Connecting loneliness with pathological personality traits: Evidence for genetic and environmental mediation from a study of older twins

Loneliness has broad public health importance, especially in older adulthood, and there is some evidence suggesting it is associated with several personality disorders (PDs). The etiology of these PD-loneliness associations, however, has rarely been studied, especially in the context of the maladaptive traits of the DSM-5 alternative model of personality disorder (AMPD). To address these limitations, we estimated phenotypic, genetic, and unique environmental associations between loneliness and maladaptive personality traits in a sample of older adults from the Minnesota Twin Registry (n = 1,356, Mage = 70.4). Loneliness was moderately to strongly associated with each of the AMPD domains of negative affect, detachment, antagonism, disinhibition, and psychoticism (r = .22-.58), with evidence of both genetic (rg = .45-.75) and unique environmental (re = .10-.48) influences explaining the associations to varying degrees. We argue that loneliness may be an underappreciated concomitant of personality pathology, with PD traits perhaps underlying its development. Indeed, these findings suggest that loneliness may be a manifestation of the genetic and environmental forces that also lead to pathological personality variation. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Insecure attachment and personality pathology: Concurrent assessment and longitudinal modeling

Insecure attachment and personality pathology are parallel frameworks for representing interpersonal dysfunction. Although research to date has revealed strong bivariate associations between these constructs, the current state of the science is nonspecific and leaves piecemeal guidance for clinical and empirical efforts. The goal of the present study was to determine the magnitude of the associations between attachment and personality pathology across two conceptualizations of maladaptivity and across three waves of time, thereby satisfying repeated calls for empirical innovation in this area. A sample of newlywed heterosexual couples (N = 202 individuals) completed longitudinal assessments of personality pathology and romantic attachment insecurity. Results suggested that the covariation of attachment and personality pathology may be marred by measurement problems related to distress saturation in attachment and personality disorder instruments. Latent curve modeling further suggested that attachment insecurity and personality disorders fluctuate concurrently within persons. Future research should work toward validating unity models of attachment and personality pathology, correcting key measures, and documenting specific mechanisms of association between these constructs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The association between personality, relationship satisfaction, and psychopathology in a three-wave, longitudinal study

OBJECTIVE

The aim of this work was to better understand the role of personality as it relates to psychopathology, with satisfaction as a mediating variable.

BACKGROUND

Personality is an important determinant of many life outcomes including relationship satisfaction and psychopathology. Previous work has demonstrated that broad domains of normal personality have low-to-moderate associations with various forms of psychopathology. Research has primarily focused on mechanisms that might explain how common personality traits put one at risk for common forms of psychopathology; this work builds upon existing work in examining relationship satisfaction as one possible mechanism. No study to date has examined whether relationship satisfaction mediates the connection between personality and psychopathology.

METHOD

We utilized multilevel modeling in a longitudinal sample of 100 newlywed couples to test the hypothesis that major domains of personality (positive temperament, negative temperament, disinhibition) have a significant effect on relationship satisfaction which, in turn, is significantly associated with internalizing and externalizing forms of psychopathology.

RESULTS

We found no evidence for the mediating role of relationship satisfaction; however, in exploratory analyses, we did find evidence for both between-person and within-person effects of personality on psychopathology.

CONCLUSIONS

This study confirms the role of personality as an important factor in consideration of dyadic processes, though not entirely deterministic for downstream functioning. Thus, separate factors in addition to personality may be worth examining in consideration of how low relationship satisfaction may be associated with psychopathology.

Social anhedonia, communication, and marital satisfaction in newlywed couples

OBJECTIVE

Social anhedonia is associated with disinterest in social interactions and poor relationship functioning, yet little is known about the specific mechanisms underlying associations between social anhedonia and romantic relationship behaviors and satisfaction. We examined the links between social anhedonia, perceptions of conflict communication patterns, and marital satisfaction.

METHOD

The current research examined the role of social anhedonia on marital quality and functioning longitudinally across a year in a sample of 100 newlywed couples using an actor-partner interdependence framework.

RESULTS

Social anhedonia was negatively associated with own and partner's marital satisfaction. It was also negatively associated with constructive communication and positively associated with destructive communication. Furthermore, cross-sectional mediation analyses showed that communication patterns mediated the social anhedonia-satisfaction link.

CONCLUSIONS

Taken together, these findings suggest that social anhedonia is likely to lead to lower marital satisfaction, partly through its effect on communication between partners.

Risky Sexual Behaviors as a Transaction of Individual Differences and Situational Context

Risky sexual behaviors (RSBs) incur large societal and personal costs. Despite widespread prevention efforts, RSBs and associated consequences (e.g., sexually transmitted infections) continue to rise. A proliferation of research has emerged on situational (e.g., alcohol use) and individual difference (e.g., impulsivity) factors to explain this rise, but these approaches assume an unrealistically static mechanism underlying RSB. Because this prior research has resulted in few compelling effects, we sought to innovate by examining the interaction of situation and individual differences in explaining RSBs. A large sample (N = 105) completed baseline reports of psychopathology and 30 daily diary reports of RSBs and associated contexts. These data were submitted to multilevel models including cross-level interactions to test a person-by-situation conceptualization of RSBs. Results suggested that RSBs are most strongly predicted from interactions of person- and situation-level factors in both protective and facilitative directions. These interactions outnumbered main effects and commonly included partner commitment as a central mechanism. These results point to theoretical and clinical gaps in preventing RSB and urge a departure from prior ways of conceptualizing sexual risk as a static outcome.

Late Onset Personality Disorders in Mid-Life and Older Adults

There is little research on personality disorder (PD) onset in older age. Many studies have shown that normative personality traits change across the life span, even into later life. This study aimed to investigate the onset of PDs in later adulthood (>age 55), and the possible influence of major life events on predicting this late onset. The current analysis was conducted with data from the St. Louis Personality and Aging Network (SPAN). Structured diagnostic interviews were administered three times over five years. Logistic regressions were conducted predicting late onset PD from baseline to FU5 and from FU5 to FU10 as a function of each major life event. 75 PD onsets occurred from baseline to FU5, and 39 PD onsets occurred from FU5 to FU10. Personal illness predicted the onset of PDs from FU5 to FU10.

