Personality disorders最新文献

The Alternative Model of Personality Disorders (AMPD) in Section III of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, text revision includes trait-based diagnostic criteria for six personality disorders (PDs). This study evaluates the predictive validity of the AMPD trait diagnostic criteria for these six PDs in capturing their Section II PD counterparts and examines whether modifications informed by meta-analytic findings (Watters et al., 2019) improve incremental validity. In community (N = 238) and community mental health samples (N = 289), we assessed Section III traits using the Personality Inventory for Diagnostic and Statistical Manual of Mental Disorders, fifth edition and Section II PDs using three different measurement methods-structured clinical interview, self-report, and informant report. A series of hierarchical regressions tested the extent to which proposed traits predicted their Section II counterparts and whether the inclusion of nondesignated traits or removal of proposed traits enhanced predictive validity. Findings confirmed that Section III proposed traits significantly predicted their corresponding Section II PDs. Results also revealed that some proposed traits failed to significantly contribute to their assigned PDs, while certain nonproposed traits improved predictive validity. Based on these results, we propose targeted, empirically informed modifications to the AMPD diagnostic trait sets to improve construct validity and clinical utility, particularly for avoidant, borderline, narcissistic, and obsessive-compulsive PDs. These findings underscore the need to refine the AMPD trait model to better capture the complexity of personality pathology. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Despite evidence for the onset of personality disorder (PD) during adolescence, few studies have examined the internal structure of the alternative model for PDs in youth. Network analysis offers a valuable alternative to factor analytic approaches by modeling the unique associations among observed indicators, allowing for identification of central features within the network of personality pathology. This preregistered, cross-sectional study used network analysis to examine links between maladaptive personality trait domains and level of personality functioning (LPF) in adolescents to identify structurally central features of adolescent PD symptomatology. A sample of 1,441 adolescents (n = 1,174 community; n = 267 clinical) completed measures of LPF (Criterion A) and maladaptive traits (Criterion B). Network analyses were conducted separately in each sample, followed by a formal network comparison test. Both networks were densely connected and demonstrated high accuracy and stability. Centrality analyses indicated that LPF domains and subdomains yielded the highest strength centrality. Network structure and global connectivity were largely invariant across the clinical and community samples. Small differences in network structure were observed between boys and girls, and between early and late adolescents, though only at the LPF subdomain level. Findings underscore the central structural role of self and interpersonal functioning (i.e., LPF) within adolescent personality pathology networks, supporting its relevance as a potential organizing framework for understanding maladaptive personality traits. The similarity in network structure across community and clinical samples further reinforces the dimensional nature of PD in adolescents. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

