Thin slice derived personality types predict longitudinal symptom trajectories

Resilient, undercontrolled, and overcontrolled personality types in Hong Kong youths and the association with mental health outcomes

OBJECTIVE

This study aimed to investigate the relationship between RUO types and mental health in a youth sample in Hong Kong.

BACKGROUND

Previous research has found that Resilient, Undercontrolled, and Overcontrolled (RUO) personality types derived from Big Five personality traits are associated with mental health outcomes. Most studies, however, have predominantly been conducted in Western societies.

METHOD

Clinical diagnostic interviews and self-rated measures of psychological constructs, covering resilience, rumination, self-esteem and more, were administered to 860 youths aged 15 to 24 recruited from an ongoing epidemiological youth mental health study in Hong Kong.

RESULTS

Three personality clusters were identified. The first (mean age = 19.6, 63.3% female) and second (mean age = 19.5, 60.7% female) cluster both have characteristics of the under- and overcontrolled personalities. The third personality type resembled the resilient profile in RUO typology (mean age = 19.6, 50.5% female) and showed the lowest prevalence of poor mental health.

CONCLUSIONS

The results suggest that the replicability of the RUO profiles was only partial in a Hong Kong sample predominantly Chinese. The resilient profile was replicated but not the undercontrolled and overcontrolled profiles proposed by previous studies. The findings of the current study implicated that culturally contextual considerations are necessary when relating mental health to personality.

Maladaptive facet trait profiles and psychopathology: a person-centered assessment approach

Person-centered approaches in personality allow greater understanding of how different subpopulations with specific personality profiles are linked with relevant outcomes. Studies under the Five Factor Model agree on the observation of a Resilient, an Undercontrolled and an Overcontrolled profile. However, studies using maladaptive traits are much more limited. The present research identify personality profiles based on the 25 maladaptative facet and examined the relationships with personality dysfunctioning, internalizing and externalizing symptoms.

A mixed sample composed of community adults (n = 742) and patients (n = 312) completed the Personality Inventory for DSM-5 Short Form, the Inventory of Depression and Anxiety Symptoms-II, Externalizing Spectrum Inventory–Brief From, the 12 items Spanish version of the WHO Disability Assessment Schedule II and Level of Personality Functioning Scale-Brief Form 2.0. Latent profile analysis was performed on PID-5-SF score. The scores on internalizing, externalizing and functioning were compared across the profiles.

Four profiles emerged: Resilient, Undercontrolled, Overcontrolled, and Ordinary type. The Overcontrolled and Undercontrolled types showed higher scores on pathology scales. While the Overcontrolled profile appeared more related to internalizing symptoms and impairment in self-functioning, the Undercontrolled profile was more linked to higher scores on externalizing symptoms and interpersonal dysfunctioning.

Processes of change in a randomized clinical trial of radically open dialectical behavior therapy (RO DBT) for adults with treatment-refractory depression

OBJECTIVE

Radically open dialectical behavior therapy (RO DBT) is an empirically supported psychotherapy for treatment-refractory depression (TRD) that targets psychological inflexibility and interpersonal functioning within the context of maladaptive overcontrol. However, it is unknown whether change in these mechanistic processes is associated with decreased symptoms. This study tested whether change in psychological inflexibility and interpersonal functioning is associated with change in depressive symptoms in RO DBT.

METHOD

Adults with TRD from The Refractory Depression: Mechanisms and Efficacy of RO DBT (RefraMED) randomized controlled trial of RO DBT, n = 250; M (SD) age = 47.2 (11.5); 65% female; 90% White, were assigned to RO DBT or treatment as usual. Psychological inflexibility and interpersonal functioning were assessed at baseline, 3 (midtreatment), 7 (posttreatment), 12, and 18 months. Mediation analyses and latent growth curve modeling (LGCM) assessed whether change in psychological inflexibility and interpersonal functioning was associated with change in depressive symptoms.

RESULTS

The effect of RO DBT in decreasing depressive symptoms was mediated by changes in psychological inflexibility and interpersonal functioning at 3 (95% CI [-2.35, -0.15]; [-1.29, -0.04], respectively), 7 (95% CI [-2.80, -0.41]; [-3.39, -0.02]), and only psychological inflexibility at 18 (95% CI [-3.22, -0.62]) months. LGCM indicated only in RO DBT was a decrease in psychological inflexibility through 18 months associated with a decrease in depressive symptoms (B = 0.13, p < .001).

