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Jakšić N, Marčinko D, Bjedov S, Mustač F, Bilić V. Personality Organization and Depressive Symptoms Among Psychiatric Outpatients: The Mediating Role of Shame. J Nerv Ment Dis 2022; 210:590-595. [PMID: 35152243 DOI: 10.1097/nmd.0000000000001494] [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: 11/25/2022]
Abstract
ABSTRACT Previous research has demonstrated relations between lower level of personality organization (PO) and multiple indices of mental health disturbances. The goal of this research was to examine whether experience of shame would mediate the relationship between PO and depressive symptoms in a sample of 321 Croatian psychiatric outpatients (64% female; mean age, 38.67 years). The total PO level exhibited positive associations with depressive symptoms and with all three subscales of shame ( p < 0.01). Characterological, behavioral, and bodily shame showed significant mediating effects in the PO-depression relationship, while controlling for the influence of age and sex. PO level seems to be strongly related to depressive disturbances, with the experience of shame representing one of the underlying mechanisms of this relationship. Given that patients with personality disorders ( i.e. , low PO level) suffer from poorer treatment outcomes for major mental disorders, more emphasis should be placed on psychotherapeutic management of shame-proneness.
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Affiliation(s)
- Nenad Jakšić
- Department of Psychiatry and Psychological Medicine, University Hospital Center Zagreb
| | | | - Sarah Bjedov
- Department of Psychiatry and Psychological Medicine, University Hospital Center Zagreb
| | - Filip Mustač
- Department of Psychiatry and Psychological Medicine, University Hospital Center Zagreb
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2
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Hörz-Sagstetter S, Ohse L, Kampe L. Three Dimensional Approaches to Personality Disorders: a Review on Personality Functioning, Personality Structure, and Personality Organization. Curr Psychiatry Rep 2021; 23:45. [PMID: 34181116 PMCID: PMC8238706 DOI: 10.1007/s11920-021-01250-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/26/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW The concept of personality functioning (Alternative DSM-5 Model of Personality Disorders) has led to increased interest in dimensional personality disorder diagnosis. While differing markedly from the current categorical classification, it is closely related to the psychodynamic concepts of personality structure and personality organization. In this review, the three dimensional approaches, their underlying models, and common instruments are introduced, and empirical studies on similarities and differences between the concepts and the categorical classification are summarized. Additionally, a case example illustrates the clinical application. RECENT FINDINGS Numerous studies demonstrate the broad empirical basis, validated assessment instruments and clinical usefulness of the dimensional concepts. Their advantages compared to the categorical approach, but also the respective differences, have been demonstrated empirically, in line with clinical observations. Evidence supports the three dimensional concepts, which share conceptual overlap, but also entail unique aspects of personality pathology, respectively.
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Affiliation(s)
| | - Ludwig Ohse
- Psychologische Hochschule Berlin (PHB), Am Köllnischen Park 2, 10179, Berlin, Germany
| | - Leonie Kampe
- Psychologische Hochschule Berlin (PHB), Am Köllnischen Park 2, 10179, Berlin, Germany
- Zentrum für Psychosoziale Medizin, Klinikum Itzehoe, Germany
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3
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Delaney JC, Yeomans F. Functions of the Treatment Contract in TFP. Psychodyn Psychiatry 2021; 49:322-338. [PMID: 34061653 DOI: 10.1521/pdps.2021.49.2.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The use of a verbal or written contract has been employed in many different modalities of treatment as a means of establishing the expectations and parameters of treatment. Traditionally, the contract is seen as serving a somewhat utilitarian purpose: setting up the practical conditions of treatment and providing a containing frame for the patient. Contracts, however, can extend to establishing agreed-upon goals of treatment, anticipating obstacles that may arise in the treatment and clarifying how they will be dealt with should they arise, and clearly defining the roles of the patient and therapist in a way that aids the exploratory process once the treatment has begun. Importantly, the mutually agreed-upon contract serves as a useful roadmap to keep the treatment focused and on track. In this article we will emphasize how the treatment contract can facilitate in-depth understanding of the patient's internal world, particularly when challenges to the contract are enacted by the patient. We will begin by briefly summarizing the functions of the contract and then focus on the key role of the treatment contract in furthering the exploratory process of the patient's dynamics as expressed in the transference/countertransference matrix.
