Pathoplastic relationships between personality and psychopathology: Exploring complex connections using a network analysis

Severe health anxiety (SHA)/hypochondriasis (HY) is often associated with personality pathology; however, studies report inconsistent results. In general populations, 12% have a personality disorder (PD). We assessed physician-referred psychiatric outpatients with SHA enrolled for a treatment study (n = 84) with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) axis II (SCID-II), Personality Inventory for DSM-5 (PID-5), Whiteley Index 7, and Short Health Anxiety Inventory, and the healthy controls (n = 84) with PID-5 only. There were 71.4% of the patients who met criteria for PDs: avoidant (22.6%), obsessive-compulsive (16.7%), depressive (16.7%), dependent (7.1%), paranoid (3.6%), borderline (2.4%), and not otherwise specified (32.1%). Severity of personality pathology was associated with severity of health anxiety. In group comparisons, PID-5 trait domains of negative affectivity, detachment, low antagonism, and low disinhibition, and facets of anxiousness, separation insecurity, and low attention seeking emerged as unique predictors of SHA. Personality pathology is common among individuals with SHA/HY. Further research is needed to understand the nature of the relationship between health anxiety and personality pathology and to determine whether treatments that target both SHA/HY and personality pathology will improve short- and long-term outcomes.

Character and temperament in major depressive disorder and a highly anxious-retarded subtype derived from melancholia

The Personality Inventory for DSM-5 (PID-5) assesses traits relevant for diagnosing personality disorder in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). We examined the PID-5 in relation to the Big-Three and Big-Five personality traits in outpatient and community adult samples. Domain-level analyses revealed that PID-5 Negative Affectivity correlated strongly with Neuroticism, and PID-5 Antagonism and Disinhibition correlated strongly negatively with Agreeableness and Conscientiousness, respectively; Antagonism and Disinhibition also were both linked strongly to Big-Three trait Disinhibition. PID-5 Detachment related strongly to personality, including Extraversion/Positive Temperament, but did not show its expected specificity to this factor. Finally, PID-5 Psychoticism correlated only modestly with Openness. Facet-level analyses indicated that some PID-5 scales demonstrated replicable deviations from their DSM-5 model placements. We discuss implications of these data for the DSM-5 model of personality disorder, and for integrating it with well-established structures of normal personality.

Effects of different types of instruction on the Scores of PID-5 profile

To evaluate the associations between Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) Alternative Model of Personality Disorder traits and domains and categorically diagnosed narcissistic personality disorder (NPD) and borderline personality disorder (BPD), respectively, 238 inpatient and outpatient participants who were consecutively admitted to the Clinical Psychology and Psychotherapy Unit of San Raffaele Hospital in Milan, Italy, were administered the Personality Inventory for DSM-5 (PID-5) and the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II). Based on SCID-II, the participants were assigned to the following groups: a) NPD (n = 49), b) BPD (n = 32), c) any other PD (n = 91), and d) no PD (n = 63). Emotional lability, separation insecurity, depressivity, impulsivity, risk taking, and hostility were significantly associated with BPD diagnosis. Attention seeking significantly discriminated participants who received an SCID-II categorical NPD diagnosis. Separation insecurity, impulsivity, distractibility, and perceptual dysregulation were the DSM-5 traits that significantly discriminated BPD participants. Domain-level analyses confirmed and extended trait-level findings.

Temperament and character traits in patients with bipolar disorder and associations with attempted suicide

The factor structure and the convergent validity of the Personality Inventory for DSM-5 (PID-5), a self-report questionnaire designed to measure personality pathology as advocated in the fifth edition, Section III of Diagnostic and Statistical Manual of Mental Disorders (DSM-5), are already demonstrated in general population samples, but need replication in clinical samples. In 240 Flemish inpatients, we examined the factor structure of the PID-5 by means of exploratory structural equation modeling. Additionally, we investigated differences in PID-5 higher order domain scores according to gender, age and educational level, and explored convergent and discriminant validity by relating the PID-5 with the Dimensional Assessment of Personality Pathology-Basic Questionnaire and by comparing PID-5 scores of inpatients with and without a DSM-IV categorical personality disorder diagnosis. Our results confirmed the original five-factor structure of the PID-5. The reliability and the convergent and discriminant validity of the PID-5 proved to be adequate. Implications for future research are discussed.

