Personality and Mental Health最新文献

Disordered personality traits are frequently defined with respect to emotion dysregulation. However, research has needed to explore connections between disordered personality traits and emotion regulation strategies, particularly in older adulthood. The current study had older adult participants (n = 210; mean age: 66 years) complete measures of disordered personality traits, emotion regulation strategies, and difficulties in emotion regulation. Results demonstrated that disordered personality traits were more robustly associated with difficulties with emotion regulation relative to strategy use frequency. However, the five disordered traits exhibited distinct profiles of correlations with the regulation measures. Notably, detachment was largely unrelated to regulatory strategy use, whereas anankastia was similarly related to engagement and disengagement in emotion regulation.

The Alternative Model for Personality Disorders (AMPD) distinguishes severity of personality dysfunction (Criterion A) from maladaptive trait expression (Criterion B). Debates about whether the Level of Personality Functioning Scale (LPFS) is unidimensional or multidimensional have attracted considerable attention but largely miss the point. Personality functioning, as conceived within psychodynamic developmental theory, is singular by definition-not because factor analyses extract a dominant factor but because psychological development itself is one process. The DSM-5 Work Group constructed Criterion A from psychodynamic instruments that interpret personality pathology as failures to develop a stable, coherent sense of self, and the capacity for meaningful relationships. Evidence for this developmental achievement appears in identity, self-direction, empathy, and intimacy, but these domains reflect facets of a single capacity rather than separable dimensions. This commentary traces the psychodynamic roots of Criterion A, integrates contemporary trait research to clarify how Criteria A and B differ conceptually, addresses key psychometric critiques, and outlines treatment implications.

The 11th revision of the International Classification of Diseases defines the severity of dysfunction as a core diagnostic criterion for personality disorders. This study examined the psychometric properties of the Czech adaptation of the Personality Disorder Severity-ICD-11 (PDS-ICD-11) scale. The sample consisted of 1704 participants (72.4% women) in community (n = 612) and treatment-seeking (n = 1092) groups. Results supported the unidimensionality of the PDS-ICD-11, good internal consistency, and expected associations with a validated measure of severity (Levels of Personality Function Scale-Brief Form 2.0; LPFS-BF 2.0), as well as with pathological traits and quality of life measures. Compared with the LPFS-BF 2.0, the PDS-ICD-11 demonstrated stronger associations with quality of life (small effect size) and was a better predictor of treatment-seeking status; however, it explained less variance in pathological traits, except for negative affectivity. Neither severity measure showed a balanced representation of trait domains, suggesting a need for refinement. Overall, the Czech PDS-ICD-11 offers a valid and efficient tool for screening the severity of personality dysfunction, with utility in both research and clinical settings.

The current study examined how psychiatric labels-BPD vs. PTSD-and client gender influence psychologists' attitudes toward a mock client, holding constant variables such as symptom presentation, relational difficulties, and trauma history. Prior research suggests that BPD is heavily stigmatized, partly due to negative stereotypes, gender bias, and the historical misuse of the borderline label. In this online experimental study, a random sample of 267 psychologists was randomly assigned to read one of four vignettes describing a female or male client diagnosed with either BPD or PTSD. The demographics of the sample were largely representative of the general population of licensed psychologists in the United States; however, individuals identifying as Hispanic and Black were under-represented. After reading the vignette, participants completed an adapted Attitudes to Personality Disorders Questionnaire and several single-item questions that captured critical aspects of clinical judgment. Overall, although psychologists reported generally positive attitudes, subtle biases toward the BPD label and gender differences in diagnostic perceptions were evident. The study highlights the need for continued efforts to address diagnostic stigma and gender bias in clinical practice, as well as for future research to examine the nuanced factors that contribute to BPD-related stigma.

A central feature of personality disorders (PDs) is interpersonal problems, which can be effectively conceptualized using the interpersonal circumplex (IPC). This study replicates and extends previous research on the relationship between the dimensional DSM-5 Alternative Model for Personality Disorders (AMPD) and interpersonal problems, as there are only a few studies in this area. The Structural Summary Method (SSM) was used in a sample of 168 psychiatric inpatients who completed Criterion A and B measures according to the AMPD: The Semi-Structured Interview for Personality Functioning DSM-5 (STiP-5.1), the Level of Personality Functioning Scale (LPFS-BF 2.0), and the Personality Inventory for DSM-5 (PID-5-BF+). Additionally, general and specific interpersonal problems were assessed with the Inventory of Interpersonal Problems (IIP-C). We found associations of both Criteria A and B of the AMPD with general interpersonal distress. Criterion A domains did not map cleanly onto the IPC's meta-concepts of agency and communion; only a subset yielded interpretable circumplex profiles, primarily in the interpersonal functioning domain. Criterion B domains generally showed clearer and more specific associations, with most mapping onto domineering and cold interpersonal problems but showing little association with nonassertive or maladaptive warm problems. These results support and extend previous evidence of empirical links between the AMPD and the IPC, highlighting the IIP-C's value for comprehensive assessment of interpersonal problems in PD. Further research is needed to clarify the overlap and distinctions between these models and to identify the interpersonal problems most relevant for treatment planning.

