Personality and Mental Health最新文献

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.

A better understanding of psychotherapeutic change is seen as essential for further development of treatment for personality disorders. The objective of this study is to describe the psychotherapeutic change process of a client with personality disorder to develop more insight in psychotherapeutic change processes. The change process was described quantitatively from ROM data and quantitatively and qualitatively from two narrative themes, agency and communion, described from the perspectives of client and treatment team. Reliable change analyses showed decrease in personality problems and increase in personality functioning and mental well-being. Content analyses from the client perspective showed positive changes in meaning, actual behavior change, and connection with others. The treatment team noticed growth in self-management ability and in connecting with own emotions and with others. These changes resulted in an increase in agency and communion. By mapping change processes through multiple sources and perspectives, the efficacy of psychotherapeutic treatment can be better understood.

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).

Psychotherapy may contribute to the experience of meaning in life. This study investigated meaning in life among patients with personality disorders during inpatient or day-hospital psychotherapy. Meaning in life was approached from two conceptual perspectives: personality functioning with an emphasis on self-direction and existential psychology. We investigated changes in the sense of meaning in life and accounted for changes in depressive symptoms and identity and interpersonal pathology. Using pre-post measures, Livesley's General Assessment of Personality Disorder, especially, the Lack-of-Meaning-Purpose-and-Direction subscale and Steger's Meaning-in-Life Presence subscale were administered to 75 patients with personality disorders during inpatient or day-hospital psychotherapy for 8-12 months. Regression models showed that levels of the lack and presence of meaning decreased and increased during treatment, respectively, controlled for changes in depressive symptoms. Decreased identity pathology was significantly associated with changes in the lack or presence of meaning. Meaning in life may act as an outcome variable in intensive psychotherapy for personality disorders. The development of identity and self-direction may restore or create the ability to give life meaning.

This paper applies error management theory (EMT) (Haselton and Buss 2000) to explore how disruptions in epistemic trust-trust in communicated information-can be understood as adaptive responses to early adversity in individuals with borderline personality disorder (BPD). I propose that epistemic mistrust (EM) and epistemic credulity (EC), characterized by inappropriate trust patterns, arise from the differential costs of trusting unreliable versus mistrusting reliable information. Although these biases may seem maladaptive, they function as evolutionary survival mechanisms in response to harsh environments. Signal detection analysis can provide empirical evidence for these trust biases by assessing how individuals with BPD make trust-related decisions. Clinically, understanding these biases as evolutionary adaptations helps reduce stigma and informs evolutionary-informed interventions to recalibrate trust responses and improve interpersonal relationships. This approach highlights the significance of integrating evolutionary perspectives in treating trust disturbances in BPD.

More work is needed to establish the validity of the Alternative Model of Personality Disorders (AMPD) in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Acceptance of the AMPD as the primary model of personality disorder requires identifying neurocognitive validators of AMPD-defined personality functioning and demonstrating superiority of the AMPD over the traditional categorical model of personality disorder. It is also important to establish the utility of the AMPD in a developmental context given evidence that personality disorder emerges in adolescence. We assessed the incremental validity of AMPD-defined level of personality functioning (LPF) versus borderline personality features (BPF) in explaining alterations in neural processing of social acceptance feedback in early adolescent girls. One hundred nine girls (M_age = 12.21, SD = 1.21; N = 79 with a psychiatric history) completed a computerized peer interaction task to elicit neural response to social acceptance feedback via electroencephalogram (EEG). Subjects or caregivers reported adolescent psychopathology. In hierarchical regressions controlling for neural response to social rejection and internalizing and externalizing symptoms, LPF incremented BPF and all other covariates in predicting response to social acceptance, but BPF did not. Higher LPF impairment was associated with enhanced reactivity to social acceptance (St.b = 0.274, p = 0.018). LPF appears to provide additional information about neural response to social reward in early adolescence beyond that provided by borderline personality features. These findings add to an emerging literature demonstrating the validity and superiority of the AMPD and help build the rationale for moving toward the AMPD as the primary model of personality disorder classification.

Objectives: The use of Out of Area (OoA) psychiatric placements for people with "Personality Disorder" (PD) is widespread in the UK. An innovative local intensive psychotherapeutic service, adapted to the transdiagnostic presentations of the most complex PD patients, likely to be placed out of the area, was devised in the English County of Devon. This paper reports the findings of a Freedom of Information (FOI) request to commissioners attempting to quantify PD OoA placements in England and the cost offset of the local therapeutic alternative to OoA placements in Devon.

Design and methods: Data from FOI requests was combined with publicly available sources to assess the scale of OoA placements for people with PD in England. OoA service use and cost data were used to examine the cost offset and effectiveness of the local alternative to OoA placements in Devon. The results found a lack of transparency and excessive use of OoA placements despite UK Government intentions. Data from the local therapeutic service demonstrated cost-effectiveness, reducing OoA placements and increasing the availability of psychotherapeutic services. This paper suggests the number of OoA placements can be reduced for people with severe and complex PD. The local therapeutic service provides a model for future rehabilitation pathways.