Personality and Mental Health最新文献

Narcissistic personality disorder (NPD) is widely thought to be highly stigmatized; however, little empirical research has characterized this stigma. In this investigation, we draw on seminal theories and constructs from the stigma literature to improve the field's understanding of NPD stigma across stigma levels (individual, interpersonal, and structural) and dimensions (concealability, origin, course, disruptiveness, aesthetics, and peril). Participants were mental health clinicians (N = 9) with experience treating NPD. Participants completed semistructured qualitative interviews exploring their observations of NPD stigma. Interview questions were guided by existing stigma frameworks. Responses were then coded thematically using inductive and deductive techniques. Results are reported by theme. Overall, clinicians agreed that NPD was a highly stigmatized disorder in both public and healthcare settings. NPD stigma was consistently reported at the individual, interpersonal, and structural levels and was most salient in the dimensions of course, origin, and peril. Stigma is thought to be a central barrier to diagnosing and treating NPD. More research and clinician education are critical next steps in reducing stigma. This investigation represents an important step forward in the characterization and conceptualization of NPD stigma. Additional work is needed to understand the experience of NPD stigma from the perspective of patients, further quantify potential mental health implications, and identify opportunities for stigma intervention.

Prior research has shown that people with borderline personality disorder (BPD) face functional impairments due to the severity of BPD symptomatology. These issues extend to the workplace, where people with BPD experience more negative workplace outcomes than healthy workers. Our study contributes to this literature by utilizing stigma theory to examine the role of stigma in occupational stress and work precarity on a nonclinical sample of employees with a reported BPD diagnosis (N = 159) and those with other disorders (N = 202). Specifically, we find that compared to employees with other mental disorders, employees with a reported BPD diagnosis experienced increased occupational stress and work history and reduced working hours and wages, and that these effects are partially explained by increases in workplace stigmatization. These findings demonstrate the role that stereotypes and prejudice can play in hindering the workplace experiences of employees with BPD.

Self-stigma occurs when a person with a mental illness internalises the negative stereotypes and attitudes associated with their condition, which can lead to reduced help-seeking and social withdrawal. Previous research has demonstrated high levels of professional stigma towards people with personality disorder, but in contrast to mental disorders such as anxiety and depression, very little is known about self-stigma in people with personality disorder. We conducted an online, cross-sectional survey of 1009 people who had received a diagnosis of personality disorder, anxiety or depression to compare levels of self-stigma and identify associated factors. We assessed self-stigma using the Internalised Stigma of Mental Illness Scale-9 and demographic and clinical factors including level of personality disturbance, invalidating childhood experiences and depressive symptoms. In multilevel analysis, people diagnosed with personality disorder did not have higher levels of self-stigma than those with anxiety and depression. Levels of self-stigma were higher among those with higher levels of personality disturbance, depression and invalidating childhood experiences. These findings highlight the importance of personality disturbance in the development of self-stigma and the need for interventions to increase mental health literacy in this area.

Borderline personality disorder (BPD) is characterized by frequent and intense conflict in intimate relationships. Emerging theoretical perspectives have suggested that communication from both individuals with BPD and their partners during times of conflict may exacerbate BPD pathology and therefore reflect an important target for intervention. Communication samples between individuals with BPD and their partners (N = 18 couples) who were seeking conjoint therapy were coded using the Rapid Marital Interactions Coding System-2. No differences were found in the amount of positive, constructive or hostile communication between individuals with BPD and their partners, and both partners used significantly more constructive communication than positive or hostile, though they were misaligned in their use of constructive communication. These findings challenge the notion that individuals with BPD communicate in a more hostile or conflictual way than their partners, despite the stigma they face in healthcare and community settings.

Developmental psychopathology models, like the mentalization theory, have facilitated the theoretical understanding of trajectories that contribute to the expression and experience of borderline personality (BP) features. Mentalization theory posits that BP vulnerabilities and interpersonal difficulties arise from insecure attachment experiences and deficits in mentalizing ability. This study explored the intersections of attachment vulnerabilities in close relationships, mentalizing domains, and their combined impact on BP features and interpersonal competence in emerging adults. The sample included 742 emerging adults (18-25 years) from colleges across 23 Indian states, who completed an online survey measuring relationship-specific attachment anxiety and avoidance (mother, father, best friend), mentalization (self-related, other-related, motivation to mentalize), BP features, and interpersonal competence. Path analysis was conducted to examine (a) the association between relationship-specific attachment dimensions and BP features/interpersonal competence and (b) mentalization as a mediator. Attachment anxiety and avoidance in specific relationships were found to have direct positive effects on BP features and direct negative effects on interpersonal competence. However, the strength and significance of these effects were not similar across relationships, shedding light on unique contributions of relationship-specific attachment difficulties on BP features and interpersonal competence. Mentalization mediated these associations, with self-related mentalization uniquely affecting BP features and other-related mentalization influencing interpersonal competence. The findings underscore the importance of relationship-specific attachment and mentalization domains in BP vulnerabilities among emerging adults. They provide empirical support for developing targeted mentalization-based interventions to enhance self and interpersonal functioning.

