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Kim YR, Lee YH. The Dimensional Conceptualization of Personality Disorders: Personality Organization, Personality Functioning, and Personality Disorders. J Pers Disord 2024; 38:105-125. [PMID: 38592910 DOI: 10.1521/pedi.2024.38.2.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
Over the past several decades, significant criticism of the categorical classification system for personality disorders has highlighted the need to transition to a dimensional classification system. This study reviewed key issues involved in the potential conversion of the diagnostic system of personality disorders from a categorical to a dimensional model. The result suggests that Kernberg's concept of personality organization can be used to indicate the overall severity of personality pathology.
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Affiliation(s)
- Young Ran Kim
- From Institute of Psychoanalytic Training and Research, New York, New York
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2
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Clark LA, Ro E, Nuzum H, Vanderbleek EN, Allen X. Personality disorder coverage, prevalence, and convergence: do the DSM-5's two models of personality disorder identify the same patients? Psychol Med 2024:1-12. [PMID: 38501282 DOI: 10.1017/s0033291724000357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
BACKGROUND Research on the Alternative DSM-5 Model for Personality Disorders (AMPD) in DSM-5's Section-III has demonstrated acceptable interrater reliability, a largely consistent latent structure, substantial correlations with theoretically and clinically relevant measures, and evidence for incremental concurrent and predictive validity after controlling for DSM-5's Section II categorical personality disorders (PDs). However, the AMPD is not yet widely used clinically. One clinician concern may be caseness - that the new model will diagnose a different set of PD patients from that with which they are familiar. The primary aim of this study is to determine whether this concern is valid, by testing how well the two models converge in terms of prevalence and coverage. METHOD Participants were 305 psychiatric outpatients and 302 community residents not currently in mental-health treatment who scored above threshold on the Iowa Personality Disorder Screen (Langbehn et al., ). Participants were administered a semi-structured interview for DSM-5 PD, which was scored for both Section II and III PDs. RESULTS Convergence across the two PD models was variable for specific PDs, Good when specific PDs were aggregated, and Very Good for 'any PD.' CONCLUSIONS Results provide strong evidence that the AMPD yields the same overall prevalence of PD as the current model and, further, identifies largely the same overall population. It also addresses well-known problems of the current model, is more consistent with the ICD-11 PD model, and provides more complete, individualized characterizations of persons with PD, thereby offering multiple reasons for its implementation in clinical settings.
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Affiliation(s)
- Lee Anna Clark
- Department of Psychology, University of Notre Dame, Notre Dame, IN, USA
| | - Eunyoe Ro
- Department of Psychology, Southern Illinois University Edwardsville, Edwardsville, IL, USA
| | - Hallie Nuzum
- Veterans Affairs Puget Sound Health Care System, Seattle Division, Seattle, WA, USA
| | | | - Xia Allen
- And Still We Rise, LLC, Boston, MA, USA
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Rivard G, Le Corff Y, Lapalme M, Forget K. Measurement invariance of the Personality Inventory for DSM-5 across sex. Front Psychiatry 2024; 15:1328937. [PMID: 38525253 PMCID: PMC10957747 DOI: 10.3389/fpsyt.2024.1328937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 02/21/2024] [Indexed: 03/26/2024] Open
Abstract
Introduction There has been an international movement towards dimensional models of personality disorders (PDs) in the last decades, which culminated in the publication of the Alternative Model of Personality Disorders (AMPD) in the Emerging Measures and Models section of the DSM-5. This model was accompanied by a APA-sanctioned Personality Inventory for DSM-5 (PID-5) for the assessment of the AMPD pathological personality traits. One major issue with the assessment of personality disorders pertains to sex differences, and measurement invariance across sex in assessment instruments for PDs is necessary in order to ensure non-biased evaluations and to make valid comparisons between men and women. This study aimed to provide more information on measurement invariance across sex for the PID-5, using both the original scoring approach provided by the authors of the instrument and the scoring approach suggested by the APA in the published version of the PID-5. Methods This study was conducted with a sample of 2273 participants from the general Québec (Canada) adult population aged 18 to 90 years (M = 46.59; SD = 16.32; 51.8% women). Results The original scoring approach model showed good fit to data after freeing paths between certain traits and reached strict invariance. The APA scoring approach also showed good fit to data and reached strict invariance, but needed an adjustment (path freed between Emotional lability and Impulsivity in men) to reach scalar invariance. Discussion In line with previous research, the PID-5 is invariant across sex and the five-factor structure adjusts well to data. The APA scoring approach appears to attenuate the cross-loading problem observed with the original scoring approach. In light of these results, we recommend using the APA scoring approach to derive domain scores.
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Affiliation(s)
- Geneviève Rivard
- The Group for Research and Intervention on Children’s Social Adjustment (GRISE), Université de Sherbrooke, Sherbrooke, QC, Canada
- Département d’orientation Professionnelle, Faculté d’éducation, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Yann Le Corff
- The Group for Research and Intervention on Children’s Social Adjustment (GRISE), Université de Sherbrooke, Sherbrooke, QC, Canada
- Département d’orientation Professionnelle, Faculté d’éducation, Université de Sherbrooke, Sherbrooke, QC, Canada
- Département de Psychiatrie, Faculté de Médecine, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Mélanie Lapalme
- The Group for Research and Intervention on Children’s Social Adjustment (GRISE), Université de Sherbrooke, Sherbrooke, QC, Canada
- Département de Psychoéducation, Faculté d’éducation, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Karine Forget
- The Group for Research and Intervention on Children’s Social Adjustment (GRISE), Université de Sherbrooke, Sherbrooke, QC, Canada
- Département de Psychiatrie, Faculté de Médecine, Université de Sherbrooke, Sherbrooke, QC, Canada
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Rossi G, Diaz-Batanero C. Differentiation of Self and Interpersonal Functioning with the Level of Personality Functioning Scale - Brief Form 2.0. J Pers Assess 2024; 106:60-71. [PMID: 37306356 DOI: 10.1080/00223891.2023.2218931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 05/17/2023] [Indexed: 06/13/2023]
Abstract
Research on Criterion A of the alternative model for personality disorders is recently expanding and provides mixed results concerning the unidimensional operational definition of severity by the model, characterized by impaired self (identity and self-direction) and interpersonal (empathy and intimacy) functioning. Studies resulted in one, as well as two or more factor structures. The present study demonstrated the importance of the structural and relational differentiation of self and interpersonal dimensions of personality functioning. One thousand seventy-four participants (community and clinical mixed sample) completed the Level of Personality Functioning Scale - Brief Form 2.0 (LPFS-BF 2.0), the Personality Inventory for DSM-5 Short Form and the Questionnaire for the World Health Organization Disability Assessment. An LPFS-BF 2.0 two-factor structure with self and interpersonal functioning factors was corroborated by confirmatory factor analyses and bifactor modeling. Joint Exploratory Factor Analysis of the LPFS-BF 2.0 domains with maladaptive personality domains clearly differentiated the personality functioning factors. While the self-functioning factor was more closely linked to negative affect (and to disinhibition and psychoticism), the interpersonal functioning factor connected to detachment. Self-functioning predicted functional impairment along and beyond personality domains. The LPFS-BF 2.0 appears a useful tool for clinical routine monitoring of both self and interpersonal functioning.
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Affiliation(s)
- Gina Rossi
- Personality and Psychopathology Research Group (PEPS), Department of Psychology, Vrije Universiteit Brussel (VUB), Belgium
| | - Carmen Diaz-Batanero
- Department of Clinical and Experimental Psychology, University of Huelva, Spain
- Mental health and drug use, Research Center for Natural Resources, Health and the Environment, University of Huelva, Spain
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5
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Emery LT, Evans CM, Dimitrova J, O'Keefe C, Simms LJ. Understanding the association between normal and maladaptive personality traits: Replication and extension of Morey et al. (2020). J Pers 2023. [PMID: 38014708 DOI: 10.1111/jopy.12904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 09/08/2023] [Accepted: 11/05/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND/OBJECTIVE The Alternative Model for Personality Disorders (AMPD) within the DSM-5 includes separable components representing general personality dysfunction (Criterion A) and maladaptive personality traits (Criterion B). Some critique Criterion A for accounting for little incremental variance in PD beyond Criterion B. However, Morey et al. (2020) hypothesized that personality dysfunction is a key mechanism through which normal-range traits account for the maladaptive component of personality traits, justifying its inclusion. We sought to replicate and extend this work in a psychiatric sample with mixed methods. METHOD In total, 152 participants recruited from mental health clinics completed multiple measures of personality dysfunction and normal-range and maladaptive traits. RESULTS Replication was only partially achieved. The degree of incremental prediction of maladaptive traits and the extent to which personality dysfunction explained the relations between normal-range and maladaptive traits varied significantly across traits, and those effects that reached significance were small in magnitude. Removing variance due to personality dysfunction reduced intercorrelations among maladaptive traits by only a small amount. CONCLUSION Counter to Morey et al. (2020), our results failed to support maladaptive traits as composites of normal-range traits and personality dysfunction, suggesting that other methods of distinguishing personality pathology severity and style are needed.
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Affiliation(s)
- Leah T Emery
- Department of Psychology, University at Buffalo, Buffalo, New York, USA
| | - Chloe M Evans
- Department of Psychology, University at Buffalo, Buffalo, New York, USA
| | - Julia Dimitrova
- Department of Psychology, University at Buffalo, Buffalo, New York, USA
| | - Courtney O'Keefe
- Department of Psychology, University at Buffalo, Buffalo, New York, USA
| | - Leonard J Simms
- Department of Psychology, University at Buffalo, Buffalo, New York, USA
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Kolla NJ, Tully J, Bertsch K. Neural correlates of aggression in personality disorders from the perspective of DSM-5 maladaptive traits: a systematic review. Transl Psychiatry 2023; 13:330. [PMID: 37884552 PMCID: PMC10603082 DOI: 10.1038/s41398-023-02612-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 09/17/2023] [Accepted: 09/21/2023] [Indexed: 10/28/2023] Open
Abstract
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published in 2013, includes an alternative model of personality disorders (AMPD) focusing on a maladaptive trait model utilized to diagnose several personality disorders. Borderline personality disorder (BPD) and antisocial personality disorder (ASPD) are two conditions categorized by AMPD that exhibit high rates of violence and aggression. Several of the traits outlined in the AMPD, including hostility, impulsivity, risk-taking, and callousness, have been previously linked to aggression in BPD and ASPD. However, to the best of our knowledge, there has never been a synthesis of neuroimaging studies that have investigated links between these traits and aggression in BPD and ASPD. To overcome this gap, we conducted a systematic review under the PRISMA framework to locate neuroimaging articles published since the release of AMPD linking trait anger/hostility, impulsivity, risk-taking, and callousness to aggression in BPD and ASPD. Key findings included the following: i) anger/hostility, associated with alterations in the interplay between prefrontal and subcortical regions (primarily the amygdala), may be a common factor explaining aggressive reactions to response to interpersonal threat or provocation; ii) alterations of fronto-temporal-limbic regions and serotonergic and endocannabinoid signaling systems may link impulsivity to aggression in BPD and ASPD; iii) weaker cortico-striatal connectivity could relate to greater risk taking and greater proclivity for violence. Insufficient evidence from neuroimaging articles was discerned to describe a relationship between callousness and aggression. Overall, results of this review reveal a relative paucity of neuroimaging studies examining AMPD traits relevant to aggression in BPD and ASPD. In addition to encouraging further investigation of neuroimaging markers of AMPD traits linked to aggression, we recommend multi-methodological designs, including the incorporation of other biomarkers, such as hormones and indices of physiological arousal, to fully expand our understanding of aggression in BPD and ASPD.
