Personality Dysfunction Research Articles

Effect of personality dysfunction severity, maladaptive schemas, resilience, and coping strategies on quality of life during treatment of personality disorders

Effect of personality dysfunction severity, maladaptive schemas, resilience, and coping strategies on quality of life during treatment of personality disorders

Association between Peer Victimization (PV) in Childhood/Adolescence and Personality Disorders among Adult Patients

Peer Victimization (PV) or being bullied in childhood/adolescence has been associated with several negative outcomes in mental health conditions beyond the time of its occurrence. However, its possible association with personality disorders has been slightly explored. In the present study we have compared the frequency of DSM IV personality disorders among adult patients with (N = 28) or without (N = 418) a reported history of PV. For this purpose, axis II was evaluated with the Self-Report Checklist for Preliminary Items for Major Categories, whereas self-esteem and self-assessment of functioning were evaluated with single questions. Patients with PV history have met the diagnostic criteria of the avoidant (60.7% vs. 12.2%), depressive (28.5% vs. 5.2%) and paranoid (17.9% vs. 5%) personality disorders more frequently than patients without history of PV. Moreover, these patients with antecedents of being bullied have also reported lower self-esteem (2 vs. 3) and in the assessment of social functioning (4 vs. 5). Our study indicated that there is a clear association between PV and avoidant, depressive and paranoid personality patterns. These results suggest that the stress related with the experience of PV threatens a basic psychobiological need such as social acceptance with implications for the beginning of long-term dysfunctional personality trajectories.

PERSONALITY FUNCTIONING FEATURES OF CLINICAL ANXIETY AND COVID-19 ANXIETY AMONG OLDER ADULTS

Abstract Introduction Anxiety is a significant mental health problem among older adults and is commonly comorbid with personality disorders (PD). However, specific relationships between personality functioning (a proposed feature of PDs) and late-life anxiety remain unclear. This study examined relationships between two models of personality functioning with late life clinical anxiety and COVID-19 anxiety. Method: Older adults (n = 222) completed the Geriatric Anxiety Scale (GAS), Coronavirus Anxiety Scale (CAS), Levels of Personality Functioning Scale-Self-Report (LPFS-SR), and Severity Indices of Personality Problems-Short Form (SIPP-SF). Results The GAS and CAS were significantly correlated to all LPFS-SR and SIPP-SF domains with large effect sizes (> .78); higher clinical and COVID-19 anxiety was associated with increased personality dysfunction. In regressions, the LPFS-SR domains significantly accounted for 65% of variance in the GAS and 59% of variance in the CAS. Identity and Self-Direction were the strongest predictors of each anxiety scale, with Empathy also significantly related to coronavirus anxiety. The SIPP-SF domains significantly accounted for 65% of variance in the GAS and 58% of variance in the CAS. Responsibility and Social Concordance were the strongest predictors of each anxiety scale, with Self-Control also significantly related to clinical anxiety. Discussion: Results indicate theoretically-supported and meaningful overlap between clinical and COVID-19 anxiety with personality dysfunction according to two different models. This extensive overlap questions the extent to which personality functioning differentiates from affective distress. The two personality dysfunction models also differed somewhat in their relationships to anxiety, suggesting the need for further research especially among older adults.

Personality and erectile dysfunction in heterosexual romantic relationships: results from men’s self-reports and women’s partner-reports

Personality and erectile dysfunction in heterosexual romantic relationships: results from men’s self-reports and women’s partner-reports

A Self-Presentational Account of Entitlement: Entitlement Relates to Strategically Portraying Entitled Identities

Abstract Although entitlement is important for understanding antisocial behavior, personality dysfunction, and personality malevolence, little evidence exists on how entitlement relates to processes that could theoretically maintain and cultivate it. In line with a self-presentation conceptualization, we speculated that entitlement probably entails the cultivation and maintenance of various identities that generally occasion better treatment from audiences. This self-presentation conceptualization of entitlement has rarely been tested, and the evidence is inconclusive. To provide a more conclusive test, participants (N = 247) completed self-report indices of 6 entitlement features—from three different multidimensional models—and self-reported their past use of various self-presentation tactics. These self-presentation tactics are used to convey distinct identities (e.g., accomplished, threatening, superior) that generally garner better treatment from audiences. Exploratory factor analysis suggested the 6 entitlement indicators were composed of a single entitlement factor; generally, consistent with the self-presentation conceptualization, this entitlement factor related to more use of all the self-presentation tactics except benevolent tactics (apologies and exemplification) and supplication. Moreover, each entitlement indicator showed an approximately similar pattern of relations to the self-presentation tactics, suggesting they all share a similar approach to self-presentation. Hence, the findings are consistent with conceptualizing entitlement and its various features as including the strategic maintenance of identities that should occasion entitled treatment; such findings may have implications for understanding the foundations of entitlement. Supplemental materials are available here: https://files.press.uillinois.edu/journals/supplemental/ajp/hart/index.html

The Relationship Between Patients' Personality Traits, the Alliance, and Change in Interpersonal Distress in Intensive Group Treatment for Personality Dysfunction.

