Psychiatric patient- and informant-reported personality: predicting concurrent and future behavior

Predicting the Severity of Lockdown-Induced Psychiatric Symptoms with Machine Learning

During the COVID-19 pandemic, an increase in the incidence of psychiatric disorders in the general population and an increase in the severity of symptoms in psychiatric patients have been reported. Anxiety and depression symptoms are the most commonly observed during large-scale dramatic events such as pandemics and wars, especially when these implicate an extended lockdown. The early detection of higher risk clinical and non-clinical individuals would help prevent the new onset and/or deterioration of these symptoms. This in turn would lead to the implementation of public policies aimed at protecting vulnerable populations during these dramatic contingencies, therefore optimising the effectiveness of interventions and saving the resources of national healthcare systems. We used a supervised machine learning method to identify the predictors of the severity of psychiatric symptoms during the Italian lockdown due to the COVID-19 pandemic. Via a case study, we applied this methodology to a small sample of healthy individuals, obsessive-compulsive disorder patients, and adjustment disorder patients. Our preliminary results show that our models were able to predict depression, anxiety, and obsessive-compulsive symptoms during the lockdown with up to 92% accuracy based on demographic and clinical characteristics collected before the pandemic. The presented methodology may be used to predict the psychiatric prognosis of individuals under a large-scale lockdown and thus supporting the related clinical decisions.

Self-informant Agreement for Personality and Evaluative Person Descriptors: Comparing Methods for Creating Informant Measures

Little attention typically is paid to the way self-report measures are translated for use in self-informant agreement studies. We studied two possible methods for creating informant measures: (a) the traditional method in which self-report items were translated from the first- to the third-person and (b) an alternative meta-perceptual method in which informants were directed to rate their perception of the targets' self-perception. We hypothesized that the latter method would yield stronger self-informant agreement for evaluative personality dimensions measured by indirect item markers. We studied these methods in a sample of 303 undergraduate friendship dyads. Results revealed mean-level differences between methods, similar self-informant agreement across methods, stronger agreement for Big Five dimensions than for evaluative dimensions, and incremental validity for meta-perceptual informant rating methods. Limited power reduced the interpretability of several sparse acquaintanceship effects. We conclude that traditional informant methods are appropriate for most personality traits, but meta-perceptual methods may be more appropriate when personality questionnaire items reflect indirect indicators of the trait being measured, which is particularly likely for evaluative traits.

Relationship Between Personality Disorders Scales, Pathological Personality Traits, and Six Domains of Functioning in Sample With Alcohol Use Disorder

BACKGROUND

Studies reveal a functional impairment in patients with personality disorders (PDs), but there is not enough information to form conclusions about this relation in patients with alcohol use disorder (AUD). The aim of this study was to investigate to what extent a personality disorders scales including pathological personality traits (PPTs) predict six domains of functioning in patients with AUD.

METHODS

In total, 48 patients with AUD diagnosis, who were treated in the psychiatric clinics, aged 20 to 65 years [M = 37.5; SD = 12.08; 12 (25%) females and 36 (75%) males], filled out the demographic questionnaire, WHO Disability Assessment Schedule 2.0 (WHODAS 2.0, Latvian version) and Latvian Clinical Personality Inventory (LCPI v2.1.). All respondents signed the informed consent form.

RESULTS

Stepwise regression analysis showed that PD Avoidant scale positively predicts impairment in Cognition and Getting along domains of functioning in AUD patients, but, on the PPTs level, it was found that Social withdrawal along with Irresponsibility and Guilt/Shame positively predict impairment in Cognition domain of functioning, and Social withdrawal along with Depressivity and Irresponsibility positively predict impairment in Getting along domain of functioning. The results of the study showed that PPT Orderliness negatively predicts impairment in Live activities domain of functioning. The PD Dependent scale and PPT Separation insecurity positively predict impairment in Participation domain of functioning.

