The externalizing spectrum in youth: Incorporating personality pathology

How Robust Is the p Factor? Using Multitrait-Multimethod Modeling to Inform the Meaning of General Factors of Youth Psychopathology

We used multitrait-multimethod (MTMM) modeling to examine general factors of psychopathology in three samples of youth (Ns = 2119, 303, 592) for whom three informants reported on the youth's psychopathology (e.g., child, parent, teacher). Empirical support for the p-factor diminished in multi-informant models compared with mono-informant models: the correlation between externalizing and internalizing factors decreased and the general factor in bifactor models essentially reflected externalizing. Widely used MTMM-informed approaches for modeling multi-informant data cannot distinguish between competing interpretations of the patterns of effects we observed, including that the p-factor reflects, in part, evaluative consistency bias or that psychopathology manifests differently across contexts (e.g., home vs. school). Ultimately, support for the p-factor may be stronger in mono-informant designs, although it is does not entirely vanish in multi-informant models. Instead, the general factor of psychopathology in any given mono-informant model likely reflects a complex mix of variances, some substantive and some methodological.

Personality traits differentiate patients with bipolar disorder and healthy controls - A meta-analytic approach

BACKGROUND

Expression of specific personality traits has been associated with the presence and disease course of bipolar disorder (BD) in multiple studies. However, until today findings are inconsistent and potentially confounding factors such as age and gender as well as the limited sample size of previous studies make it difficult to generalize these findings. To overcome these limitations and to specify the role of personality traits in the context of BD, we performed a meta-analysis in patients with BD and healthy controls (HC), focusing on the traits of the big three and the big five: Neuroticism (N), Extraversion (E), Openness (O), Conscientiousness (C), Agreeableness (A) and Psychoticism (P).

METHODS

Two online databases (Pubmed and Web of Science) were searched systematically to identify relevant articles, including publications up to December 31, 2019. From studies that met our inclusion criteria (n = 18), we extracted relevant data of patients with BD (n = 1694) and HC (n = 2153) and calculated effect sizes for each personality trait. Further, we performed moderator analysis on gender, age, quality score and years of publication.

RESULTS

Our results indicate that patients with BD exhibit higher scores on N (large positive effect size; n = 18, g = 1.44, 95%-CI : 1.11 to 1.77) and lower scores on C (medium negative effect size; n = 6, g = -0.78, 95%-CI: -1.13 to -0.43) and E (small negative effect size; n = 13, g = -0.38, 95%-CI: -0.52 to -0.23) compared to HC. We found a moderating effect of mean age on the effect size of N with smaller differences in N levels between patients with BD and HC in older samples (-0.0437, z = - 3.96, p <0.0001). Our results were robust with respect to potential publication biases and the inclusion of potentially confounding factors such as gender, age, quality score and years of publication.

LIMITATIONS

Due to the lack of available data no subgroup analysis on the effect of mood states of patients and subtypes of BD could be performed. Moreover, our analyses are based on cross-sectional data so that findings should be interpreted with care, especially concerning causal conclusions.

CONCLUSIONS

Patients with BD showed differences in several personality traits compared to HC. Our results provide the basis for future research with focus on personality and psychopathology in patients with BD. Identifying the interaction between expressions of personality traits and BD might provide novel approaches in prevention and therapy.

Relational Aggression and Narcissistic Traits: How Youth Personality Pathology Informs Aggressive Behavior

Low agreeableness features centrally in personality profiles of Cluster B personality disorder (PD) diagnoses, and it has been associated with relational aggression (RAgg; intentionally damaging others' social relationships). Researchers have hypothesized that RAgg may be a potential developmental precursor for Cluster B PDs. However, a dimensional approach to personality dysfunction is preferable to the categorical system found in the current diagnostic manual. To build a bridge between two disjointed literatures (categorical PDs and RAgg), the aim of this project is to detail how RAgg in youth is situated in the trait space represented by disagreeableness in a dimensional model of personality pathology. Caregivers of 911 youth (ages 6-18) reported on youth's RAgg and disagreeableness. We found that RAgg was most strongly related to three facets: Narcissistic traits, Hyperexpressive traits, and Dominance-Egocentrism traits. Overall, these findings provide support for RAgg as an early manifestation of personality pathology, particularly for narcissistic traits.