Depression Research and Treatment has issued a second compendium of papers focused on temperament, character, and depression. The psychobiology theory of personality proposed by Cloninger is a currently prevailing theory of personality that has been extensively investigated in the context of many different types of mental and personality disorders. This special issue reports up-to-date research findings on the psychobiology theory and depression from different countries. The current issue consists of six reports. Miettunen and colleagues in Finland present findings from a longitudinal birth cohort study (N = 4941). Participants with depression at 31 years of followup had higher rates of harm avoidance (HA) than participants without any psychiatric disorders. Participants without any psychiatric history were followed for another 12 years. Those who subsequently developed depression had high HA in 1997. The authors hypothesize that high HA is a potential indicator for subsequent depression. This study only used temperament scales and thus no information was available on the association between character and depression. Students in senior high schools (N = 1234) who were invited to participate in an internet-based intervention program for depression were studied by Christian and colleagues in Norway. High HA and low self-directedness (SD) emerged as strong predictors of adolescent depression. Interestingly, use of the internet intervention program was associated with low reward dependence (RD) in addition to depression severity. Garcia and colleagues studied an adolescent population (N = 304) in Sweden. Based on positive affect (PA) and negative affect (NA) scores derived from the Positive Affect and Negative Affect Schedule, the participants were categorized into four groups: self-fulfilling (high PA and low NA), high affective (high PA and high NA), low affective (low PA and low NA), and self-destructive (low PA and high NA). The self-fulfilling group was characterized by higher persistence (PS), SD, and cooperativeness (CO) than the three other groups. The self-destructive group was characterized by high HA and RD. The authors claim character maturity (expressed as high SD and CO) is important for psychological well-being. In Japan, Lu and colleagues followed graduate students (N = 184) on two occasions separated by a five-month interval. In a structural regression model, they posited that trait anxiety and depression constructs were linked to high HA and low SD. Although trait anxiety and depression scores were moderately correlated with each other, these two constructs showed different associations with Temperament and Character Inventory (TCI) subscale scores. Thus, trait depression was linked to high self-transcendence (ST) whereas trait anxiety was linked to low RD, PS, and CO. The authors claim that character maturity is linked to trait rather than state aspects of depression and anxiety. Directly exposed survivors of the Oklahoma City bombing randomly selected from a bombing survivor registry (N = 151) were examined by North and colleagues in the USA. Posttraumatic stress disorder (PTSD) after the bombing was associated with low SD and CO together with high ST and HA. Postdisaster major depression (MD) was more prevalent among those with PTSD than those without it, but low SD and CO could not be predicted by post-disaster MD. The authors emphasized the importance of developing and validating measures of resilience. A unique measure of temperament, the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego (TEMPS), was used by Tei-Tominaga and colleagues to study job stress among employees in one Japanese company (N = 728). Depression was predicted by high levels of cyclothymic and anxious temperament traits even after controlling for the effects of work-related stressors such as demanding work conditions and overcommitment. These articles all indicate the importance of temperament and character traits in the development of depression among a variety of populations across different countries. Despite some differences between the studies, a common theme may be that low SD and high HA are predictors of depression either directly or being mediated by third variables. Toshinori Kitamura C. Robert Cloninger Andrea Fossati Jorg Richter

Miller and Lynam's (2017) commentary proved to be very helpful in clarifying that ralerting-CV and rcontrast-CV coefficient values reported in our study indicated that the Narcissistic Personality Inventory (NPI) yielded a trait profile much more closely aligned with expert ratings of Diagnostic and Statistical Manual of Mental Disorders (4th edition; DSM-IV) narcissistic personality disorder (NPD) than did other measures. The commentary gives us the opportunity to make it clear that our study was designed to demonstrate the clinical usefulness of Personality Inventory for DSM-5 (PID-5) domain and trait scales in profiling pathological narcissism. Thus, demonstrating the superiority/inferiority of the Pathological Narcissism Inventory (PNI) over the NPI was not among the aims of our study. The publication of the commentary also gives us the opportunity to clarify the reasons why we think that the interpretation of the ralerting-CV and rcontrast-CV coefficients deserves some cautions. As a final remark, we think that the time has come to move from personality disorder classifications based on "clinical wisdom" to a redefinition of personality pathology in terms of systems of traits. (PsycINFO Database Record