Childhood Maltreatment, Personality Pathology, and Intimate Partner Aggression

The goal of the current study was to examine the early childhood roots of adult personality pathology and intimate partner aggression in later life. Childhood maltreatment is associated with perpetration of intimate partner aggression (IPA) in adulthood, although the effect is generally only small to moderate in size. Childhood maltreatment is also linked with the Diagnostic and Statistical Manual of Mental Disorders (DSM) personality disorders (PDs) in adulthood, which in turn are correlated with IPA in adult romantic relationships. This suggests that one pathway by which childhood maltreatment leads to adult IPA is through maladaptive personality patterns. In the current analyses, data from 495 older, racially diverse adults and their romantic partners recruited from the St. Louis Personality and Aging Network (SPAN) study were used to examine whether childhood maltreatment may impact adult IPA through adult personality pathology. Findings from structural equation modeling demonstrated that for most of the 10 DSM-5 PD (Section II) constructs, there was a significant indirect effect from childhood maltreatment to IPA in later life through a latent variable of personality pathology. Our findings confirm that IPA does occur among romantic partners in later life, that it is robustly associated with personality pathology traits in later life, and that personality pathology in later life may have its roots in early neglect and maltreatment.

Comparing Phenotypic, Genetic, and Environmental Associations between Personality and Loneliness

As a strong risk factor for mortality, individual differences in loneliness are of clear public health significance. Four of the Big Five traits have emerged as cross-sectional correlates, but the etiology of these links is unclear, as are relations with more specific personality facets. Thus, we estimated phenotypic, genetic, and environmental associations between loneliness and both broader and narrower personality dimensions. Traits that indexed Negative Emotionality (e.g., Neuroticism, Stress Reactivity, Alienation) and low Positive Emotionality (e.g., low Extraversion, low Well-Being) had the strongest associations with loneliness, though low Conscientiousness, low Agreeableness, and high Aggression were also implicated. These associations were explained by both genetic (0.30<|rg|<0.80) and unique environmental (0.10<|re|<0.35) influences, consistent with an etiology of loneliness involving several personality domains.

Borderline Personality Traits and Romantic Relationship Dissolution

Many studies have found that borderline personality disorder (BPD) is associated with romantic relationship instability, with relationship dissolution being a recurring theme. Scant research, however, has examined the dissolution strategies and post-breakup outcomes for individuals with elevated levels of borderline traits. Findings from two studies revealed that there was an association between BPD criteria and tendency to employ less adaptive dissolution strategies when terminating a relationship. Furthermore, elevated levels of BPD traits were associated with less self-concept clarity and more unwanted pursuit of ex-partners. These findings both provide insight into how individuals with BPD traits experience relationship dissolution and suggest possible factors underlying the unstable relationship processes typically associated with borderline traits.

A Hierarchical Taxonomy of Psychopathology (HiTOP) Primer for Mental Health Researchers

Mental health research is at an important crossroads as the field seeks more reliable and valid phenotypes to study. Dimensional approaches to quantifying mental illness operate outside the confines of traditional categorical diagnoses, and they are gaining traction as a way to advance research on the causes and consequences of mental illness. The Hierarchical Taxonomy of Psychopathology (HiTOP) is a leading dimensional research paradigm that synthesizes decades of data on the major dimensions of psychological disorders. In this article, we demonstrate how to use the HiTOP model to formulate and test research questions through a series of tutorials. To boost accessibility, data and annotated code for each tutorial are included at OSF (https://osf.io/8myzw). After presenting the tutorials, we outline how investigators can use these ideas and tools to generate new insights in their own substantive research programs.

Validity and utility of Hierarchical Taxonomy of Psychopathology (HiTOP): III. Emotional dysfunction superspectrum

The Hierarchical Taxonomy of Psychopathology (HiTOP) is a quantitative nosological system that addresses shortcomings of traditional mental disorder diagnoses, including arbitrary boundaries between psychopathology and normality, frequent disorder co-occurrence, substantial heterogeneity within disorders, and diagnostic unreliability over time and across clinicians. This paper reviews evidence on the validity and utility of the internalizing and somatoform spectra of HiTOP, which together provide support for an emotional dysfunction superspectrum. These spectra are composed of homogeneous symptom and maladaptive trait dimensions currently subsumed within multiple diagnostic classes, including depressive, anxiety, trauma-related, eating, bipolar, and somatic symptom disorders, as well as sexual dysfunction and aspects of personality disorders. Dimensions falling within the emotional dysfunction superspectrum are broadly linked to individual differences in negative affect/neuroticism. Extensive evidence establishes that dimensions falling within the superspectrum share genetic diatheses, environmental risk factors, cognitive and affective difficulties, neural substrates and biomarkers, childhood temperamental antecedents, and treatment response. The structure of these validators mirrors the quantitative structure of the superspectrum, with some correlates more specific to internalizing or somatoform conditions, and others common to both, thereby underlining the hierarchical structure of the domain. Compared to traditional diagnoses, the internalizing and somatoform spectra demonstrated substantially improved utility: greater reliability, larger explanatory and predictive power, and greater clinical applicability. Validated measures are currently available to implement the HiTOP system in practice, which can make diagnostic classification more useful, both in research and in the clinic.

Marital Satisfaction as a Moderator of Molecular Genetic Influences on Mental Health

The quality of one's romantic relationship is associated with mental health. Low levels of relationship quality may be a stressor that triggers a predisposition or diathesis to mental illness. Analyses were conducted to examine whether relationship quality moderated the association between polygenic risk scores (PRSs) for several mental health syndromes on phenotypic measures of those syndromes. Data were drawn from the Midlife in the United States (MIDUS) study of health and well-being. A subsample was genotyped, and PRSs were calculated. The PRS for anxiety was more strongly related to the anxiety phenotype when satisfaction was low than when satisfaction was high, providing evidence of a genetic susceptibility process between marital distress and anxiety. The expression of genetic influences on a phenotype in the presence of certain environmental stressors is complex and may depend on the specific phenotype and the methodology by which genetic influences are estimated.

