Personality inventory for DSM-5 brief form(PID-5-BF) in Chinese students and patients: evaluating the five-factor model and a culturally informed six-factor model

Evaluating a maladaptive personality-informed model of social support and post-traumatic stress disorder

BACKGROUND

Social support is a robust predictor of post-traumatic stress disorder (PTSD). Although the inverse relationship between perceived social support and PTSD (social causation model) is supported, less is understood about the antecedents of the social causation model. Further, there is limited research in non-Western psychiatric populations that experience elevated rates of trauma and PTSD (e.g., mood disorders). The present study evaluated whether cumulative traumatic life events influenced current PTSD symptoms through maladaptive personality traits and perceptions of social support among Asian patients with mood disorders.

METHODS

A total of 200 Asian patients (77.5 % Chinese) with mood disorders were assessed for maladaptive personality traits, perceptions of social support, cumulative traumatic life events, PTSD, and depressive symptoms. Structural equation modelling was conducted to evaluate the extended social causation model.

RESULTS

The extended social causation model demonstrated acceptable fit to the data (Comparative Fit Index [CFI] = 0.90; absolute Root Mean Square Error of Approximation [RMSEA] = 0.08). There were significant indirect effects of cumulative traumatic life events on current PTSD symptoms (β = 0.29, p < .001; 85 % variance explained) and depressive symptoms (β = 0.28, p < .001; 69 % variance explained).

LIMITATIONS

Results may not be generalizable beyond the Singapore population due to the socio-cultural and environmental context.

CONCLUSIONS

The present findings provide conceptual support for a maladaptive personality-informed model of social support and PTSD, which could better inform trauma-focused interventions in preventing and treating the debilitating effects of PTSD in psychiatric populations.

Clinical cut scores for the Persian version of the personality inventory for DSM-5

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.

Assessing measurement invariance of the SEGUE framework among Chinese and Ghanaian patients: A cross-sectional study

Objective

Measurement invariance assesses the psychometric equivalence of a construct across groups or across time. This study aimed to find out whether the newly modified 5-point Likert scale SEGUE Framework for evaluating doctor's communication skills demonstrates measurement invariance among Chinese and Ghanaian patients.

Methods

Measurement invariance tests were conducted using two samples collected from the two cultures respectively (China: N = 598 and Ghana: N = 591). Confirmatory Factor Analysis (CFA) was used to test for the factor structure. Multiple-group CFA was used to test the measurement invariance of the SEGUE between the two samples.

Results

The same five-factor model showed acceptable model fit in both Chinese and Ghanaian samples. Cross-cultural measurement invariance tests revealed that scalar invariance was observed across the two samples.

Conclusion

Cross-cultural adaptations of instruments should exhibit measurement invariance to ensure that measures are interpreted and used consistently. Findings of our study suggest that the SEGUE Framework is invariant across the two cultures, which increases confidence in data collection and comparison.

Innovation

This is the first study to establish measurement invariance among Chinese and Ghanaians using the SEGUE Framework which assesses doctors' communication from patients' perspectives.

Assessing the measurement invariance of the Personality Inventory for DSM-5 across Black and White americans

The Personality Inventory for DSM-5 (PID-5) is the primary tool for assessing maladaptive personality traits within the DSM-5 alternative model for personality disorders. Evidence has begun to accumulate on the replicability and measurement invariance of its five-domain factor structure across countries, clinical and community populations, and sex, but its equivalency across racial groups within a given country is largely unstudied. Attempting to replicate the evidence of noninvariance demonstrated by Bagby et al. (2022), we examined the factor structure of the PID-5 across White Americans (n = 612) and Black Americans (n = 613) within the United States. The five-domain structure emerged across both samples with reasonably congruent factor loadings. Therefore, we tested for measurement invariance using the 13-step framework advocated by Marsh et al. (2009) for personality data. We found support for the PID-5's comparability across racial groups, offering some preliminary backing for its use with Black Americans, though additional evidence is needed to clarify the conflicting results and further validate the instrument. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Dimensional models of personality disorders: Challenges and opportunities

Categorical models of personality disorders have been beneficial throughout psychiatric history, providing a mechanism for organizing and communicating research and treatment. However, the view that individuals with personality disorders are qualitatively distinct from the general population is no longer tenable. This perspective has amassed steady criticism, ranging from inconsequential to irreconcilable. In response, stronger evidence has been accumulated in support of a dimensional perspective that unifies normal and pathological personality on underlying trait continua. Contemporary nosology has largely shifted toward this dimensional perspective, yet broader adoption within public lexicon and routine clinical practice appears slow. This review focuses on challenges and the related opportunities of moving toward dimensional models in personality disorder research and practice. First, we highlight the need for ongoing development of a broader array of measurement methods, ideally facilitating multimethod assessments that reduce biases associated with any single methodology. These efforts should also include measurement across both poles of each trait, intensive longitudinal studies, and more deeply considering social desirability. Second, wider communication and training in dimensional approaches is needed for individuals working in mental health. This will require clear demonstrations of incremental treatment efficacy and structured public health rebates. Third, we should embrace cultural and geographic diversity, and investigate how unifying humanity may reduce the stigma and shame currently generated by arbitrarily labeling an individual's personality as normal or abnormal. This review aims to organize ongoing research efforts toward broader and routine usage of dimensional perspectives within research and clinical spaces.