This study examined patients' personality traits as operationalized by the five-factor model in relation to early alliance and reduction of interpersonal distress through an intensive group treatment program for personality dysfunction. A sample of 79 consecutively admitted psychiatric outpatients with personality dysfunction who attended an 18-week intensive group treatment program completed the NEO Five-Factor Inventory at pretreatment, the Inventory of Interpersonal Problems at pre- and posttreatment, and the Edmonton Therapeutic Alliance Scale, a measure of the therapeutic alliance with the program therapist, at Session 5. Results indicated that patients who were relatively extraverted tended to rate the alliance with their program therapist higher and subsequently reported more improvement of interpersonal distress. The presence of a personality disorder did not moderate this mediation. Patients' extraversion likely promotes a bonding with the therapist and facilitates the interpersonal group work necessary for improvement. Assessing patients' level of extraversion before starting intensive group treatment might indicate which intervention strategies could be useful with that patient within the program frame.

Organization of Clinician-Rated Personality Disorder Types According to ICD-11 Severity of Personality Dysfunction.

Objective: The International Classification of Diseases, 11th edition (ICD-11) model of personality disorders (PD) allows clinicians to classify personality dysfunction according to four levels of severity. This approach is partially inspired by Kernberg's levels of personality organization, in which various PD types are organized according to their level of severity. This study sought to investigate whether the established ICD-10 PD categories can be organized according to the four levels of ICD-11 PD severity, and to what extent this organization aligns with Kernberg's four levels of personality organization. Method: A sample of 247 patients were rated by their mental health professionals according to ICD-10 PD categories and ICD-11 PD severity levels. Results: The frequencies of ICD-10 PDs on the different ICD-11 PD severity levels were generally found to be consistent with Kernberg's model. Accordingly, borderline and antisocial PDs predominantly occurred at the most severe levels, whereas anankastic, avoidant, and dependent PDs typically occurred at the milder levels. Only paranoid and histrionic PDs were less consistent with Kernberg's model. Conclusions: The findings indicate that the new ICD-11 PD severity dimension largely aligns with Kernberg's model of personality functioning with respect to the organization of PD types. Clinicians may therefore conceptualize familiar PD types in terms of their ICD-11 PD severity and vice versa.

Dysphagia Evaluation in a Multidisciplinary VA Cognitive Care Clinic.

The VA Cognitive Care Clinic (CCC) provides comprehensive evaluation and longitudinal treatment for older Veterans with neurocognitive disorders and their caregivers through multidisciplinary care including geriatrics, palliative medicine, neuropsychology, and social work. Speech-language pathology (SLP) was recently incorporated into the CCC team in response to calls for more proactive approaches to diagnosis and management of dysphagia (swallowing dysfunction) in persons with dementia. While dysphagia is estimated to be highly prevalent in this population, prior work has been limited by inadequate dementia characterization. The purpose of this novel quality improvement project was to provide descriptive information regarding the occurrence of dysphagia in persons with dementia seen in CCC. CCC patients underwent comprehensive neuropsychological and geriatrics assessments that led to a multidisciplinary determination of dementia diagnosis and subtype. Validated dysphagia-specific clinical evaluation tools included the Eating Assessment Tool (EAT-10; dysphagia-specific patient-reported outcome measure), the 3-ounce water swallow test to assess swallowing safety (aspiration risk), and the Test of Masticating and Swallowing Solids (TOMASS) to assess swallowing efficiency. A REDCap database was constructed to track CCC evaluation results and patient-specific variables derived from the electronic health record. Descriptive statistics were calculated for dementia diagnosis, subtype, and dysphagia measures. 124 patients were seen in CCC between 2017 and 2021. Eighty-eight patients (73%) received a dementia diagnosis with the majority meeting criteria for Alzheimer's disease (53%) or mixed etiology (24%). Sixty-eight (55%) of these patients were evaluated by an SLP during their initial intake appointment. Twenty of 59 patients (39%) scored 3 or higher on the EAT-10, indicating concern for dysphagia. Twenty-six of 64 patients (41%) failed the 3-ounce water swallow test. Thirty-one of 62 patients (50%) demonstrated inefficient mastication based on length of total masticatory time on the TOMASS. Findings from this initial cohort indicate that approximately one-half of patients with dementia assessed by a SLP demonstrated clinical signs of swallowing safety or efficiency impairment. Patient report of dysphagia-related symptoms occurred at a significantly lower rate, supporting the need for SLP services in multidisciplinary memory and geriatrics clinics to facilitate early identification of dysphagia and avoid serious dysphagia-related consequences, including pneumonia and malnutrition.

