston, TX, USA
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7
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Rucker J, Berry B, Sharp C. Assessing Criterion A of the Alternative Model for Personality Disorders: The Potential of Performance-Based Personality Measures. J Pers Disord 2024; 38:171-194. [PMID: 38592912 DOI: 10.1521/pedi.2024.38.2.171] [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
The conceptualization of personality disorder has been refined through recent nosological advances introduced in the Alternative Model for Personality Disorders (AMPD). These advances locate self and interpersonal (dys)function at the core of personality pathology. Self-report personality assessment instruments have demonstrated promise in the assessment of Criterion A domains. However, research highlighting the utility of performance-based personality assessment instruments has been largely absent in these advances, despite acknowledgment of their potential. We adhered to PRISMA review guidelines to survey and assess the potential relevance and utility of select performance-based personality instruments in assessing Criterion A domains of the AMPD. We conclude that performance-based personality measures are uniquely positioned to assess maladaptive self- and interpersonal functioning and may address some limitations of self-report measures. Toward this end, we propose a working model that provides ranges of test scores that correspond to the 5-point scale of the Criterion A domains of the AMPD.
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Affiliation(s)
- John Rucker
- From The Menninger Clinic, Baylor College of Medicine, Houston, Texas
| | - Benjamin Berry
- From The Menninger Clinic, Baylor College of Medicine, Houston, Texas
| | - Carla Sharp
- Department of Psychology, University of Houston
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Rivard G, Le Corff Y, Lapalme M, Forget K. Measurement invariance of the Personality Inventory for DSM-5 across sex. Front Psychiatry 2024; 15:1328937. [PMID: 38525253 PMCID: PMC10957747 DOI: 10.3389/fpsyt.2024.1328937] [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: 10/27/2023] [Accepted: 02/21/2024] [Indexed: 03/26/2024] Open
Abstract
Introduction There has been an international movement towards dimensional models of personality disorders (PDs) in the last decades, which culminated in the publication of the Alternative Model of Personality Disorders (AMPD) in the Emerging Measures and Models section of the DSM-5. This model was accompanied by a APA-sanctioned Personality Inventory for DSM-5 (PID-5) for the assessment of the AMPD pathological personality traits. One major issue with the assessment of personality disorders pertains to sex differences, and measurement invariance across sex in assessment instruments for PDs is necessary in order to ensure non-biased evaluations and to make valid comparisons between men and women. This study aimed to provide more information on measurement invariance across sex for the PID-5, using both the original scoring approach provided by the authors of the instrument and the scoring approach suggested by the APA in the published version of the PID-5. Methods This study was conducted with a sample of 2273 participants from the general Québec (Canada) adult population aged 18 to 90 years (M = 46.59; SD = 16.32; 51.8% women). Results The original scoring approach model showed good fit to data after freeing paths between certain traits and reached strict invariance. The APA scoring approach also showed good fit to data and reached strict invariance, but needed an adjustment (path freed between Emotional lability and Impulsivity in men) to reach scalar invariance. Discussion In line with previous research, the PID-5 is invariant across sex and the five-factor structure adjusts well to data. The APA scoring approach appears to attenuate the cross-loading problem observed with the original scoring approach. In light of these results, we recommend using the APA scoring approach to derive domain scores.
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Affiliation(s)
- Geneviève Rivard
- The Group for Research and Intervention on Children’s Social Adjustment (GRISE), Université de Sherbrooke, Sherbrooke, QC, Canada
- Département d’orientation Professionnelle, Faculté d’éducation, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Yann Le Corff
- The Group for Research and Intervention on Children’s Social Adjustment (GRISE), Université de Sherbrooke, Sherbrooke, QC, Canada
- Département d’orientation Professionnelle, Faculté d’éducation, Université de Sherbrooke, Sherbrooke, QC, Canada
- Département de Psychiatrie, Faculté de Médecine, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Mélanie Lapalme
- The Group for Research and Intervention on Children’s Social Adjustment (GRISE), Université de Sherbrooke, Sherbrooke, QC, Canada
- Département de Psychoéducation, Faculté d’éducation, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Karine Forget
- The Group for Research and Intervention on Children’s Social Adjustment (GRISE), Université de Sherbrooke, Sherbrooke, QC, Canada
- Département de Psychiatrie, Faculté de Médecine, Université de Sherbrooke, Sherbrooke, QC, Canada
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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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Hanegraaf L, Paton B, Hohwy J, Verdejo-Garcia A. Combining novel trait and neurocognitive frameworks to parse heterogeneity in borderline personality disorder. J Pers 2023; 91:1344-1363. [PMID: 36650906 DOI: 10.1111/jopy.12811] [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: 08/05/2022] [Revised: 12/02/2022] [Accepted: 01/12/2023] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Borderline Personality Disorder (BPD) diagnosis comprises several constellations of trait, neurocognitive, and psychosocial alterations. Dimensional models of psychopathology provide new opportunities to parse heterogeneity and create a stronger interface between individual characterization and psychosocial outcomes. However, dimensional models have focused on either traits or neurocognitive features, lacking integration to capture the multifaceted nature of BPD. METHOD We assessed 100 participants with BPD using a combination of tools stemming from trait (Alternative Model for Personality Disorders) and neurocognitive models (Research Domain Criteria; RDoC) to examine if trait-derived subgroups display distinctive social-processing and psychosocial profiles. We used two complementary analytical approaches: person-centered (k-means clustering) and construct-based (multiple factor analysis). RESULTS Our person-centered approach identified four subgroups with separable internalizing, detached, externalizing, and low psychopathology trait profiles. These profiles revealed distinctive patterns of affiliation, emotion recognition and mentalization performance in RDoC tasks, and psychosocial measures of quality of life and social connectedness. RDoC-based measures showed close construct proximity with negative affectivity, disinhibition, and antagonism trait domains, relative to the detachment domain, which had close proximity with self-knowledge. CONCLUSIONS Altogether, findings support consilience between trait-based and neurobiological frameworks and suggest that trait models are useful to parse BPD heterogeneity leading to unique social functioning profiles.
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Affiliation(s)
- Lauren Hanegraaf
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Bryan Paton
- School of Psychological Sciences, College of Engineering, Science and Environment, The University of Newcastle, Callaghan, New South Wales, 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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11
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Hopwood CJ, Morey LC, Markon KE. What is a psychopathology dimension? Clin Psychol Rev 2023; 106:102356. [PMID: 37926058 DOI: 10.1016/j.cpr.2023.102356] [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: 07/05/2023] [Revised: 09/06/2023] [Accepted: 10/30/2023] [Indexed: 11/07/2023]
Abstract
Coherence in the science and practice of mental health assessment depends upon a tight connection between psychopathology concepts that are used and the way those concepts are operationalized and defined. In contrast, the use of the same word to mean more than one thing contributes to incoherence, inefficiency, and confusion. In this paper, we review three possible meanings of the word "dimension" as it relates to the assessment of psychopathology and describe how the indiscriminate use of this word has caused confusion in the general context of the transition to a more evidence-based approach to mental health diagnosis. We attempt to disambiguate the term "dimension" by demarcating three concepts that can be distinguished based on different empirical standards: continuous variables, unidimensional dimensions, and distinct dimensions.
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12
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Cheli S, Cavalletti V, Hopwood CJ. Threatening Beliefs About Self and Others Moderate the Association Between Psychoticism and Psychological Distress. J Nerv Ment Dis 2023; 211:819-827. [PMID: 37738457 DOI: 10.1097/nmd.0000000000001726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/24/2023]
Abstract
ABSTRACT Psychoticism is a multidimensional personality construct involving odd or eccentric behavior, quasi-psychotic experiences, mistrust, interpersonal detachment, and liability for schizophrenia-spectrum disorders, as well as significant distress. Recent advances suggest it can be understood as a dimension that is continuously distributed in the population, leading to questions about factors that contribute to distress and dysfunction among people with a schizotypal liability. We investigated in a large nonclinical sample of young adults whether associations between psychoticism and psychological distress would increase in the presence of threatening beliefs. In our study ( N = 2127), we found that the association between psychoticism and psychological distress is moderated by threatening beliefs including self-criticism, fear of compassion, and socially prescribed perfectionism. These results suggest that distress increases among people with schizotypal traits in the context of negative beliefs about self and others. We discuss implications for clinical practice and directions for further research.
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Chauhan K, Donahue J, Thompson R. The predictive validity of the DSM-5 alternative model for borderline personality disorder: Associations with coping strategies, general distress, rumination, and suicidal ideation across one year. Personal Ment Health 2023; 17:272-281. [PMID: 36919337 DOI: 10.1002/pmh.1580] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 01/13/2023] [Accepted: 02/13/2023] [Indexed: 03/16/2023]
Abstract
The DSM-5 Alternative Model for Personality Disorders (AMPD) characterizes borderline personality disorder (BPD) in part as a constellation of maladaptive personality trait facets including emotional lability, anxiousness, separation insecurity, depressivity, impulsivity, risk-taking, and hostility. Previous studies have supported the construct validity of AMPD-BPD; however, research examining its predictive validity in relation to theoretically and clinically relevant constructs remains needed. The present study investigates the longitudinal relationships between AMPD-BPD and general distress, rumination, and suicidal ideation, as well as adaptive and maladaptive coping targeted in Dialectical Behavior Therapy (DBT) in a sample of participants with elevated BPD symptomology. We also examined if dysfunctional coping skill use at 9-month follow-up explained the relationship between baseline BPD traits and outcomes at 1-year. There were significant correlations between baseline trait BPD with dysfunctional coping skill use at 9-month follow-up and psychological distress and rumination at 1-year follow-up. Dysfunctional skill use exhibited a significant indirect effect in the association between trait BPD and rumination after 1 year. The findings of this study support the construct validity of AMPD-BPD that can inform treatment and research.
