Narcissistic Personality and Its Relationship with Post-Traumatic Symptoms and Emotional Factors: Results of a Mediational Analysis Aimed at Personalizing Mental Health Treatment

Association between pathogenic beliefs and personality disorders

Background and objectives

Personality disorders are significant entities in the field of psychiatry and serve as predisposing factors for Axis I clinical disorder. The Treatment of choice is psychotherapy, and one specific approach is Control Mastery Therapy, which emphasizes addressing Pathogenic beliefs (PB). This study aimed to investigate whether there is a relationship between PB and specific personality disorders and whether these beliefs align with the core features specified in the Diagnostic and Statistical Manual of Mental Disorders (DSM) for that personality disorder.

Materials and methods

This study employed a retrospective cross-sectional design and included 319 participants, comprising individuals receiving treatment at the Psychotherapy Clinic at Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University between 2007 and 2023. All participants were assessed and completed the Structured Clinical Interview for DSM-IV Axis II - Personality Disorders Questionnaire (SCID-II-PQ), Pathogenic Beliefs Scale, and Outcome-Inventory (depression). A generalized linear model (binary logistic regression) was employed, and the predictors included personality disorders. The outcome was the pathogenic belief, and covariates encompassed age, sex, education, clinical diagnosis, and depression score. A sensitivity analysis was conducted to examine the effect on the model when outliers of depressive scores were present.

Results

After adjusting for depression, ten personality disorders were found to predict 16 pathogenic beliefs out of the 27 outcomes examined. Notably, histrionic and obsessive-compulsive personality disorders showed no association with specific pathogenic beliefs. Furthermore, certain pathogenic beliefs were predicted by multiple personality disorders, while conversely, some personality disorders were associated with multiple pathogenic beliefs as well. Sensitivity analysis revealed that outliers influenced the relationships between certain disorders and pathogenic beliefs, particularly those with small effect sizes.

Conclusions

The profound impact of pathogenic beliefs intertwined with personality disorders, particularly influenced by childhood trauma and evident in Cluster B and schizotypal disorders, underscores the critical need for targeted psychotherapeutic interventions. Addressing these beliefs directly is key to enhancing treatment efficacy and patient outcomes. Pathogenic belief should be elicited in clinical settings regardless of personality disorder, especially those who experienced depression. Moving forward, rigorous research is imperative to validate and refine therapeutic approaches aimed at reshaping pathogenic beliefs, ensuring they become pivotal in transforming clinical practice and advancing mental health care.

Dispositional awe negatively predicts corruption via the sense of connectedness

Corruption is a political and economic issue that has a detrimental impact on social and economic development. This study investigated the predictive effect of dispositional awe on corruption, and the underlying mechanisms from the perspective of connectedness. A sample of 548 (Nfemale = 371) individuals, aged between 16 and 71 years old (M = 21.18, SD = 3.39), was collected. Participants completed scales to measure dispositional awe, the sense of connectedness, corruption, and social desirability. Structural equation modelling and a bootstrap procedure were used to analyze the relationship between the variables. Results showed that dispositional awe negatively predicted corruption, including the tendencies for giving and accepting bribes, and this could be explained by the sense of connectedness, after controlling for the effect of social desirability. The findings highlight the significance of dispositional awe in relation to corruption, enhance our understanding of the underlying mechanisms connecting the two variables, and provide practical implications for the prevention of corruption.

Neutrophil-to-lymphocyte ratio in relation to trauma severity as prognosis factors in patients with multiple injuries complicated by multiple organ dysfunction syndrome: A retrospective analysis

OBJECTIVE

This study aimed to explore potential risk factors for the occurrence of multiple organ dysfunction syndrome (MODS) in patients with multiple injuries by evaluating neutrophil-to-lymphocyte ratio (NLR)-associated trauma severity.

