Personality Pathology Research Articles

The Co-occurrence of Personality Disorders and Substance Use Disorders.

Despite significant negative outcomes, the co-occurrence of personality disorders (PDs) and substance use disorders (SUDs) continues to be underrecognized, and the mechanisms contributing to this co-occurrence remain unclear. This review summarizes recent work on PD-SUD co-occurrence, with a focus on borderline and antisocial PDs, general substance use patterns among those with PDs, and the association of personality traits with SUDs. The prevalence of co-occurring PD-SUD is generally high, with estimates ranging depending on the type of PD and SUD, the population assessed, and the sampling methods and measures used. Current theoretical explanations for co-occurrence include shared etiology and predisposition models, with research highlighting the importance of transactional processes. Potential underlying mechanisms include personality traits and transdiagnostic characteristics. Recent research has increased focus on substances besides alcohol, dimensional models of personality pathology, and transactional explanations of co-occurrence, but more research is needed to disentangle the nuanced PD-SUD relationship.

Personality disorders in older adults: Differences in self-informant ratings.

Previous research on self-informant reports in assessing personality disorders (PDs) has been mainly focused on adults, leaving older adults under-studied. We examined self-informant agreement in PD screening among older adults (≥60 years) using the Gerontological Personality disorders Scale (GPS). Potential differences such as who reports more personality pathology on a PD screener (i.e., GPS), item accessibility and the effect of relational aspects were studied as well. Data of 326 older adult-informant dyads, of which the older adults were sampled from five general practices in the Netherlands, were used. Results indicate that self-informant agreement ranged from r = 0.26-0.73, with lower concordance on the GPS-subscale measuring intrapersonal aspects of personality pathology. Informants were more sensitive to habitual pathological personality features than older adults. Two GPS items showed differential item functioning across self- and informant-report. Of relational aspects, only congeniality affected the GPS-iv scores; lower ratings on congeniality were associated with higher GPS-iv scores (i.e., higher reporting of personality problems).

Intervention effect of Marxist spiritual education on patients with borderline personality disorder

Background Borderline personality disorder is a subtype of pathological personality. Some studies believe that pathological personality will affect the treatment of depression, and borderline personality is the most obvious one. Borderline personality disorder has a certain impact on the repair of psychosocial function. Ringing can even increase the risk of suicide. The emotional state of patients with this disease is quite similar to the emotional symptoms of patients with depression, which is easy to be missed or misdiagnosed, and there is a long continuity of borderline personality disorder. Therefore, the choice of treatment for patients with this disease is very critical.Subjects and Methods In the perspective of Marxism, spiritual life is the inner need and important content of the all-round development of human beings. Marxist spiritual education provides correct values and spiritual connotation. The effect of Marxist spiritual education on the intervention of patients with borderline personality disorder was discussed. In this experiment, 60 patients with borderline personality disorder were randomly selected from a hospital. SPSS 23.0 statistical software was used to process the data of self-rating anxiety scale (SAS) before and after the experiment.ResultsBefore intervention, there was no statistical significance in patients’ SAS scale scores (P>0.05). After intervention, the score of SAS scale was higher than that before intervention, and the difference was statistically significant (P<0.05).ConclusionsMarxist spiritual education has obvious improvement effect on borderline personality disorder, and can promote the physical and mental health development of patients.

Personality and Lifetime Need Frustration: A Person-Centered Perspective on Interpersonal Problems and Personality Pathology

The current research adopted a person-centered approach to examine whether people’s experiences of lifetime need frustration interact with their personality trait profiles to predict their problems and pathology from the perspectives of both the interpersonal circumplex (IPC) and the five-factor model (FFM). Data (N = 1,026) were analyzed using multilevel modeling. Consistent with prediction, lifetime need frustration predicted participants’ overall levels of interpersonal distress and personality pathology. Furthermore, levels of lifetime need frustration predicted the strength of the relationship between participants’ trait profiles (i.e., IPC and FFM) and their corresponding profiles of interpersonal problems and personality pathology. Findings from the present study demonstrate how between-person differences in lifetime need frustration give rise to the within-person organization of psychological maladjustment and highlight the importance of people’s traits in predicting their unique maladaptations to having their basic psychological needs frustrated.