BackgroundWith the publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), an alternative model for personality disorders based on personality dysfunction and pathological personality traits was introduced. The Personality Inventory for DSM-5 (PID-5) is a 220-item self-report inventory designed to assess the personality traits of this model. Recently, a short 100-item version of the PID-5 (PID-5-SF) has been developed. The aim of this study was to investigate the score reliability and structure of the Norwegian PID-5-SF. Further, criterion validity with the five factor model of personality (FFM) and pathological personality beliefs was examined.MethodsA derivation sample of university students (N = 503) completed the PID-5, the Big Five Inventory (BFI), and the Personality Beliefs Questionnaire – Short Form (PBQ-SF), whereas a replication sample of 127 students completed the PID-5-SF along with the aforementioned measures.ResultsThe short PID-5 showed overall good score reliability and structural validity. The associations with FFM traits and pathological personality beliefs were conceptually coherent and similar for the two forms of the PID-5.ConclusionsThe results suggest that the Norwegian PID-5 short form is a reliable and efficient measure of the trait criterion of the alternative model for personality disorders in DSM-5.Electronic supplementary materialThe online version of this article (doi:10.1186/s40359-016-0169-5) contains supplementary material, which is available to authorized users.

To assess how the maladaptive personality domains and facets that were included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Alternative Model of Personality Disorders relate to adult attachment styles, 480 Italian nonclinical adults were administered the Personality Inventory for DSM-5 (PID-5) and the Attachment Style Questionnaire (ASQ). To evaluate the uniqueness of the associations between the PID-5 scales and the ASQ scales, the participants were also administered the Big Five Inventory (BFI). Multiple regression analyses showed that the ASQ scales significantly predicted both PID-5 domain scales and BFI scales; however, the relationships were different both qualitatively and quantitatively. With the exception of the PID-5 risk taking scale (adjusted R(2) = 0.02), all other PID-5 trait scales were significantly predicted by the ASQ scales, median adjusted R(2) value = 0.25, all ps < 0.001. Our findings suggest that the maladaptive personality domains and traits listed in the DSM-5 Alternative Model of Personality Disorders show meaningful associations with adult attachment styles.

IntroductionThe Alternative Model for Personality Disorders in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5 AMPD) requires the assessment of personality functioning (Criterion A), using the Level of Personality Functioning Scale (LPFS), and the presence of pathological personality traits (Criterion B), operationalized with the Personality Inventory for DSM-5 (PID-5). Several studies have investigated the associations between the LPFS and the PID-5 personality traits as well as the normal-range personality traits of the Five-Factor Model (FFM) of personality. The goal of the present study was to meta-analytically integrate the findings of these studies to examine the extent to which the LPFS is related to the PID-5 and FFM traits.MethodsA systematic literature search was conducted in the databases PsycINFO, Medline, Embase, and Web of Science for studies providing information about the correlations of the measures of the LPFS with versions of the PID-5 and/or measures of the FFM in adult samples. The bivariate correlations of scales measuring the LPFS with the measures of the PID-5 and FFM traits were meta-analytically pooled.ResultsData from 44 studies and 47 independent samples were identified and used in the analyses. The results showed medium-to-large weighted average correlations between the LPFS total score and the PID-5 traits, ranging from.44 (antagonism) to.64 (detachment). Overall, lower correlations were found between the LPFS and the FFM traits.DiscussionTentative explanations for these associations are discussed, and suggestions to reduce them—including potential modifications to one or both criteria—are presented.Systematic review registrationhttps://osf.io/49rs7, identifier doi.org/10.17605/OSF.IO/49RS7.

