Externalizing Spectrum Inventory Research Articles

Maladaptive facet trait profiles and psychopathology: a person-centered assessment approach

Person-centered approaches in personality allow greater understanding of how different subpopulations with specific personality profiles are linked with relevant outcomes. Studies under the Five Factor Model agree on the observation of a Resilient, an Undercontrolled and an Overcontrolled profile. However, studies using maladaptive traits are much more limited. The present research identify personality profiles based on the 25 maladaptative facet and examined the relationships with personality dysfunctioning, internalizing and externalizing symptoms.A mixed sample composed of community adults (n = 742) and patients (n = 312) completed the Personality Inventory for DSM-5 Short Form, the Inventory of Depression and Anxiety Symptoms-II, Externalizing Spectrum Inventory–Brief From, the 12 items Spanish version of the WHO Disability Assessment Schedule II and Level of Personality Functioning Scale-Brief Form 2.0. Latent profile analysis was performed on PID-5-SF score. The scores on internalizing, externalizing and functioning were compared across the profiles.Four profiles emerged: Resilient, Undercontrolled, Overcontrolled, and Ordinary type. The Overcontrolled and Undercontrolled types showed higher scores on pathology scales. While the Overcontrolled profile appeared more related to internalizing symptoms and impairment in self-functioning, the Undercontrolled profile was more linked to higher scores on externalizing symptoms and interpersonal dysfunctioning.

Psychometric properties of the Spanish adaptation of the Externalizing Spectrum Inventory-Brief Form (ESI-BF).

The Externalizing Spectrum Inventory-Brief Form (ESI-BF) measures tendencies toward disinhibition, lack of control, aggression, and substance use. This study adapts the ESI-BF to the Spanish population and assesses its psychometric properties. The study included 742 community adults obtained by stratified random sampling with proportional allocation according to gender, age, and geographical area of the Spanish territory and a clinical sample consisting of 333 patients. All participants completed the Personality Inventory for Diagnostic and Statistical Manual of Mental Disorders, fifth edition (PID-5) and the Alcohol Substance Dependence Severity Scale, in addition to the Spanish version of the ESI-BF. Reliability was quantified using McDonald's omega and Cronbach's α reliability coefficients. Validity evidences were studied applying confirmatory factor analysis (CFA) and correlations. Results indicated adequate reliability of scores on the ESI-BF's general factors and most of its facets. Regarding internal structure, and in line with previous studies, both symmetric and S-1 hierarchical two-subfactor (bifactor) emerged as the best-fitting models. Considering both criticisms of symmetric models and parsimony, the S-1 bifactor model, which showed configural invariance across gender and samples, was retained. Validity evidence based on the relationship with other measures of personality and alcohol consumption show correlations values theoretically expected in both clinical and community samples. Findings suggest that the Spanish adaptation of the ESI-BF shows functional near-equivalence to the original version. Its effective psychometric properties make it useful instrument for further research related to the externalizing spectrum. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Supplemental Material for Psychometric Properties of the Spanish Adaptation of the Externalizing Spectrum Inventory–Brief Form (ESI-BF)

Supplemental Material for Psychometric Properties of the Spanish Adaptation of the Externalizing Spectrum Inventory–Brief Form (ESI-BF)

Exploring the predictive power of impulsivity measures in predicting self-reported and informant-reported inpatient disruptive behaviors

ABSTRACT Impulsivity is strongly associated with aggression and antisocial conduct. Although self-report measures are a time-efficient means to assess impulsivity, they may be susceptible to socially desirable responding, particularly in forensic psychiatry. The current study aimed to investigate the predictive validity of three measures of impulsivity in predicting self- and informant-reported antisocial behavior: the Barratt Impulsiveness Scale, the Self-Centered Impulsivity scale of the Psychopathic Personality Inventory-Revised and the general Disinhibition factor of the Externalizing Spectrum Inventory. Next, the mediating role of a measure of self-deception, the Virtuous Responding scale, was examined in these associations. Participants (N = 94) were inpatients from addiction care and forensic psychiatry. Two regression analyses were conducted using self-reported antisocial behavior in the first, and informant-reported antisocial behavior in the second analysis as outcome variables. In addition, a mediated regression analysis was conducted, using the Virtuous Responding scale as a mediator. The impulsivity measures showed a substantially lower predictive validity when informant-reported behavior was predicted. The Virtuous Responding scale appeared to be unreliable in the current sample and showed no mediation effect. The results showed insufficient support for the predictive validity of the three measures of impulsivity. Alternative time-efficient assessments for impulsivity are needed, such as informant-based measures.

