Personality disorders最新文献

Suicide is a leading cause of death worldwide and is often empirically examined in relation to internalizing psychiatric constructs, such as depression, but less commonly in relation to externalizing disorders. The purpose of this preregistered meta-analysis was to explore the relations between suicide-related variables (i.e., ideation, attempts, and self-harm) and psychopathy-a maladaptive personality construct falling under the externalizing umbrella. The results showed small-to-moderate associations between total psychopathy scores and suicidal ideation (r = .19), behavior (r = .12), and self-harm (r = .20). Psychopathy subscales and factor scores varied widely in their correlations with suicide-related variables, highlighting the utility of assessing psychopathy using a more nuanced, trait-based approach. Potential mechanisms underlying these relations and clinical implications of the findings are discussed. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The Alternative DSM-5 Model for Personality Disorders and ICD-11 adopt a dimensional approach to personality disorders, defining them in terms of impairments in self-related (identity, self-direction) and interpersonal (empathy, intimacy) personality functions. This study examined the clinical utility of a clinician-rated global evaluation of personality functioning based on the Level of Personality Functioning Scale (LPFS). A total of 346 German mental health professionals provided LPFS ratings for 1,403 patients, stratified by 38 diagnostic categories, including, but not limited to, personality disorders. Clinicians reported on each patient's treatment outcome, recommended optimal treatment components for each patient, and provided their perspective on the clinical utility of the LPFS and its potential risk of stigmatizing patients. On average, clinicians rated the LPFS as "very useful," its applicability as "rather easy," and the risk of patient stigmatization as "rather low." Logistic and ordinal Bayesian multilevel models indicated meaningful associations between LPFS ratings and clinical judgments, highlighting its effectiveness in conveying clinical impressions. Greater impairments in personality functioning were associated with poorer clinician-rated treatment outcome and poorer prognosis. In addition, associations with optimal treatment components yielded a nuanced pattern, with clinicians typically recommending short-term outpatient psychotherapy for patients with mild impairments, long-term psychotherapy for patients with moderate to severe impairments, and intensive care interventions (e.g., outreach care, assisted living) for those with extreme impairments. The results indicate that German mental health professionals consider the LPFS to be a clinically useful concept and that it may be valuable in organizing and communicating information about patients. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Contemporary models conceptualize personality disorder (PD) as a combination of personality dysfunction and pathological personality traits. However, some perspectives suggest that pathological traits, along with functional impairment, may be sufficient indicators of PD. This study builds on previous research by investigating whether identity disturbance, defined as impaired coherence, inconsistency, and discontinuity in the sense of self, contributes to pathological personality trait scores beyond basic five-factor personality traits. Additionally, it examines whether the associations between pathological personality trait domains, PD diagnosis, and functional impairment remain when controlling for identity disturbance and basic personality traits. The study included two samples: 776 community individuals (344 with a psychiatric history) and 77 psychiatric patients diagnosed with PD. Structural equation models with latent factors indicated that pathological personality trait domains can be described as a combination of variance from basic personality traits and to a lesser extent identity disturbance. When identity disturbance was controlled for, however, pathological trait domains no longer differentiated individuals with PD from community participants with psychiatric histories. Furthermore, individual pathological trait domains did not demonstrate incremental validity in predicting functional impairment beyond the contributions of basic personality traits and identity disturbance. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Measures of psychopathic personality traits have been utilized in a variety of settings and are often weighed heavily in decision-making. Though there is evidence of testing bias in marginalized groups, no evaluation of potential bias has been conducted for bias among sexual orientation minorities. This study utilized a slope-intercept bias approach to evaluate the testing bias of three self-report psychopathy measures: the Triarchic Psychopathy Measure, the Comprehensive Assessment of Psychopathic Personality-Self-Report, and the Levenson Self-Report Psychopathy Scale. Broadly, the current findings suggest psychopathy measures predominantly overpredict personality psychopathology and related impairment in sexual minorities, especially detachment, and disinhibition. Reassuringly, although some measures and scales had significantly overpredicted antisocial behaviors, none of these differences reached a threshold of clinically meaningful implications. Nonetheless, the risk of both testing and clinician bias should continue to be assessed in sexual minority persons and other diverse groups to ensure equitable evaluations. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