CONCLUSIONS

Obtained results add deeper insight into understanding of the relationship between personality disorders scales including pathological personality traits and six domains of functioning in patients with AUD.

Personality Inventory for DSM-5-Short Form (PID-5-SF): Reliability, Factorial Structure, and Relationship With Functional Impairment in Dual Diagnosis Patients

Section III of the Diagnostic and Statistical Manual of Mental Disorders-Fifth edition (DSM-5) has generated a personality paradigm consisting of 25 personality facets identified in five domains. The developed assessment instrument Personality Inventory for DSM-5 (PID-5) has showed good psychometric properties, but the potential for certain improvements still remain. In this article, a sample of 282 dual diagnosis patients is used to provide evidence of the psychometric properties of the PID-5-Short Form. The mean value of Cronbach's alpha coefficients reached .73 on the facets and .84 for domains and test-retest values ranged between .57 to .83 for facets and .70 to .87 for the domains. Confirmatory factor analyses conducted showed good fit on both models tested: the five correlated factor structure and hierarchical structure of personality traits. The WHODAS 2.0 domains of understanding and communicating, and participating in society, appear to show the strongest relationship with personality facets. In general, the PID-5-Short Form shows adequate psychometric properties for use in dual diagnosis patients.

Comparability of self- and other-rated personality structure

It is commonly accepted that gathering information via multiple assessment methods (e.g., interview and questionnaire, self- and informant report) is important for establishing construct validity. Although numerous articles report convergent and discriminant agreement correlations between self- and other ratings of personality, studies of the structure of personality from such ratings are less common. The present study addresses this gap using a meta-analytic data set (N range = 157-9,295) of various versions (i.e., self- and other-report, full-length and short alternative format) of the Schedule for Nonadaptive and Adaptive Personality (SNAP; Clark, 1993; Clark, Simms, Wu, & Casillas, 2014). We hypothesized that (a) structures across all measure formats would be highly comparable and (b) to the extent that they were dissimilar, perspective (self vs. other) and measure format (long vs. short form), respectively, would influence comparability. Results revealed strong congruence among 3-factor structures (Negative Emotionality, Positive Emotionality, and Disinhibition vs. Constraint) across all versions of the SNAP, suggesting that personality as assessed by this broad measure of personality traits across the normal-abnormal spectrum has a robust structure across different rater perspectives and rating formats. Because the comparability analyses were highly congruent and differences among the comparisons were minimal, we concluded-contrary to our expectations-that different formats and different rater perspectives have little effect on structural comparability. Results generally support Funder's (1995) realistic accuracy model, suggesting that trait relevance, cue detection, and information usage are key factors in structuring informant ratings. Limitations of the present study and implications for future research are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Trait Impulsivity in Alcohol-naïve Offspring at High Risk for Alcoholism

BACKGROUND

Impulsivity is considered to be a vulnerability marker for substance use disorders, including alcoholism, in offspring with familial alcoholism. However, it is not adequately explored whether different age groups offspring at high risk for alcoholism differ in their impulsivity. The present study examined trait impulsivity in offspring at high risk for alcoholism, and further examined impulsivity by categorizing these offspring into different age groups. The study also examined the association between impulsivity and age, and the association of executive functions with age and education.

MATERIALS AND METHODS

Sample consisted of alcohol-naïve offspring at high (n = 34) and low (n = 34) risk for alcoholism. Participants were matched on age (±1 year), education (±1 year), and gender. The measures included were: Mini-international neuropsychiatric interview, family interview for genetic studies, sociodemographic data sheet, Annett's handedness questionnaire, Barratt's Impulsiveness Scale-version 11, and tests assessing executive functions.

RESULTS

Offspring at high risk for alcoholism demonstrated significantly high impulsivity. Furthermore, offspring at high risk were categorized into three subgroups with age. Results showed no significant difference between the subgroups with respect to impulsivity. Correlation analysis revealed no significant association between impulsivity and age. However, executive functions (concept formation, working memory, and safe decision-making) showed significant positive association, while perseveration and risky decision-making showed a negative association with age and education in both the groups.