CONCLUSIONS

This supports RO DBT theory about targeting processes related to maladaptive overcontrol. Interpersonal functioning, and in particular, psychological flexibility, may be mechanisms that decrease depressive symptoms in RO DBT for TRD. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Using A Thin Slice Coding Approach to Assess Preschool Overweight and Obesity

Obesity is a major public health problem and cause of significant burden across the lifespan. Longitudinal samples, beginning in early childhood offer an advantageous approach to studying obesity, given the potential to observe within-individual changes over time. Yet among the many available longitudinal studies of children, particularly those studying psychological disorders, do not assess for overweight/obesity status or related constructs necessary to compute BMI. We offer a unique thin slice approach for assessing obesity/overweight status using previously collected video data. The current study observationally coded overweight/obesity status in a clinically enriched sample of preschoolers oversampled for depression (N=299). Preschoolers (ages 3-6 years) completed 1-8 structured observational tasks with an experimenter. Overweight/obesity was coded using a "thin slice" technique with 7,820 unique ratings available for analysis. Parent-reported physical health problems were assessed throughout the study and BMI percentiles were available from ages 8-19 years. Thin-slice ratings of overweight/obesity were reliably observed in preschoolers' ages 3-6 years. Thin-slice ratings of overweight/obesity during preschool significantly predicted adolescent BMI percentiles at six separate assessments spanning ages 8-19 years. Further, preschool overweight/obese thin-slice ratings were associated with more physical health problems over time and less sport/activity participation during preschool. Overweight/obesity can be observationally identified in preschool-age children and offers a reliable estimate of future BMI percentile. Study findings highlight how previously collected data could be utilized to study the developmental trajectories of overweight/obesity to inform this critical public health problem.

Bottom-up transdiagnostic personality subtypes are associated with state psychopathology: A latent profile analysis

Introduction

Personality-based profiling helps elucidate associations between psychopathology symptoms and address shortcomings of current nosologies. The objective of this study was to bracket the assumption of a priori diagnostic class borders and apply the profiling approach to a transdiagnostic sample. Profiles resembling high-functioning, undercontrolled, and overcontrolled phenotypes were expected to emerge.

Methods

We used latent profile analysis on data from a sample of women with mental disorders (n = 313) and healthy controls (n = 114). 3-5 profile solutions were compared based on impulsivity, perfectionism, anxiety, stress susceptibility, mistrust, detachment, irritability, and embitterment. The best-fitting solution was then related to measures of depression, state anxiety, disordered eating, and emotion regulation difficulties to establish clinical significance.

Results

A 5-profile solution proved best-fitting. Extracted profiles included a high-functioning, a well-adapted, an impulsive and interpersonally dysregulated, an anxious and perfectionistic, and an emotionally and behaviorally dysregulated class. Significant differences were found in all outcome state measures, with the emotionally and behaviorally dysregulated class exhibiting the most severe psychopathology.

Discussion

These results serve as preliminary evidence of the predictive nature and clinical utility of personality-based profiles. Selected personality traits should be considered in case formulation and treatment planning. Further research is warranted to replicate the profiles and assess classification stability and profiles' association with treatment outcome longitudinally.

Childhood behavioral inhibition and overcontrol: Relationships with cognitive functioning, error monitoring, anxiety and obsessive-compulsive symptoms

Anxiety and obsessive-compulsive disorders are common childhood psychiatric disorders. Behavioral inhibition (BI) is a widely studied risk factor for anxiety. Less is known about overcontrol, a related behavioral phenotype characterized by concern for errors, perfectionism, and inflexibility and also associated with anxiety and obsessive-compulsive disorder. Both BI and overcontrol show associations with aberrant cognitive control and neural error responding (via the error-related negativity; ERN) yet it is unknown whether each imparts differential risk. Understanding whether overcontrol demonstrates independent associations from BI with cognitive functioning, neural error monitoring, and childhood anxiety and obsessive-compulsive presentations could aid in identifying a novel mechanistic treatment target. We assessed BI, overcontrol, cognitive functioning and psychopathology in a cross-sectional sample of 5-6 year old children (N = 126). Children completed an electroencephalogram (EEG) to assess the ERN. Overcontrol was associated with worse cognitive shifting, worse inhibitory control and higher anxiety and obsessive-compulsive symptoms, beyond BI. BI was associated with worse cognitive shifting, better inhibitory control and higher anxiety symptoms, beyond overcontrol. When assessed simultaneously, only overcontrol demonstrated a significant relationship with a blunted ERN. Moreover, overcontrol mediated (cross-sectionally) the well-established relationship between ERN and anxiety and obsessive-compulsive symptoms. BI and overcontrol impart differential risk for child cognitive functioning and anxiety while overcontrol demonstrates additional risk for aberrant neural error monitoring, anxiety and obsessive-compulsive presentations. Overcontrol may also be a mechanistic pathway between the ERN and transdiagnostic anxiety and obsessive-compulsive symptoms. Overcontrol may be a target warranted for early-childhood intervention in anxiety and OCD.