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Affiliation(s)
- Nathan J Kolla
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
- Centre for Addiction and Mental Health, Toronto, ON, Canada.
- Department of Psychiatry, University of Saskatchewan, Saskatoon, SK, Canada.
| | - John Tully
- Academic Unit of Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Katja Bertsch
- Department of Psychology, Ludwig-Maximilians-University, Munich, Germany
- NeuroImagine Core Unit Munich (NICUM), University Hospital LMU, Munich, Germany
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
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Ringwald WR, Emery L, Khoo S, Clark LA, Kotelnikova Y, Scalco MD, Watson D, Wright AG, Simms LJ. Structure of Pathological Personality Traits Through the Lens of the CAT-PD Model. Assessment 2023; 30:2276-2295. [PMID: 36633104 PMCID: PMC10413206 DOI: 10.1177/10731911221143343] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Personality pathology is increasingly conceptualized within hierarchical, dimensional trait models. The Comprehensive Assessment of Traits Relevant to Personality Disorders (CAT-PD) is a pathological-trait measure with potential to improve on currently prevailing instruments because it has wider content coverage; however, its domain-level structure, which is of scientific and clinical interest, is not established. In this study, we investigated the structure and construct validity of the CAT-PD's domain level to facilitate wider use of the measure. We estimated five- and six-factor models with exploratory factor analysis in a pooled sample of eight independent subsamples (N = 3,987) and found that both models fit the data well; each had interpretable factors that were invariant across gender, sample type, and Black/White racial groups; and the factors had good convergent validity with other measures of maladaptive traits, Big Five personality, and interpersonal problems. Our results support the validity of the CAT-PD for assessing multiple levels of the pathological trait hierarchy.
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Affiliation(s)
| | - Leah Emery
- Department of Psychology, University at Buffalo
| | - Shereen Khoo
- Department of Psychology, University of Notre Dame
| | | | | | | | - David Watson
- Department of Psychology, University of Notre Dame
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Kerr S, McLaren V, Cano K, Vanwoerden S, Goth K, Sharp C. Levels of Personality Functioning Questionnaire 12-18 (LoPF-Q 12-18): Factor Structure, Validity, and Clinical Cut-Offs. Assessment 2023; 30:1764-1776. [PMID: 36124366 PMCID: PMC10200067 DOI: 10.1177/10731911221124340] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The Levels of Personality Functioning Questionnaire 12-18 (LoPF-Q 12-18) is the only self-report measure informed by the Level of Personality Functioning (Diagnostic and Statistical Manual of Mental Disorders [5th ed.; DSM-5; American Psychiatric Association, 2013]) Alternative Model of Personality Disorders developed for adolescents. The present investigation includes two studies evaluating the English LoPF-Q 12-18. In Study 1, single-factor and bifactor structures (unidimensional severity criterion and four specific factors: identity, self-direction, empathy, intimacy) were evaluated in an ethnically diverse community sample (N = 453; age 10-18; 57% female). Study 2 used a community control (n = 298; age 10-18; 54.4% female) and clinical sample (n = 94; age 11-18; 58.5% female) to examine reliability, validity, and clinical utility. Study 1 results supported the bifactor model, with a robust general factor and little multidimensionality caused by the group factors, suggesting an essentially unidimensional structure. Study 2 revealed good internal consistency and construct validity and provided clinical cut-offs, supporting the use of the LoPF-Q 12-18 total score in research and clinical applications.
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Affiliation(s)
| | | | | | | | - Kirstin Goth
- Psychiatric University Clinics Basel, Switzerland
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9
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Katar KS, Örsel S, Gündoğmuş AG. Investigation of the role of personality traits and emotion regulation on personality functioning in patients with depression/anxiety disorder. Personal Ment Health 2023; 17:232-245. [PMID: 36693422 DOI: 10.1002/pmh.1577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 12/10/2022] [Accepted: 01/09/2023] [Indexed: 01/26/2023]
Abstract
The relationship between the dimensional assessment of personality and difficulties in emotion regulation has yet to be made clear. The present study aimed to investigate the role of personality traits and emotion regulation on personality functioning. Difficulties in Emotion Regulation Scale (DERS), Beck Anxiety Inventory, Beck Depression Inventory, Personality Inventory for DSM-5 (PID-5) and Level of Personality Functioning Scale (LPFS) were rated for 220 patients with depression and/or anxiety disorder diagnosis and 100 healthy controls. Stepwise regression analyses (SRA) were used to find potential predictors of personality functioning, and generalized linear analyses (GLA) were used to find mediators between the traits and personality functioning. SRA results in the clinical group showed that higher depression, antagonism, difficulties in impulse control and difficulties in awareness predicted higher levels of dysfunction in personality. According to GLA results in the clinical group, the impulse subscale of DERS partially mediated the relationship between antagonism and level of impairment in personality functioning. Our results indicate that certain emotion regulation styles and personality traits play an important role in predicting personality functioning in the clinical sample of depression and anxiety patients. Future studies should focus on specific emotion dysregulation strategies and broaden the dimensional personality literature in different samples.
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Affiliation(s)
- Kübra Sezer Katar
- University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Sibel Örsel
- University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Ayse Gökçen Gündoğmuş
- University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
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10
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Torres-Rosado L, Lozano OM, Sanchez-Garcia M, Fernández-Calderón F, Diaz-Batanero C. Operational definitions and measurement of externalizing behavior problems: An integrative review including research models and clinical diagnostic systems. World J Psychiatry 2023; 13:278-297. [PMID: 37383280 PMCID: PMC10294133 DOI: 10.5498/wjp.v13.i6.278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 03/04/2023] [Accepted: 04/20/2023] [Indexed: 06/19/2023] Open
Abstract
Measurement of externalizing disorders such as antisocial disorders, attention-deficit/hyperactivity disorder or borderline disorder have relevant implications for the daily lives of people with these disorders. While the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD) have provided the diagnostic framework for decades, recent dimensional frameworks question the categorical approach of psychopathology, inherent in traditional nosotaxies. Tests and instruments develop under the DSM or ICD framework preferentially adopt this categorical approach, providing diagnostic labels. In contrast, dimensional measurement instruments provide an individualized profile for the domains that comprise the externalizing spectrum, but are less widely used in practice. Current paper aims to review the operational definitions of externalizing disorders defined under these different frameworks, revise the different measurement alternatives existing, and provide an integrative operational definition. First, an analysis of the operational definition of externalizing disorders among the DSM/ICD diagnostic systems and the recent Hierarchical Taxonomy of Psychopathology (HiTOP) model is carried out. Then, in order to analyze the coverage of operational definitions found, a description of measurement instruments among each conceptualization is provided. Three phases in the development of the ICD and DSM diagnosis systems can be observed with direct implications for measurement. ICD and DSM versions have progressively introduced systematicity, providing more detailed descriptions of diagnostic criteria and categories that ease the measurement instrument development. However, it is questioned whether the DSM/ICD systems adequately modelize externalizing disorders, and therefore their measurement. More recent theoretical approaches, such as the HiTOP model seek to overcome some of the criticism raised towards the classification systems. Nevertheless, several issues concerning this model raise mesasurement challenges. A revision of the instruments underneath each approach shows incomplete coverage of externalizing disorders among the existing instruments. Efforts to bring nosotaxies together with other theoretical models of psychopathology and personality are still needed. The integrative operational definition of externalizing disorders provided may help to gather clinical practice and research.
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Affiliation(s)
- Lidia Torres-Rosado
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva 21071, Spain
| | - Oscar M Lozano
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva 21071, Spain
- Research Center for Natural Resources, Health and Environment, University of Huelva, Huelva 21071, Spain
| | - Manuel Sanchez-Garcia
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva 21071, Spain
- Research Center for Natural Resources, Health and Environment, University of Huelva, Huelva 21071, Spain
| | - Fermín Fernández-Calderón
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva 21071, Spain
- Research Center for Natural Resources, Health and Environment, University of Huelva, Huelva 21071, Spain
| | - Carmen Diaz-Batanero
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva 21071, Spain
- Research Center for Natural Resources, Health and Environment, University of Huelva, Huelva 21071, Spain
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11
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Roche MJ, Jaweed S. Comparing Measures of Criterion A to Better Understand Incremental Validity in the Alternative Model of Personality Disorders. Assessment 2023; 30:689-705. [PMID: 34918562 DOI: 10.1177/10731911211059763] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Alternative Model of Personality Disorders distinguishes between the severity of personality dysfunction (Criterion A) and individual differences in personality disorder expression (Criterion B). Several Criterion A measures exist, but few studies have compared these measures with each other. Moreover, debates about whether the constructs of Criteria A and B are redundant (i.e., weak incremental validity) should be framed around how different Criterion A measures perform relative to others. This study of 204 undergraduate students evaluated multiple measures of Criterion A. These measures were strongly correlated with Criterion B, but evidenced incremental validity (39% of outcomes, 5% average additional variance explained) with outcomes of psychopathology and interpersonal impairments, and less consistent incremental validity with suicidality, aggression, and mental health utilization. We discuss how these results inform the construct of Criterion A relative to Criterion B and evaluate strengths/weaknesses of Criterion A measures.
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12
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Yang T, Roberts C, Winton-Brown T, Lloyd M, Kwan P, O'Brien TJ, Velakoulis D, Rayner G, Malpas CB. Childhood trauma in patients with epileptic vs nonepileptic seizures. Epilepsia 2023; 64:184-195. [PMID: 36300720 PMCID: PMC10100454 DOI: 10.1111/epi.17449] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Childhood trauma has been implicated as a risk factor for the etiology of psychogenic nonepileptic seizures (PNES). Relatively little attention has been paid to whether profiles of specific trauma types differ between patients with epilepsy and PNES. Investigating childhood trauma profiles in these patient groups may identify psychological vulnerabilities that predispose to developing PNES, and aid early diagnoses, prevention, and treatment. METHODS Data were collected from two cohorts (nRetrospective = 203; nProspective = 209) admitted to video-electroencephalography (EEG) monitoring units in Melbourne Australia. The differences in Childhood Trauma Questionnaire domain score between patient groups were investigated using standardized effect sizes and general linear mixed-effects models (GLMMs). Receiver-operating characteristic curves were used to investigate classification accuracy. RESULTS In the retrospective cohort, patients diagnosed with PNES reported greater childhood emotional abuse, emotional neglect, physical abuse, sexual abuse, and physical neglect relative to patients with epilepsy. These differences were replicated in the prospective cohort, except for physical abuse. GLMMs revealed significant main effects for group in both cohorts, but no evidence for any group by domain interactions. Reported sexual abuse showed the best screening performance of PNES, although no psychometric scores were adequate as isolated measures. SIGNIFICANCE Patients with PNES report a greater frequency of childhood trauma than patients with epilepsy. This effect appears to hold across all trauma types, with no strong evidence emerging for a particular trauma type that is more prevalent in PNES. From a practical perspective, inquiry regarding a history of sexual abuse shows the most promise as a screening measure.
