Dimensions Of Personality Pathology Research Articles

Dimensions of personality organisation, mentalisation and evaluation of life and romantic relationship satisfaction

Introduction and objective: The Kernberg’s concept on the levels of personality organisation enables us to understand, on the one hand, the pathomechanism of personality disorders necessary for case conceptualisation in psychotherapy and, on the other hand, to predict individuals’ everyday functioning in interpersonal relationships and the experienced life satisfaction. In this study, we inquire whether dimensions of pathological personality structure are associated with negative evaluations of life satisfaction and interpersonal relationships. Additionally, we explored whether these relationships are modified by impaired mentalisation (as a mediator) and clinical group membership (as a moderator). Materials and methods: The study involved 88 participants (71 women) from both clinical (n = 45) and non-clinical groups, aged between 20 to 69 years (mean, M = 31.39; standard deviation, SD = 11.38). The participants completed the Kernberg’s Inventory of Personality Organization (IPO), the Relationship Assessment Scale (RAS), the Satisfaction With Life Scale (SWLS), and the Mentalization Questionnaire (MZQ). Results: The results indicate that higher intensity of all dimensions of personality pathology (identity, defence mechanisms, aggression, reality testing, and moral functioning) is significantly associated with lower life satisfaction (rho = from −0.49 to −0.32) and greater difficulties in mentalisation (rho = 0.72 to 0.56). Increased intensity of defence mechanisms is also related to lower romantic relationship satisfaction (rho = −0.23). Moderated mediation analyses with 5000 bootstrap samples (where life satisfaction is an dependent variable, dimensions of personality organisation are independent variables, mentalisation disturbance is a mediator, and clinical group membership moderates all relationships) showed that disrupted mentalisation plays a mediating role in explaining life satisfaction and that clinical vs. non-clinical group membership may not moderate these relationships. Conclusion: The results help specify the relationships between the characteristics of Kernberg’s personality structure dimensions and the evaluation of everyday life satisfaction, suggesting an important role of mentalisation processes as transdiagnostic factors worth addressing in life satisfaction appraisal.

The Structural Model of Relationships Between Dimensions of Personality Pathology and bullying Through Self handicapping Among High School Students

Background and Aim: The phenomenon of bullying in schools is one of the things that can threaten the safety of students and consequently cause educational issues. The present study aimed to evaluate the structural model of the relationship between the dimensions of personality pathology and bullying through conditional self-handicapping among high school students. Methods: This research was conducted using the structural equation modeling method. The statistical population of the present study included all high school girls of District 2 of Tehran in the academic year 2021-22, who were 145,398 students, according to the Tehran Department of Education. According to the Michel (1993) criteria and the multi-stage cluster sampling method, 300 people were selected as a sample. They completed the following instruments: Schwinger, & Stiensmeier-Pelster self-incapacitation questionnaire (2011), Olweus bullying questionnaire (1986), and the short form of the fifth edition of the Diagnostic and Statistical Manual Personality Questionnaire (PID-5-BF). Data analysis was done using Pearson correlation method and structural equation modeling with SPSS and Lisrel software. Results: The findings of the structural model test showed that personality dimensions have a positive relationship with self-handicapping (β=0.43; P<0.001) and bullying (β=0.33; P<0.001). Also, the relationship between self-handicapping and bullying was positive (β=0.25; P<0.001). The results of mediation effects showed that academic self-handicapping plays a mediating role in the relationship between abnormal personality dimensions and bullying (P<0.001). Conclusion: The results generally showed that the tested model has a good fit with the conceptual model.

Le modèle alternatif des troubles de la personnalité en population française : évaluation avec des outils brefs

