Personality disorders最新文献

Treatment dropout is high among outpatients with borderline personality disorder (BPD) and is associated with myriad negative therapeutic and psychosocial outcomes. Identifying predictors of treatment dropout can inform treatment provision for this population. The present study investigated whether symptom profiles of static and dynamic factors could predict treatment dropout. Treatment-seeking outpatients with BPD (N = 102) completed pre-treatment measures of BPD symptom severity, emotion dysregulation, impulsivity, motivation, self-harm, and attachment style to determine their collective impact on dropout prior to 6 months of treatment. Discriminant function analysis was used to classify group membership (treatment dropout vs. nondropout) but did not produce a statistically significant function. Groups were distinguished by baseline levels of emotion dysregulation with higher dysregulation predicting premature treatment dropout. Clinicians working with outpatients with BPD might benefit from optimizing emotion regulation and distress tolerance strategies earlier in treatment to reduce premature dropout. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The backbone of any field of science is quality data. In personality disorder (PD) science and the broader field of clinical psychology, researchers must consider whether participants were attentive to, understood, and responded honestly and with sufficient effort to self-report questionnaires. We review literature regarding the prevalence of invalid (i.e., careless, low effort, inattentive, or inaccurate) responding, its impact on analysis and interpretation, and available methods of detection. We also present the results of a systematic review of 251 empirical articles across three major journals to characterize the current state of questionable data detection in PD science both in absolute terms and as compared to practices in the larger field of clinical science. In response to the disconcertingly low prevalence rate of self-report validity checks (approximately 22% of PD studies), we conclude by providing practical recommendations for improving data validity in PD science at the points of study design, data analysis, and reporting of results. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Recent initiatives in the empirically based classification of psychopathology, namely, the Hierarchical Taxonomy of Psychopathology (HiTOP), have made significant strides in addressing the limitations of traditional taxonomies (i.e., Diagnostic and Statistical Manual of Mental Disorders, International Classification of Diseases). The current study aimed to extend this work by helping to clarify the lower order structure of an understudied dimension of psychopathology-antagonism (i.e., HiTOP antagonistic externalizing spectrum)-a core feature of many externalizing disorders and related to important outcomes such as interpersonal problems, childhood conduct problems, and incarceration. We examined the hierarchical structure of several measures of antagonistic externalizing features across both self-report and clinical interview ratings for 2,279 community participants with a diverse range of personality pathology (~75% with a personality disorder) and antagonistic behaviors (~30% with intermittent explosive disorder). Exploratory structural equation modeling was used to account for the shared variance between variables within self-report and interview methods. Results revealed an optimal lower order structure consisting of six factors labeled Antisociality, Anger, Hostility, Narcissism, Mistrust, and Attention Seeking. Factor scores yielded expected relations with self-report and interview ratings of psychopathology, personality, and childhood trauma. Implications for future research in classification and treatment of psychopathology are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

In contrast to latent variable models suggesting a common etiology, network theory proposes that symptoms of psychopathology co-occur because of direct, dynamic associations among them. We examined how symptoms associated with borderline personality disorder, depression, and anxiety mutually reinforce one another over time, forming a network. We further identified symptoms that drove the network by exerting the most influence on other symptoms. Participants were 37 undergraduate students aged 18 to 26. Following baseline assessment, participants were prompted to answer a Qualtrics-based survey of current symptoms of BPD, depression, and anxiety twice daily for 40 days. Multilevel time-series network analyses were conducted with (a) BPD symptoms alone and (b) BPD, depressive and anxiety symptoms. In the network of BPD symptoms, momentary interpersonal difficulties predicted later dissociation, which predicted later affective fluctuation at the within-person level. Dissociation exerted the strongest influence on the overall symptom network. When depressive and anxiety symptoms were included, the networks identified several cross-disorder connections, such as anhedonia and feeling tense, which highlight potential pathways that describe the comorbidity of BPD with anxiety and depressive syndromes. Overall, cognitive symptoms and dissociation were identified as the most influential symptoms across the networks. This study indicates that BPD, depression, and anxiety symptoms may mutually reinforce one another concurrently and over time. Cognitive symptoms exert the highest influence on the cross-disorder networks, such that they influence BPD, depressive, and anxiety symptoms. Our results support the need of targeting cognitions in the treatment of comorbid BPD. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

BPD Compass is a short-term (18-session) intervention for borderline personality disorder (BPD) that was designed to address the higher-order dimensions of personality implicated in this condition in the Alternative Model of Personality Disorders (AMPD): Negative affectivity, Antagonism, and Disinhibition. We received three commentaries on our manuscript describing the conceptual background for BPD Compass; the purpose of this rejoinder is to respond to that feedback. In our rejoinder, we challenge researchers and clinicians to stretch their assumptions about what treatment for BPD should look like, describe the utility of a cognitive-behavioral approach for subsequent dissemination, and discuss how information Criterion A of the AMPD can also be used to personalize course of treatment with BPD Compass. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Borderline personality disorder (BPD) is a heterogenous condition, and variations in its presentation may be accounted for by individual differences in personality dimensions. Extant treatments for BPD are long term and intensive; it is possible that prioritizing the personality-based difficulties that underlie an individual's symptoms may improve the efficiency of care. This article describes the conceptual background for the development of a novel, personality-based intervention for BPD (BPD Compass), which was informed by recent research on personality mechanisms maintainin this condition, and was designed to address gaps left by existing treatments and to be maximally efficient and disseminable. BPD Compass is a comprehensive, short-term package with a fully modular design that allows for personalization (e.g., all skills can be presented in isolation or in any order based on pretreatment assessment). We discuss the theoretical background for its development, an overview of the skills included in the treatment, as well as preliminary efficacy data. (PsycInfo Database Record (c) 2023 APA, all rights reserved).