Pattern of Structural Relationships between Dysfunctional Personality Beliefs and Dependence Severity in Substance Dependent People: Mediated by difficulty in Emotion Regulation

Pattern of Structural Relationships between Dysfunctional Personality Beliefs and Dependence Severity in Substance Dependent People: Mediated by difficulty in Emotion Regulation

Keratoconus and personality traits: A case–control study

AbstractPurpose: Aim of the present study is to evaluate and characterize the presence of dysfunctional personality traits in patients affected by keratoconus (KC) as compared with unaffected control.Methods: This is monocenter, interventional, prospective, case–control study recruiting 30 consecutive patients, aged 18–30, diagnosed with KC and age‐ and gender‐matched healthy controls. Enrolled patients underwent full ophthalmic and psychiatric evaluation. The latter consisted of the Structured Clinical Interview for DSM‐5 Disorder (SCID‐5), Symptoms Check List‐90 Revised (SCL‐90), NEO Five‐Factor Inventory (NEO‐FFI), and Temperament Evaluation Memphis, Pisa, Paris and San Diego (TEMPS‐A).Results: Overall, 51 subjects were recruited, of whom 31 in the study and 20 in the control group. Significant differences emerged from the comparison of minimum corneal thickness (<0.0001), of keratometry (K1: p = 0.0063; K2: p < 0.0001), and of best corrected visual acuity values (p < 0.0001) between the study and the control group. Patients affected by KC demonstrated lower scores at the National Eye Institute Visual Function Questionnaire‐25 than the healthy controls (p < 0.0001). Mean scores of TEMPS‐A subscales of patients with and without KC differed significantly regarding cyclothymic (p = 0.0272), irritable (p = 0.0404) and anxious (p = 0.0155) temperament. For NEO‐FFI subscales (Table 2), patients with KC showed higher mean scores for neuroticism compared to non‐KC controls (p = 0.0077). Means scores of SCL‐90 showed no difference in all the subscales with the only exception of psychoticism (p = 0.0155). The SCID‐5 demonstrated a higher odd for patients with KC for psychiatric disorders and mood disorders (p = 0.0309), mainly of Cluster B (p = 0.0728) and Cluster C (p = 0.0359).Conclusions: Mood disorder and dysfunctional personality traits represent common comorbidities in KC. A prompt diagnosis and an effective management are mandatory to guarantee the best standard of care to affected patients.

Are Signals Regulating Energy Homeostasis Related to Neuropsychological and Clinical Features of Gambling Disorder? A Case-Control Study.

Gambling disorder (GD) is a modestly prevalent and severe condition for which neurobiology is not yet fully understood. Although alterations in signals involved in energy homeostasis have been studied in substance use disorders, they have yet to be examined in detail in GD. The aims of the present study were to compare different endocrine and neuropsychological factors between individuals with GD and healthy controls (HC) and to explore endocrine interactions with neuropsychological and clinical variables. A case−control design was performed in 297 individuals with GD and 41 individuals without (healthy controls; HCs), assessed through a semi-structured clinical interview and a psychometric battery. For the evaluation of endocrine and anthropometric variables, 38 HCs were added to the 41 HCs initially evaluated. Individuals with GD presented higher fasting plasma ghrelin (p < 0.001) and lower LEAP2 and adiponectin concentrations (p < 0.001) than HCs, after adjusting for body mass index (BMI). The GD group reported higher cognitive impairment regarding cognitive flexibility and decision-making strategies, a worse psychological state, higher impulsivity levels, and a more dysfunctional personality profile. Despite failing to find significant associations between endocrine factors and either neuropsychological or clinical aspects in the GD group, some impaired cognitive dimensions (i.e., WAIS Vocabulary test and WCST Perseverative errors) and lower LEAP2 concentrations statistically predicted GD presence. The findings from the present study suggest that distinctive neuropsychological and endocrine dysfunctions may operate in individuals with GD and predict GD presence. Further exploration of endophenotypic vulnerability pathways in GD appear warranted, especially with respect to etiological and therapeutic potentials.