ObjectivesThe aim of this work was to study whether the French versions of the brief tools available to clinicians within the framework of the Alternative Model of Personality Disorders (AMPD) can account for the risks of personality disorders in the general population. Tools are available to accurately investigate either the Level of Personality Functioning (LPF) or the Pathological Personality Dimensions (PPD) which in turn allow the validation of the relevance of the AMPD for its criteria A and B. As these tools, such as Morey's Level of Personality Functioning Scale Self Rated (LPFS-SR) for Criteria A or the Personality Inventory for DSM-5 (PID5) by Krueger et al. for Criteria B, are lengthy, the question arises as to the use of the short tools derived from them. MethodData was collected from a sample of 433 people recruited on a volunteer basis with a complete protocol. The sample was predominantly female (83% female, 16% male, 2 people who did not wish to report their gender) and rather young (67% were 18–24 years old). The short version, the LPFS- BF of Hutsbaut et al., which we used in this work allows, as confirmed by several works, to consider on the basis of 12 items the global level of personality functioning. In order to assess the pathological dimensions of personality (PPD), we chose the short version of the Personality Inventory for DSM 5 (PID 5 BF) by Krueger et al. and used its validated French translation that satisfies the factor composition of the original version: Negative Affectivity, Antagonism, Detachment, Disinhibition and Psychoticism. To assess the intensity of personality disorders we used the dedicated subscale (Items 19 and 20) that the DSM 5 proposes in its Cross-Cutting Symptoms Measures of Level 1, in its French translation. A score higher than 2 was our Gold Standard when we tested the metric capacity of the two questionnaires to evaluate the A Criteria and then the B Criteria of the AMPD. ResultsThe overall results (Table 1) show levels that place the group in a non-clinical level. In terms of the severity of personality disorders it can be seen that 27 % are at risk of personality disorder (PDs>2). Comparing these two sub-groups (Table 1), we observed significant differences for all the factors studied, pointing towards a higher score for people at risk of PDs. A logistic regression analysis of the evaluation of persons at risk lead us to find that gender and age do not have a significant influence (p=0.225 and p=0.065 respectively) in a valid model (chi square=157, df=4, p<0.001) including the overall score on the LPFS (z=5.76, p<0.001) and the PID 5 (z=2.26, p<0.001). The Area Under the Curve (AUC=0.859) of this translation (Table 3) is consistent with the original version (AUC=0.84). It has metrological qualities (Sn=73.91%, Sp=85.33%, LR+=5.1, LR−=0.3005) that allowed us to use a threshold of 24 as a discriminant of a risk of moderate or severe personality disorder. In addition, if we followed the AMPD and considered the threshold of 24 on the LFPS-BF to be a risk score for personality disorder, we could see (Fig. 2) that the scores on the PID 5 BF fairly well reflected the expected pattern with a large AUC (0.901). According to the AMPD, the cut-points for the dimensions that would evoke the presence of criteria B in the case of the presence of criterion A (LPFS-BF>24) could be either a score greater than 2 for Negative Affectivity, a score greater than 0.8 for Detachment, Antagonism and Disinhibition, or a score greater than 1.2 for Psychoticism (Table 4). DiscussionThe translation of the LPFS-BF that we used in this work has sufficient qualities to assess situations at risk of personality disorders when higher than 24. Its consistency was good (=0.84), and its factor composition in two factors (Self and Interpersonal Relations) was equivalent to the original version. The use of PID5-BF could therefore be used as a complement to the screening of AMPD A criteria, with a 25 for cut-point. The evaluation of the AMPD B criteria with the PID5-BF seemed relevant in view of our results; each of the subscales seemed to be able to correctly evaluate (AUC) persons with an LPFS-BF score at risk. However, the risk thresholds need to be confirmed in further work because of the essential role that the dimensions play in the diagnosis of types of personality disorders.

Transdiagnostic Associations With Interpersonal and Affective Variability in Borderline Personality Pathology.

Emotional and behavioral variability are unifying characteristics of borderline personality disorder (BPD). Ambulatory assessment (AA) has been used to quantify this variability in terms of the categorical BPD diagnosis, but evidence suggests that BPD instead reflects general personality pathology. This study aimed to clarify the conceptualization of BPD by mapping indices of variability in affect, interpersonal behavior, and perceptions of others onto general and specific dimensions of personality pathology. A sample of participants who met diagnostic criteria for BPD (n = 129) and healthy controls (n = 47) reported on their daily interactions during a 21-day AA protocol. Multilevel SEM was used to examine associations between shared and specific variance in maladaptive traits with dynamic patterns of functioning. The authors found that variability is an indicator of shared trait variance and Negative Affectivity, not any other specific traits, reinforcing the idea that BPD is best understood as general personality pathology.

