Personality disorders最新文献

Our cross-sectional study provides a head-to-head comparison of Section II and Section III of Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) diagnostic models of personality disorders (PDs) in identifying significant personality correlates of psychiatric hospitalization (PH). PH is an indicator of a breakdown in one's existing ability to manage mental crisis. The sample was recruited from psychiatric clinical services (N = 60) as well as universities and the local community (N = 49). We used the Structured Clinical Interview for DSM-5 PD (SCID-5-PD) for Section II DSM-5 diagnosis, the Self and Interpersonal Functioning Scale (SIFS) for Criterion A and the Personality Inventory for DSM-5 (PID-5) for Criterion B. Separate logistic regressions analyses showed high discriminative utility for all diagnostic models: the number of Section II diagnosis, level of personality functioning, and five maladaptive traits (AUC between .89 and .97). Binomial logistic regression with a forward stepwise procedure showed that Section II number of diagnoses revealed incremental utility over Criteria A and B in distinguishing between individuals experiencing a mental health crisis requiring PH and those not requiring immediate intervention. We conclude that each diagnostic model, when considered individually, exhibits a high degree of discriminatory performance. However, employing all these models concurrently for identifying personality correlates of PH proves impractical. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The objective of this preregistered study was to gather evidence on training and clinical experiences offered by clinical psychology doctoral programs on the treatment of antagonism-a construct from the personality and psychopathology literature that captures individual differences in aggressiveness, callousness, grandiosity, domineering, and manipulativeness. We surveyed current graduate students (N = 376) in APA-accredited clinical psychology doctoral programs (M_age = 28.4; 83.2% female; 65.2% White) about their experiences in training and treatment of antagonistic patients (ANT-patients) as well as experiences with patients with predominant negative affect (NA; e.g., anxious and depressed). Students reported significantly less training to treat antagonism compared to NA (|ds| = 0.43-2.88), as well as lower rates of direct clinical experience, generally poorer treatment experiences, and stronger countertransference reactions (|ds| = 0.53-1.40). These discrepancies were especially large for adult-focused students compared to child/adolescent-focused students. In fact, adult-focused students reported a mean competency rating of M = 1.71, between the scalar points not competent at all (1) and a little bit competent (2). Overall, these results indicate a lack of training and competence to treat antagonism among current graduate students, especially adult-focused students. We believe the crux of this issue is a field-wide lack of robust empirical work on antagonism treatments (for adults). Moving forward, we implore researchers and funding agencies to help address this substantial gap, which is both an ethical and practical imperative. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Although clinical psychologists have long speculated that antagonistic individuals may lack insight into their moral deficits, some evidence has shown that more (vs. less) antagonistic people view moral traits as somewhat desirable and rate themselves as lower on moral characteristics (suggestive of some insight). But, we suggest that antagonistic people's struggles with insight can be detected as part of a basic social-cognitive bias that entails believing the self is better-than-average on socially desirable characteristics (i.e., the "better-than-average effect" [BTAE]). Specifically, although antagonistic people may rate themselves lower on moral characteristics than less antagonistic people, they may still believe that their relative standing on moral characteristics compares favorably to others. Participants (N = 515) completed indicators of the Dark Tetrad (D4) constructs (narcissism, Machiavellianism, psychopathy, and sadism) and rated themselves in relation to others on moral and immoral character traits. Overall, participants exhibited very large BTAEs (i.e., rated the self as "better-than-average" on moral character traits); only psychopathy and sadism consistently related negatively to BTAEs, but people with elevations in each D4 construct (or any D4 facet) still exhibited large-to-very-large BTAEs. Such antagonistic participants viewed themselves as possessing substantially greater amounts of moral than immoral character traits but viewed average others as possessing an equal mix of these traits. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Complex posttraumatic stress disorder (CPTSD) is characterized in the International Classification of Diseases-11 by affect dysregulation, negative self-concept, and relationship impairments, symptoms also presented in borderline personality disorder (BPD). Some research shows CPTSD as a distinct disorder, others as a subgroup or a replacement for BPD. No review currently amalgamates the findings on whether CPTSD presents too similarly to BPD to be a standalone disorder. This article systematically reviewed similarities and differences in symptom presentations of the two disorders. Six databases were searched (PsycINFO, EMBASE, PubMed, Web of Science, PsycEXTRA, and Open Access Theses and Dissertations) and identified papers were summarized narratively. The majority of studies found distinct profiles for CPTSD and BPD. One study found no differences between the constructs; however, this used a population without severe trauma. CPTSD and BPD can present comorbidly, these individuals will have likely experienced earlier and more frequent interpersonal trauma and display greater functional impairment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Borderline personality disorder (BPD) is a debilitating disorder characterized by deficits in social connectedness, which is a multifaceted construct with structural (i.e., the number, diversity, or frequency of social relationships), functional (i.e., the actual or perceived resources relationships provide), and quality (i.e., the positive and negative aspects of social relationships) elements (Holt-Lunstad, 2018). However, the literature is sparse and lacks integration regarding which specific elements of social connectedness are deficient in BPD and why. This systematic review synthesized the literature on the bidirectional relationship of social connectedness and BPD. Electronic searches of three databases (i.e., PsycInfo, PsycArticles, and PubMed) identified 1,962 articles which underwent title and abstract screening and, if potentially eligible, full-text review. Sixty two articles met the eligibility criteria and underwent data extraction and risk of bias assessment. Cross-sectional research supported associations between BPD and problems in structural, functional, and quality social connectedness, with most research underscoring deficits in quality social connectedness. Preliminary longitudinal research suggested that BPD pathology predicts problems across these domains, but little to no research exists testing the reverse direction. Although people with BPD may not have difficulties forming relationships, they exhibit a range of problems within those relationships. BPD may elicit such problems in social connectedness, but it is unclear whether such issues reciprocally exacerbate and elicit BPD, and longitudinal research investigating such directionality is needed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Borderline personality disorder (BPD) is a serious mental disorder, which has been linked to a number of negative outcomes in adolescents and adults. BPD is generally linked to more severe impairments in personality functioning. The (differential) association of specific BPD symptoms with severity level, however, has not been explored yet. The present study explores the relationship between all nine BPD symptoms and impairments in personality functioning in adolescents using a cross-sectional design. A total of 116 treatment-seeking adolescents were administered semistructured interviews for DSM-IV Axis I and Axis II disorders and the semistructured interview for personality functioning DSM-5 (STiP-5.1). Furthermore, the potential association of symptom disorders, and more specifically mood disorders, with level of personality functioning was assessed. Together, the nine BPD criteria were significantly related to STiP-5.1 total score, even when controlling for the presence of a mood disorder. However, when taking the effect of number of symptom disorders and the other BPD symptoms into account, only the presence of recurrent self-harm and/or suicidal behavior and intense anger, were associated with a higher level of impairment in personality functioning. These findings emphasize the diagnostic importance of repeated self-harm and suicidality and provide additional evidence for the value of using BPD criteria to easily identify teenagers at risk. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Personality disorders (PDs) are characterized by problems with identity and self-direction. Since the recent dimensional PD models of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) and the International Statistical Classification of Diseases and Related Health Problems, 11th edition, the role of identity and self-direction in personality pathology has been made explicitly by including these problems in a general personality pathology criterion. This criterion reflects impairment in personality functioning (IPF), which is assessed on a continuum to determine the severity of personality pathology. The present study aimed to psychometrically evaluate the Five-Item Screening Scale for Personality Disorders (FISSPD; Skodol et al., 2011), a short screener for IPF, in a Dutch-speaking clinical sample of 820 adults. This screener mainly taps into self-related impairment, with four items measuring self-related impairment and one item measuring interpersonal impairment. The factor structure, scale reliability, measurement invariance (across sex, age, and patients with vs. without PD), and convergent validity were investigated. The Dutch FISSPD showed a unidimensional structure and good scale reliability. Scalar measurement invariance was established across sex, age (patients below vs. above age 40), and patients with versus without PD. The Dutch FISSPD was significantly related to identity and all DSM-IV/5 Section-II PD symptoms. The present study indicates that the Dutch FISSPD has potential as a reliable and valid screener for personality pathology in adult patients. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Borderline personality disorder (BPD) is a severe mental disorder characterized by a pervasive pattern of emotional and behavioral dysregulation. Dysfunction and distress may be compounded by stigmatizing beliefs held by members of the community. There is a lack of research focusing on stigmatizing beliefs about BPD held by the general population. This study addressed this gap by examining the relationship between BPD and a variety of stigma domains in a community sample. The current study explored whether (a) stigma is more strongly related to BPD symptomatic behavior or the diagnostic label of BPD, (b) attaching a diagnosis of BPD to symptomatic behavior or nonclinical behavior influences stigma, and (c) the gender of a vignette character influences the stigmatization of BPD. A total of 295 participants read vignettes and completed questionnaires assessing stigma type and intensity. Findings from the current study suggest that stigma is higher for BPD symptomatic behavior than for the diagnosis itself. Attaching a diagnostic label of BPD to BPD symptomatic behavior did not significantly impact the resultant stigma; however, the diagnosis was found to increase stigma for nonclinical behavior. Findings concerning BPD stigma and gender are in line with broader gender stereotypes. Specifically, there was greater pity for women displaying BPD behavior, whereas there was greater anger for men displaying the same behavior. BPD symptomatic behavior vignettes depicting a man also received a higher level of dangerousness and fear. Study limitations and future directions are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Shame is an essential affect in many patients with borderline personality disorder (BPD) and can be associated with most of the BPD diagnostic criteria. Severe shame is a highly aversive emotion with concomitant beliefs about the self as deeply inferior, insignificant, disgusting, and unloved. Shame and how it is manifested in the subjective experience and behavior in people diagnosed with BPD is remarkably under-researched, and our knowledge of the phenomenology of shame in BPD needs to be improved. Severe shame is often less accessible and available to conscious awareness, making it difficult to access via questionnaires and self-report measures. Therefore, this study is based on semi-structured interviews with 21 women Structural clinical interview for DSM-5 disorders' diagnosed with BPD. All interviews were analyzed using the interpretive phenomenological approach. Based on the analysis, the participants' descriptions of how severe shame manifests itself in their subjective experience and behavior are classified into 10 themes: the self is deeply flawed and unlovable; self-hatred/self-contempt; eye contact is awkward and shameful; shameful over being mentally ill; shameful identity diffusion; hiding behind façade/social roles; pleasing others/performing to avoid shame; self-destructive behavior to mitigate shame; sex associated with shame; and shame during the therapy session. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Problematic interpersonal relationships may represent both, a risk factor for the development or trigger of personality disorder (PD) symptoms and its consequences. Since peer relationships become more and more important in adolescence, the current study explores the cross-sectional association between recent bullying experiences and levels of impairment in personality functioning according to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) alternative model of personality disorders (AMPD; Criterion A) in help-seeking adolescents (N = 493). Logistic and multiple regression analyses revealed that patients who were frequently bullied in the past 3 months (i.e., at least once a week) were more likely to reach the diagnostic threshold for PD according to the AMPD (OR = 1.71, p = .025) and showed higher levels of impairment in identity (β = .41, p < .001), empathy (β = .26, p = .002), and intimacy (β = .30, p = .001), but not self-direction, compared to patients who did not report any bullying experiences. Occasional bullying in the past 3 months (i.e., every few weeks) was neither associated with a greater likelihood to reach the diagnostic threshold for PD nor with greater impairments in identity, self-direction, empathy, or intimacy compared to no bullying. While the current study provides support for a correlation between bullying experiences and personality dysfunction (particularly in the elements identity and intimacy), longitudinal research is needed to clarify whether experiences of bullying cause or trigger personality dysfunction or/and vice versa. (PsycInfo Database Record (c) 2024 APA, all rights reserved).