Self-regulation profiles reflecting distinct levels of eating disorder and comorbid psychopathology in the adult population: A latent profile analysis.

Previous research showed that individuals with eating disorders (EDs) can be subtyped by their levels of psychopathology and self-regulation abilities. However, nothing is known about whether self-regulation abilities are solely suited to depict the heterogeneity in ED and comorbid psychopathology in nonclinical samples. Therefore, this study sought to explore self-regulation profiles and their ability to discriminate ED, depression and anxiety disorders, and personality dysfunction in the adult population. Within a German representative sample, N=2391 adults (18-92 years) were examined using latent profile analysis to identify profiles based on established cognitive and emotional self-regulation scales including attention control, cognitive reappraisal, and difficulties in identifying feelings. Profiles were validated with ED, depression, anxiety, and personality dysfunction measures. The final solution selected as best balancing goodness of fit and interpretability included four profiles-High-Functioning, Moderate-Functioning, Dysregulated, and Alexithymic-with high explanatory power of R2 =.99. Profiles were characterized primarily by differences in difficulties in identifying feelings followed by differences in attention control and differed significantly regarding ED, depression and anxiety disorders, and personality dysfunction, with the Dysregulated profile showing the most unfavorable correlates. This study uniquely revealed that low cognitive and emotional self-regulation were indicators for ED, depression, anxiety, and personality dysfunction in the adult population. Future research should investigate whether the identified profiles predict the development of ED and comorbid psychopathology longitudinally. Individuals with eating disorders present with difficulties in cognitive and emotional self-regulation, likely maintaining their symptoms. This representative study in the German adult population sought to build profiles based on cognitive and emotional self-regulation that differed in eating disorder and comorbid psychopathology. We discuss the potential to detect individuals with elevated eating disorder and comorbid psychopathology based on the identified profiles in nonclinical settings.

QLTI-23. BRAIN TUMOR-RELATED PAIN: INNOVATIVE APPROACHES TO DIAGNOSIS, TREATMENT, AND QUALITY OF LIFE ISSUES: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract OBJECTIVE The purpose of this systematic review and meta-analysis is to evaluate the various innovative approaches to diagnosing and treating patients presenting with brain tumor-related pain. BACKGROUND Brain tumors make up for lower than 2% of all cancers, which is heavily linked to high morbidity, deteriorated quality of life, and the death of the affected patients. Glioblastoma (GBM) makes up 38% of the malignant brain glioma.The main treatment approaches for gliomas are widely dependent on chemotherapy and radiation therapy. However, these methods have been associated with vast side effects which constitute the quality of life of the patient. METHODS This systematic review and meta-analysis conformed to PRISMA guidelines. A total of 3025 studies were assessed through the eligibility criteria to remain with twenty eligible studies. The included studies were then grouped into two categories; group one comprised 14 studies that focused on an innovative approach to diagnosis and treatment of gliomas, and six studies comprised of studies that focused on health-related quality of life (HRQoL) of patients with brain tumors. RESULTS Twenty studies that met the inclusion criteria were analyzed independently and in two groups: diagnosis and treatment and quality of life issues of brain tumor patients. In one group, one study revealed a relatively progression-free survival (PFS) going up to 57 weeks and overall survival (OS) time of more than 20 weeks after the initial surgery. Group two indicated HRQoL issues associated with symptoms such as headaches, fatigue, trauma, cognitive and personality dysfunction, leg weakness, and neurological deficits. CONCLUSION Timely diagnosis of the gliomas has significant improvements to the overall survival. Treatment approaches explored in the studies include Temozolomide (TZ), Gliadel Wafer, immunogeno-type, peptide vaccination, Bevacizumab, chemotherapy, radiation therapy, and Temsirolimus. Chemotherapy and radiation therapy have been linked to a deteriorated quality of life of the patients

The Inventory of Personality Organization: A valid instrument to detect the severity of personality dysfunction.