CONCLUSION

The present study demonstrates high impulsivity trait in offspring at high risk for alcoholism. The high impulsivity could pose a risk for addiction and may require preventive intervention.

Convergence of Self-Reports and Informant Reports on the Personality Assessment Screener

The present study is the first to investigate the Personality Assessment Screener, a brief self-report measure of risk for emotional and behavioral dysfunction, in relation to the informant report version of this instrument, the Personality Assessment Screener–Other. Among a sample of undergraduate roommate dyads ( N = 174), self-report and informant report total scores on the Personality Assessment Screener/Personality Assessment Screener–Other moderately converged ( r = 0.45), with generally greater agreement between perspectives observed for externalizing behaviors compared with internalizing distress. In addition, selves tended to report more psychological difficulties relative to informant ratings ( d = 0.45) with an average absolute discrepancy between sources of 6.31 ( SD = 4.96) out of a possible range of 66. Discrepancies between self-report and informant report were significantly associated with characteristics of the dyadic relationship (e.g., length of acquaintanceship) as well as the severity of self-reported psychological difficulties and positive impression management.

The validity of the multi-informant approach to assessing child and adolescent mental health

Child and adolescent patients may display mental health concerns within some contexts and not others (e.g., home vs. school). Thus, understanding the specific contexts in which patients display concerns may assist mental health professionals in tailoring treatments to patients' needs. Consequently, clinical assessments often include reports from multiple informants who vary in the contexts in which they observe patients' behavior (e.g., patients, parents, teachers). Previous meta-analyses indicate that informants' reports correlate at low-to-moderate magnitudes. However, is it valid to interpret low correspondence among reports as indicating that patients display concerns in some contexts and not others? We meta-analyzed 341 studies published between 1989 and 2014 that reported cross-informant correspondence estimates, and observed low-to-moderate correspondence (mean internalizing: r = .25; mean externalizing: r = .30; mean overall: r = .28). Informant pair, mental health domain, and measurement method moderated magnitudes of correspondence. These robust findings have informed the development of concepts for interpreting multi-informant assessments, allowing researchers to draw specific predictions about the incremental and construct validity of these assessments. In turn, we critically evaluated research on the incremental and construct validity of the multi-informant approach to clinical child and adolescent assessment. In so doing, we identify crucial gaps in knowledge for future research, and provide recommendations for "best practices" in using and interpreting multi-informant assessments in clinical work and research. This article has important implications for developing personalized approaches to clinical assessment, with the goal of informing techniques for tailoring treatments to target the specific contexts where patients display concerns. (PsycINFO Database Record

The validity of the multi-informant approach to assessing child and adolescent mental health

Child and adolescent patients may display mental health concerns within some contexts and not others (e.g., home vs. school). Thus, understanding the specific contexts in which patients display concerns may assist mental health professionals in tailoring treatments to patients' needs. Consequently, clinical assessments often include reports from multiple informants who vary in the contexts in which they observe patients' behavior (e.g., patients, parents, teachers). Previous meta-analyses indicate that informants' reports correlate at low-to-moderate magnitudes. However, is it valid to interpret low correspondence among reports as indicating that patients display concerns in some contexts and not others? We meta-analyzed 341 studies published between 1989 and 2014 that reported cross-informant correspondence estimates, and observed low-to-moderate correspondence (mean internalizing: r = .25; mean externalizing: r = .30; mean overall: r = .28). Informant pair, mental health domain, and measurement method moderated magnitudes of correspondence. These robust findings have informed the development of concepts for interpreting multi-informant assessments, allowing researchers to draw specific predictions about the incremental and construct validity of these assessments. In turn, we critically evaluated research on the incremental and construct validity of the multi-informant approach to clinical child and adolescent assessment. In so doing, we identify crucial gaps in knowledge for future research, and provide recommendations for "best practices" in using and interpreting multi-informant assessments in clinical work and research. This article has important implications for developing personalized approaches to clinical assessment, with the goal of informing techniques for tailoring treatments to target the specific contexts where patients display concerns. (PsycINFO Database Record