"Pathological personality, relationship satisfaction, and intimate partner aggression: Analyses using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, alternative model of personality disorder traits": Correction

Reports an error in "Pathological personality, relationship satisfaction, and intimate partner aggression: Analyses using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, alternative model of personality disorder traits" by Madison S. Smith, Amber M. Jarnecke and Susan C. South (Personality Disorders: Theory, Research, and Treatment, 2020[Nov], Vol 11[6], 398-408). In the original article, there were wording errors in the Results section. In the last sentence of the "Antagonism" section under the "Actor-Partner Analyses of Satisfaction and IPA" heading, the PID-5-IRF actor effect was described as "individuals whose partners rate them as more antagonistic are more likely to perpetrate psychological IPA." However, the PID-5-IRF actor effect should have been described as "individuals who rate their partners as more antagonistic are more likely to perpetrate psychological IPA." The online version of this article has been corrected. (The following abstract of the original article appeared in record 2020-26463-001). Personality disorders (PDs) have been linked to lower levels of marital satisfaction and the perpetration of intimate partner aggression (IPA). Much of this work has used self-reports of PD symptoms conceptualized via the Diagnostic and Statistical Manual of Mental Disorder's (DSM) categorical approach. The current study adds to the literature by examining how marital satisfaction and IPA are associated with a dimensional assessment of PDs, specifically by conceptualizing PDs using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Section III alternative model of personality disorder. By collecting data from both partners in a sample of newlywed couples, we also leverage PD trait agreement between (a) both partner's own self-reports (similarity), (b) self- and spouse report (accuracy), and (c) self and ratings of partner (perceptual similarity), to examine couple-level predictors of relationship well-being (i.e., satisfaction and psychological/physical IPA). Data were drawn from a sample of 101 newly married couples who participated in baseline and follow-up data collection over a period of 12 months. Actor-partner interdependence analyses revealed significant self-report actor and partner effects on marital satisfaction and psychological and physical IPA; for spouse report, actor effects were more consistent than partner reports. Agreement was moderate for both similarity and accuracy, but greater agreement was related to greater relationship satisfaction, particularly at later time points. Thus, although reports of elevated personality pathology are detrimental to marital functioning, spousal agreement may protect against these effects. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Autoregressive and Cross-Lagged Associations Between Psychological Intimate Partner Aggression and Psychopathology in Newlyweds

Most research to date relies on cross-sectional data to identify associations between psychopathology (i.e., internalizing and externalizing disorders) and intimate partner aggression (IPA). Studies that utilize longitudinal data tend to survey only one member of a dyad, examine only perpetration or victimization, and/or use statistical methods that converge within- and between-person effects. The current study examines the associations between psychopathology, psychological IPA perpetration, and psychological IPA victimization at three time points over the course of 1 year in a sample of newlyweds. An autoregressive latent trajectory model with structured residuals (ALT-SR) tested the hypotheses that within-person internalizing and externalizing psychopathology would predict IPA perpetration and victimization at each subsequent time point, and IPA victimization would predict subsequent internalizing and externalizing symptoms. Results of the ALT-SR model did not support hypotheses. Rather, results suggest internalizing symptoms were negatively associated with externalizing symptoms at subsequent time points, and vice versa. IPA perpetration was positively associated with IPA victimization at the following time points. These results elucidate the interplay between psychopathology and IPA, suggesting that although these constructs show bivariate relationships with one another, psychopathology is not a significant within-person predictor of subsequent psychological IPA.

Pathology in Relationships

Committed, long-term romantic relationships are ubiquitous among modern society. They are one of the most important contexts for the development, maintenance, and treatment of psychopathology. In this review, I first place psychopathology within the most commonly cited theoretical model of marital satisfaction and stability and then discuss how relationship satisfaction is conceptualized and assessed in this literature. In the second half of the review, I describe the theories regarding how romantic relationships may be connected to psychopathology. Relationship distress is easily incorporated into a diathesis-stress model as an important trigger for psychopathology. Next, I review cross-sectional research, longitudinal research, and treatment efficacy research linking relationship quality and psychopathology. I provide evidence for the robustness of these effects and areas where research must expand. I finish with a summary section that synthesizes what is known about the mechanisms linking relationship distress and psychopathology.

Les progrès dans la réalisation de la classification quantitative de la psychopathologie☆

Shortcomings of approaches to classifying psychopathology based on expert consensus have given rise to contemporary efforts to classify psychopathology quantitatively. In this paper, we review progress in achieving a quantitative and empirical classification of psychopathology. A substantial empirical literature indicates that psychopathology is generally more dimensional than categorical. When the discreteness versus continuity of psychopathology is treated as a research question, as opposed to being decided as a matter of tradition, the evidence clearly supports the hypothesis of continuity. In addition, a related body of literature shows how psychopathology dimensions can be arranged in a hierarchy, ranging from very broad "spectrum level" dimensions, to specific and narrow clusters of symptoms. In this way, a quantitative approach solves the "problem of comorbidity" by explicitly modeling patterns of co-occurrence among signs and symptoms within a detailed and variegated hierarchy of dimensional concepts with direct clinical utility. Indeed, extensive evidence pertaining to the dimensional and hierarchical structure of psychopathology has led to the formation of the Hierarchical Taxonomy of Psychopathology (HiTOP) Consortium. This is a group of 70 investigators working together to study empirical classification of psychopathology. In this paper, we describe the aims and current foci of the HiTOP Consortium. These aims pertain to continued research on the empirical organization of psychopathology; the connection between personality and psychopathology; the utility of empirically based psychopathology constructs in both research and the clinic; and the development of novel and comprehensive models and corresponding assessment instruments for psychopathology constructs derived from an empirical approach.