The official classification of personality disorders in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) remains categorical. However, a dimensional alternative for personality disorders is presented as an emerging model. The model is organized in five higher order domains (Negative Affectivity, Detachment, Antagonism, Disinhibition and Psychoticism), with relationships with the Big Five Model of Personality, strongly established within the Personality Psychology. The proposal also includes 25 facets or second-order traits, included within the main domains. Domains and facets represent psychopathological traits with clinical relevance. To assess this model, the Personality Inventory for DSM-5 (PID-5) was developed. PID-5 has two forms: extensive (220 items) that assesses domains and facets, and brief (25 items) that assesses only the domains. In a previous study, evidence for a short version (31 items) adapted to the Argentine population was provided, that overcomes some of the limitations of the original one. In this work, the psychometric properties of a reduced and modified version of the PID-5 are studied, which allows evaluating five domains and 25 facets, through a reduced number of items (108). We worked with a non-probabilistic sample of n = 525 subjects from the general population, who answered the adapted version of the PID-5 and the Adjectives Checklist to Assess the Big Five Personality Factors (AEP), a Big Five Model measure. The following data analyses were performed: (1) Exploratory and Confirmatory Factor Analysis to evaluate the internal structure of PID-5; (2) reliability analysis to assess the internal consistency of the PID-5 scales; (3) item analysis to assess discriminating power; (4) multivariate analysis of variance (MANOVA) to examine significant differences due to gender and age; and (5) bivariate correlation analysis to analyze PID-5 convergent validity. The results provided evidence of validity and reliability. Exploratory and Confirmatory Factor Analysis suggested a five-factor structure. The facets presented factor loadings in the domain theoretically expected, with some exceptions: Suspiciousness (loaded in Psychoticism), Hostility (loaded in Disinhibition), Depressivity (loaded in Detachment) and Insensitivity (loaded in Detachment). CFA also suggested a good model fit (CFI = .98; RMSEA = .04; SRMR = 0.083). Psychoticism, Detachment, and Disinhibition facets had their higher factor loadings in the expected domain. Negative affectivity showed higher correlations with the rest of the scales. Internal consistency was satisfactory, especially at the domain level, and the items had good discrimination indices. Correlations with the corresponding of the Big Five factors were observed, similar to previous studies. The five PID-5 domains were also found positively correlated. Additionally, gender and age differences were found. In line with previous literature, results suggest that some facets scales are “pure” markers of these domains ( e. g. , Psychoticism and Antagonism facets), whereas others ( e. g. , Negative Affectivity facets such as Depressiveness, Suspicion, Hostility), are located “in between” domains since they share features of more than one domain. Psychoticism facets presented higher loadings in their domains and lower in the rest. This is not surprising; although most of psychopathology cannot be understood as categories, schizophyte and Schizotypal Personality Disorder are exceptions, and Psychoticism would be the representation of these categories in the APA model. Findings also provide evidence of convergent validity for the instrument, as well as theorical evidence regarding the relationship between normal and pathological personality traits. This version can be used to evaluate the model, both in research and clinical practice. It has advantages over the original longer version, in terms of administration time and participants' fatigue, while maintaining its psychometric properties. The results are also expected to contribute to the recent literature on the dimensional approach to personality psychopathology. However, complementary studies, particularly with a clinical population, are needed. https://doi.org/10.16888/interd.2023.40.1.7

Reports an error in "Profiling pathological narcissism according to DSM-5 domains and traits: A study on consecutively admitted Italian psychotherapy patients" by Andrea Fossati, Antonella Somma, Serena Borroni, Aaron L. Pincus, Kristian E. Markon and Robert F. Krueger (Psychological Assessment, Advanced Online Publication, Jun 23, 2016, np). In the article, several values were reversed and the mean was misreported in Table 2. The corrected table is present in the erratum. (The following abstract of the original article appeared in record 2016-31181-001.) Pathological narcissism represents a clinically relevant, albeit controversial personality construct, with multiple conceptualizations that are operationalized by different measures. Even in the recently published Diagnostic and Statistical Manual for Mental Disorders-Fifth Edition (DSM-5), 2 different views of narcissistic personality disorder (NPD) are formulated (i.e., Section II and Section III). The DSM-5 Section III alternative PD model diagnosis of NPD is based on self and interpersonal dysfunction (Criterion A) and a profile of maladaptive personality traits (Criterion B), specifically elevated scores on Attention Seeking and Grandiosity. Given the diversity of conceptualizations of pathological narcissism, we evaluated the convergences and divergences in DSM-5 trait profiles characterizing multiple measures of narcissism in a clinical sample of 278 consecutively admitted Italian psychotherapy patients. Patients were administered the Italian versions of the Personality Inventory for DSM-5 (PID-5) and 4 measures of NPD, (a) the Narcissistic Personality Inventory (NPI); (b) the NPD scale of the Personality Diagnostic Questionnaire-4+; (c) the Structured Clinical Interview for Axis II Personality Disorders, Version 2.0 (SCID-II) as an observer-rated measure of NPD; and (d) the Pathological Narcissism Inventory (PNI). Multiple regression analyses showed that PID-5 traits explained from 13% to more than 60% of the variance in the different NPD measures. Attention Seeking was consistently associated with all measures of NPD, whereas Grandiosity was associated with some of the NPD measures. All measures of NPD were also significantly related to additional DSM-5 maladaptive traits. (PsycINFO Database Record

New evidence for a pain personality? A critical review of the last 120 years of pain and personality