Examining the Presence, Frequency, and Associated Characteristics of Nonsuicidal Self-Injury by Proxy: Initial Validation of the Nonsuicidal Self-Injury by Proxy Questionnaire (NSSIBPQ)

Nonsuicidal self-injury (NSSI) by proxy is the intentional destruction of one's own body tissue through the elicitation of another being's actions. Despite its clinical relevance, research on NSSI by proxy is limited and there are no available measures of this behavior. This research aimed to characterize NSSI by proxy among young adults and provide preliminary data on the validity of a new self-report measure, the NSSI by Proxy Questionnaire (NSSIBPQ). Two nationwide community samples of young adults (one general community sample and one with a history of traditional NSSI and suicidality) completed online studies. NSSI by proxy was reported by 18% of the general community sample and 45% of the self-injuring sample. Findings support the clinical relevance of NSSI by proxy and its potential to meet criteria for an NSSI disorder diagnosis. Results also provide preliminary support for the internal consistency and convergent, discriminant, and concurrent validity of the NSSIBPQ.

Borderline personality disorder traits and rates of NSSI during the COVID-19 pandemic: An initial investigation

Objective: The current study evaluated frequency of nonsuicidal self-injury (NSSI) and associated maladaptive traits between three time periods: pre-pandemic, early pandemic, and later pandemic. Participants: Two college student samples (n = 362; n = 337) were collected via two online studies. Method: Participants completed measures assessing maladaptive borderline personality traits, engagement in NSSI over the past month, and reasons for and types of NSSI engaged in across the lifetime. Results: Results demonstrated a stable and potentially a slight increase in general rates of NSSI over the course of the pandemic. Further, specific maladaptive traits that underly borderline personality disorder (i.e., despondence, fragility, self-disturbance, and anxious-uncertainty) were related to engagement in NSSI 1-month post COVID. Conclusion: The study highlights the need for added interventions that might reach at risk populations during these heightened periods of stress.

Psychometric properties of the Persian version of short-form five factor borderline inventory (FFBI-SF)

BACKGROUND

The Five-Factor Borderline Inventory-Short Form (FFBI-SF) is a self-report measure developed to assess traits of Borderline Personality Disorder (BPD) from the perspective of the Five-Factor Model of general personality. This study was designed to examine the factor structure, internal consistency, and convergent/discriminant validity of the Persian FFBI-SF in a sample of Iranian university students.

METHODS

A total of 641 university students (M-age = 28.04, SD = 8.21, 66.7% women) completed the online forms of the FFBI-SF, PID-5-BF, and Mini IPIP.

RESULTS

Confirmatory factor analysis supported the original and modified (without item 47) twelve-factor models. Also, Cronbach's alpha (α) for the FFBI-SF scores ranged from unacceptable to excellent ranges. However, when relying on MIC values to measure internal consistency, the FFBI-SF Total and subscale scores demonstrated adequate internal consistency. Finally, the FFBI Total and subscale scores showed the expected relations with other personality measures scores (e.g., Neuroticism, Antagonism, and Conscientiousness), which supports the validity of the interpretation of the FFBI-SF scores.

CONCLUSIONS

The findings indicated that FFBI-SF is a useful tool with sound psychometric properties for assessing BPD traits in Iranian students and may spark research in other Iranian settings (e.g., community and clinical samples).

The clinical utility of the ICD-11 classification of personality disorders and related traits: A preliminary scoping review

OBJECTIVES

A diagnostic system that fails to deliver clinically useful information will not be utilized and consequently will be unable to provide valuable data for health policy and clinical decision making. Therefore, it is imperative to obtain an accurate depiction of the clinical utility of the eleventh revision of the International Classification of Diseases (ICD-11) Personality Disorder (PD) model. The current mixed-methods systematic review aimed to determine the clinical utility of the ICD-11 PD classification system.

METHOD

An electronic screening of six databases was conducted and resulting studies were subjected to specific exclusion criteria, which elicited eight studies of interest. Study characteristics were tabulated and methodological quality was appraised.

RESULTS

Four studies offered strong support for the model's clinical utility, three offered some support accompanied by notable limitations and one study could only offer criticisms.

