Personality and Mental Health最新文献

Procrastination trait describes irrational delays of scheduled tasks despite clear awareness of the adverse consequences of doing so. Although procrastination is well-known to be linked to psychiatric or pathological processes, the criterion for "psychopathological procrastination" distinguishing from the procrastination trait is understudied. This is a 5-year longitudinal observational study. Participants (N = 464) completed measures of trait procrastination in 2018, with a follow-up conducted in 2023 (N = 267) collecting subclinical symptomatology. A constrained multivariate direct gradient model (cmDGM) was employed to prospectively predict subclinical psychiatric symptomatology formulated by the DSM-5 framework. The two-stage psychopathological connectome model was then constructed to constitute a "diagnostic criterion" reflecting "psychopathological procrastination." Procrastination prospectively predicted subclinical psychopathological symptoms and unhealthy lifestyles. Subclinical bridge hubs of "failure to self-regulate delays," "failure to control adverse consequences," "useless to self-change," "out-of-control irruptions," "poor sleep quality," and "negative emotional reactions" were identified in the two-stage psychopathological network. These hubs constituted the 9-item pathological procrastination diagnostic criterion (3PDC) with good diagnostic performance (AUC = 0.82, p < 0.01). The present study revealed the predictive role of procrastination for subclinical psychiatric symptomatology and further established the subclinical 3PDC to lay the foundation for the "diagnostics of psychopathological procrastinators."

Antisocial Personality Disorder (ASPD) is a personality disorder that entails significant impairments and/or costs at the individual, interpersonal, and community levels. Given its clinical relevance, scientific research is placing a significant focus on the study of the central characteristics of this condition to guide prevention and clinical practice. Within this framework, the present study aimed to investigate the associations and centrality of ASPD criteria and maladaptive trait domains in mental health professionals' conceptualization of the disorder, thus taking into account both categorical and dimensional approaches to personality pathology. The research involved 322 mental health professionals who reviewed the importance of ASPD criteria (Section II) and maladaptive trait domains (Criterion B of Section III). Data were analyzed using a network analysis approach. Both edge weights and node centrality were investigated. Within the criteria network, all centrality indices unanimously highlighted the role of lack of remorse. Regarding the trait domain network, the contributions of antagonism, detachment, and disinhibition were emphasized. The findings of this research collect and systematize the mental health professionals' perspective through the network analysis approach to provide further understanding of ASPD's central features. Such data may have useful practical implications for both research and clinical practice.

Borderline personality disorder (BPD) is highly stigmatized. It is associated with negative clinician attitudes, which have been shown to improve with training. This study presents data collected at formal trainings in good psychiatric management (GPM) of BPD at several sites in the United States, Canada, Brazil, and Sweden. Three hundred twenty seven clinical professionals completed a 48-question true/false quiz testing knowledge of GPM, with a small subset (N = 33) that also completed a 13-item assessment of attitudes about BPD. Knowledge of GPM did not differ between course participants of different disciplines (e.g., psychiatry, psychology, and social work) but did differ according to level of GPM training and experience practicing GPM. Clinicians with experience working in specialty treatment programs focused on BPD scored higher than clinicians without this type of experience, but the scores of these more generalist clinicians were lower only by a few points. Using linear regression, we analyzed the association between GPM knowledge and negative clinician attitudes toward care of people with BPD. Greater knowledge of GPM was associated with decreased ratings of dislike of BPD patients, avoidance of treating them, and hopelessness about their prognosis.

Borderline personality disorder (BPD) is a psychiatric condition characterised by pervasive patterns of thinking and feeling, which can lead to social dysfunction and poor mental health. BPD has a significant impact not just on individuals with the diagnosis but also on those around them. Currently, no medication is licenced for BPD. Despite this, it is common for people with BPD to be prescribed multiple psychotropics. All psychotropic medications are associated with adverse events. A systematic review was conducted to explore factors that influence prescribing in adult BPD patients. Searches were conducted of EMBASE, PsycINFO, PubMed, EThOS and Web of Science. One-hundred and two unique studies were identified, of which 13 suitable studies with diverse methodologies were included in the final synthesis. Of these, seven studies produced quantitative results, whereas the remaining six produced qualitative results. The synthesis identified several demographic factors statistically associated with prescribing. Most notably, prescribing was more likely in older patients and those with comorbid conditions. In addition to demographic factors identified, two key themes were generated from analysis of qualitative data from both healthcare professionals (HCPs) and patients discussing drivers: that the patient-HCP relationship and the care pathway are crucial to the prescribing process from both perspectives. Prescribing medications for BPD is common, but there is limited data on the factors that affect this prescribing choice. HCPs must be aware of their own roles and perceptions in their relationships with BPD patients so that patients receive the most suitable treatment.

Generative artificial intelligence (GAI) programs can identify symptoms and make recommendations for treatment for mental disorders, including borderline personality disorder (BPD). Despite GAI's potential as a clinical tool, stereotypes are inherent in their algorithms but not obvious until directly assessed. Given this concern, we assessed and compared GAIs' (ChatGPT-3.5, 4, and Google Gemini) symptom recognition and public stigma for a woman and man vignette character with BPD. The GAIs' responses were also compared to a sample of mental health care practitioners (MHCPs; n = 218). Compared to MHCPs, GAI showed more empathy for the characters. GAI were also less likely to view the characters' mental health symptoms as developmental stage problems and rated these symptoms as more chronic and unchangeable. The GAI also rated the vignette characters as less trustworthy and more likely to have difficulty forming close relationships than the MHCPs. Across GAI, gender biases were found with Google Gemini showing less empathy, more negative reactions, and greater public stigma, particularly for a woman with BPD, than either ChatGPT-3.5 or ChatGPT-4. A woman with BPD was also rated as having more chronic mental health problems than a man by all GAI. Overall, these results suggest that GAI may express empathy but reflects gender bias and stereotyped beliefs for people with BPD. Greater transparency and incorporation of knowledgeable MHCPs and people with lived experiences are needed in GAI training to reduce bias and enhance their accuracy prior to use in mental health applications.