Importance of personality disorders in epilepsy

<p>Epilepsy is one of the most common neurological disorders. Therapeutic success shows high variability between patients, at least 20-30% of the cases are drug-resistant. It can highly affect the social status, interpersonal relationships, mental health and the overall quality of life of those affected.<br>Although several studies can be found on the psychiatric diseases associated with epilepsy, only a few researches focus on the occurrence of personality disorders accompanying the latter. The aim of this review is to help clinicians to recognize the signs of personality disorders and to investigate their connection and interaction with epilepsy in the light of current experiences.<br>The researches reviewed in this study confirm that personality disorders and pathological personality traits are common in certain types of epilepsy and they affect many areas of patients&rsquo; lives. These studies draw attention to the importance of a multidisciplinary approach to this neurological disorder and to provide suggestions about the available help options. Considering the high frequency of epilepsy-related pathological personality traits that can have a great impact on the therapeutic cooperation and on the patients&rsquo; quality of life, it important that the neurologist recognizes early the signs of the patient&rsquo;s psychological impairment. Thus they can get involved in organizing the support of both the patient and their environment by including psychiatrists, psychologists, social and self-help associations.<br>As interdisciplinary studies show, epilepsy is a complex disease and besides trying to treat the seizures, it is also important to manage the patient&rsquo;s psychological and social situation. Cooperation, treatment response and quality of life altogether can be significantly improved if our focus is on guiding the patient through the possibilities of assistance by seeing the complexity and the difficulties of their situation.</p>.

Contemporary integrative interpersonal theory in diagnosing relational dynamics in personality disorders

Accumulating empirical evidence suggests that despite some issues of clinical utility, dimensional models of personality disorders perform better than categorical ones. The aim of the paper was to present the contemporary integrative interpersonal theory (CIIT), which can become an extension of dimensional models by taking into account the pathomechanism and relational dynamics of personality disorders. Interpersonal situation, which is the field for the expression of personality pathology, is the basic unit of analysis of functioning in the presented approach. The interpersonal situation model is structured by the motives of causality and communality, and more precisely defined by the concept of four systems: self, affect, perception and behaviour. Personality pathology manifests itself through a combination of dysregulation and distortion in each system, and the coordinated pattern of motivation, perception, emotions and behaviours can be depicted as an interpersonal signature. The concept can be used to analyse internal and interpersonal relationships of an individual, as well as to monitor and diagnose the relational processes between the patient and the clinician. Using the presented theory in practice would increase the accuracy of conceptualisation by understanding an individual pathomechanism, including both external and internal relevant factors. Additionally, the interpersonal situation model can be a valuable tool to help identify and organise patient data.

Structural connectivity of grandiose versus vulnerable narcissism as models of social dominance and subordination

Social dominance and subordination have been linked to fronto-limbic and fronto-thalamic networks and are related to phenotypes such as grandiose vs. vulnerable narcissistic traits. The latter have been linked to clinical features such as empathy and emotional regulation. In this study we tested the hypotheses that narcissistic traits are associated with white matter integrity in fasciculus uncinate, cingulum, and anterior thalamic radiation (ATR). We applied the Pathological Narcissism Inventory (PNI) to assess narcissistic traits in a sample of 267 psychiatrically healthy individuals. We used 3 T MRI to acquire Diffusion Tensor Imaging data for analysis with TBSS in FSL applying TFCE to test for correlations of fractional anisotropy (FA) and PNI scales. We detected a significant positive correlation of PNI total and FA in the right posterior cingulum. PNI Vulnerability was significantly correlated with FA in the left anterior and right posterior cingulum. We did not find overall correlations with PNI Grandiosity, but additional analyses showed significant effects with FA of ATR. Our results strengthen network models for narcissism underlying both personality variation and pathology. Especially associations of narcissistic vulnerability within fronto-limbic tracts suggest overlaps within neural correlates of related phenotypes like neuroticism, social subordination, and negative emotionality.

Personality Pathology and Momentary Stress Processes.

The expression of personality pathology differs between people and within a person in day-to-day life. Personality pathology may reflect, in part, dysregulation in basic behavioral processes. Thus, a useful approach for studying maladaptive trait expression comes from literature on stress and daily hassles, which provide dynamic accounts for the relations between individual differences and maladaptive dysregulation. This study sought to integrate maladaptive traits and dynamic stress processes to further dynamic models of personality pathology. In a combined clinical/community sample (N=297) oversampled for interpersonal problems, we used ecological momentary assessment (observation N=19,968) to investigate how maladaptive traits moderated the processes of stress generation, stress reactivity, and affective spillover/inertia. Tests of our preregistered hypotheses provided a mix of supportive and null findings for stress processes identified in past research, and mixed support for the moderating role of personality. The results provide insights into the relations between everyday stressors and personality pathology.