This study examined the existence and validity of variants of callous-unemotional (CU) traits. Data were available for 309 detained boys (M_age = 16.96) who completed self-reports, experimental tasks, and were administered a diagnostic interview. Two different methods were used to differentiate between participants with different constellations of CU traits and anxiety. Using a simple cutoff approach, participants were assigned to four groups: low CU traits and low anxiety (n = 148), low CU traits and high anxiety (n = 69), high CU traits and low anxiety ("primary CU variant"; n = 68), and high CU traits and high anxiety ("secondary CU variant"; n = 24). Latent profile analyses arrived at three classes but failed to find a "secondary CU variant" class. Group comparisons that were based on the simple cutoff approach showed that youth who fell in the secondary (vs. primary) CU variant group presented more depressive symptoms and were less able to differentiate between emotions. These two groups did not significantly differ in any of the other 36 correlates (e.g., impulsivity, maltreatment, and treatment engagement). Only a few significant differences emerged between the two CU variant groups and youth characterized by low CU traits and high anxiety. Taken together, we found limited support for the existence and utility of CU variants among detained boys. Not only did the identification of the CU variants depend upon the method that was used, the two CU variant groups rarely were significantly different in theoretically important features. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Despite an overall prevalence of about 4% and a possible association with well-studied conditions such as schizotypy, little is known about effective treatments for Cluster A personality disorders (PDs), that is, paranoid, schizoid, and schizotypal PD. The aim of this systematic review and meta-analysis was to conduct a narrative synthesis of existing randomized controlled trials and explore the effectiveness of psychosocial and pharmacological treatments for these disorders. Nineteen studies including 468 participants diagnosed with any one of the three Cluster A PDs were included in the systematic review. Data from 291 (k = 5) and 213 (k = 5) participants were included in two different meta-analyses evaluating the reduction of distinctive clinical features and the increase of general functioning following treatment, respectively. All the treatments in meta-analyses reported a low overall attrition rate (0.23). The two meta-analyses showed medium-to-large effect sizes (g = .60-.91), but were limited by small sample sizes and large heterogeneity. Collected findings suggest that treatments for paranoid, schizoid, and schizotypal PD may be feasible and effective. We discuss implications for further research. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The categorical borderline personality disorder (BPD) diagnosis identifies people who struggle to manage negative emotions. As the field transitions to dimensional personality disorder (PD) models, it is important to know whether alternative diagnostic constructs capture emotion regulation difficulties to the same degree. If not, it may make sense to modify the dimensional models or else retain the BPD syndrome to preserve its incremental utility for clinical description, treatment planning, and prognosis. In three adult samples (total N = 1,197), we modeled self-rated emotion dysregulation as a function of Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) Alternative Model of Personality Disorder dimensions and traditional BPD features. We found that personality dysfunction had bivariate correlations with emotion dysregulation of .70-.80 across samples, almost identical to those observed for BPD. Combined, personality dysfunction and maladaptive personality traits explained 52%-73% of individual differences in emotion dysregulation. Controlling for Alternative Model of Personality Disorder constructs, a standalone measure of BPD features accounted for an additional 7%, 0.6%, and 1% of emotion-dysregulation variation across samples. We conclude that emotion dysregulation is better conceptualized as a general feature of the PD space, rather than a specific deficit in borderline or any other PD. We encourage additional investigation into ways that dimensional models of personality pathology relate to emotion dysregulation. The study's raw data and analysis code are available at https://osf.io/x9jbs/. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Although a recent systematic review examined the relationship between mistrust and borderline personality disorder (BPD; Preti et al., 2023), it did not statistically quantify the strength of this association. This highlights the need for a meta-analytic review of mistrust in BPD. To address this gap, we conducted a meta-analysis comparing laboratory-based assessments of mistrust between individuals with BPD and control groups. This meta-analysis was preregistered with International Prospective Register of Systematic Reviews (CRD42023479031). The final database search was conducted on October 17, 2024, across Embase, MEDLINE, PsycINFO, Scopus, and Web of Science to identify relevant studies. We included studies published in English or translated into English that employed valid, reliable laboratory-based measures of mistrust and psychometrically sound tools for assessing BPD symptoms or features. A three-level meta-analytic model was used to assess mistrust differences between BPD and control groups. The risk of bias in the included records was evaluated using the Joanna Briggs Institute Critical Appraisal Checklists. Our search yielded 1,717 reports, of which 26 met the inclusion criteria (N = 3,716). Based on 70 effect sizes from these reports, the meta-analysis indicated a small-to-moderate effect size (g = 0.44, 95% confidence interval = [0.27, 0.61], p < .001), demonstrating that individuals with BPD exhibited significantly higher levels of mistrust compared to controls. Subgroup analyses identified the mistrust paradigm as a statistically significant moderator. These results underscore the significant role of mistrust in BPD. We suggest that assessing mistrust and fostering interpersonal trust during treatment could lead to more effective interventions for BPD. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Increased prevalence of personality pathology, characterized by both personality disorder diagnoses and presentation of personality disorder traits, has been identified among sexual and gender minorities (SGMs) compared to their cisgender and heterosexual counterparts. Additionally, certain subgroups within the SGM community, namely bisexual and transgender populations, are found to have a prevalence of personality pathology elevated above that of other SGM subgroups. However, research on personality pathology prevalence across sexuality and gender identity is in its infancy, remaining scarce and inconclusive. Further, while literature has speculated that the increased levels of personality pathology observed within the SGM community may arise from manifestations of minority stress, this is yet to be explored empirically. This study examined self-reported personality pathology from SGM community members as well as their cisgender and heterosexual counterparts and explored potential relationships between personality pathology and minority stress. Using a cross-sectional survey design, 368 participants recruited within Australia completed measures of personality functioning, maladaptive personality traits, and, for SGM participants, minority stress. Greater presentation of personality pathology was identified among SGM participants, with higher mean scores across personality measures. Personality pathology scores were found to be highest among noncisgender individuals and sexuality groups other than heterosexual and gay/lesbian. As theorized, minority stress was positively correlated with increased personality pathology. Implications regarding the potential for overpathologizing of SGM populations are discussed. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The alternative model for personality disorders (AMPD) constitutes a major shift in conceptualizing personality pathology and has gained considerable attention among both clinicians and personality pathology researchers. The AMPD has two core components: personality dysfunction (Criterion A) and maladaptive traits (Criterion B). As measures of these components are strongly correlated in self-report, cross-sectional data, some researchers question Criterion A's necessity. We used both self- and interviewer-reported methods to enhance understanding of these AMPD components through principal factors analysis (PFA) and bifactor analysis. Further, we investigated these factors' associations with psychopathology (e.g., mood and anxiety disorder symptoms, criteria for substance use disorders) and psychosocial functioning dimensions (e.g., life satisfaction, interpersonal and occupational problems, daily functioning), again using both self-reported and interviewer-rated measures of these constructs. Six hundred community adults, half each either screened-in as at-risk for personality pathology or currently in outpatient therapy, participated in the study. In both the PFA and bifactor analyses, a distress-and-pathology factor emerged (e.g., negative affectivity, poor self-dysfunction) along with two primarily interpersonal factors: antagonism-disinhibition and detachment. A key difference between the PFA and bifactor analyses was that the interpersonal factors emerged without distress in the bifactor analysis because of the extraction of a general factor and reflected distinct self versus interviewer perspectives. The distress-and-pathology factor consistently displayed meaningful associations with psychopathology symptoms, personality pathology, and psychosocial functioning, whereas the two interpersonal factors were more specifically associated with personality pathology. We discuss the findings' implications for conceptualizing personality pathology and its treatment. (PsycInfo Database Record (c) 2026 APA, all rights reserved).