Investigating the Personality Inventory for DSM-5 using self and spouse reports

Two new clinical tools, the Personality Inventory for DSM-5 (PID-5) and its informant report version, the PID-5-IRF, were developed to assess personality pathology as described by the new trait-based model within Section III of DSM-5. The current study used both self and spousal reports to evaluate agreement between the PID-5 and the PID-5-IRF and to determine the extent to which these measures capture personality pathology as conceptualized in Section II of DSM-5. A nonclinical sample (N = 96 individuals) of recently married couples completed the self-report PID-5, the PID-5-IRF, and the SNAP-2 to assess self-reported DSM-IV PD criteria. Analyses found good to excellent agreement between spousal reports on the PID-5 and the PID-5-IRF for facets in the negative affectivity, detachment, and antagonism domains. In addition, both the PID-5 and the PID-5-IRF each individually accounted for a significant proportion of variance in self-reported DSM-IV PD criteria. Implications for the present findings are discussed.

Callous-Unemotional traits in youth from a DSM-5 trait perspective

The current study investigated how the Callous-Unemotional (CU) trait specifier is empirically associated with the proposed trait system for personality pathology in DSM-5, and addressed the use of multiple raters in the assessment of CU traits and additional maladaptive traits in an adolescent community sample. Both mothers and adolescents (N = 197) participated in the present study. Results showed that CU traits are located in different parts of the personality space, and are significantly associated with four broad maladaptive trait dimensions, Negative Affect, Detachment, Antagonism, and Disinhibition. Despite moderate agreement between raters, self- and maternal-rated CU traits were related in a congruent manner with PID-5 traits, and adolescents provided incremental information in CU trait assessment above maternal ratings. The present results have clear implications for the conceptualization of CU traits within the overarching model of personality pathology, proposed in DSM-5, and partially supported the application of a multi-informant approach in CU trait assessment.

Addictions and Personality Traits: Impulsivity and Related Constructs

Behavioral tendencies that might be captured through self-report measures may provide insight into personality features that are associated with substance addictions. Recently, impulsivity and related constructs, such as sensation-seeking, have been examined to help better understand their relationships with addictions. Here, we review recent findings that show links over developmental epochs between addictive behaviors and impulsivity, sensation-seeking, and other constructs that are theoretically linked. These findings have significant implications for generating improved treatments and interventions aimed at preventing the development of addictive disorders.

Dually diagnosed patients' benefits of mutual-help groups and the role of social anxiety

There is debate about whether dually diagnosed patients benefit from mutual-help groups (MHGs), partly because social anxiety may make participation problematic. We examined dually diagnosed patients' participation in MHGs and outcomes at 6, 12, and 24 months post-treatment, and the extent to which social anxiety was associated with participation. We also examined whether MHG participation and social anxiety were related to outcomes, and whether social anxiety moderated associations between participation and outcomes. We found high rates of MHG participation. Among patients who attended at least one meeting, outcomes were positive. Social anxiety was not associated with levels of MHG participation, but more participation was associated with better outcomes. When social anxiety moderated associations between MHG participation and outcomes, patients with more social anxiety benefited more from participation. Treated dually diagnosed patients participate in, and benefit from, MHGs, and participation and benefits are comparable, or even strengthened, among more socially-anxious patients.

