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Evaluating Dialectical Behavior Therapy Training With Mental Health Clinicians. 心理健康临床医师对辩证行为疗法培训的评价。
IF 2.3 3区 医学 Q3 PSYCHIATRY Pub Date : 2023-02-01 DOI: 10.1521/pedi.2023.37.1.95
Ansley M Bender, Ronan L H Wilson, Lisa Borntrager, Edmund W Orlowski, Kim Gryglewicz, Marc S Karver

A substantial body of research supports dialectical behavior therapy (DBT) as an evidence-based treatment for those with borderline personality disorder (BPD); however, there remains a lack of mental health clinicians trained in this modality, resulting in limited clinician competencies and skills. Furthermore, the effectiveness of DBT trainings with mental health clinicians remains understudied. The present study evaluated a comprehensive 5-day DBT-Linehan Board of Certification training program. Informed by the Theory of Planned Behavior, this study assessed changes in clinician knowledge, attitudes, perceived behavioral control (PBC), intentions, and behaviors relevant to DBT at baseline, posttraining, and 6-month follow-up. Results showed large, significant pre-to-post training improvements in clinicians' knowledge, attitudes, PBC, and intentions related to DBT implementation. Large improvements in knowledge, attitudes, and PBC were sustained at follow-up. A significant improvement in actual behaviors was also found at follow-up. Implications of the present study and directions for future research are discussed.

大量研究支持辩证行为疗法(DBT)作为边缘型人格障碍(BPD)患者的循证治疗;然而,仍然缺乏接受过这种方式培训的心理健康临床医生,导致临床医生的能力和技能有限。此外,与心理健康临床医生进行DBT培训的有效性仍有待研究。本研究评估了一个全面的为期5天的DBT-Linehan认证委员会培训计划。根据计划行为理论,本研究评估了临床医生在基线、训练后和6个月随访期间与DBT相关的知识、态度、感知行为控制(PBC)、意图和行为的变化。结果显示,在临床医生实施DBT相关的知识、态度、PBC和意图方面,岗前培训有了显著的改善。在随访中,知识、态度和PBC都有了很大的改善。在随访中也发现了实际行为的显著改善。讨论了本研究的意义和未来的研究方向。
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引用次数: 0
Construct Validity of Triarchic Model Traits in the Dunedin Multidisciplinary Health and Development Study Using the Multidimensional Personality Questionnaire. 运用多维人格问卷在达尼丁多学科健康与发展研究中构建三角模式特征的效度。
IF 2.3 3区 医学 Q3 PSYCHIATRY Pub Date : 2023-02-01 DOI: 10.1521/pedi.2023.37.1.71
Emma Veltman, Richie Poulton, Christopher J Patrick, Martin Sellbom

The triarchic model of psychopathy emphasizes the role of three phenotypic personality domains (boldness, meanness, and disinhibition) that have been operationalized using the well-established Multidimensional Personality Questionnaire. The present study sought to further validate the MPQ-Tri scales and examine their temporal stability and predictive validity across two time points (ages 18 and 26) from the Dunedin Multidisciplinary Health and Development Study, a population-representative and longitudinal sample (N = 1,037). This investigation necessitated modification of the MPQ-Tri scales to enable their use in a broader range of samples, including the Dunedin Study. The revised MPQ-Tri scales demonstrated good temporal stability, and correlation and multiple linear regression analyses predominantly revealed associations consistent with theoretical expectations. Overall, the findings provide support for the MPQ-Tri scales as reliable, stable, and valid measures of the triarchic constructs, which provide a unique opportunity to examine highly novel research questions concerning psychopathy in a wide variety of samples.

精神病的三重模型强调了三种表型人格域(大胆,卑鄙和去抑制)的作用,这些人格域已经通过完善的多维人格问卷进行了操作。本研究试图进一步验证MPQ-Tri量表,并从达尼丁多学科健康与发展研究中检验其在两个时间点(18岁和26岁)的时间稳定性和预测有效性,这是一个具有人口代表性的纵向样本(N = 1,037)。这项调查需要修改MPQ-Tri量表,使其能够在更广泛的样本范围内使用,包括达尼丁研究。修正后的MPQ-Tri量表表现出良好的时间稳定性,相关分析和多元线性回归分析主要显示了与理论预期一致的关联。总的来说,这些发现为MPQ-Tri量表作为可靠、稳定和有效的三重结构测量提供了支持,它提供了一个独特的机会,可以在各种各样的样本中检查有关精神病的高度新颖的研究问题。
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引用次数: 0
The Synergistic Effects of Neuroticism and Extraversion on Suicidal Ideation, Single Attempts, and Multiple Attempts in an Inpatient Sample. 神经质和外向性对住院病人自杀意念、单次尝试和多次尝试的协同作用。
IF 2.3 3区 医学 Q3 PSYCHIATRY Pub Date : 2022-12-01 DOI: 10.1521/pedi.2022.36.6.717
Chandler J McDaniel, Hilary L DeShong, Katrina Rufino, Michael R Nadorff