In the eleventh revision of the International Classification of Diseases (ICD-11), the severity of personality dysfunction became the central dimension of personality disorder's (PDs) definition, besides the trait domain qualifiers. Personality functioning, also known as personality organization (PO), is becoming an increasingly important concept in administering, predicting, and measuring severity and nature of personality disturbance. Otto Kernberg and his team developed several tools to measure personality impairment. The Inventory of Personality Organization (IPO) is a self-report rating scale for the measurement of PO. Aim of this study was to identify severity groups according to the level of PO and to explore their validity. A clinical sample of 118 patients was recruited from a 4-weeks in-patient cognitive psychotherapy program. Beside the IPO, Structured Clinical Interview for the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders, (DSM-IV.) Axis I and II, Symptom Check List-90 (SCL-90), State-Trait Anger Expression Inventory and Dissociative Experience scale (DES). Two types of analyses were conducted: a person-centered (latent profile) analysis and various variable-centered tests to confirm the factor structure of IPO and calculate group differences. The three-factor (CFI = 0.990, TLI = 0.990, RMSEA = 0.022, SRMR = 0.089) and the five-factor (CFI = 0.995, TLI = 0.995, RMSEA = 0.014, SRMR = 0.090) models of the IPO was supported. Latent class analysis identified three subgroups of PO: "Well-integrated," "Moderately integrated," and "Disintegrated" classes. There were no significant differences between the three classes in the number of Axis 1 diagnoses (p = 0.354; η2 = 0.01). Group differences in the number of PDs, the number of PD symptoms as well as in the presence of borderline and depressive PD were significant (all p < 0.001; V = 0.35-0.42; η2 = 0.15-0.26). Persons with more severe PO problem level had higher rates of psychopathological symptoms, state and trait anger, and dissociative characteristics (all p < 0.001; η2 = 0.13-0.36). The IPO can be an appropriate instrument to measure the severity of personality disorganization and to classify participants along a continuum of severity in this regard. Our results present further evidence that the severity of personality dysfunction, the central dimension of the ICD-11 and the Alternative Model for PDs is detectable with an instrument, the IPO, that was initially developed to detect the disturbances in PO.

Personality, Defenses, Mentalization, and Epistemic Trust Related to Pandemic Containment Strategies and the COVID-19 Vaccine: A Sequential Mediation Model.

The COVID-19 pandemic has considerably influenced all domains of people's lives worldwide, determining a high increase in overall psychological distress and several clinical conditions. The study attempted to shed light on the relationship between the strategies adopted to manage the pandemic, vaccine hesitancy, and distinct features of personality and mental functioning. The sample consisted of 367 Italian individuals (68.1% women, 31.9% men; M age = 37, SD = 12.79) who completed an online survey, including an instrument assessing four response styles to the pandemic and lockdown(s), the Personality Inventory for DSM-5-Brief Form, the Defense Mechanisms Rating Scales-Self-Report-30, the Reflective Functioning Questionnaire, and the Epistemic Trust, Mistrust, Credulity Questionnaire. Maladaptive response patterns to pandemic restrictions were related to dysfunctional personality traits, immature defense mechanisms, poor mentalization, and epistemic mistrust or credulity. Moreover, more severe levels of personality pathology were predictive of an extraverted-maladaptive response style to health emergency through the full mediation of low overall defensive functioning, poor certainty of others' mental states, and high epistemic credulity. Recognizing and understanding dysfunctional psychological pathways associated with individuals' difficulties in dealing with the pandemic are crucial for developing tailored mental-health interventions and promoting best practices in healthcare services.

Psychometric Properties of the Italian Version of the 25-Item Hikikomori Questionnaire.

A serious form of social withdrawal, initially described within Japan as hikikomori, has received increasing attention from the international scientific community during the last decade. The 25-item Hikikomori Questionnaire (HQ-25) was initially developed and validated in Japan. To date, data on its psychometric properties in other populations where cases of hikikomori have been described are still scarce. Thus, the aims of this study were to (1) translate, adapt, and validate the Italian version of the HQ-25 analyzing its psychometric properties; and (2) verify the association between hikikomori and personality functioning, social support, and problematic Internet use. A sample of 372 Italian adults aged 18 to 50 years completed the HQ-25 and measures of psychoticism, personality dysfunction, social support, and problematic Internet use were employed to test the convergent validity of the HQ-25. The data showed a satisfactory fit for a three-factor model, significantly better than a one-factor model. The three factors (socialization, isolation, and emotional support, as in the original study on the HQ-25) correlated positively with psychoticism, personality dysfunction, and problematic Internet use, and correlated negatively with social support. A lifetime history of hikikomori was present in 1.1% of the sample (n = 4). This is the first study to use the Italian validated version of the HQ-25 with an adult population. The findings from this study provide evidence of the satisfactory psychometric properties of the Italian version of the HQ-25 and support further investigation of the HQ-25 as an instrument to help screen for and investigate the presence of hikikomori.