The mediating role of rumination in the relationship between pathological personality traits and Self‐ and other‐blame among parents of children with autism spectrum disorder: Structural Equation Modeling (SEM)

The mediating role of rumination in the relationship between pathological personality traits and Self‐ and other‐blame among parents of children with autism spectrum disorder: Structural Equation Modeling (SEM)

Эмоциональные факторы дефицита социальной перцепции при неврастении

Introduction. The study is aimed at identifying emotional factors that determine the deficit of social perception in neurasthenia. Theoretical analysis. Insufficient knowledge of the phenomenology of neurasthenia and the difficulties of its differential diagnosis at the stage of pathological personality development is shown. The lack of targeted assistance to patients and their objectively rapid disability is emphasized. The hypothesis is formulated that patients with neurasthenia have a pronounced violation of social perception, determined by social anhedonia. Empirical analysis. In the group of patients with neurasthenia, in comparison with healthy subjects, there are pronounced difficulties in recognizing emotions by verbal and nonverbal manifestations, finding the necessary tone of communication and weakness of analytical abilities that allow to anticipate the dynamics of social situations. Factor analysis has shown the decisive role of emotional determinants in the development of the studied disorders – a high level of social anhedonia and associated personal, reactive anxiety and depression. Conclusion. Emotional factors form a pronounced social anhedonia that determines the formation of social perception deficit. A weak focus on the details of social situations, a tendency to attribute one’s own experiences to others determine the low level of effectiveness of social interaction, gradual withdrawal from contacts and complete social disintegration.

Awareness of Narrative Identity Questionnaire (ANIQ) in Early Adolescents: Psychometric Evaluation and Association with Features of Personality Disorder

Identity formation is central to adolescent development. Challenges in establishing a stable sense of self is associated with maladaptive identity function, which has been recognized as a core feature of personality pathology. The narrative identity framework offers a unique lens to garner salient information about one’s sense of self. The Awareness of Narrative Identity Questionnaire (ANIQ) is a self-report measure of narrative identity validated in adults but is yet to be validated in adolescents. The current study aimed to conduct the first psychometric evaluation of the ANIQ in a sample of 205 youth aged 10–14 years (M = 12.1 ± 1.06 years; 50.7% female; 73.7% Hispanic) recruited from a public charter school. Results confirmed the four-factor structure of the ANIQ and showed high internal consistency. Convergent validity was supported through negative associations between the ANIQ and borderline personality features and identity diffusion. Incremental validity of the ANIQ over identity diffusion in predicting borderline personality features was also examined, but not supported. Overall, results support the ANIQ as a promising instrument for the assessment of narrative identity in youth. However, some improvements to the ANIQ might be necessary in order to use it as a clinical tool in identifying youth with personality pathology.

Pathological personality explains individual differences in global emotion dysregulation within the pathway between child maltreatment and severe depressive symptoms.

Global emotion dysregulation mediates the relationship between child maltreatment and severe depressive symptoms; however, there is a lack of research on maladaptive personality traits and their contribution to individual differences in global emotion dysregulation within this conceptual model. The present study tested a preliminary serial mediation model where maladaptive personality traits and global emotion dysregulation mediate the relationship between child maltreatment and severe depressive symptoms. A total of 200 patients with mood disorders (Mage = 36.5 years; 54% females) were assessed for maladaptive personality traits (Personality Inventory for Diagnostic and Statistical Manual of Mental Disorders [5th ed.] Brief Form), global emotion dysregulation (Difficulties in Emotion Regulation Scale-Short), childhood trauma (Childhood Trauma Questionnaire), and depressive symptoms (Patient Health Questionnaire-9). Ordinary least squares regression and partial least squares-structural equation modeling revealed a consistent and significant indirect effect of child maltreatment on severe depressive symptoms through negative affectivity, detachment, psychoticism, and global emotion dysregulation. Among child maltreatment types, only emotional abuse had a significant indirect effect on severe depressive symptoms through maladaptive personality traits and global emotion dysregulation, b = 0.50, SE = 0.09, 95% confidence intervals [0.326, 0.694] after controlling for age, gender, and remaining types of child maltreatment. Findings support the view that maladaptive personality traits shed important insights on individual differences in global emotion dysregulation, and this information could aid clinical formulation and treatment of childhood adversity-related psychopathology. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Supplemental Material for Pathological Personality Explains Individual Differences in Global Emotion Dysregulation Within the Pathway Between Child Maltreatment and Severe Depressive Symptoms