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Affiliation(s)
- Jill C Delaney
- Clinical Associate Faculty, Weill Cornell Medical College, Department of Psychiatry; and Senior Fellow, The Personality Disorders Institute, New York Presbyterian Hospital, Department of Psychiatry, White Plains, New York
| | - Frank Yeomans
- Clinical Associate Professor of Psychiatry, Director of Training, Personality Disorders Institute, Weill Cornell Medical College; Adjunct Associate Clinical Professor of Psychiatry, Department of Psychiatry, Columbia University College of Physicians and Surgeons; and President, International Society for TFP
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4
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Cosentino S, Arias-Pujol E, Pérez-Testor C. Psychometric Properties of the Spanish Short Version of the Inventory of Personality Organization (IPO-18) in a Nonclinical Sample. J Pers Assess 2021; 103:659-666. [PMID: 33527846 DOI: 10.1080/00223891.2021.1878524] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This report supports validation for the Spanish 18-item short version of the Inventory of Personality Organization (IPO), a self-reported instrument for the assessment of personality organization, according to Kernberg's object-relation based model. The IPO is used to depict personality structure types, using three scales: psychological defense mechanisms, degree of identity integration and reality testing. The review of the literature suggests alternatively factorial solutions. Accordingly, this study, using a nonclinical sample (N = 315), tested the fit of several factorial models (2- and 3- factor solution) via the maximum likelihood approach. Confirmatory Factor Analysis revealed a better fit for the 2-factor solution (CFI = .97, TLI = .96, RMSEA = .037, AIC = 311.06), in accordance with Kernberg's theory. Each of the 2 IPO subscales shows good levels of internal consistency, and they are associated with increased negative affect, aggressive dyscontrol as well as depression, anxiety and general level of psychopathological distress in line with theoretical expectations. Our results suggest that the Spanish short version of the IPO is a reliable and valid tool for the assessment of personality organization following Kernberg's model.
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Affiliation(s)
- Salvatore Cosentino
- Department of Psychology, FPCEE Blanquerna, Ramon Llull University, Barcelona, Spain
| | - Eulàlia Arias-Pujol
- Department of Psychology, FPCEE Blanquerna, Ramon Llull University, Barcelona, Spain
| | - Carles Pérez-Testor
- Department of Psychology, FPCEE Blanquerna, Ramon Llull University, Barcelona, Spain
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5
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Meisner MW, Lenzenweger MF, Bach B, Vestergaard M, Petersen LS, Haahr UH, Kongerslev M, Simonsen E. Exploring Identity Disturbance and Psychotic Spectrum Symptoms as Predictors of Borderline and Schizotypal Personality Disorders. Psychopathology 2021; 54:193-202. [PMID: 34058737 DOI: 10.1159/000516209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 03/28/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Borderline personality disorder (BPD) and schizotypal personality disorder (SPD) were introduced in DSM-III and retained in DSM-5 Section II. They often co-occur and some aspects of the clinical differentiation between the 2 diagnoses remain unclear (e.g., psychotic-like features and identity disturbance). METHODS The present study explored if self-reported identity disturbance and psychosis proneness could discriminate between the BPD and SPD DSM-5 diagnoses. All patients were interviewed with the Schedules for Clinical Assessment in Neuropsychiatry and the Structured Clinical Interview for DSM-5 Personality Disorders, and administered the Inventory of Personality Organization, Self-Concept and Identity Measure, Schizotypal Personality Questionnaire, Perceptual Aberration Scale, and the Magical Ideation Scale. RESULTS A total of 105 patients were initially assessed, 26 were excluded, and the final sample (N = 79) was composed of 34 BPD patients, 25 SPD patients, and 20 patients with co-occurring SPD and BPD. The BPD group (n = 34) was first compared with the pure SPD group (n = 25), and secondly with the total group of patients diagnosed with SPD (n = 25 + 20). Logistic regression analyses indicated that primitive defenses and disorganization best differentiated the BPD and the pure SPD group, while primitive defenses and interpersonal factor along with perceptual aberrations best differentiated the BPD and the total SPD group. CONCLUSION Identity disturbance did not predict the diagnostic groups, but BPD patients were characterized by primitive defenses, which are closely related to identity disturbance. Pure SPD was characterized by oddness/eccentricity, while the lack of specificity for cognitive-perceptual symptoms suggests that the positive symptoms do not differentiate BPD from SPD.
