Personality Disorder Traits Research Articles

Maladaptive conscientiousness is still conscientiousness

Dimensional models have gained traction for conceptualizing personality pathology, with increasing evidence that dimensions in those models link with general models of personality. One link that has been debated is between conscientiousness and the pathological traits of Obsessive-Compulsive Personality Disorder (OCPD), such as compulsivity, perfectionism, and workaholism. Research has supported the conceptualization of those pathological traits as maladaptively high conscientiousness. However, a pressing question is whether measures intended to assess maladaptive conscientiousness remain high-fidelity measures of conscientiousness, or if they become saturated with neuroticism. The only instrument that is ideally situated to answer this conceptual question is the Five Factor Obsessive Compulsive Inventory (FFOCI), because it was specifically developed as a measure of conscientiousness that assesses the maladaptive ranges of the trait. Thus, we investigated how well the FFOCI’s conscientiousness score replicated the nomological networks of traditional measures of conscientiousness. A sample of 305 participants, sampled for enhanced representation of the extreme ends of the conscientiousness distribution, completed a set of self-report questionnaires. In addition, 150 nominated peer informants described the targets’ personality. Results provided cross-method support for the FFOCI’s domain score as a measure of conscientiousness, including strong discrimination from neuroticism scores. This suggests that maladaptive conscientiousness is still conscientiousness and that the FFOCI assesses the trait in a way that uniquely spans traditional boundaries of normal and pathological measures.

Measuring pathological traits of the dependent personality disorder based on the HiTOP

We developed and validated a self-report scale for screening pathological traits of dependent personality disorder (DPD) from the Hierarchical Taxonomy of psychopathology (HiTOP) perspective. The sample was 693 adults who answered the new scale, the Dimensional Clinical Personality Inventory DPD (IDCP-DPD), the PID-5, the FFDI, and the FFBI. The IDCP-DPD was composed of six factors grouped in one general score. The scores showed associations with external measures in the expected direction, and the means comparisons showed large differences. Our findings indicated the IDCP-DPD as a useful clinical measure, and the structure observed confirms the spectrum level of the HiTOP.

Visual content underlying perception and memory for facial expression: Associations with personality disorder traits

Visual content underlying perception and memory for facial expression: Associations with personality disorder traits

Validity of a Revised Obsessive-Compulsive Personality Disorder (OCPD) Trait Profile and Its Relationship with Social Interaction Anxiety and Coping

There is evidence suggesting that the conceptualization and operationalization of Obsessive-Compulsive Personality Disorder (OCPD) is not satisfactory (Watters et al., 2019). In this study, we used an online sample (N = 1008) to investigate the construct validity of the PID-5 OCPD trait measure. Regression analyses supported our hypothesis that rigid perfectionism captured the core phenomenology of OCPD whereas restricted affectivity and intimacy avoidance were not conceptually related to the OCPD construct. Based on the biosocial theory for overcontrol (Lynch, 2018), we introduced anxiousness and workaholism to the PID-5 OCPD trait profile. In establishing the validity of the revised OCPD trait profile, we investigated, for the first time, the role of social interaction anxiety and maladaptive coping in OCPD. Our revised OCPD profile showed good validity and was characterized by marked social interaction anxiety and dysfunctional coping mechanisms. The findings may lead to a new conceptualization of OCPD which prioritizes deficits in social interaction and coping. We identify areas that need to be prioritized in the evaluation of OCPD by mental health professionals and offer avenues for new clinical research in the field.

Reliability and construct validity of the general factor of personality disorder.