METHODS

This retrospective case-control study included 95 patients with multiple injuries, who were admitted to our hospital (between January 2018 and December 2020). Clinical data including gender, age, underlying disease, number of injury sites (NIS), injury severity score (ISS), hemoglobin level within 24 h of admission (HL-24h), neutrophil count (NC), white blood cell count, platelet count (PC), NLR, d-dimer level, activated partial thromboplastin time (APTT), complicated shock within 24 h of admission (CS-24h), length of stay, as well as prognostic outcome was systematically analyzed. According to MODS occurrence, patients were divided into a MODS group (n = 27) and a non-MODS group (n = 68). The risk factors affecting patients with multiple injuries complicated by MODS were identified using univariate and multivariate logistic regression analyses. Candidate risk factors were further analyzed using receiver operating characteristic (ROC) curves.

RESULTS

Univariate analysis revealed a significant difference between the MODS and non-MODA groups in terms of NIS, ISS, HL-24h, PC, APTT, d-dimer level, CS-24h, NLR, NC, prognostic outcome, and other indicators (p < .05). Multivariate logistic regression analysis showed that  d-dimer levels within 24 h of admission and ISS, NLR, and CS-24h were significantly associated with multiple injuries complicated by MODS. Compared with the non-MODS controls, the NLR in the MODS group showed a much higher level and tended to rise with the increase in ISS score, indicating a significant intergroup difference (p < .05). The ROC curve analysis results suggested that the NLR had good sensitivity and specificity for predicting the prognosis of patients with MODS with multiple injuries.

CONCLUSION

d-dimer level, ISS, NLR, and CS-24h are important risk factors for MODS in patients with multiple injuries. Notably, NLR expression may be a good indicator of injury severity and predictor of the occurrence of MODS in patients with multiple injuries. Therefore, assessment of injury severity and coagulation function, active resuscitation, as well as prevention of infection should be emphasized during treatment of multiple injuries, to reduce and prevent the risk of MODS in patients with multiple injuries.

A Network Analysis Approach toward Adaptive Overt Narcissism Network

The relationship between narcissistic personality and art and beauty appreciation has recently become the focus of research investigations. Adaptive narcissists raise their sense of worth in order to shield themselves from harm caused by others. Because they aspire to be more attractive, healthier, and successful versions of themselves, they frequently have greater success in life than the majority of people. Grandiose and overtly narcissistic behavior are the main recognized characteristics of an overt narcissist, which is currently regarded as a personality disorder that puts mental health and wellbeing at peril. On a random sample collection of data from 1101 respondents to an online questionnaire, we conducted a network analysis of the Adaptive Overt Narcissism Scale (AONS) items. In this study, we used a network analysis approach to examine the network structure of adaptive overt narcissism, as well as its relationships with psychological functioning. The present study utilized network analysis to investigate the centrality measures of items in the Adaptive Overt Narcissism Scale (AONS) and their interrelationships. Results indicated that item Q6.8 ("I appreciate art and beauty") had low betweenness, closeness, and strength centrality measures, indicating that it was less influential in the network. However, it also had negative expected influence, suggesting that its absence would have a destabilizing effect on the network. These results highlight the importance of the appreciation of art and beauty in deactivating the adaptive overt narcissist network. Further research is needed to explore the mechanisms underlying this relationship and its implications for narcissism prevention and intervention.

Awe weakens the AIDS-related stigma: The mediation effects of connectedness and empathy

Stigma toward people with HIV or AIDS produces significant harms to their life and also hinders the prevention of AIDS. In the present study, we tested whether awe can weaken AIDS-related stigma and the mediating role of connectedness and empathy between them through a cross-sectional study (Study 1, N = 372) and two experimental studies (Study 2a and 2b, N = 110 and N = 180, respectively). Results showed that awe reduced AIDS-related stigma (Study 2a and 2b), via the serial mediation of connectedness and empathy (Study 1 and 2b). These findings suggest that the experience of awe increases one's connectedness to the world, which then enhances empathy and decreases AIDS-related stigma. This study expands our understanding of the relationship between awe and stigma, providing empirical basis for decreasing social prejudice to others.