Suicidality and Personality Pathology in Adolescence: A Systematic Review

This work presents a review of research papers examining the role of emerging personality pathology in suicidal ideation and behaviours in adolescence. Initially, 226 studies were selected in line with PRISMA guidelines, and 33 articles were finally included in this review. The data show percentages of any personality disorder diagnosis ranging from 19.5 to 22.8% in suicide attempters, while in autopsy studies, the rate of personality disorder diagnosis varied between 29.6 and 42.1%. The overwhelming majority of the studies focus on the role of borderline personality disorder (BPD) in suicidal behaviours, also highlighting its predictive role at a longitudinal level. Furthermore, the literature review shows that personality traits supposed to underlie BPD, such as affective instability, impulsivity and identity diffusion, have specific predictive links with suicidal conduct. Other personality pathology dimensions, such as aggressiveness, sadism and perfectionism that are associated with other personality disorders, namely, antisocial and narcissistic personality disorders, have also shown a significant mediating role for suicidal risk. Overall, these results seem to parallel the role of personality pathology in predicting suicide in adulthood and point to the relevance of assessing the presence of emerging patterns of personality disorders for the clinical management of suicidal risk in adolescence.

Mentalization-Based Treatment in Adolescent Inpatients: A Naturalistic Multi-Informant Study of Outcomes.

The present era of major cutbacks in intensive treatment programs throughout Europe stresses the importance of evaluating the outcomes of such programs for adolescents with severe personality pathology and comorbidity. Personality pathology has proven to be a valid concept in adolescents, with relatively high prevalence, that needs to be targeted by evidence-based interventions. The present study focused on the evaluation of outcomes of a 12-month mentalization-based treatment for adolescents (MBT-A) program in 118 inpatient adolescents with personality pathology symptoms, using a multi-informant multidomain design. The results showed that during treatment, adolescents improved on general psychiatric symptoms, personality pathology dimensions, and health-related and generic quality of life. Improvement was not only statistically significant, but also clinically important, especially for internalizing domains. Implications for clinical practice and research are discussed.

The Role of Mothers’ Affective Status on Pathological Dimensions of Personality in Their Children during the Young Adulthood

This study examined the influence of mothers’ affective status on pathological personality dimensions of their children during young adulthood. Results showed significant positive relationships between dimensions of depression, anxiety, stress and the total score of affective status in mothers’ and negative affect, detachment, antagonism, disinhibition, and psychoticism dimensions of the personality of their children during young adulthood. In addition, findings showed that a total score of mothers’ affective status explained 31%, 32%, 20%, 36%, and 49% of negative affect, detachment, antagonism, disinhibition, and psychoticism variations of their children in early adulthood respectively.

Mean-level change in pathological personality dimensions over 4 decades in clinical and community samples: A cross-sectional study.

Although normal personality traits change gradually with age, personality disorders have been reported to remit rapidly and completely in little more than 10 years. Such a benign prognosis is surprising and may be due in part to the combined use of categorical diagnoses, seriously ill patients, and longitudinal designs in the existing literature. This study examines, for the first time, the development of personality pathology across a life span by means of dimensional models, represented by the Dimensional Assessment of Personality Pathology-Basic Questionnaire and the Personality Inventory for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. We draw upon a cross-sectional design and four large clinical and community samples to avoid previous biases. We found that personality pathology declined by around 0.5 SD overall from age 20 to 60, though with noticeable differences between domains: Dissocial behavior and antagonism decreased by between two thirds and 1 SD; compulsivity increased at the same rate; disinhibition, negative affect, and psychoticism dropped by 0.5 SD; and detachment remained stable or rose slightly. In short, the changes in many clinically important traits are modest, occur at a slow pace, and roughly parallel the maturation effect found for normal personality traits. The resulting picture of personality disorder development is not as optimistic as previous studies would have us believe. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Locating psychopathy within the domain space of personality pathology

