Ripples in the water: Fluctuations of narcissistic states in daily life

Narcissistic traits are traditionally viewed as consistent similar to the mirrorlike self-reflection of Narcissus in the water. However, evidence suggests that state levels of narcissism are more dynamic than previously believed. The current research explored fluctuations within and between grandiose and vulnerable narcissism in daily life. We investigated whether individuals' levels of grandiosity and vulnerability (a) vary, (b) are instable, and (c) display inertia and cross-lagged effects in their daily narcissistic expressions. Participants (N = 253; Mage = 22, 85% female) completed grandiose and vulnerable narcissistic trait questionnaires. Using ecological momentary assessment, they further completed up to 60 grandiose and vulnerable narcissistic state questionnaires over 6 days. The results showed that higher grandiose and vulnerable narcissistic traits led to more within-person variability within their corresponding states. Additionally, higher grandiose leadership/authority traits related to greater vulnerable within-person variability, while grandiose self-absorption/self-admiration reduced this. Similarly, all narcissistic traits, except for exploitativeness/entitlement and egocentrism, were positively related to increased instability in their corresponding state. Further, both grandiose and vulnerable narcissistic states demonstrated significant inertia, that is, lingering narcissistic endorsements within their own states. Overall, though the effect sizes were limited, the results showed that grandiosity and vulnerability include time-variant states that are intertwined and need to be acknowledged as additional moving, dimensional constructs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Imagery rescripting: The value of an added positive emotion component

BACKGROUND AND OBJECTIVES

Imagery Rescripting (ImRs) aims to reduce trauma-related negative emotions and intrusions. Positive emotions during ImRs may aid coping with the consequences of trauma, but protocols vary in the extent to which they explicitly target such positive emotions. We used a multiple-day design with a trauma film paradigm to investigate whether adding an explicit positive emotion component to ImRs improved intervention effects in a non-clinical sample. In addition, we explored potentially differential effects on high, medium, and low arousal positive affect.

METHODS

Participants (n = 105) were randomly assigned to either a standard ImRs condition, to an ImRs condition with an added explicit positive emotion component targeting joy (ImRs+), or to a non-intervention control (NIC) condition. Participants watched a trauma film on day 1, received the condition-specific intervention on day 2, and completed additional post-assessments of positive and negative affect on day 3. In addition, participants recorded intrusions from the trauma film from day 1 until day 3.

RESULTS

Compared to standard ImRs and NIC, ImRs + significantly increased positive affect. Exploratory analyses showed that this increase concerned medium and high, but not low arousal positive affect. No significant between-group differences were found for negative affect and intrusion-related outcomes.

LIMITATIONS

Floor effects for intrusions and negative affect limited our ability to fully investigate the potential benefits of targeting positive affect.

CONCLUSIONS

Adding a positive emotion component to ImRs reliably improved positive affect. More research is needed to determine whether explicitly targeting positive affect improves efficacy of ImRs for intrusion-related outcomes.

The effect of aggressive fantasizing on aggressive inclinations: Moderating effects of dispositional anger expression

Experiencing victimization or mistreatment often induces feelings of anger. The catharsis hypothesis suggests that venting anger may aid in alleviating these negative emotions. Although this hypothesis has faced criticism, therapeutic interventions rooted in catharsis are employed to assist victims in managing their anger. One notable application of the catharsis principle in psychotherapeutic practice with victims involves engaging in aggressive fantasies: Victims who harbor aggressive fantasies against their offenders are supported in working with these fantasies to navigate the complex emotions arising from their victimization. Research investigating the effects of aggressive fantasizing on victims has yielded inconsistent findings, with some studies indicating positive and others suggesting negative outcomes. Herein, we examine whether (instructed) aggressive fantasizing diminishes (catharsis hypothesis) or heightens (escalation hypothesis) subsequent aggressive inclinations compared to non-aggressive fantasizing. Additionally, the moderating role of victims' dispositional tendencies to express anger, specifically Anger Expression-out and Anger Expression-control, in the relationship between aggressive fantasizing and aggressive inclinations was examined. We recruited individuals (N = 245) who had experienced victimization through highly unfair treatment and instructed them to imagine confronting their wrongdoer using either aggressive or non-aggressive communication. Participants then reported their aggressive inclinations. Data supported the escalation hypothesis, revealing that aggressive fantasizing amplifies subsequent aggressive inclinations. Importantly, individuals with higher Anger Expression-out demonstrated greater susceptibility to this effect; whereas, Anger Expression-control did not moderate the link between aggressive fantasizing and inclinations. These findings further challenge the catharsis hypothesis and underscore the role of dispositional anger expression tendencies on the effects of aggressive fantasizing.

Sadism and Personality Disorders

PURPOSE OF REVIEW

Sadistic pleasure-the enjoyment of harm-infliction to others-can have devastating interpersonal and societal consequences. The goal of the current review is to illuminate the nomological net of traits related to sadism. We aim to achieve an understanding of the current empirical status on the link between sadism and personality disorders, psychopathy, the Dark Triad, and basic personality traits in clinical and community-based samples.

RECENT FINDINGS

The field is dominated by self-report studies on the Dark Triad with convenience samples. The link with DSM personality disorders has hardly been empirically studied. Existing evidence shows that sadism is most strongly related to increased psychopathic personality traits. Sadism can originate both from the interpersonal, affective, and behavioural basis of dark personality traits. There are diverging ideas on the differential status between sadism, psychopathy, and other dark traits. Research is needed on the causal impact of the broader range of personality disorders on sadism, in more diverse samples, including behavioural assessments of sadistic pleasure, as well as on the interplay of such personality traits with situational and affective aspects, and victim attitudes.

The Relationship Between Early Maladaptive Schemas and Cluster C Personality Disorder Traits: A Systematic Review and Meta-Analysis

PURPOSE OF REVIEW

We systematically reviewed and meta-analyzed the literature on the relationship between early maladaptive schemas (EMSs) and Cluster C personality disorders (PDs). Our aim was to clarify which of the 18 EMSs exhibit the strongest associations and are most frequently endorsed in clinical and non-clinical samples with Cluster C PDs and traits.

RECENT FINDINGS

After initially screening 2622 records, 12 studies were selected with 5310 participants. Meta-analyses of the raw correlation coefficients for each EMS-Cluster C PD link (3-8 studies per meta-analysis) indicated that the 18 EMSs were significantly related to all three Cluster C PDs with r's ranging from .13 to .63. However, when considering endorsement rates among multiple regression studies that controlled for the EMSs intercorrelations and the effects of other PD traits and demographics, specific EMS constellations emerged for each Cluster C PD. Overall, the findings of the current paper suggest that Cluster C PDs might be conceptualized on the basis of a hybrid EMS model, in which all EMSs contribute to global personality dysfunction whereas specific EMS patterns reflect unique personality disorder style expressions. Longitudinal research with appropriate methodology is needed to draw more definite conclusions on the EMSs-Cluster C PDs relationships.