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Affiliation(s)
- Tianren Yang
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Caitlin Roberts
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Toby Winton-Brown
- Alfred Brain, Alfred Health, Melbourne, Victoria, Australia.,Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia.,Department of Psychiatry, Alfred Health, Melbourne, Victoria, Australia
| | - Michael Lloyd
- Alfred Brain, Alfred Health, Melbourne, Victoria, Australia.,Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia.,Department of Psychiatry, Alfred Health, Melbourne, Victoria, Australia
| | - Patrick Kwan
- Alfred Brain, Alfred Health, Melbourne, Victoria, Australia.,Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Terence J O'Brien
- Alfred Brain, Alfred Health, Melbourne, Victoria, Australia.,Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Dennis Velakoulis
- Neuropsychiatry, Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
| | - Genevieve Rayner
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia.,Alfred Brain, Alfred Health, Melbourne, Victoria, Australia.,Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia.,Department of Medicine, Austin Hospital, The University of Melbourne, Melbourne, Victoria, Australia
| | - Charles B Malpas
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia.,Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia.,Alfred Brain, Alfred Health, Melbourne, Victoria, Australia.,Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
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Athar ME, Ebrahimi A. Validation of the Personality Inventory for DSM-5–Brief Form (PID-5-BF) with Iranian University Students and Clinical Samples: Factor Structure, Measurement Invariance, and Convergent, Discriminant, and Known-Groups Validity. J Pers Assess 2022; 105:371-381. [PMID: 36511889 DOI: 10.1080/00223891.2022.2152347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The Personality Inventory for DSM-5, Brief Form (PID-5-BF) was developed to assess DSM-5's Alternative Trait Model for Diagnosing Personality Disorders (AMPD). This study aimed to examine the factor structure, internal consistency, measurement invariance, and convergent, discriminant, and known-group validity of the Persian PID-5-BF with 941 university students (aged 18-67, M age= 28.36, SD = 9.09, 39.1% males) and 178 male from a clinical (aged 18-60, M age= 33.77, SD = 10.60) sample in Iran. Confirmatory factor analyses supported the five-factor model in both groups, being fully and partially invariant across gender and study groups, respectively. PID-5-BF subscales were internally consistent, yielded expected associations with other personality variables, and differentiated the student sample from the clinical group, supporting the measure's convergent, discriminant, and known-group validity. Our results indicated that the PID-5-BF holds promise as a screening measure of dimensional maladaptive personality traits in Iranian students and clinical samples.
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Affiliation(s)
- Mojtaba Elhami Athar
- School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
- Darkmind Research Group, Tabriz, Iran
| | - Ali Ebrahimi
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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14
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Vizgaitis AL, Lenzenweger MF. Identity and Personality Pathology: A Convergence Across the DSM-5 Personality Disorder Model and the Alternative Model for Personality Disorders. J Pers Disord 2022; 36:537-558. [PMID: 36181489 DOI: 10.1521/pedi.2022.36.5.537] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Long-standing theory regarding personality pathology as well as the recently proposed DSM-5 Alternative Model for Personality Disorders (AMPD) posit that self/identity problems are a hallmark feature cutting across forms of personality pathology. With emergence of the AMPD, researchers have started to focus empirical investigations on identity pathology as a transdiagnostic factor across personality pathology. The current study investigated identity pathology across indicators of personality pathology from both the current categorical perspective (DSM-5 PD) and the dimensional perspective in the AMPD. Identity diffusion and low self-concept clarity were correlated with all PD feature scales and all maladaptive personality dimension scales. Regression analyses revealed most indicators of personality pathology were significant correlates of identity diffusion and low self-concept clarity. Borderline and Avoidant PD feature scales and Negative Affectivity and Detachment maladaptive personality dimension scales emerged as the strongest correlates of identity pathology. The role that identity pathology plays in personality pathology is highlighted.
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Affiliation(s)
- Alexandra L Vizgaitis
- Department of Psychology, State University of New York at Cortland, Cortland, New York
| | - Mark F Lenzenweger
- Department of Psychology, State University of New York at Binghamton, and Department of Psychiatry, Weill Cornell Medical College, New York, New York
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15
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Zajenkowska A, Wiśniewska D, Leniarska M, Jasielska MD, Bodecka M, Zajenkowski MM, Kaźmierczak I, Klimiuk J, Niemczyk L, Niemczyk K, Pinkham AE. Predictors of depressive symptoms among hospitalized COVID-19 patients with respiratory problems. PSYCHOL HEALTH MED 2022; 28:1288-1297. [PMID: 36082408 DOI: 10.1080/13548506.2022.2121970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
COVID-19 patients and survivors quite often experience depressive symptoms, which can increase risk for lower immune system response and poorer recovery. Vulnerability to depressive symptoms may be elevated in those patients who have the most severe COVID-19 course of illness, that is, patients who require supplementary oxygen therapy or even intubation. The current study involved a unique sample of patients who were hospitalized due to COVID-19 and who required respiratory support (N = 34, 10 women) in which we investigated depressive symptoms as well as psychopathological personality traits (PID5) as predictors. The majority of patients (76.5%) presented some degree of depressive symptoms. Although we expected severe levels of depressive symptoms to be most prevalent, more patients showed rather moderate levels. At the same time, Negative Affectivity was most predictive of depressive symptoms. We suggest that medical care for patients with greater emotional sensitivity and vulnerability to stress be supplemented with psychological support in order to address depressive symptoms and foster recovery.
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Affiliation(s)
- Anna Zajenkowska
- Maria Grzegorzewska University, Institute of Psychology, Warsaw, Poland
| | | | | | | | - Marta Bodecka
- Maria Grzegorzewska University, Institute of Psychology, Warsaw, Poland
| | | | | | - Joanna Klimiuk
- Department of Internal Diseases, Pneumonology and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - Longin Niemczyk
- Department of Nephrology, Dialysis and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Kazimierz Niemczyk
- Department of Otorhinolaryngology Head and Neck Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Amy E Pinkham
- School of Behavioral and Brain Sciences, the University of Texas at Dallas, Richardson, Texas, USA.,Department of Psychiatry, University of Texas Southwestern Medical School, Dallas, Texas, USA
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16
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Miller JD, Bagby RM, Hopwood CJ, Simms LJ, Lynam DR. Normative data for PID-5 domains, facets, and personality disorder composites from a representative sample and comparison to community and clinical samples. Personal Disord 2022; 13:536-541. [PMID: 35084874 PMCID: PMC10052968 DOI: 10.1037/per0000548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The introduction of the alternative model of personality disorders in the fifth edition of the Diagnostic and Statistical Model of Mental Disorders (American Psychiatric Association, 2013) represented a substantive change in how personality disorders (PDs) are diagnosed. One barrier to its adoption (among several) in clinical practice, however, is a lack of information as to what constitutes an elevated score on the 25 domains and facets that comprise Criterion B. Unique sets of facets can be configured to assess any 1 of 6 PDs retained in the alternative model of personality disorders; each of these facets can in turn be added to create a PD sum score. In the current study, using the Personality Inventory for Diagnostic and Statistical Model of Mental Disorders, Fifth Edition (Krueger et al., 2012), we report mean scores using this instrument that align with 1.0, 1.5, and 2.0 SD elevations for the 25 facets, five domains, and six PD composites on the basis of Krueger and colleagues' (2012) representative sample and compare these with those obtained from a community and a clinical sample. These normative data may be useful to clinicians in determining whether a client has elevated scores on pathological personality domains, facets, or PDs. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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17
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Gablonski TC, Senft B, Andreas S. Level of Structural Integration and Its Association with Intersession Experiences and Outcomes: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159254. [PMID: 35954610 PMCID: PMC9367804 DOI: 10.3390/ijerph19159254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/18/2022] [Accepted: 07/19/2022] [Indexed: 02/04/2023]
Abstract
The level of structural integration (LSI), a psychodynamic/psychoanalytic concept originally developed by the Operationalized Psychodynamic Diagnosis (OPD), provides a promising empirical approach that is recognized beyond the boundaries of psychoanalysis and is highly relevant for therapy and research. The aim of our study was to investigate the intersession experiences of patients in psychotherapy with different levels of structural integration. The sample consisted of 69 inpatients who were undergoing psychotherapeutic treatment. The patients were asked to complete the German version of the Intersession Experience Questionnaire (IEQ), the short version of the OPD Structure Questionnaire (OPD-SQS) and the Brief-Symptom Inventory (BSI). LSI is associated with the situations, contents and negative emotions in the intersession experiences of patients, as well as their symptom distress over the course of therapy. Furthermore, the level of structural integration is a significant predictor of outcomes. Patients with different LSI had different intersession experiences.
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Affiliation(s)
| | - Birgit Senft
- Reha-Klinik für Seelische Gesundheit Klagenfurt, 9020 Klagenfurt am Wörthersee, Austria;
| | - Sylke Andreas
- Institute for Psychology, University of Klagenfurt, 9020 Klagenfurt am Wörthersee, Austria;
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18
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Iacob CI, Folostina R, Avram E. Trait resilience as a moderator between personality dysfunction and caregiving stress in caregivers of children and adults with developmental disabilities. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2022; 70:425-434. [PMID: 38699495 PMCID: PMC11062279 DOI: 10.1080/20473869.2022.2092934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 06/17/2022] [Indexed: 05/05/2024]
Abstract
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.
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Affiliation(s)
- Claudia I. Iacob
- Department of Applied Psychology and Psychotherapy, University of Bucharest, Bucharest, Romania
| | - Ruxandra Folostina
- Department of Special Education, University of Bucharest, Bucharest, Romania
| | - Eugen Avram
- Department of Applied Psychology and Psychotherapy, University of Bucharest, Bucharest, Romania
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19
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Labancz E, Balázs K, Kuritárné Szabó I. The psychometric properties of the Hungarian version of the Personality Inventory for DSM-5 in a clinical and a community sample. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-020-00831-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AbstractThe alternative dimensional model for personality disorders characterizes the individual on pathological personality traits, which can be measured by the Personality Inventory for DSM-5 (PID-5). Our study focused on the psychometric properties of the Hungarian version of PID-5 in 239 psychiatric patients and 226 non-clinical participants. The distribution of gender, age, and educational level were the same in the two samples. In the clinical sample, we examined the assumed unidimensionality of the 25 facets. The results of the exploratory factor analysis for five factors indicated the supposed five-factor structure. The convergent validity was studied by correlations with Big Five Inventory. The PID-5 domains showed moderate or strong correlation with the domains of Big Five except for Psychoticism. The comparison of the clinical and non-clinical samples revealed that psychiatric patients had a higher score on all pathological facets and domains, except for the domain of Antagonism with all its related facets, and the facet of Risk Taking. As a whole, we recommend the use of the Hungarian version of the PID-5 in research and clinical practice.
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20
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Bliton CF, Roche MJ, Pincus AL, Dueber D. Examining the Structure and Validity of Self-Report Measures of DSM-5 Alternative Model for Personality Disorders Criterion A. J Pers Disord 2022; 36:157-182. [PMID: 34287067 DOI: 10.1521/pedi_2021_35_531] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The Level of Personality Functioning Scale (LPFS) operationalizes Criterion A of the DSM-5 Alternative Model for Personality Disorders. Despite progress in LPFS measurement development and validation, there is a lack of research, and some disagreement, concerning structural, convergent, and incremental validity of LPFS self-report measures. The present study aimed to compare the LPFS Self-Report, LPFS Self-Report of Criterion A, and LPFS Brief Form. Internal structure was assessed through principal component analyses, factor analyses, and bifactor analyses of unidimensionality. Associations with both pathological and basic personality characteristics among the LPFS measures were explored. Incremental validity of LPFS severity in predicting pathological personality outcomes controlling for basic personality traits, and the reverse, were examined. Results suggest a unidimensional structure robustly associated with other pathological personality assessments. LPFS severity and basic personality traits mutually offered unique explanatory power. We discuss the implications of assessing personality pathology using LPFS self-report measures.