Criterion B of the alternative model of personality disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), outlines maladaptive trait dimensions that characterize personality disorders. Emerging evidence from bifactor confirmatory factor analyses suggest these traits are related at a higher order level by a general factor of personality disorder (g-PD). Further, emerging evidence points to traits most closely related to borderline personality disorder as underpinnings of g-PD. Further investigation is required to better understand the shared basis of personality disorder, with attention to the reliability and validity of g-PD. The g-PD theory was examined in a clinical (n = 242), and community sample (n = 252) of adults, using a brief form of the Personality Inventory for DSM-5 (PID-5). Structural analyses supported a correlated 6-factor model and a bifactor solution, validating the g-PD structure. Reliability indices supported the unidimensionality, reliability, and replicability of the g-PD factor. The strongest loading and most unidimensional items on the g-PD factors were from the Negative Affectivity and Disinhibition trait domains, partially replicating the trait profile of borderline personality disorder traits. In validity analyses, the nomological network of the general and specific factors were examined. g-PD was more strongly correlated with internalizing measures and impairment than specific factors, but specific factors were more strongly correlated with thought disorder and externalizing measures than g-PD. Our results support the nature and reliability of a general factor characterized by Negative Affectivity and Disinhibition unifying personality disorder traits in a brief form of the PID-5. Implications for the alternative model of personality disorder, PID-5, and g-PD theory are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Borderline personality disorder traits and mentalising ability: The self-other social cognition paradox.

Borderline personality disorder (BPD) is a psychiatric condition characterised by a pervasive pattern of impulsivity, low self-image, and interpersonal conflicts. Previous findings indicate a mixed relationship between BPD and social cognition; little research as investigated whether BPD traits influence performance on specific elements of social cognitive tasks, i.e., positive/negative valence. Community-based typical controls (n = 151; 51% female) were recruited through an online survey. Participants completed aspects of the Personality Assessment Inventory pertaining to BPD traits, the Interpersonal Reactivity Index, and measures of both emotion recognition and mentalising. Following group stratification into high/low BPD traits, participants with high BPD traits were observed to perform significantly better when identifying negative valence stimuli. Furthermore, high levels of affect instability was found to significantly influence negative valence recognition. This research highlights previous research which shows a paradox between higher performance on measures of social cognition, with a group of individuals who report significant interpersonal and relational difficulties. This research supports the assessment of social cognitive processes for people with BPD and/or high BPD traits to support clinical formulation of strengths and difficulties.

Mentalizing in first-episode psychosis: Correlates with symptomatology and traits of borderline personality disorder.

To explore the associations between mentalizing, positive and negative symptoms of psychosis, and traits of borderline personality disorder, in a sample of patients with first-episode psychosis, and in a non-clinical sample. A quantitative cross-sectional design was employed. Thirty-two adults with first-episode psychosis and 148 non-clinical participants were assessed using the reflective functioning questionnaire. The questionnaire measures two dimensions of mentalizing, certainty and uncertainty about mental states. Traits of borderline personality disorder and symptoms of psychosis were measured using the self-report version of the Zanarini rating scale, the Community Assessment of Psychotic Experiences, and the Green et al., paranoid thought scale. Patients with first-episode psychosis reported increased mentalizing impairments, characterized as hypomentalizing tendencies, compared to the non-clinical group. Regression analysis showed significant associations between higher scores on the uncertainty about mental states scale and negative symptoms of psychosis in both groups. No associations were found between mentalizing impairments and traits of borderline personality disorder in the clinical sample, although associations were found in the non-clinical sample. The present findings suggests that impairments in mentalizing may be associated with negative symptoms of psychosis across both clinical and non-clinical samples. Mentalizing impairments was found to be associated with traits of borderline personality disorder, but this finding was only confirmed in the non-clinical sample. Mentalizing should therefore be considered in the early assessment and treatment of patients experiencing difficulties with negative symptoms of psychosis.

Temperament, parenting, mental disorders, life stressors and help-seeking behavior of Asian adolescent suicide attempters: A case control study.