Early Maladaptive Schemas and Schema Modes in clinical disorders: A systematic review

PURPOSE

Although schema therapy has been predominantly applied to treat personality disorders, interest into its application in other clinical disorders is growing. Central to schema therapy are Early Maladaptive Schemas (EMS) and Schema Modes. Since existing EMS and Schema Modes were primarily developed in the context of personality disorders, their relevance for clinical disorders is unclear.

METHODS

We conducted a systematic review of the presence of EMS and Schema Modes in clinical disorders according to DSM criteria. Per disorder, we evaluated which EMS and Schema Modes were more pronounced in comparison with clinical as well as non-clinical control groups and which EMS and Schema Modes were most highly endorsed within the disorder.

RESULTS

Although evidence concerning EMS was scarce for several disorders, and only few studies on Schema Modes survived inclusion criteria, we identified meaningful relationships and patterns for EMS and Schema Modes in various clinical disorders.

CONCLUSIONS

The present review highlights the relevance of EMS and Schema Modes for clinical disorders beyond personality disorders. Depending on the theme of the representation, EMS act as vulnerabilities both across diagnoses and for specific disorders. Thus, EMS and resulting Schema Modes are potential, valuable targets for the prevention and treatment of clinical disorders.

Showing True Colours: EMA Case Descriptions of Narcissistic States

Traditionally, narcissistic characteristics are considered relatively stable, although clinical accounts and recent research show that additional narcissistic states are variable and fluctuate in actuality. Narcissism research tends to focus on cross-sectional, group-based, trait approaches. Momentary ecological assessments allow one to discover individuals' true colors by observing narcissistic experiences while they unfold in real-time and real-world settings. Within momentary ecological assessments, inspecting single cases enables insight into individual dynamics and presentations. Consequently, this research collected grandiose and vulnerable narcissistic trait and state data 10 times a day for 6 days. Based on the highest trait scores, two individual cases are presented per category: predominantly grandiose narcissistic, predominantly vulnerable narcissistic, and combined narcissistic. Overall, the descriptions provide evidence for the dynamics within and between grandiose and vulnerable narcissistic states. Further, broad patterns for each narcissistic dimension were uncovered, in which the grandiose subdimension experienced mainly grandiosity, and the vulnerable and combined subdimensions experienced both grandiosity and vulnerability. Out of the three, the combined subdimension experienced the highest instability and levels of daily vulnerability. However, each individual case showed unique fluctuation patterns that highlight the importance of personalized, real-life assessments in research and clinical care.

The hot and the cold in destructive leadership: Modeling the role of arousal in explaining leader antecedents and follower consequences of abusive supervision versus exploitative leadership

Due to its devastating consequences, research needs to theoretically and empirically disentangle different sub-types of destructive leadership. Based on concepts derived from aggression research distinguishing re- and proactive aggression, we provide a process model differentiating abusive supervision and exploitative leadership. High versus low arousal negative affect is installed as the central mediating factor determining (1) whether perceived goal-blockage (leadership antecedents) leads to abusive supervision versus exploitative leadership and (2) whether a specific leadership behavior leads to active versus passive follower behavior (leadership consequence). Further, theoretical anchoring of individual and contextual moderators onto the model's process paths is provided and exemplary hypotheses for concrete moderation effects are deduced. Based on the provided process model, we highlight four recommendations to facilitate process-based construct differentiation in future research on destructive leadership. To precisely understand the differences and commonalities in different forms of destructive leadership will ultimately enable custom-tailored inter- and prevention.

Plain Language Summary

Negative leadership—also named “destructive” leadership—has very bad effects on followers and organizations. There are not just one, but many forms of destructive leadership and it is important to understand where different sub-types come from (i.e., to understand their antecedents) and which specific effect they have (i.e., to understand their consequences). In this paper, we focus on better understanding two forms of destructive leadership, namely abusive supervision and exploitative leadership. These two forms are similar to the two main forms of aggression. Abusive supervision is similar to reactive aggression, an impulsive “hot blooded” form of aggression. Exploitative leadership is similar to proactive aggression, a premeditated “cold blooded” form of aggression. We explain the parallels between the two forms of aggression and the two forms of leadership and provide a model which allows to predict when one versus the other form of leadership occurs and to which follower behavior they lead. An important factor in this model is the physiological characteristic of the emotional reaction to an event (i.e., arousal). An emotional reaction can be high in arousal; for instance, anger is a high arousal negative emotional reaction. On the contrary, boredom, for instance, is a low arousal negative emotional reaction. Dependent on whether both a leader and a follower react to a negative event (e.g., not getting what they want, being treated badly by others) with high or low arousal, their behavior will be different. We explain how this mechanism works and how it can help us to better predict leaders' and followers' behavior. We also outline how individual characteristics of the leader and follower and characteristics of their environment and context interact with arousal and their behavior.

The role of subclinical psychopathic traits on experimentally induced self- and other-compassion

Psychopathic traits come with high levels of anger and aggression. Since previous studies showed that compassion can mitigate both anger and aggression, the current research puts compassion forward as a possible target to alleviate psychopathy's destructive patterns. Specifically, the present study explored the influence of subclinical psychopathic traits-as well as their three subcomponents egocentricity, callousness, and antisociality-on the efficacy of experimentally induced self-compassion (SC) and other-compassion (OC). This manuscript is part of a larger study in which student and community participants (N = 230, M age = 27.41, 65.2% female) completed a psychopathic trait questionnaire to assess their dimensional level of psychopathy, filled out state SC and OC questionnaires, and were randomized to participate in an experimental self- or other-compassion induction. It was expected that psychopathic traits would positively relate to increases in SC but negatively relate to increases in OC. Baseline levels of both SC and OC negatively related to psychopathy. Overall, as expected, the results on change scores show that subclinical psychopathic traits positively related to a stronger increase in SC, irrespective of the type of compassion induction. This positive relation between a stronger increase in SC and psychopathy total and callousness was more pronounced after the SC induction, rather than after the OC induction. Psychopathic traits did not differentially influence changes in OC. One implication of this study is that high psychopathic and callousness traits predispose to profit extra from targeting SC. Furthermore, psychopathic traits do not hinder increasing compassion for others. These findings suggest that compassion is a promising intervention to improve the wellbeing of people with elevated subclinical psychopathic traits and those around them. Although further research is needed to assess the impact of compassion on anger and aggression specifically, and on clinical psychopathy, the current study suggests that both SC and OC may be useful intervention targets in case of elevated psychopathic traits.