This study explores the structural properties of the Personality Inventory for the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, Brief Form (PID-5-BF) by applying network analysis and community detection as a data-driven alternative to traditional factor models. Traditionally, the PID-5-BF assesses personality traits across five domains-Negative Affectivity, Detachment, Antagonism, Disinhibition, and Psychoticism-but has shown notable inconsistencies in item alignment and factorial coherence. To examine these issues, data were collected from 2,766 Italian participants (71.7% female, 28.3% male, M_age = 32.94 years, SD = 13.2). The estimated network revealed a stable structure, supported by robust centrality measures (closeness = 0.59, expected influence = 0.75, strength = 0.75). Community detection identified five empirically coherent clusters-Disinhibition, Demoralization, Detachment and Irritability, Psychosocial Alienation, and Pathological Egocentrism-suggesting an alternative organization of maladaptive traits in this population. To assess generalizability, a second analysis was conducted on a Hungarian sample (N = 355), yielding a five-structure solution with different item compositions. While the network approach emphasizes item-level associations, the specific configurations varied across samples in ways that reflect contextual influences. Nonetheless, this method offers complementary insights to traditional factorial models, highlighting how personality traits may organize differently across populations and supporting the use of network-based approaches in refining dimensional models of personality pathology. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Alexithymia is a multifaceted construct encompassing difficulties identifying and describing feelings, limited imaginal capacity, and externally oriented thinking. Despite the high prevalence among borderline personality disorder (BPD) patients, less is known about symptom-level associations between alexithymia and BPD criteria. Prior studies highlight an elevated risk of self-injurious and suicidal behaviours associated with alexithymia. Understanding the symptom-level relationships with alexithymia may provide a more specific target for intervention. This study explored the associations between alexithymia and BPD symptom criteria in 478 psychiatric outpatients (n = 146 BPD, n = 196 other personality disorders, and n = 136 no personality disorder [PD]), assessed using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), and Structured Interview for DSM-IV Personality Disorders. BPD symptoms were dichotomized as present if scored ≥ 1 (definitely present). Alexithymia was measured using the Toronto Alexithymia Scale (TAS-20). Depression severity was assessed using the Beck Depression Inventory (BDI-II). Logistic regression was used to examine relationships between alexithymia and BPD symptom criteria in each group. In the BPD group, identity disturbance (p = .0013) was significantly related to alexithymia using the Benjamini-Hochberg Procedure for multiple comparisons. The association remained when controlling for depression severity. Among those without any PD, alexithymia was significantly associated with chronic feelings of emptiness (p = .0024) before controlling for depression. In BPD, alexithymia was most strongly associated with identity disturbance. Previous studies have linked alexithymia and identity disturbance to suicidality. This study is the first to identify an association between alexithymia and identity disturbance in BPD, underscoring impairments in the self and self-mentalizing a potential target for suicide prevention in BPD. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Psychoeducation, delivering up-to-date information about mental illness is crucial for supporting patients' recovery. While recognized for various disorders, its role in borderline personality disorder (BPD) lacks review. This study synthesizes the current evidence about psychoeducational interventions for BPD. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, this scoping review consulted databases (PubMed, PsychINFO, Web of Science, Cumulative Index to Nursing and Allied Health Literature, and Información Científica y Técnica en Salud de América Latina y el Caribe), and grey literature (ProQuest Dissertations and Theses Global and Google Scholar). A Complementary search (contacting relevant researchers and including relevant references from included articles) was included. Two reviewers screened and extracted the data using the Template for Intervention Description and Replication checklist. Seven studies were analyzed, and positive effects were found on diverse outcomes: BPD symptoms, coping strategies, well-being, communication, quality of life, social functioning, perceived stress, mental health symptoms, and stigma. Psychoeducational interventions for BPD can help people who experience BPD to optimize their recovery process. However, replication and improvements are to yield sustained effects and reach more to this population. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

It has been posited that extremely high or extremely low levels of any personality trait in the five-factor model can be maladaptive. However, the Alternative Model of Personality Disorders in Section III of the Diagnostic and Statistical Manual of Mental Disorders-fifth edition (DSM-5) is composed almost exclusively of unipolar maladaptive traits. The lack of maladaptively low neuroticism and high extraversion fails to fully cover psychopathy; the lack of maladaptively high extraversion fails to cover histrionic personality disorder; the lack of maladaptively high agreeableness fails to cover dependent personality disorder; and the lack of maladaptively high conscientiousness fails to cover obsessive-compulsive personality disorder. The goal of this study was to discern whether Five-Factor Model Personality Disorder (FFMPD) scales demonstrate incremental validity over the Personality Inventory for DSM-5 (PID-5) in capturing variance in symptom measures of each of these personality disorders. A combined sample of N = 733 completed an online questionnaire battery that included the PID-5 and FFMPD scales for psychopathy, histrionic personality disorder, dependent personality disorder, and obsessive-compulsive personality disorder, along with symptom measures for each of these conditions. A series of hierarchical regression models was conducted in which each symptom measure was regressed on the PID-5 (entered in Step 1) and the corresponding FFMPD measure (entered in Step 2). Results suggest that adding the FFMPD measure to the models accounted for significantly more variance in its corresponding symptom measure than the PID-5 alone. Taken together, these results suggest that maladaptive variants of personality traits that are often considered healthy (e.g., low neuroticism, high extraversion) confer important information about personality disorder symptoms and functioning and should be included in the Alternative Model of Personality Disorders. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

There are currently three models for diagnosing personality disorders for practitioners to choose from in the formal diagnostic classification systems Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD): the categorical model retained from DSM-IV, a dimensional model in the ICD-11, and the DSM-5 Alternative Model for Personality Disorders (AMPD) that is a hybrid of categorical and dimensional methods. We used a sequential mixed-methods approach to explore how psychologists and psychiatrists decide which model to use for diagnosing personality pathology. In Study 1, we elicited eight themes and seven subthemes that capture the factors that psychologists and psychiatrists (N = 18) consider when deciding whether or not to use the AMPD. In Study 2, these themes were converted to 16 statements reflecting factors that practitioners might consider when deciding which diagnostic model to use when working in a therapeutic role. Psychiatrists (n = 13) and psychologists (n = 70) rated each of the 16 factors according to the degree to which they influence deciding which diagnostic model to use. The most important factors were those pertaining to usefulness in communicating personality information, knowledge about and training in each model, usefulness of the model for describing clients' difficulties and pathology, and level of acceptance of the model by peers and experts in the field. While our data do not identify which model lends itself best to clear communication about personality functioning, or which model is most scientifically sound and accepted within the field, our data indicate that practitioners consider those things important, so clear guidance about those matters based on empirical evidence is needed. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