Self- and informant-reported perspectives on symptoms of narcissistic personality disorder

Because narcissistic individuals tend to have an inflated view of themselves and their abilities, the reliance on self-reported information in the assessment and diagnosis of narcissistic personality disorder (NPD) is problematic. Hence, the use of informants in the assessment of NPD may be necessary. In the current study we examined self- and informant-reported features of NPD using agreement, frequency, and discrepancy analyses. The results indicated that informants tended to report more NPD features than selves, and that there were either low or nonsignificant levels of self-informant agreement among the 9 NPD diagnostic criteria and its categorical diagnosis. Informants were increasingly more likely to report higher raw scores relative to selves, indicating that the discrepancy between self- and informant reports increases with the NPD scale. Informants also reported NPD features that selves often did not, suggesting that current prevalence estimates of NPD, which use only self-reported information, are most likely underestimates. These results highlight the importance of gathering informant-reported data in addition to self-reported data when assessing NPD. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

Pathological personality traits among patients with absent, current, and remitted substance use disorders

Personality traits may provide underlying risk factors for and/or sequelae to substance use disorders (SUDs). In this study Schedule for Nonadaptive and Adaptive Personality (SNAP) traits were compared in a clinical sample (N=704, age 18-45) with current, past, or no historical alcohol or non-alcohol substance use disorders (AUD and NASUD) as assessed by DSM-IV semi-structured interview. Results corroborated previous research in showing associations of negative temperament and disinhibition to SUD, highlighting the importance of these traits for indicating substance use proclivity or the chronic effects of substance use. Certain traits (manipulativeness, self-harm, disinhibition, and impulsivity for AUD, and disinhibition and exhibitionism for NASUD) were higher among individuals with current relative to past diagnoses, perhaps indicating concurrent effects of substance abuse on personality. The positive temperament characteristics detachment and entitlement distinguished AUDs and NASUDs, respectively, perhaps clarifying why this higher order trait tends to show limited relations to SUD generally. These findings suggest the importance of systematically integrating pathological and normative traits in reference to substance-related diagnosis.

Intensive referral to 12-step dual-focused mutual-help groups

BACKGROUND

This study implemented and evaluated procedures to help clinicians effectively refer dually diagnosed (substance use and psychiatric disorders) patients to dual-focused mutual-help groups (DFGs).

METHODS

Using a cohort cyclical turnover design, individuals with dual diagnoses beginning a new outpatient mental health treatment episode (N=287) entered a standard- or an intensive-referral condition. Participants provided self-reports of 12-step mutual-help (DFG and substance-focused group [SFG]) attendance and involvement and substance use and psychiatric symptoms at baseline and six-month follow-up. The intensive referral intervention focused on encouraging patients to attend DFG meetings.

RESULTS

Compared to patients in the standard condition, those in the intensive referral intervention were more likely to attend and be involved in DFGs and SFGs, and had less drug use and better psychiatric outcomes at follow-up. Attending more intensive-referral sessions was associated with more DFG and SFG meeting attendance. More need fulfillment in DFGs, and more readiness to participate in SFGs, were associated with better alcohol and psychiatric outcomes at six months. However, only 23% of patients in the intensive-referral group attended a DFG meeting during the six-month follow-up period.

CONCLUSIONS

The intensive referral intervention enhanced participation in both DFGs and SFGs and was associated with better six-month outcomes. The findings suggest that intensive referral to mutual-help groups focus on its key components (e.g., linking patients to 12-step volunteers) rather than type of group.

Level of agreement between self and spouse in the assessment of personality pathology

Informant reports can provide important information regarding the presence of pathological personality traits, and they can serve as useful supplements to self-report instruments. Ratings from a spouse may be a particularly valuable source of personality assessment because spouses are very well acquainted with the target person, have typically known the person for a long time, and witness behaviors across a variety of situations. In the current study, self- and spouse report measures based on the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) personality disorder criteria were collected from a nonclinical sample of 82 couples (N = 164). Agreement between self- and spouse report for several pathological personality factors was significant and somewhat higher than has been found for self and peer agreement. Nevertheless, the magnitude of self-spouse agreement was still moderate in size (mean r = .36). Findings are discussed with regard to using spouse report in the assessment of personality pathology.