Dimensional latent factor structure of psychopathology in adults with chronic illness

The goal of the present study was to determine if the internalizing and externalizing model of psychopathology is applicable in a sample of adults with chronic illness. Confirmatory factor analyses were used to examine the factor structure of internalizing and externalizing symptoms in a sample of adults (N = 172) with a unique chronic physical health condition (postural orthostatic tachycardia syndrome; POTS) and in a sample of adults without any chronic illness diagnoses (N = 199). Measurement invariance was used to compare levels of internalizing and externalizing symptoms across samples. Confirmatory factor analyses suggested that psychological distress in individuals with chronic illness can be effectively characterized by an internalizing dimension composed of distress and fear subcomponents as well as an externalizing dimension. Measurement invariance testing reached adequate levels of fit, allowing for examination of latent means; individuals with chronic illness had higher scores on the internalizing dimension and lower scores on the externalizing dimension than healthy controls. Regression analyses suggested that among those with a chronic illness, internalizing symptoms were significantly, negatively related to acceptance of illness and higher health-related quality of life. Findings suggest that assessing internalizing symptoms broadly may allow for better identification of chronically ill individuals experiencing psychological distress than a focus on categorical diagnoses. However, professionals also need to be aware of the overlap between physical and psychological symptoms in adults with chronic illnesses in order to avoid inaccurate diagnoses. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Personality disorders and intimate partner aggression: A replication and extension in older, married couples

Intimate partner aggression (IPA) is a significant public health burden, and thus efforts to identify individual characteristics that predict perpetration of IPA is an important research question. Personality disorders are a significant correlate of IPA, both cross-sectionally and longitudinally. Much of that work, however, had been conducted in younger samples. IPA in older adults is a relatively understudied area of research generally. Thus, examining the association between personality pathology and IPA in older adults is novel and important. In previous work using the St. Louis Personality and Aging Network sample, we found that borderline personality disorder was a robust correlate of perpetrating partner aggression in older, romantically involved participants. In the current analyses, we attempted to replicate our original findings in the same sample assessed 2.5 years later. We also extended the original work by using both self- and partner-reported IPA and by using latent factors of personality pathology. We found that prevalence of IPA in this sample was similar to the baseline assessment; 69.1% reported IPA in the past year, with the vast majority being psychological/verbal rather than physical aggression. Agreement between partners on perpetration was modest. Borderline personality pathology was again the strongest and most consistent predictor of IPA. Our findings speak to the continuing public health burden of borderline personality pathology into older age as evidenced by associations with perpetration of IPA. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The distinction between symptoms and traits in the Hierarchical Taxonomy of Psychopathology (HiTOP)

The Hierarchical Taxonomy of Psychopathology (HiTOP) is an empirically and quantitatively derived dimensional classification system designed to describe the features of psychopathology and, ultimately, to replace categorical nosologies. Among the constructs that HiTOP organizes are "symptom components" and "maladaptive traits," but past HiTOP publications have not fully explicated the distinction between symptoms and traits. We propose working definitions of symptoms and traits and explore challenges, exceptions, and remaining questions. Specifically, we propose that the only systematic difference between symptoms and traits in HiTOP is one of time frame. Maladaptive traits are dispositional constructs that describe persistent tendencies to manifest features of psychopathology, whereas symptoms are features of psychopathology as they are manifest during any specific time period (from moments to days to months). This has the consequence that almost every HiTOP dimension, at any level of the hierarchy, can be assessed as either a trait or a symptom dimension, by adjusting the framing of the assessment. We discuss the implications of these definitions for causal models of the relations between symptoms and traits and for distinctions between psychopathology, normal personality variation, and dysfunction.

The Impact of Personality Disorders on Longitudinal Change in Relationship Satisfaction in Long-Term Married Couples

Personality disorders (PDs) are significantly, negatively related to marital satisfaction. We examine how maladaptive personality is related to change in marital satisfaction over time utilizing data from the St. Louis Personality and Aging Network (SPAN), a longitudinal, community-based study of personality and health in older adults. Participants were assessed at baseline for PD (self-report, informant-report, and structured interview); self- and spouse-reported relationship satisfaction assessed at baseline and five follow-ups was analyzed with latent growth curve modeling. Higher levels of PD at baseline were associated with lower self and spouse relationship satisfaction at baseline. On average, satisfaction did not change significantly over the study period, but there was significant individual variability. Higher levels of schizoid PD were protective of declines in partner's perception of satisfaction. Findings suggest that partners in long-term married unions may have adapted to the presence of their own or their spouse's level of personality pathology.

The longitudinal impact of DSM-5 Section III specific personality disorders on relationship satisfaction

Maladaptive personality features, in the form of dimensional traits or symptoms of personality disorders, have been linked with lower levels of relationship satisfaction. Most of this research, however, has been cross-sectional, and little is known about the effect of specific personality disorder types, as measured dimensionally, on relationship satisfaction. In the current study, we used actor partner interdependence modeling (APIM) with self-reported personality traits from the Personality Inventory for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and spouse-reported traits from the Personality Inventory for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Informant Report Form. Composite scores for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Section III Specific Personality Disorder Types, based on combinations of PID facets as outlined in the Section III criteria, were used to predict relationship satisfaction 1 year after personality was assessed. The alternative model of personality disorders composites significantly predicted relationship satisfaction both cross-sectionally and longitudinally. Results indicated that spouse reports of personality disorder types from the alternative model of personality disorders framework were robust predictors of satisfaction. Thus, individuals who perceive their partners as high in personality pathology (at any point in a relationship) are likely to be subsequently dissatisfied in the relationship. Interventions targeting perceptions of one's partner might be an effective way to improve marital satisfaction for these individuals. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Validity and utility of Hierarchical Taxonomy of Psychopathology (HiTOP): I. Psychosis superspectrum