Narcissistic traits and compassion: Embracing oneself while devoiding others

Grandiose narcissistic traits refer to exploitative and arrogant attitudes, while vulnerable narcissistic traits entail hypersensitivity to judgment and low self-esteem. Little is known about how individuals with narcissistic traits can improve their attitudes toward themselves and others. The current research puts self- and other compassion forward as possible targets to alleviate some of destructive patterns of narcissism. Generally, self-compassion (SC) has previously been associated with beneficial effects on psychological wellbeing, while other compassion (OC) is advantageous for interpersonal relationships. This study explored the relationship between narcissistic traits and the efficacy of experimental compassion inductions. Student and community participants (N = 230, M age = 27.41, 65.2% female) completed grandiose and vulnerable narcissistic trait, SC and OC state questionnaires, and either an SC or OC induction. It was expected that individuals with higher narcissistic traits (particularly grandiose traits) would benefit from the inductions and show higher SC after but would have greater difficulty showing meaningful increases in OC (especially OC directed at the general population). The results indicated that individual differences in grandiose and vulnerable narcissistic traits are related to the magnitude of improvements following the inductions: the theorized lack of SC in individuals with vulnerable oversensitivity to judgment traits seems possible to be counteracted through different types of compassion exercises. Moreover, higher grandiose exploitativeness-entitlement and global vulnerable narcissistic traits related to less increases than others. However, directly inducing OC in individuals with these traits was linked to greater OC improvements than improvements after inducing SC. Overall, the present findings suggest that self-compassionate behavior can be improved in individuals with high oversensitivity and that other compassionate behavior could potentially be increased if, specifically, other compassion exercises are utilized when higher levels of certain narcissistic traits are present.

Painfully bored: the role of negative urgency and history of Non-Suicidal Self-Injury in Self-Administering painful stimuli

The current study aims to examine the causal effect of boredom on non-suicidal self-injury (NSSI), expanding prior experimental research by including an anger induction to compare to a boredom induction, and additionally measuring whether participants specifically seek painful stimulation. In a sample of mostly undergraduate students (N = 146), emotional state was manipulated through video induction, and NSSI behavior was simultaneously measured, operationalized through self-administration of electric shocks. Participants’ pain thresholds were measured beforehand. NSSI history and negative urgency were included as potential moderators. Results showed that boredom increased both frequency and intensity of self-administered electric shocks, especially in participants with an NSSI history. Negative urgency was not a significant moderator. No causal anger-NSSI link was found, possibly due to the anger induction not being sufficiently effective. Clinical implications are considered through suggestions of boredom coping skills training as an intervention strategy in NSSI populations.

Modulating Behavioural and Self-Reported Aggression with Non-Invasive Brain Stimulation: A Literature Review

Aggressive behaviour is at the basis of many harms in society, such as violent crime. The efforts to explain, study, and possibly reduce aggression span various disciplines, including neuroscience. The specific brain networks which are involved in the modulation of aggressive behaviour include cortical asymmetry and brain areas such as the dorsolateral prefrontal cortex (DLPFC), the ventrolateral prefrontal cortex (VLPFC), and the ventromedial prefrontal cortex (VMPFC). Recent non-invasive brain stimulation (NIBS) research suggests that both transcranial direct current stimulation (tDCS) and continuous theta burst stimulation (cTBS) can play a role in the modulation of aggressive behaviour by directly changing brain activity. In this review, we systematically explore and discuss 11 experimental studies that aimed to modulate aggressive behaviour or self-reported aggression using NIBS. Out of these 11 studies, nine significantly up- or downregulated aggression by using tDCS or cTBS targeting the DLPFC, VLPFC or VMPFC. The potential applications of these findings span both the clinical and the forensic psychological domains. However, the results are limited by the methodological heterogeneity in the aggression measures used across the studies, and by their generally small sample sizes. Future research should consider improving the localization and specificity of NIBS by employing neuro-navigational instruments and standardized scoring methods.

Virtual Reality for Aggression Assessment: The Development and Preliminary Results of Two Virtual Reality Tasks to Assess Reactive and Proactive Aggression in Males

Validly measuring aggression is challenging because self-reports are plagued with biased answer tendencies and behavioral measures with ethical concerns and low ecological validity. The current study, therefore, introduces a novel virtual reality (VR) aggression assessment tool, differentially assessing reactive and proactive aggression. Two VR tasks were developed, one in an alley environment (N = 24, all male, Mage = 23.88, 83.3% students) and an improved second one in a bar (N = 50, all male, Mage = 22.54, 90% students). In this bar VR task, participants were randomly assigned to either the reactive condition where they were triggered by a cheating and insulting dart-player or to the proactive condition where they could earn extra money by aggressing. Participants' level of self-reported aggression and psychopathy was assessed, after which they engaged in either the reactive or proactive VR task. Changes in affect and blood pressure were also measured. Aggression in the reactive VR task was evidenced to mostly display convergent validity because it positively correlated with self-reported aggression and total and fearless dominance factor scores of psychopathy, and there was a trend relationship with increased systolic blood pressure. The validity of the proactive aggression variant of our VR bar paradigm received less support, and needs more refinement. It can be concluded that VR is a potentially promising tool to experimentally induce and assess (reactive) aggression, which has the potential to provide aggression researchers and clinicians with a realistic and modifiable aggression assessment environment.

The efficacy of incorporating mental imagery in cognitive restructuring techniques on reducing hostility: A randomized controlled trial

BACKGROUND AND OBJECTIVES

Cognitive restructuring (CR) is an effective intervention for hostility. However, the number of patients who fail to benefit suggest that the efficacy of CR can be further improved. The present study investigated whether enhancing CR with mental imagery techniques can increase its efficacy.

METHODS

A high hostility sample (28% male, and 72% female) was randomized over one session of imagery enhanced CR (I-CR) (n = 34), traditional CR (n = 32) or an active control session (AC) (n = 21). Changes in hostile beliefs, aggressive tendencies, state anger and hostility traits were assessed pre- and post-treatment, and at one-week follow-up.

RESULTS

Results showed that both I-CR and CR efficaciously reduced hostile beliefs, aggressive tendencies and anger, to a stronger degree than AC. I-CR was more efficacious and sustainable over time than both CR and AC in reducing hostile beliefs and aggressive tendencies.

LIMITATIONS

This study was conducted using a small, non-treatment seeking sample.

CONCLUSIONS

Findings suggest that implementing imagery techniques in CR for hostile beliefs enhances its' efficacy.