PurposeThe need to elucidate risk factors for adolescent suicide is urgent, as suicide consistently ranks among the top causes of death globally. Understanding suicide risk factors could inform more effective interventions. Previous studies have identified certain risk factors associated with suicide, but there is a paucity of research among adolescent and multi-ethnic Asian populations.Materials and methodsThis case-control study sampled 13-to-19-year-old Asian adolescents who had attempted suicide (N = 60) and controls (N = 58) matched by age, ethnicity and gender at group-level (73.7% female). Life stressors, temperament, parenting style, mental health conditions and help-seeking behavior were examined.ResultsAll domains of life stress apart from emerging adult responsibility were higher among cases than controls, especially home life, peer pressure and romantic relationships. Suicide attempters tended to avoid new situations, be less adaptable to changes, have a negative outlook and irregular sleep-wake cycle. Additionally, they perceived their parents to be significantly more aggressive, neglecting, rejecting and cold, while parents’ perceptions of their own parenting were only significantly different in the domain of parental neglect. Cases were more likely to exhibit disorders of disruptive behavior, eating, mood, anxiety, symptoms of schizophrenia and experience of disturbing events. Significant differences were also found for 10 out of 12 Axis II disorders, particularly borderline, depressive, and avoidant personality disorder traits. No significant case-control differences were found regarding overall rates of help-seeking.ConclusionFindings from this study may help in suicide prevention efforts through more tailored interventions.

Sex differences in personality disorders in a Chinese clinical population.

IntroductionSex differences in the frequency and severity of personality disorders (PDs) have been widely reported in Western countries. However, limited literature suggests a similar sex distribution in the Chinese clinical population. This study investigated sex differences in self-reported and interviewed patients with PDs in a clinical population in China.Materials and methodsThe participants were 1,389 consecutive outpatients with a mean age of 30.5 years, including 634 (45.6%) males and 755 (54.4%) females. Self-reported PD traits were assessed using the Personality Diagnostic Questionnaire Fourth Edition Plus (PDQ-4+). PDs were diagnosed according to the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) Axis II (SCID-II).ResultsMale outpatients reported more paranoid, schizotypal, antisocial, and passive-aggressive PD traits, whereas females reported more borderline PD traits on the PDQ-4+. Self-reported PD traits in male outpatients were more likely to reach the positive threshold of antisocial PD than in females (χ2 = 5.293, p = 0.021). Males were more likely to meet the criteria for schizoid (χ2 = 5.050, p = 0.025), narcissistic (χ2 = 27.244, p < 0.001), antisocial (χ2 = 11.430, p = 0.001), avoidant (χ2 = 5.098, p = 0.024), and obsessive-compulsive PD (χ2 = 5.496, p = 0.019) diagnoses in the SCID-II. In contrast, females were more likely to meet the criteria of histrionic (χ2 = 12.327, p = 0.001), borderline (χ2 = 28.538, p < 0.001), and dependent (χ2 = 4.919, p = 0.027) diagnoses.DiscussionThese findings indicate gender differences in the traits, frequency, and pattern of PDs when assessed in a Chinese clinical population.

The relationship between sense of agency and borderline personality disorder traits in the general population

The relationship between sense of agency and borderline personality disorder traits in the general population

The role of sense of coherence and loneliness in borderline personality disorder traits: a longitudinal twin study

BackgroundBorderline personality disorder (BPD) implies having problems with identity and relations with other people. However, not much is known about whether these indications of BPD are present in adolescence, i.e., before personality disorders usually are diagnosed. In this study, we examined the prediction of an aspect of identity (i.e., sense of coherence [SOC]) and social relations (i.e., perceived loneliness) throughout adolescence on BPD traits in young adulthood. In addition, we examined to what degree the predictive ability could be attributed to genetic and environmental factors. We also examined whether life events in adolescence were related to BPD traits.MethodsThree thousand three hundred ninety-one twins, consisting of seven national birth cohorts from Norway, participated in the study. SOC, loneliness and life events were measured three times throughout adolescence with self-report questionnaires, with 2 years in between measurements. BPD traits were measured at the end of adolescence around the age of 19 with a structured interview. Regression analyses were performed to examine the prediction of SOC, loneliness and life events on BPD traits. Cholesky decomposition models were then used to determine to what degree the associations were due to genetic and environmental influences.ResultsThe prediction of SOC and loneliness on BPD traits increased from R = .25 (when measured 6 years prior to the assessment of BPD traits) to R = .45 (when measured shortly before the assessment of BPD traits). In addition, negative life events considered dependent on a person’s behavior were related to BPD traits. Negative independent and positive dependent life events did not contribute to the prediction of BPD traits. Cholesky decomposition models showed that SOC and loneliness were associated with BPD traits mainly due to shared genetic influences (i.e., the proportion due to genetic influences ranged from 71 to 86%). Adding negative dependent life events to the prediction of BPD traits did not change these percentages.ConclusionsThese findings indicate that the weaker SOC, the stronger feelings of loneliness, and the negative life events associated with BPD traits are mainly consequences of the genetic aspects of BPD traits, rather than having direct effects on levels of BPD symptoms.