A robust literature demonstrates that psychopathology and personality pathology are well-represented within quantitatively-derived, hierarchical dimensional models. Nevertheless, the location of core traits comprising psychopathic personality (psychopathy) as defined by the triarchic model has not been clearly explicated. We extended hierarchical structural models of personality pathology to include triarchic psychopathy trait dimensions (boldness, meanness, disinhibition) to interface the hierarchical framework of pathological personality dimensions with basic psychopathy trait dimensions. Using data from a racially diverse undergraduate sample (N = 749), “bass-ackwards” analyses revealed a coherently organized hierarchical structure of personality pathology. Psychopathy dimensions were clearly situated within levels of the hierarchy extending beyond the highest, undifferentiated general-factor level. A broad externalizing factor emerged at level 2, which bifurcated into callous-disinhibition and fearless dominance subfactors at level 3 – encompassing psychopathic traits of meanness and disinhibition (thought to represent the trait commonality between antisocial personality disorder and psychopathy) and boldness (thought to differentiate psychopathy from antisocial personality disorder), respectively, at the final two levels of the hierarchy. These results position triarchic psychopathy traits within an extended externalizing spectrum that accommodates boldness-related content.

Personality Disorders in Adult Female Child Sexual Abuse Survivors: Dimensions of Personality Pathology and Characteristics of Abuse

The relationship between child sexual abuse (CSA) and later personality disorders (PDs) has been established in numerous studies. However, there are still a number of uncertainties about the specifics of this association. This study further explored the child sexual abuse survivors' (CSASs) vulnerability to PDs by introducing the variable of personality organization (PO) and dimensions of personality pathology as conceptualized by Kernberg, and by including additional variables of CSA characteristics. It was hypothesized that in the CSA group, the occurrence of borderline personality organization (BPO) would be significantly higher than in the non-CSA group and that characteristics of abuse associated with its higher severity would prevail in individuals with BPO. The study group consisted of 329 women who completed measures of PO and experiences of CSA. The results were consistent with formulated hypotheses. Significantly more CSASs than those who did not experience CSA were characterized by close to BPO (cBPO). Moreover, CSASs group differed from the group without the CSA experience with regard to all BPO dimensions. The biggest difference between the CSA and the control group concerned the dimension referring to the difficulties in creating close, intimate relationships. With regard to CSA features, women characterized by cBPO, in contrast to those characterized by neurotic personality organization (NPO), significantly more often reported having experienced CSA more than once, involving physical contact, from more than one offender and from the offender they previously known. The findings of the study support the idea that the optimal treatment approach for CSASs should address both the personality structure and the specificity of the impact of CSA along with its characteristics.

Supplemental Material for Mean-Level Change in Pathological Personality Dimensions Over 4 Decades in Clinical and Community Samples: A Cross-Sectional Study

Supplemental Material for Mean-Level Change in Pathological Personality Dimensions Over 4 Decades in Clinical and Community Samples: A Cross-Sectional Study

Linking dimensions and dynamics in psychopathology research: An example using DSM-5 instruments

The DSM-5 includes two measures to assess dimensions of personality pathology (Personality Inventory for DSM-5; PID-5) and cross-cutting symptoms of psychopathology (DSM-5 Cross-cutting Symptom Measure; CCS). Few studies have evaluated these measures in an ecologically valid context. Participants (N = 248, student sample) completed self-report versions of the DSM-5 measures, and then completed a two-week daily diary of internalizing and externalizing outcomes. The CCS scales evidenced convergent and discriminant validity with these outcomes, PID-5 Negative Affectivity and Detachment were related to internalizing outcomes, and PID-5 Antagonism was related to externalizing outcomes. We also demonstrated the benefit of linking static dimensions to temporally-dynamic processes by examining how PID-5/CCS dimensions moderated the within-person associations among daily cognitive distortions and internalizing and externalizing outcomes.

Dysfunctional Beliefs and Personality Traits

This study examined the pattern of associations between dimensions of personality dysfunction, dysfunctional beliefs, and adverse emotional outcomes. We recruited two samples of undergraduates (n = 167; n = 104). Dysfunctional beliefs showed positive correlations with pathological personality dimensions Negative Emotionality, Introversion, and Psychoticism, and negative correlations with Big Five dimensions of Emotional Stability, Conscientiousness, Openness, and Conscientiousness. Hierarchical regression analyses showed that dysfunctional beliefs are predictive of adverse emotional outcomes above and beyond dimensions of personality dysfunction. Dysfunctional beliefs also mediated the relationship between personality traits (Negative Emotionality, Emotional Stability) and important emotional outcomes like depression, anxiety, anger, demoralization and cynicism. The implication of the mediation analyses is that dimensions of personality (i.e., Negative Emotionality, Emotional Stability) have their effect on a variety of affective outcomes by operating through the mechanism of dysfunctional beliefs.