The Hierarchical Taxonomy of Psychopathology (HiTOP) is a scientific effort to address shortcomings of traditional mental disorder diagnoses, which suffer from arbitrary boundaries between psychopathology and normality, frequent disorder co-occurrence, heterogeneity within disorders, and diagnostic instability. This paper synthesizes evidence on the validity and utility of the thought disorder and detachment spectra of HiTOP. These spectra are composed of symptoms and maladaptive traits currently subsumed within schizophrenia, other psychotic disorders, and schizotypal, paranoid and schizoid personality disorders. Thought disorder ranges from normal reality testing, to maladaptive trait psychoticism, to hallucinations and delusions. Detachment ranges from introversion, to maladaptive detachment, to blunted affect and avolition. Extensive evidence supports the validity of thought disorder and detachment spectra, as each spectrum reflects common genetics, environmental risk factors, childhood antecedents, cognitive abnormalities, neural alterations, biomarkers, and treatment response. Some of these characteristics are specific to one spectrum and others are shared, suggesting the existence of an overarching psychosis superspectrum. Further research is needed to extend this model, such as clarifying whether mania and dissociation belong to thought disorder, and explicating processes that drive development of the spectra and their subdimensions. Compared to traditional diagnoses, the thought disorder and detachment spectra demonstrated substantially improved utility: greater reliability, larger explanatory and predictive power, and higher acceptability to clinicians. Validated measures are available to implement the system in practice. The more informative, reliable and valid characterization of psychosis-related psychopathology offered by HiTOP can make diagnosis more useful for research and clinical care.

Pathological personality, relationship satisfaction, and intimate partner aggression: Analyses using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, alternative model of personality disorder traits

Personality disorders (PDs) have been linked to lower levels of marital satisfaction and the perpetration of intimate partner aggression (IPA). Much of this work has used self-reports of PD symptoms conceptualized via the Diagnostic and Statistical Manual of Mental Disorder's (DSM) categorical approach. The current study adds to the literature by examining how marital satisfaction and IPA are associated with a dimensional assessment of PDs, specifically by conceptualizing PDs using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Section III alternative model of personality disorder. By collecting data from both partners in a sample of newlywed couples, we also leverage PD trait agreement between (a) both partner's own self-reports (similarity), (b) self- and spouse report (accuracy), and (c) self and ratings of partner (perceptual similarity), to examine couple-level predictors of relationship well-being (i.e., satisfaction and psychological/physical IPA). Data were drawn from a sample of 101 newly married couples who participated in baseline and follow-up data collection over a period of 12 months. Actor-partner interdependence analyses revealed significant self-report actor and partner effects on marital satisfaction and psychological and physical IPA; for spouse report, actor effects were more consistent than partner reports. Agreement was moderate for both similarity and accuracy, but greater agreement was related to greater relationship satisfaction, particularly at later time points. Thus, although reports of elevated personality pathology are detrimental to marital functioning, spousal agreement may protect against these effects. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Redefining phenotypes to advance psychiatric genetics: Implications from hierarchical taxonomy of psychopathology

Genetic discovery in psychiatry and clinical psychology is hindered by suboptimal phenotypic definitions. We argue that the hierarchical, dimensional, and data-driven classification system proposed by the Hierarchical Taxonomy of Psychopathology (HiTOP) consortium provides a more effective approach to identifying genes that underlie mental disorders, and to studying psychiatric etiology, than current diagnostic categories. Specifically, genes are expected to operate at different levels of the HiTOP hierarchy, with some highly pleiotropic genes influencing higher order psychopathology (e.g., the general factor), whereas other genes conferring more specific risk for individual spectra (e.g., internalizing), subfactors (e.g., fear disorders), or narrow symptoms (e.g., mood instability). We propose that the HiTOP model aligns well with the current understanding of the higher order genetic structure of psychopathology that has emerged from a large body of family and twin studies. We also discuss the convergence between the HiTOP model and findings from recent molecular studies of psychopathology indicating broad genetic pleiotropy, such as cross-disorder SNP-based shared genetic covariance and polygenic risk scores, and we highlight molecular genetic studies that have successfully redefined phenotypes to enhance precision and statistical power. Finally, we suggest how to integrate a HiTOP approach into future molecular genetic research, including quantitative and hierarchical assessment tools for future data-collection and recommendations concerning phenotypic analyses. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Psychopathy as an Emergent Interpersonal Syndrome: What Is the Function of Fearlessness?

Lilienfeld and colleagues (this issue) propose that some personality disorders can be conceptualized as emergent interpersonal syndromes (EIS). An EIS elicits negative interpersonal reactions in others. Further, an EIS results from statistical interactions between symptom dimensions that are uncorrelated. As a prototypical EIS, psychopathy is an interaction between boldness (or fearlessness) and interpersonal antagonism. The authors marshal many threads of research to develop an intriguing idea that suggests the "whole" of psychopathy is more than the sum of its parts. Unfortunately, the authors focus primarily on psychopathy, and fail to provide convincing quantitative data for the statistical interaction that forms the basis for their theory. Also missing from this model of personality pathology is a consideration of what function boldness serves; viewing boldness as a means to accomplish the (maladaptive) rewarding goals that motivate the individual high in antagonism and disinhibition may serve to flesh out this theory and our conceptualization of personality pathology more broadly.

Symptom-level analysis of DSM-IV/DSM-5 personality pathology in later life: Hierarchical structure and predictive validity across self- and informant ratings

Dissatisfaction with the categorical model of personality disorder led to several investigations on alternative, dimensional systems. The majority of these studies were conducted at the syndrome-level where each diagnostic criterion is summed or averaged within each disorder. Studies at the symptom-level have identified symptom dimensions that define and cut across categories, but the number and nature of dimensions varies across studies. The purpose of the present study was to examine the hierarchical structure and impact of personality pathology at the symptom-level across self- and informant ratings in a large community sample of older adults (N = 1,630; ages 55 to 64). Results indicated that multiple structural patterns can be organized within a common hierarchical framework, with a general factor of maladjustment at the top, 2 broad dimensions of internalizing and externalizing pathology directly below, and progressively more specific symptom dimensions toward the bottom. Factors at each level of the hierarchy were similar across self- and informant ratings. The 4-factor model showed significant incremental validity in predicting a range of life outcomes over simpler models, while increasingly complex models incrementally but modestly improved predictive power. Several consistencies emerged between the current findings and prior factor analytic studies. The most unexpected result was the conspicuous absence of a disinhibition factor reflecting antisocial and impulsivity-related problems. This anomaly may involve the older age of our sample and the changing expression of personality pathology in later life. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