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Affiliation(s)
- Chloe F Bliton
- Department of Psychology, Pennsylvania State University, University Park, Pennsylvania
| | - Michael J Roche
- Department of Psychology, West Chester University, West Chester, Pennsylvania
| | - Aaron L Pincus
- Department of Psychology, Pennsylvania State University, University Park, Pennsylvania
| | - David Dueber
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, Kentucky
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21
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Garner AR, Blocher N, Tierney D, Baumgardner M, Watson A, Romero G, Skadberg R, Younginer T, Waugh MH. Applying the DSM-5 Alternative Model of Personality Disorders and the Shedler-Westen Assessment Procedure to the Classic Case of "Madeline G.": Novice and Expert Rater Convergences and Divergence. Front Psychol 2022; 13:794616. [PMID: 35242078 PMCID: PMC8885620 DOI: 10.3389/fpsyg.2022.794616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
Prior research supports the learnability of the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition Alternative Model of Personality Disorders (AMPD). However, researchers have yet to compare novice ratings on the AMPD's Level of Personality Functioning Scale and the 25 pathological personality traits with expert ratings. Furthermore, the AMPD has yet to be examined with the idiographic Shedler-Westen Assessment Procedure (SWAP). We compared the aggregated AMPD clinical profile of a group of psychology doctoral students who learned the AMPD to high levels of reliability to that of an expert rater using the crucible of the classical case of "Madeline G." Examination of AMPD and SWAP ratings of "Madeline G." revealed excellent overall concordance but suggests that novice raters tend to perceive lower levels of personality impairment.
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Affiliation(s)
- Alisa R Garner
- Department of Psychology, University of Tennessee-Knoxville, Knoxville, TN, United States
| | - Natalie Blocher
- Department of Psychology, University of Tennessee-Knoxville, Knoxville, TN, United States
| | - David Tierney
- Department of Psychology, University of Tennessee-Knoxville, Knoxville, TN, United States
| | - Megan Baumgardner
- Department of Psychology, University of Tennessee-Knoxville, Knoxville, TN, United States
| | - Alayna Watson
- Department of Psychology, University of Tennessee-Knoxville, Knoxville, TN, United States
| | - Gloria Romero
- Department of Psychology, University of Tennessee-Knoxville, Knoxville, TN, United States
| | - Rebecca Skadberg
- Department of Psychology, University of Tennessee-Knoxville, Knoxville, TN, United States
| | - Taylor Younginer
- Department of Psychology, University of Tennessee-Knoxville, Knoxville, TN, United States
| | - Mark H Waugh
- Department of Psychology, University of Tennessee-Knoxville, Knoxville, TN, United States.,Oak Ridge National Laboratory, Oak Ridge, TN, United States
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22
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Bliton CF, Rosenstein LK, Pincus AL. Trading Patients: Applying the Alternative Model for Personality Disorders to Two Cases of DSM-5 Borderline Personality Disorder Over Time and Across Therapists. Front Psychol 2022; 13:794624. [PMID: 35237208 PMCID: PMC8884405 DOI: 10.3389/fpsyg.2022.794624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 01/03/2022] [Indexed: 11/16/2022] Open
Abstract
The DSM-5 Alternative Model for Personality Disorders (AMPD) dimensionally defines personality pathology using severity of dysfunction and maladaptive style. As the empirical literature on the clinical utility of the AMPD grows, there is a need to examine changes in diagnostic profiles and personality expression in treatment over time. Assessing these changes in individuals diagnosed with borderline personality disorder (BPD) is complicated by the tendency for patients to cycle through multiple therapists over the course of treatment leaving the potential for muddled diagnostic clarity and disjointed case conceptualizations. Following patient trajectories across therapists offers a unique opportunity to examine the AMPD’s sensitivity to and utility for capturing personality stability and change over time for patients with BPD. This article demonstrates the utility of the AMPD for two clinical cases in three distinct ways: (i) highlighting heterogeneity in BPD between patients, (ii) comparing improvements in personality severity and style over time, and (iii) elucidating profile change across therapist ratings. We present two patients diagnosed with DSM-5 Section II BPD, crossing between two therapists over the course of 3 years of psychodynamic psychotherapy. Treating clinicians rated patients for their respective treatment phases using the Level of Personality Functioning Scale (LPFS), capturing severity, and the Personality Inventory for the DSM-5 (PID-5), capturing style. AMPD diagnostic profiles differentiated patients with BPD in both severity and style, and captured within-patient change beyond within-therapist response bias. Results indicated greater improvements in personality severity while personality style remained more stable. Implications for the patients’ treatment progress and associated challenges are discussed, as are considerations for the utility of the AMPD in therapy.
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Affiliation(s)
- Chloe F Bliton
- Department of Psychology, The Pennsylvania State University, University Park, PA, United States
| | - Lia K Rosenstein
- Department of Psychology, The Pennsylvania State University, University Park, PA, United States
| | - Aaron L Pincus
- Department of Psychology, The Pennsylvania State University, University Park, PA, United States
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23
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Ringwald WR, Edershile EA, Hale J, Williams TF, Simms LJ, Creswell KG, Bachrach RL, Wright AG. Role of pregaming motives in accounting for links between maladaptive personality traits and drinking consequences. Personal Disord 2022; 13:192-197. [PMID: 34941348 PMCID: PMC8923913 DOI: 10.1037/per0000540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
College students are at heightened risk of engaging in unhealthy alcohol use that leads to negative consequences (e.g., motor vehicle accidents, poor academic performance). Understanding how individual differences, such as maladaptive personality traits, contribute to that risk could improve intervention efforts. A potential pathway through which personality confers risk for consequences is by influencing students' motivation to drink. In this study of 441 college students, we investigated whether different motivations to pregame, a particularly risky and common drinking practice on college campuses, accounts for links between maladaptive traits and alcohol-related consequences. Results of bivariate analyses showed that all pregaming motives and maladaptive traits (except detachment) were strongly correlated with negative consequences. In path analytic models that adjusted for shared variance between pregaming motives and between maladaptive traits, results showed that traits had indirect effects on total drinking consequences via individual differences in pregaming motives as well as direct effects that were independent of motives. Specifically, antagonism, disinhibition, and negative affectivity predicted more drinking consequences via stronger motives to pregame for instrumental reasons over and above the general motivation to pregame, whereas detachment predicted fewer consequences via weaker instrumental pregaming motives. Antagonism and disinhibition were also associated with more drinking consequences, and detachment with fewer consequences, over and above pregaming motives and general personality problems. Our study indicates that one way maladaptive personality traits may shape alcohol-related consequences in college students is by associations with their motivations to pregame. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
| | | | - Jonathan Hale
- Department of Pathology & Laboratory Medicine, Lewis Katz School of Medicine at Temple University
| | | | | | | | - Rachel L. Bachrach
- Department of Psychology, University of Pittsburgh,Center for Health Equity Research and Promotion; Mental Illness Research, Education, and Clinical Center, VA Pittsburgh Healthcare System
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24
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Riegel KD, Schlosserova L, Zbornik TS. Self-reported narcissistic traits in patients with addiction through the lens of the ICD-11 model for personality disorders. Front Psychiatry 2022; 13:1041480. [PMID: 36506455 PMCID: PMC9732545 DOI: 10.3389/fpsyt.2022.1041480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 11/08/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND There is a presumption that pathological narcissism, or narcissistic personality disorder per se, can be considered a precursor to addiction. Although the ICD-11 model does not distinguish specific personality disorders, narcissistic psychopathology should be captured through personality trait qualifiers. OBJECTIVES To verify the capacity of the ICD-11 model in the detection of narcissistic psychopathology in patients with addiction; to test its discrimination capacity, convergent validity, and specificity toward the gender and the type of addiction. MATERIALS AND METHODS Two samples were employed in the study. Sample 1 (n = 421) consisted of patients with addiction; Sample 2 (n = 567) consisted of general population volunteers. Age range was 18-75 years and a battery of self-assessment questionnaires containing Personality Inventory for DSM-5-Brief Form Plus Modified; Triarchic Psychopathy Measure; Hypersensitive Narcissism Scale; and Level of Personality Functioning Scale-Self-Report was administered by pencil-and-paper method. RESULTS The following was confirmed: (1) capacity of the ICD-11 model in relation to capture narcissistic pathology; (2) the differentiation capacity between the clinical and non-clinical population; (3) gender specificity in relation to grandiose and vulnerable narcissism; (4) the connection between the overall degree of impairment in personality functioning and most of trait qualifiers; (5) certain specifics of patients with addiction in relation to the type of addiction. CONCLUSION Results support the empirical and clinical relevance of the ICD-11 model in capturing narcissistic pathology in addicted patients. Clinical implications concerning assessment and treatment in addiction settings, and certain limits regarding the Anankastia domain are discussed.
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Affiliation(s)
- Karel D Riegel
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia
| | - Lucia Schlosserova
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia
| | - Tadeas S Zbornik
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia
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25
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Halberstadt AL, Skrzynski CJ, Wright AG, Creswell KG. Predicting smoking and nicotine dependence from the DSM-5 alternative model for personality pathology. Personal Disord 2022; 13:84-95. [PMID: 33705195 PMCID: PMC8916785 DOI: 10.1037/per0000487] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Individuals with personality disorders (PDs) have higher morbidity and mortality than the general population, which may be due to maladaptive health behaviors such as smoking. Previous studies have examined the links between categorical PD diagnoses/personality traits and smoking/nicotine dependence, but little is known about how the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition alternative model for personality disorders relates to smoking and nicotine dependence. The current study examined this question in a sample of 500 participants using the Levels of Personality Functioning Scale to assess general personality pathology, the Personality Inventory for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition to measure specific traits, the Fagerström test for Nicotine Dependence to assess nicotine dependence, and questions about current and past smoking to assess smoking status (i.e., current, former, never). Multinomial logistic regression results demonstrated that general personality pathology (Criterion A) was not related to smoking status, and there were no reliable associations between traits (Criterion B) and smoking status. However, correlations showed that higher negative affectivity and disinhibition were related to higher levels of nicotine dependence within smokers. Findings are discussed in regard to previous findings linking personality pathology to smoking/nicotine dependence as well as the general validity of this new personality disorder diagnostic system. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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26
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Gutiérrez F, Aluja A, Rodríguez C, Gárriz M, Peri JM, Gallart S, Calvo N, Ferrer M, Gutiérrez-Zotes A, Soler J, Pascual JC. Severity in the ICD-11 personality disorder model: Evaluation in a Spanish mixed sample. Front Psychiatry 2022; 13:1015489. [PMID: 36699492 PMCID: PMC9868964 DOI: 10.3389/fpsyt.2022.1015489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 12/16/2022] [Indexed: 01/12/2023] Open
Abstract
Severity is the main component of the ICD-11 personality disorder (PD) classification, but pertinent instruments have only recently been developed. We analyzed the psychometric properties of the ICD-11 Personality Disorder Severity scale (PDS-ICD-11) in a mixed sample of 726 community and clinical subjects. We also examined how the different components of the ICD-11 PD system -five trait domains, the borderline pattern specifier, and severity, all of them measured through self-reports- are interconnected and operate together. PDS-ICD-11 properties were adequate and similar to those of the original instrument. However, regressions and factor analyses showed a considerable overlap of severity with the five personality domains and the borderline specifier (72.6%). Bifactor modeling resulted in a general factor of PD (g-PD) that was not equivalent to severity nor improved criterion validity. The whole ICD-11 PD system, i.e., five personality domains, borderline, and severity, explained an average of 43.6% of variance of external measures of well-being, disability, and clinical problems, with severity contributing 4.8%. Suggestions to further improve the ICD-11 PD taxonomy include remodeling the present definition of severity to give more weight to the real-life consequences of traits.