The current study sought to investigate the differential risk/protective factors of neuroticism and extraversion among individuals with only suicide ideation, those with a single suicide attempt, and those with multiple attempts. We hypothesized that extraversion would moderate the relation between neuroticism and suicide attempts (single and multiple) but not ideation. Patients in a private facility (N = 3343) completed measures assessing suicide history and general personality traits. Four moderation analyses were conducted with extraversion moderating the relationship between neuroticism and suicide ideation, single attempt (compared to zero attempts), and multiple attempts (compared to zero attempts and to single attempts). Extraversion moderated neuroticism only when comparing individuals with multiple suicide attempts to those with no attempts. Individuals who were low in both neuroticism and extraversion had higher levels of attempts than individuals with low neuroticism and high extraversion, highlighting the importance of considering biological predispositions as risk factors for suicide.

本研究旨在探讨只有自杀意念者、有一次自杀企图者和多次自杀企图者的神经质和外向性的不同风险/保护因素。我们假设外向性会调节神经质和自杀企图(单一和多重)之间的关系,但不会调节意念。私立医院的病人(N = 3343)完成了自杀史和一般人格特征的评估。对神经质与自杀意念、单次自杀企图(与零自杀企图相比)和多次自杀企图(与零自杀企图和单次自杀企图相比)之间的关系进行了四项调节分析。只有在将多次自杀企图的个体与没有自杀企图的个体进行比较时,外向性才会缓和神经质。神经质和外向性都较低的个体比神经质和外向性都较低的个体有更高的自杀企图,这突出了将生物倾向作为自杀风险因素考虑的重要性。
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引用次数: 2
Examining the Construct Validity of Borderline Personality Traits Using Familial Aggregation and Other External Validators. 用家族聚合和其他外部验证器检验边缘型人格特质的构念效度。
IF 2.3 3区 医学 Q3 PSYCHIATRY Pub Date : 2022-12-01 DOI: 10.1521/pedi.2022.36.6.641
Allison M Letkiewicz, Justin D Spring, Vivian L Carrillo, Stewart A Shankman

Numerous studies have questioned the reliability and validity of borderline personality disorder's (BPD) categorical conceptualization. DSM-5 Section III's alternative trait-based model of BPD may better capture borderline pathology, but aspects of its validity should be further established. Thus, the authors examined whether a latent BPD factor derived from Section III traits exhibits (1) familial aggregation among siblings and (2) association with constructs related to borderline pathology. The authors also tested whether gender moderated associations. A total of 498 community-recruited adults completed the Personality Inventory for DSM-5, a behavioral assessment of risk-taking, and reported their history of childhood maltreatment, substance use, nonsuicidal self-injury, and suicidal ideation. Familial aggregation was assessed among 232 sibling pairs. Siblings' BPD scores were significantly correlated and most external validators were significantly associated with BPD, with the exception of risk-taking. Results did not vary by gender. Findings further support the construct validity of Section III's BPD trait profile.

许多研究质疑边缘型人格障碍(BPD)分类概念化的可靠性和有效性。DSM-5第三部分的替代性基于特征的BPD模型可能更好地捕捉边缘性病理,但其有效性方面有待进一步建立。因此,作者研究了来自第三部分特征的潜在BPD因子是否表现出(1)兄弟姐妹之间的家族聚集性和(2)与边缘性病理相关的结构相关。作者还测试了性别是否会调节这种关联。共有498名社区招募的成年人完成了DSM-5的人格量表,这是一项冒险行为评估,并报告了他们的童年虐待史、药物使用史、非自杀性自残史和自杀意念史。对232对兄弟姐妹进行家族聚集性评估。兄弟姐妹的BPD得分显著相关,大多数外部验证者与BPD显著相关,冒险行为除外。结果没有因性别而异。研究结果进一步支持了第三部分BPD特征谱的结构效度。
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引用次数: 0
Association of Multidimensional Schizotypy with PID-5 Domains and Facets. 多维分裂型与PID-5结构域和方面的关联。
IF 2.3 3区 医学 Q3 PSYCHIATRY Pub Date : 2022-12-01 DOI: 10.1521/pedi.2022.36.6.680
Kathryn C Kemp, Jessica A Kaczorowski, Christopher J Burgin, Michael L Raulin, Donald R Lynam, Chelsea Sleep, Joshua D Miller, Neus Barrantes-Vidal, Thomas R Kwapil