The impacts of anhedonia on brain functional alterations in patients with major depressive disorder: A resting-state functional magnetic resonance imaging study of regional homogeneity

BACKGROUND

Anhedonia, as one of the core manifestations of major depressive disorder (MDD), has an effect on prognosis of the disease. However, the neuropathology of MDD is complex and the neural basis of anhedonia remains unclear. The aim of the present study was to investigate the impacts of anhedonia on brain functional alterations in patients with MDD.

METHODS

A total of 62 individuals including MDD patients with anhedonia (n = 22), MDD patients without anhedonia (n = 20), and healthy controls (HCs, n = 20) were recruited. All participants underwent resting-state functional magnetic resonance imaging scanning and intrinsic brain function was explored by using regional homogeneity (ReHo) method. A two-sample t-test was performed to explore ReHo differences between MDD patients and HCs, then analysis of variance (ANOVA) was introduced to obtain brain regions with significant differences among three groups, and finally post hoc tests were calculated for inter-group comparisons. Correlations between ReHo values of each survived area and clinical characteristics in MDD patients were further analyzed.

RESULTS

Compared with HCs, MDD showed increased ReHo in the left superior temporal gyrus (STG) and bilateral inferior frontal gyrus (IFG), as well as decreased ReHo in the left superior frontal gyrus (SFG). Interestingly, this relationship was attenuated and no longer significant after consideration for the effect of anhedonia in MDD patients. MDD patients with anhedonia were more likely to exhibit decreased ReHo in the left SFG and left middle cingulate gyrus (MCG) when comparing to HCs. No significant difference was found between MDD patients without anhedonia and HCs, either the two groups of MDD patients. There was no significant association between ReHo values of each survived area and clinical characteristics in MDD patients.

CONCLUSIONS

The present results suggest that the impacts of anhedonia on brain functional alterations in MDD should be emphasized and disturbed intrinsic brain function in the frontal-limbic regions may be associated with anhedonia in MDD patients.

Pre-existing Psychiatric Morbidity Is Strongly Associated to Takotsubo Syndrome: A Case-Control Study

Background

Takotsubo syndrome (TTS) is an emerging disease characterized by an acute and reversible myocardial dysfunction which may have an influence on clinical status and prognosis. Despite extensive research, its pathophysiology has not been completely elucidated; among other hypothesis, a heart-brain interaction has been proposed.

Methods

The aim of this study was to assess the impact of psychiatric disorders and of some personality types on the pathogenesis of TTS. We conducted a retrospective observational case-control study. We enrolled a total of 50 patients, 25 with a previous diagnosis of TTS and 25 patients with a history of acute coronary syndrome (ACS), that underwent a comprehensive lifetime psychiatric assessment.

Results

We found no significant difference between TTS and ACS patients in cardiovascular risk profile. The frequency of lifetime psychiatric disorders was significantly greater in TTS. In particular, in the univariate analysis, TTS group showed a higher prevalence of mood disorders (Major Depressive Disorder, Bipolar Disorder, Dysthymia; 16 vs. 2, P < 0.001) and anxiety disorder (Generalized Anxiety Disorder, Panic Disorder, Agoraphobia; 20 vs. 8, P = 0.001) compared with ACS group. There was also a significant tendency in TTS patients to psychotropic medication use, substance abuse, and psychologist or psychiatrist consulting. However, there was no difference between the groups in previous stressful events and Type D personality. Moreover, the multivariate analysis showed that mood disorders were independently associated with TTS (OR 16.9, 95% CI, 2.2–127).

Conclusion

Our study demonstrated that pre-existing anxiety disorders and mostly mood disorders were significantly higher in TTS patients than in ACS group, suggesting the role of psychiatric disorders as possible pathophysiological substrate of TTS.

Psychometric properties of the Persian version of short-form five factor borderline inventory (FFBI-SF)

BACKGROUND

The Five-Factor Borderline Inventory-Short Form (FFBI-SF) is a self-report measure developed to assess traits of Borderline Personality Disorder (BPD) from the perspective of the Five-Factor Model of general personality. This study was designed to examine the factor structure, internal consistency, and convergent/discriminant validity of the Persian FFBI-SF in a sample of Iranian university students.

METHODS

A total of 641 university students (M-age = 28.04, SD = 8.21, 66.7% women) completed the online forms of the FFBI-SF, PID-5-BF, and Mini IPIP.

RESULTS

Confirmatory factor analysis supported the original and modified (without item 47) twelve-factor models. Also, Cronbach's alpha (α) for the FFBI-SF scores ranged from unacceptable to excellent ranges. However, when relying on MIC values to measure internal consistency, the FFBI-SF Total and subscale scores demonstrated adequate internal consistency. Finally, the FFBI Total and subscale scores showed the expected relations with other personality measures scores (e.g., Neuroticism, Antagonism, and Conscientiousness), which supports the validity of the interpretation of the FFBI-SF scores.

CONCLUSIONS

The findings indicated that FFBI-SF is a useful tool with sound psychometric properties for assessing BPD traits in Iranian students and may spark research in other Iranian settings (e.g., community and clinical samples).