DSM-5 pathological personality traits are associated with the ability to understand the emotional states of others

Understanding the Psychosis Spectrum Using a Hierarchical Model of Social Cognition

BACKGROUND AND HYPOTHESIS

Social cognitive impairments are central to psychosis, including lower severity psychosis-like experiences (PLEs). Nonetheless, progress has been hindered by social cognition's poorly defined factor structure, as well as limited work examining the specificity of social cognitive impairment to psychosis. The present study examined how PLEs relate to social cognition in the context of other psychopathology dimensions, using a hierarchical factors approach to social cognition.

STUDY DESIGN

Online community participants (N = 1026) completed psychosis, autism, and personality disorder questionnaires, as well as 3 social cognitive tasks that varied in methodology (vignette vs video) and construct (higher- vs lower-level social cognition). Exploratory (EFA) and confirmatory factor analyses (CFA) were used to model social cognition, with the best models being examined in association with PLEs and psychopathology dimensions.

STUDY RESULTS

EFA and CFA supported a hierarchical model of social cognition, with 2 higher-order factors emerging: verbal/vignette task methodology and a multimethod general social cognition factor. These higher-order factors accounted for task-level associations to psychopathology, with relations to positive symptoms (r = .23) and antagonism (r = .28). After controlling for other psychopathology, positive symptoms were most clearly related to tasks with verbal methodology (β = -0.34).

CONCLUSIONS

These results suggest that broad social cognitive processes and method effects may account for many previous findings in psychosis and psychopathology research. Additionally, accounting for broad social cognitive impairment may yield insights into more specific social cognitive processes as well.

A Multi-Method Study of Interpersonal Complementarity and Mentalization

Research finds cross-sectional relationships between mentalizing impairments and maladaptive personality traits. The current study connects mentalizing impairments to dynamic interpersonal processes using a multi-method design. A sample of 218 participants completed the Movie for the Assessment of Social Cognition (MASC; Dziobek et al., 2006) to assess mentalizing ability. Subsequently, participants rated their agentic and communal behavior and their perception of interaction partners' agentic and communal behavior over 21-days. Mentalizing ability moderated the within-person relationship between behavior and perception for both agency and communion. Worse performance on the MASC was associated with weaker interpersonal complementarity, suggesting that mentalizing impairments lead to deviations from expected patterns of behavior and perception across interpersonal situations. These findings confirm the assumption of Contemporary Integrative Interpersonal Theory that mentalization impairments can disrupt normative interpersonal processes (Cain et al., 2024; Pincus & Hopwood, 2012).

Construct validity evidence reporting practices for the Reading the Mind in the Eyes Test: A systematic scoping review

The Reading the Mind in the Eyes Test (RMET) is one of the most influential measures of social cognitive ability, and it has been used extensively in clinical populations. However, questions have been raised about the validity of RMET scores. We conducted a systematic scoping review of the validity evidence reported in studies that administered the RMET (n = 1461; of which 804 included at least one clinical sample) with a focus on six key dimensions: internal consistency, test-retest reliability, factor structure, convergent validity, discriminant validity, and known group validity. Strikingly, 63% of these studies failed to provide validity evidence from any of these six categories. Moreover, when evidence was reported, it frequently failed to meet widely accepted validity standards. Overall, our results suggest a troubling conclusion: the validity of RMET scores (and the research findings based on them) are largely unsubstantiated and uninterpretable. More broadly, this project demonstrates how unaddressed measurement issues can undermine a voluminous psychological literature.

Profiles of theory of mind impairments and personality in clinical and community samples: integrating the alternative DSM-5 model for personality disorders

Introduction

Deficits in theory of mind (ToM)-the ability to infer the mental states of others-have been linked to antagonistic traits in community samples. ToM deficits have also been identified in people with personality disorders (PD), although with conflicting evidence, partly due to the use of categorical diagnoses. The DSM-5 Alternative Model for Personality Disorders (AMPD) provides an opportunity for a more precise understanding of the interplay between ToM abilities and personality pathology. Therefore, the study aims to determine whether and how individuals with diverse ToM profiles differ regarding personality impairment (AMPD Criterion A) and pathological facets (AMPD Criterion B).

Method

Adults with PD (n = 39) and from the community (n = 42) completed tests assessing ToM skills and self-reported questionnaires assessing AMPD Criteria A and B. Hierarchical agglomerative and TwoStep cluster analyses were consecutively computed using scores and subscores from ToM tests as clustering variables. Multivariate analyses of variance were subsequently performed to compare the clusters on both AMPD Criteria. Five clinically and conceptually meaningful clusters were found. The most notable differences across clusters were observed for Intimacy and Empathy dysfunctions (Criterion A), as well as for the Deceitfulness, Callousness, and Hostility facets from the Antagonism domain and the Restricted affectivity facet from the Detachment domain (Criterion B).