Psychometric Properties of the Externalizing Spectrum Inventory: Replication and Extension across Clinical and Non-Clinical Samples

The Externalizing Spectrum Inventory aims at assessing personality features that underlie externalizing disorders such as substance abuse and antisocial behaviors. The objective was to replicate the psychometric properties of the 160-item Externalizing Spectrum Inventory in Dutch clinical and non-clinical samples. First, Cronbach’s alpha, test-retest reliability and the factor structure were analyzed on a mixed sample of inpatients (n = 149), undergraduates (n = 227), and community participants (n = 178). The factor structure was evaluated through confirmatory and exploratory factor analyses; for the latter Parallel Analysis was used, based on Minimum Rank Factor Analysis. Next, the criterion validity was analyzed using the Aggression Questionnaire and the NEO-Five Factor Inventory as external measures. The Dutch Externalizing Spectrum Inventory subscales showed sufficient reliability (α=.68-.94; ICC=.68-.91), except in the undergraduate sample (α=.49-.96; ICC=.43-.97). The factor structure of the Externalizing Spectrum Inventory was not confirmed and the exploratory analysis yielded different factor solutions across samples. The criterion validity was supported with regard to trait aggression and partly supported with regard to the Five Factor Model. The results suggest that the ESI-160 and its original factor model can be used for prediction purposes. However, further research of the factor structure is strongly recommended.

Substance use is associated with reduced devaluation sensitivity.

Substance use has been linked to impairments in reward processing and decision-making, yet empirical research on the relationship between substance use and devaluation of reward in humans is limited. We report findings from two studies that tested whether individual differences in substance use behavior predicted reward learning strategies and devaluation sensitivity in a nonclinical sample. Participants in Experiment 1 (N = 66) and Experiment 2 (N = 91) completed subscales of the Externalizing Spectrum Inventory and then performed a two-stage reinforcement learning task that included a devaluation procedure. Spontaneous eye blink rate was used as an indirect proxy for dopamine functioning. In Experiment 1, correlational analysis revealed a negative relationship between substance use and devaluation sensitivity. In Experiment 2, regression modeling revealed that while spontaneous eyeblink rate moderated the relationship between substance use and reward learning strategies, substance use alone was related to devaluation sensitivity. These results suggest that once reward-action associations are established during reinforcement learning, substance use predicted reduced sensitivity to devaluation independently of variation in eyeblink rate. Thus, substance use is not only related to increased habit formation but also to difficulty disengaging from learned habits. Implications for the role of the dopaminergic system in habitual responding in individuals with substance use problems are discussed.

Efficiently measuring dimensions of the externalizing spectrum model: Development of the Externalizing Spectrum Inventory-Computerized Adaptive Test (ESI-CAT).

The development of the Externalizing Spectrum Inventory (ESI) was motivated by the need to comprehensively assess the interrelated nature of externalizing psychopathology and personality using an empirically driven framework. The ESI measures 23 theoretically distinct yet related unidimensional facets of externalizing, which are structured under 3 superordinate factors representing general externalizing, callous aggression, and substance abuse. One limitation of the ESI is its length at 415 items. To facilitate the use of the ESI in busy clinical and research settings, the current study sought to examine the efficiency and accuracy of a computerized adaptive version of the ESI. Data were collected over 3 waves and totaled 1,787 participants recruited from undergraduate psychology courses as well as male and female state prisons. A series of 6 algorithms with different termination rules were simulated to determine the efficiency and accuracy of each test under 3 different assumed distributions. Scores generated using an optimal adaptive algorithm evidenced high correlations (r > .9) with scores generated using the full ESI, brief ESI item-based factor scales, and the 23 facet scales. The adaptive algorithms for each facet administered a combined average of 115 items, a 72% decrease in comparison to the full ESI. Similarly, scores on the item-based factor scales of the ESI-brief form (57 items) were generated using on average of 17 items, a 70% decrease. The current study successfully demonstrates that an adaptive algorithm can generate similar scores for the ESI and the 3 item-based factor scales using a fraction of the total item pool. (PsycINFO Database Record

Striatal Dopamine, Externalizing Proneness, and Substance Abuse: Effects on Wanting and Learning during Reward-Based Decision Making.

