Personality Pathology and Interpersonal Problem Stability

What are we missing in dimensional models that might explain core dynamic processes in borderline personality disorder? Commentary on Miskewicz et al. (2022)

Comments on the original article by Miskewicz et al. (see record 2021-98114-001) regarding dimensional models that might explain core dynamic processes in borderline personality disorder. Miskewicz et al.'s findings provide strong evidence that although dynamic processes in borderline personality disorderare important, a trait-only model cannot fully explain core dynamic processes underlying symptom fluctuations as a function of context in borderline personality disorder (BPD). In fact, any single model is likely insufficient to explain BPD functioning in all its complexity. An important next step is to examine how traits and other theoretically and empirically informed constructs might synergistically (rather than merely independently) explain the dynamic expression of BPD symptoms in real-world contexts. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Decoupling Personality and Acute Psychiatric Symptoms in a Depressed Sample and a Community Sample

The association between depression and neuroticism is complex, but due to the difficulty in assessing neuroticism during mood episodes, the mechanisms underlying this relationship remain poorly understood. In this study, we sought to decompose neuroticism into finer-grained elements that were uncorrelated with psychiatric symptoms and to examine the incremental validity of those elements in explaining deficits in interpersonal functioning. A bifactor model with one general factor and six specific factors fit the data well in both a depressed (N=807) and a community (N=1,284) sample, and the specific factors were relatively independent of acute symptoms. Moreover, two specific factors (Angry Hostility and Self-Consciousness) accounted for incremental variance in interpersonal functioning problems in the community sample and in a subgroup of depressed participants. The results demonstrate that neuroticism can be decomposed into components that are distinct from symptoms and that are incrementally associated with deficits in interpersonal functioning.

Interpersonal Dynamics in Personality and Personality Disorders

Clinical and basic personality psychologists interact less than they should, given their similar interests. In clinical personality psychology, available evidence supports a transition from the current categorical system to a hierarchical trait scheme for diagnosing the stable features of personality disorder. However, trait models do not capture the dynamic aspects of personality disorders as they have been described in the clinical literature, and thus miss a clinically critical feature of personality pathology. In contrast, basic personality psychologists have coalesced around a consensual structure of individual differences and become increasingly interested in the dynamic processes that underlie and contextualize traits. But trait psychology models are not sufficiently specific to characterize dynamic personality processes. In this paper, I filter clinical descriptions of personality disorders through the lens of interpersonal theory to specify a recursive within–situation interpersonal pattern of motives, affects, behaviours, and perceptions that could contribute to the stable between–situation patterns of maladaptive behaviour of historical interest to both basic and clinical personality psychologists. I suggest that this interpersonal model adds specificity to recent proposals regarding processes in the basic personality literature and has significant potential to advance research on personality dynamics. © 2018 European Association of Personality Psychology

Coping Action Patterns as Mechanisms of Change Across Psychotherapies: Three Case Examples of Personality Disorders With Recurrent Major Depression

Maladaptive coping has been shown to be related to increased symptoms of distress and lower levels of well-being, whereas the use of adaptive coping has been shown to diminish distress and improve functioning. This suggests that change in coping may constitute a significant mechanism of change in psychotherapy. Utilizing a novel observer-rating method for assessing coping, the current report examined changes in overall coping functioning (OCF) in three participants with diverse personality disorders who were undergoing two different types of psychotherapy (cognitive-behavioral therapy and dynamic therapy) for recurrent major depression. Results showed that overall coping functioning improved in two cases and remained stable in a third. Preliminary findings, based on a detailed examination of changes in specific coping patterns, suggest that improvement may differ according to severity of personality pathology. As hypothesized, coping improved in both types of psychotherapy. Thus, overall results suggest that coping may constitute an important general mechanism of change.

