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Preliminary Steps Toward Extracting the Specific Alternative Model for Personality Disorders Diagnoses From Criteria A and B Self-Reports. 从标准A和B自我报告中提取人格障碍诊断的特定替代模型的初步步骤。
IF 2.3 3区 医学 Q3 PSYCHIATRY Pub Date : 2022-08-01 Epub Date: 2022-01-05 DOI: 10.1521/pedi_2012_35_541
Dominick Gamache, Philippe Leclerc, Maude Payant, Kristel Mayrand, Marie-Chloé Nolin, Louis-Alexandre Marcoux, Stéphane Sabourin, Marc Tremblay, Claudia Savard

The Alternative DSM-5 Model for Personality Disorders (AMPD) retains six specific personality disorders (PDs) that can be diagnosed based on Criterion A level of impairment and Criterion B maladaptive facets. Those specific diagnoses are still underresearched, despite the preference expressed by most PD scholars for a mixed/hybrid classification. This study explores the possibility of using Criterion A and B self-report questionnaires to extract the specific AMPD diagnoses. Plausible prevalence estimates were found in three samples (outpatient PD, private practice, community; N = 766) using the facet score ≥ 2 and t score > 65 methods for determining the presence of a Criterion B facet; diagnoses had meaningful correlations with external variables. This study provides evidence-albeit preliminary-that the extraction of the specific AMPD PDs from self-report questionnaires might be a viable avenue. Ultimately, it could promote the use and dissemination of those diagnoses for screening purposes in clinical and research settings.

DSM-5人格障碍替代模型(AMPD)保留了六种特定的人格障碍(pd),可以根据标准A水平的损害和标准B的适应不良方面进行诊断。尽管大多数PD学者倾向于混合/混合分类,但这些特定的诊断仍未得到充分研究。本研究探讨了使用标准A和B自我报告问卷来提取特定AMPD诊断的可能性。在三个样本(门诊PD、私人诊所、社区;N = 766),采用关节突评分≥2和t评分> 65的方法确定B标准关节突的存在;诊断结果与外部变量有显著相关。这项研究提供了证据——尽管是初步的——从自我报告问卷中提取特定的AMPD pd可能是一个可行的途径。最终,它可以促进这些诊断在临床和研究环境中用于筛查目的的使用和传播。
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引用次数: 5
Why, How, and When to Integrate Narrative Identity Within Dimensional Approaches to Personality Disorders. 为什么,如何以及何时将叙事身份整合到人格障碍的维度方法中。
IF 2.3 3区 医学 Q3 PSYCHIATRY Pub Date : 2022-08-01 Epub Date: 2022-01-05 DOI: 10.1521/pedi_2012_35_540
Majse Lind, Carla Sharp, William L Dunlop

Researchers and clinicians are beginning to adopt dimensional approaches in the study and treatment of personality disorders (PD). Although dimensional approaches in the DSM-5 and ICD-11 hold considerable benefit, they need to better incorporate an appreciation of individuals' life stories, or narrative identities. Doing so will be necessary to flesh out the emphasis that both frameworks place on the role of identity in personality pathology. In this article, the authors review why, how, and when narrative identity theory and research can be integrated within dimensional approaches to PD. The authors describe established ways to assess narrative identity, review extant research on this construct in relation to PD, and signal areas crucial for future research. Stories lie at the heart of what it means to be human. The authors conclude that a greater consideration of the ways in which the self is storied can help further understanding and treatment of PD.