Alexithymia in Facebook Addiction: Above and Beyond the Role of Pathological Narcissism.

Personality dysfunctions and deficits in the capacity to cope with negative emotional states have been related to internet addictions. However, in relation to Facebook addiction, this issue remains poorly investigated. Specifically, few studies explored the role played by grandiose and vulnerable narcissism in Facebook addiction. Furthermore, the relationship between alexithymia and pathological narcissism has not yet been explored in relation to problematic Facebook use. The main objective of this study was to examine the association among Facebook addiction, pathological narcissism and alexithymia. A cross sectional study was designed to this aim. A sample of adult participants (N=270; Mage=41.05; SD=14.05) was administered the Bergen Facebook Addiction Scale (BFAS), The Pathological Narcissism Inventory (PNI) and the Toronto Alexithymia Scale (TAS-20). Results showed that pathological narcissism, and especially grandiose narcissism, appears to be an important factor associated to problematic Facebook usage among adults. Moreover, difficulties in the capacity to identify their own emotional states may be a risk factor for such condition. In conclusion, these results are in line with other data found in the field of behavioral addictions and add further reflection for planning more specific clinical intervention programs for individuals addicted to Facebook with narcissistic traits. These may benefit from a greater focus on the impairments in self-monitoring capacities such as emotional awareness. Personality psychopathologies should be targeted by clinical interventions, but also broader functional impairments (as such as alexithymia) should be addressed as more strategic therapeutic objectives in the field of Facebook Addiction.

Personality Functioning: An Opportunity for Treatment Personalization

As the literature shows, the categorical diagnosis of personality has received numerous criticisms. Over the years, authors suggest that personality dysfunction is distributed along a dimensional continuum.

Latent variable model of triarchic psychopathy constructs in an incarcerated offender sample: Factor reliability and validity.

The triarchic model of psychopathy posits that three distinct trait dispositions-disinhibition, meanness, and boldness-contribute to the interpersonal, affective, and impulsive-unrestrained features of this condition and is represented to varying degrees in all conceptualizations and measures of psychopathy. Using data for incarcerated males (n = 273) and females (n = 83) from 10 different prisons in Italy, we specified a latent variable model of the triarchic trait constructs in which scale measures of disinhibition, meanness, and boldness composed of items from the following inventories served as indicators: Triarchic Psychopathy Measure, Psychopathic Personality Inventory-Revised, Minnesota Multiphasic Personality Inventory-2 Restructured Form, and NEO Five Factor Inventory. A correlated three-factor solution evidenced adequate model fit, with individual triarchic trait scales loading strongly onto their target factors. The model exhibited comparable fit and factor loadings when specified using data for males only, and its factors showed expected relations with pertinent criterion variables, including measures of normative personality and clinical dysfunction along with staff ratings of prison behavior and release prognosis. Extending prior research with nonclinical participants from the U.S., present study results demonstrate the viability of a latent variable model of the triarchic traits in an incarcerated offender sample from a separate culture (Italy). The significance of this work lies in the potential of the triarchic traits to serve as conceptual-empirical points of reference for integrating findings across studies of psychopathy employing diverse samples and assessment measures. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Borderline Personality Disorder: Updates in a Postpandemic World.

Progress in understanding borderline personality disorder has unfolded in the last decade, landing in a new COVID-19-influenced world. Borderline personality disorder is now firmly established as a valid diagnosis, distinct from its co-occurring mood, anxiety, trauma-related, and behavioral disorders. Further, it is also understood as a reflection of general personality dysfunction, capturing essential features shared among all personality disorders. Neuroimaging research, representing the vast neurobiological advances made in the last decade, illustrates that the disorder shares frontolimbic dysfunction with many psychiatric diagnoses but has a distinct signature of interpersonal and emotional hypersensitivity. This signature is the conceptual basis of the psychotherapies and clinical management approaches proven effective for the disorder. Medications remain adjunctive and are contraindicated by some guidelines internationally. Less invasive brain-based therapeutics show promise. The most significant change in the treatment landscape is a focus on briefer, less intensive formats of generalist management. Shorter variants of therapies, such as dialectical behavior therapy and mentalization-based treatment, are in the process of being shown to be adequately effective. Earlier intervention and greater emphasis on functional improvement are needed to more effectively curb the disabilities and risks of borderline personality disorder for patients and their families. Remote interventions show promise in broadening access to care.