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Affiliation(s)
- Kapil Chauhan
- Howard University College of Medicine, Washington, DC, USA
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Cervantes BR, Kerr S, Vanwoerden S, Sharp C. Operationalizing intimacy and identity aspects of personality functioning in relation to personality disorder in adolescents. Front Psychiatry 2023; 14:1153274. [PMID: 37113535 PMCID: PMC10126270 DOI: 10.3389/fpsyt.2023.1153274] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 03/20/2023] [Indexed: 04/29/2023] Open
Abstract
According to dimensional models of personality pathology, deficits in interpersonal (intimacy and empathy) and self (identity and self-direction) function (Criterion A) are core to all personality disorders. These aspects of personality functioning (Criterion A) have seldom been evaluated for how they might relate to one another in the context of personality pathology in adolescents. Moreover, the use of performance-based measures to evaluate aspects of Criterion A function remains an untapped resource. Therefore, the present study aimed to evaluate relations between two features of Criterion A, maladaptive intimacy and maladaptive (or diffused) identity, in adolescence. For intimacy, we leverage a performance-based approach to studying intimacy, operationalized in a developmentally relevant way (perceived parental closeness). For identity, we rely on a validated self-report measure of identity diffusion. We examined the relationship between these features with each other and their relations with borderline features. Additionally, we explored whether identity diffusion mediated the expected relationship between perceived parental closeness and borderline features. We hypothesized that greater distance in perceived parental closeness would be associated with higher levels of borderline features, as well as higher levels of identity diffusion, and that identity diffusion would account for the relationship between intimacy and personality pathology. The sample included 131 inpatient adolescents (M age = 15.35, 70.2% female). Results indicated that intimacy, operationalized as perceived parental closeness, with both mothers and fathers was significantly associated with levels of identity diffusion and borderline features. In addition, greater feelings of closeness with parents were associated with lower severity of borderline features via healthier identity function. Implications of the results, limitations, and future directions are discussed.
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Affiliation(s)
| | - Sophie Kerr
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Salome Vanwoerden
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Carla Sharp
- Department of Psychology, University of Houston, Houston, TX, United States
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15
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TÖRE T. Comparative Examination of ICD-11 and DSM-5 Alternative Model in Personality Disorders. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2023. [DOI: 10.18863/pgy.1071669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Personality disorders tried to be explained by changing diagnoses and approaches varying from school to school throughout history. With the updated approaches and scientific developments in today's diagnostic booklets, developing and more understandable diagnostic categories for personality disorders are created. New models can be an important resource for diagnosis, treatment and common language among clinicians. Both ICD-11 and DSM-5 main part section III. have highlighted new models beyond the previous personality disorders diagnostic approach. In both models, personality disorders are examined according to severity levels and prominent personality features model. Moreover, personality disorder includes structures that take into account the course of basic personality traits such as self, identity and bilateral relations. While DSM-5 part III. Alternative model on personality disorders section has a content of 5 prominent features, 25 sub-features and functionality which are all for evaluating the disorder, the ICD-11 model includes an approach that includes five features and borderline pattern and definitions, and a 4-dimensional structure in which functionality is evaluated. Although both models include models of features that stand out in personality but not completely overlap with each other. For example, while Psychoticism finds its place as a personality trait in alternative model in section III of DSM-5, as it is not accepted in personality feature in ICD-11. In contrast, the borderline pattern is not named as a feature in DSM-5 in section III, but the ICD-11 treats the borderline pattern as a kind of feature. This is one of the important differences between the two guidelines. Similarly, the criteria by which functionality and impairment are evaluated are not compatible with each other and do not progress in parallel. This means that two different guidelines accept different severity levels as thresholds. However, it can be said that both models accept the personality disorders approach, which includes longitudinal processes in which personality traits can be seen instead of categorical models. The differences between the new models can be interpreted as an obstacle to the development of a common language in terms of diagnosis and treatment.
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16
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Profiles of patients with a personality disorder admitted in a day hospital treatment program: Revealing spectra from the Hierarchical Taxonomy of Psychopathology. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04388-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
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17
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De Wit-De Visser B, Rijckmans M, Vermunt JK, van Dam A. Pathways to antisocial behavior: a framework to improve diagnostics and tailor therapeutic interventions. Front Psychol 2023; 14:993090. [PMID: 36844347 PMCID: PMC9947159 DOI: 10.3389/fpsyg.2023.993090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 01/17/2023] [Indexed: 02/11/2023] Open
Abstract
The Antisocial Personality Disorder (ASPD), and antisocial behavior (ASB) in general, is associated with significant impact on individuals themselves, their environment, and society. Although various interventions show promising results, no evidence-based treatments are available for individuals with ASPD. Therefore, making informed choices about which treatment can be applied to an individual patient is complicated. Furthermore, contradictory findings on therapy effectiveness and underlying factors of ASB, such as cognitive impairments and personality traits, fuel the debate whether the conceptualization of ASPD in the DSM-5 is accurate and whether this population can be seen as homogeneous. A conceptual framework, based on the reciprocal altruism theory, is presented in which we propose different pathways to ASB. These pathways suggest underlying dynamics of ASB and provide an explanation for previous contradictory research outcomes. This framework is intended to serve as a clinically relevant model that provides directions for improving diagnostics and matching treatments to underlying dynamics in the antisocial population.
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Affiliation(s)
- Brenda De Wit-De Visser
- GGZ WNB, Research and Innovation, Halsteren, Netherlands
- Tilburg School of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welfare, Tilburg University, Tilburg, Netherlands
| | - Madeleine Rijckmans
- Fivoor, Fivoor Science and Treatment Innovation, Poortugaal, Netherlands
- Clinical and Forensic Psychology, Department of Developmental Psychology, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
| | - Jeroen K. Vermunt
- Department of Methodology and Statistics, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
| | - Arno van Dam
- GGZ WNB, Research and Innovation, Halsteren, Netherlands
- Tilburg School of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welfare, Tilburg University, Tilburg, Netherlands
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18
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Nysaeter TE, Hummelen B, Christensen TB, Eikenaes IUM, Selvik SG, Pedersen G, Bender DS, Skodol AE, Paap MCS. The Incremental Utility of Criteria A and B of the DSM-5 Alternative Model for Personality Disorders for Predicting DSM-IV/DSM-5 Section II Personality Disorders. J Pers Assess 2023; 105:111-120. [PMID: 35285763 DOI: 10.1080/00223891.2022.2039166] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The DSM-5 Alternative Model for Personality Disorders (AMPD) includes two main criteria: moderate or greater impairment in personality functioning (Criterion A) and the presence of one or more pathological personality traits (Criterion B). The aim of the study was to investigate the incremental utility of Criteria A and B for predicting DSM-5 Section II personality disorders (PD). The sample (N = 317) consisted of three well-defined groups: non-clinical participants (n = 35), psychiatric patients with PD (n = 193), and without PD (n = 83). All were assessed using the Structured Clinical Interview for the DSM-5 Alternative Model for Personality Disorders Module I (SCID-5-AMPD-I): Level of Personality Functioning Scale (LPFS), and the Personality Inventory for DSM-5 (PID-5). Logistic regression analyses showed that the SCID-5-AMPD-I could predict the presence of PDs in general, and the three specific PDs that were investigated (i.e., Antisocial, Borderline, and Avoidant PDs). The PID-5 domains enhanced prediction of the specific PDs, but not the presence of PDs in general, when entered in the second step. Our results support the AMPD model: Criterion A predicted the presence of DSM-5 Section II PDs in general, whereas measures of Criterion B incremented prediction of Antisocial, Borderline, and Avoidant PDs.
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Affiliation(s)
| | - Benjamin Hummelen
- Department of Research and Innovation, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | | | - Ingeborg Ulltveit-Moe Eikenaes
- National Advisory Unit for Personality Psychiatry (NAPP), Oslo university Hospital, Oslo, Norway.,Division of Mental Health and Addiction Treatment, Vestfold Hospital Trust, Tønsberg, Norway
| | | | - Geir Pedersen
- The Norwegian Centre of Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Section for Personality Psychiatry and Specialized Treatments, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Donna S Bender
- Division of Computer Science and Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Andrew E Skodol
- Department of Psychiatry, University of Arizona College of Medicine, Tucson, AZ, USA
| | - Muirne C S Paap
- Department of Research and Innovation, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Department of Child and Family Welfare, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
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19
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Le Corff Y, Aluja A, Rossi G, Lapalme M, Forget K, García LF, Rolland JP. Construct Validity of the Dutch, English, French, and Spanish LPFS-BF 2.0: Measurement Invariance Across Language and Gender and Criterion Validity. J Pers Disord 2022; 36:662-679. [PMID: 36454156 DOI: 10.1521/pedi.2022.36.6.662] [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: 12/05/2022]
Abstract
With the introduction of the Alternative Model of Personality Disorders in the DSM-5, the need for short measures of the level of personality functioning has emerged, both for screening purposes and for assessing change during treatment. The Level of Personality Functioning Scale-Brief Form 2.0 (LPFS-BF 2.0) was constructed for this and has received support for its two-factor structure and criterion validity. The authors aimed to provide additional construct validity evidence for the LPFS-BF 2.0 by examining its factor structure and measurement invariance across the Dutch, English, French, and Spanish versions and across gender, and its criterion validity. Results showed that the two-factor model had a good fit to the data in the four linguistic versions. Configural and metric invariance were supported across linguistic versions and gender, while scalar invariance was partially supported. Reporting a mental health disorder and having consulted with a mental health professional were associated with higher LPFS-BF 2.0 scores.