We examined whether striatal dopamine moderates the impact of externalizing proneness (disinhibition) on reward-based decision-making. Participants completed disinhibition and substance abuse subscales of the brief form Externalizing Spectrum Inventory, and then performed a delay discounting task to assess preference for immediate rewards along with a dynamic decision-making task that assessed long-term reward learning (i.e., inclination to choose larger delayed versus smaller immediate rewards). Striatal tonic dopamine levels were operationalized using spontaneous eyeblink rate. Regression analyses revealed that high disinhibition predicted greater delay discounting among participants with lower levels of striatal dopamine only, while substance abuse was associated with poorer long-term learning among individuals with lower levels of striatal dopamine, but better long-term learning in those with higher levels of striatal dopamine. These results suggest that disinhibition is more strongly associated with the wanting component of reward-based decision-making, whereas substance abuse behavior is associated more with learning of long-term action-reward contingencies.

Functional coherence of insula networks is associated with externalizing behavior.

The externalizing spectrum encompasses a range of maladaptive behaviors, including substance-use problems, impulsivity, and aggression. Although previous literature has linked externalizing behaviors with prefrontal and amygdala abnormalities, recent studies suggest insula functionality is implicated. This study investigated the relation between insula functional coherence and externalizing in a large community sample (N = 244). Participants underwent a resting functional MRI scan. Three nonartifactual intrinsic connectivity networks (ICNs) substantially involving the insula were identified after completing independent components analysis. Three externalizing domains-general disinhibition, substance abuse, and callous aggression-were measured with the Externalizing Spectrum Inventory. Regression models tested whether within-network coherence for the 3 insula ICNs was related to each externalizing domain. Posterior insula coherence was positively associated with general disinhibition and substance abuse. Anterior insula/ventral striatum/anterior cingulate network coherence was negatively associated with general disinhibition. Insula coherence did not relate to the callous aggression domain. Follow-up analyses indicated specificity for insula ICNs in their relation to general disinhibition and substance abuse as compared with other frontal and limbic ICNs. This study found insula network coherence was significantly associated with externalizing behaviors in community participants. Frontal and limbic ICNs containing less insular cortex were not related to externalizing. Thus, the neural synchrony of insula networks may be central for understanding externalizing psychopathology.

Validation of the full and brief Externalizing Spectrum Inventory in Dutch forensic inpatients

The Externalizing Spectrum Inventory (ESI) was designed for assessing a broad spectrum of externalizing problems, including impulsive-aggressive behavior and substance abuse. After translation of the ESI into Dutch, a computerized version of the full Dutch ESI (ESI-NL) was administered to a mixed sample consisting of inpatients in forensic and addiction care (n = 99) and non-psychiatric community participants (n = 104). Internal consistencies, test–retest reliabilities, ‘predictive’ validity of the full and 160-item ESI-NL total scores and subscales were examined, along with the correlations between these two versions. The results indicated high reliability and predictive validity for both versions and a strong similarity between the two in direct comparisons. The 160-item Dutch ESI is recommended for clinical studies on violence proneness and externalizing problem behavior.

"Optimizing efficiency of psychopathology assessment through quantitative modeling: Development of a brief form of the Externalizing Spectrum Inventory": Correction to Patrick et al. (2013).

"Optimizing efficiency of psychopathology assessment through quantitative modeling: Development of a brief form of the Externalizing Spectrum Inventory": Correction to Patrick et al. (2013).

Greater externalizing personality traits predict less error‐related insula and anterior cingulate cortex activity in acutely abstinent cigarette smokers