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Affiliation(s)
- Maria W Meisner
- Psychiatric Research Unit, Region Zealand, Slagelse, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mark F Lenzenweger
- Department of Psychology, The State University of New York at Binghamton, Binghamton, New York, USA.,Department of Psychiatry, Weill Cornell Medical College, New York, New York, USA
| | - Bo Bach
- Psychiatric Research Unit, Region Zealand, Slagelse, Denmark.,Mental Health Services West, Psychiatry Region Zealand, Slagelse, Denmark
| | | | - Lea S Petersen
- Psychiatric Research Unit, Region Zealand, Slagelse, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ulrik H Haahr
- Psychiatric Research Unit, Region Zealand, Slagelse, Denmark
| | - Mickey Kongerslev
- Mental Health Services East, Psychiatry Region Zealand, Roskilde, Denmark.,Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Erik Simonsen
- Psychiatric Research Unit, Region Zealand, Slagelse, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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6
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Rumination mediates the relationship between personality organization and symptoms of borderline personality disorder and depression. PERSONALITY AND INDIVIDUAL DIFFERENCES 2021. [DOI: 10.1016/j.paid.2020.110339] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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7
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Shalala N, Tan J, Biberdzic M. The mediating role of identity disturbance in the relationship between emotion dysregulation, executive function deficits, and maladaptive personality traits. PERSONALITY AND INDIVIDUAL DIFFERENCES 2020. [DOI: 10.1016/j.paid.2020.110004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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8
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Miller CE, Townsend ML, Day NJS, Grenyer BFS. Measuring the shadows: A systematic review of chronic emptiness in borderline personality disorder. PLoS One 2020; 15:e0233970. [PMID: 32609777 PMCID: PMC7329066 DOI: 10.1371/journal.pone.0233970] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 05/15/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Chronic feelings of emptiness is an under-researched symptom of borderline personality disorder (BPD), despite indications it may be central to the conceptualisation, course, and outcome of BPD treatment. This systematic review aimed to provide a comprehensive overview of chronic feelings of emptiness in BPD, identify key findings, and clarify differences between chronic feelings of emptiness and related constructs like depression, hopelessness, and loneliness. METHOD A PRISMA guided systematic search of the literature identified empirical studies with a focus on BPD or BPD symptoms that discussed chronic feelings of emptiness or a related construct. RESULTS Ninety-nine studies met criteria for inclusion in the review. Key findings identified there were significant difficulties in defining and measuring chronic emptiness. However, based on the studies reviewed, chronic emptiness is a sense of disconnection from both self and others. When experienced at frequent and severe levels, it is associated with low remission for people with BPD. Emptiness as a construct can be separated from hopelessness, loneliness and intolerance of aloneness, however more research is needed to explicitly investigate these experiences. Chronic emptiness may be related to depressive experiences unique to people with BPD, and was associated with self-harm, suicidality, and lower social and vocational function. CONCLUSIONS AND IMPLICATIONS We conclude that understanding chronic feelings of emptiness is central to the experience of people with BPD and treatment focusing on connecting with self and others may help alleviate a sense of emptiness. Further research is required to provide a better understanding of the nature of chronic emptiness in BPD in order to develop ways to quantify the experience and target treatment. Systematic review registration number: CRD42018075602.