The current state and future of factor analysis in personality disorder research

The major debates in the personality disorder (PD) field center on the structure of personality pathology. Factor analysis is designed to elucidate the underlying structure of observed phenomena. Therefore, factor analysis has already played a major role in the debates about the structure of PD, and will continue to be an often-used and indispensable tool moving forward. However, misconceptions about the utility and interpretation of factor analyses abound. The purpose of this article is to provide a conceptual primer on available factor analytic techniques and how they have been applied in PD research, and to highlight novel ways of using factor analysis moving forward. The techniques reviewed include exploratory and confirmatory factor analysis, exploratory structural equation modeling, multilevel structural equation modeling, and person-specific (i.e., P-technique) factor analysis. Additionally, the notion that exploratory and confirmatory factor analytic approaches lie on an exploratory to confirmatory spectrum is introduced. Examples from the published literature are used to illustrate key points. (PsycINFO Database Record

Identifying the Manipulative Mating Methods Associated With Psychopathic Traits and BPD Features

Psychopathy and borderline personality disorder (BPD) traits are associated with coercion and manipulation within relationships. The authors investigated whether BPD traits were uniquely associated with manipulation for emotional closeness whereas psychopathy was used for the purpose of attaining physical closeness. A community sample (N = 164) reported on mating behaviors, psychopathic traits, and BPD traits. Hierarchical regressions were conducted to predict mating behaviors that would account for the overlap between psychopathy and BPD. Total psychopathic traits were associated with lower levels of relationship exclusivity, greater use of partner poaching, and perpetration of sexual coercion. Specifically, callousness and egocentricity were related to lower relationship exclusivity. BPD traits were associated with the use of mate retention strategies, mate poaching, and victimization in sexual coercion. These findings indicate that manipulative mating behaviors encompass tools to achieve sex and intimacy. Those with BPD traits use these tools for emotional closeness, whereas those with psychopathic traits use them to obtain physical closeness and gratification.

Stability and fluctuation of personality disorder features in daily life

Very little is known about the daily stability and fluctuation of personality pathology. To address this gap in knowledge, we investigated the naturalistic manifestation of personality pathology over the course of 100 days. A group of individuals (N = 101) diagnosed with any personality disorder (PD) completed a daily diary study over 100 consecutive days (Mdn = 94 days, range = 33-101 days). Participants completed daily ratings of 30 manifestations of personality pathology. Patterns of stability and variability over the course of the study were then examined. Results indicated that individual PD manifestations and domains of PD manifestations were variable across days and differed widely in their frequency. Additionally, individual averages and level of variability in PD domains were highly stable across months, individual averages of PD domains were predicted by baseline dispositional ratings of PD traits with a high degree of specificity, and daily variability PD domains was associated with elevated levels of PD traits. This pattern of findings suggests that dynamic processes of symptom exacerbation and diminution that are stable in mean level and variability in expression over time characterizes personality pathology. Further, dispositional ratings are significant predictors of average daily expression of PD features. (PsycINFO Database Record

DSM-5 section III personality traits and section II personality disorders in a Flemish community sample

The Personality Inventory for DSM-5 (PID-5; Krueger et al., 2012) is a dimensional self-report questionnaire designed to measure personality pathology according to the criterion B of the DSM-5 Section III personality model. In the current issue of DSM, this dimensional Section III personality model co-exists with the Section II categorical personality model derived from DSM-IV-TR. Therefore, investigation of the inter-relatedness of both models across populations and languages is warranted. In this study, we first examined the factor structure and reliability of the PID-5 in a Flemish community sample (N=509) by means of exploratory structural equation modeling and alpha coefficients. Next, we investigated the predictive ability of section III personality traits in relation to section II personality disorders through correlations and stepwise regression analyses. Results revealed a five factor solution for the PID-5, with adequate reliability of the facet scales. The variance in Section II personality disorders could be predicted by their theoretically comprising Section III personality traits, but additional Section III personality traits augmented this prediction. Based on current results, we discuss the Section II personality disorder conceptualization and the Section III personality disorder operationalization.

Daily Interpersonal and Affective Dynamics in Personality Disorder

In this naturalistic study, the authors adopt the lens of interpersonal theory to examine between- and within-person differences in dynamic processes of daily affect and interpersonal behaviors among individuals (N = 101) previously diagnosed with personality disorders who completed daily diaries over the course of 100 days. Dispositional ratings of interpersonal problems and measures of daily stress were used as predictors of daily shifts in interpersonal behavior and affect in multilevel models. Results indicate that ∼40%-50% of the variance in interpersonal behavior and affect is due to daily fluctuations, which are modestly related to dispositional measures of interpersonal problems but strongly related to daily stress. The findings support conceptions of personality disorders as a dynamic form of psychopathology involving the individuals interacting with and regulating in response to the contextual features of their environment.