Journal of Personality Disorders最新文献

The Alternative Model for Personality Disorders identifies the level of personality functioning (LPF) as the entry criterion for personality disorder. The Level of Personality Functioning-Brief Form 2.0 (LPFS-BF 2.0) has demonstrated adequate psychometric properties, although mixed evidence on its factor structure and the lack of established clinical cutoffs limit its utility. In the present study, we first examined the factor structure of the LPFS-BF 2.0 using data from 365 young adults. Next, we examined the measure's convergent and discriminant validity, clinical utility, and cutoff score in a mixed college (n = 94) and clinical (n = 70) sample. Results revealed acceptable fit of a bifactor model with an essentially unidimensional structure and general support for convergent and discriminant validity. The LPFS-BF 2.0 distinguished those above versus below the clinical cutoff of the Semi-Structured Interview for Personality Functioning with strong sensitivity and specificity. The LPFS-BF 2.0 appears psychometrically sound and clinically useful in capturing personality dysfunction.

We aimed to investigate the relationships of ICD-11 personality disorder (PD) severity and five maladaptive personality domains with narcissistic grandiosity and narcissistic vulnerability among 398 Croatian adult psychiatric patients. They completed the following self-report questionnaires: the ICD-11 Personality Disorder Severity Scale, the Personality Assessment Questionnaire for ICD-11, and the Pathological Narcissism Inventory. Narcissistic grandiosity showed meaningful associations with the Disinhibition and Anankastia domains. Conversely, narcissistic vulnerability was significantly more strongly associated with PD severity and the Negative Affectivity domain, and it also showed meaningful associations with the Disinhibition, Anankastia, and Dissociality domains. An even more nuanced picture emerged on the facet-level of pathological narcissism, while some novel findings were obtained pertaining to gender differences in the above-mentioned relations. Future studies utilizing additional multidimensional measures of pathological narcissism and gender-sensitive assessment are warranted.

The present systematic review and meta-analysis sought to assess the internal structure and consistency of the Level of Personality Functioning Scale-Brief Form 2.0 (LPFS-BF 2.0) across different populations and cultures. Studies identified through systematic research were subjected to eligibility criteria, resulting in 30 included studies and 110 effect sizes. Study characteristics were tabulated, their methodological quality was assessed, and findings were synthesized using a random-effects meta-analysis. Findings overall supported the internal structure of the LPFS-BF 2.0 and indicated sound internal consistency for the total scale. Moderator analyses indicated that internal consistency differed minimally by index type, sample type, gender, age, country, and language. The findings overall suggest that the LPFS-BF 2.0 assesses a coherent and internally consistent construct, making it a potentially useful tool for evaluating personality functioning across diverse populations. Future investigations should further explore interrater reliability, test-retest stability, and alignment with interview-based personality disorder severity.

Patients with personality disorders (PDs) often struggle in life after treatment, even when symptomatic remission is achieved. The question arises of whether current outcome measurements are relevant for patients and people around them. To address this, we used concept mapping, a mixed-method approach, to construct a framework of recovery from the perspectives of patients, their significant others, and therapists (n = 39). Participants brainstormed what recovery involved and then prioritied and clustered these ideas (n = 61). Data were analyzed using multidimensional scaling and hierarchical cluster analysis, resulting in 45 statements grouped into four themes: understanding and recognizing yourself, regulating emotions, giving direction to your life, and connecting with others. Understanding and recognizing yourself was identified as the most important area of change. This study offers an evidence-based framework for recovery in PD, providing a foundation for developing outcome measurements that reflect the needs of patients and their significant others beyond symptom reduction.

Borderline personality disorder (BPD) is a mental health condition characterized by a pervasive pattern of impulsivity, affective dysregulation, and cognitive-perceptual symptoms. Treatment of BPD remains a significant challenge to mental health clinicians. People who suffer from BPD frequently have comorbid psychiatric disorders, which makes treatment more complex. This case study describes a course of ketamine-assisted psychotherapy (KAP) to treat a patient with co-occurring BPD and depression. KAP uses the antidepressant and psychedelic effects of ketamine embedded in a psychotherapy format to utilize the concept of an inner healing intelligence within the patient and the intersubjective relationship between patient and therapist as therapeutic factors. The positive outcomes in this case study suggest that more systematic research is warranted in the use of KAP for treatment of BPD and other personality disorders.