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Affiliation(s)
- Yann Le Corff
- Groupe de recherche et d'intervention sur les adaptations sociales de l'enfance (GRISE), Département d'orientation professionnelle, Faculté d'éducation, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Anton Aluja
- Human Behavior Laboratory, Lleida Institute for Biomedical Research Dr. Pifarré Foundation and Department of Psychology, University of Lleida, Catalonia, Spain
| | - Gina Rossi
- Department of Psychology, Personality and Psychopathology Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Mélanie Lapalme
- Groupe de recherche et d'intervention sur les adaptations sociales de l'enfance (GRISE), Département d'orientation professionnelle, Faculté d'éducation, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Karine Forget
- Groupe de recherche et d'intervention sur les adaptations sociales de l'enfance (GRISE), Département d'orientation professionnelle, Faculté d'éducation, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Luis F García
- Lleida Institute for Biomedical Research Dr. Pifarré Foundation and Department of Psychology, Autonomous University of Madrid, Spain
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20
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Komasi S, Hemmati A, Rezaei F, Rahmani K, Miettunen J, Amianto F, Hopwood CJ. Comparison of the relative sensitivity of two dimensional personality models to the psychopathological symptoms: the section III DSM-5 maladaptive traits versus affective temperaments. BMC Psychiatry 2022; 22:503. [PMID: 35897003 PMCID: PMC9327203 DOI: 10.1186/s12888-022-04156-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 07/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Personality Inventory for DSM-5 (PID-5) and Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A) are tools designed for personality dispositions for mental health symptoms. The present study was conducted to compare these models in terms of their relative sensitivity to the symptoms of personality disorders (PDs) and non-personality disorders (NPDs). METHODS Subjects in this cross-sectional study were 1232 (805 female; 63.5%) community samples in western Iran. Data were collected using the PID-5, the TEMPS-A, the Symptom Checklist-90 (SCL-90-R), and the Personality Diagnostic Questionnaire (PDQ-4). Correlations and Regression models were used to examine associations between traits and symptoms. RESULTS Maladaptive traits assessed by the PID-5 were more strongly associated with PD symptoms, whereas affective temperaments measured by the TEMPS-A were more strongly associated with NPD symptoms. CONCLUSION The present findings highlighted the practical utility of both the PID-5 and TEMPS-A indicating risk for psychopathology, but also suggest a distinction between PDs and NPDs in terms of underlying personality dispositions.
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Affiliation(s)
- Saeid Komasi
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran. .,Neurosciences Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Azad Hemmati
- grid.411189.40000 0000 9352 9878Department of Psychology, University of Kurdistan, Sanandaj, Iran
| | - Farzin Rezaei
- Neurosciences Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran. .,Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Khaled Rahmani
- grid.484406.a0000 0004 0417 6812Liver and Digestive Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Jouko Miettunen
- grid.10858.340000 0001 0941 4873Center for Life Course Health Research, University of Oulu, & Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Federico Amianto
- grid.7605.40000 0001 2336 6580Department of Neurosciences, Psychiatry Section, Regional Pilot Centre for Eating Disorders, University of Torino, Torino, Italy
| | - Christopher J. Hopwood
- grid.7400.30000 0004 1937 0650Department of Psychology, University of Zurich, Zurich, Switzerland
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21
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Maerz J, Buchheim A, Rabl L, Riedl D, Viviani R, Labek K. The interplay of Criterion A of the Alternative Model for Personality Disorders, mentalization and resilience during the COVID-19 pandemic. Front Psychol 2022; 13:928540. [PMID: 35959052 PMCID: PMC9358045 DOI: 10.3389/fpsyg.2022.928540] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 07/04/2022] [Indexed: 01/07/2023] Open
Abstract
Background and aims The COVID-19 pandemic has been accompanied by a worsening of mental health levels in some, while others manage to adapt or recover relatively quickly. Transdiagnostic factors such as personality functioning are thought to be involved in determining mental health outcomes. The present study focused on two constructs of personality functioning, Criterion A of the Alternative Model for Personality Disorders (AMPD, DSM-5) and mentalization, as predictors of depressive symptoms and life satisfaction during the COVID-19 pandemic. A second focus of the study was to examine whether this relationship was mediated by resilience. Methods Linear regression analyses were used to examine the relationship between personality functioning measured by Criterion A (AMPD, DSM-5) and mentalizing abilities as predictors, and depression and life satisfaction as mental health outcomes. To assess the hypothesis that this relationship is mediated by resilience a structural equation modeling approach was conducted. Data from N = 316 individuals from the general population were collected. Results Linear regression models revealed highly significant associations between Criterion A/mentalization and both outcome measures. Structural equation models showed a significant partial mediation by resilience of these relationships. Conclusion Our results support the hypothesis that mentalizing serves as a protective function by promoting resilience to the impact of stress and threats. Criterion A and mentalization performed similarly as predictors of mental health outcomes, providing empirically overlapping operationalizations of personality functioning. This finding emphasizes the importance of personality functioning in positive and negative mental health outcomes. Furthermore, our results are consistent with a mediating role of resilience.
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Affiliation(s)
- Jeff Maerz
- Institute of Psychology, University of Innsbruck, Innsbruck, Austria
| | - Anna Buchheim
- Institute of Psychology, University of Innsbruck, Innsbruck, Austria
| | - Luna Rabl
- Institute of Psychology, University of Innsbruck, Innsbruck, Austria
| | - David Riedl
- University Hospital of Psychiatry II, Medical University Innsbruck, Innsbruck, Austria
| | - Roberto Viviani
- Institute of Psychology, University of Innsbruck, Innsbruck, Austria
- Department of Psychiatry and Psychotherapy III, University of Ulm, Ulm, Germany
| | - Karin Labek
- Institute of Psychology, University of Innsbruck, Innsbruck, Austria
- *Correspondence: Karin Labek,
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22
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Yan R, Ringwald WR, Hernandez JV, Kehl M, Bae SW, Dey AK, Low C, Wright AGC, Doryab A. Exploratory Machine Learning Modeling of Adaptive and Maladaptive Personality Traits from Passively Sensed Behavior. FUTURE GENERATIONS COMPUTER SYSTEMS : FGCS 2022; 132:266-281. [PMID: 35342213 PMCID: PMC8951872 DOI: 10.1016/j.future.2022.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Continuous passive sensing of daily behavior from mobile devices has the potential to identify behavioral patterns associated with different aspects of human characteristics. This paper presents novel analytic approaches to extract and understand these behavioral patterns and their impact on predicting adaptive and maladaptive personality traits. Our machine learning analysis extends previous research by showing that both adaptive and maladaptive traits are associated with passively sensed behavior providing initial evidence for the utility of this type of data to study personality and its pathology. The analysis also suggests directions for future confirmatory studies into the underlying behavior patterns that link adaptive and maladaptive variants consistent with contemporary models of personality pathology.
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Affiliation(s)
- Runze Yan
- School of Engineering and Applied Science, University of Virginia, United States
| | | | - Julio Vega Hernandez
- Mobile Sensing + Health Institute, Center for Behavioral Health, Media, and Technology, University of Pittsburgh, United States
| | - Madeline Kehl
- Department of Psychology, University of Pittsburgh, United States
| | - Sang Won Bae
- School of Systems and Enterprises, Stevens Institute of Technology, United States
| | - Anind K Dey
- Information School, University of Washington, United States
| | - Carissa Low
- Mobile Sensing + Health Institute, Center for Behavioral Health, Media, and Technology, University of Pittsburgh, United States
| | - Aidan G C Wright
- Department of Psychology, University of Pittsburgh, United States
| | - Afsaneh Doryab
- School of Engineering and Applied Science, University of Virginia, United States
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23
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Mulay AL, Lenger KA, Waugh MH, Cain NM, Florimbio AR, Gottfried ED, Lenzenweger MF, Lewis KC, Shier EK. Contributions of Multimethod Personality Assessment in Indirect Evaluation. J Pers Assess 2022:1-12. [PMID: 35771230 DOI: 10.1080/00223891.2022.2090370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Indirect assessment is a useful tool in forensic evaluation, especially in cases of threat assessment. To this end, we illustrated the ability to conceptualize a complicated case (i.e., Theodore John Kaczynski) using an indirect approach, with a particular emphasis upon dimensional frameworks of personality. Raters who were unrelated to Mr. Kaczynski's case and with expertise in relevant domains were asked to study information available in the public domain about Mr. Kaczynski and provide ratings using several assessment instruments. Our aim was not to provide a professional clinical opinion, but rather engage in scholarly discourse about the utility of instruments. Mr. Kaczynski was rated to demonstrate characteristics associated with lone actor terrorists. He showed an elevation on a measure of psychosis, and raters conceptualized trauma as an important aspect of his functioning. He demonstrated impairments in detachment and psychoticism (Criterion B of the AMPD) and interpersonal functioning (Criterion A of the AMPD). Clinical conceptualizations for Mr. Kaczynski emphasized schizotypal and paranoid personality disorders. This analysis of an infamous case about which considerable data are publicly available demonstrates the ease with which indirect and multimethod assessment can be applied and integrated in forensic assessment, using modern conceptualizations of personality pathology.
