Personality disorders最新文献

Disinhibited attachment behavior (DAB) among infants is persistent and associated with behavioral and relational problems throughout childhood and adolescence. Little is known about risk factors for DAB among infants reared at home, although studies have linked DAB with maternal psychiatric hospitalization and maternal borderline personality disorder. The aim of the current study was to further assess the association between DAB, maternal severe mental illness (SMI; schizophrenia, bipolar disorder, and depression), and maternal PD symptoms. Ninety-three mothers and their infants participated in the study: 46.2% with SMI and 53.8% with no-diagnosis. During pregnancy, mothers were assessed on the Structured Clinical Interview for DSM-5 and the Standardized Assessment of Personality Abbreviated Scale a validated measure of personality disorder (PD) symptoms. Infants were assessed for DAB at 1 year of age using the rating of infant stranger engagement, assessed during the strange situation procedure. Infants of mothers with clinical levels of PD symptoms were significantly more likely to display DAB (OR = 3.44) compared to infants of mothers without clinical levels of PD symptoms. Maternal SMI was not significantly associated with infant DAB. Because most mothers with clinical levels of PD symptoms also had comorbid diagnoses in this study, further work is needed to evaluate the role of comorbidity. These results add to the emerging literature indicating that maternal personality symptoms may be a risk factor for indiscriminate forms of attachment behavior among home-reared infants. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Narcissistic traits are traditionally viewed as consistent similar to the mirrorlike self-reflection of Narcissus in the water. However, evidence suggests that state levels of narcissism are more dynamic than previously believed. The current research explored fluctuations within and between grandiose and vulnerable narcissism in daily life. We investigated whether individuals' levels of grandiosity and vulnerability (a) vary, (b) are instable, and (c) display inertia and cross-lagged effects in their daily narcissistic expressions. Participants (N = 253; M_age = 22, 85% female) completed grandiose and vulnerable narcissistic trait questionnaires. Using ecological momentary assessment, they further completed up to 60 grandiose and vulnerable narcissistic state questionnaires over 6 days. The results showed that higher grandiose and vulnerable narcissistic traits led to more within-person variability within their corresponding states. Additionally, higher grandiose leadership/authority traits related to greater vulnerable within-person variability, while grandiose self-absorption/self-admiration reduced this. Similarly, all narcissistic traits, except for exploitativeness/entitlement and egocentrism, were positively related to increased instability in their corresponding state. Further, both grandiose and vulnerable narcissistic states demonstrated significant inertia, that is, lingering narcissistic endorsements within their own states. Overall, though the effect sizes were limited, the results showed that grandiosity and vulnerability include time-variant states that are intertwined and need to be acknowledged as additional moving, dimensional constructs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

An extensive theoretical literature links identity pathology with deficits in mentalization, which is the ability to understand the internal mental states of self and others. However, only a few investigations have attempted to bridge theory and data by empirically testing the relation between mentalization and identity pathology, and none have done so with mentalization measured using a laboratory task. The current study investigated the association between mentalization deficits and identity pathology in a large, nonclinical sample. Participants (N = 305) completed a self-report measure assessing identity pathology and a laboratory task assessing mentalization ability. Whereas the existing theoretical literature would argue for a robust association between identity pathology and mentalization impairment, our results revealed essentially no association between identity pathology and mentalization impairment. Moreover, we found essentially no association between identity pathology and any of a number of specific mentalization deficits in our sample. Our findings failed to provide empirical support for the clinical and theoretical literature linking mentalization and identity pathology. Given our adequate statistical power to detect even relatively small associations, we offer these findings to advance theoretical and methodological discussion in this important area. We discuss the implications of these null findings, particularly attuned to the possibility that a link between mentalization impairment and identity pathology may be more complicated than hypothesized. We also consider that these results might be related to methodological features of our study (e.g., self-report and laboratory measures; the range of mentalization impairment in our sample). (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The International Classification of Diseases (11th edition; ICD-11) has adopted a classification of personality disorders (PDs) that abolishes the established International Classification of Diseases (10th edition; ICD-10) PD types in favor of global severity and stylistic trait domain specifiers. The goal of the current study was to describe the empirical relationship between traditional PD types and the ICD-11 trait domains, which is anticipated to inform and guide clinicians in this profound transition. A total of 246 patients were rated by their clinicians. The Informant-Personality Inventory for ICD-11 was used to rate ICD-11 trait domains while PD types were assigned categorically according to ICD-10. Empirical associations were investigated by means of bivariate correlation and logistic regression analyses with bootstrapping. Results overall showed expected and conceptually meaningful associations between ICD-11 trait domains and categorical ICD-10 PD types, with only a few unexpected deviations. Findings suggest that ICD-11 trait domains capture stylistic features of the established PD types in a conceptually coherent manner. These findings may facilitate continuity and guide translation between categorical PD types (i.e., ICD-10 and Diagnostic and Statistical Manual of Mental Disorders [fifth edition]) and the new ICD-11 classification in mental health care. Future research should seek to replicate these findings in various clinical settings while also integrating the essential PD severity classification. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Despite nearly 30 years of research demonstrating its effectiveness in the treatment of borderline personality disorder (BPD) and related problems, few studies have investigated mechanisms of change for dialectical behavior therapy (DBT; Linehan, 1993a). Improvements in mindfulness and emotion regulation have been highlighted as key potential mechanisms of change in DBT (Lynch et al., 2006). The present study examined the time course of and associations between mindfulness, emotion regulation, and BPD symptoms during DBT. Participants were 240 repeatedly and recently self-harming adults (M_age = 27.75) with BPD who were randomly assigned to receive either 6 or 12 months of standard DBT. Primary hypotheses were that: (a) changes in mindfulness would occur before changes in emotion regulation, and (b) changes in emotion regulation would mediate the association of changes in mindfulness with changes in BPD symptoms. Results from changepoint analysis illuminated the proportion of participants for whom first changes occurred in emotion regulation (40.7%), mindfulness (32.4%), or both (26.9%). Contrary to hypotheses, five-wave, cross-lagged analyses did not indicate mediational effects of either mindfulness or emotion regulation on the association of either variable with change in BPD symptoms. Supplemental analyses, however, suggested that changes in emotion regulation mediated the inverse association of changes in mindfulness with changes in BPD symptoms. Findings highlight patterns of change in key, proposed mechanisms of change in DBT and suggest important future research directions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