Self-other disagreement in personality assessment: significance and prognostic value

The feasibility of the use of multiple informant reports in clinical practice was examined in a sample of 105 psychiatric outpatients who provided self-ratings and (2-3) informants' reports on the Five Factor Personality Inventory. The response rate was 97%. The patients assessed themselves as less extraverted and more emotionally stable than their proxies did. In addition, the significance of self-other disagreement was investigated. Our first hypothesis, stating that self-other disagreement would correlate with (personality) pathology, was confirmed: self-other disagreement predominantly occurred in introverted, shy, hostile and depressed persons who tended to have more personality problems and co-morbidity. We found no support for our second hypothesis, stating that self-other disagreement would predict a diminished therapy effect. An important finding, however, was that self-other disagreement proved to be a strong predictor of dropout. Furthermore, a decrease in depression, hostility and shyness was positively correlated with a decrease in self-other disagreement.

Assessing normal and abnormal personality functioning: strengths and weaknesses of self-report, observer, and performance-based methods

Assessing personality characteristics; distinguishing the boundaries between normal and abnormal functioning; identifying impairment in the domains of work, interpersonal relationships, and emotional state due to maladaptive personality traits; and translating these findings into effective, appropriate treatment interventions is a complicated endeavor. Valid, reliable conclusions about an individual's personality functioning and adjustment cannot be reached unless one has accurate information about that person's patterns of behavior, cognitions, emotions, and interpersonal relationships. I discuss strengths and weaknesses of assessment approaches utilizing explicit assessment methods, such as self-report measures and clinical interviews; information obtained from knowledgeable observers; and performance-based, implicit assessment methods such as the Rorschach Comprehensive System (Exner, 2003). In contrast to explicit methods of assessment, implicit methods can provide salient information about a personality construct whether or not individuals have accurately conceptualized that construct, have weighed how the construct describes them, are self-aware, and are willing to openly provide information relevant to that construct. I propose that the accuracy of conclusions about an individual's personality style, problems in adjustment, and treatment needs may be improved if conclusion are based on a multimethod assessment approach that incorporates information gathered using explicit assessment methods, information provided by significant others, and data from performance-based or implicit measures of personality.

Abnormal personality and the mood and anxiety disorders: implications for structural models of anxiety and depression

Substantial overlap exists between the mood and anxiety disorders. Previous research has suggested that their comorbidity can be explained by a shared factor (negative emotionality), but that they may also be distinguished by other unique components. The current study explicated these relations using an abnormal personality framework. Current diagnoses of major depression and several anxiety disorders were assessed in 563 Gulf War veterans. Participants also completed the schedule for nonadaptive and adaptive personality (SNAP) to determine how these disorders relate to abnormal personality traits. Analyses of individual diagnoses indicated that depression, generalized anxiety disorder (GAD), and post-traumatic stress disorder (PTSD) were more strongly related to personality than were other anxiety disorders. The Self-Harm Scale distinguished major depression from all other disorders, highlighting its significance for future structural models. Our results add to a growing body of evidence suggesting that GAD and PTSD have more in common with major depression than with their anxiety disorder counterparts.

Development and initial validation of a 15-item informant version of the Geriatric Depression Scale

OBJECTIVE

To develop a brief informant version of the Geriatric Depression Scale for use in screening for depression in older adults.

DESIGN

A scale development and validation study.

SETTING

Internal medicine and geriatric outpatient clinics located at the James A. Haley Veterans' Medical Center and the University of South Florida Medical Center, Tampa, Florida.

PARTICIPANTS

A total of 147 patients (81 females and 66 males) and their adult informants.

MEASUREMENTS

Self and informant versions of the 30-item Geriatric Depression Scale, NEO-FFI, and a health behaviors questionnaire.

RESULTS

The 15-item informant version of the GDS was found to have sufficient internal consistency reliability (alpha = 0.86) and retest reliability (r = 0.81) to support its use as a clinical instrument. Construct validity was demonstrated by a pattern of correlations with external demographic and personality variables consistent with those of other versions of the GDS, as well as substantive correlations with these other versions. Efficacy of the GDSI-15 was found to be as good as that for the full 30-item informant version of the GDS.

