Personality disorders最新文献

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).

Existing literature on the effects of borderline personality disorder (BPD) and eating disorder (ED) comorbidity in terms of clinical presentation and treatment outcome has been limited and inconclusive. The present study examined whether clients with EDs and varying levels of BPD symptoms presented with more severe ED symptoms at admission, and whether they responded to dialectical behavior therapy (DBT)-based treatment. Participants (N = 176) were adults in a DBT-based partial hospitalization program for EDs at an academic medical center. Participants completed self-report measures at admission, 1-month postadmission, discharge, and 6-month follow-up. Results suggested that patients with elevated BPD symptoms at admission had greater ED symptoms during treatment, evidenced by small to moderate effect sizes. However, patients with high BPD symptoms demonstrated steeper declines in binge eating, fasting, and parasuicidal behavior early during treatment compared to patients with low BPD symptoms. Individuals with high BPD symptoms at admission (i.e., probable BPD diagnosis) were as likely to meet remission criteria and relapse as individuals with low BPD symptoms, though this null finding may be influenced by small cell sizes. Our findings also suggest that DBT skills use does not predict changes in symptoms. In sum, our findings suggest that while clients with higher BPD symptoms may improve during DBT-based partial hospitalization, their ED symptoms may remain more severe. Future studies are needed to determine whether adjunctive treatments improve outcomes for clients with EDs and comorbid BPD symptoms in DBT programs and whether skills use quality is a better predictor of ED symptom changes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Reports an error in "Moderators of the relationship between callous-unemotional traits and externalizing problems in youth" by Blair D. Batky, Allison N. Shields, Randall T. Salekin and Jennifer L. Tackett (Personality Disorders: Theory, Research, and Treatment, Advanced Online Publication, Jul 06, 2023, np). In the original article, the authors changed the order of authorship from "Blair D. Batky, Allison N. Shields, Jennifer L. Tackett, and Randall T. Salekin" to "Blair D. Batky, Allison N. Shields, Randall T. Salekin, and Jennifer L. Tackett." All versions of this article have been corrected. The names appear correctly in the original record. (The following abstract of the original article appeared in record 2023-87326-001). Callous-unemotional (CU) traits (i.e., tendencies to experience low levels of guilt and empathy) are associated with severe and persistent conduct problems in youth. However, some youth with elevated CU traits do not exhibit severe externalizing problems, and further research is needed to identify conditions under which CU traits are more versus less strongly associated with higher levels of externalizing behavior. To this end, the current preregistered study examined whether internalizing problems, five-factor model personality traits, and parenting practices moderated associations between CU traits and externalizing problems. Caregivers of 1,232 youth ages 6-18 (M_age = 11.46) reported on youths' CU traits, externalizing, internalizing, and five-factor model traits as well as on their own parenting practices. We found that the relationship between CU traits and externalizing was robust to the moderating effects of internalizing problems and parenting practices, but CU traits were more strongly related to externalizing problems at higher levels of neuroticism and at lower levels of agreeableness and conscientiousness. Results contribute to a more comprehensive understanding of externalizing problems among youth high in CU traits and may inform future longitudinal and intervention research seeking to identify factors that reduce externalizing behavior among high-CU youth. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

[Correction Notice: An Erratum for this article was reported online in Personality Disorders: Theory, Research, and Treatment on Oct 26 2023 (see record 2024-19662-001). In the original article, the authors changed the order of authorship from "Blair D. Batky, Allison N. Shields, Jennifer L. Tackett, and Randall T. Salekin" to "Blair D. Batky, Allison N. Shields, Randall T. Salekin, and Jennifer L. Tackett." All versions of this article have been corrected. The names appear correctly in this record.] Callous-unemotional (CU) traits (i.e., tendencies to experience low levels of guilt and empathy) are associated with severe and persistent conduct problems in youth. However, some youth with elevated CU traits do not exhibit severe externalizing problems, and further research is needed to identify conditions under which CU traits are more versus less strongly associated with higher levels of externalizing behavior. To this end, the current preregistered study examined whether internalizing problems, five-factor model personality traits, and parenting practices moderated associations between CU traits and externalizing problems. Caregivers of 1,232 youth ages 6-18 (M_age = 11.46) reported on youths' CU traits, externalizing, internalizing, and five-factor model traits as well as on their own parenting practices. We found that the relationship between CU traits and externalizing was robust to the moderating effects of internalizing problems and parenting practices, but CU traits were more strongly related to externalizing problems at higher levels of neuroticism and at lower levels of agreeableness and conscientiousness. Results contribute to a more comprehensive understanding of externalizing problems among youth high in CU traits and may inform future longitudinal and intervention research seeking to identify factors that reduce externalizing behavior among high-CU youth. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Loneliness has broad public health importance, especially in older adulthood, and there is some evidence suggesting it is associated with several personality disorders (PDs). The etiology of these PD-loneliness associations, however, has rarely been studied, especially in the context of the maladaptive traits of the DSM-5 alternative model of personality disorder (AMPD). To address these limitations, we estimated phenotypic, genetic, and unique environmental associations between loneliness and maladaptive personality traits in a sample of older adults from the Minnesota Twin Registry (n = 1,356, M_age = 70.4). Loneliness was moderately to strongly associated with each of the AMPD domains of negative affect, detachment, antagonism, disinhibition, and psychoticism (r = .22-.58), with evidence of both genetic (r_g = .45-.75) and unique environmental (r_e = .10-.48) influences explaining the associations to varying degrees. We argue that loneliness may be an underappreciated concomitant of personality pathology, with PD traits perhaps underlying its development. Indeed, these findings suggest that loneliness may be a manifestation of the genetic and environmental forces that also lead to pathological personality variation. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Insecure attachment and personality pathology are parallel frameworks for representing interpersonal dysfunction. Although research to date has revealed strong bivariate associations between these constructs, the current state of the science is nonspecific and leaves piecemeal guidance for clinical and empirical efforts. The goal of the present study was to determine the magnitude of the associations between attachment and personality pathology across two conceptualizations of maladaptivity and across three waves of time, thereby satisfying repeated calls for empirical innovation in this area. A sample of newlywed heterosexual couples (N = 202 individuals) completed longitudinal assessments of personality pathology and romantic attachment insecurity. Results suggested that the covariation of attachment and personality pathology may be marred by measurement problems related to distress saturation in attachment and personality disorder instruments. Latent curve modeling further suggested that attachment insecurity and personality disorders fluctuate concurrently within persons. Future research should work toward validating unity models of attachment and personality pathology, correcting key measures, and documenting specific mechanisms of association between these constructs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).