The p factor and dimensional structural models of youth personality pathology and psychopathology

The Hierarchical Taxonomy of Psychopathology (HiTOP) is a developing dimensional nosology which provides a joint framework for study of psychopathology and personality pathology. Dimensional structural models of psychopathology often include an overarching dimension of psychopathology (p factor) representing covariation among all forms of psychopathology. The p factor can be recovered in youth and adult samples, and has been found to relate to personality traits in similar ways in youth and adults. However, placement of personality pathology in an overarching psychopathology structure has almost exclusively been investigated in adults. We review evidence for the relationships between normal-range and pathological personality traits and psychopathology in adults and youth, ultimately making the case for study of a joint personality - psychopathology framework in youth.

Correlates between Five-Factor Model traits and the Revised Diagnostic Interview for Borderlines dimensions in an adolescent clinical sample

OBJECTIVE

Extensive evidence supports the association between Five-Factor Model (FFM) traits involving high neuroticism, low agreeableness and low conscientiousness and borderline personality disorder (BPD) characteristics, particularly among adults in community samples. However, studies supporting this link in adolescent samples are relatively limited, and few studies have examined the links between FFM traits and specific dimensions of BPD, such as those distinguished by the Revised Diagnostic Interview for Borderlines (DIB-R). In this study, we examined associations between FFM traits and BPD characteristics in a group of clinical and non-clinical adolescents.

METHOD

We evaluated the correlations between the FFM personality traits, as measured by the NEO-Five-Factor Inventory and BPD characteristics as measured by the DIB-R in a sample of adolescents (N = 162).

RESULTS

Consistent with previous research, BPD dimensions were highly associated with high neuroticism, low conscientiousness, low agreeableness and to a somewhat lesser extent with low extraversion. Specificity of associations between FFM traits and DIB-R section scores was limited, in part because of strong intercorrelations among DIB-R scores.

DISCUSSION

These results imply that evidence about trait-BPD associations in adult samples generalizes well to adolescents. Clinical implications of these findings are discussed.

The relationship among resting-state brain activity and connectivity, agreeableness and displaced aggression: Two possible mediation models

BACKGROUND

Displaced aggression is a specific form of attack prompted by rumination on anger experiences and revenge thought which might lead to expression of anger on innocent people. There is sufficient evidence demonstrating the potential role of agreeableness in reducing displaced aggression in theory. However, little is known about the neural basis of displaced aggression and how agreeableness and the underlying neural mechanisms link to displaced aggression.

METHODS

In this investigation, we examined these issues on 123 college students by assessing resting-state brain activity (i.e. amplitude of low-frequency fluctuation, ALFF) and connectivity (i.e. resting-state functional connectivity, RSFC).

RESULTS

Whole-brain correlation analysis revealed that a higher level of displaced aggression was linked with decreased ALFF in the left dorsomedial prefrontal cortex (dmPFC) and decreased RSFC between the left dmPFC and left ventromedial prefrontal cortex (vmPFC). Mediation analysis further revealed that left dmPFC activity and the left dmPFC-vmPFC connectivity mediated the relationship between agreeableness and displaced aggression, as well as agreeableness mediated the relation between left dmPFC activity and the left dmPFC-vmPFC connectivity and displaced aggression.

LIMITATIONS

Only ALFF and RSFC were used as indicators of brain function in this study. The two mediation models need to be further tested by longitudinal design or experimental methods in further studies.

CONCLUSIONS

This study suggested that dmPFC and vmPFC might be the functional neural markers of displaced aggression and provided two possible mediation models regarding the relationship among the resting-state brain activity and connectivity, agreeableness and displaced aggression.