CONCLUSION

Future investigation of the ICD-11 PD classification system's (a) communicative value between clinicians and their patients, and between clinicians and their patient's families; (b) ease of use; and (c) feasibility in terms of practical application is required to achieve a complete understanding of its clinical utility and ultimately bring clarity to the current ambiguous findings.

Thought control strategies as predictors of borderline personality disorder and suicide risk

BACKGROUND

Borderline Personality Disorder (BPD) is characterized by a pattern of instability in interpersonal relationships, affect, self-image and is marked by behavioral impulsivity including suicidal ideation and attempts. Additionally, individuals with BPD tend to engage in maladaptive ruminative thinking that is also related to suicidal ideation and attempts. Given these relations, this study aims to understand the 5 strategies of thought control (distraction, punishment, reappraisal, worry, and social control) as predictors of BPD symptoms and suicide risk.

METHODS

The sample was collected at a Southeastern University using a convenience sample of undergraduate participants. The final sample (n = 403) had an age range of 18 to 27 (M  = 19.67, SD = 1.45), was 74.4% female and 25.6% male, and was primarily Caucasian (69.7%) and African American (24.8%).

RESULTS

Results demonstrate that distraction was negatively associated with BPD and suicide risk while worry and punishment were positively associated with BPD and suicide risk across three different measures of BPD. Social control was negatively associated with suicide risk and BPD but only on one of the BPD measures. Lastly, reappraisal was positively related to BPD symptoms on two measures.

LIMITATIONS

Given the sample characteristics, there may be limitations in the generalizability of the findings.

CONCLUSIONS

The findings represent a first step towards examining thought control strategies as possible predictors of BPD symptoms and suicide that can inform clinical interventions designed to increase or decrease utilization of these specific strategies.

Elucidating the relationships between shame, anger, and self-destructive behaviors: The role of aversive responses to emotions

Shame and anger are distinct yet interrelated emotions that have both been implicated in the occurrence of impulsive, self-destructive behavior (ISDB); however, the intricacies of these relations remain sparsely examined. Some research, mostly with anxiety and depression, suggests that an aversive reaction to the experience of negative emotions can result in efforts to escape or avoid such experiences. The current study sought to extend this model to the experience of shame. Consistently, we predicted that aversive reactions to shame would be associated with anger, which would be associated with ISDB. Four hundred and seventy-five undergraduate students completed a series of online questionnaires. Serial mediation was performed and r-square indicated that 35.55% of the variance in impulsive behavior was explained by this model. As predicted, shame had a significant indirect effect on anger through aversive reactions to emotions and on ISDB through aversive reactions to emotions and anger. Unexpectedly the reverse model, with an aversive reaction to anger predicting shame and ISDB, was also significant suggesting possible bidirectional relations between these constructs. This study is among the first to examine a possible mechanism by which shame can lead to ISDB, providing potential points of intervention for treatment.

Borderline personality disorder traits and suicide risk: The mediating role of insomnia and nightmares

BACKGROUND

Borderline personality disorder (BPD) is associated with high rates of suicide risk and problems related to sleep, including insomnia and nightmares. The purpose of the current study was to assess the potential indirect effect of BPD traits on suicide risk through both/either insomnia and nightmares.

METHODS

Participants (N = 281) were recruited via Amazon's Mechanical Turk to complete the study remotely online. Participants completed measures of BPD traits and symptoms, suicide risk (history of suicidal thoughts and behaviors), insomnia symptoms, and distress and impairment related to nightmares.

RESULTS

BPD traits and symptoms were moderately to highly correlated to suicide risk, insomnia, and nightmares. In parallel mediation models, BPD traits had a significant indirect effect on suicide risk through insomnia symptoms but not nightmares.

LIMITATIONS

The current study assessed problems within the general population and not in a clinical sample. Second, the study relied solely on self-report measures. Futures studies would benefit from investigating these relations in clinical samples utilizing observer-report and interview methods.

CONCLUSIONS

BPD traits appear to relate to increased risk for suicide through the relation with sleep concerns, particularly insomnia symptoms. Therefore, assessing and treating sleep problems within individuals with BPD may result in a lower risk for suicide.