研究人员和临床医生开始在人格障碍(PD)的研究和治疗中采用维度方法。尽管DSM-5和ICD-11中的维度方法具有相当大的好处,但它们需要更好地纳入对个人生活故事或叙事身份的欣赏。这样做将有必要充实这两个框架对身份在人格病理学中的作用的强调。在本文中,作者回顾了叙事身份理论和研究为什么、如何以及何时可以整合到PD的维度方法中。作者描述了评估叙事身份的既定方法,回顾了与PD相关的现有研究,并指出了未来研究的关键领域。故事是人类意义的核心。作者得出结论,更多地考虑自我故事的方式可以帮助进一步理解和治疗PD。
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引用次数: 4
Prevalence of Personality Disorders Across Veteran Samples: A Meta-Analysis. 退伍军人人格障碍患病率:荟萃分析。
IF 2.3 3区 医学 Q3 PSYCHIATRY Pub Date : 2022-06-01 DOI: 10.1521/pedi.2022.36.3.339
Emily R. Edwards, Hannah Tran, Joseph Wrobleski, Yocheved Rabhan, Justin Yin, Catarina Chiodi, M. Goodman, Joseph C. Geraci
Despite priorities around mental health, Veteran health care organizations have historically considered personality disorders to be preexisting conditions ineligible for disability benefits. However, growing evidence suggests potentially elevated prevalence of these disorders among military and Veteran samples and attests to implications of risk. The current study provides a meta-analytic review of literature on the prevalence of personality disorders in Veteran samples. Analysis of 27 unique samples, comprising 7,161 Veterans, suggests alarmingly high rates of Veteran personality disorders. Prevalence was highest for paranoid (23%) and borderline (21%) personality disorders and lowest for histrionic (0.8%) personality disorder. Rates were generally highest among Veterans experiencing substance use or elevated suicide risk and among studies establishing diagnoses through clinical interview (versus official medical record review). Results attest to the need for Veteran health care organizations to acknowledge personality disorders in this population, through both research and treatment, and to consider reclassifying personality disorders as potential "service-connected conditions."
尽管优先考虑心理健康,但退伍军人医疗保健组织历来认为人格障碍是不符合残疾福利条件的先存疾病。然而,越来越多的证据表明,这些疾病在军人和退伍军人样本中的患病率可能会上升,并证明了风险的影响。目前的研究对退伍军人样本中人格障碍患病率的文献进行了荟萃分析综述。对包括7161名退伍军人在内的27个独特样本的分析表明,退伍军人人格障碍的发生率高得惊人。偏执型(23%)和边缘型(21%)人格障碍的患病率最高,表演型(0.8%)人格障碍患病率最低。在经历药物使用或自杀风险升高的退伍军人中,以及通过临床访谈(与官方医疗记录审查相比)确定诊断的研究中,自杀率通常最高。研究结果证明,退伍军人医疗保健组织需要通过研究和治疗来承认这一人群中的人格障碍,并考虑将人格障碍重新归类为潜在的“服务相关疾病”
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引用次数: 2
Factor Convergence and Predictive Analysis of the Five Factor and Alternative Five Factor Personality Models with the Five-Factor Personality Inventory for ICD-11 (FFICD). ICD-11 (FFICD)五因素人格量表的五因素和备选五因素人格模型的因素收敛与预测分析
IF 2.3 3区 医学 Q3 PSYCHIATRY Pub Date : 2022-06-01 DOI: 10.1521/pedi_2021_35_542
A. Aluja, M. Sorrel, L. F. García, Ó. García, F. Gutiérrez
The authors analyze and compare the factor convergence and predictive power of the Revised NEO Personality Inventory (NEO-PI-R) and the Zuckerman-Kuhlman-Aluja Personality Questionnaire (ZKA-PQ/SF) with respect to the Five-Factor Personality Inventory for ICD-11 (FFiCD). A total of 803 White Spanish subjects were analyzed. All the personality domains had significant predictive power with regard to the FFiCD except NEO Openness. The explained variance of the personality domains with respect to FFiCD Negative Affectivity (71% and 77%) and Detachment (56% and 56%) were similar for NEO-PI-R and ZKA-PQ/SF, respectively, but the NEO-PI-R accounted for greater variance for FFiCD Anankastia, Dissociality, and Disinhibition. The FFiCD facets of Rashness, Thrill- Seeking (Disinhibition), and Unassertiveness (Detachment) were located in factors other than those theoretically expected. The authors conclude that normal personality measured by the NEO-PI-R and the ZKA-PQ/SF contribute, in a differential but complementary way, to knowledge of the maladaptive personality measured by the FFiCD.