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Affiliation(s)
- Caitlin E. Miller
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Michelle L. Townsend
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Nicholas J. S. Day
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Brin F. S. Grenyer
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
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Drinkwater KG, Denovan A, Dagnall N. Lucid Dreaming, Nightmares, and Sleep Paralysis: Associations With Reality Testing Deficits and Paranormal Experience/Belief. Front Psychol 2020; 11:471. [PMID: 32256437 PMCID: PMC7093643 DOI: 10.3389/fpsyg.2020.00471] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 02/28/2020] [Indexed: 01/13/2023] Open
Abstract
Focusing on lucid dreaming, this paper examined relationships between dissociated experiences related to rapid eye movement (REM) sleep (lucid dreaming, nightmares, and sleep paralysis), reality testing, and paranormal experiences/beliefs. The study comprised a UK-based online sample of 455 respondents (110 males, 345 females, Mean age = 34.46 years, SD = 15.70), who had all previously experienced lucid dreaming. Respondents completed established self-report measures assessing control within lucid dreaming, experience and frequency of nightmares, incidence of sleep paralysis, proneness to reality testing deficits (Inventory of Personality Organization subscale, IPO-RT), subjective experience of receptive psi and life after death (paranormal experience), and paranormal belief. Analysis comprised tests of correlational and predictive relationships between sleep-related outcomes, IPO-RT scores, and paranormal measures. Significant positive correlations between sleep and paranormal measures were weak. Paranormal measures related differentially to sleep indices. Paranormal experience correlated with lucid dreaming, nightmares, and sleep paralysis, whereas paranormal belief related only to nightmares and sleep paralysis. IPO-RT correlated positively with all paranormal and sleep-related measures. Within the IPO-RT, the Auditory and Visual Hallucinations sub-factor demonstrated the strongest positive associations with sleep measures. Structural equation modeling indicated that Auditory and Visual Hallucinations significantly positively predicted dissociated experiences related to REM sleep, while paranormal experience did not. However, paranormal experience was a significant predictor when analysis controlled for Auditory and Visual Hallucinations. The moderate positive association between these variables explained this effect. Findings indicated that self-generated, productive cognitive-processes (as encompassed by Auditory and Visual Hallucinations) played a significant role in conscious control and awareness of lucid dreaming, and related dissociative sleep states (sleep paralysis and nightmares).
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Affiliation(s)
- Kenneth G. Drinkwater
- Department of Psychology, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, United Kingdom
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10
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Waugh MH, McClain CM, Mariotti EC, Mulay AL, DeVore EN, Lenger KA, Russell AN, Florimbio AR, Lewis KC, Ridenour JM, Beevers LG. Comparative Content Analysis of Self-Report Scales for Level of Personality Functioning. J Pers Assess 2020; 103:161-173. [PMID: 31917602 DOI: 10.1080/00223891.2019.1705464] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Content validity analyses of eight self-report instruments for assessing severity of personality disorder (PD), also known as Level of Personality Functioning (LPF), were conducted using the conceptual scheme of the Alternative Model for Personality Disorders (AMPD; APA, 2013). The item contents of these eight inventories were characterized for the LPF constructs of Identity (ID), Self-Direction (SD), Empathy (EM), and Intimacy (IN) along with the pathological personality trait domains of Negative Affectivity, Detachment, Antagonism, Disinhibition, and Psychoticism. Severity of pathology (SV) reflected in item content was also rated. Raters demonstrated robust agreement for AMPD and SV constructs across instruments. Similarity between instrument AMPD construct profiles was quantified by intraclass correlations (ICC). Results showed the instruments were generally similar in AMPD-construct coverage, but some important differences emerged. The subscales of the instruments also were characterized for the degree to which they reflect the four LPF (ID, SD, EM, IN) domain constructs. Collectively, these content validity comparisons clarify the equivalence of instruments for AMPD constructs and the relative proportions of construct coverage within instrument subscales. These results can inform future research with LPF self-report instruments and guide clinicians in selecting an LPF-related instrument for use in practice.