Associations of specific and multiple types of childhood abuse and neglect with personality pathology among adolescents referred for mental health services

The present study investigated the unique association between five types of childhood abuse and neglect and 18 lower-order dimensions of personality pathology, and using latent classes analysis (LCA) explored patterns of childhood abuse or neglect experiences. Further differences across latent classes on personality pathology traits, personality disorder symptom count and a diagnosis of personality disorder were examined. Participants were 178 adolescents and young adults (12–22 years; M = 16.02, 65.7% girls; 83% Axis I/II disorder) from the Netherlands referred for mental health services. Emotional abuse was uniquely associated with 11 personality pathology traits; sexual and physical were associated with three and four traits, respectively. LCA yielded three classes, namely, severe maltreatment (class 1), low-moderate emotional maltreatment and sexual abuse (class 2), and least maltreatment (class 3). After controlling for age, gender, presence of any Axis I disorder, multivariate analysis of covariance indicated that classes with more types of maltreatment experiences and higher severity (classes 1 and 2) endorsed more personality pathology traits, personality disorder symptom counts and a diagnosis of a personality disorder than the least maltreatment class. Findings have theoretical and clinical implications entailing the identification of patterns of maltreatment types and related personality pathology traits among youth.

The mediating role of emotion dysregulation as a transdiagnostic factor in the relationship between pathological personality dimensions and emotional disorders symptoms severity

The present study aims to investigate the mediating role of emotional dysregulation as a transdiagnostic factor in the relationship between pathological personality dimensions and emotional disorder symptoms severity. A total of 440 university students were selected randomly from two universities, and were assessed through Personality Inventory for DSM 5 Brief Form (PID-5-BF)-Adult, Depression, Anxiety and stress Scales (DASS-21), and Difficulties in Emotion Regulation Scale (DERs). The results obtained from the correlation revealed that there is a direct and significant relationship between pathological personality dimensions and emotional disorders (anxiety and depression). In addition, Structural Equation Modeling (SEM) depicted that emotional dysregulation, as a transdiagnostic factor, can mediate the relationship between pathological personality and emotional disorders (anxiety, depression, and stress). The current findings illustrate how emotional dysregulation can increase the influenceability of pathological personality dimensions on emotional disorders.

Childhood Maltreatment, Pathological Personality Dimensions, and Suicide Risk in Young Adults.

Several studies have demonstrated that child maltreatment (psychological, physical, and sexual abuse, and neglect) may be a significant factor in the development of pathological personality traits that increase the risk for suicidal ideation and behavior from adolescence to adulthood. Currently, the challenge is to understand how different forms of early negative experiences render an individual prone to develop specific personality traits and, in turn, be more vulnerable to suicide risk. To understand the relationship between childhood maltreatment and personality dimensions in suicide risk, our study aims to explore the role of self-criticism and dependency, two different pathological personality traits, as potential mediators of the link between different types of childhood maltreatment and suicide risk in young adults. For this purpose, 306 students from three Italian public universities were recruited. We used the Italian version of the Childhood Experience of Care and Abuse Questionnaire (CECA.Q) to assess experiences of lack of care by parents (i.e., antipathy and neglect) as well as psychological and physical abuse before the age of 17 years. The Depressive Experiences Questionnaire (DEQ) was used to assess the personality dimensions of self-criticism and dependency, and the Suicide History Self-Rating Screening Scale was administered to assess suicide risk. Results revealed that lack of care and psychological abuse were significantly associated with suicide risk and this association was partially mediated by the maladaptive personality dimension of self-criticism. These findings suggest that the combined effect of specific forms of dysfunctional parental behavior during childhood and the development of rigid and dysfunctional negative personality traits may increase the risk for suicidal ideation and behavior during adulthood.

The construct validity of general and specific dimensions of personality pathology.