"Lack of empathy" is a diagnostic criterion of narcissism, but the nature of interpersonal functioning in narcissism is still being debated. Both, empathy and narcissism, are multidimensional constructs, and their relation might depend upon contextual factors. We investigated social affect and cognition in narcissism spanning self-reported traits and experiential states (Ecological Momentary Assessment) as well as behavioral and brain indicators (task-related functional magnetic resonance imaging). N = 140 individuals were selected to cover the full dimensional range of grandiose and vulnerable narcissism, including their constituent self-regulatory dimensions of agentic, antagonistic, and neurotic narcissism. Grandiose narcissism was associated with lower social affect at almost all analysis levels. The associations can be attributed to antagonistic self-regulatory dynamics, and are associated with lower brain activation during subjective experiencing of social affect in regions of the salience network. Social cognition was habitually lowered but not impaired in antagonistic narcissism. Our findings do not support a general "lack of empathy." (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The present study investigated the predictive validity of Criterion A and B of the Alternative Model for Personality Disorders (AMPD) compared to the DSM-5 Section II personality disorder (PD) model in predicting patient outcomes 1 year after initial assessment, in a hetero-method longitudinal design. A clinical sample of 84 participants were administered both traditional Section II and AMPD interviews by two independent interviewers. One year after assessment, disability (World Health Organization Disability Assessment Schedule 2.0) and symptom severity (Brief Symptom Inventory) were assessed. The Section II PD model did not predict disability (R² = .01) nor symptom severity (R² = .03). The AMPD model, on the other hand, predicted both disability (R² = .23) and symptom severity (R² = .29) 1-year postinitial assessment. Both Criterion A and B were significant predictors, but when jointly combined only Criterion A remained significantly predictive of both disability and symptom severity while Criterion B did not. Criterion A thus appears to capture core vulnerabilities of personality-disordered patients that are related to future functioning and symptom severity. Implications for clinical practice are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Personality impairment is a core feature of personality disorders in both current (i.e., Diagnostic and Statistical Manual of Mental Disorders, fifth edition [DSM-5] personality disorders, International Classification of Diseases,11th revision personality disorders) and emerging (i.e., DSM-5's alternative model of personality disorders) models of psychopathology. Yet, despite its importance within clinical nosology, attempts to identify its optimal lower-order structure have yielded inconsistent findings. Given its presence in diagnostic models, it is important to better understand its empirical structure across a variety of instantiations. To the degree that impairment is multifaceted, various factors may have different nomological networks and varied implications for assessment, diagnosis, and treatment. Therefore, participants were recruited from two large public universities in the present preregistered study (N = 574) to explore the construct's structure with exploratory "bass-ackward" factor analyses at the item level. Participants completed over 250 items from six commonly used measures of personality dysfunction. Criterion variables in its nomological network were also collected (e.g., general and pathological personality traits, internalizing/externalizing behavior, and personality disorders) using both self- and informant-reports. These factor analyses identified four lower-order facets of impairment (i.e., negative self-regard, disagreeableness, intimacy problems, and lack of direction), all of which showed moderate to strong overlap with traits from both general and pathological models of personality. (PsycInfo Database Record (c) 2024 APA, all rights reserved).