Interpretation bias modification for hostility: A randomized clinical trial

Objective: Hostility is a transdiagnostic phenomenon that can have a profound negative impact on interpersonal functioning and psychopathological severity. Evidence suggests that cognitive bias modification for interpretation bias (CBM-I) potentially reduces hostility. However, stringent efficacy studies in people with clinical levels of hostility are currently lacking. Method: The present study investigated the effects of CBM-I in two studies: one feasibility study (Study 1) in a mixed clinical-community sample of men (N = 29), and one randomized clinical study (Study 2) in a mixed-gender sample with clinical levels of hostility (N = 135), pre-registered at https://osf.io/r46jn. We expected that CBM-I would relate to a larger increase in benign interpretation bias and larger reductions in hostile interpretation bias, hostility symptoms and traits, and general psychiatric symptoms at post-intervention compared to an active control (AC) condition. We also explored the beneficial carry-over effects of CBM-I on working alliance in subsequent psychotherapy 5 weeks after finishing CBM-I (n = 17). Results: Results showed that CBM-I increased benign interpretation bias in both studies and partially reduced hostile interpretation bias in Study 2, but not in Study 1. Findings of Study 2 also showed greater reductions in behavioral (but not self-reported) aggression in CBM-I relative to control, but no condition differences were found in self-report hostility measures and general psychiatric symptoms. Conclusions: Overall, we found modest support for CBM-I as an intervention for hostility, with some evidence of its efficacy for hostile interpretation bias and aggression. We discuss study limitations as well as directions for future research. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Humor in Dark Personalities: An Empirical Study on the Link Between Four Humor Styles and the Distinct Subfactors of Psychopathy and Narcissism

Background

Humor is a main ingredient of interpersonal relationships. Two sets of psychopathological traits known for their devastating impact on interpersonal relationships are psychopathy and narcissism. The current study was developed to provide a fine-grained analysis of the relationship between four humor styles (affiliative, self-enhancing, self-defeating, and aggressive) and both psychopathic and narcissistic traits. Specifically, it addresses how humor styles relate to the three psychopathy subfactors (following the triarchic model) and four subfactors of grandiose narcissism.

Method

Self-report measures in a non-clinical male sample N = 177.

Results

Multiple regression analyses revealed psychopathic and narcissistic traits’ relation to using both benign and injurious humor. Subfactor analyses showed that aggressive and self-defeating humor were mostly associated with impulsivity and entitlement, while dominance levels actuated the use of humor to cope with stress. The cold-heartedness component of psychopathy proved to be particularly humorless, setting it aside as a distinctively disturbing psychopathic subfactor.

Conclusions and implications

Humor strongly colors the interpersonal style of both psychopathic and narcissistic personalities. Differential components of both personality types inform on the possible underlying motivations that drive the use of distinct styles of humor. This implies that psychopathic and narcissistic traits could potentially be lowered through the alternation of humor styles.

Toward a More Valid Assessment of Behavioral Aggression: An Open Source Platform and an Empirically Derived Scoring Method for Using the Competitive Reaction Time Task (CRTT)

While the Competitive Reaction Time Task (CRTT) is the most used behavioral aggression paradigm, it is characterized by methodological heterogeneity and quantification strategies for its' outcome are unstandardized. Therefore, the standards of measuring aggression should be improved. This article contributes on such an improvement by providing: (a) a freely available CRTT online administration program, and (b) a factor-analytically derived scoring method. Based on a combined sample (n = 423), a two-factor model was fit to the 30-trial CRTT version. The first factor included all trial scores subsequent to the first time the participant received aversive feedback (i.e., provoked factor) and the second factor included all trial scores prior to this first aversive feedback (i.e., unprovoked factor). Construct validity was evidenced based on the factors` differential relationship with self-reported aggression and narcissism. Our factor analytic findings empirically support the superiority of one of the existing CRTT scoring methods, that is, separately averaging all preprovocation versus all postprovocation trials. We discuss practical recommendations for CRTT users and outline future empirical avenues. This article aims at stimulating joint efforts to move toward standardization of CRTT implementation and outcome measure analysis.

Early maladaptive schemas and their relation to personality disorders: A correlational examination in a clinical population

Personality disorder (PD) pathology has been linked to early maladaptive schemas (EMSs). Because of a large heterogeneity in study populations, sample size, statistical analyses and conceptualizations in the literature, the exact relationships between PDs and EMSs are still unclear. The current study examined the relationship between borderline, dependent, avoidant and obsessive–compulsive PDs, represented dimensionally as number of traits, and 15 different EMSs as measured by the Young Schema Questionnaire (YSQ). A total of N = 130 inpatients took part in the study (M^age = 43.6, gender = 51.5% female). Stepwise regressions indicated that borderline, dependent, avoidant and obsessive–compulsive PD traits were partly characterized by specific EMSs and EMSs grouped as domains (i.e., other‐directedness domain for dependent PD and overvigilance for obsessive–compulsive PD) and that relations with a variety of domains and EMSs were overlapping for the PD dimensions (i.e., disconnection and rejection for both borderline and avoidant PDs). This suggests that PDs are reflected by a hybrid model of EMSs, with some EMSs and domains that relate to a broader vulnerability factor for PDs, and other domains that differentially relate to the independent PDs. Findings are informative for clinicians, as various EMSs per PD may be targeted in therapy.

Psychopathy subfactors distinctively predispose to dispositional and state-level of sadistic pleasure

BACKGROUND AND OBJECTIVES

Sadistic pleasure - the enjoyment of harm-infliction to others - can have devastating interpersonal and societal consequences. The current knowledge on non-sexual, subclinical forms of sadistic pleasure is poor. The present study therefore focussed on the personality correlates of sadistic pleasure and investigated the relationship between the different subcomponents of psychopathy and both dispositional and state-level sadistic pleasure.

METHOD

N = 120 males drawn from a community sample filled out questionnaires to assess their level of psychopathy and dispositional sadism. Then, participants engaged in a bug-grinder procedure in which they were led to believe that they were killing pill bugs. The positive affect they reported after ostensibly killing the bugs served as measures of sadistic pleasure. The bug-grinding task was repeated a second time after installing either a positive victim attitude combined with giving human names to the bugs, or a negative victim attitude combined with labeling the bugs with numbers.

RESULTS

Although the Self-centred Impulsivity component of psychopathy had some relevance to sadism, it was the Coldheartedness subscale that showed the strongest relationship to sadistic pleasure. Specifically, increased Coldheartedness was uniquely related to more positive affect, along with less guilt after bug grinding.

LIMITATIONS

Drawbacks of the study include the unique reliance on a male, community sample, and the potential impact of demand characteristics, including a suggestion that the participant put at least some bugs into the grinder.

CONCLUSIONS

Our findings underscore the differential predictive value of psychopathy components for sadistic pleasure. Coldheartedness can be considered especially disturbing because of its unique relationship to harm-infliction of the most irreversible nature (i.e. killing), and gaining pleasure out of it.

Schema modes mediate the effect of emotional abuse in childhood on the differential expression of personality disorders

BACKGROUND

There is sound evidence that childhood maltreatment increases the likelihood of developing personality disorders (PDs). However, research on the possible mechanisms involved in the relationship between childhood maltreatment and PDs is scarce. One potential mediator of the maltreatment-PD relationship are schema modes, reflecting dynamic states of cognition, emotion, and behaviour.

AIMS

The current study aimed to explore the mediating effect of schema modes on the association between childhood maltreatment and the expression of Cluster B (borderline and antisocial) and C (avoidant and dependent) PDs.

METHOD

Within a mixed sample of N = 120 clinical PD patients and non-clinical participants, a multivariate path model including interview-assessed childhood maltreatment (emotional abuse, emotional neglect, sexual abuse, and physical abuse), schema modes (child, parent, coping and healthy modes), and borderline, antisocial, avoidant and dependent PDs was explored.