作者分析并比较了修订的近地天体人格量表(NEO-PI-R)和Zuckerman-Kuhlman-Aluja人格问卷(ZKA-PQ/SF)与ICD-11五因素人格量表的因子收敛性和预测力。共对803名西班牙白人受试者进行了分析。除NEO开放性外,所有人格领域对FFiCD都具有显著的预测能力。NEO-PI-R和ZKA-PQ/SF的人格域在FFiCD负性情感(71%和77%)和分离(56%和56%)方面的解释方差分别相似,但NEO-PI-R对FFiCD Anankastia、Dissociality和Dishibitotion的解释方差更大。Rashness、Thrill-Seeking(去抑制)和Unassertive(超然)的FFiCD方面位于理论预期之外的因素中。作者得出结论,通过NEO-PI-R和ZKA-PQ/SF测量的正常人格以一种不同但互补的方式有助于了解通过FFiCD测量的不适应人格。
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引用次数: 0
Childhood Maltreatment and Borderline Personality Disorder: The Mediating Role of Difficulties with Emotion Regulation. 儿童虐待与边缘型人格障碍:情绪调节困难的中介作用。
IF 2.3 3区 医学 Q3 PSYCHIATRY Pub Date : 2022-06-01 DOI: 10.1521/pedi.2022.36.3.264
Nina Bertele, A. Talmon, J. Gross, C. Schmahl, Marius Schmitz, I. Niedtfeld
Exposure to childhood maltreatment (CM) increases the risk of developing borderline personality disorder (BPD). However, it remains unclear what mechanisms might mediate this link. One candidate of interest is difficulties with emotion regulation. This study aims to examine the pattern of relations among CM, difficulties with emotion regulation, and the risk of developing BPD. A total of 162 individuals diagnosed with current BPD and 162 matched healthy controls completed self-reported questionnaires assessing CM and difficulties with emotion regulation. The authors found high correlations between CM and BPD diagnosis (r = .73, p < .001). Difficulties with emotion regulation were found to mediate the link between CM and BPD diagnosis (p < .001). Results suggest that CM may play a key role in the etiology of BPD and that difficulties with emotion regulation might be a mediating component between CM and BPD.
暴露于儿童虐待(CM)增加了发展边缘型人格障碍(BPD)的风险。然而,目前尚不清楚是什么机制介导了这种联系。一个有趣的候选是情绪调节困难。本研究旨在探讨情感障碍、情绪调节困难与患BPD风险之间的关系模式。共有162名诊断为当前BPD的个体和162名匹配的健康对照者完成了评估CM和情绪调节困难的自我报告问卷。作者发现CM与BPD诊断之间存在高度相关性(r = 0.73, p < 0.001)。发现情绪调节困难介导CM与BPD诊断之间的联系(p < 0.001)。结果表明,CM可能在BPD的病因中起关键作用,情绪调节困难可能是CM与BPD之间的中介成分。
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引用次数: 2
Psychopathic Personality in Early Childhood: A Critical Comment on Lopez-Romero et al. (2021). 儿童早期的精神病人格:对Lopez-Romero等人(2021)的批判性评论。
IF 2.3 3区 医学 Q3 PSYCHIATRY Pub Date : 2022-06-01 DOI: 10.1521/pedi.2022.36.3.249
J. Dvoskin, S. Golding, K. Heilbrun, E. Cauffman, D. DeMatteo, J. Edens, S. Hart, E. Mulvey, Jennifer L Skeem, Jodi L. Viljoen, G. Vincent
A recent article published in the Journal of Personality Disorders (López-Romero et al., 2021) described the identification of "putative psychopathic personality" in a school cohort of 3-6-year-old children from Spain. This comment offers cautionary considerations of the original article on scientific grounds and critical comments on policy grounds. We caution researchers, policymakers, attorneys, judges, and the general public about the dangers of using this label given present knowledge about the antecedents, early indicators, and stability of the adult disorder of psychopathic personality when assessed in childhood.