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Affiliation(s)
- Abby L Mulay
- Department of Psychiatry and Behavioral Sciences, Community and Public Safety Psychiatry Division, Medical University of South Carolina
| | | | - Mark H Waugh
- Department of Psychology, University of Tennessee, Knoxville
| | - Nicole M Cain
- Graduate School of Applied and Professional Psychology, Rutgers University
| | | | - Emily D Gottfried
- Department of Psychiatry and Behavioral Sciences, Community and Public Safety Psychiatry Division, Medical University of South Carolina
| | - Mark F Lenzenweger
- Department of Psychology, State University of New York at Binghamton, & Department of Psychiatry, Weill Cornell Medical College
| | | | - Emily K Shier
- College of Humanities & Social Sciences, Grand Canyon University
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24
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Dolczewski M. Semi-structured interview for self-esteem regulation research. Acta Psychol (Amst) 2022; 228:103642. [PMID: 35716626 DOI: 10.1016/j.actpsy.2022.103642] [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: 03/15/2022] [Revised: 06/03/2022] [Accepted: 06/06/2022] [Indexed: 11/16/2022] Open
Abstract
There are numerous controversies in research exploring personality dynamics and intrapsychic processes, e.g. insufficient insight provided by available measures such as self-report questionnaires. As a consequence, new methods are developed. Some of the recent theories indicate that self-esteem is not a stable personality trait, but a dynamic construct fluctuating as a result of (mostly) social interactions. I present a semi-structured interview protocol as a method of data collection which can provide rich verbal and non-verbal material referring to self-esteem regulation. Analysis system is not included as there can be many different approaches to use collected data, e.g. qualitative content analysis or narrative inquiry methods. In this paper, I present exemplary statements of participants corresponding to every part of the interview. The examples are explained considering theoretical background. Finally, the strengths and limitations of presented method are discussed, as well as possible research areas to explore with it.
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Affiliation(s)
- Michał Dolczewski
- Department of Psychology and Cognitive Science, Adam Mickiewicz University, Szamarzewskiego 89/AB 60 - 568, Poznań, Poland.
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25
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Guillot-Valdés M, Guillén-Riquelme A, Buela-Casal G. Content Validity through Expert Judgment for the Depression Clinical Evaluation Test. Int J Clin Health Psychol 2022; 22:100292. [PMID: 35572073 PMCID: PMC9055062 DOI: 10.1016/j.ijchp.2022.100292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 12/14/2021] [Indexed: 12/20/2022] Open
Abstract
Background/Objective The evaluation of depression requires valid and reliable measuring instruments, which collect a wide spectrum of symptoms that this disorder displays, in order to carry out an accurate and differential diagnosis. The objective of this work is the construction of the Depression Clinical Evaluation Test (DCET), where affective, somatic, cognitive, behavioral and interpersonal symptoms are considered and also analyze its content validity through an expert judgment. Method Based on different diagnostic and manual classifications, a specification table for a depression test was established. In its evaluation, 16 experts in Psychological Assessment, Psychometry and/or Psychopathology participated. A total of 300 items were created. The experts had to assess the items according to the criteria of Content, Relevance, Clarity, Comprehension, Sensitivity, and Offensiveness. In addition, 50 adults, evaluated the compression of the items. Results The degree of understanding for all the items was high and the expert judgment favoured the suppression of 104 items, thus obtaining a shorter measuring instrument with a total of 196 items for ease of application. Conclusions The content validity of the test is adequate and fits the agreed definition of depression.
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26
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Bliton CF, Roche MJ, Pincus AL, Dueber D. Examining the Structure and Validity of Self-Report Measures of DSM-5 Alternative Model for Personality Disorders Criterion A. J Pers Disord 2022; 36:157-182. [PMID: 34287067 DOI: 10.1521/pedi_2021_35_531] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The Level of Personality Functioning Scale (LPFS) operationalizes Criterion A of the DSM-5 Alternative Model for Personality Disorders. Despite progress in LPFS measurement development and validation, there is a lack of research, and some disagreement, concerning structural, convergent, and incremental validity of LPFS self-report measures. The present study aimed to compare the LPFS Self-Report, LPFS Self-Report of Criterion A, and LPFS Brief Form. Internal structure was assessed through principal component analyses, factor analyses, and bifactor analyses of unidimensionality. Associations with both pathological and basic personality characteristics among the LPFS measures were explored. Incremental validity of LPFS severity in predicting pathological personality outcomes controlling for basic personality traits, and the reverse, were examined. Results suggest a unidimensional structure robustly associated with other pathological personality assessments. LPFS severity and basic personality traits mutually offered unique explanatory power. We discuss the implications of assessing personality pathology using LPFS self-report measures.
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Affiliation(s)
- Chloe F Bliton
- Department of Psychology, Pennsylvania State University, University Park, Pennsylvania
| | - Michael J Roche
- Department of Psychology, West Chester University, West Chester, Pennsylvania
| | - Aaron L Pincus
- Department of Psychology, Pennsylvania State University, University Park, Pennsylvania
| | - David Dueber
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, Kentucky
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27
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Ruchensky JR, Dowgwillo EA, Kelley SE, Massey C, Slavin-Mulford J, Richardson LA, Blais MA, Stein MB. Exploring the Alternative Model for Personality Disorders Using SCORS-G Ratings on Thematic Apperception Test Narratives. J Pers Disord 2022; 36:201-216. [PMID: 34427493 DOI: 10.1521/pedi_2021_35_535] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The Alternative Model for Personality Disorders (AMPD) in Section III of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013) conceptualizes personality pathology as a combination of impairment (Criterion A) and traits (Criterion B). One measure used to develop Criterion A was the Social Cognition and Object Relations Scale - Global Rating Method (SCORS-G), which is a multidimensional, object-relational clinician-rated measure of personality functioning. Although there are conceptual links between the AMPD and SCORS-G dimensions, there exists no research examining the relationship. To address this, we examined associations between the SCORS-G dimensions and measures of the AMPD constructs in a large, archival dataset of outpatients and inpatients. More pathological scores on SCORS-G dimensions reflecting self- and interpersonal functioning were associated with greater pathological traits and impairment. Overall, results support further investigation into SCORS-G as a useful measure in AMPD research and assessment.
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Affiliation(s)
| | | | - Shannon E Kelley
- Clinical Psychology Department, William James College, Newton, Massachusetts
| | - Christina Massey
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | | | - Laura A Richardson
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Mark A Blais
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Michelle B Stein
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
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Waugh MH, Mulay AL, Rossi G, Meehan KB. Editorial: The AMPD in Clinical and Applied Practice: Emerging Trends and Empirical Support. Front Psychol 2022; 13:867933. [PMID: 35369200 PMCID: PMC8970333 DOI: 10.3389/fpsyg.2022.867933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 02/07/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
- Mark H. Waugh
- Health Services Division, Oak Ridge National Laboratory, Oak Ridge, TN, United States
- Department of Psychology, University of Tennessee, Knoxville, TN, United States
| | - Abby L. Mulay
- Community and Public Safety Psychiatry Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Gina Rossi
- Personality and Psychopathology Research Group, Department of Psychology, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Kevin B. Meehan
- Department of Psychology, Long Island University – Brooklyn, New York, NY, United States
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Garner AR, Blocher N, Tierney D, Baumgardner M, Watson A, Romero G, Skadberg R, Younginer T, Waugh MH. Applying the DSM-5 Alternative Model of Personality Disorders and the Shedler-Westen Assessment Procedure to the Classic Case of "Madeline G.": Novice and Expert Rater Convergences and Divergence. Front Psychol 2022; 13:794616. [PMID: 35242078 PMCID: PMC8885620 DOI: 10.3389/fpsyg.2022.794616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
Prior research supports the learnability of the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition Alternative Model of Personality Disorders (AMPD). However, researchers have yet to compare novice ratings on the AMPD's Level of Personality Functioning Scale and the 25 pathological personality traits with expert ratings. Furthermore, the AMPD has yet to be examined with the idiographic Shedler-Westen Assessment Procedure (SWAP). We compared the aggregated AMPD clinical profile of a group of psychology doctoral students who learned the AMPD to high levels of reliability to that of an expert rater using the crucible of the classical case of "Madeline G." Examination of AMPD and SWAP ratings of "Madeline G." revealed excellent overall concordance but suggests that novice raters tend to perceive lower levels of personality impairment.