CONCLUSIONS

The GDSI-15 may be a useful adjunct or alternative to standard screening methods in assessing patients in outpatient settings.

Evidence-based assessment of personality disorders

The purpose of this article is to provide a foundation for the development of evidence-based guidelines for the assessment of personality disorders, focusing in particular on integrated assessment strategies. The general strategy recommended herein is to first administer a self-report inventory to alert oneself to the potential presence of particular maladaptive personality traits followed by a semistructured interview to verify their presence. This strategy is guided by the existing research that suggests particular strengths of self-report inventories and semistructured interviews relative to unstructured clinical interviews. However, the authors also consider research that suggests that further improvements to the existing instruments can be made. The authors emphasize, in particular, a consideration of age of onset, distortions in self-perception and presentation, gender bias, culture and ethnicity, and personality change.

When clinical description becomes statistical prediction

This article reconsiders the issue of clinical versus statistical prediction. The term clinical is widely used to denote 1 pole of 2 independent axes: the observer whose data are being aggregated (clinician/expert vs. lay) and the method of aggregating those data (impressionistic vs. statistical). Fifty years of research suggests that when formulas are available, statistical aggregation outperforms informal, subjective aggregation much of the time. However, these data have little bearing on the question of whether, or under what conditions, clinicians can make reliable and valid observations and inferences at a level of generality relevant to practice or useful as data to be aggregated statistically. An emerging body of research suggests that clinical observations, just like lay observations, can be quantified using standard psychometric procedures, so that clinical description becomes statistical prediction.

Incremental validity and the assessment of psychopathology in adults

Results from studies on incremental validity are described for (a) interviews, (b) personality inventories, (c) projective techniques, and (d) brief self-rated and clinician-rated measures. In some of the studies (clinical judgment studies), psychologists were given increasing amounts of information. In other studies (statistical prediction studies), increasing amounts of assessment information were entered into a statistical prediction rule. Although relatively little research has been conducted on incremental validity, results that have been obtained tend to favor the use of interviews, personality inventories (e.g., the Minnesota Multiphasic Personality Inventory--2; J. N. Butcher, W. G. Dahlstrom, J. R., Graham, A. Tellegen, & B. Kaemmer, 1989), and brief self-rated measures (e.g., the Anxiety Sensitivity Index, S. Reiss, R. A. Peterson, D. M. Gursky, & R. M. McNally, 1986). Results are generally less encouraging for projective techniques.

Shared, not unique, components of personality and psychosocial functioning predict depression severity after acute-phase cognitive therapy

In a sample of 100 patients with recurrent major depression, we collected depression severity data early and late in acute-phase cognitive therapy, plus a wide range of psychosocial variables that have been studied extensively in depression research, including measures of interpersonal, cognitive, and social functioning, and personality traits using an inventory that is linked with the Big-Three tradition in personality assessment theory. By assessing this broad range of variables in a single study, we could examine the extent to which relations of these variables with depression were due to (a) a common factor shared across this diverse set of constructs, (b) factors shared among each type of construct (personality vs. psychosocial measures), or (c) specific aspects of the individual measures. Only the most general factor shared across the personality and psychosocial variables predicted later depression.

Separate personality traits from states to predict depression

Results have been inconsistent regarding the ability of personality measures to predict future depression severity levels, leading some researchers to question the validity of personality assessment, especially when patients are acutely depressed. Using a combination of regression and factor analytic techniques, we separated the variance of personality measures into stable trait and variable state-affect components. Findings supported the hypotheses that depression severity measured at different time points would correlate with both stable trait and concurrent state-affect components in personality measures, whereas change in depression severity would correlate with state changes but not with stable trait scores. Thus, personality assessments tap both state affect and trait variance, with the state-affect variance masking the trait variance when patients are depressed.