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Affiliation(s)
- Mark H Waugh
- Oak Ridge National Laboratory.,University of Tennessee, Knoxville
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11
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Sellbom M, Corey DM, Ben-Porath YS. Examining the Validity of the Multidimensional Personality Questionnaire in the Assessment of Police Candidates. Assessment 2019; 28:295-309. [PMID: 31718241 DOI: 10.1177/1073191119887443] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A well-validated test of normal personality functioning is necessary in preemployment evaluations of candidates for public safety positions. In this study, we evaluated the construct validity and predictive validity of one such measure, the Multidimensional Personality Questionnaire (MPQ), in a large sample of candidates for law enforcement positions. We examined associations between MPQ scale scores and biographical data, clinician suitability ratings on the 10 established California Commission on Peace Officer and Standards and Training (POST) psychological screening dimensions, and (for a subsample) posthire performance outcome data. MPQ scores generally demonstrated a conceptually expected pattern of associations with criterion variables, supporting their construct validity. Scores related to negative emotionality were particularly salient predictors of a range of POST-10 suitability ratings. Scales assessing aspects of positive emotionality, impulsivity, as well as absorption, emerged as the best predictors of posthire performance problems.
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Stanley B, Perez-Rodriguez MM, Labouliere C, Roose S. A Neuroscience-Oriented Research Approach to Borderline Personality Disorder. J Pers Disord 2018; 32:784-822. [PMID: 29469663 DOI: 10.1521/pedi_2017_31_326] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Traditionally, the study of personality disorders had been based on psychoanalytic or behavioral models. Over the past two decades, there has been an emerging neuroscience model of borderline personality disorder (BPD) grounded in the concept of BPD as a condition in which dysfunctional neural circuits underlie its pathological dimensions, some of which include emotion dysregulation (broadly encompassing affective instability, negative affectivity, and hyperarousal), abnormal interpersonal functioning, and impulsive aggression. This article, initiated at a joint Columbia University- Cornell University Think Tank on BPD with representation from the Icahn School of Medicine at Mount Sinai, suggests how to advance research in BPD by studying the dimensions that underlie BPD in addition to studying the disorder as a unitary diagnostic entity. We suggest that linking the underlying neurobiological abnormalities to behavioral symptoms of the disorder can inform a research agenda to better understand BPD with its multiple presentations.
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Affiliation(s)
- Barbara Stanley
- Department of Psychiatry, Columbia University, New York City
| | | | | | - Steven Roose
- Department of Psychiatry, Columbia University, New York City.,New York State Psychiatric Institute, New York City
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Dagnall N, Denovan A, Parker A, Drinkwater K, Walsh RS. Confirmatory Factor Analysis of the Inventory of Personality Organization-Reality Testing Subscale. Front Psychol 2018; 9:1116. [PMID: 30026714 PMCID: PMC6041939 DOI: 10.3389/fpsyg.2018.01116] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 06/11/2018] [Indexed: 01/21/2023] Open
Abstract
The reality testing dimension of the Inventory of Personality Organization, the IPO-RT, has emerged as an important index of proneness to reality testing deficits. However, to date few studies have examined the factorial structure of the IPO-RT in isolation. This is an important and necessary development because studies use the IPO-RT as a discrete measure. Additionally, psychometric evaluation of the IPO suggests alternative factorial solutions. Specifically, recent work supports multidimensionality, whereas initial IPO assessment evinced a unidimensional structure. Accordingly, this study, using a heterogeneous sample (N = 652), tested the fit of several factorial models (one-factor, four-factor oblique, second-order, and bifactor) via maximum likelihood with bootstrapping due to multivariate non-normality. Analysis revealed superior fit for the bifactor solution (correlated errors) (CFI = 0.965, SRMR = 0.036, RMSEA = 0.042). This model comprised a general reality testing dimension alongside four subfactors (auditory and visual hallucinations, delusional thinking, social deficits, and confusion). Inter-factor correlations were in the moderate range. Item loadings and omega reliability supported the notion that the IPO-RT emphasizes a single latent construct. The model demonstrated invariance across gender and partial age invariance. Overall, from a psychometric perspective, the IPO-RT functioned effectively at both global and, to an extent, factorial levels. Findings recommend that the IPO-RT should be scored as a total scale, and rather than treat subscales independently, future studies should consider examining factor variance alongside overall scale scores.
