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.
{"title":"Psychotherapeutic Change in Intensive Day Treatment for Personality Disorders: A Single Case Study of Quantitative and Qualitative Change in Agency and Communion.","authors":"Silvia M Pol, Elke Brok, Gerben J Westerhof","doi":"10.1002/pmh.70007","DOIUrl":"10.1002/pmh.70007","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":"19 1","pages":"e70007"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11815315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Angelien Steen, Arjan W Braam, Adriaan W Hoogendoorn, Han Berghuis, Gerrit Glas
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.
{"title":"Meaning in Life as an Outcome of Inpatient or Day-Hospital Psychotherapy for Personality Disorder.","authors":"Angelien Steen, Arjan W Braam, Adriaan W Hoogendoorn, Han Berghuis, Gerrit Glas","doi":"10.1002/pmh.70001","DOIUrl":"10.1002/pmh.70001","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":"19 1","pages":"e70001"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
本文运用错误管理理论(EMT) (Haselton and Buss 2000)来探讨认知信任的中断(对沟通信息的信任)如何被理解为边缘型人格障碍(BPD)患者对早期逆境的适应性反应。我认为,以不适当的信任模式为特征的认知不信任(EM)和认知轻信(EC),源于信任不可靠信息与不信任可靠信息的差异成本。尽管这些偏见可能看起来不适应,但它们作为应对恶劣环境的进化生存机制发挥着作用。信号检测分析可以通过评估BPD患者如何做出与信任相关的决策,为这些信任偏差提供经验证据。临床上,将这些偏见理解为进化适应有助于减少耻辱感,并为进化知情干预提供信息,以重新校准信任反应并改善人际关系。这种方法强调了在治疗BPD中信任干扰时整合进化观点的重要性。
{"title":"Disruption of Epistemic Trust in Borderline Personality Disorder: A Possible Adaptation to Avoid Making Costly Mistakes.","authors":"Yağızcan Kurt","doi":"10.1002/pmh.70006","DOIUrl":"10.1002/pmh.70006","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":"19 1","pages":"e70006"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Correspondence on \"Unveiling Public Stigma for Borderline Personality Disorder: A Comparative Study of Artificial Intelligence and Mental Health Care Providers\".","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1002/pmh.70026","DOIUrl":"https://doi.org/10.1002/pmh.70026","url":null,"abstract":"","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":"19 3","pages":"e70026"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Correction to Long-Lasting Symptoms in Borderline Personality Disorder: Defining an Emergent Population With Differential Clinical and Therapeutic Features.","authors":"","doi":"10.1002/pmh.70040","DOIUrl":"https://doi.org/10.1002/pmh.70040","url":null,"abstract":"","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":"19 4","pages":"e20000"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Agnese Zagorska, Anna Briede, Ksenija Vasiļjeva, Evija Strika, Ieva Stokenberga
This study examines the psychometric properties of the Latvian adaptation of the Level of Personality Functioning Scale-Self Report (LPFS-SR) and its alignment with the Alternative DSM-5 Model for Personality Disorders (AMPD). A clinical sample (N = 142) and a nonclinical sample (N = 306) were formed. Internal consistency, factor structure, and criterion validity were assessed to evaluate the scale's psychometric properties. Confirmatory factor analysis compared five structural models: one-factor, two-factor, four-factor, higher order, and bifactor. The bifactor model demonstrated the best fit, capturing both general and subscale-specific variance in personality functioning. Correlation and regression analyses explored associations between the LPFS-SR and the Personality Inventory for DSM-5 (PID-5). The findings support the Latvian LPFS-SR as a valid and reliable tool for assessing personality functioning and are consistent with the principles of the AMPD.
{"title":"Psychometric Properties of the Latvian LPFS-SR in Clinical and Nonclinical Samples.","authors":"Agnese Zagorska, Anna Briede, Ksenija Vasiļjeva, Evija Strika, Ieva Stokenberga","doi":"10.1002/pmh.70028","DOIUrl":"10.1002/pmh.70028","url":null,"abstract":"<p><p>This study examines the psychometric properties of the Latvian adaptation of the Level of Personality Functioning Scale-Self Report (LPFS-SR) and its alignment with the Alternative DSM-5 Model for Personality Disorders (AMPD). A clinical sample (N = 142) and a nonclinical sample (N = 306) were formed. Internal consistency, factor structure, and criterion validity were assessed to evaluate the scale's psychometric properties. Confirmatory factor analysis compared five structural models: one-factor, two-factor, four-factor, higher order, and bifactor. The bifactor model demonstrated the best fit, capturing both general and subscale-specific variance in personality functioning. Correlation and regression analyses explored associations between the LPFS-SR and the Personality Inventory for DSM-5 (PID-5). The findings support the Latvian LPFS-SR as a valid and reliable tool for assessing personality functioning and are consistent with the principles of the AMPD.</p>","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":"19 3","pages":"e70028"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Personality Functioning Is Not a Unitary Entity.","authors":"Orestis Zavlis","doi":"10.1002/pmh.70033","DOIUrl":"10.1002/pmh.70033","url":null,"abstract":"","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":"19 3","pages":"e70033"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12206940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The stigma of personality disorder is longstanding, widespread, prodigious, and harmful. Fortunately, recent advances in our understanding of personality pathology, as well as an increasing interest in stigma, have demonstrated the importance of destigmatization and have catalyzed significant research in this area. In this special issue of Personality and Mental Health, we spotlight the stigma of personality disorders to understand the current research landscape in this area, and to chart a direction for future research. Each of the nine papers included here advances our understanding of stigma, including its manifestation, impacts, and potential solutions. Collectively, they show significant progress in the study of personality disorders stigma, support the importance of destigmatizing personality pathology, and highlight pathways for future research.