RESULTS

The path model depicted five significant indirect links from emotional abuse on PDs via distinct schema modes. The impact of emotional abuse on borderline PD was mediated by child and coping modes, while parent modes mediated the link to antisocial PD. Healthy modes acted as a mediator on dependent and avoidant PDs.

CONCLUSIONS

The results indicate emotional abuse as a main predictor of schema mode clusters and emphasize the mediating role of schema modes on the maltreatment-related pathways towards PDs. Therapeutic implications are discussed with a special focus on healthy modes.

Severity Indices of Personality Problems-Short Form in Old-Age Psychiatry: Reliability and Validity

The Severity Indices of Personality Problems (SIPP; Verheul et al., 2008) is a popular self-report questionnaire that measures severity of maladaptive personality functioning. Two studies demonstrated the utility of the short form (SIPP-SF) among older adults but validation in clinical settings is lacking. Therefore, we examined the psychometric properties of the SIPP-SF in a large sample of older adult Dutch outpatients (N = 124; age range = 60-85 years, M = 69.8, SD = 5.3). The SIPP-SF domains showed good to excellent internal reliability (Cronbach's α = .75-.91) and effectively discriminated between participants with and without a personality disorder, as assessed with the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II). Convergent validity of the SIPP-SF was examined with instruments for measuring personality pathology among older adults (Informant Personality questionnaire [HAP]; Gerontological Personality Disorders Scale [GPS]). The GPS generally correlated with the SIPP-SF domains in expected directions, with small to large effect sizes. For the HAP, only 1 scale correlated with all SIPP-SF domains. No associations were found between the SIPP-SF and psychiatric symptomatology as measured by the Brief Symptom Inventory (BSI). The SIPP-SF appears to be a promising instrument for assessing maladaptive personality functioning among older adult outpatients.

Executive Functioning in 60+ Autistic Males: The Discrepancy Between Experienced Challenges and Cognitive Performance

As executive functioning (EF) is especially sensitive to age-related cognitive decline, EF was evaluated by using a multi-method assessment. Fifty males (60-85 years) with a late adulthood autism spectrum condition (ASC) diagnosis and 51 non-ASC males (60-83 years) were compared on cognitive tests across EF domains (cognitive flexibility, planning, processing speed, and working memory) and a self- and proxy report of the Behavior Rating Inventory of Executive Function-Adult Version. While no objective performance differences emerged, autistic males and their proxies did report more EF challenges than non-ASC males on the subjective measure. In order to know how to support the older autistic men who received their ASC diagnosis in late adulthood with their daily life EF challenges, it is important to understand what underlies these subjective EF problems.

Borderline personality disorder traits and affect reactivity to positive affect induction followed by a stressor

BACKGROUND AND OBJECTIVES

Affective hyperreactivity is a core feature of Borderline Personality Disorder (BPD), yet little is known about reactivity of positive affect (PA). Objectives were to explore the relationship between BPD traits and affect reactivity in response to a personalized PA-induction and a subsequent stressor. Patient status (seeking outpatient treatment for personality-related problems; yes/no), depressive symptoms, and age were examined as alternative predictors of affect reactivity.

METHODS

One hundred and eight females (35 patients) reported on their BPD and depressive symptoms. They completed the Best Possible Self-exercise and a modified Trier Social Stress Task. Trajectories of high and low arousal PA (HAP and LAP) and negative affect (NA) were analyzed with mixed regression modelling.

RESULTS

Patient status (for HAP) and depressive symptoms (for LAP and NA) predicted affect reactivity better than BPD traits. Patients showed a weaker HAP increase after PA-induction, and a similar HAP decrease after the stressor, compared to non-patients. Higher depressive symptoms predicted stronger improvement of LAP and NA after PA-induction, and less pronounced deterioration of LAP and NA after the stressor, relative to baseline.

LIMITATIONS

The sample was a convenience sample amplified with outpatients. Future research should (1) use clinical groups, (2) randomize to neutral vs. PA-induction, and (3) continue to differentiate between HAP and LAP.

CONCLUSIONS

Our results do not support models postulating BPD-specific affective hyperreactivity. HAP and LAP have different trajectories, depending on the degree of psychopathology. The resilience-enhancing potential of a PA-focus in psychotherapy needs further research.

Cognitive predictors of reactive and proactive aggression in a forensic sample: A comparison with a non-clinical sample

This study aimed at examining cognitive predictors of reactive and proactive aggression in a forensic-psychiatric (n = 80) and a non-clinical sample (n = 98; Brugman et al., 2015). Three different cognitive predictors were incorporated: (1) attentional bias towards aggressive stimuli (measured with Emotional Stroop task) and towards angry faces (measured with a visual search task); (2) interpretation biases (measured with Aggressive Interpretative Bias Task (AIBT) and a vignette task), and (3) implicit self-aggression association (measured with a Single-Target Implicit Association Task). To measure aggression, the Reactive-Proactive Aggression Questionnaire (RPQ) and the Taylor Aggression Paradigm (TAP) were used. An automatic self-aggression association positively predicted proactive aggressive behavior on the TAP in both samples. Furthermore, this self-aggression association predicted, increased self-reported proactive aggression (RPQ) in the forensic sample only. Pain, injury, and danger interpretations reported on the vignettes, negatively predicted self-reported proactive aggression in both samples. A stronger aggressive interpretation bias on the AIBT predicted more reactive aggressive behavior (TAP) in the non-clinical sample only. Taken together, findings show both common and distinct mechanisms in reactively vs. proactively driven aggressive behavior.

Exploring mechanisms of change in schema therapy for chronic depression

BACKGROUND AND OBJECTIVES

The underlying mechanisms of symptom change in schema therapy (ST) for chronic major depressive disorder (cMDD) have not been studied. The aim of this study was to explore the impact of two potentially important mechanisms of symptom change, maladaptive schemas (proxied by negative idiosyncratic core-beliefs) and the therapeutic alliance.

METHODS

We drew data from a single-case series of ST for cMDD. Patients with cMDD (N = 20) received on average 78 repeated weekly assessments over a course of up to 65 individual sessions of ST. Focusing on repeated assessments within-individuals, we used mixed regression to test whether change in core-beliefs and therapeutic alliance preceded, followed, or occurred concurrently with change in depressive symptoms.

RESULTS

Changes in core-beliefs did not precede but were concurrently related to changes in symptoms. Repeated goal and task agreement ratings (specific aspects of alliance) of the same session, completed on separate days, were at least in part associated with concurrent changes in symptoms.

LIMITATIONS

By design this study had a small sample-size and no control group.

CONCLUSIONS

Contrary to what would be expected based on theory, our findings suggest that change in core-beliefs does not precede change in symptoms. Instead, change in these variables occurs concurrently. Moreover, alliance ratings seem to be at least in part colored by changes in current mood state.

