Development and Validation of the Stalking and Obsessive Relational Intrusions Questionnaire (SORI-Q)

Stalking and obsessive relational intrusions both refer to a pervasive and unwanted pattern of pursuit behaviors, the former being a criminal offense evoking fear and a sense of menace in the victim, while the latter may be perceived as annoying or otherwise undesirable, but not necessarily fear inducing. While the individual and societal costs of stalking and obsessive relational intrusion are increasingly recognized, research regarding these behaviors and their consequences has been limited by measurement issues, as most studies have relied on questionnaires and checklists based on very limited validation data. The goal of the present study is to report on the development and validation of the Stalking and Obsessive Relational Intrusions Questionnaire (SORI-Q), a 28-item self-report questionnaire designed to probe for perpetration of stalking-like behaviors. Young adults (age 18-30 years) from a community sample (N = 1,804; 82.6% women) were recruited online. They completed the SORI-Q, along with measures of dark personality traits, insecure attachment dimensions, and intimate partner violence. Overall, the SORI-Q displayed sound psychometric properties. Exploratory and Confirmatory Factor Analysis yielded a two-factor solution (Hyper-intimacy and Domineering control) with adequate to good fit indices. The total scale and the two factor scores showed high internal consistency (above 0.70 for all indices). A number of gender differences were observed at total-, factor-, and item-level, the most outstanding being that women had a higher score on the total SORI-Q score, and on the Domineering control factor and most of its items. The questionnaire showed conceptually meaningful positive correlations with dark personality traits, attachment anxiety, and intimate partner violence. Dominance analysis revealed that attachment anxiety and Machiavellianism were the strongest statistical predictors of SORI-Q scores. The SORI-Q should be seen as a promising new measure of stalking-like and ORI behaviors in young adults from community settings.

Stalking perpetration through the lens of the alternative DSM-5 model for personality disorders

Emerging dimensional models of personality disorders such as the Alternative DSM-5 Model for Personality Disorders (AMPD) provide new opportunities to explore the associations between personality pathology and harmful interpersonal behaviours such as stalking perpetration. Two goals are pursued by this study: (a) To document associations between stalking, level of personality pathology, and pathological personality domains/facets; and (b) to determine the relative importance of maladaptive personality facets in the statistical prediction of stalking. Data from 1489 young adults (18-30 years old) from a community sample were analysed. Moderate positive significant correlations were found between stalking, level of personality pathology, and maladaptive personality domains. A clear gradient of severity of stalking behaviours was found across five severity degrees of personality pathology. Dominance analyses revealed that Deceitfulness was the most dominant statistical predictor in women. Unusual Beliefs and Experiences, a facet from the Psychoticism domain, made an important contribution in the prediction of stalking in men only. Impulsivity was a key predictor in both genders but more markedly in men. Results suggest that the AMPD represents a useful framework to study stalking perpetration. Identification of key personality predictors might prove relevant for identifying risk factors, underlying motives, and treatment targets for stalking perpetrators.

Analysis of the interaction between personality dysfunction and traits in the statistical prediction of physical aggression: Results from outpatient and community samples

The Alternative Model for Personality Disorders (AMPD), included in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) and the World Health Organization's International Classification of Diseases (11th ed.; ICD-11) are, respectively, hybrid categorical-dimensional and dimensional frameworks for personality disorders (PDs). Both models emphasize personality dysfunction and personality traits. Previous studies investigating the links between the AMPD and ICD-11, and self-reported physical aggression have mostly focused on traits and did not take into account the potential interaction between personality dysfunction and traits. Thus, the aim of this study is to identify dysfunction*trait interactions using regression-based analysis. Outpatients with personality disorder from a specialized public clinic (N = 285) and community participants (N = 995) were recruited to complete self-report questionnaires. Some small-size, albeit significant and clinically/conceptually meaningful personality dysfunction*trait interactions were found to predict physical aggression in both samples. Interaction analyses might further inform, to some degree, about the current discussion pertaining to the potential redundancy between dysfunction and traits, the optimal personality dysfunction structure (in the case of the AMPD), as well as clinical assessment based on AMPD/ICD-11 PD frameworks.