Externalizing Behavior Across Childhood as Reported by Parents and Teachers: A Partial Measurement Invariance Model

The externalizing spectrum may explain covariation among externalizing disorders observed in childhood and adulthood. Few prospective studies have examined whether externalizing spectrum might manifest differently across time, reporters, and gender during childhood. We used a multitrait, multimethod model with parent and teacher report of attention-deficit/hyperactivity disorder (ADHD) symptoms, oppositional defiant disorder (ODD) symptoms, and conduct disorder (CD)symptoms from kindergarten to Grade 5 in data from the Fast Track Project, a large multisite trial for children at risk for conduct problems ( n = 754). The externalizing spectrum was stably related to ADHD, ODD, and CD symptoms from kindergarten to Grade 5, with similar contributions from parents and teachers. Configural, metric, and scalar invariance were largely supported across time, suggesting that the structure of the externalizing spectrum is stable over time. Configural and partial metric invariance were supported across gender, but scalar invariance was not supported, with intercepts consistently higher for males than for females. Overall, our findings confirm other research that the externalizing spectrum can be observed early in development as covariation between ADHD, ODD, and CD, and extend that work to show that it is relatively consistent across time and reporter, but not consistent across gender.

Bidirectional Pathways between Relational Aggression and Temperament from Late Childhood to Adolescence

Relational aggression is linked to numerous adverse consequences. However, we know little about how temperament leads individuals to become perpetrators/victims of relational aggression, or how being a perpetrator/victim influences the development of temperament. We used longitudinal data from 674 Mexican-origin youth to examine relations between relational aggression and mother- and child-reported temperament from 5^th grade (M_age=10.8; SD=0.60) through 11^th grade (M_age=16.8; SD=0.50). Results show that: (a) high Negative Emotionality and low Effortful Control predicted increases in victimization; (b) low Effortful Control predicted increases in perpetration; (c) victims increased in Negative Emotionality and decreased in Effortful Control; and (d) perpetrators increased in Negative Emotionality and Surgency. Thus, temperament serves as both an antecedent to and a consequence of relational aggression.

Estradiol and cortisol interactions in youth externalizing psychopathology

Growing evidence has indicated that gonadal and stress hormones interact to shape socially dominant behavior and externalizing psychopathology; however, such work to date has focused exclusively on the testosterone-cortisol interaction, despite expectations that estradiol should be associated with similar behavioral outcomes to testosterone. Here, we present the first empirical test of the hypothesis that adolescent males and females (N=105, ages 13-18) with high estradiol and low cortisol concentrations are at highest risk for externalizing problems, but - replicating previous work - only among adolescents high on pathological personality traits. Parents reported on youth psychopathology and personality, and hormone concentrations were measured via passive drool. Results confirmed the hypothesis: high estradiol was associated with more externalizing behaviors, but only when cortisol was low and personality traits of disagreeableness and emotional instability were high. Further, these associations held when controlling for testosterone concentrations. These findings provide the first empirical evidence of a hypothalamic pituitary adrenal (HPA)×hypothalamic pituitary gonadal (HPG) axis interaction that extends the "dual hormone" hypothesis beyond testosterone.

Transdiagnostic factors of psychopathology and substance use disorders: a review

PURPOSE

Research on the structure of mental disorders and comorbidity indicates that many forms of psychopathology and substance use disorders are manifestations of relatively few transdiagnostic latent factors. These factors have important consequences for mental disorder research and applied practice.

METHODS

We provide an overview of the transdiagnostic factor literature, with particular focus on recent advances.

RESULTS

Internalizing and externalizing transdiagnostic factors have been well characterized in terms of their structures, links with disorders, stability, and statistical properties (e.g., invariance and distributions). Research on additional transdiagnostic factors, such as thought disorder, is quickly advancing latent structural models, as are integrations of transdiagnostic constructs with personality traits. Genetically informed analyses continue to clarify the origins of transdiagnostic factor levels, and links between these factors and important environmental exposures provide promising new avenues of inquiry.

CONCLUSIONS

Transdiagnostic factors account for the development and continuity of disorders and comorbidity over time, function as the primary links between disorders and important outcomes such as suicide, mediate associations between environmental exposures and disorders, provide an empirically supported classification system, and serve as foci for efficient, broadband intervention approaches. Overall, transdiagnostic factor research indicates the paramount importance of understanding these constructs and, thereby, broadening our understanding of mental disorder in general.

Advancements in the field of personality development

A summary is provided what the fields of personality and developmental psychology had to offer each other the past decade, reflected in the eleven contributions enclosed in this special issue. Strengths and opportunities to further advance the field are identified, including the extension of general trait with maladaptive trait models, the use of alternative methods to assess personality, and the adoption of configural approaches to describe traits in individuals, beyond more traditional person-centered approaches.