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Affiliation(s)
- Alisa R Garner
- Department of Psychology, University of Tennessee-Knoxville, Knoxville, TN, United States
| | - Natalie Blocher
- Department of Psychology, University of Tennessee-Knoxville, Knoxville, TN, United States
| | - David Tierney
- Department of Psychology, University of Tennessee-Knoxville, Knoxville, TN, United States
| | - Megan Baumgardner
- Department of Psychology, University of Tennessee-Knoxville, Knoxville, TN, United States
| | - Alayna Watson
- Department of Psychology, University of Tennessee-Knoxville, Knoxville, TN, United States
| | - Gloria Romero
- Department of Psychology, University of Tennessee-Knoxville, Knoxville, TN, United States
| | - Rebecca Skadberg
- Department of Psychology, University of Tennessee-Knoxville, Knoxville, TN, United States
| | - Taylor Younginer
- Department of Psychology, University of Tennessee-Knoxville, Knoxville, TN, United States
| | - Mark H Waugh
- Department of Psychology, University of Tennessee-Knoxville, Knoxville, TN, United States.,Oak Ridge National Laboratory, Oak Ridge, TN, United States
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Bliton CF, Rosenstein LK, Pincus AL. Trading Patients: Applying the Alternative Model for Personality Disorders to Two Cases of DSM-5 Borderline Personality Disorder Over Time and Across Therapists. Front Psychol 2022; 13:794624. [PMID: 35237208 PMCID: PMC8884405 DOI: 10.3389/fpsyg.2022.794624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 01/03/2022] [Indexed: 11/16/2022] Open
Abstract
The DSM-5 Alternative Model for Personality Disorders (AMPD) dimensionally defines personality pathology using severity of dysfunction and maladaptive style. As the empirical literature on the clinical utility of the AMPD grows, there is a need to examine changes in diagnostic profiles and personality expression in treatment over time. Assessing these changes in individuals diagnosed with borderline personality disorder (BPD) is complicated by the tendency for patients to cycle through multiple therapists over the course of treatment leaving the potential for muddled diagnostic clarity and disjointed case conceptualizations. Following patient trajectories across therapists offers a unique opportunity to examine the AMPD’s sensitivity to and utility for capturing personality stability and change over time for patients with BPD. This article demonstrates the utility of the AMPD for two clinical cases in three distinct ways: (i) highlighting heterogeneity in BPD between patients, (ii) comparing improvements in personality severity and style over time, and (iii) elucidating profile change across therapist ratings. We present two patients diagnosed with DSM-5 Section II BPD, crossing between two therapists over the course of 3 years of psychodynamic psychotherapy. Treating clinicians rated patients for their respective treatment phases using the Level of Personality Functioning Scale (LPFS), capturing severity, and the Personality Inventory for the DSM-5 (PID-5), capturing style. AMPD diagnostic profiles differentiated patients with BPD in both severity and style, and captured within-patient change beyond within-therapist response bias. Results indicated greater improvements in personality severity while personality style remained more stable. Implications for the patients’ treatment progress and associated challenges are discussed, as are considerations for the utility of the AMPD in therapy.
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Affiliation(s)
- Chloe F Bliton
- Department of Psychology, The Pennsylvania State University, University Park, PA, United States
| | - Lia K Rosenstein
- Department of Psychology, The Pennsylvania State University, University Park, PA, United States
| | - Aaron L Pincus
- Department of Psychology, The Pennsylvania State University, University Park, PA, United States
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31
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Cheli S, Lam WWT, Estapé T, Winterling J, Bahcivan O, Andritsch E, Weis J, Centeno I, Serpentini S, Farkas C, Wengström Y, Fioretto L, Baider L, Lam CCL, Goldzweig G. Risk perception, treatment adherence, and personality during COVID-19 pandemic: An international study on cancer patients. Psychooncology 2022; 31:46-53. [PMID: 34314560 PMCID: PMC8420575 DOI: 10.1002/pon.5775] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/06/2021] [Accepted: 07/22/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To explore the role of personality traits in moderating the relation between COVID-19 risk perception and treatment adherence, and between risk perception and psychosocial distress in patients diagnosed with cancer. METHODS An online survey (n = 1281) was conducted worldwide in seven countries (Austria, Germany, Hong Kong, Italy, Spain, Sweden, and Turkey). Inclusion criteria were to be 18 years of age or older, have received a cancer diagnosis, and be in treatment or follow-up. A few moderated regression models were performed with both personality traits and Hierarchical Taxonomy of Psychopathology super-spectra as moderators. RESULTS Detachment, negative affectivity, psychoticism and all the super-spectra significantly moderated the relation between coronavirus risk perception and psychosocial distress, after the adjusting effect of confidence in safeguards. Only negative affectivity moderated the association between coronavirus risk perception and treatment adherence. CONCLUSIONS Personality traits may foster the understanding of how a patient might adjust to cancer treatment and, more generically, to highly stressful events such as the COVID-19 pandemic. Further research is needed to confirm the results in different cancer stages and types.
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Affiliation(s)
- Simone Cheli
- School of Human Health SciencesUniversity of FlorenceFlorenceItaly
- Center for Psychology and HealthTages CharityFlorenceItaly
| | - Wendy W. T. Lam
- Faculty of MedicineSchool of Public HealthJockey Club Institute of Cancer CareThe University of Hong KongHong KongChina
| | | | - Jeanette Winterling
- Comprehensive Cancer CentreKarolinska University HospitalStockholmSweden
- Department of Neurobiology, Care Sciences and SocietyDivision of NursingKarolinska InstitutetStockholmSweden
| | | | | | - Joachim Weis
- Medical Faculty Comprehensive Cancer CenterUniversity Clinic CentreFreiburgGermany
| | - Isabel Centeno
- Fundación Elisabeth Kübler‐RossSan Pedro Garza GarcíaMexico
| | | | | | - Yvonne Wengström
- Comprehensive Cancer CentreKarolinska University HospitalStockholmSweden
- Department of Neurobiology, Care Sciences and SocietyDivision of NursingKarolinska InstitutetStockholmSweden
| | | | - Lea Baider
- Assuta Medical CenterOncology InstituteTel‐AvivIsrael
| | - Cherry C. L. Lam
- Faculty of MedicineSchool of Public HealthJockey Club Institute of Cancer CareThe University of Hong KongHong KongChina
| | - Gil Goldzweig
- The Academic College of Tel Aviv–YaffoTel‐AvivIsrael
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Mariotti EC, Waugh MH, McClain CM, Beevers LG, Clemence AJ, Lewis KC, Miller R, Mulay AL, Ridenour JM, Huprich SK, Pitman SR, Meehan KB. Assessing Self-Definition and Relatedness in Level of Personality Functioning. J Pers Disord 2021; 35:857-880. [PMID: 33764821 DOI: 10.1521/pedi_2021_35_516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The two polarities model (TPM) of personality organizes psychological assessment and psychotherapy and connects to personality disorder diagnosis using the DSM-5 Alternative Model for Personality Disorders (AMPD). The authors developed scales assessing the TPM from an existing self-report measure for level of personality functioning (LPF), a core component of the AMPD. Iterative content analyses of the LPF measure yielded scales for Autonomy and Communion corresponding to dimensions of the TPM. The scales were refined via internal consistency analyses using a measure of psychological attachment and studied in development and validation samples. Associations with relevant external criteria were explored in a series of multiple regressions. The new content-based LPF scales were illustrated with a case vignette. Although the new Autonomy/Communion scales await further validation prior to clinical use, initial evidence suggests that they may bridge the nomological nets of the TPM and AMPD and potentially offer clinical utility in assessment and treatment planning.
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Affiliation(s)
| | - Mark H Waugh
- University of Tennessee, Knoxville.,Oak Ridge National Laboratory, Oak Ridge, Tennessee
| | | | | | | | | | - Racheli Miller
- Center for Compassion Focused Therapy, New York, New York
| | - Abby L Mulay
- Medical University of South Carolina, Charleston, South Carolina
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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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Strus W, Łakuta P, Cieciuch J. Anankastia or Psychoticism? Which One Is Better Suited for the Fifth Trait in the Pathological Big Five: Insight From the Circumplex of Personality Metatraits Perspective. Front Psychiatry 2021; 12:648386. [PMID: 34721093 PMCID: PMC8551367 DOI: 10.3389/fpsyt.2021.648386] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 09/14/2021] [Indexed: 11/13/2022] Open
Abstract
Both the ICD-11 and the DSM-5 (Section III) classification systems introduced dimensional models of personality disorders, with five broad domains called the Pathological Big Five. Nevertheless, despite large congruence between the two models, there are also substantial differences between them, with the most evident being the conceptualization of the fifth dimension: Anankastia in the ICD-11 vs. Psychoticism in the DSM-5. The current paper seeks an answer to the question of which domain is structurally better justified as the fifth trait in the dimensional model of personality disorders. For this purpose, we provided both a conceptual and empirical comparison of the ICD-11 and the DSM-5 models, adopting the Circumplex of Personality Metatraits-a comprehensive model of personality structure built on the basis of the higher-order factors of the Big Five-as a reference framework. Two studies were conducted: the first on a sample of 242 adults (52.9% female; M age = 30.63, SD age = 11.82 years), and the second on a sample of 355 adults (50.1% female; M age = 29.97, SD age = 12.26 years) from the non-clinical population. The Personality Inventory for ICD-11 (PiCD), the Personality Inventory for DSM-5 (PID-5), and the Circumplex of Personality Metatraits Questionnaire-Short Form (CPM-Q-SF) were administered in both studies, together with the PID-5BF+M algorithm for measuring a common (ICD-11 + DSM-5) six-domain model. Obtained empirical findings generally support our conceptual considerations that the ICD-11 model more comprehensively covered the area of personality pathology than the DSM-5 model, with Anankastia revealed as a more specific domain of personality disorders as well as more cohesively located within the overall personality structure, in comparison to Psychoticism. Moreover, the results corroborated the bipolar relations of Anankastia vs. Disinhibition domains. These results also correspond with the pattern of relationships found in reference to the Big Five domains of normal personality, which were also included in the current research. All our findings were discussed in the context of suggestions for the content and conceptualization of pathological personality traits that flow from the CPM as a comprehensive model of personality structure including both pathological and normal poles of personality dimensions.