The linguistic equivalence of the Personality Inventory for DSM-5 (PID-5) has never been investigated using a within-subject design, that is, among bilingual individuals. Also, the stability-equivalence of the PID-5 using two linguistic versions is unknown. Thus, this within-subject, test-retest study aims at (a) establishing the measurement invariance of the PID-5 among bilinguals, and (b) providing indices of stability-equivalence using distinct versions with tight confidence intervals. Data from a sample of bilingual participants (N = 605), who were administered the PID-5 over a 1-2-week interval in French and English, were utilized. The PID-5 reached the (full) strong invariance level using longitudinal invariance analyses, indicating that the PID-5 structure is the same and that scores are interchangeable, while controlling for sampling confounds. The indices of stability-equivalence were high across traits. The PID-5 yields scores reflective of genuine differences, at least at the domain level, providing solid ground to study personality across societies.

To compare the effectiveness of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), Section II personality disorder (PD) model, and of the Alternative Model for Personality Disorders (AMPD) model in characterizing vulnerable (VN) and grandiose (GN) narcissism, a sample of clinical psychotherapy participants (N = 369) was administered the Schedule for Nonadaptive and Adaptive Personality-2, the Levels of Personality Functioning Scale-Self Report (LPFS-SR), the Personality Inventory for DSM-5, the Five-Factor Narcissism Inventory-Short Form (FFNI-SF), and the Pathological Narcissism Inventory (PNI). In multiple regression models, the LPFS-SR scales and the Personality Inventory for DSM-5 (PID-5) domain scales explained 34.6% and 23.7% more variance than the self-reports of the 10 Section II PD symptom counts in the FFNI-SF and PNI GN scores, respectively. Similarly, AMPD measures outperformed self-reported symptom counts of the 10 Section II PDs, accounting for 28.8% and 22.6% more variance in the FFNI-SF and PNI VN scale scores, respectively.

A higher prevalence of personality disorder diagnoses has been found among individuals with gender dysphoria. However, previous studies on this topic have been limited and methodologically inconsistent. The object of this research was to determine the prevalence of personality disorder diagnoses in individuals requesting medical gender reassignment. A registerbased follow-up study tracked individuals who contacted the nationally centralized gender identity services in Finland in 1996-2019 (n = 3,665) and 8:1 age- and sex-matched population controls (n = 29,292). All their specialist-level psychiatric treatment contacts in 1994-2022 were identified in the National Care Register for Health Care. ICD-10 diagnoses and dates of the contacts were extracted. Among the gender dysphoria group, 15.0% (551 out of 3,665) had received a diagnosis in the personality disorder group (F60-69 excluding F64.x), while among the control subjects, 2.1% (625 out of 29,292) had received such a diagnosis.

The aim of this study was to assess emotional dysregulation (ED) and sexual risk behavior (SRB) in borderline personality disorder (BPD) and to investigate the relationship between ED, SRB and other clinical variables. Sixty-one women with BPD and 76 healthy controls (HCs) completed: SRB Scale, DERS, Inventory of Statements About Self-Injury, SUPPS-P, HADS, Mental Pain Scale, and BPD Checklist. The BPD group exhibited higher levels of ED, SRB, psychological pain, anxiety, depression, and impulsivity than the HCs. In the BPD group, significant correlations were found between ED, SRB, and psychological pain, impulsivity, and specific dimensions of nonsuicidal self-injury (NSSI). To identify predictors of SRB, stepwise multiple regression analysis was used. The BPD model included five significant predictors accounting for 65% variability: number of sexual partners and age of sexual initiation, NSSI, impulsivity, and ED - lack of emotional clarity, while in HCs, it was influenced by alcohol misuse.

Obsessive-compulsive personality disorder is the most common personality disorder, with a prevalence of approximately 6.5% in the general population. However, little is known about the effective psychotherapy for this disorder. In this case series, we employed evolutionary systems therapy to support five adults diagnosed with obsessive-compulsive personality disorder. Evolutionary systems therapy is a novel form of psychotherapy that integrates evolutionary psychopathology, compassion-focused therapy, and metacognitively oriented treatments. Primary outcome (personality pathology) was assessed monthly from baseline to follow-up. Secondary outcomes (anxiety, depression, perfectionism, self-criticism, overcontrol) were assessed at initial and final sessions. Moreover, we evaluated the feasibility of intervention (completion, attendance, adverse events). At the end of 6 months of treatment, all the participants reported reliable changes and remitted from diagnosis. These outcomes were maintained at 1-month and 3-month follow-ups. Further research is needed to provide evidence about the acceptability of evolutionary systems therapy in the treatment of obsessive-compulsive personality disorder.