A Hierarchical Taxonomy of Psychopathology Can Transform Mental Health Research

For more than a century, research on psychopathology has focused on categorical diagnoses. Although this work has produced major discoveries, growing evidence points to the superiority of a dimensional approach to the science of mental illness. Here we outline one such dimensional system-the Hierarchical Taxonomy of Psychopathology (HiTOP)-that is based on empirical patterns of co-occurrence among psychological symptoms. We highlight key ways in which this framework can advance mental-health research, and we provide some heuristics for using HiTOP to test theories of psychopathology. We then review emerging evidence that supports the value of a hierarchical, dimensional model of mental illness across diverse research areas in psychological science. These new data suggest that the HiTOP system has the potential to accelerate and improve research on mental-health problems as well as efforts to more effectively assess, prevent, and treat mental illness.

Big Five personality domains and relationship satisfaction: Direct effects and correlated change over time

OBJECTIVE

The Big Five Model (BFM) of personality domains is significantly related to romantic relationship outcomes, particularly marital satisfaction. Few studies to date, however, have examined the BFM domains and relationship outcomes longitudinally.

METHOD

We used latent growth curve modeling to estimate the initial levels (intercept) and the rate of change (slope) in the BFM domains and marital satisfaction and determine if change in one construct was associated with change in the other. All available data were retained from participants who remained married to the same individual, as well as early waves for participants who divorced or were widowed, in the Midlife in the United States study (N = 1,965). We expected negative associations between (a) intercepts of Neuroticism and relationship satisfaction and (b) the intercept/slope of Neuroticism with change in marital satisfaction. The other BFM domains were expected to have positive effects on change in satisfaction.

RESULTS

The results suggested that change over time in Neuroticism and Conscientiousness is detrimental to satisfaction, while initial levels of Conscientiousness may predict declining marital satisfaction.

CONCLUSIONS

Changes in Neuroticism accompany parallel changes in relationship satisfaction in a large sample of married U.S. adults, suggesting an ongoing bidirectional influence between these constructs in enduring marriages.

Relationship quality from pre- to postplacement in adoptive couples

Although there is an extensive research literature examining the change in relationship quality of birth parents during the transition to parenthood, there is comparatively less work on how the relationship of adoptive parents fares from pre- to postplacement of the adopted child. In the current study, we examine the relationship quality (global satisfaction, feelings of love, feelings of ambivalence) of 127 adoptive parents across the transition from preplacement to approximately 6 months postplacement of the adopted child. Following the vulnerability-stress-adaptation (VSA) model of marital quality and stability, we examined various intrapersonal vulnerability factors, couple adaptive processes, and stressful factors primarily related to the adoption process as predictors of relationship quality across 3 waves (4 to 6 weeks prior to placement of the adopted child, 4 to 6 weeks postplacement of the adopted child in the home, and 5 to 6 months post-postplacement). Results indicated that, in general, relationship satisfaction and feelings of love decreased, and relationship ambivalence increased, from pre- to postplacement across the sample. Significant predictors of greater relationship satisfaction, regardless of time, included higher self-esteem, greater relationship maintenance, a better sexual relationship, and more partner support; love was significantly predicted by greater maintenance and sexual relationship, lower conflict, and a history of infertility; and higher conflict significantly predicted higher ambivalence. Our findings suggest that, in general, adaptive processes between couples are the most consistent predictors of marital quality over the transition to parenthood in adoptive parents. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Dehumanization, prejudice, and social policy beliefs concerning people with developmental disabilities

We investigated the nature of prejudice toward people with developmental disabilities, its potential roots in dehumanization, its implications for social policy beliefs affecting this target group, and strategies for reducing prejudice toward people with developmental disabilities. Studies 1 ( N = 196, MTurk) and 2 ( N = 296, undergraduates) tested whether prejudice took a hostile or ambivalent (both hostile and benevolent components) form. Consistent support for a hostile prejudice model was found. This model was comprised of beliefs that people with developmental disabilities may harm others, should be kept separate from others, and are dependent on others. Also, greater dehumanization was associated with greater prejudice, and prejudice mediated the effect of dehumanization on participants’ social policy beliefs. Study 3 ( N = 151, MTurk) provided construct validity for the newly developed multidimensional measure of prejudice. Study 4 ( N = 156, undergraduates) showed that presenting a person with developmental disabilities in either humanizing or individuating ways reduced dehumanization and prejudice and, in turn, increased the favorability of social policy beliefs.

Progress in achieving quantitative classification of psychopathology

Shortcomings of approaches to classifying psychopathology based on expert consensus have given rise to contemporary efforts to classify psychopathology quantitatively. In this paper, we review progress in achieving a quantitative and empirical classification of psychopathology. A substantial empirical literature indicates that psychopathology is generally more dimensional than categorical. When the discreteness versus continuity of psychopathology is treated as a research question, as opposed to being decided as a matter of tradition, the evidence clearly supports the hypothesis of continuity. In addition, a related body of literature shows how psychopathology dimensions can be arranged in a hierarchy, ranging from very broad "spectrum level" dimensions, to specific and narrow clusters of symptoms. In this way, a quantitative approach solves the "problem of comorbidity" by explicitly modeling patterns of co-occurrence among signs and symptoms within a detailed and variegated hierarchy of dimensional concepts with direct clinical utility. Indeed, extensive evidence pertaining to the dimensional and hierarchical structure of psychopathology has led to the formation of the Hierarchical Taxonomy of Psychopathology (HiTOP) Consortium. This is a group of 70 investigators working together to study empirical classification of psychopathology. In this paper, we describe the aims and current foci of the HiTOP Consortium. These aims pertain to continued research on the empirical organization of psychopathology; the connection between personality and psychopathology; the utility of empirically based psychopathology constructs in both research and the clinic; and the development of novel and comprehensive models and corresponding assessment instruments for psychopathology constructs derived from an empirical approach.