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Affiliation(s)
- Fernando Gutiérrez
- Institute of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain.,Institut d'Investigacións Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Anton Aluja
- Lleida Institute for Biomedical Research Dr. Pifarré Foundation, Lleida, Spain.,Department of Psychology, University of Lleida, Lleida, Spain
| | - Claudia Rodríguez
- Institute of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Miguel Gárriz
- Neuropsychiatry and Drug Addiction Institute, Parc de Salut Mar, Barcelona, Spain
| | - Josep M Peri
- Institute of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Salvador Gallart
- Department of Psychiatry, Mental Health, and Addiction, GSS-Hospital Santa Maria, Lleida, Spain
| | - Natalia Calvo
- Department of Psychiatry, Vall d'Hebron University Hospital, Barcelona, Spain.,Network Centre for Biomedical Research in Mental Health (CIBERSAM), Barcelona, Spain.,Psychiatry and Legal Medicine Department, Autonomous University of Barcelona, Barcelona, Spain
| | - Marc Ferrer
- Department of Psychiatry, Vall d'Hebron University Hospital, Barcelona, Spain.,Network Centre for Biomedical Research in Mental Health (CIBERSAM), Barcelona, Spain.,Psychiatry and Legal Medicine Department, Autonomous University of Barcelona, Barcelona, Spain
| | - Alfonso Gutiérrez-Zotes
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Barcelona, Spain.,Pere Virgili Health Research Institute (IISPV), CERCA, Reus, Spain.,Pere Mata Psychiatric University Hospital, Reus, Spain
| | - Joaquim Soler
- Psychiatry and Legal Medicine Department, Autonomous University of Barcelona, Barcelona, Spain.,Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Juan Carlos Pascual
- Psychiatry and Legal Medicine Department, Autonomous University of Barcelona, Barcelona, Spain.,Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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27
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Kirkpatrick RH, Munoz DP, Khalid-Khan S, Booij L. Methodological and clinical challenges associated with biomarkers for psychiatric disease: A scoping review. J Psychiatr Res 2021; 143:572-579. [PMID: 33221025 DOI: 10.1016/j.jpsychires.2020.11.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 09/20/2020] [Accepted: 11/09/2020] [Indexed: 12/20/2022]
Abstract
Over the past decade, psychiatric research has been on an important hunt for biomarkers of psychiatric disease. In psychiatry, the term "biomarker" is a broad umbrella term used to identify any biological variable that can be objectively measured and applied to a diagnosis; this includes genetic and epigenetic assessments, hormone levels, measures of neuro-anatomy and many other scientific modalities. However, despite hundreds of studies on the topic being published yearly and other medical specialties having success in discovering biomarkers, clinical psychiatric practice has not had the same success. This paper aims to consolidate the many opinions on the search for psychiatric biomarkers to suggest key methodological and clinical challenges that psychiatric biomarker research faces. Psychiatry as a specialty has many fundamental differences compared to other medical specialties in methods of diagnosing, underlying etiology and disease pathologies that may be limiting the success of biomarker research in itself and puts strict requirements on the research being conducted. The academic and clinical environment in which the research is being conducted also heavily influences the translation of the findings. Finally, once biomarkers are identified, more often than not they are inapplicable to clinical settings, unable to integrate into clinical practice and fail to outperform current diagnostic practices and guidelines. We also make six recommendations for more promising future research in psychiatric biomarkers.
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Affiliation(s)
- Ryan H Kirkpatrick
- Centre for Neuroscience Studies, Queen's University, Kingston, Canada; School of Medicine, Queen's University, Kingston, Canada.
| | - Douglas P Munoz
- Centre for Neuroscience Studies, Queen's University, Kingston, Canada; School of Medicine, Queen's University, Kingston, Canada; Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Canada; Department of Psychology, Queen's University, Kingston, Canada
| | - Sarosh Khalid-Khan
- Centre for Neuroscience Studies, Queen's University, Kingston, Canada; School of Medicine, Queen's University, Kingston, Canada; Department of Psychology, Queen's University, Kingston, Canada; Department of Psychiatry, Queen's University, Kingston, Canada
| | - Linda Booij
- Department of Psychology, Queen's University, Kingston, Canada; Department of Psychology, Concordia University, Montréal, Canada; CHU Sainte-Justine Hospital, University of Montréal, Montréal, Canada; Department of Psychiatry, McGill University, Montréal, Canada.
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Choate AM, Gorey C, Rappaport LM, Wiernik BM, Bornovalova MA. Alternative model of personality disorders traits predict residential addictions treatment completion. Drug Alcohol Depend 2021; 228:109011. [PMID: 34521057 PMCID: PMC8595711 DOI: 10.1016/j.drugalcdep.2021.109011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 08/06/2021] [Accepted: 08/26/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Among people receiving residential treatment for a substance use disorder (SUD), premature treatment termination predicts poor post-treatment outcomes. We examined the utility of the alternative model for personality disorders (AMPD) for predicting premature residential SUD treatment termination, including interactions with age and gender. METHODS Participants (N = 374) were receiving residential treatment for SUD and enrolled in a clinical trial with two conditions: Skills for Improving Distress Intolerance (SIDI) and Supportive Counseling (NCT01741415). Participants were assessed at intake on AMPD traits using the Personality Inventory for DSM-5 (PID-5) and tracked longitudinally. After establishing gender and age measurement invariance, we used competing risk models to predict treatment completion versus premature termination using interactions of PID-5 scores with age and gender. FINDINGS Disinhibition and Negative Emotionality domains and facets predicted premature treatment termination, particularly among younger, male participants. There were positive effects of SIDI on treatment completion for participants with high levels of domain and facet Negative Emotionality. A small proportion (≈ 12 %) of the PID-5 items showed differential item functioning by age or gender; however, the aggregate impact on test-level total scores was negligible. CONCLUSIONS Participants (particularly young men) displaying poor self-control and emotional regulation are at risk for premature termination. These findings, together with minimal aggregate differential item functioning at the scale level, suggest that the PID-5 is a practically useful, construct-valid, non-proprietary measure, aspects of which can be used for screening in residential SUD treatment. Furthermore, among those with high negative emotionality, SIDI may be effective in preventing premature treatment termination.
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Affiliation(s)
- Alexandria M Choate
- Department of Psychology, University of South Florida, Tampa, FL, United States
| | - Claire Gorey
- Department of Psychology, University of South Florida, Tampa, FL, United States
| | | | - Brenton M Wiernik
- Department of Psychology, University of South Florida, Tampa, FL, United States
| | - Marina A Bornovalova
- Department of Psychology, University of South Florida, Tampa, FL, United States.
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Hong RY, Sheng D, Yee WQ. Pathological personality, situations, and their joint influences on daily emotional symptoms. J Pers 2021; 90:426-440. [PMID: 34558664 DOI: 10.1111/jopy.12675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 06/23/2021] [Accepted: 09/21/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The present research aims to advance current understanding on how individuals with pathological personality traits construe their day-to-day situational experiences. METHOD College students (N = 231) completed a measure of personality pathology, followed by six assessments of everyday situations and anxiety/depression symptoms over two weeks. RESULTS Multilevel analyses indicated that personality pathology was meaningfully associated with situational experiences. Major findings suggested that situations that entailed aggravations and interpersonal confrontations were associated with negative affectivity, antagonism, and psychoticism. Detached individuals were less likely to experience pleasant and social situations. Exploratory analyses suggested an amplification effect where individuals high on personality pathology were more anxious or depressed when they perceived certain situational features, compared to their low trait counterparts. However, such cross-level interactions constituted a small minority; most personality traits and situations exerted additive effects on symptoms. CONCLUSION Situational experiences appear to be driven in part by personality pathology. The exacerbation of daily negative symptoms can be attributed to the joint (largely additive) influence of the trigger situations and pathological personality traits.
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Affiliation(s)
- Ryan Y Hong
- Department of Psychology, National University of Singapore, Singapore, Singapore
| | - Dan Sheng
- Department of Psychology, National University of Singapore, Singapore, Singapore
| | - Wan Qi Yee
- Department of Psychology, National University of Singapore, Singapore, Singapore
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Heltne A, Bode C, Hummelen B, Falkum E, Selvik SG, Paap MCS. Norwegian Clinicians' Experiences of Learnability and Usability of SCID-II, SCID-5-PD and SCID-5-AMPD-I Interviews: A Sequential Multi-Group Qualitative Approach. J Pers Assess 2021; 104:599-612. [PMID: 34546142 DOI: 10.1080/00223891.2021.1975726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The DSM-5 presents two competing diagnostic frameworks for personality disorders: the standard categorical model and the Alternative Model of Personality Disorders (AMPD). The AMPD was initially criticized for being too complex and theory laden for clinical implementation. Though inter-rater reliability studies have contested initial claims of the model's complexity, little attention has been paid to how clinicians experience the usability and learnability of either model. We interviewed twenty Norwegian clinicians about their experiences with either the SCID-II/5-PD (n = 9), SCID-5-AMPD-I (n = 8), or both (n = 3). Separate thematic analyses were conducted for SCID-II/5-PD and SCID-5-AMPD-I groups, and group themes were compared. We identified four themes for each group, relating to required skills, training, challenges and information gained through the interview. We found that training and clinical experience were considered to be important for both interviews. Moreover, the SCID-5-AMPD-I was considered to rely more explicitly on theory specific to the development and content of the AMPD model in general and the LPFS specifically We also identified shared and unique challenges and shortcomings of each interview. We comment on how our findings relate to the debate surrounding the AMPD, and recommend development of clear training guidelines for both interviews.
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Affiliation(s)
- Aleksander Heltne
- Department of Research and Innovation, Clinic for Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Christina Bode
- Department of Psychology, Health & Technology, Faculty of Behavioural Management and Social Sciences, University of Twente, Enschede, The Netherlands
| | - Benjamin Hummelen
- Department of Research and Innovation, Clinic for Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Erik Falkum
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Sara Germans Selvik
- Department of Psychiatry, Helse Nord-Trønderlag, Namsos Hospital, Namsos, Norway.,Department of Mental Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Muirne C S Paap
- Department of Research and Innovation, Clinic for Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Department of Child and Family Welfare, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
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31
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Clark LA, Corona-Espinosa A, Khoo S, Kotelnikova Y, Levin-Aspenson HF, Serapio-García G, Watson D. Preliminary Scales for ICD-11 Personality Disorder: Self and Interpersonal Dysfunction Plus Five Personality Disorder Trait Domains. Front Psychol 2021; 12:668724. [PMID: 34322060 PMCID: PMC8311289 DOI: 10.3389/fpsyg.2021.668724] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 06/17/2021] [Indexed: 12/17/2022] Open
Abstract
The ICD-11 personality disorder model is the first fully dimensional assessment of personality pathology. It consists of a personality disorder (PD) dysfunction-severity dimension, which encompasses both self- and interpersonal dysfunction, and six optional qualifiers for five prominent personality traits-Negative Affectivity (NA), Detachment (DET), Dissociality (DSL), Disinhibition (DSN), and Anankastia (ANK)-plus a borderline pattern that is defined by the criteria of DSM-IV borderline PD. This article reports on the development of a new self-report measure to assess self- and interpersonal dysfunction and the five trait qualifiers. It is the first comprehensive measure of the ICD-11 PD model in that (a) it is the only one to include both PD dysfunction-severity as well as trait scales and because (b) it is based on the Clinical Description and Diagnostic Guidelines, which are more detailed than the "statistical" model description that is currently on the ICD-11 website. The authors wrote 992 items and then reduced the pool to 300 items by eliminating redundancy and selecting the consensus best few items for each subconstruct. Data were collected using an online sample of 383 Prolific workers. Using exploratory factor analysis, seven domain scales were developed, each of which contained two to four scales assessing components of the domain. These preliminary scales' psychometrics were excellent, as were the domains' and their components' convergent and discriminant validity, with a few generally minor exceptions. Structural analyses at the component level revealed a three-factor structure consisting of two moderately correlated Internalizing factors, one centered on Self Dysfunction with two NA components and a DSN component (Distractibility) and the other on Interpersonal Dysfunction with DET and ANK components; as well as an Externalizing factor with DSL and a DSN component (Reckless Impulsivity) that was uncorrelated with the other two factors. Two aspects of the results in particular are striking: (1) ANK was not the opposite end of a DSN dimension, but rather contributed to an Internalizing Interpersonal Dysfunction dimension and (2) DSN had both an Internalizing and an Externalizing component. Implications of the findings and study limitations are discussed.