The underlying vulnerability for schizophrenia-spectrum disorders is expressed across a continuum of clinical and subclinical symptoms referred to as schizotypy. Schizotypy is a multidimensional construct with positive, negative, and disorganized dimensions. The present study examined associations of positive, negative, and disorganized schizotypy with pathological personality traits and facets assessed by the Personality Inventory for DSM-5 (PID-5) in 1,342 young adults. As hypothesized, positive schizotypy was associated with the PID-5 psychoticism domain and facets, negative schizotypy was associated with the detachment domain and facets and the restricted affectivity facet, and disorganized schizotypy's strongest associations were with the distractibility and eccentricity facets and the negative affect domain. The PID-5 facets accounted for upwards of two thirds of the variance in each schizotypy dimension. The authors conclude by providing regression-based algorithms for computing positive, negative, and disorganized schizotypy scores based on the PID-5 facets.

精神分裂症谱系障碍的潜在易感性表现为连续的临床和亚临床症状,称为分裂型。精神分裂型是一个具有积极、消极和无序维度的多维结构。本研究调查了1342名年轻人的阳性、阴性和无组织分裂型与病态人格特征的关系,并通过DSM-5人格量表(PID-5)评估了这些特征。研究结果表明,积极分裂型与抑郁-5型精神状态相关,消极分裂型与分离状态相关,消极情感状态相关,无序分裂型与分心、偏心状态相关,消极情感状态相关。在每个分裂型维度中,PID-5方面占变异的三分之二以上。作者通过提供基于回归的算法来计算基于PID-5方面的阳性、阴性和无组织分裂型得分。
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引用次数: 6
The Relationship Between Patients' Personality Traits, the Alliance, and Change in Interpersonal Distress in Intensive Group Treatment for Personality Dysfunction. 人格障碍群体强化治疗中患者人格特质、联盟与人际困扰变化的关系
IF 2.3 3区 医学 Q3 PSYCHIATRY Pub Date : 2022-12-01 DOI: 10.1521/pedi.2022.36.6.731
Katie Aafjes-van Doorn, David Kealy, Johannes C Ehrenthal, John S Ogrodniczuk, Anthony S Joyce, Rainer Weber

This study examined patients' personality traits as operationalized by the five-factor model in relation to early alliance and reduction of interpersonal distress through an intensive group treatment program for personality dysfunction. A sample of 79 consecutively admitted psychiatric outpatients with personality dysfunction who attended an 18-week intensive group treatment program completed the NEO Five-Factor Inventory at pretreatment, the Inventory of Interpersonal Problems at pre- and posttreatment, and the Edmonton Therapeutic Alliance Scale, a measure of the therapeutic alliance with the program therapist, at Session 5. Results indicated that patients who were relatively extraverted tended to rate the alliance with their program therapist higher and subsequently reported more improvement of interpersonal distress. The presence of a personality disorder did not moderate this mediation. Patients' extraversion likely promotes a bonding with the therapist and facilitates the interpersonal group work necessary for improvement. Assessing patients' level of extraversion before starting intensive group treatment might indicate which intervention strategies could be useful with that patient within the program frame.