Associations between personality disorders and cannabis use and cannabis use disorder: a population-based twin study

BACKGROUND AND AIMS

Individual differences in DSM-IV personality disorders (PDs) are associated with increased prevalence of substance use disorders. Our aims were to determine which combination of PDs trait scores best predict cannabis use (CU) and cannabis use disorder (CUD), and to estimate the size and significance of genetic and environmental risks in PD traits shared with CU and CUD.

DESIGN

Linear mixed-effects models were used to identify PD traits for inclusion in twin analyses to explore the genetic and environmental associations between the traits and cannabis use.

SETTING

Cross-sectional data were obtained from Norwegian adult twins in a face-to-face interview in 1999-2004 as part of a population-based study of mental health.

PARTICIPANTS

Subjects were 1419 twins (μage  = 28.2 years, range = 19-36) from the Norwegian Institute of Public Health Twin Panel with complete PD and cannabis data.

MEASUREMENTS

PD traits were assessed using DSM-IV criteria. Life-time CU and CUD were based on DSM-IV abuse and dependence criteria, including withdrawal and craving.

FINDINGS

After adjusting for age and sex, antisocial [β = 0.23, 95% confidence interval (CI) = 0.19-0.28] and borderline PDs (β = 0.20, 95% CI = 0.14-0.26) were associated strongly with CU. Antisocial (β = 0.26, 95% CI = 0.21-0.31) and borderline PDs (β = 0.12, 95% CI = 0.06-0.18) were also linked strongly to CUD. Genetic risks in antisocial and borderline PD traits explained 32-60% of the total variance in CU and CUD. Dependent and avoidant PDs explained 11 and 16% of the total variance in CU and CUD, respectively.

CONCLUSIONS

Individual differences in the liability to cannabis use and cannabis use disorder appear to be linked to genetic risks correlated with antisocial and borderline personality disorder traits.

Measurement invariance of the DSM-5 Section III pathological personality trait model across sex

The dimensional pathological personality trait model proposed in the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5), Section III Criterion B, has shown promising results for its validity and utility in conceptualizing personality pathology. However, as its structural equivalence across sex is yet to be tested, the validity for the model across males and females remains uncertain. In the present article, we examined sex measurement invariance of the DSM-5 trait model in a large undergraduate sample using the Personality Inventory for DSM-5. A series of confirmatory and exploratory factor analyses suggested that, although the exact facet-domain relationships as specified in the DSM-5 were not observed, the facets generally organize into a model with five latent factors similar to those listed in the DSM-5 Section III Criterion B. Further, these five factors were fully measurement invariant across sex at the configural, metric, and scalar levels. Examination of the latent trait mean levels suggests that females tend to have higher scores on latent Negative Affectivity, whereas males tend to have higher scores on latent Antagonism, Detachment, Psychoticism, and Disinhibition. These results indicate that the DSM-5 Section III pathological personality trait model is fully structurally equivalent across sex, a property that is lacking in the traditional categorical model in Section II. This further validates the use of the dimensional DSM-5 trait model for personality disorder assessment and conceptualization in both research and clinical settings. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Criterion A of the AMPD in HiTOP

The categorical model of personality disorder classification in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM-5]; American Psychiatric Association, 2013 ) is highly and fundamentally problematic. Proposed for DSM-5 and provided within Section III (for Emerging Measures and Models) was the Alternative Model of Personality Disorder (AMPD) classification, consisting of Criterion A (self-interpersonal deficits) and Criterion B (maladaptive personality traits). A proposed alternative to the DSM-5 more generally is an empirically based dimensional organization of psychopathology identified as the Hierarchical Taxonomy of Psychopathology (HiTOP; Kotov et al., 2017 ). HiTOP currently includes, at the highest level, a general factor of psychopathology. Further down are the five domains of detachment, antagonistic externalizing, disinhibited externalizing, thought disorder, and internalizing (along with a provisional sixth somatoform dimension) that align with Criterion B. The purpose of this article is to discuss the potential inclusion and placement of the self-interpersonal deficits of the DSM-5 Section III Criterion A within HiTOP.

Longitudinal analyses of adoptive parents' expectations and depressive symptoms

Grounded in a theoretical model specific to adoptive parents, we examined the relationship between parental expectations and depressive symptoms across time. Assessments of 129 adoptive parents of 64 children were performed at three time points before and after placement of an adopted child with the family: 4-6 weeks pre-placement and 4-6 weeks and 5-6 months post-placement. Expectations were assessed in four dimensions: expectations of self as parents, of the child, of family and friends, and of society. Depressive symptoms were assessed with the Center for Epidemiologic Studies-Depression scale. Associations between parental expectations and depressive symptoms were analyzed, and longitudinal multilevel modeling was conducted to explore influences on expectations over time. Parental expectations changed from pre- to post-placement. With the exception of expectations of self as parent, adoptive parents' pre-adoption expectations were affirmed in the post-adoption time periods. In each expectation dimension, higher affirmation of expectations was correlated with decreased depressive symptoms before and after placement of a child. While parental expectations are not unique to adoptive parents, the essence and characteristics of certain expectations are unique to these parents. When working with adoptive parents, nurses who care for families should assess expectations both pre- and post-placement with awareness of their relationship to depressive symptoms.

Transitions of Adoptive Parents: A Longitudinal Mixed Methods Analysis

As adoptive parents create a new family, they face myriad changes both pre-and post-placement of their child. The aim of this study was to describe parent perceptions and depressive symptoms during this transition via reports collected with an online survey. Using content analysis, we analyzed a total of 110 responses from 64 parents at three time points: 4-6weeks pre-placement, and 4-6weeks and 5-6months post-placement. Five main themes were revealed: Transition from uncertainty to a new normal; unique experiences related to adoption; rest/fatigue: out of balance; life stressors; and faith/spirituality. Two subthemes were also identified: previous losses (pre-placement) and joy and love (post-placement). During the transition from pre-to post-placement, adoptive parents experience a unique passage, with both challenges and strengths exclusive to this group of parents. While acknowledging the commonalities of some parenting experiences, healthcare and adoption professionals should recognize the unique dynamics that adoption brings to families.