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Affiliation(s)
- Neil Dagnall
- Department of Psychology, Manchester Metropolitan University, Manchester, United Kingdom
| | - Andrew Denovan
- Department of Psychology, Manchester Metropolitan University, Manchester, United Kingdom
| | - Andrew Parker
- Department of Psychology, Manchester Metropolitan University, Manchester, United Kingdom
| | - Kenneth Drinkwater
- Department of Psychology, Manchester Metropolitan University, Manchester, United Kingdom
| | - R Stephen Walsh
- Department of Psychology, Manchester Metropolitan University, Manchester, United Kingdom
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Clarkin JF, Cain NM, Lenzenweger MF. Advances in transference-focused psychotherapy derived from the study of borderline personality disorder: clinical insights with a focus on mechanism. Curr Opin Psychol 2017; 21:80-85. [PMID: 29065381 DOI: 10.1016/j.copsyc.2017.09.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 09/12/2017] [Accepted: 09/15/2017] [Indexed: 10/18/2022]
Abstract
The most current conceptualization of personality pathology emphasizes the assessment of the severity of selected domains of functioning involving lack of accurate perceptions of self and others that are common across the personality disorder categories. Advances in our understanding of personality pathology have stimulated further development of Transference-Focused Psychotherapy (TFP) for patients with borderline personality disorder, including treatment focus on both behavior and mental representations of self and others, the trajectory of change in TFP, and the extension of TFP principles to the entire domain of personality pathology.
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Affiliation(s)
- John F Clarkin
- Clinical Professor of Psychology in Psychiatry, Weill Cornell Medical College, New York, NY, USA.
| | - Nicole M Cain
- Associate Professor of Psychology, Long Island University-Brooklyn, USA
| | - Mark F Lenzenweger
- Distinguished Professor of Psychology, Binghamton University, The State University of New York, Binghamton, NY, USA
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15
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Miner MH, Romine RS, Raymond N, Janssen E, MacDonald A, Coleman E. Understanding the Personality and Behavioral Mechanisms Defining Hypersexuality in Men Who Have Sex With Men. J Sex Med 2016; 13:1323-1331. [PMID: 27486137 PMCID: PMC4996734 DOI: 10.1016/j.jsxm.2016.06.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 06/28/2016] [Accepted: 06/30/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Hypersexuality has been conceptualized as sexual addiction, compulsivity, and impulsivity, among others, in the absence of strong empirical data in support of any specific conceptualization. AIM To investigate personality factors and behavioral mechanisms that are relevant to hypersexuality in men who have sex with men. METHODS A sample of 242 men who have sex with men was recruited from various sites in a moderate-size mid-western city. Participants were assigned to a hypersexuality group or a control group using an interview similar to the Structured Clinical Interview for the Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition. Self-report inventories were administered that measured the broad personality constructs of positive emotionality, negative emotionality, and constraint and more narrow constructs related to sexual behavioral control, behavioral activation, behavioral inhibition, sexual excitation, sexual inhibition, impulsivity, attention-deficit/hyperactivity disorder, and sexual behavior. MAIN OUTCOME MEASURES Hierarchical logistic regression was used to determine the relation between these personality and behavioral variables and group membership. RESULTS A hierarchical logistic regression controlling for age showed a significant positive relation between hypersexuality and negative emotionality and a negative relation with constraint. None of the behavioral mechanism variables entered this equation. However, a hierarchical multiple regression analysis predicting sexual behavioral control indicated that lack of such control was positively related to sexual excitation and sexual inhibition owing to the threat of performance failure and negatively related to sexual inhibition owing to the threat of performance consequences and general behavioral inhibition CONCLUSION Hypersexuality was found to be related to two broad personality factors that are characterized by emotional reactivity, risk taking, and impulsivity. The associated lack of sexual behavior control is influenced by sexual excitatory and inhibitory mechanisms, but not by general behavioral activation and inhibitory mechanisms.