本研究通过人格功能障碍的强化团体治疗方案,考察了患者人格特质与早期联盟和减少人际困扰的关系,并采用五因素模型进行操作。79名连续入院的人格障碍精神科门诊患者参加了为期18周的强化小组治疗项目,他们在治疗前完成了NEO五因素量表,在治疗前和治疗后完成了人际问题量表,并在第5期完成了埃德蒙顿治疗联盟量表,该量表衡量了与项目治疗师的治疗联盟。结果表明,相对外向的患者倾向于评价与他们的项目治疗师的联盟,随后报告更多的人际关系困扰的改善。人格障碍的存在并没有缓和这种调解作用。患者的外向性可能促进了与治疗师的联系,并促进了改善所必需的人际团体工作。在开始强化小组治疗之前评估患者的外向性水平可能会表明哪种干预策略对该患者在方案框架内是有用的。
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引用次数: 0
Construct Validity of the Dutch, English, French, and Spanish LPFS-BF 2.0: Measurement Invariance Across Language and Gender and Criterion Validity. 荷兰语、英语、法语和西班牙语LPFS-BF 2.0的构念效度:跨语言、性别的测量不变性和标准效度。
IF 2.3 3区 医学 Q3 PSYCHIATRY Pub Date : 2022-12-01 DOI: 10.1521/pedi.2022.36.6.662
Yann Le Corff, Anton Aluja, Gina Rossi, Mélanie Lapalme, Karine Forget, Luis F García, Jean-Pierre Rolland

With the introduction of the Alternative Model of Personality Disorders in the DSM-5, the need for short measures of the level of personality functioning has emerged, both for screening purposes and for assessing change during treatment. The Level of Personality Functioning Scale-Brief Form 2.0 (LPFS-BF 2.0) was constructed for this and has received support for its two-factor structure and criterion validity. The authors aimed to provide additional construct validity evidence for the LPFS-BF 2.0 by examining its factor structure and measurement invariance across the Dutch, English, French, and Spanish versions and across gender, and its criterion validity. Results showed that the two-factor model had a good fit to the data in the four linguistic versions. Configural and metric invariance were supported across linguistic versions and gender, while scalar invariance was partially supported. Reporting a mental health disorder and having consulted with a mental health professional were associated with higher LPFS-BF 2.0 scores.

随着DSM-5中人格障碍替代模型的引入,对人格功能水平的短期测量的需求已经出现,既用于筛查目的,也用于评估治疗期间的变化。为此构建了《人格功能水平量表-简要表2.0》(LPFS-BF 2.0),其双因素结构和标准效度得到了支持。作者旨在通过检查其在荷兰语、英语、法语和西班牙语版本和性别之间的因素结构和测量不变性,以及其标准效度,为LPFS-BF 2.0提供额外的结构效度证据。结果表明,双因素模型与四种语言版本的数据拟合良好。跨语言版本和性别支持配置和度量不变性,而部分支持标量不变性。报告精神健康障碍和咨询过精神健康专业人员与更高的LPFS-BF 2.0得分相关。
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引用次数: 2
Borderline Personality Disorder Symptoms in a Community Sample of Sexually and Gender Diverse Adults. 性别和性别不同的成人社区样本中的边缘性人格障碍症状。
IF 2.3 3区 医学 Q3 PSYCHIATRY Pub Date : 2022-12-01 DOI: 10.1521/pedi.2022.36.6.701
Dominic M Denning, Rory T Newlands, Arianna Gonzales, Lorraine T Benuto

The current study aimed to identify borderline personality disorder (BPD) symptom disparities in sexually and/or gender diverse adults, determine if BPD symptoms vary across sexual orientation and gender identity, and identify factors related to BPD symptoms in this population. A sample of 218 sexually and gender diverse adults completed measures for BPD symptoms and trauma/stressors. Results suggest that sexually and/or gender diverse adults scored higher on six of the nine diagnostic criteria for BPD and were likely to have a probable BPD diagnosis, although these disparities were not observed across groups. Factors such as age, abuse and neglect and stigmatizing events were associated with more BPD symptoms, although the relationship between stigma and BPD symptoms did not remain when controlling for other factors. Results suggest that sexual orientation and gender identity are important factors when investigating BPD, and stigma may in part account for this disparity, although future research is needed.

本研究旨在确定性取向和/或性别不同的成年人的边缘性人格障碍(BPD)症状差异,确定BPD症状是否因性取向和性别认同而异,并确定该人群中与BPD症状相关的因素。218名性别和性别不同的成年人完成了BPD症状和创伤/压力源的测量。结果表明,性别和/或性别不同的成年人在BPD的九项诊断标准中的六项得分更高,并且很可能被诊断为BPD,尽管这些差异在组间没有观察到。年龄、虐待和忽视以及污名化事件等因素与更多的BPD症状相关,尽管在控制其他因素时,污名化与BPD症状之间的关系并不存在。结果表明,性取向和性别认同是调查BPD时的重要因素,尽管还需要进一步的研究,但耻辱感可能是造成这种差异的部分原因。
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引用次数: 1
Identity and Personality Pathology: A Convergence Across the DSM-5 Personality Disorder Model and the Alternative Model for Personality Disorders. 身份与人格病理学:跨DSM-5人格障碍模型和人格障碍替代模型的趋同。
IF 2.3 3区 医学 Q3 PSYCHIATRY Pub Date : 2022-10-01 DOI: 10.1521/pedi.2022.36.5.537
Alexandra L Vizgaitis, Mark F Lenzenweger