Elucidating DSM-5 and ICD-11 Diagnostic Features of Borderline Personality Disorder Using Schemas and Modes

BACKGROUND

Borderline personality disorder (BPD) comprises a heterogeneous constellation of problems operationalized in the DSM-5 and the forthcoming ICD-11. In schema therapy, schemas and modes are employed to conceptualize and treat these problems.

AIM

The current study investigated whether the 9 diagnostic BPD features are associated with schemas and modes.

METHOD

Psychiatric outpatients with predominant BPD features (n = 142; 68% females) were administered the Structured Clinical Interview for DSM-IV Axis II (SCID-II) and self-report inventories for schemas and modes. Associations were investigated by means of bivariate point-biserial correlations and multiple logistic regression analysis.

RESULTS

BPD features were largely associated with conceptually related schemas and modes. Consistent with the schema therapy literature and previous research, we found schemas of Abandonment/Instability and Mistrust/Abuse along with modes of Angry/Enraged Child, (internalized) Punitive Parent, and Impulsive Child to uniquely predict thematically related BPD features including fear of abandonment, self-destructiveness, feelings of emptiness, stress-related paranoid ideation, inappropriate anger, and impulsivity.

CONCLUSION

Most of the 9 BPD features were related to conceptually meaningful schemas/modes, suggesting that BPD is composed of dormant themes along with salient affective-behavioral responses. Consequently, individual BPD features may be differentially conceptualized and targeted in therapy by means of schemas and modes.

Cognitive Behavioral Therapy vs. Eye Movement Desensitization and Reprocessing for Treating Panic Disorder: A Randomized Controlled Trial

Objective: Cognitive Behavioral Therapy (CBT) is an effective intervention for patients with panic disorder (PD). From a theoretical perspective, Eye Movement Desensitization and Reprocessing (EMDR) therapy could also be useful in the treatment of PD because: (1) panic attacks can be experienced as life threatening; (2) panic memories specific to PD resemble traumatic memories as seen in posttraumatic stress disorder (PTSD); and (3) PD often develops following a distressing life event. The primary objective of this Randomized Controlled Trial (RCT), was to compare EMDR therapy with CBT for PD and determine whether EMDR is not worse than CBT in reducing panic symptoms and improving Quality Of Life (QOL). Methods: Two-arm (CBT and EMDR) parallel RCT in patients with PD (N = 84). Patients were measured at baseline (T1), directly after the last therapy session (T2), and 3 months after ending therapy (T3). Non-inferiority testing (linear mixed model with intention-to-treat analysis) was applied. Patients were randomly assigned to 13 weekly 60-min sessions of CBT (N = 42) or EMDR therapy (N = 42). Standard protocols were used. The primary outcome measure was severity of PD at T3, as measured with the Agoraphobic Cognitions Questionnaire (ACQ), the Body Sensations Questionnaire (BSQ), and the Mobility Inventory (MI). The secondary outcome measure was QOL, as measured with the World Health Organization Quality of Life short version (WHOQOL-Bref), at T3. Results: The severity of PD variables ACQ and BSQ showed non-inferiority of EMDR to CBT, while MI was inconclusive (adjusted analyses). Overall QOL and general health, Psychological health, Social relationships, and Environment showed non-inferiority of EMDR to CBT, while Physical health was inconclusive. Conclusion: EMDR therapy proved to be as effective as CBT for treating PD patients. Trial Registration: Dutch Trial Register, Nr. 3134 http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3134.

Examining the reactive proactive questionnaire in adults in forensic and non-forensic settings: A variable- and person-based approach

The Reactive Proactive Questionnaire (RPQ) was originally developed to assess reactive and proactive aggressive behavior in children. Nevertheless, some studies have used the RPQ in adults. This study examines the reliability of the RPQ within an adult sample by investigating whether reactive and proactive aggression can be distinguished at a variable- and person-based level. Male adults from forensic samples (N = 237) and from the general population (N = 278) completed the RPQ questionnaire. Variable-based approaches, including factor analyses, were conducted to verify the two-factor model of the RPQ and to examine alternative factor solutions of the 23 items. Subsequently, a person-based approach, i.e., Latent Class Analysis (LCA), was executed to identify homogeneous classes of subjects with similar profiles of aggression in the observed data. The RPQ proved to have sufficient internal consistency. Multiple-factor models were examined, but the original two-factor model was statistically and theoretically considered as most solid and in line with previous research. The multi-level LCA identified three different classes of aggression severity (class 1 showed low aggressive behavior; class 2 subjects displayed modest aggression levels; and class 3 exhibited the highest level of aggressive behavior). In addition, class 1 and 2 showed more reactive than proactive aggression, whereas class 3 displayed comparable levels of reactive/proactive aggression. The RPQ appears to have clinical relevance for adult populations in the way that it can distinguish severity levels of aggression. Before the RPQ is implemented in adult populations, norm scores need to be developed. Aggr. Behav. 43:155-162, 2017. © 2016 Wiley Periodicals, Inc.

Are non-demented patients with Parkinson's disease able to decide about their own treatment?

INTRODUCTION

Patients with Parkinson's disease (PD) are often confronted with difficult medical decisions, which might be hampered by cognitive impairment or chronic stress. Little is known, however, about the capacity to make medical decisions and the influence of cognition and stress on this ability. This study determined whether non-demented Parkinson's disease patients are able to make medical decisions and whether this capacity is influenced by cognition and stress.

METHODS

Forty-six Parkinson's disease patients and 94 healthy controls were assessed with the MacArthur Competence Assessment Tool for Treatment during which participants were presented with deep brain stimulation as a treatment option for a fictional Parkinson's disease patient. Furthermore, all participants were examined with a stress questionnaire and a neuropsychological test battery.

RESULTS

Parkinson's disease patients performed better on the total scale and 'Understanding' subscale of the MacArthur Competence Assessment Tool for Treatment than healthy controls. Lower performance on the Concept Shifting Test in the Parkinson's disease group and lower performance on Letter Digit Substitution Test in the healthy control group predicted lower medical decision-making capacity. No association was found between stress and medical decision-making.

CONCLUSION

Non-demented Parkinson's disease patients show no impairments in medical decision-making compared to healthy controls. In fact, Parkinson's disease patients have a better understanding of their disease and the benefits and risks of treatment options than healthy controls. Psychomotor speed and attention were negatively associated with medical decision-making in both groups. This implies that when these cognitive functions decline, the capacity to make medical decisions also declines.

Through rose-coloured glasses: An empirical test of narcissistic overestimation

BACKGROUND

Grandiosity is designated as a hallmark trait of narcissism. The current study tested whether narcissistic traits are related to overestimation of a range of agentic performances.

METHOD

Eighty-five non-patients executed six objective tasks to assess their level of (emotional) intelligence, first impression, attractiveness, social skills and learning performance. They were also asked to estimate their level of functioning in these six areas. This estimation was given on two moments: before and after performing the objective tasks. Our main variable of interest was the degree to which subjective estimation exceeds objective scores.