Maladaptive Personality Traits in a Group of Patients with Substance Use Disorder and ADHD.

Background and Objectives: the comorbidity of personality disorders in patients who use psychoactive substances is common in psychiatric practice. The epidemiology of disharmonious personality traits in patients with ADHD and addictions in adulthood is still insufficiently researched. The study investigated the typology of personality traits in a group of adult patients consuming psychoactive substances, in whom symptoms of ADHD were identified. Materials and Methods: the study evaluates a group of 104 patients with chronic psychoactive substances abuse, in whom symptoms of ADHD were identified in early adulthood, in terms of comorbid personality traits. Results: statistically significant data have been obtained regarding the presence of clinical traits characteristic for cluster B personality disorders, the patients presenting lower levels of self-control, self-image instability, difficulties in the areas of social relationships and own identity integration. Conclusions: ADHD symptomatology precedes the clinical traits of personality disorders in patients with addictions, negatively influencing chronic evolution and quality of life.

An agenda for establishing the DSM-5 alternative model of personality disorder (AMPD) trait model in adolescence: Comment on Clark and Watson (2022).

In the years since the publication of the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5; American Psychiatric Association, 2013), considerable progress has been made in understanding the structure of the traits included in the Alternative Model of Personality Disorders (AMPD) in adulthood. In the next phase of research, the structure of the pathological trait model needs to be established more firmly in adolescence as well. There is promising evidence from studies of the Personality Inventory for DSM-5 (PID-5; Krueger et al., 2012) that the structure of pathological traits in adolescents shows considerable overlap with the structure in adult samples, but it is premature to conclude that the structure is entirely the same. To make additional progress in assessing personality pathology in youth, measures should be developed in multiple formats and for multiple informants; normal-range personality trait constructs should be included in measures for research and clinical use in young people; and research should incorporate Clark and Watson's (2022) recommendations to add new facets and the domain of Anankastia to adolescent measures of personality pathology. Adolescents stand to benefit from a trait taxonomy in the AMPD that more explicitly includes them. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Clinical utility of the alternative model of personality disorders: A 10th year anniversary review.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, (DSM-5) alternative model of personality disorders (AMPD) has now been available for researchers and clinicians for a decade. The present article aims to provide a narrative review of literature on the AMPD framework with particular emphasis on its clinical utility, inclusive of clinicians' and patients' acceptability, ease of use, diagnostic accuracy, continuity with clinically familiar constructs, and proposed utility for treatment planning, case-formulation, and clinical management. The review specifically covers the utility of Criterion A (i.e., Level of Personality Functioning Scale) and Criterion B (i.e., maladaptive personality traits) in relation to common disorders of personality. By drawing on empirical studies, surveys, clinical cases, and recommendations, the current review points to various aspects of clinical utility as well as areas for improvement. One way of increasing the AMPD's feasibility for clinicians is to omit the transitional personality disorder (PD) hybrid types while retaining a purer diagnostic classification of PD severity and traits that also align with the International Classification of Diseases, Eleventh Revision (ICD-11), PD classification. This would allow for a more efficient assessment for busy practitioners working in general psychiatry and primary care while retaining the possibility of a more fine-grained elaboration of the PD diagnosis in high-resource specialist settings. Such revision could possibly be introduced in DSM-5.1 or DSM-6. We also propose that future exploration of the AMPD's clinical utility may involve its potential value for allocation of clinical resources, communication between clinicians and their patients' relatives, and utility for informing different treatment modalities. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

How selves differ within and across cognitive domains: self-prioritisation, self-concept, and psychiatric traits