Long-standing theory regarding personality pathology as well as the recently proposed DSM-5 Alternative Model for Personality Disorders (AMPD) posit that self/identity problems are a hallmark feature cutting across forms of personality pathology. With emergence of the AMPD, researchers have started to focus empirical investigations on identity pathology as a transdiagnostic factor across personality pathology. The current study investigated identity pathology across indicators of personality pathology from both the current categorical perspective (DSM-5 PD) and the dimensional perspective in the AMPD. Identity diffusion and low self-concept clarity were correlated with all PD feature scales and all maladaptive personality dimension scales. Regression analyses revealed most indicators of personality pathology were significant correlates of identity diffusion and low self-concept clarity. Borderline and Avoidant PD feature scales and Negative Affectivity and Detachment maladaptive personality dimension scales emerged as the strongest correlates of identity pathology. The role that identity pathology plays in personality pathology is highlighted.

关于人格病理学的长期理论以及最近提出的DSM-5人格障碍替代模型(AMPD)认为,自我/身份问题是跨越人格病理学形式的一个标志性特征。随着AMPD的出现,研究人员开始关注身份病理学作为跨人格病理学的跨诊断因素的实证研究。本研究从目前的分类视角(DSM-5 PD)和AMPD的维度视角考察了人格病理指标中的身份病理。身份扩散和自我概念清晰度低与PD特征量表和适应不良人格量表相关。回归分析显示,大多数人格病理指标与身份扩散和低自我概念清晰度显著相关。边缘型和回避型PD特征量表以及消极情感和超脱适应不良人格维度量表是身份病理学的最强相关量表。强调了身份病理学在人格病理学中的作用。
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引用次数: 2
Relations Between Anxiety Sensitivity and Attachment in Outpatients With Borderline Personality Disorder. 边缘型人格障碍门诊患者焦虑敏感性与依恋的关系
IF 2.3 3区 医学 Q3 PSYCHIATRY Pub Date : 2022-10-01 DOI: 10.1521/pedi.2022.36.5.606
Jessie N Doyle, Margo C Watt, Jacqueline N Cohen, Marie-Eve Couture, MacGillivray M Smith

Borderline personality disorder (BPD) is characterized by dysregulated emotion, interpersonal relationships, and impulsivity, and is putatively linked to a known transdiagnostic risk factor, anxiety sensitivity (AS). AS is a dispositional fear of the physical, cognitive, and/or social consequences of arousal-related somatic sensations. Gratz et al. (2008) demonstrated significantly higher AS in outpatients with BPD and a predictive value of AS over and above emotion dysregulation and impulsivity. The present study sought to extend these findings with a larger sample of outpatients with BPD by investigating predictive value of AS dimensions; relations between AS and attachment style; and impact of BPD treatment on AS. Participants completed measures at three time points: pretreatment and 6 and 12 months posttreatment. AS social was the best predictor; attachment anxiety correlated positively with AS global and AS physical. AS levels significantly decreased from pretreatment to 6 months posttreatment. Clinical implications discussed include targeting AS in BPD treatment.

边缘型人格障碍(BPD)以情绪失调、人际关系失调和冲动为特征,并被认为与已知的跨诊断风险因素焦虑敏感性(AS)有关。AS是一种对与觉醒相关的躯体感觉的生理、认知和/或社会后果的性格性恐惧。Gratz et al.(2008)证明BPD门诊患者的AS明显较高,AS的预测价值高于情绪失调和冲动性。本研究试图通过调查AS维度的预测价值,在更大的BPD门诊患者样本中扩展这些发现;依恋类型与AS的关系;BPD治疗对AS的影响。参与者在三个时间点完成测量:治疗前、治疗后6个月和12个月。AS social是最好的预测因子;依恋焦虑与整体AS和肢体AS呈正相关。治疗6个月后AS水平显著降低。讨论的临床意义包括靶向AS治疗BPD。
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引用次数: 0
期刊
Journal of Personality Disorders
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