The Level of Personality Functioning Scale-Brief Form 2.0 (LPFS-BF 2.0) is a brief measure for personality functioning based on the Alternative Model for Personality Disorders. Despite a strong emerging research base in support of the measure, most studies have been conducted in North America or Europe, and few studies have explored its association with theoretically relevant correlates such as mentalizing and attachment. The current study examined its factor structure, reliability, measurement invariance, and validity in Iranian samples using Exploratory Structural Equation Modeling. Two Iranian samples participated, composed of community-dwelling adults (N = 579, 58.9% female, M_age = 33.47) and university students (N = 390, 70.8% female, M_age = 27.09). Participants completed the LPFS-BF 2.0 alongside measures of categorical personality pathology, mentalizing, and attachment. Competing measurement models were contrasted, and invariance was tested across samples, sexes, age groups, and diagnostic status. A two-factor Exploratory Structural Equation Modeling model representing self and interpersonal functioning demonstrated optimal fit with good reliability and measurement invariance across all groups. Both domains showed strong associations with attachment insecurities, mentalizing deficits, and personality pathology. The mean score of self dysfunction was significantly higher in students, females, emerging adults, and diagnosed participants, while the interpersonal domain showed no significant group differences. The LPFS-BF 2.0 showed robust psychometric properties in Iranian samples, supporting its cross-cultural utility. Given that self dysfunction varied significantly by sample type, sex, age, and diagnostic status while interpersonal dysfunction did not, the self domain appears to better distinguish between demographic and clinical groups. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

The Five-Factor Obsessive-Compulsive Inventory (FFOCI) provides an assessment of personality traits relevant to obsessive-compulsive personality disorder. Obsessive-compulsive personality disorder is the most prevalent personality disorder within community samples, and the literature marks that some demographic groups are more at risk than others. The FFOCI, however, has never been explored to demonstrate that it assesses these traits in the same way across groups. The current study adds to the literature by evaluating its measurement invariance across gender, education, and age via the alignment method in a sample of 500 U.S. census-matched adults. A novel contribution of the study is the use of the alignment method, which suggested that the FFOCI demonstrated invariance across groups, allowing for mean-level comparison in traits related to overcontrol. Analyses demonstrated that invariance of the FFOCI held across age, gender, and educational level. Mean-level comparisons between groups showed that college-educated individuals were not significantly higher than noncollege-educated on traits relating to overcontrol. There were nuanced differences between men and women, and differences between age groups were more complicated than originally anticipated. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

The factor structure of personality disorder (PD) criteria has long been debated, but due to previous heterogeneous findings, a common structure to represent covariation among the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV)/DSM-5 Section II PD criteria remains an open question. This study integrated individual participant data from 25 samples (N = 30,545) to conduct factor analyses of PD criteria. Measurement invariance tests across gender, clinical status, and assessment method indicated substantial structural differences between interview-based and self-report measures. In interviews, a confirmatory 10-factor model with factors representing specific DSM-5 PDs showed a major misfit, with results from exploratory factor analyses suggesting that this was due to a relatively small number of substantial secondary loadings. In self-reports, a confirmatory 10-factor model showed greater misfit than in interviews, and exploratory solutions were more complex. When five factors were extracted, the factors showed some similarity to maladaptive trait domains such as Negative Affectivity and Disinhibition, but there were substantial differences in factor content between interviews and self-reports. In bifactor models, a general factor explained more common variance in self-reports, whereas the content of general factors was similar in both assessment methods. Our findings suggest that interview and self-report measures of PD criteria are not structurally equivalent. To advance research on the structure of PD, it may be useful to consequently focus on the shared variance of multiple methods. For this purpose, future multimethod studies should combine interviews and self-reports with other assessment methods such as informant reports. (PsycInfo Database Record (c) 2026 APA, all rights reserved).