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Affiliation(s)
- Lee Anna Clark
- Department of Psychology, University of Notre Dame, Notre Dame, IN, United States
| | | | - Shereen Khoo
- Department of Psychology, University of Notre Dame, Notre Dame, IN, United States
| | - Yuliya Kotelnikova
- Department of Psychology, University of Notre Dame, Notre Dame, IN, United States
| | | | - Greg Serapio-García
- Department of Psychology, University of Notre Dame, Notre Dame, IN, United States
| | - David Watson
- Department of Psychology, University of Notre Dame, Notre Dame, IN, United States
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32
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Hörz-Sagstetter S, Ohse L, Kampe L. Three Dimensional Approaches to Personality Disorders: a Review on Personality Functioning, Personality Structure, and Personality Organization. Curr Psychiatry Rep 2021; 23:45. [PMID: 34181116 PMCID: PMC8238706 DOI: 10.1007/s11920-021-01250-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/26/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW The concept of personality functioning (Alternative DSM-5 Model of Personality Disorders) has led to increased interest in dimensional personality disorder diagnosis. While differing markedly from the current categorical classification, it is closely related to the psychodynamic concepts of personality structure and personality organization. In this review, the three dimensional approaches, their underlying models, and common instruments are introduced, and empirical studies on similarities and differences between the concepts and the categorical classification are summarized. Additionally, a case example illustrates the clinical application. RECENT FINDINGS Numerous studies demonstrate the broad empirical basis, validated assessment instruments and clinical usefulness of the dimensional concepts. Their advantages compared to the categorical approach, but also the respective differences, have been demonstrated empirically, in line with clinical observations. Evidence supports the three dimensional concepts, which share conceptual overlap, but also entail unique aspects of personality pathology, respectively.
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Affiliation(s)
| | - Ludwig Ohse
- Psychologische Hochschule Berlin (PHB), Am Köllnischen Park 2, 10179, Berlin, Germany
| | - Leonie Kampe
- Psychologische Hochschule Berlin (PHB), Am Köllnischen Park 2, 10179, Berlin, Germany
- Zentrum für Psychosoziale Medizin, Klinikum Itzehoe, Germany
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33
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Niemeyer LM, Grosz MP, Zimmermann J, Back MD. Assessing Maladaptive Personality in the Forensic Context: Development and Validation of the Personality Inventory for DSM-5 Forensic Faceted Brief Form (PID-5-FFBF). J Pers Assess 2021; 104:30-43. [PMID: 34037499 DOI: 10.1080/00223891.2021.1923522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The current study proposes an adaptation of the PID-5 to assesses maladaptive personal traits in forensic settings. Specifically, we adapted the item set of the PID-5 Faceted Brief Form (PID-5-FBF) to the forensic context and validated the resulting PID-5 Forensic Faceted Brief Form (PID-5-FFBF) using self- and informant-reports of 199 male prisoners. Exploratory factor analyses suggested a four-factor solution comprising Antagonism, Detachment, Disinhibited Aggression, and Insecurity. Antagonism and Detachment were very similar to the domains with the same name from the five-factor solution of the PID-5. Insecurity conceptually resembled Negative Affectivity. Disinhibited Aggression represented a forensically highly relevant composition of Antagonism, Disinhibition, and Negative Affectivity. We report results for this four- and the canonical five-factor solution throughout the manuscript. The PID-5-FFBF domains showed convergent associations with the corresponding Big Five personality traits. Furthermore, the PID-5-FFBF domains were differentially correlated with indicators of psychological adjustment and forensically relevant outcomes such as institutional misbehavior and risk for reoffending. In particular, Insecurity was associated with lower levels of psychological adjustment, while Antagonism and Disinhibited Aggression were associated with higher levels of institutional misbehavior and risk for reoffending. These findings provide initial evidence for the validity and utility of the PID-5-FFBF in forensic settings.
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Affiliation(s)
- Lisa M Niemeyer
- Department of Psychology, University of Münster, Münster, Germany
| | - Michael P Grosz
- Department of Psychology, University of Münster, Münster, Germany
| | | | - Mitja D Back
- Department of Psychology, University of Münster, Münster, Germany
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34
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Simonsen S, Eikenaes IUM, Bach B, Kvarstein E, Gondan M, Møller SB, Wilberg T. Level of alexithymia as a measure of personality dysfunction in avoidant personality disorder. Nord J Psychiatry 2021; 75:266-274. [PMID: 33146059 DOI: 10.1080/08039488.2020.1841290] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Avoidant Personality Disorder (AvPD) is considered a mild to moderate personality disorder. However, few studies have focused on the heterogeneity of AvPD in terms of symptoms and severity. In the current study we set out to replicate and extend earlier findings showing that there is variation among patients with AvPD in terms of alexithymia and, further, that this variation is especially associated with specific facets of personality functioning and is not explained by measures of depression, symptom severity, or co-occurring personality disorder traits. METHOD We used intake data from a sample of AvPD patients (n = 56) who had been treated in similar outpatient services. Alexithymia was measured using the Toronto Alexithymia Scale (TAS-20). Patients filled out questionnaires that were analysed using linear regression models. RESULTS AND CONCLUSIONS Using well-established cut-off points for low, intermediate and high levels of alexithymia we found an almost equal distribution of alexithymia groups in our sample. Alexithymia was associated with higher personality dysfunction on twelve out of sixteen facets of personality functioning. For eight of these personality facets the alexithymia total score explained significant variance even after controlling for self-reported depression, symptom severity and clinician ratings of personality disorder. Results suggest that AvPD is heterogeneous and that alexithymia may be important as an indicator of severity of specific personality dysfunction.
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Affiliation(s)
| | | | - Bo Bach
- Center for Personality Disorder Research, Psychiatric Research Unit, Region Zealand, Slagelse, Denmark
| | - Elfrida Kvarstein
- Section for Personality Psychiatry and Specialized Treatments, Oslo University Hospital/Institute for Clinical medicine, University of Oslo, Oslo, Norway
| | | | | | - Theresa Wilberg
- Department for Research and Innovation, Clinic for Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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35
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CONSTANTIN T, NICUȚĂ EG, GRĂDINARU D. Psychometric Properties of the Personality Inventory for DSM-5 in a Romanian Community Sample. JOURNAL OF EVIDENCE-BASED PSYCHOTHERAPIES 2021. [DOI: 10.24193/jebp.2021.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The Personality Inventory for DSM-5 (PID-5) evaluates 25 maladaptive personality traits proposed in the Alternative Model of Personality Disorders. The questionnaire has been extensively investigated and validated in several languages. The current research sought to examine the psychometric properties of the instrument in a sample of nonclinical Romanian participants (N = 1276). Results indicated excellent internal consistency for the domain level, and very good reliability for the facet level. The assumption of unidimensionality was supported at both the domain and facet levels, apart from Risk Taking. Two domain scoring methods were also compared. One of them takes into consideration all the 25 lower order facets, whereas the other uses only 15 facets. Results show that mean differences across the two scoring methods were small, except for Disinhibition. Moreover, confirmatory factor analyses revealed slightly better fit indices for the model which uses 15 facets only. Lastly, the hierarchical structure of maladaptive personality traits was explored. Results are discussed in the light of previous literature.
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Affiliation(s)
- Ticu CONSTANTIN
- Department of Psychology, Faculty of Psychology and Education Sciences, Alexandru Ioan Cuza University, Toma Cozma 3, 700554 Iasi, Romania
| | - Elena G. NICUȚĂ
- Department of Psychology, Faculty of Psychology and Education Sciences, Alexandru Ioan Cuza University, Toma Cozma 3, 700554 Iasi, Romania
| | - Diana GRĂDINARU
- Department of Psychology, Faculty of Psychology and Education Sciences, Alexandru Ioan Cuza University, Toma Cozma 3, 700554 Iasi, Romania
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36
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Investigating how individual differences influence responses to the COVID-19 crisis: The role of maladaptive and five-factor personality traits. PERSONALITY AND INDIVIDUAL DIFFERENCES 2021; 176:110786. [PMID: 33642660 PMCID: PMC7901380 DOI: 10.1016/j.paid.2021.110786] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 01/03/2023]
Abstract
Introduction Coronavirus disease (COVID-19) pandemic impacted both the physical and psychological aspects of people's lives. Personality traits are one of the factors that explain the diverse responses to stressful situations. This study aimed to investigate whether five-factor and maladaptive personality traits are associated with depressive and anxiety symptoms, suicide risk, self-reported COVID-19 symptoms, and preventive behaviors during the COVID-19 pandemic, comprehensively. Methods We conducted an online survey among a representative sample of 1000 Koreans between May 8 to 13, 2020. Participants' five-factor and maladaptive personality traits were measured using the multidimensional personality inventory, the Bright and Dark Personality Inventory. COVID-19 symptoms, depressive and anxiety symptoms, suicide risk, and preventive behaviors were also measured. Results The results revealed that maladaptive personality traits (e.g., negative affectivity, detachment) had positive correlations with depressive and anxiety symptoms, suicide risk, and COVID-19 symptoms, and the five-factor personality traits (e.g., agreeableness, conscientiousness) had positive correlations with preventive behaviors. Conclusion Our findings extend the current understanding of the relationship between five-factor and maladaptive personality traits and responses to the COVID-19 pandemic. Longitudinal follow-up should further investigate the influence of personality traits on an individual's response to the COVID-19 pandemic.
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Rishede MZ, Juul S, Bo S, Gondan M, Bjerrum Møeller S, Simonsen S. Personality Functioning and Mentalizing in Patients With Subthreshold or Diagnosed Borderline Personality Disorder: Implications for ICD-11. Front Psychiatry 2021; 12:634332. [PMID: 33868051 PMCID: PMC8044580 DOI: 10.3389/fpsyt.2021.634332] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 03/08/2021] [Indexed: 11/25/2022] Open
Abstract
The 11th revision of the International Classification of Diseases for Mortality and Morbidity Statistics (ICD-11) defines personality disorder according to personality functioning, which relates to self- and interpersonal functioning. The aim of the present study was to assess the relationship between mentalizing and personality functioning in patients with subthreshold or diagnosed borderline personality disorder. A total of 116 eligible participants were included. Mentalizing was assessed using the Mentalization Questionnaire (MZQ), personality functioning (self- and interpersonal functioning) was assessed using the Level of Personality Functioning Scale-Brief Form 2.0 (LPFS-BF), and borderline severity was assessed using the Zanarini Rating Scale (ZAN-BPD). Mediation analysis was employed to test if mentalizing accounted for the relationship between borderline severity and self- and interpersonal functioning. We found a significant relationship between borderline severity and both subscales of the LPFS-BF. Mentalizing fully and significantly mediated the relationship between borderline severity and interpersonal functioning. However, mentalizing only partly mediated the relationship between borderline severity and self-functioning. Controlling for the covariates gender and age did not impact the results. Mentalizing is likely to be involved in the ICD-11 model of personality functioning, especially interpersonal functioning. This could emphasize the relevance of therapy aimed at strengthening mentalizing abilities when treating personality pathology in general and people with borderline personality disorder in particular. However, self-functioning may be more nuanced, as aspects other than mentalizing also influence self-functioning. The study is explorative in nature and has methodological limitations that require caution in the interpretation and generalizability.