最近发表在《人格障碍杂志》(López-Romero et al., 2021)上的一篇文章描述了对西班牙一群3-6岁儿童的“假定精神病人格”的识别。这个评论提供了对原始文章的科学依据的谨慎考虑和对政策依据的批判性评论。我们提醒研究人员、政策制定者、律师、法官和公众注意使用这个标签的危险,因为目前对儿童时期评估的成人精神病态人格障碍的前因、早期指标和稳定性有了解。
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引用次数: 1
Transdiagnostic Associations With Interpersonal and Affective Variability in Borderline Personality Pathology. 边缘型人格病理学中人际和情感变异性的跨诊断关联。
IF 2.3 3区 医学 Q3 PSYCHIATRY Pub Date : 2022-06-01 DOI: 10.1521/pedi.2022.36.3.320
Whitney R Ringwald, Michael N Hallquist, Alexandre Y Dombrovski, Aidan G C Wright

Emotional and behavioral variability are unifying characteristics of borderline personality disorder (BPD). Ambulatory assessment (AA) has been used to quantify this variability in terms of the categorical BPD diagnosis, but evidence suggests that BPD instead reflects general personality pathology. This study aimed to clarify the conceptualization of BPD by mapping indices of variability in affect, interpersonal behavior, and perceptions of others onto general and specific dimensions of personality pathology. A sample of participants who met diagnostic criteria for BPD (n = 129) and healthy controls (n = 47) reported on their daily interactions during a 21-day AA protocol. Multilevel SEM was used to examine associations between shared and specific variance in maladaptive traits with dynamic patterns of functioning. The authors found that variability is an indicator of shared trait variance and Negative Affectivity, not any other specific traits, reinforcing the idea that BPD is best understood as general personality pathology.

情绪和行为变异是边缘型人格障碍(BPD)的统一特征。动态评估(AA)已被用于量化BPD分类诊断的可变性,但有证据表明,BPD反映的是一般的人格病理。本研究旨在通过将情感、人际行为和他人感知方面的变异性指数映射到人格病理学的一般和特定维度来阐明BPD的概念。符合BPD诊断标准的参与者样本(n = 129)和健康对照(n = 47)报告了他们在21天AA方案中的日常互动情况。多水平扫描电镜被用来检查共享和特定变异的不适应性状与动态功能模式之间的关系。作者发现,可变性是共同特征变异和消极情感的一个指标,而不是任何其他特定特征,这加强了BPD最好被理解为一般人格病理学的观点。
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引用次数: 2
Associations Between Borderline Personality Disorder Symptoms and Online Self-Disclosure in Clinically Referred Youth. 青少年边缘型人格障碍症状与网上自我表露的关系
IF 2.3 3区 医学 Q3 PSYCHIATRY Pub Date : 2022-06-01 DOI: 10.1521/pedi.2022.36.3.359
Marike H. F. Deutz, Marjolein J S Lambooy, H. Vossen, O. Laceulle, M. V. van Aken, C. Hessels
Communicating online via social media has proven to facilitate disclosure of intimate topics and can therefore be helpful in the development of intimate relationships. However, for youth with borderline personality disorder (BPD) symptoms, it may be more difficult to know when, what, and to whom to disclose (i.e., effective disclosure) in online contacts. The authors examine associations between BPD symptoms, online self-disclosure, and ineffective online self-disclosure (e.g., regretting sharing something online). The sample consisted of 235 clinically referred youth (66.4% female), aged 12-25 years (M = 17.82, SD = 2.96). Structural equation modeling revealed that BPD symptoms were related to higher levels of same- and cross-sex online self-disclosure as well as to more ineffective online self-disclosure. There was no moderation by sex or age. This study suggests that youth with BPD symptoms are at risk for oversharing personal information, which could affect forming and maintaining intimate relationships and increases online risks.