BackgroundHow we build and maintain representations of ourselves involves both explicit features which are consciously accessible on reflection and implicit processes which are not, such as attentional biases. Understanding relations between different ways of measuring self-cognition both within and across such cognitive domains is important for understanding how selves may differ from one another, and whether self-cognition is best understood as largely uni-dimensional or more multi-dimensional. Further, uncovering this structure should inform research around how self-cognition relates to psychiatric and psychological conditions. This study explores the relations between different constructs of self-cognition and how variability within them relates to psychiatric traits.MethodsOur final dataset includes within-subject (n = 288, general population) measures of explicit self-concept (using both the Self Concept Clarity Scale and Self Concept and Identity Measure), implicit self-prioritisation in a shape-label matching task (for both reaction time and sensitivity) and measurement of traits for five psychiatric conditions (autism, borderline personality disorder, schizophrenia, depression and anxiety). We first test whether self-cognitive measures within and across domains are correlated within individuals. We then test whether these dimensions of self-cognition support a binary distinction between psychiatric conditions that either are or are not characterised in terms of self, or whether they support self-cognition as transdiagnostically predictive of the traits associated with psychiatric conditions. To do this we run a series of planned correlations, regressions, and direct correlation comparison statistics.ResultsResults show that implicit self-prioritisation measures were not correlated with the explicit self-concept measures nor the psychiatric trait measures. In contrast, all the psychiatric traits scores were predicted, to varying degrees, by poorer explicit self-concept quality. Specifically, borderline personality disorder traits were significantly more strongly associated with composite explicit self-concept measures than any of depression, anxiety, or autism traits scores were.ConclusionsOur results suggest that selves can differ considerably, along different cognitive dimensions. Further, our results show that self-cognition may be a promising feature to include in future dimensional characterisations of psychiatric conditions, but care should be taken to choose relevant self-cognitive domains.

Self- but not other-mentalizing moderates the association between BPD symptoms and somatic complaints in community-dwelling adolescents.

The aim of this study was to evaluate the potential moderator role of poor mentalization in the association between borderline personality disorder (BPD) traits and somatization, specifically focusing on the polarities of self- and other-mentalizing. This is a cross-sectional, general population study evaluating adolescents (n=162, 61.3% female; ages 12-18, M=14.63, SD=1.02). The relationship between BPD traits and somatization was evaluated with self-mentalization (attention to emotions and clarity of emotions) and other-mentalizing as moderator variables. One hundred sixty-two adolescents without serious mental health disorders were evaluated using self-report measures for borderline personality disorder traits (screening questionnaire for the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II), somatic symptoms using the Somatic Symptoms Questionnaire (SSQ), self-mentalizing using the Trait Meta-Mood Scale-24 (TMMS) and other-mentalizing using the Adolescent Mentalizing Interview (AMI)). Linear regressions were conducted to test the moderation effects of self- and other-mentalizing in the relationship between BPD symptoms and somatic complaints, controlling for age and sex. Moderation analysis was conducted using PROCESS version 3.5. The association between BPD symptoms and somatic complaints was moderated by a self-mentalizing dimension (emotional clarity) (b=-0.019, 95% CI=-0.0379 to -0.0002, p=.0476), but not other-mentalizing (b=0.027, 95% CI=0.000 to 0.053, p=.051). The effect of BPD symptoms on somatization disappears when emotional clarity is high, regardless the level of attention to emotions. Self-mentalizing appears to be an adaptive skill as it attenuates the relationship between BPD traits and somatization. Specifically, emotional clarity rather than simple attention to emotions is the aspect of self-mentalizing attenuating this association. These results support that self-mentalization is an important function in the management of body-associated emotions even in non-clinical levels of BPD traits. Findings suggest that strengthening self-mentalizing skills across development might contribute to resilience and salutogenesis.