Do DSM-5 Section II personality disorders and Section III personality trait domains reflect the same genetic and environmental risk factors?

BACKGROUND

DSM-5 includes two conceptualizations of personality disorders (PDs). The classification in Section II is identical to the one found in DSM-IV, and includes 10 categorical PDs. The Alternative Model (Section III) includes criteria for dimensional measures of maladaptive personality traits organized into five domains. The degree to which the two conceptualizations reflect the same etiological factors is not known.

METHODS

We use data from a large population-based sample of adult twins from the Norwegian Institute of Public Health Twin Panel on interview-based DSM-IV PDs and a short self-report inventory that indexes the five domains of the DSM-5 Alternative Model plus a domain explicitly targeting compulsivity. Schizotypal, Paranoid, Antisocial, Borderline, Avoidant, and Obsessive-compulsive PDs were assessed at the same time as the maladaptive personality traits and 10 years previously. Schizoid, Histrionic, Narcissistic, and Dependent PDs were only assessed at the first interview. Biometric models were used to estimate overlap in genetic and environmental risk factors.

RESULTS

When measured concurrently, there was 100% genetic overlap between the maladaptive trait domains and Paranoid, Schizotypal, Antisocial, Borderline, and Avoidant PDs. For OCPD, 43% of the genetic variance was shared with the domains. Genetic correlations between the individual domains and PDs ranged from +0.21 to +0.91.

CONCLUSION

The pathological personality trait domains, which are part of the Alternative Model for classification of PDs in DSM-5 Section III, appears to tap, at an aggregate level, the same genetic risk factors as the DSM-5 Section II classification for most of the PDs.

Gene-Environment Interplay in the Context of Romantic Relationships

A growing body of research supports an important role for genetic factors on intimate, romantic relationships. In this article, we review research that has examined the interplay between genetic and environmental influences on romantic relationships and the associations between relationship outcomes and important individual differences related to relationships. We first elaborate on how behavioral genetic and molecular genetic methods can be used to understand the etiology of relationship outcomes. We then review empirical studies that have examined gene-environment correlations and gene-by-environment interactions in predicting romantic relationship outcomes (e.g., relationship formation, relationship quality and functioning, relationship dissolution) and their association with the physical health, mental health, and well-being of relationship partners.

Does education lower allostatic load? A co-twin control study

Many studies have found that education is associated with better health, but the causal basis of this association is unclear. The current study used a co-twin control design to examine if differences in years of education within twin pairs predict allostatic load. The strength of this design is that it controls for genetic and other familial confounds shared between twins. The sample consisted of 381 twins (with 292 twins from 146 complete pairs; mean age=57; 61% female) who participated in the biomarker project of the Midlife Development in the United States (MIDUS) study. Individual-level analyses showed a significant, negative association between years of education and allostatic load, but this association was explained entirely by familial influences shared between twins. The results of this study suggest that schooling does not itself protect against allostatic load.

Post-adoption depression: Parental classes of depressive symptoms across time

BACKGROUND

Approximately 10-15% of birth mothers and fathers experience postpartum depression, but reports of depressive symptoms in adoptive parents are more variable. Findings from investigators range from 10% to 32%, which may mask the experiences of distinct groups of adoptive parents from pre-to post-placement of a child.

METHODS

We performed latent class growth analysis using the Center for Epidemiologic Studies-Depression scores of 129 primarily heterosexual, adoptive parents (50% females) for three time points: 4-6 weeks pre-placement of the child, 4-6 weeks post-placement, and 5-6 months post-placement. Mixed effects models by parent depressive trajectories were also conducted for three types of variables: interpersonal, psychological symptoms, and life orientation.

RESULTS

Five classes of depressive symptom trajectories were found. The majority of parents (71%) belonged to a class with low levels of depressive symptoms across time. However, two classes of parents were above the threshold for depressive symptoms at placement, and three classes of parents were above the threshold at 6 months post-placement. The majority of interpersonal, psychological symptom, and life orientation variables were significant across classes and by time.

LIMITATIONS

The homogeneity of the sample calls for replication of study findings.

CONCLUSIONS

An explanation for inconsistencies in the range of adoptive parent depressive symptoms may be explained by different subgroups of parents who vary by their trajectory of depressive symptoms before and after placement of the child. Adoption and mental health professionals should be aware that select adoptive parents may struggle pre-and post-placement of a child.

Internalizing and Externalizing Symptoms and Marital Relationship Functioning: The Mediating Role of Demand-Withdraw Communication Processes

Marital outcomes are associated with internalizing and externalizing symptoms; however, the processes by which these domains are associated with marital outcomes are not well understood. This study examined how demand-withdraw (DW) couple communication accounts for the association between symptoms of mental illness and marital distress. A mediational model was tested in a sample of 100 newlywed couples to determine: (a) whether internalizing and externalizing symptoms influenced own and partner's level of DW communication, and (b) whether this communication pattern was associated with relationship outcomes, including lower marital satisfaction and presence of conflict. Results suggested that DW communication had significant effects on both partner's marital outcomes and mediated the association between externalizing symptoms (for husbands) and marital distress.

Biometric Modeling of Gene-Environment Interplay: The Intersection of Theory and Method and Applications for Social Inequality

For more than a decade, biometric moderation models have been used to examine whether genetic and environmental influences on individual differences might vary within the population. These quantitative Gene × Environment interaction models have the potential to elucidate not only when genetic and environmental influences on a phenotype might differ, but also why, as they provide an empirical test of several theoretical paradigms that serve as useful heuristics to explain etiology-diathesis-stress, bioecological, differential susceptibility, and social control. In the current article, we review how these developmental theories align with different patterns of findings from statistical models of gene-environment interplay. We then describe the extant empirical evidence, using work by our own research group and others, to lay out genetically informative plausible accounts of how phenotypes related to social inequality-physical health and cognition-might relate to these theoretical models.