Discussion

The results support the association between antagonistic personality facets and ToM deficits. However, clusters showing impairments in ToM abilities did not necessarily exhibit high levels of personality dysfunction or pathological facets, emphasizing that both constructs are not isomorphic. Nevertheless, specific profiles can help refine existing interventions to make them more sensitive and specific to the nature of ToM dysfunctions while considering personality functioning and facets.

Initial risk factors, self-compassion trajectories, and well-being outcomes during the COVID-19 pandemic: A person-centered approach

Introduction

We investigated whether initial risk classes and heterogeneous trajectories of self-compassion over the course of the pandemic may impact well-being outcomes 1 year into the pandemic.

Methods

A large, representative sample of Canadians (N = 3,613; 50.6% women) was sampled longitudinally over 11 waves (April 2020-April 2021), using a rolling cross-sectional survey design. Analyses were conducted in three steps: (1) latent class analysis to identify heterogeneity in risk factors (sociodemographic, cognitive-personality, health-related) early in the pandemic, (2) latent class growth analysis (LCGA) to identify longitudinal self-compassion trajectories, and (3) GLM to examine effects of risk factor classes and self-compassion trajectories, as well as their interaction, on later well-being (mental health, perceived control, life satisfaction).

Results and Discussion

Four risk factor classes emerged, with 50.9% of participants experiencing low risk, 14.3% experiencing multiple risks, 20.8% experiencing Cognitive-Personality and Health risks, and 14.0% experiencing sociodemographic and Cognitive-Personality risks. Four self-compassion trajectories also emerged, with 47.7% of participants experiencing moderate-high self-compassion that decreased then stabilized, 32.0% experiencing moderate self-compassion that decreased then stabilized, 17.3% experiencing high and stable self-compassion across time, and 3.0% experiencing low and decreasing self-compassion. Comparisons of well-being outcomes 1 year post-pandemic indicated that higher levels of self-compassion over time may protect against the impact of initial risk on well-being outcomes. Further work is still needed on heterogeneity in experiences of risk and protective factors during stressful life events.

Relationship of neurocognitive ability, perspective taking, and psychoticism with hostile attribution bias in non-clinical participants: Theory of mind as a mediator

Objectives

Hostile attribution bias is reportedly common from non-clinical population to those with serious mental illness, such as schizophrenia, and is known to be closely related to theory of mind (ToM). This study aimed to investigate whether ToM skills mediate the relationship among neurocognitive ability, personality traits, and attribution bias.

Methods

A total of 198 (101 females) non-clinical youths were recruited. To assess their neurocognitive ability and ToM skills, the participants were asked to complete Raven’s Standard Progressive Matrices (SPM) and the Korean version of the Reading the Mind in Eyes Test (K-RMET). To determine their personality traits, the Eysenck Personality Questionnaire (psychoticism) and interpersonal reactivity index (perspective taking) were used. To evaluate hostile attribution bias, the Ambiguous Intentions Hostility Questionnaire was administered. Path analysis and bias-corrected percentile bootstrap methods were used to estimate model fit and the parameters of the mediating effects.

Results

Based on model comparison, the best model characterized (1) two direct pathways from psychoticism and the K-RMET to hostility attribution bias and (2) three indirect pathways, wherein SPM, perspective taking, and psychoticism influenced hostile attribution bias through K-RMET. The final model fit indices were good [x²/df = 1.126; comparative fit index = 0.996; root mean square error of approximation = 0.026; standard root mean square residual = 0.026 and Akaike information criterion = 28.251] and the K-RMET fully mediated the association between SPM, perspective taking, psychoticism, and hostile attribution bias.

Conclusion

The main findings suggested that ToM skills, such as the RMET, play an important role in explaining the relationship among neurocognitive ability, personality traits, and hostile attribution bias. ToM skills and a remediation strategy may need to be developed to balance the enhanced hostility bias that underlies the paranoia.

Trait resilience as a moderator between personality dysfunction and caregiving stress in caregivers of children and adults with developmental disabilities

Background

Long-term care of a relative with a disability is associated with negative consequences on the caregiver's mental health. Therefore, investigating how some personality traits, such as resilience, protect caregivers with dysfunctional personality traits from caregiving stress is necessary. This study examines the moderating role of resilience in the relationship between caregiver's personality dysfunction and care stress.

Methods

A total of 224 family caregivers of children and adults with developmental disabilities participated in this cross-sectional research. They completed self-report measures of resilience, personality dysfunction, and care stress.

Results

The results show that medium and high levels of resilience protect familial caregivers from the adverse effects of personality dysfunction on stress. The relationship is maintained for three of the five dysfunctional personality traits (antagonism, disinhibition, and psychoticism).

Conclusions

From a theoretical point of view, the results show the contribution of the dimensional personality model to the study of caregiving stress. From a practical standpoint, the results can be used to optimise the resilience of familial caregivers, providing them with tools to take better care of their relatives.