Attenuated activity in performance-monitoring brain regions following erroneous actions may contribute to the repetition of maladaptive behaviors such as continued drug use. Externalizing is a broad personality construct characterized by deficient impulse control, vulnerability to addiction and reduced neurobiological indices of error processing. The insula and dorsal anterior cingulate cortex (dACC) are regions critically linked with error processing as well as the perpetuation of cigarette smoking. As such, we examined the interrelations between externalizing tendencies, erroneous task performance, and error-related insula and dACC activity in overnight-deprived smokers (n = 24) and non-smokers (n = 20). Participants completed a self-report measure assessing externalizing tendencies (Externalizing Spectrum Inventory) and a speeded Flanker task during functional magnetic resonance imaging scanning. We observed that higher externalizing tendencies correlated with the occurrence of more performance errors among smokers but not non-smokers. Suggesting a neurobiological contribution to such suboptimal performance among smokers, higher externalizing also predicted less recruitment of the right insula and dACC following error commission. Critically, this error-related activity fully mediated the relationship between externalizing traits and error rates. That is, higher externalizing scores predicted less error-related right insula and dACC activity and, in turn, less error-related activity predicted more errors. Relating such regional activity with a clinically relevant construct, less error-related right insula and dACC responses correlated with higher tobacco craving during abstinence. Given that inadequate error-related neuronal responses may contribute to continued drug use despite negative consequences, these results suggest that externalizing tendencies and/or compromised error processing among subsets of smokers may be relevant factors for smoking cessation success.

Optimizing efficiency of psychopathology assessment through quantitative modeling: Development of a brief form of the Externalizing Spectrum Inventory.

The Externalizing Spectrum Inventory (ESI; Krueger, Markon, Patrick, Benning, & Kramer, 2007) provides for integrated, hierarchical assessment of a broad range of problem behaviors and traits in the domain of deficient impulse control. The ESI assesses traits and problems in this domain through 23 lower order facet scales organized around 3 higher order dimensions, reflecting general disinhibition, callous aggression, and substance abuse. The full-form ESI contains 415 items, and a shorter form would be useful for questionnaire screening studies or multimethod research protocols. In the current work, we employed item response theory and structural modeling methods to create a 160-item brief form (ESI-BF) that provides for efficient measurement of the ESI's lower order facets and quantification of its higher order dimensions either as scale-based factors or as item-based composites. The ESI-BF is recommended for use in research on psychological or neurobiological correlates of problems such as risk-taking, delinquency, aggression, and substance abuse, and studies of general and specific mechanisms that give rise to problems of these kinds.

Effortful control and externalizing problems in young adults

The present study evaluates the relationship between effortful control (EC) and externalizing psychopathology in young adults. EC, the capacity to delay immediate impulses in favor of long-term goals, has been robustly linked to externalizing behaviors in children and adolescents. However, such data is limited in adults, and mechanisms underlying this relationship have yet to be evaluated. We hypothesized that the effect of low EC on greater externalizing problems would be mediated by elevated psychological distress. In total 236 undergraduate students completed the EC subscale of the Adult Temperament Questionnaire, the Brief Symptom Inventory, and the Externalizing Spectrum Inventory (ESI). The ESI was found to have four factors representing Callous Aggression, Impulsive Urgency, prosocial control, and Substance Abuse. The degree to which low trait EC manifested in increased Callous Aggression, Impulsive Urgency and decreased prosocial behavior was mediated by elevated psychological distress. However, EC was not related to Substance Abuse. These data indicate that EC plays an important role in shaping psychological and social adjustment in adulthood.

Supplemental Material for Optimizing Efficiency of Psychopathology Assessment Through Quantitative Modeling: Development of a Brief Form of the Externalizing Spectrum Inventory

Supplemental Material for Optimizing Efficiency of Psychopathology Assessment Through Quantitative Modeling: Development of a Brief Form of the Externalizing Spectrum Inventory

Validity of the Externalizing Spectrum Inventory in a criminal offender sample: Relations with disinhibitory psychopathology, personality, and psychopathic features.

The Externalizing Spectrum Inventory (ESI; Krueger, Markon, Patrick, Benning, & Kramer, 2007) provides a self-report based method for indexing a range of correlated problem behaviors and traits in the domain of deficient impulse control. The ESI organizes lower order behaviors and traits of this kind around higher order factors encompassing general disinhibitory proneness, callous-aggression, and substance abuse. In the current study, we used data from a male prisoner sample (N = 235) to evaluate the validity of ESI total and factor scores in relation to external criterion measures consisting of externalizing disorder symptoms (including child and adult antisocial deviance and substance-related problems) assessed via diagnostic interviews, personality traits assessed with self-reports, and psychopathic features as assessed with both interviews and self-reports. Results provide evidence for the validity of the ESI measurement model and point to its potential usefulness as a referent for research on the neurobiological correlates and etiological bases of externalizing proneness.