A Scoring Procedure for Malignant Narcissism Based on Personality Inventory for DSM-5 Facets

The current study focuses on the development and validation of a scoring procedure for malignant narcissism using the Personality Inventory for DSM-5, a self-report measure of Criterion B from the Alternative Model for Personality Disorders. In Study 1, a prototype matching approach was used to aggregate ratings from 15 clinicians specializing in personality disorder treatment and/or assessment. Indices of inter-rater agreement and inter-rater reliability revealed high convergence as to the most important maladaptive facets for malignant narcissism. The scoring procedure, based on additive counts for score computation, included eleven Criterion B facets covering core features of malignant narcissism. Study 2 evaluated the criterion and incremental validity of the scoring procedure in a sample of 288 patients from a personality disorder treatment clinic, as well as in a sample of 1103 participants from the community. In both samples, results from nonparametric mean comparisons, receiver operating characteristic curves, bivariate Pearson correlations, and hierarchical multiple linear regressions showed significant associations between malignant narcissism and broader components of personality functioning, as well as with relevant emotional, relational, and/or behavioral features. This new scoring procedure is a simple and valid method for measuring malignant narcissism, and is suitable for clinical and research settings.

Latent profiles of patients with borderline pathology based on the alternative DSM-5 model for personality disorders

BACKGROUND

There have been multiple attempts to try to parse out heterogeneity within borderline pathology by identifying patient subtypes; thus far, these works have yielded few consistent results. Recent developments in the operationalization of borderline pathology may provide new opportunities to identify clinically and conceptually meaningful subgroups of patients. The Alternative DSM-5 Model for Personality Disorders (AMPD) offers a categorical-dimensional operationalization of Borderline personality disorder (BPD) that has yet to be tested for identification of patient subgroups. The purpose of the present study is to test whether the combination of the Criterion A elements (pertaining to level of severity) and the seven pathological facets from Criterion B that define BPD in the AMPD can yield meaningful patient profiles.

METHODS

A total of 211 outpatients from a specialized PD treatment program (133 women, Mage = 33.66, SD = 10.97) were selected based on the presence of at least moderate borderline pathology according to cutoffs recently proposed for the Borderline Symptom List-23. Valid Criterion A (Self and Interpersonal Functioning Scale) and B (Personality Inventory for DSM-5 Faceted Brief Form) self-reports were administered to measure elements and facets that define BPD in the AMPD model; these variables were used as indicators in a latent profile analysis (LPA).

RESULTS

The optimal solution generated by LPA yielded four distinct profiles: (a) Borderline traits; (b) Moderate pathology with Impulsivity; (c) Moderate pathology with Identity problems and Depressivity; and (d) Severe pathology. Clinically meaningful distinctions emerged among profiles on AMPD indicators and external variables relevant to PD, especially aggression and impulsivity.

CONCLUSIONS

Profiles reflected both the "severity" and "style" components imbedded within Criterion A and B of the AMPD, as they were mainly distinguished by a continuum of severity but also by some meaningful qualitative differences that may have important clinical implications for treatment planning and contracting. Results also suggest that the four Criterion A elements have independent value to identify important differences in patients with borderline pathology. They also highlight that some Criterion B facets that define BPD in the AMPD may be especially important to identify subgroups of patients, mainly Impulsivity and Depressivity.

A Proposed Classification of ICD-11 Severity Degrees of Personality Pathology Using the Self and Interpersonal Functioning Scale

Background: The 11th version of the World Health Organization's International Classification of Diseases (ICD-11) has adopted a dimensional approach to personality disorder (PD) nosology. Notably, it includes an assessment of PD degree of severity, which can be classified according to five categories. To date, there is no gold standard measure for assessing degree of PD severity based on the ICD-11 model, and there are no empirically-based anchor points to delineate the proposed categories. With the operationalization of PD degrees of severity in the ICD-11 PD model now being closely aligned with Criterion A of the DSM-5 Alternative Model for Personality Disorders (AMPD), sharing a focus on self and interpersonal dysfunction, self-report instruments developed for the latter model might prove useful as screening tools to determine degrees of severity in the former. Methods: The Self and Interpersonal Functioning Scale, a brief validated self-report questionnaire originally designed to assess level of personality pathology according to the AMPD framework, was used to derive anchor points to delineate the five severity degrees from the ICD-11 PD model. Data from five clinical and non-clinical samples (total N = 2,240) allowed identifying anchor points for classification, based on Receiver Operating Characteristic curve analysis, Latent Class Analysis, and data distribution statistics. Categories were validated using multiple indices pertaining to externalizing and internalizing symptoms relevant to PD. Results: Analyses yielded the following anchor points for PD degrees of severity: No PD = 0-1.04; Personality Difficulty = 1.05-1.29; Mild PD = 1.30-1.89; Moderate PD = 1.90-2.49; and Severe PD = 2.50 and above. A clear gradient of severity across the five categories was observed in all samples. A high number of significant contrasts among PD categories were also observed on external variables, consistent with the ICD-11 PD degree of severity operationalization. Conclusions: The present study provides potentially useful guidelines to determine severity of personality pathology based on the ICD-11 model. The use of a brief self-report questionnaire as a screening tool for assessing PD degrees of severity should be seen as a time-efficient support for clinical decision and treatment planning.