Attachment, Mentalization, and Criterion B of the Alternative DSM-5 Model for Personality Disorders (AMPD)

BACKGROUND

The mentalization theory posits that interpersonal difficulties and maladaptive personality traits develop from an insecure attachment pattern with one's caregiver and corresponding deficits in mentalizing-the ability to understand others' and one's own mental states. Mentalizing deficits have been theorized as the basis for all psychopathology, with the paradigmatic case being Borderline Personality Disorder. Nevertheless, developments in the personality field indicate personality pathology is best represented dimensionally, and such a proposal was outlined by the Alternative DSM-5 Model for Personality Disorders (AMPD). Despite evidence linking the mentalization theory to personality disorders, however, it has yet to be applied to Criterion B of the AMPD. The aim of the present study was to evaluate the moderating role of mentalizing in the relation between attachment and Criterion B maladaptive trait function in a sample of undergraduates. We hypothesized a model in which: (1) attachment insecurity would be positively associated with the Negative Affectivity, Antagonism, and Disinhibition personality domains; (2) mentalizing ability would be negatively associated with these domains; and, (3) there would be an interaction effect between attachment and mentalizing when predicting these same domains.

METHODS

Personality domains were measured dimensionally via the Personality Inventory for DSM-5 (PID-5-SF), while the dependence and avoidance domains of attachment were assessed via the Relationship Questionnaire (RQ). Mentalizing ability was tapped by the Movie for the Assessment of Social Cognition (MASC). The AMPD personality domains and trait facets were examined as dependent variables; attachment dependence, attachment avoidance, and overall mentalizing ability were entered as independent variables; and interaction terms between mentalizing and each attachment dimension were used to test moderation via MANCOVAs.

RESULTS

Consistent with expectations, results indicated overall mentalizing moderated the relation between attachment avoidance and Negative Affectivity. Posthoc analyses revealed similar effects on the relations between attachment avoidance and the Emotional Lability, Hostility, and Perseveration trait facets; however, there were no significant moderation findings related to attachment dependence.

CONCLUSIONS

These results support the mentalization theory's application to Criterion B of the AMPD, particularly in relation to the links between Negative Affectivity and borderline-related traits, and encourage future research of dimensional maladaptive personality. They further bolster support for understanding maladaptive personality as a dimensional construct.

Linking RDoC and HiTOP: A new interface for advancing psychiatric nosology and neuroscience

The Research Domain Criteria (RDoC) and the Hierarchical Taxonomy of Psychopathology (HiTOP) represent major dimensional frameworks proposing two alternative approaches to accelerate progress in the way psychopathology is studied, classified, and treated. RDoC is a research framework rooted in neuroscience aiming to further the understanding of transdiagnostic biobehavioral systems underlying psychopathology and ultimately inform future classifications. HiTOP is a dimensional classification system, derived from the observed covariation among symptoms of psychopathology and maladaptive traits, which seeks to provide more informative research and treatment targets (i.e., dimensional constructs and clinical assessments) than traditional diagnostic categories. This article argues that the complementary strengths of RDoC and HiTOP can be leveraged in order to achieve their respective goals. RDoC's biobehavioral framework may help elucidate the underpinnings of the clinical dimensions included in HiTOP, whereas HiTOP may provide psychometrically robust clinical targets for RDoC-informed research. We present a comprehensive mapping between dimensions included in RDoC (constructs and subconstructs) and HiTOP (spectra and subfactors) based on narrative review of the empirical literature. The resulting RDoC-HiTOP interface sheds light on the biobehavioral correlates of clinical dimensions and provides a broad set of dimensional clinical targets for etiological and neuroscientific research. We conclude with future directions and practical recommendations for using this interface to advance clinical neuroscience and psychiatric nosology. Ultimately, we envision that this RDoC-HiTOP interface has the potential to inform the development of a unified, dimensional, and biobehaviorally-grounded psychiatric nosology.

A Brief but Comprehensive Review of Research on the Alternative DSM-5 Model for Personality Disorders

PURPOSE OF REVIEW

Both the Alternative DSM-5 Model for Personality Disorders (AMPD) and the chapter on personality disorders (PD) in the recent version of ICD-11 embody a shift from a categorical to a dimensional paradigm for the classification of PD. We describe these new models, summarize available measures, and provide a comprehensive review of research on the AMPD.

RECENT FINDINGS

A total of 237 publications on severity (criterion A) and maladaptive traits (criterion B) of the AMPD indicate (a) acceptable interrater reliability, (b) largely consistent latent structures, (c) substantial convergence with a range of theoretically and clinically relevant external measures, and (d) some evidence for incremental validity when controlling for categorical PD diagnoses. However, measures of criterion A and B are highly correlated, which poses conceptual challenges. The AMPD has stimulated extensive research with promising findings. We highlight open questions and provide recommendations for future research.