事实证明,通过社交媒体进行在线交流可以促进亲密话题的披露,因此有助于亲密关系的发展。然而,对于有边缘性人格障碍(BPD)症状的青少年来说,在网络交往中,可能更难以知道何时、向谁披露什么(即有效披露)。作者研究了BPD症状、在线自我表露和无效在线自我表露(例如,后悔在网上分享某些东西)之间的联系。样本包括235名12-25岁的临床转诊青年(66.4%为女性)(M = 17.82, SD = 2.96)。结构方程模型显示,BPD症状与更高水平的同性和异性在线自我表露以及更无效的在线自我表露有关。没有性别和年龄的限制。这项研究表明,有BPD症状的青少年有过度分享个人信息的风险,这可能会影响亲密关系的形成和维持,并增加网络风险。
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引用次数: 3
Psychopathic Personality Configurations in Early Childhood: A Response to Dvoskin et al. (2022). 儿童早期的精神病人格配置:对Dvoskin等人的回应(2022)。
IF 2.3 3区 医学 Q3 PSYCHIATRY Pub Date : 2022-06-01 DOI: 10.1521/pedi.2022.36.3.254
L. López-Romero, R. Salekin, E. Romero, H. Andershed, O. Colins
Dvoskin et al. (2022) offered a cautionary comment on an article published in the Journal of Personality Disorders (López-Romero et al., 2021). This comment was focused on the scientific and policy grounds of our study, and cautioned against the use of the "putative psychopathic personality" label for applied purposes. While we agree with most of their concerns and cautions, we aim to provide additional clarification on the raised concerns, noting that the purpose of our study is purely exploratory, and that its findings are not intended for applied purposes. We do expect that our study and this commentary will further clarify the importance of examining psychopathic personality from a developmental perspective, opening new ways of discussion regarding how to best conceptualize and study a construct that, while waiting for additional longitudinal research, has been shown as relevant in identifying a group of children and adolescents at increased risk for maladjustment.
德沃斯金等人(2022)对发表在《人格障碍杂志》(López-Romero等人,2021)上的一篇文章提出了警告性评论。这一评论集中在我们研究的科学和政策基础上,并警告不要将“假定的精神病人格”标签用于应用目的。虽然我们同意他们的大部分担忧和警告,但我们的目标是对所提出的担忧提供额外的澄清,并指出我们研究的目的纯粹是探索性的,其发现并不打算用于应用目的。我们确实希望我们的研究和这篇评论将进一步阐明从发展的角度审视精神病人格的重要性,为如何最好地概念化和研究一种结构开辟新的讨论方式,在等待额外的纵向研究的同时,这种结构已被证明与识别一组儿童和青少年适应不良风险增加有关。
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引用次数: 3
Examining the Structure and Validity of Self-Report Measures of DSM-5 Alternative Model for Personality Disorders Criterion A. DSM-5人格障碍标准A备选模型自我报告量表的结构与效度检验。
IF 2.3 3区 医学 Q3 PSYCHIATRY Pub Date : 2022-04-01 Epub Date: 2021-07-21 DOI: 10.1521/pedi_2021_35_531
Chloe F Bliton, Michael J Roche, Aaron L Pincus, David Dueber

The Level of Personality Functioning Scale (LPFS) operationalizes Criterion A of the DSM-5 Alternative Model for Personality Disorders. Despite progress in LPFS measurement development and validation, there is a lack of research, and some disagreement, concerning structural, convergent, and incremental validity of LPFS self-report measures. The present study aimed to compare the LPFS Self-Report, LPFS Self-Report of Criterion A, and LPFS Brief Form. Internal structure was assessed through principal component analyses, factor analyses, and bifactor analyses of unidimensionality. Associations with both pathological and basic personality characteristics among the LPFS measures were explored. Incremental validity of LPFS severity in predicting pathological personality outcomes controlling for basic personality traits, and the reverse, were examined. Results suggest a unidimensional structure robustly associated with other pathological personality assessments. LPFS severity and basic personality traits mutually offered unique explanatory power. We discuss the implications of assessing personality pathology using LPFS self-report measures.

人格功能水平量表(LPFS)采用DSM-5人格障碍替代模型标准A进行操作。尽管在LPFS测量开发和验证方面取得了进展,但在LPFS自我报告测量的结构效度、收敛效度和增量效度方面缺乏研究,存在一些分歧。本研究旨在比较LPFS自我报告、标准A的LPFS自我报告和LPFS简要表。内部结构通过主成分分析、因子分析和单维度双因子分析进行评估。探讨了LPFS测量与病理和基本人格特征的关系。检验了LPFS严重程度在控制基本人格特质的情况下预测病理人格结局的增量效度,以及相反的增量效度。结果表明,单维结构与其他病理人格评估密切相关。LPFS的严重程度和基本人格特征相互提供了独特的解释力。我们讨论了使用LPFS自我报告方法评估人格病理学的意义。
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引用次数: 11
期刊
Journal of Personality Disorders
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