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Affiliation(s)
- Michael H Miner
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA.
| | | | - Nancy Raymond
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA; Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - Erick Janssen
- Institute for Family and Sexuality Studies, Department of Neurosciences, KU Leuven, Leuven, Flanders, Belgium
| | - Angus MacDonald
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Eli Coleman
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
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Neacsiu AD, Herr NR, Fang CM, Rodriguez MA, Rosenthal MZ. Identity disturbance and problems with emotion regulation are related constructs across diagnoses. J Clin Psychol 2014; 71:346-61. [PMID: 25534425 DOI: 10.1002/jclp.22141] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE This study examined the relation between identity disturbance and emotion dysregulation in a cross-diagnostic sample. We assessed whether these constructs are related and relevant beyond borderline personality disorder (BPD). METHOD We recruited 127 participants who completed measures assessing identity disturbance, emotion dysregulation, anxiety, and depression. The sample included primarily depressed adults meeting criteria for multiple diagnoses as well as psychiatrically healthy participants. RESULTS Identity disturbance was significantly higher among psychiatric participants with and without BPD compared to healthy controls. Emotion dysregulation was a significant predictor of identity disturbance, even when controlling for BPD diagnosis, depression, and anxiety. In particular, clarity in emotional situations and problems using emotion regulation strategies were most closely related to identity disturbance. CONCLUSION The results of this study suggest that future research should examine identity disturbance and its relation with emotion regulation transdiagnostically.
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17
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Lenzenweger MF. Factors underlying the psychological and behavioral characteristics of Office of Strategic Services candidates: the assessment of men data revisited. J Pers Assess 2014; 97:100-10. [PMID: 25036728 DOI: 10.1080/00223891.2014.935980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
During World War II, the Office of Strategic Services (OSS), the forerunner of the Central Intelligence Agency, sought the assistance of clinical psychologists and psychiatrists to establish an assessment program for evaluating candidates for the OSS. The assessment team developed a novel and rigorous program to evaluate OSS candidates. It is described in Assessment of Men: Selection of Personnel for the Office of Strategic Services (OSS Assessment Staff, 1948). This study examines the sole remaining multivariate data matrix that includes all final ratings for a group of candidates (n = 133) assessed near the end of the assessment program. It applies the modern statistical methods of both exploratory and confirmatory factor analysis to this rich and highly unique data set. An exploratory factor analysis solution suggested 3 factors underlie the OSS assessment staff ratings. Confirmatory factor analysis results of multiple plausible substantive models reveal that a 3-factor model provides the best fit to these data. The 3 factors are emotional/interpersonal factors (social relations, emotional stability, security), intelligence processing (effective IQ, propaganda skills, observing and reporting), and agency/surgency (motivation, energy and initiative, leadership, physical ability). These factors are discussed in terms of their potential utility for personnel selection within the intelligence community.
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Affiliation(s)
- Mark F Lenzenweger
- a Department of Psychology , The State University of New York at Binghamton
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