RESULTS

Narcissistic traits were related to overestimation of (emotional) intelligence, attractiveness and social skills, particularly at a global level before performing the tasks.

LIMITATIONS

The use of a homogenous student sample; Mainly agentic performances, were studied.

CONCLUSION

Overall, the findings provide a theoretical validation of unwarranted feelings of grandiosity as a core narcissistic criterion. Copyright © 2016 John Wiley & Sons, Ltd.

Acting and Feeling Like a Vulnerable Child, an Internalized "Bad" Parent, or a Healthy Person: The Assessment of Schema Modes in Non-Clinical Adolescents

Schema modes are strong, predominant, momentary (state-like) emotional and cognitive states, and maladaptive coping responses that occur when underlying personality schemas are activated by emotional events. The current study employed the Schema Mode Inventory for Adolescents (SMI-A) to assess such schema modes in a sample of non-clinical adolescents (n = 530). Confirmatory factor analysis revealed that the hypothesized model of the SMI-A with 14 separate schema modes provided a good fit for the data. Reliability coefficients for the various schema modes were all in the adequate to good range. Finally, the validity of the SMI-A was supported by significant and meaningful relations between schema modes on the one hand and early maladaptive schema domains, symptoms of psychopathology, and quality of life on the other. Taken together, the psychometric properties of the SMI-A are promising, and the SMI-A can be considered a viable instrument to assess schema modes in adolescents.

An Empirical Test of Rejection- and Anger-Related Interpretation Bias in Borderline Personality Disorder

The authors tested whether borderline personality disorder (BPD) is characterized by interpretation bias for disambiguating stimuli in favor of threatening interpretations, especially concerning abuse, abandonment, rejection, and anger-core emotional triggers for BPD patients. A mixed sample of 106 patients with marked BPD traits and nonpatients were assessed with SCID I and II and were presented with vignettes depicting ambiguous social interactions. Interpretations of these vignettes were assessed both in a closed and an open answer format. Results showed that BPD traits were related to a rejection- (closed and open answer formats) and an anger-related interpretation bias (closed answer option only). Cluster C traits were associated with self-blame interpretations. Aside from further validating the cognitive model of BPD, these findings denote interpretation bias as a key feature in patients with BPD that might contribute to their emotional hyperreactivity and interpersonal problems. These findings also highlight the importance of therapeutically normalizing interpretative bias in BPD and cluster C patients.

Schema therapy for chronic depression: Results of a multiple single case series

BACKGROUND AND OBJECTIVES

The aim of this study was to test the effects of individual schema therapy (ST) for patients with chronic depression.

METHODS

Using a multiple-baseline single case series design, patients with chronic major depressive disorder (N = 25) first entered a 6-24 weeks baseline phase; this phase functioned as a no-treatment control condition. Then, patients started a 12 week exploration phase during which symptoms and underlying schemas were explored; this phase functioned as an attention control condition. Next, patients received up to 65 sessions of individual ST. The Beck Depression Inventory II (BDI-II) and the Quick Inventory of Depressive Symptomatology (QIDS) were the primary outcome measures. The BDI-II was assessed once a week during all phases of the study resulting in 100 repeated assessments per participant on average. Mixed regression analysis was used to contrast change in symptoms during the intervention with change in symptoms during the baseline and exploration control phases.

RESULTS

When compared to the no-treatment control period, the intervention had a significant, large effect on depressive symptoms (Cohen's d BDI-II = 1.30; Cohen's d QIDS = 1.22). Effects on secondary continuous outcomes were moderate to large.

LIMITATIONS

The small sample size and lack of a control group.

CONCLUSIONS

These findings provide evidence that ST might be an effective treatment for patients with chronic depression.

The Role of the Insular Cortex in Retaliation

The insular cortex has consistently been associated with various aspects of emotion regulation and social interaction, including anger processing and overt aggression. Aggression research distinguishes proactive or instrumental aggression from retaliation, i.e. aggression in response to provocation. Here, we investigated the specific role of the insular cortex during retaliation, employing a controlled behavioral aggression paradigm implementing different levels of provocation. Fifteen healthy male volunteers underwent whole brain functional magnetic resonance imaging (fMRI) to identify brain regions involved in interaction with either a provoking or a non-provoking opponent. FMRI group analyses were complemented by examining the parametric modulations of brain activity related to the individual level of displayed aggression. These analyses identified a hemispheric lateralization as well as an anatomical segregation of insular cortex with specifically the left posterior part being involved in retaliation. The left-lateralization of insular activity during retaliation is in accordance with evidence from electro-physiological studies, suggesting left-lateralized fronto-cortical dominance during anger processing and aggressive acts. The posterior localization of insular activity, on the other hand, suggests a spatial segregation within insular cortex with particularly the posterior part being involved in the processing of emotions that trigger intense bodily sensations and immediate action tendencies.

Cognitive predictors of violent incidents in forensic psychiatric inpatients

This study tested the predictive value of attentional bias, emotion recognition, automatic associations, and response inhibition, in the assessment of in-clinic violent incidents. Sixty-nine male forensic patients participated and completed an Emotional Stroop to measure attentional bias for threat and aggression, a Single Target - Implicit Association Task to assess automatic associations, a Graded Emotional Recognition Task to measure emotion recognition, and an Affective Go/NoGo to measure response inhibition. Violent incidents were derived from patient files and scored on severity level. The predictive value of level of psychopathy was tested with the Psychopathy Checklist - Revised (PCL-R). Generalized linear mixed model analyses showed that increased attention towards threat and aggression, difficulty recognizing sad faces and factor 2 of the PCL-R predicted the sum of violent incidents. Specifically, verbal aggression was predicted by increased attention towards threat and aggression, difficulty to recognize sad and happy faces, and PCL-R factor 2; physical aggression by decreased response inhibition, higher PCL-R factor 2 and lower PCL-R factor 1 scores; and aggression against property by difficulty recognizing angry faces. Findings indicate that cognitive tasks could be valuable in predicting aggression, thereby extending current knowledge on dynamic factors predicting aggressive behavior in forensic patients.

The relationship between personality disorder traits and reactive versus proactive motivation for aggression

There is a strong link between personality disorders (PDs) and aggression. This is reflected in high prevalence rates of PD diagnoses in forensic samples, and in several diagnostic criteria of PDs directly referring to elevated levels of aggression. Aggression can stem from two distinct types of motivation; reactive or impulsive aggression that serves as a defensive reaction to provocation, and proactive or premeditated aggression used to gain extrinsic benefits. Although some clinical conditions like antisocial, borderline, and narcissistic PDs or PD traits, have been empirically linked to reactive and/or proactive aggression, the current study pioneers assessing the relationship between reactive and proactive aggression and traits of all 10 PDs. A mixed sample of patient and non-patient (N=238) participants were administered with the SCID II to assess the level of PD traits; they also completed the Reactive Proactive Questionnaire to determine levels of reactive and proactive aggression. Results showed that paranoid PD traits were positively related to reactive aggression, whereas proactive aggression was uniquely related to antisocial PD traits. This highlights the importance of differentiating between distinct motivations for aggression in PD samples.