Reports of sex and age differences in the presentation of borderline symptoms have been limited to the Western literature and have not systematically compared adolescents with emerging and older adults with borderline personality disorder (BPD). This study aimed to examine the impact of age and sex on the expression of borderline symptoms in adolescents, young adults, and older adults with BPD. A sample of 493 Iranian individuals with a confirmed diagnosis of BPD was segregated into 2 age groups: 134 young people aged 12-25 (mean = 17.60), and 142 adults aged 26 and older (mean = 31.69). Young people were divided into: 241 adolescents (mean = 15.59) and 100 young adults (mean = 22.45). Older groups compared with their younger counterparts showed significantly greater severity of borderline symptoms and greater difficulties with emotion regulation, but younger groups showed greater emotional and behavioral dysregulation. Sex differences generally mirrored those reported in the Western literature. Despite being limited by its cross-sectional design, this study suggests that adolescents, young adults, and older adults differ significantly in the way their borderline symptoms are expressed. The development of gender identity in adolescents with BPD and a disturbed sense of self is a neglected but potentially fruitful area of future research.

Assessing dark personality traits with self-reports may be hampered by biases such as socially desirable responding. To address this, observer reports could be an effective complement or alternative to self-reports. This meta-analysis aimed to investigate the correlations of observer reports of the Dark Triad and Dark Tetrad traits with these traits' self-reports. A comprehensive search in PubMed, Web of Science, Scopus and PsycINFO yielded 24 studies that met the inclusion criteria (with 32 effect sizes) and included the assessment of at least one of the dark traits. Results showed positive self-observer correlations of medium-high magnitude for psychopathy (r = 0.47) and of medium magnitude for narcissism and Machiavellianism (respectively, r = 0.44 and 0.41). In addition, for Machiavellianism and psychopathy, it was shown that the better acquainted the observer and the observed, the higher the self-observer correlations. For sadism, no results could be obtained because only one study included the assessment of this trait. This is the first meta-analysis of inter-rater agreement in assessing the Dark Tetrad. The findings suggest that observer reports could be a supplement or even be alternatives to self-reports when assessing the Dark Tetrad traits.

Background: This study aimed to adapt and evaluate the psychometric properties of the PID5BF + M as a brief measure for assessing DSM-5 and ICD-11 personality disorder traits in Iranian drug users. The sample consisted of 380 participants, including both clinical (28.68%) and nonclinical (71.32%) groups, with 43.7% female participants. All participants completed the Personality Inventory for DSM-5 and ICD-11 Brief Form-Modified (PID5BF + M), the Symptom Checklist-25 (SCL-25), the Brief Five-Factor Inventory (BFI-10), the Level of Personality Functioning Scale-Brief Form (LPFS-BF 2.0), and the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST).

Results: The findings revealed that the PID5BF + M demonstrates strong psychometric properties, with a six-factor structure that is culturally appropriate for the Iranian population. Significant associations were found between the ICD-11/DSM-5 traits and both internalizing and externalizing symptoms, as well as with normal personality factors.

Conclusions: The PID5BF + M appears to be a valid and reliable tool for assessing DSM-5 and ICD-11 personality disorder traits in Iranian drug users, showing promising potential for use in clinical and research settings within this cultural context.

Given the lack of sufficient studies exploring the nature of sleep problems from the perspective of the alternative model of personality disorders (AMPD) proposed by the DSM-5, the present study is aimed at determining the associations between five trait domains such as negative affectivity and sleep problems (insomnia, parasomnia, hypersomnia, circadian rhythm sleep disorder, restless legs syndrome, and sleep-disordered breathing) in an adult population. Adults aged 18-65 from western Iran were invited to the study via virtual platforms (N = 928; 62% female) and responded online to the Brief Form of Personality Inventory for DSM-5 and the Holland Sleep Disorder Questionnaire to assess sleep problems. The regression analyses indicated that the AMPD trait domains could significantly predict both specific sleep problems (R² ranges from 0.13 to 0.17; all p ≤ 0.001) and total score of sleep problems (R² = 0.23; p < 0.001). Psychoticism (β ranges from 0.26 to 0.39; all p < 0.001) and negative affectivity (β ranges from 0.14 to 0.29; all p ≤ 0.002) were the strongest specific domains associated with all sleep problems. The findings highlighted links between maladaptive domains of the AMPD and multiple sleep problems. The unique profiles of each sleep problem are useful in selecting treatments tailored to specific sleep problems in adults.

This paper examines the prevalence and comorbidity of complex post-traumatic stress disorder (CPTSD) and borderline personality disorder (BPD) among individuals with probable personality disorder, using baseline data from the Structured Psychological Support clinical trial. The clinical characteristics and personality functioning of participants are summarised and compared between those meeting criteria for BPD, CPTSD, both or neither condition. Among 292 participants, 97% reported significant trauma exposure, and over half met the criteria for CPTSD. Those with CPTSD exhibited higher levels of social dysfunction and depression compared with those with BPD, despite both groups showing elevated emotion dysregulation and anxiety. Comorbidity of CPTSD and BPD was high, with 50% of the sample meeting criteria for both conditions. Participants with comorbid CPTSD and BPD displayed poorer baseline scores across all measures of mental health and functioning than those who met criteria for BPD alone. No statistically significant differences were found in suicidal behaviour or treatment-seeking between groups. There were no significant differences in International Classification of Diseases-11 personality trait domains between participants with CPTSD and BPD, but people with comorbid CPTSD and BPD displayed higher levels of trait negative affectivity than those with BPD alone. The findings highlight the need for trauma-informed assessments in clinical settings and a better understanding of the impact of CPTSD on treatment outcomes for people with personality disorder, including how existing treatments may need to be modified to better meet the needs of people with these highly comorbid conditions. TRIAL REGISTRATION: Current controlled trials ISRCTN13918289 (registered 11/11/2022).