Autistic traits and obsessive-compulsive personality traits in OCD patients

BackgroundStudies have reported a high prevalence of autism spectrum disorder in young people with obsessive-compulsive disorder with a negative effect on psychosocial functioning. However, the extent to which autism spectrum disorder and obsessive-compulsive personality disorder traits overlap and by inference, the extent to which these separately classified Diagnostic and Statistical Manual of Mental Disorders disorders five (obsessive-compulsive personality disorder, personality disorder, autism spectrum disorder, neurodevelopmental disorder) may share a nosological relationship has not so far been systematically investigated in clinical samples.This study is done to detect the frequency of obsessive-compulsive personality traits and autistic traits in a sample of patients with obsessive-compulsive disorder.ResultsResults revealed that younger patients had significantly more severe and extreme obsessive-compulsive disorder scores. Moreover, Structured Clinical Interview for DSM-IV (SCID-II) and Autism Spectrum Quotient analysis revealed that younger patients had a significantly higher prevalence of personality traits and autistic traits respectively. Statistical significance as many patients with severe and extreme Yale-Brown Obsessive-Compulsive Scale showed criteria of obsessive-compulsive personality disorder. No association of statistical significance was found between obsessive-compulsive disorder severity and autistic trait presence. On the contrary, statistical significance was found between autistic traits and obsessive-compulsive personality disorder.ConclusionsThere is the presence of comorbidity of obsessive-compulsive personality traits and autism spectrum traits in obsessive-compulsive disorder patients. Obsessive-compulsive personality traits prevalence in obsessive-compulsive disorder patients was higher than in autistic traits. Several factors of genetic predisposition, environmental factors like education and marital status, employment, and intrinsic factors as age of patients all exhibited a pivotal role in obsessive-compulsive disorder prevalence and severity.

Supplemental Material for Child Versus Adolescent Borderline Personality Disorder Traits: Frequency, Psychosocial Correlates, and Observed Mother–Child Interactions

Supplemental Material for Child Versus Adolescent Borderline Personality Disorder Traits: Frequency, Psychosocial Correlates, and Observed Mother–Child Interactions

Understanding individuals' desire for change, perceptions of impairment, benefits, and barriers of change for pathological personality traits.

Despite clinical theory suggesting that individuals are largely unaware of personality-related problems (Gallrein et al., 2013; Oltmanns & Powers, 2012); work in this area shows that individuals possess insight into their pathological traits and the impairment they may cause. Individuals generally dislike pathological traits and desire change in the direction of greater adaptivity (Lamkin et al., 2018; Miller et al., 2018). Individuals may also be able to make small, intentional changes in some personality domains (e.g., neuroticism; Hudson & Fraley, 2015; Hudson & Roberts, 2014) but not others (no positive change in conscientiousness or agreeableness). It remains unclear why many individuals exhibit relatively little change in their pathological traits (e.g., antagonism), given their awareness of the problems these traits cause and their desire for change. The goal of the present study was to explore the relation between personality disorder (PD) traits and desire for change, perceived impairment and benefits, and barriers to change among an online sample (N = 497). Findings suggest that most individuals were uninterested in changing their trait levels; however, individuals with elevated PD traits were more interested in change than those with lower levels. Pathological traits were generally perceived as impairing rather than beneficial; however, mean level analyses revealed similar levels of perceived impairment and benefits for those relatively high on antagonism. Individuals reported that personality change was stymied in part because it was too hard, they were unmotivated to make the changes, or they did not know how to go about making such changes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Childhood trauma and borderline personality disorder traits: A discordant twin study.

A discordant twin design was utilized to examine the potentially causal effects of childhood trauma (CT; i.e., emotional abuse, physical abuse, sexual abuse, and witnessing violence) on borderline personality disorder traits (BPD traits) in early adulthood. The participants were 2,808 twins between 17 and 23 years from the Oslo University Adolescent and Young Adult Twin Project. BPD traits were assessed by the Structured Interview for DSM-IV Personality (SIDP-IV), and CT was assessed using the Childhood Trauma Interview (CTI). BPD traits (h² = .50) and CT (h² = .33-.69) were both found to be moderately heritable. Small but statistically significant associations between CT and BPD traits were found in the total sample. After controlling for shared environmental and genetic factors in the discordant twin pairs, the analyses showed little to no evidence for causal effects of CT on BPD traits. The results indicated that the associations between CT and BPD traits stem from common genetic influences. These findings are inconsistent with the widely held assumption that CT causes the development of BPD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).