Modern personality disorder (PD) theory and research attempt to distinguish transdiagnostic impairments common to all PDs from constructs that explain varied PD expression. Bifactor modeling tests such distinctions; however, the only published PD criteria bifactor analysis focused on only 6 PDs and did not examine the model's construct validity. We examined the structure and construct validity of competing PD criteria models using confirmatory and exploratory factor analytic methods in 628 patients who completed structured diagnostic interviews and self-reports of personality traits and impairment. Relative to alternative models, two bifactor models - one confirmatory model with 10 specific factors for each PD (acceptable fit) and one exploratory model with four specific factors resembling broad personality domains (excellent fit) - fit best and were compared via connections with external criteria. General and specific factors related meaningfully and differentially to personality traits, internalizing symptoms, substance use, and multiple indices of psychosocial impairment. As hypothesized, the general factor predicted interpersonal dysfunction above and beyond other psychopathology. The general factor also correlated strongly with many pathological personality traits. The present study supported the validity of a model with both a general PD impairment dimension and separate individual difference dimensions; however, it also indicated that currently prominent models, which assume general PD impairments and personality traits are non-overlapping, may be misspecified.

Normative development of the Child Behavior Checklist Dysregulation Profile from early childhood to adolescence: Associations with personality pathology.

The Dysregulation Profile (DP) is a broad indicator of concurrent affective, behavioral, and cognitive dysregulation, often measured with the anxious/depressed, aggressive behavior, and attention problems syndrome scales of the Child Behavior Checklist. Despite an expanding body of research on the DP, knowledge of the normative developmental course of the DP from early childhood to adolescence is lacking. Furthermore, although we know that the DP longitudinally predicts personality pathology, no research yet has examined whether next to the DP in early childhood, the rate of change of the DP across development predicts personality pathology. Therefore, using cohort-sequential latent growth modeling in a population-based sample (N = 668), we examined the normative developmental course of mother-reported DP from ages 4 to 17 years and its associations with a wide range of adolescent-reported personality pathology dimensions 3 years later. The results showed that the DP follows a nonlinear developmental course with a peak in early adolescence. The initial level of the DP at age 4 and, to a lesser extent, the rate of change in the DP predicted a range of personality pathology dimensions in late adolescence. The findings suggest that the DP is a broad developmental precursor of personality pathology in late adolescence.

A five-factor model of developmental personality pathology precursors.

There is growing consensus that the dimensional structure of early personality pathology can be organized within a similar framework as in adults (De Clercq, De Fruyt, Van Leeuwen, & Mervielde, 2006; Tromp & Koot, 2008). From this perspective, the Dimensional Personality Symptom Itempool (DIPSI) was recently expanded from a 4- to a 5-dimensional trait structure (Verbeke & De Clercq, 2014), including Disagreeableness, Emotional Instability, Introversion, Compulsivity, and Oddity. This developmental maladaptive trait structure is in need of further research, however, before it can be accepted as a valid framework for describing early manifestations of personality dysfunction. By use of exploratory structural equation modeling (ESEM) analyses, the current study explored the fit of the 5-factor DIPSI framework across 4 different samples (N = 1456), and replicated 5 higher-order factors that demonstrated scalar invariance across age and metric invariance across informants and clinical status. These results underscore the robustness of 5 underlying dimensions of personality pathology at a young age and highlight adequate psychometric properties of the proposed DIPSI measure for describing childhood personality pathology precursors. (PsycINFO Database Record

Establishing a clinically relevant cutoff to the Dependency Scale from the dimensional clinical personality inventory

The Clinical Dimensional Personality Inventory (IDCP) is a 163-item self-report tool developed for the assessment of 12 dimensions of personality pathology. One of the scales comprising the instrument—the Dependency scale—is intended to provide psychometric information on traits closely related to the Dependent Personality Disorder (DPD). In the present study, we used both Item Response Theory modeling and Receiver Operating Characteristic curve analysis to establishing a clinically meaningful cutoff for the IDCP Dependency Scale. Participants were 2.481 adults, comprised by outpatients diagnosed with DPD, outpatients diagnosed with other PDs, and adults from the general population. The Wright's item map graphing technique revealed that outpatients were located at the very high levels in the latent scale continuum of the Dependency Scale, with a very large effect size for the mean difference between patients and non-patients. The ROC curve analysis supported a cutoff at 2.3 points in the Dependency Scale, which yielded 0.86 of sensitivity and 0.79 of specificity. Findings from the present investigation suggest the IDCP Dependency Scale is useful as a screening tool of the core features of the DPD. We address potential clinical applications for the instrument, and discuss limitations from the present study.