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Affiliation(s)
- Włodzimierz Strus
- Institute of Psychology, Cardinal Stefan Wyszyński University in Warsaw, Warsaw, Poland
| | - Patryk Łakuta
- Institute of Psychology, Cardinal Stefan Wyszyński University in Warsaw, Warsaw, Poland
| | - Jan Cieciuch
- Institute of Psychology, Cardinal Stefan Wyszyński University in Warsaw, Warsaw, Poland
- University Research Priority Program Social Networks, University of Zurich, Zurich, Switzerland
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35
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Wright AGC, Hopwood CJ. Integrating and distinguishing personality and psychopathology. J Pers 2021; 90:5-19. [PMID: 34480760 DOI: 10.1111/jopy.12671] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/27/2021] [Accepted: 08/28/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE We asked authors of this Special Issue to answer the following four questions: (1) Is there evidence that personality and psychopathology can be integrated? (2) Is integration important? (3) Can they be distinguished? and (4) How can the difference be measured? METHOD We review each of the papers and place the special issue in a historical context. RESULTS Authors uniformly agreed that personality and psychopathology can be integrated within a common structure and that this is important. The third and fourth questions were more challenging. Though authors generally agreed that there is a distinction between the person and their mental health problems, articulations of that distinction were fuzzy and it is clear that current methods cannot adequately delineate these domains. CONCLUSIONS We summarize the issue by offering five directions for future research: (1) develop measurement tools that distinguish between the person, the context, and their transaction, (2) measure behavior and context at multiple timescales, (3) distinguish behavior and dysfunction in measurement, (4) use multimethod data to tap different levels of behavior, and (5) examine person-specific processes. Each of these directions comes with challenges, but the payoff of resolving them will be a more principled, evidence-based, and clinically useful model for the distinction between personality and psychopathology.
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Affiliation(s)
- Aidan G C Wright
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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36
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Luo X, Hopwood CJ, Good EW, Turchan JE, Thomas KM, Levendosky AA. Using Interpersonal Dimensions of Personality and Personality Pathology to Examine Momentary and Idiographic Patterns of Alliance Rupture. Front Psychol 2021; 12:711109. [PMID: 34484067 PMCID: PMC8415308 DOI: 10.3389/fpsyg.2021.711109] [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: 05/17/2021] [Accepted: 07/22/2021] [Indexed: 11/17/2022] Open
Abstract
The Alternative Model of Personality Disorders (AMPD) integrates several theoretical models of personality functioning, including interpersonal theory. The interpersonal circumplex dimensions of warmth and dominance can be conceptualized as traits similar to those in AMPD Criterion B, but interpersonal theory also offers dynamic hypotheses about how these variables that change from moment to moment, which help to operationalize some of the processes alluded to in AMPD Criterion A. In the psychotherapy literature, dynamic interpersonal behaviors are thought to be critical for identifying therapeutic alliance ruptures, yet few studies have examined moment-to-moment interpersonal behaviors that are associated with alliance ruptures at an idiographic level. The current study examined the concurrent and cross-lagged relationships between interpersonal behaviors and alliance ruptures within each session in the famous Gloria films ("Three Approaches to Psychotherapy"). Interpersonal behaviors (warmth and dominance) as well as alliance ruptures (i.e., withdrawal and confrontation) were calculated at half minute intervals for each dyad. We identified distinct interpersonal patterns associated with alliance ruptures for each session: Gloria (patient)'s warmth was positively related with withdrawal ruptures concurrently in the session with Carl Rogers; Gloria's dominance and coldness were related with increased confrontation ruptures in the session with Fritz Perls concurrently, while her coldness was also predicted by confrontation ruptures at previous moments; lastly, both Gloria's dominance and Albert Ellis's submissiveness were positively related with withdrawal ruptures. These interpersonal patterns demonstrated the promise of using AMPD dimensions to conceptualize momentary interpersonal processes related to therapy ruptures, as well as the clinical importance of attuning to repetitive, dyad-specific interpersonal cues of ruptures within each session.
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Affiliation(s)
- Xiaochen Luo
- Department of Counseling Psychology, Santa Clara University, Santa Clara, CA, United States
| | | | - Evan W. Good
- Department of Psychology, Michigan State University, East Lansing, MI, United States
| | - Joshua E. Turchan
- Department of Psychology, Michigan State University, East Lansing, MI, United States
- Counseling & Psychiatric Services, Michigan State University, East Lansing, MI, United States
| | | | - Alytia A. Levendosky
- Department of Psychology, Michigan State University, East Lansing, MI, United States
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Barkauskienė R, Gaudiešiūtė E, Skabeikytė G. Change in the Definition of Personality Disorder in Transition to ICD-11: A Look from Clinical and Developmental Perspectives. PSICHOLOGIJA 2021. [DOI: 10.15388/psichol.2021.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The recent body of research reveals fundamental limitations to the categorical concept of a personality disorder that has led researchers to adopt a new personality disorder concept. During the last decade DSM-5 and ICD-11 diagnostic classifications have accepted the dimensional view towards personality pathology. Despite the differences between the two classifications, the joint aspect of both models is the construct of Levels of personality functioning. The construct of personality functioning involves personality (dys)function in the self and interpersonal domains. This two-step conceptualization includes (a) impairments of self and interpersonal functioning, indicating general signs and severity of personality disorder, and (b) pathological personality traits, reflecting ‘stylistic’ differences in the expression of personality disorder. The new conceptualization of personality disorder reflects the innovative multi-theoretical integration of known, empirically-based personality assessment paradigms. The relationship between personality functioning and interpersonal, psychodynamic, and personological paradigms provides the theoretical integrity and empirically-based structure necessary to understand the overall severity of personality pathology. Many methods (interviews, self-assessment scales, and questionnaires) have already been developed for the assessment of personality functioning, and their development will be encouraged by the ICD-11 classification established in 2022. At present, only one instrument has been developed in Lithuania for assessing the level of personality functioning in young people aged 12–18 (Barkauskienė & Skabeikytė, 2020). The empirical data about the validity of this construct and its capability to differentiate between the normal and impaired personality in adults and adolescents provide promising results, but are still accumulating. Research suggests that adolescence is a stage in development when personality pathology can fully unfold and be validly confirmed, which opens up opportunities for early intervention. Although the dimensional personality disorder model needs to further prove its importance, there is already evidence that it is less stigmatizing and returns psychology and personality into the concept of a personality disorder. This review presents changes in the conceptualization of personality disorders by discussing them from both clinical and developmental perspectives and highlighting the results of key research in recent years.
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Nazari A, Huprich SK, Hemmati A, Rezaei F. The Construct Validity of the ICD-11 Severity of Personality Dysfunction Under Scrutiny of Object-Relations Theory. Front Psychiatry 2021; 12:648427. [PMID: 34366910 PMCID: PMC8340676 DOI: 10.3389/fpsyt.2021.648427] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 04/06/2021] [Indexed: 11/26/2022] Open
Abstract
The current classification of personality disorder in ICD-11 includes a description of personality functioning, derived from a number of theoretical paradigms, but most notably consistent with the psychodynamic approach. Concurrently, an object-relations model of personality functioning in a dimensional assessment of severity is provided in the Structured Interview of Personality Organization-Revised (STIPO-R). To date, there are no published measures of International Classification of Diseases-11 (ICD-11) personality severity, though the construct is very comparable to the concepts assessed in the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) levels of personality functioning concept, which is measured by the Level of Personality Functioning Scale-Self-Report (LPFS-SR). This study examined the validity of ICD-11 personality functioning, as measured by the LPFS-SR, by evaluating its associations with the STIPO-R in Kurdistan region. The samples included 231 University students and 419 inpatient participants across four hospitals (267 with a diagnosed personality disorder). All the components of LPFS-SR and STIPO-R were positively and significantly intercorrelated. The components of each measure discriminated PD and non-PD patients from a University, non-clinical group adequately. Despite slightly better performance of the STIPO-R in this discrimination, the measures had a high congruence in predicting personality dysfunction. Overall, the findings of the present study support the validity of ICD-11 construct for evaluating personality functioning.
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Affiliation(s)
- Amin Nazari
- Department of Psychology, University of Kurdistan, Sanandaj, Iran
| | - Steven K. Huprich
- Department of Psychology, University of Detroit Mercy, Detroit, MI, United States
- Department of Psychiatry and Behavioral Sciences, College of Human Medicine, Michigan State University, Lansing, MI, United States
| | - Azad Hemmati
- Department of Psychology, University of Kurdistan, Sanandaj, Iran
| | - Farzin Rezaei
- Neurosciences Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
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Genovese G, Meduri A, Muscatello MRA, Gangemi S, Cedro C, Bruno A, Aragona P, Pandolfo G. Central Serous Chorioretinopathy and Personality Characteristics: A Systematic Review of Scientific Evidence over the Last 10 Years (2010 to 2020). ACTA ACUST UNITED AC 2021; 57:medicina57060628. [PMID: 34208694 PMCID: PMC8235071 DOI: 10.3390/medicina57060628] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/02/2021] [Accepted: 06/14/2021] [Indexed: 12/13/2022]
Abstract
Background and Objectives: to investigate the current state of art in the study of personality disorders in central serous chorioretinopathy (CSC), also taking into account the dimensional approach. Materials and Methods: this systematic review was conducted according to PRISMA guidelines. We included articles written in English or Italian, published in peer reviewed journals from 1 January 2010 to 31 December 2020. Results: after the screening, 10 studies were included. The results suggest that CSC patients are not characterized by the prevalence of a formal personality disorder, but they are better explained by typical personality traits that may alter their relationship with others. CSC patients seems to be characterized by high levels of aggressiveness and anxiety traits along with low sociability. We propose a model of disease where stress exacerbates prior specific traits in a vicious circle where some traits might be involved in disease progression and manifestation. Conclusions: maladaptive personality traits might be an essential feature of the disease and may represent a possible link between psychiatric symptoms, such as insomnia, anxiety, and depression, and endocrinological patterns. Further research should use a specific assessment scale evaluating both the level of interpersonal functioning and specific maladaptive traits.