{"title":"Advancing the Science and Reduction of Personality Disorders Stigma: Introduction to a Special Issue of Personality and Mental Health.","authors":"Sara R Masland, Carla Sharp","doi":"10.1002/pmh.70044","DOIUrl":"10.1002/pmh.70044","url":null,"abstract":"<p><p>The stigma of personality disorder is longstanding, widespread, prodigious, and harmful. Fortunately, recent advances in our understanding of personality pathology, as well as an increasing interest in stigma, have demonstrated the importance of destigmatization and have catalyzed significant research in this area. In this special issue of Personality and Mental Health, we spotlight the stigma of personality disorders to understand the current research landscape in this area, and to chart a direction for future research. Each of the nine papers included here advances our understanding of stigma, including its manifestation, impacts, and potential solutions. Collectively, they show significant progress in the study of personality disorders stigma, support the importance of destigmatizing personality pathology, and highlight pathways for future research.</p>","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":"19 4","pages":"e70044"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Classification of Personality Pathology.","authors":"Peter Tyrer, Roger Mulder, Carla Sharp","doi":"10.1002/pmh.70043","DOIUrl":"https://doi.org/10.1002/pmh.70043","url":null,"abstract":"","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":"19 4","pages":"e70043"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01Epub Date: 2024-09-06DOI: 10.1002/pmh.1634
Katherine M Lawson, Azad Hemmati, Farzin Rezaei, Khaled Rahmani, Saeid Komasi, Christopher J Hopwood
The present study examined the extent to which the currently established factor structure of the Personality Inventory for DSM-5 (PID-5; Krueger et al., 2013) generalizes to a large Persian community sample, as well as relations between the resulting PID-5 factors and two temperament measures. Cross-sectional data came from 946 adults (65% female) from western Iran. With the use of exploratory structural equation modeling (ESEM) with target rotation, we found factor loadings that showed fairly similar patterns to those found in two previous meta-analytic PID-5 studies with predominantly North American and European samples (Watters & Bagby, 2018; Somma et al., 2019). Despite slight differences in each of the target rotations, there were moderate congruence coefficients (~0.85) between loadings for the five PID-5 domains, with the weakest evidence supporting the Disinhibition factor. The resulting PID-5 factors showed meaningful associations with temperament domains assessed via the Temperament and Character Inventory (TCI; Cloninger, 1994) and Temperament Evaluation of Memphis, Pisa, Paris and San Diego-Autoquestionnaire (TEMPS-A; Akiskal et al., 2005). Overall, our findings suggest that the documented structure of personality pathology assessed by the PID-5 generalizes somewhat to this sample of Persian participants, and pathological personality traits show important overlap with temperament, although these constructs are meaningfully distinct.
{"title":"The structure of pathological personality traits and temperament in a Persian community sample.","authors":"Katherine M Lawson, Azad Hemmati, Farzin Rezaei, Khaled Rahmani, Saeid Komasi, Christopher J Hopwood","doi":"10.1002/pmh.1634","DOIUrl":"10.1002/pmh.1634","url":null,"abstract":"<p><p>The present study examined the extent to which the currently established factor structure of the Personality Inventory for DSM-5 (PID-5; Krueger et al., 2013) generalizes to a large Persian community sample, as well as relations between the resulting PID-5 factors and two temperament measures. Cross-sectional data came from 946 adults (65% female) from western Iran. With the use of exploratory structural equation modeling (ESEM) with target rotation, we found factor loadings that showed fairly similar patterns to those found in two previous meta-analytic PID-5 studies with predominantly North American and European samples (Watters & Bagby, 2018; Somma et al., 2019). Despite slight differences in each of the target rotations, there were moderate congruence coefficients (~0.85) between loadings for the five PID-5 domains, with the weakest evidence supporting the Disinhibition factor. The resulting PID-5 factors showed meaningful associations with temperament domains assessed via the Temperament and Character Inventory (TCI; Cloninger, 1994) and Temperament Evaluation of Memphis, Pisa, Paris and San Diego-Autoquestionnaire (TEMPS-A; Akiskal et al., 2005). Overall, our findings suggest that the documented structure of personality pathology assessed by the PID-5 generalizes somewhat to this sample of Persian participants, and pathological personality traits show important overlap with temperament, although these constructs are meaningfully distinct.</p>","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":" ","pages":"387-401"},"PeriodicalIF":2.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}