The role of the partner and relationship satisfaction on treatment outcome in patients with chronic fatigue syndrome

BACKGROUND

Cognitive behaviour therapy (CBT) for chronic fatigue syndrome (CFS) leads to a significant decrease in CFS-related symptoms and disability. The primary objective of this study was to explore whether partners' solicitous responses and patients' and partners' perceived relationship satisfaction had an effect on treatment outcome.

METHOD

The treatment outcome of a cohort of 204 consecutively referred patients treated with CBT was analysed. At baseline, CFS patients completed the Maudsley Marital Questionnaire. The Checklist Individual Strength subscale Fatigue and the Sickness Impact Profile total scores completed by CFS patients post-treatment were used as measures of clinically significant improvement. Partners completed the Family Response Questionnaire, the Maudsley Marital Questionnaire, the Brief Illness Perception Questionnaire, and the Causal Attribution List. Logistic regression analyses were performed with clinically significant improvement in fatigue and disability as dependent variables and scores on questionnaires at baseline as predictors.

RESULTS

Solicitous responses of the partner were associated with less clinically significant improvement in fatigue and disability. Partners more often reported solicitous responses when they perceived CFS as a severe condition. Patients' relationship dissatisfaction was negatively associated with clinically significant improvement in fatigue.

CONCLUSIONS

Partners' solicitous responses and illness perceptions at the start of the therapy can negatively affect the outcome of CBT for CFS. We emphasize the importance of addressing this in therapy.

No Effects of Bilateral tDCS over Inferior Frontal Gyrus on Response Inhibition and Aggression

Response inhibition is defined as the capacity to adequately withdraw pre-planned responses. It has been shown that individuals with deficits in inhibiting pre-planned responses tend to display more aggressive behaviour. The prefrontal cortex is involved in both, response inhibition and aggression. While response inhibition is mostly associated with predominantly right prefrontal activity, the neural components underlying aggression seem to be left-lateralized. These differences in hemispheric dominance are conceptualized in cortical asymmetry theories on motivational direction, which assign avoidance motivation (relevant to inhibit responses) to the right and approach motivation (relevant for aggressive actions) to the left prefrontal cortex. The current study aimed to directly address the inverse relationship between response inhibition and aggression by assessing them within one experiment. Sixty-nine healthy participants underwent bilateral transcranial Direct Current Stimulation (tDCS) to the inferior frontal cortex. In one group we induced right-hemispheric fronto-cortical dominance by means of a combined right prefrontal anodal and left prefrontal cathodal tDCS montage. In a second group we induced left-hemispheric fronto-cortical dominance by means of a combined left prefrontal anodal and right prefrontal cathodal tDCS montage. A control group received sham stimulation. Response inhibition was assessed with a go/no-go task (GNGT) and aggression with the Taylor Aggression Paradigm (TAP). We revealed that participants with poorer performance in the GNGT displayed more aggression during the TAP. No effects of bilateral prefrontal tDCS on either response inhibition or aggression were observed. This is at odds with previous brain stimulation studies applying unilateral protocols. Our results failed to provide evidence in support of the prefrontal cortical asymmetry model in the domain of response inhibition and aggression. The absence of tDCS effects might also indicate that the methodological approach of shifting cortical asymmetry by means of bilateral tDCS protocols has failed.

Reducing proactive aggression through non-invasive brain stimulation

Aggressive behavior poses a threat to human collaboration and social safety. It is of utmost importance to identify the functional mechanisms underlying aggression and to develop potential interventions capable of reducing dysfunctional aggressive behavior already at a brain level. We here experimentally shifted fronto-cortical asymmetry to manipulate the underlying motivational emotional states in both male and female participants while assessing the behavioral effects on proactive and reactive aggression. Thirty-two healthy volunteers received either anodal transcranial direct current stimulation to increase neural activity within right dorsolateral prefrontal cortex, or sham stimulation. Aggressive behavior was measured with the Taylor Aggression Paradigm. We revealed a general gender effect, showing that men displayed more behavioral aggression than women. After the induction of right fronto-hemispheric dominance, proactive aggression was reduced in men. This study demonstrates that non-invasive brain stimulation can reduce aggression in men. This is a relevant and promising step to better understand how cortical brain states connect to impulsive actions and to examine the causal role of the prefrontal cortex in aggression. Ultimately, such findings could help to examine whether the brain can be a direct target for potential supportive interventions in clinical settings dealing with overly aggressive patients and/or violent offenders.

Diagnostic value of the Dutch version of the McLean Screening Instrument for BPD (MSI-BPD)

Borderline personality disorder (BPD) often goes unrecognized, and therefore a short but accurate screening tool is desired. The present study investigated the psychometric properties of the 10-item McLean Screening Instrument for BPD (MSI-BPD) in 159 well-diagnosed female participants. The MSI-BPD showed excellent internal consistency (α = .90). When compared to BPD diagnoses based on a structured clinical interview (SCID-II), the MSI-BPD showed substantial congruent validity (receiver operating characteristic area under the curve = 0.96). The cutoff point proposed by the developers of the MSI-BPD (7 or more) showed high specificity (.96) and good sensitivity (.71). The optimal cutoff point in the present study (5 or more) showed somewhat lower specificity (.86), but importantly better sensitivity (.94). Taken together, the Dutch version of the MSI-BPD demonstrated good psychometric properties for a screening tool.

The influence of stress on social cognition in patients with borderline personality disorder

BACKGROUND

Borderline personality disorder (BPD) is characterized by severe difficulties in interpersonal relationships and emotional functioning. Theories of BPD suggest that individuals with BPD have heightened emotional sensitivity, increased stress reactivity, and problems in making sense of intentions of others. In this study we investigated stress reactivity in BPD and its interference with social cognition, and tested whether any differences are specific for BPD or are inherent to personality disorders in general.

METHODS

We investigated 22 patients with BPD, 23 patients with Cluster C personality disorder (CPD), and 24 nonpatients on facial emotion recognition and social evaluation before and after stress induction based on the Trier Social Stress Test (TSST).

RESULTS

The results show that stress increased subjective negative emotions in the BPD group to a larger extent than in the other groups, whereas physiological responses were attenuated. Importantly stress induction increased negative evaluations about others, but surprisingly to a similar extent in the BPD and CPD groups as in the nonpatient control group. In addition facial emotion recognition performance was higher after than before stress, but no significant group differences were observed.

CONCLUSION

These results suggest that heightened psychological reactivity in BPD co-occurs with attenuated physiological responses to psychosocial stress and that stress affects social cognition to a similar extent in BPD as in others.