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Affiliation(s)
- Giovanni Genovese
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98121 Messina, Italy; (A.M.); (M.R.A.M.); (C.C.); (A.B.); (P.A.); (G.P.)
- Correspondence:
| | - Alessandro Meduri
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98121 Messina, Italy; (A.M.); (M.R.A.M.); (C.C.); (A.B.); (P.A.); (G.P.)
| | - Maria Rosaria Anna Muscatello
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98121 Messina, Italy; (A.M.); (M.R.A.M.); (C.C.); (A.B.); (P.A.); (G.P.)
| | - Sebastiano Gangemi
- School and Operative Unit of Allergy and Clinical Immunology, Policlinico “G. Martino”, Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy;
| | - Clemente Cedro
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98121 Messina, Italy; (A.M.); (M.R.A.M.); (C.C.); (A.B.); (P.A.); (G.P.)
| | - Antonio Bruno
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98121 Messina, Italy; (A.M.); (M.R.A.M.); (C.C.); (A.B.); (P.A.); (G.P.)
| | - Pasquale Aragona
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98121 Messina, Italy; (A.M.); (M.R.A.M.); (C.C.); (A.B.); (P.A.); (G.P.)
| | - Gianluca Pandolfo
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98121 Messina, Italy; (A.M.); (M.R.A.M.); (C.C.); (A.B.); (P.A.); (G.P.)
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Pires R, Henriques-Calado J, Sousa Ferreira A, Bach B, Paulino M, Gama Marques J, Ribeiro Moreira A, Grácio J, Gonçalves B. The Utility of ICD-11 and DSM-5 Traits for Differentiating Patients With Personality Disorders From Other Clinical Groups. Front Psychiatry 2021; 12:633882. [PMID: 33935831 PMCID: PMC8085522 DOI: 10.3389/fpsyt.2021.633882] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 02/26/2021] [Indexed: 11/13/2022] Open
Abstract
The ICD-11 Classification of Personality Disorders delineates five trait domain qualifiers (i.e., negative affectivity, detachment, dissociality, disinhibition, and anankastia), whereas the DSM-5 Alternative Model of Personality Disorders also delineates a separate domain of psychoticism. These six combined traits not only characterize individual stylistic features, but also the severity of their maladaptive expressions. It was, therefore, the aim of this study to investigate the utility of ICD-11 and DSM-5 trait domains to differentiate patients with personality disorders (PD) from patients with other mental disorders (non-PD). The Personality Inventory for DSM-5 Brief Form Plus (PID5BF+M) was administered to a sample of patients diagnosed with a personality disorder (N = 124, M age = 42.21, 42.7% females) along with a sample of patients diagnosed with other mental disorders (N = 335, M age = 44.83, 46.6% females). Group differences were explored using the independent sample t test or the Mann-Whitney U test for independent samples, and discriminant factor analysis was used to maximize group differences for each trait domain and facet score. The PD group showed significantly higher scores for the total PID5BF+M composite score, for the trait domains of negative affectivity, antagonism/dissociality, and disinhibition and for the trait facets of emotional lability, manipulativeness, deceitfulness, and impulsivity. The trait domains of disinhibition, negative affectivity, and antagonism/dissociality as well as the trait facets of impulsivity, deceitfulness, emotional lability, and manipulativeness were the best discriminators between PD and non-PD patients. The global PID5BF+M composite score was also one of the best discriminators supporting its potential as a global severity index for detecting personality dysfunction. Finally, high scores in three or more of the 18 PID5BF+M facets suggested the possible presence of a PD diagnosis. Despite some limitations, our findings suggest that the ICD-11 and DSM-5 traits have the potential to specifically describe the stylistic features that characterize individuals with PD, including the severity of their maladaptive expressions.
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Affiliation(s)
- Rute Pires
- Faculdade de Psicologia, Universidade de Lisboa, Lisbon, Portugal
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Lisbon, Portugal
| | - Joana Henriques-Calado
- Faculdade de Psicologia, Universidade de Lisboa, Lisbon, Portugal
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Lisbon, Portugal
| | - Ana Sousa Ferreira
- Faculdade de Psicologia, Universidade de Lisboa, Lisbon, Portugal
- Instituto Universitário de Lisboa - Business Research Unit (BRU-IUL), Lisbon, Portugal
| | - Bo Bach
- Center for Personality Disorder Research, Psychiatric Research Unit, Slagelse, Denmark
| | - Marco Paulino
- Faculdade de Psicologia, Universidade de Lisboa, Lisbon, Portugal
- Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - João Gama Marques
- Clínica de Psiquiatria Geral e Transcultural, Hospital Júlio de Matos, Centro Hospitalar Psiquiátrico de Lisboa, Lisbon, Portugal
- Clínica Universitária de Psiquiatra e Psicologia Médica, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Ana Ribeiro Moreira
- Centro Hospitalar de Lisboa Ocidental, Hospital de Egas Moniz, Lisbon, Portugal
| | - Jaime Grácio
- Champalimaud Clinical Centre, Champalimaud Centre for the Unknown, Champalimaud Foundation, Lisbon, Portugal
- Champalimaud Research, Champalimaud Centre for the Unknown, Champalimaud Foundation, Lisbon, Portugal
- NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Bruno Gonçalves
- Faculdade de Psicologia, Universidade de Lisboa, Lisbon, Portugal
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Lisbon, Portugal
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Model-based PID-5 domain clusters and levels of impairment in self and interpersonal functioning. PERSONALITY AND INDIVIDUAL DIFFERENCES 2021. [DOI: 10.1016/j.paid.2020.110477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Dinger U, Fuchs M, Köhling J, Schauenburg H, Ehrenthal JC. Change of Emotional Experience in Major Depression and Borderline Personality Disorder During Psychotherapy: Associations With Depression Severity and Personality Functioning. J Pers Disord 2021; 35:1-20. [PMID: 30785864 DOI: 10.1521/pedi_2019_33_420] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This study examines emotional experience in major depressive disorder (MDD) with and without comorbid borderline personality disorder (BPD). It investigates if depression severity or personality functioning mediates group differences and which aspects of emotional experience change during psychotherapy. The emotional experience of MDD-BPD patients (n = 44) was compared to MDD-only patients (n = 35) before and after multimodal short-term psychotherapy. Emotions were classified based on valence and an active/passive polarity. MDD-BPD patients exhibited more active-negative emotions. This group difference was mediated by the level of personality functioning, but not by depression severity. Although passive-negative emotions decreased and positive emotions increased during therapy, there was no significant change in active-negative emotions. The two patient groups did not significantly differ in the change of emotional experience. Lower levels of personality functioning in depressed patients with BPD are associated with a broader spectrum of negative emotions, specifically more active-negative emotions.
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Abstract
Coinciding with the development and revision of conceptual models of psychopathology, there has been a proliferation in the number of self-report clinical questionnaires and studies evaluating their psychometric properties. Unfortunately, many clinical measures are constructed and evaluated using suboptimal methods. This review provides current guidelines for the conceptualization, development, and psychometric validation of clinical questionnaires using latent variable methods. A two-stage exploratory-confirmatory framework is provided. The exploratory stage includes item selection and revision, initial structural evaluation, and preliminary tests of concurrent validity (e.g., convergent and discriminant). The confirmatory stage involves replicating factor structure using a more restrictive model, identifying areas of model strain, conducting additional tests of concurrent and predictive validity, and evaluating measurement invariance. Recommendations are provided for (a) item generation, (b) how to use different types of exploratory and confirmatory factor models to determine structure, and (c) evaluating reliability and validity using a latent variable measurement model approach.
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Affiliation(s)
- Anthony J Rosellini
- Center for Anxiety and Related Disorders, Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts 02215, USA; ,
| | - Timothy A Brown
- Center for Anxiety and Related Disorders, Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts 02215, USA; ,
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44
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Johnson BN, Vanwoerden S. Future directions in personality pathology development research from a trainee perspective: Suggestions for theory, methodology, and practice. Curr Opin Psychol 2021; 37:66-71. [PMID: 32891979 PMCID: PMC7895861 DOI: 10.1016/j.copsyc.2020.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/02/2020] [Accepted: 08/09/2020] [Indexed: 11/28/2022]
Abstract
Research on personality disorder (PD) development has received increased attention in the last two decades, spurring reconceptualization in theoretical models of etiology, use of advanced methods, and development of effective treatments. The current manuscript briefly reviews the state of the field and proposes avenues of new research on the development of personality pathology in theoretical, methodological, and clinical veins. We identify the need to adopt a unifying and comprehensive theory to describe PD development across the lifespan, novel statistical methods to complement traditional methods relied on thus far, and the adoption of developmentally sensitive interventions that are disseminated to professionals and trainees alike. These directions for future research aim to augment prevention efforts to reduce the burden of PDs earlier in life.