FFMPD scales: Comparisons with the FFM, PID-5, and CAT-PD-SF

A series of 8 Five Factor Model Personality Disorder (FFMPD) scales have been developed to assess, from the perspective of the Five Factor Model (FFM), the maladaptive traits included within DSM-5 Section II personality disorders. An extensive body of FFMPD research has accumulated. However, for the most part, each study has been confined to the scales within 1 particular FFMPD Inventory. The current study considered 36 FFMPD scales, at least 1 from each of the 8 FFMPD inventories, including 8 scales considered to be from neuroticism, 8 from extraversion, 5 from openness, 8 from agreeableness, and 7 from conscientiousness. Their convergent, discriminant, and structural relationship with the FFM was considered, and compared with the structural relationship with the FFM obtained by the Personality Inventory for DSM-5 (PID-5) and the Computerized Adaptive Test-Personality Disorder-Static Form (CAT-PD-SF). Support for an FFM structure was obtained (albeit with agreeableness defining 1 factor and antagonism a separate factor). Similarities and differences across the FFMPD, PID-5, and CAT-PD-SF scales were highlighted. (PsycINFO Database Record

Borderline personality disorder is equally trait-like and state-like over ten years in adult psychiatric patients

Borderline personality disorder (PD) has historically been cast as an unabating condition. Longitudinal data, however, support a more variable time course marked by remission and relapse. In the present study, we tested the possibility that borderline PD has both stable (i.e., consistently present across time and situation, as modern diagnostic systems stipulate) and dynamic (i.e., episodic and situational) elements. Participants were 668 patients from the Collaborative Longitudinal Personality Disorders Study who were administered semistructured diagnostic interviews 5 times over a decade. Trait-state-occasion modeling dissected borderline pathology into time-invariant (i.e., trait) and time-varying (i.e., state) components. Contradicting traditional views of PD intransigence, less than half of borderline PD variability (approximately 45%) was time-invariant (i.e., perfectly stable) over the study timeframe. Furthermore, we found that the time-invariant component of borderline pathology, which we termed borderline proneness, was very closely related (r = .81) to a previously validated Five Factor Model trait composite of borderline features. Moreover, the trait versus state components showed a clear pattern of discriminant validity in relation to several putative causal agents for borderline PD (i.e., environmental pathogens, temperament dimensions). We conclude that borderline pathology contains a stable core and sizable situational components, and that both elements relate systematically to normative personality dimensions and known risk factors. These findings have key implications for etiological research, prognosis, and treatment for borderline PD. (PsycINFO Database Record

Basic personality model

The personality structure of persons within clinical populations may not be fundamentally different from the personality structure of persons who have not sought treatment for their maladaptive personality traits. Indeed, there has long been an interest in understanding personality disorders as maladaptive variants of general personality structure. Presented herein is an understanding of personality disorder from the perspective of basic personality research; more specifically, the five factor model (FFM) of general personality structure. Potential advantages of understanding personality disorders from the perspective of the FFM are provided.

The Five-Factor Model Is a Competing Theory of Borderline Personality Disorder: Commentary on Gunderson et al

Gunderson, Fruzzetti, Unruh, and Choi-Kahn (2018) review four competing theories of borderline personality border (BPD). Regrettably, they did not acknowledge the theory that BPD is a maladaptive variant of Five-Factor Model general personality structure. This commentary indicates how the FFM of BPD addresses well, and does so empirically, the points of comparison, made by Gunderson et al.

Development of a Short Form of the Five-Factor Borderline Inventory

The Five-Factor Borderline Inventory (FFBI) is a 120-item dimensional measure of borderline personality disorder (BPD) that was developed from the description of BPD from the perspective of the Five-Factor Model. The FFBI includes 12 subscales and 1 total score. The current study created a short form of the FFBI (FFBI-SF) using item response theory analyses based on an undergraduate student sample that completed the FFBI. Based on the results, the final FFBI-SF included 48 items, with 4 items per subscale. The construct validity of the short form was compared with the original FFBI in five additional samples. The FFBI-SF showed strong convergence with other BPD scales and comparable convergent and discriminant validity with the FFM compared with the FFBI. The correlational profiles generated by the total score and subscales were highly convergent. Results of the current study suggest that the FFBI-SF may be an accessible and useful assessment tool of BPD.