Mania symptoms are impairing, multidimensional, and complexly related to other mood and psychopathology dimensions. For example, manic activation (e.g., restlessness and flight of ideas) and euphoria (e.g., expansive and grandiose mood) correlate with both dysphoria (e.g., depressed mood and worry) and well-being (e.g., hopefulness and energy). This empirical overlap may distort or obscure mania's observed relations to psychosocial dysfunction and personality traits. Adults (N = 605; M = 46 years old; 57% women), recruited from community mental health centers and by random telephone dialing, completed mood (Inventory of Depression and Anxiety Symptomatology), personality (Personality Inventory for DSM-5; Schedule for Nonadaptive and Adaptive Personality), and psychosocial functioning (e.g., Disability Assessment Schedule; Social Functioning Questionnaire) measures. We tested cross-sectional relations of manic activation and euphoria with functioning and trait dimensions. Using linear correlation and regression analyses, we interpreted results significant at p < 0.01 with effect size r ≥ 0.10. Part correlations (controlling for dysphoria or well-being) that were stronger or reversed compared to whole correlations indicated statistical suppression. Manic activation correlated widely with dysfunction (e.g., disability and social problems) and traits (e.g., negative affectivity, disinhibition, and psychoticism). Well-being suppressed manic euphoria's relations, particularly with dysfunction, negative affectivity, disinhibition, and psychoticism. Dysphoria also suppressed manic activation's relations with trait positive temperament and related dimensions. The full extent of manic euphoria and activation's relations with psychosocial dysfunction and personality became clear only after accounting for concurrent well-being or dysphoria. The placement of mania in multidimensional symptom assessment systems may advance by considering these suppression situations.

Evidence suggests a relationship between alexithymia and self-report measures of interoception. As measures of alexithymia often include items that may pick up on interoceptive difficulty, however, it is possible that previously reported associations are driven by a lack of independence of measurement. Here, we explored the effect of removing sensation-related items from the Toronto Alexithymia Questionnaire (TAS-20) on the association between the TAS-20 and self-report measures of interoceptive accuracy (Studies 1 and 2; N = 330 and N = 476, respectively) and attention (Study 2). In both studies, removal of sensation-related items significantly reduced associations between the self-report measures of interoception and alexithymia. This effect was specific to the removal of sensation-related items (removing a random set of items did not result in a reduction in the size of the association). Importantly, relationships between alexithymia and self-reported interoception remained after item removal. Although effects were modest, it is recommended that future studies exploring relationships with self-report measures of interoception-particularly in relation to constructs where sensation-related items may broadly feature-should implement sensitivity analyses or employ alternative instruments that exclude sensation-related items, to ensure associations are not driven by a lack of independence of measurement.

For the SIPP-118, a widely used instrument for measuring the severity of personality disorders in 16 facets and five domains, T-scores, and percentile rank scores were established. Various approaches based on classical test theory and item response theory (IRT) for establishing T-scores were compared, which are assumed to achieve in-creasing levels of accuracy. Three approaches were evaluated: (1) a simple linear conversion of raw scores to T-scores, (2) a normalizing conversion (Rankit), and (3) an approach based on IRT. We compared T-scores resulting from these approaches with IRT-based factor scores. The findings show that the linear approach produced distorted T-scores for many facets of the SIPP-118, especially in the lower, more pathological range of scores. The Rankit and IRT-based approaches yielded in practice almost identical T-scores and both corresponded quite well with factor scores that were actually based on an IRT model for these facets or domain scores. Implications for the practice of establishing T-scores are discussed. IRT provided the most accurate trait estimates, but it requires a complex calculation that takes into account item parameters and the individual's response pattern. Regression-based IRT-score approximations and Rankit-based T-scores yielded adequate estimates as well.

Major depression (MD) is a serious mental health disorder projected to become the leading cause of global disability by 2030. Borderline personality disorder (BPD) frequently co-occurs with MD. Individuals with both conditions often experience prolonged recovery times and exhibit high levels of suicidal behaviour. Network theory and its application, network analysis, presents a novel framework for conceptualising and understanding the comorbidity between MD and BPD. This network analysis aims to identify influential symptoms within a BPD/MD network and explore the clinical relevance of these relationships. Data from 548 participants were pooled from four clinical trials run between 1994 and 2013 at the Department of Psychological Medicine, University of Otago, Christchurch, New Zealand. All participants were diagnosed with current MD (as part of major depressive disorder or bipolar II disorder). Baseline MD and BPD symptom data from trial entry assessments were entered into a cross-sectional network analysis. A further network analysis was estimated with the addition of three covariates (age, gender and depression severity) alongside the MD and BPD symptoms. Network analyses identified several connecting symptoms between MD and BPD. After controlling for depression severity, BPD symptoms of identity disturbance and unstable relationships had unique and robust relationships with MD suicidal ideation and behaviours. Further exploration of these bridge relationships found that participants who exhibited identity disturbance were almost three times more likely to have reported a previous suicide attempt. Results from this study have implications for risk assessment and treatment of individuals with comorbid MD and BPD.