Nonsuicidal self-injury (NSSI) and borderline personality disorder (BPD) are serious mental health problems that may have common developmental pathways. Adverse childhood environments coupled with trait impulsivity and emotion dysregulation purportedly increase the risk of NSSI and BPD. The primary aim of this study was to examine the association of these risk factors with NSSI and BPD over a 1-year period among young adults (N = 229; aged 18-35; 75.5% female). Participants completed measures of relevant variables at baseline and every 3 months over 12 months. Hypotheses were that emotion regulation difficulties would mediate the association of childhood maltreatment with NSSI and BPD and that impulsivity would moderate the association of childhood maltreatment with ERD. Findings from multilevel modelling analyses indicated that emotion regulation difficulties mediated the association of childhood maltreatment with both NSSI and BPD. Contrary to hypotheses, impulsivity did not moderate the association of childhood maltreatment with emotion regulation difficulties. These findings highlight the importance of emotion regulation difficulties in NSSI and BPD among young adults.

Individuals with Borderline Personality Disorder (BPD) are frequent users of mental health services and may be perceived negatively by mental health professionals. Educational training has been associated with improved attitudes towards individuals with this diagnosis, but few interventions have been delivered in collaboration with lived experience experts. This study evaluated an educational intervention for mental health professionals that was delivered with lived experience experts. The impact of the training on staff attitudes, namely personal competence, empathy and treatment optimism was examined. Professionals in South Australian public sector health and community-based services attended a 1-day training on Foundation Skills for working with individuals with BPD. Each session was co-delivered with a lived experience expert. Participants (N = 694) completed a brief survey to assess staff attitudes, namely personal competence, empathy and treatment optimism towards people with BPD pre- and post-training. They also provided open-ended feedback about what they liked most and least about the training. Personal competence, empathy and treatment optimism were significantly improved post-training. Participant characteristics related to experience and familiarity with BPD were key factors associated with training outcomes. The findings provide support for training delivered collaboratively with lived experience experts. Further research is needed to determine to what extent the lived experience perspective contributed to training outcomes.

This critical literature review explores the barriers that individuals with borderline personality disorder face when engaging in compassionate acts, including self-compassion, receiving compassion from others and expressing compassion towards others. Borderline personality disorder is characterised by emotional instability, impulsive behaviours and difficulties in maintaining stable relationships. Although compassionate acts are known to enhance recovery and well-being, individuals with borderline personality disorder often struggle with these behaviours. This review identifies several key barriers, including adverse childhood experiences, stigma and systemic discrimination, known as sanism, and internal challenges such as self-judgement, shame and fear of compassion. By synthesising findings from 29 studies, this review highlights the complex interplay between these factors and their impact on the ability of individuals with borderline personality disorder to engage in compassionate behaviours. The findings emphasise the need for personalised, trauma-informed therapeutic interventions and broader societal changes to foster a more compassionate environment for individuals with borderline personality disorder. Future research should focus on longitudinal studies, inclusion of individuals with lived experiences and exploring diverse sources of compassion to enhance understanding and support recovery in this population.

Stigma and discrimination towards those with a mental disorder are prevalent. This is especially true of those with a personality disorder (PD). The current study explores the extent to which individuals living with a PD experience internalized stigma and discrimination due to their diagnosis as well as the prevalence of self-reported microaggressions and negative attitudes towards individuals with PDs by mental health providers. Individuals with personality disorders (n = 218; Sample 1) and mental health providers (n = 75; Sample 2) were recruited online via postings on social media, online forums, and email listservs. Individuals with PDs endorsed several factors of internalized stigma including alienation, social withdrawal, stereotype endorsement, stigma resistance, and reported significant discriminatory experiences. Results also showed that provider attitudes towards those with PDs are mixed but they largely rejected microaggressions, apart from negative reactions, and appeared aware of the negative consequences of mental health stigma. However, providers may appear patronizing when providing unwanted advice to those with a mental illness. By gaining a better understanding of the experiences of individuals living with a PD and those who treat them, we can more effectively counter harmful stigmatization and discrimination.

Borderline personality disorder (BPD) is disproportionately diagnosed among sexual and gender minority (SGM) individuals relative to cisgender heterosexuals. However, research aimed at understanding the reasons for this disparity is scarce. The current study employed a mixed-methods design to understand how mental healthcare providers' justifications for the BPD diagnosis differ based on the SGM status of the patient described and their own professional backgrounds. Two hundred seventy-one providers who were randomly assigned to one of three identical vignette conditions, with SGM status manipulated, indicated their agreement with the BPD diagnosis and explained the reason for their agreement. Results from thematic content analyses illustrated that providers referenced three themes when explaining their agreement with the BPD diagnosis: (1) BPD as provisional, (2) BPD as certain, and (3) BPD criteria met. Providers referenced a greater variety of themes to explain their disagreement with the diagnosis: (1) situational factors, (2) insufficient time course, (3) diagnostic criteria unmet, (4) insufficient assessment information, (5) differential diagnosis, (6) developmental immaturity, and (7) stigma concerns. None of these justifications were differentially employed based on the SGM status of the vignette. However, differences were observed based on providers' backgrounds; psychologists more frequently cited concerns about time course, developmental immaturity, and having insufficient assessment information than psychiatrists, counselors, and social workers in disagreeing with the BPD diagnosis. Implications for reducing BPD diagnostic bias are discussed.