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Affiliation(s)
- Benjamin N Johnson
- The Pennsylvania State University, Mount Sinai Beth Israel, United States
| | - Salome Vanwoerden
- University of Pittsburgh Medical Center, Western Psychiatric Hospital, United States
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Franquillo AC, Guccione C, Angelini G, Carpentieri R, Ducci G, Caretti V. The Role of Personality in Schizophrenia and Psychosis: A Systematic Review. CLINICAL NEUROPSYCHIATRY 2021; 18:28-40. [PMID: 34909018 PMCID: PMC8629049 DOI: 10.36131/cnfioritieditore20210103] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Although personality is a widely discussed topic within the academic field, little is still known about its role in affecting psychopathology, specifically schizophrenia, which can involve psychosis. While the existing literature connects these fields, it is necessary to deepen the knowledge about the relationship between these and the role that personality disorders and traits have on such psychopathology. With the implementation of the AMPD in the DSM-5 and the related assessment of impairment in personality functioning and pathological personality traits, moving from traditional models as the FFM Model of Personality, the present systematic review aims to clarify and summarize the state of the art of the studies regarding this topic. According to the Prisma Statement, literature collection was built based on two databases: PubMed and PsycINFO, and the search focused on recent studies in a period from 2011 to 2020 to check for studies consistent with recent updates. The search process started from 866 articles and ended with 10 selected studies from the two databases, covering years from 2011 to 2020. Studies differ in sample size, measures, aim, and outcome making the present literature review diversified in its content. This review gathers evidence and sheds light on the complexity of these topics and their interconnection. Future studies may be required to clarify the clinical implications of these aspects, aiming at incrementing treatments with a more specific focus on assessment that can provide enhanced preventions.
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Affiliation(s)
- Anna Chiara Franquillo
- LUMSA University, Rome, ,Corresponding author Anna Chiara Franquillo, LUMSA University, Rome E-mail:
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Posavac SS, Kardes FR, Posavac HD, Gaffney DR. The Utility of Clinical Psychology Concepts for Judgment and Decision-Making Research: The Case of Histrionic Features. PERSONALITY AND SOCIAL PSYCHOLOGY BULLETIN 2021; 48:65-77. [PMID: 33514279 DOI: 10.1177/0146167220980887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This research was conducted to highlight the utility of considering clinical psychology concepts in judgment and decision research. Our overarching thesis is that the judgments and choices people make may often be influenced by clinically relevant phenomena, and that understanding these relationships can, in a reciprocal fashion, help advance our understanding of judgment and decision making as well as specific clinical diagnoses and proclivities. We focused on histrionic personality disorder and conducted four studies that show that histrionic symptomology predicts preferences and choices that facilitate grabbing others' attention, even when such choices cost more money, and are at the expense of giving up more tangible features. In addition to demonstrating a new implication of the histrionic personality, we provide insight into the process underlying this tendency and discuss implications for mental health service providers.
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47
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Yalch MM, Stewart AM, Dehart RM. Influence of Betrayal Trauma on Antisocial Personality Disorder Traits. J Trauma Dissociation 2021; 22:122-134. [PMID: 32716816 DOI: 10.1080/15299732.2020.1792025] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Antisocial personality disorder (ASPD) is linked to a number of social problems and accordingly is the focus of intensive empirical study. There is reason to believe that ASPD is influenced at least in part by exposure to trauma, but there has been minimal research on the association between trauma and ASPD traits. Specifically, research has not examined how traumatic experiences with different degrees of interpersonal betrayal differentially influence ASPD traits. This is notable in light of recent studies indicating that exposure to traumatic experiences high in betrayal (i.e., high betrayal trauma) is the primary predictor of borderline and narcissistic personality pathology. In this study, we examined the relative associations between high, medium, and low betrayal trauma and ASPD traits in a sample recruited from Amazon's Mechanical Turk (N = 363) using structural equation modeling. Results confirmed a strong association between trauma and ASPD traits in general, although the influence of specific forms of trauma differed depending on both sex and how trauma was calculated (i.e., in terms of severity vs. exposure). In general, high betrayal trauma was the most consistent predictor of ASPD traits for men, whereas medium and low betrayal traumas were more consistently associated with ASPD traits for women. Study findings extend research on betrayal trauma to more malevolent forms of personality pathology. Sex differences in the influence of trauma across ASPD traits suggest the possibility of sex-specific personality responses to trauma high in betrayal, a topic that can be addressed in the future research.
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Affiliation(s)
- Matthew M Yalch
- Department of Psychology, Palo Alto University , Palo Alto, CA, USA
| | - Amber M Stewart
- Department of Psychology, Palo Alto University , Palo Alto, CA, USA
| | - Ryanne M Dehart
- Department of Psychology, Palo Alto University , Palo Alto, CA, USA
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48
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Escolà-Gascón Á. Researching unexplained phenomena II: new evidences for anomalous experiences supported by the Multivariable Multiaxial Suggestibility Inventory-2 (MMSI-2). CURRENT RESEARCH IN BEHAVIORAL SCIENCES 2020. [DOI: 10.1016/j.crbeha.2020.100005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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Haggerty G, Esang M, Salaheldin K, Lima A. The relationship between prototype ratings of personality and self and interpersonal functioning with an adolescent inpatient sample. Clin Psychol Psychother 2020; 28:364-372. [PMID: 32881158 DOI: 10.1002/cpp.2512] [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: 06/27/2019] [Revised: 06/15/2020] [Accepted: 08/17/2020] [Indexed: 11/10/2022]
Abstract
Personality pathology is conceptualized, in part, as impairments in self and interpersonal functioning. Although most of the research has focused on adult samples, fewer have looked at this relationship in adolescent samples. This paper investigates the relationship between clinician-rated personality prototypes, the Shedler-Westen Assessment Procedure-Prototype Matching Adolescent Version (SWAP-A-P) derived from the SWAP-II-A, and a measure of self and interpersonal functioning, the Social Cognition and Object Relation Scale-Global Rating (SCORS-G). Clinicians rated 66 adolescents hospitalized at a safety net teaching hospital in the northeast. The patient's individual and group therapist rated the patients at discharge using the SWAP-A-P and the SCORS-G at discharge blind to each other's ratings. Results showed that more severe personality pathology was linked with more impairments in self and interpersonal functioning.
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Affiliation(s)
- Greg Haggerty
- Graduate Medical Education, Mather Hospital/Northwell Health, Port Jefferson, New York, USA
| | - Michael Esang
- Department of Behavioral Sciences, Nassau University Medical Center, East Meadow, New York, USA
| | - Khalid Salaheldin
- Graduate Medical Education, Mather Hospital/Northwell Health, Port Jefferson, New York, USA.,Department of Psychiatry, Mather Hospital Northwell Health
| | - Ateaya Lima
- Graduate Medical Education, Mather Hospital/Northwell Health, Port Jefferson, New York, USA.,Department of Psychiatry, Mather Hospital Northwell Health
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Papamalis FE. Examining the Relationship of Personality Functioning and Treatment Completion in Substance Misuse Treatment. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2020; 14:1178221820951777. [PMID: 33088177 PMCID: PMC7543119 DOI: 10.1177/1178221820951777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 07/28/2020] [Indexed: 12/30/2022]
Abstract
Background: Treatment retention is a major factor contributing to favourable outcome in
the treatment of substance misuse, but the literature remains very limited.
Despite evidence of the association of personality with drug use
experimentation and relapse, surprisingly little is known about its role in
the treatment process. Clients’ personality functioning as measured by
malleable and context sensitive characteristic adaptations in treatment are
of concern. Aims: This study examines whether, and to what extent, personality functioning
contributes to or hinders treatment completion. This paper examined the
extent to which service users’ characteristic adaptations may be potential
determinants of treatment completion. Methodology: A longitudinal multi-site design was utilised, examining the therapy process
in a naturalistic setting in five inpatient treatment units. The study
examined whether service users’ characteristic adaptations (SIPP-118)
predict completion, while controlling psychosocial, motivational and
treatment engagement indicators involving n = 340 participants from 5
inpatient centres. Multivariate regression analyses were
applied to examine the predictive role of characteristic adaptations on
treatment completion. Results: Findings indicated that certain dysfunctional characteristic adaptations
emerged as strong predictors of treatment completion. Dysfunctional levels
on Self-control and Social concordance were significant predictors of drop
out from treatment. Individuals with low capacity to tolerate, use and
control one’s own emotions and impulses were almost three times more likely
to drop-out compared to those without [OR] = 2.73, Wald = 6.09,
P = .014, 95% CI [1.2, 6.0]. Individuals with
dysfunctional levels on the ability to value someone’s identity, withhold
aggressive impulses towards others and work together with
others were 2.21 more times more likely to complete
treatment [OR] = 2.21, Wald = 4.12, P = .042, 95% CI [1.0,
4.7]. The analysis at the facet level provided additional insight.
Individuals with higher adaptive levels on Effortful Control were 46% more
times likely to complete treatment than the group [OR] = 4.67, Wald =
10.231, P = .001, 95% CI [1.81, 12.04], 47% more likely on
Aggression regulation [OR] = 4.76, Wald = 16.68, P <
.001, 95% CI [2.1, 10.3], and 26% more likely on Stable self-image [OR] =
2.62, Wald = 6.75, P < .009, 95% CI [0.9, 3.0]. Conclusions: These findings extend our knowledge of the predictive role of characteristic
adaptations in treatment completion and highlight the clinical utility of
capturing these individual differences early on. Delineating the role of
characteristic adaptations in treatment may provide the basis for enhancing
treatment effectiveness through individualized interventions that are
scientifically driven and may open new avenues for the scientific enquiry of
personality and treatment.
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