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Affiliation(s)
- Marie Zerafine Rishede
- Stolpegaard Psychotherapy Centre, Mental Health Services in the Capital Region of Denmark, Gentofte, Denmark
| | - Sophie Juul
- Stolpegaard Psychotherapy Centre, Mental Health Services in the Capital Region of Denmark, Gentofte, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Sune Bo
- Psychiatric Research Unit, Slagelse, Denmark
| | - Matthias Gondan
- Stolpegaard Psychotherapy Centre, Mental Health Services in the Capital Region of Denmark, Gentofte, Denmark
| | - Stine Bjerrum Møeller
- Stolpegaard Psychotherapy Centre, Mental Health Services in the Capital Region of Denmark, Gentofte, Denmark
| | - Sebastian Simonsen
- Stolpegaard Psychotherapy Centre, Mental Health Services in the Capital Region of Denmark, Gentofte, Denmark
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Stone LE, Segal DL. An Empirical Evaluation of the DSM-5 Alternative Model of Personality Disorders in Later Life. Int J Aging Hum Dev 2020; 93:904-926. [PMID: 33325241 DOI: 10.1177/0091415020980762] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Personality disorders (PDs) in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) are conceptualized as distinct clinical syndromes. However, debate persists about the clinical utility of this categorical model, with many researchers supporting a dimensional model that focuses on pathological personality traits and personality dysfunction. This model was published in Section III of DSM-5 and named the Alternative Model of Personality Disorders (AMPD). This study evaluated the AMPD by examining relationships between traits and dysfunction with traditional categorical PD constructs among older adults. Older adults (N = 202) completed the Personality Inventory for DSM-5, Levels of Personality Functioning Scale-Self-Report, and Coolidge Axis II Inventory. Results indicated that pathological personality traits do not relate to categorical PDs in directions predicted by the AMPD. Personality functioning related to categorical PDs in expected theoretical patterns according to the AMPD but lacked incremental validity above pathological personality traits. An implication of these findings is that the AMPD does not fully resolve the age-related issues with the traditional categorical PD model.
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Affiliation(s)
- Lisa E Stone
- 14676 Department of Psychology, University of Colorado at Colorado Springs, USA
| | - Daniel L Segal
- 14676 Department of Psychology, University of Colorado at Colorado Springs, USA
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Sharp C, Wall K. DSM-5 Level of Personality Functioning: Refocusing Personality Disorder on What It Means to Be Human. Annu Rev Clin Psychol 2020; 17:313-337. [PMID: 33306924 DOI: 10.1146/annurev-clinpsy-081219-105402] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Level of Personality Functioning (LPF) represents the entry criterion (Criterion A) of the Alternative Model for Personality Disorders (AMPD) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). It is defined as a dimensional general severity criterion common to all personality disorders and conceptually independent of personality types or traits, and it represents maladaptive self (identity and self-direction) and interpersonal (empathy and intimacy) functioning. We review the history, measurement, and significance of LPF. We show that the inclusion of LPF in the AMPD is well justified if it is defined as a general adaptive failure of a subjective intrapsychic system needed to fulfill adult life tasks. If so defined, LPF distinguishes itself from maladaptive traits (Criterion B of the AMPD) and captures the contribution humans make as agentic authors to the interpretation and management of the self. While Criterion B maladaptive traits provide important descriptive nuance to manifestations of personality pathology, maladaptive LPF is conditional to the diagnosis of personality disorder.
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Affiliation(s)
- Carla Sharp
- Department of Psychology, University of Houston, Houston, Texas 77204, USA; ,
| | - Kiana Wall
- Department of Psychology, University of Houston, Houston, Texas 77204, USA; ,
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Buer Christensen T, Hummelen B, Paap MCS, Eikenaes I, Selvik SG, Kvarstein E, Pedersen G, Bender DS, Skodol AE, Nysæter TE. Evaluation of Diagnostic Thresholds for Criterion A in the Alternative DSM-5 Model for Personality Disorders. J Pers Disord 2020; 34:40-61. [PMID: 31682197 DOI: 10.1521/pedi_2019_33_455] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The Level of Personality Functioning Scale (LPFS) of the Alternative DSM-5 Model for Personality Disorders (AMPD) was formulated to assess the presence and severity of personality disorders (PDs). Moderate impairment (Level 2) in personality functioning, as measured by the LPFS, was incorporated into the AMPD as a diagnostic threshold for PD in Criterion A of the general criteria, as well as for the "any two areas present" rule for assigning a specific PD diagnosis. This study represents the first evaluation of the diagnostic decision rules for Criterion A, in a clinical sample (N = 282). The results indicate that an overall diagnostic threshold for PDs should be used with caution because it may not identify all DSM-IV PDs. The "any two areas present" rule proved to be a reasonable alternative, although this finding should be interpreted with caution because the LPFS does not measure the disorder-specific A criteria.
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Affiliation(s)
| | - Benjamin Hummelen
- Department of Personality Psychiatry, Clinic Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Department of Research and Development, Clinic Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Muirne C S Paap
- Department of Research and Development, Clinic Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Department of Special Needs, Education, and Youth Care, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Ingeborg Eikenaes
- Department of Personality Psychiatry, Division of Mental Health and Addiction Treatment, Vestfold Hospital Trust, Tonsberg, Norway
| | - Sara Germans Selvik
- Department of Psychiatry, Hospital Namsos, Namsos, Norway.,Department of Mental Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Elfrida Kvarstein
- Department of Personality Psychiatry, Clinic Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Geir Pedersen
- Department of Personality Psychiatry, Clinic Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,NORMENT, KG Jebsen Center for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Donna S Bender
- Department of Psychiatry and Behavioral Sciences and Counseling and Psychological Services, Tulane University, New Orleans, Louisiana
| | - Andrew E Skodol
- Department of Psychiatry, University of Arizona College of Medicine, Tucson, Arizona
| | - Tor Erik Nysæter
- Department of Mental Health, Sorlandet Hospital, Arendal, Norway
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Somma A, Krueger RF, Markon KE, Alajmo VBM, Arlotta E, Beretta S, Boni F, Busso SL, Manini R, Nazzaro G, Maffei C, Fossati A. DSM-5 Alternative Model of Personality Disorder Dysfunctional Personality Traits as Predictors of Self-Reported Aggression in an Italian Sample of Consecutively Admitted, Personality-Disordered Psychotherapy Patients. J Pers Disord 2020; 34:5-24. [PMID: 31206343 DOI: 10.1521/pedi_2019_33_430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In order to assess the relationships between DSM-5 Alternative Model of Personality Disorder (AMPD) maladaptive personality traits and self-reports of aggression, 508 Italian adult participants who met at least one DSM-IV Axis II/DSM-5 Section II personality disorder (PD) diagnosis were administered the Personality Inventory for DSM-5 (PID-5) and the Aggression Questionnaire (AQ). Analysis results showed that multiple regression results, PID-5 Hostility, Callousness, and Risk Taking trait scale scores explained a large amount of variance in AQ Physical Aggression (PA) scores. Moreover, PID-5 Hostility, Callousness, and Risk Taking explained more than 20% of the variance in the AQ Physical Aggression scale scores that was left unexplained by selected continuously scored DSM-IV Axis II/DSM-5 Section II PDs, whereas SCID-II Paranoid, Narcissistic, Borderline, and Antisocial PDs added only 4% of variance to the amount of variance in AQ Physical Aggression scores that was already explained by the PID-5 trait scale scores.
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Affiliation(s)
- Antonella Somma
- Vita-Salute San Raffaele University, Milan, Italy, and IRCCS San Raffaele Turro Hospital, Milan, Italy
| | | | | | - Valentina B M Alajmo
- Vita-Salute San Raffaele University, Milan, Italy, and IRCCS San Raffaele Turro Hospital, Milan, Italy
| | - Emanuela Arlotta
- Vita-Salute San Raffaele University, Milan, Italy, and IRCCS San Raffaele Turro Hospital, Milan, Italy
| | - Stefano Beretta
- Vita-Salute San Raffaele University, Milan, Italy, and IRCCS San Raffaele Turro Hospital, Milan, Italy
| | - Francesca Boni
- Vita-Salute San Raffaele University, Milan, Italy, and IRCCS San Raffaele Turro Hospital, Milan, Italy
| | - Stefano L Busso
- Vita-Salute San Raffaele University, Milan, Italy, and IRCCS San Raffaele Turro Hospital, Milan, Italy
| | - Riccardo Manini
- Vita-Salute San Raffaele University, Milan, Italy, and IRCCS San Raffaele Turro Hospital, Milan, Italy
| | - Giovanni Nazzaro
- Vita-Salute San Raffaele University, Milan, Italy, and IRCCS San Raffaele Turro Hospital, Milan, Italy
| | - Cesare Maffei
- Vita-Salute San Raffaele University, Milan, Italy, and IRCCS San Raffaele Turro Hospital, Milan, Italy
| | - Andrea Fossati
- Vita-Salute San Raffaele University, Milan, Italy, and IRCCS San Raffaele Turro Hospital, Milan, Italy
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Borroni S, Scalabrini A, Masci E, Mucci C, Diamond D, Somma A, Fossati A. Assessing Mental Representation as an Indicator of Self and Interpersonal Functioning in Psychotherapy Patients. J Psychiatr Pract 2020; 26:349-359. [PMID: 32936582 DOI: 10.1097/pra.0000000000000498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The goal of this study was to test in a clinical sample the interrater reliability and convergent validity of the Differentiation-Relatedness Scale (D-RS), a measure that evaluates mental representations based on open-ended descriptions of self and significant others. The study also investigated the ability of the D-RS to predict personality disorders (PDs) from Section II of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and the dysfunctional trait domains presented in the Alternative DSM-5 Model for Personality Disorders Criterion B in Section III of the DSM-5. We also evaluated if the D-RS predicts observed Section II PDs over and above Criterion B of the Alternative DSM-5 Model for Personality Disorders. We found that the interrater reliability of the D-RS was good on the basis of the mean scores of 6 independent raters and that it showed moderate convergent validity. Results of dominance analyses indicated that the D-RS is a significant predictor of Section II borderline PD and of the overall number of DSM-5 PDs. When we considered the Section III Criterion B for PDs, the D-RS was not able to predict any of the Personality Inventory for DSM-5 domains, suggesting that the D-RS may be more related to personality functioning behind mental representations than to maladaptive personality traits. Finally, results of hierarchical regression analyses suggested that the D-RS produced a significant but modest increase in the prediction of borderline PD traits and the overall number of PDs traits even when the effect of the Personality Inventory for DSM-5 domains were controlled for.
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Weekers LC, Hutsebaut J, Bach B, Kamphuis JH. Scripting the DSM-5 Alternative Model for Personality Disorders assessment procedure: A clinically feasible multi-informant multi-method approach. Personal Ment Health 2020; 14:304-318. [PMID: 32147943 DOI: 10.1002/pmh.1481] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 01/13/2020] [Accepted: 02/23/2020] [Indexed: 12/21/2022]
Abstract
Published case studies on the DSM-5 (section III) Alternative Model for Personality Disorders (AMPD) generally utilized unstandardized assessment procedures or mono-method approaches. We present a case from clinical practice to illustrate a standardized, clinically feasible procedure for assessing personality pathology according to the full AMPD model, using a multi-method approach. We aim to present a procedure that can guide and inspire clinicians that are going to work with dimensional models as presented in DSM-5 and ICD-11. Specifically, we show how questionnaire and interview data from multiple sources (i.e. patient and family) can be combined. The clinical case also illustrates how Criterion A (i.e. functioning) and B (i.e. traits) are interrelated, suggesting that the joint assessment of both Criterion A and B is necessary for a comprehensive and clinically relevant case formulation. It also highlights how multi-method information can enhance diagnostic formulations. Finally, we show how the AMPD model can serve treatment planning and provide suggestions for how patient feedback might be delivered. © 2020 John Wiley & Sons, Ltd.
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Affiliation(s)
- Laura C Weekers
- Viersprong Institute for Studies on Personality Disorders, De Viersprong, Halsteren, The Netherlands
| | - Joost Hutsebaut
- Viersprong Institute for Studies on Personality Disorders, De Viersprong, Halsteren, The Netherlands
| | - Bo Bach
- Center for Personality Disorder Research, Psychiatric Research Unit, Region Zealand Psychiatry, Slagelse, Denmark
| | - Jan H Kamphuis
- Viersprong Institute for Studies on Personality Disorders, De Viersprong, Halsteren, The Netherlands.,Department of Clinical Psychology, University of Amsterdam, The Netherlands
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Coelho O, Pires R, Ferreira AS, Gonçalves B, AlJassmi M, Stocker J. Arabic Version of the Personality Inventory for the DSM-5 (PID-5) in a Community Sample of United Arab Emirates Nationals. Clin Pract Epidemiol Ment Health 2020; 16:180-188. [PMID: 32874193 PMCID: PMC7431702 DOI: 10.2174/1745017902016010180] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/30/2020] [Accepted: 05/31/2020] [Indexed: 11/25/2022]
Abstract
Background: Section III of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) proposes a model for conceptualizing personality disorders in which they are characterized by impairments in personality functioning and maladaptive personality traits. The Personality Inventory for DSM-5 (PID-5) is a self-report measure that assesses the presence and severity of these maladaptive personality traits. Objective: The current study examined the reliability and validity of the Arabic version of the Personality Inventory for DSM-5 (PID-5) to measure maladaptive personality traits in the Emirati population of the United Arab Emirates. Methods: The Arabic version of the PID-5 was administered to a community sample of 1,090 United Arab Emirates nationals (89.5% female and 10.5% male, mean age = 22.44 years old). The descriptive measures, internal consistency, test-retest reliability, convergent validity with NEO – Five Factor Inventory, as well as PID-5’s factor structure, were all addressed. Results: The PID-5facets and domains mean scores were higher in the Emirati sample compared to the original US sample. Internal consistency of the PID-5 scales was acceptable to high and test-retest coefficients ranged from 0.84 (facets) to 0.87 (domains). As expected, the five domains of the Arabic version of the PID-5 correlated significantly with all Five-Factor Model domains of personality. Additionally, the Arabic version of the PID-5 confirmed a five-factor structure that resembles the PID-5 domains. Conclusion: The findings of this study provided initial support for the use of the Arabic version of the PID-5 to assess maladaptive personality traits in the Emirati population of the United Arab Emirates.
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Affiliation(s)
- Olga Coelho
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal
| | - Rute Pires
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal
| | | | - Bruno Gonçalves
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal
| | - Maryam AlJassmi
- College of Natural and Health Sciences, Zayed University, P.O. Box 19282 Dubai, U.A.E
| | - Joana Stocker
- College of Natural and Health Sciences, Zayed University, P.O. Box 19282 Dubai, U.A.E
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Chun JW, Park CH, Kim JY, Choi J, Cho H, Jung DJ, Ahn KJ, Choi JS, Kim DJ, Choi IY. Altered core networks of brain connectivity and personality traits in internet gaming disorder. J Behav Addict 2020; 9:298-311. [PMID: 32592635 PMCID: PMC8939405 DOI: 10.1556/2006.2020.00014] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 09/20/2019] [Accepted: 03/01/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND AND AIMS Although the Internet has provided convenience and efficiency in many areas of everyday life, problems stemming from Internet use have also been identified, such as Internet gaming disorder (IGD). Internet addiction, which includes IGD, can be viewed as a behavioral addiction or impulse control disorder. This study investigated the altered functional and effective connectivity of the core brain networks in individuals with IGD compared to healthy controls (HCs). METHODS Forty-five adults with IGD and 45 HCs were included in this study. To examine the brain networks related to personality traits that influence problematic online gaming, the left and right central executive network (CEN) and the salience network (SN) were included in the analysis. Also, to examine changes in major brain network topographies, we analyzed the default mode network (DMN). RESULTS IGD participants showed lower functional connectivity between the dorsal lateral prefrontal cortex (DLPFC) and other regions in the CEN than HC participants during resting state. Also, IGD participants revealed reduced functional connectivity between the dorsal anterior cingulate cortex and other regions in the SN and lower functional connectivity in the medial prefrontal cortex of the anterior DMN. Notably, in IGD individuals but not HC individuals, there was a positive correlation between IGD severity and effective connectivity and a positive correlation between reward sensitivity and effective connectivity within the ventral striatum of the SN. CONCLUSIONS Problematic online gaming was associated with neurofunctional alterations, impairing the capacity of core brain networks.
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Affiliation(s)
- Ji-Won Chun
- Department of Medical Informatics, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
| | - Chang-Hyun Park
- Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
| | - Jin-Young Kim
- Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
| | - Jihye Choi
- Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
| | - Hyun Cho
- Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
| | - Dong Jin Jung
- Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
| | - Kook-Jin Ahn
- Department of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
| | - Jung-Seok Choi
- Department of Psychiatry, SMG-SNU Boramae Center, Seoul, Republic of Korea
| | - Dai-Jin Kim
- Department of Medical Informatics, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea,Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea,Corresponding author. Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, Republic of Korea, Tel.: +82 2 2258 7586. E-mail:
| | - In Young Choi
- Department of Medical Informatics, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
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Bogaerts A, Luyckx K, Bastiaens T, Kaufman EA, Claes L. Identity Impairment as a Central Dimension in Personality Pathology. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2020. [DOI: 10.1007/s10862-020-09804-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Bogaerts A, Claes L, Bastiaens T, Luyckx K. Personality disorder symptomatology in Belgian emerging adults: Associations with identity processes and statuses. EUROPEAN JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2020. [DOI: 10.1080/17405629.2020.1764842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Annabel Bogaerts
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Faculty of Medicine and Health Sciences, University Antwerp, Antwerp, Belgium
| | - Tim Bastiaens
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- University Psychiatric Centre, KU Leuven, Kortenberg, Belgium
| | - Koen Luyckx
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- UNIBS, University of the Free State, Bloemfontein, South Africa
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Morey LC, Good EW, Hopwood CJ. Global personality dysfunction and the relationship of pathological and normal trait domains in the DSM-5 alternative model for personality disorders. J Pers 2020; 90:34-46. [PMID: 32422689 DOI: 10.1111/jopy.12560] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 05/11/2020] [Accepted: 05/12/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The DSM-5 Alternative Model of Personality Disorders distinguishes core personality dysfunction common to all personality pathology from maladaptive traits that delineate specific variants of disorder. Previous research shows the convergence between maladaptive and normal range trait domains as well as substantial correlations between maladaptive traits and core dysfunctions, leading some to conclude that personality traits and dysfunction are redundant. This study sought to examine the potential utility of the concept of core dysfunctions as a means of clarifying the nature of the relationship between maladaptive and normal-range traits. METHOD Three nonclinical samples (n = 178, 307, and 1,008) were evaluated for personality dysfunction, maladaptive traits, and normal-range traits using different measures. RESULTS Results indicated that: (1) normal trait domains and core dysfunction contribute independently to understanding maladaptive traits; (2) the correlation of a normal trait domain with its putative maladaptive equivalent is consistently accounted for in part by core dysfunction; and (3) the multitrait multimethod matrices of normal and maladaptive personality trait domains demonstrate appreciable discriminant validity problems that are clarified by a consideration of core dysfunction. CONCLUSION These results suggest that maladaptive traits reflect the distinguishable contributions of core personality dysfunction (problems) and normal-range personality traits (person).
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Affiliation(s)
- Leslie C Morey
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, USA
| | - Evan W Good
- Department of Psychology, Michigan State University, East Lansing, MI, USA
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Orme WH, Szczepanek AE, Allen JG, Oldham JM, Madan A, Frueh BC, Fowler JC. Lifetime and prospective associations among personality trait domains and suicide-related behaviors in patients with severe mental illness. J Affect Disord 2020; 266:492-497. [PMID: 32063548 DOI: 10.1016/j.jad.2020.01.182] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 01/09/2020] [Accepted: 01/31/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Despite extensive research and clinical efforts, the suicide rate in the United States continues to rise, driving the need for more research to identify latent factors that increase risk for suicide and to guide treatment decision-making. METHODS The current study examined a large cohort (N = 1,219) of high-risk psychiatric inpatients to explore associations between personality traits and suicide-related variables measured retrospectively (lifetime history prior to hospital admission) and prospectively (at discharge and 12-month follow-up). RESULTS Lifetime suicide-related behavior (SRB: combination of ideational severity, aborted, interrupted, actual attempts, and non-suicidal self-injury) was associated with age (younger), gender (female), and elevated scores on the Personality Inventory for DSM-5 (PID-5) negative affectivity, borderline trait composite score, and five-factor model traits of conscientiousness and neuroticism. Patients who manifested persistent suicidal ideation throughout a 6-8 week inpatient treatment (n = 162; 16.9%) tended to be younger, female, and to have elevated PID-5 borderline trait composite scores. Twelve-month post-discharge SRB was predicted by elevated PID-5 borderline trait composite scores. LIMITATIONS Personality traits accounted for a small amount of variance in the overall model, thus limiting prediction based on individual traits. CONCLUSIONS This large sample of high-risk inpatients with longitudinal outcomes provides a rare assessment of proximal personality traits in predicting lifetime SRB, persistent suicidal ideation observed during the course of a 6-8-week intensive inpatient treatment, and SRB outcomes within 12 months after discharge from hospitalization. Personality traits should be included in future attempts to create predictive algorithms that include relevant biological data (neuroimaging, genetic, microbiome).
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Affiliation(s)
- William H Orme
- Houston Methodist Behavioral Health, 6550 Fannin St Houston, TX 77030, USA; University of Texas McGovern School of Medicine, 1941 East Rd, Houston, TX 77054, USA.
| | | | - Jon G Allen
- Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
| | - John M Oldham
- Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
| | - Alok Madan
- Houston Methodist Behavioral Health, 6550 Fannin St Houston, TX 77030, USA; Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA; University of Texas McGovern School of Medicine, 1941 East Rd, Houston, TX 77054, USA
| | - B Christopher Frueh
- University of Texas McGovern School of Medicine, 1941 East Rd, Houston, TX 77054, USA; University of Hawaii, 200 West Kawili St., Hilo, HI 96720, USA
| | - J Christopher Fowler
- Houston Methodist Behavioral Health, 6550 Fannin St Houston, TX 77030, USA; Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA; University of Texas McGovern School of Medicine, 1941 East Rd, Houston, TX 77054, USA
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