Supplemental Material for Pathological Personality Explains Individual Differences in Global Emotion Dysregulation Within the Pathway Between Child Maltreatment and Severe Depressive Symptoms

Shame-coping clusters: comparisons regarding attachment insecurities, mentalizing deficits, and personality pathology, controlling for general emotion dysregulation

BackgroundGeneral Emotion Dysregulation (GED) is increasingly implicated as an underlying factor in personality pathology; however, the regulation of specific emotions, such as shame, has been relatively overlooked in the literature. We aimed to identify distinct clusters of shame-coping/regulation and compare them regarding attachment insecurities, mentalizing deficits, and personality pathology, controlling for GED.MethodsA convenience sample of 600 participants (351 females and 249 males) from the general population with ages ranging from 18 to 65 (M = 33.78, SD = 12.80) completed a battery of self-report instruments, measuring shame-coping styles, GED, attachment insecurities, mentalizing deficits, criteria A and B of the alternative model for personality disorders, and borderline personality traits. A two-stage clustering method was employed, with shame-coping styles as the clustering variables. The identified clusters were then compared for their effects on dependent variables using multivariate and univariate analyses. These comparisons were also performed after controlling for GED.ResultsMultiple determination methods suggested a two-cluster solution: maladaptive and adaptive shame-coping. Attack-self, withdrawal, and attack-other styles were the main discriminators. Compared with the adaptive cluster, the maladaptive cluster was characterized by higher use of maladaptive and lower use of adaptive shame-coping styles. Multivariate analyses demonstrated significant differences for all the between-cluster comparisons, with and without GED as the covariate (p < .001).ConclusionsThe current study provides evidence for the presence of homogenous clusters of shame-coping in community-based adults. Between-cluster contrasts after controlling for GED suggest that addressing shame-coping could have incremental utility over and above GED.

Dating in a digital world: The role of pathological personality traits in psychological reactions to direct and ambiguous rejection

Ghosting is a type of interpersonal rejection involving a unilateral communication interruption without explanation, using technological channels. Vulnerable narcissism and borderline traits can increase sensitivity to interpersonal rejection and reduce tolerance to ambiguity, whereas grandiose narcissism is related to low rejection sensitivity. Yet, the influence of narcissism and borderline on responses to ghosting is unexplored. We examined the influence of pathological personality traits on psychological reactions to direct breakup and ghosting (i.e., ambiguous breakup) in a sample of 604 young adults (mean age = 22.4 ± 2.74). After measuring borderline and narcissistic traits (grandiose and vulnerable), participants were randomly assigned to one of two scenario-based conditions: direct breakup or ghosting events. Negative emotions and state paranoia were assessed after the experimental manipulation. Participants experienced greater negative emotions and state paranoia in the ghosting condition compared to direct breakup. Individuals high in vulnerable narcissism and borderline traits anticipated higher negative emotions and state paranoia. Grandiose narcissism was unrelated to such reactions. Unexpectedly, pathological personality traits did not moderate the effect of breakup ambiguity on individuals' psychological reactions. Findings suggest that the impact of pathological personality traits is reduced in front of such a socially painful stimulus as an ambiguous rejection.

Replication of the associations of positive, negative, and disorganized schizotypy with interview-assessed symptoms and impairment: Convergence with previous studies.

Schizophrenia-spectrum psychopathology appears best understood as being expressed across a continuum of clinical and subclinical symptoms and impairment referred to as schizotypy. This brief report describes a comprehensive replication study examining the associations of positive, negative, and disorganized schizotypy with interview ratings of impairment, psychopathology, and personality pathology in a sample of 161 young adults. Consistent with past studies, positive, negative, and disorganized schizotypy had distinct and hypothesized associations with symptoms and impairment. Positive schizotypy was associated with prodromal symptoms and schizotypal, paranoid, and borderline personality traits. Negative schizotypy was associated with impaired functioning, negative symptoms, and schizoid, schizotypal, and paranoid traits, as well as any broad personality disorder diagnosis; it was also associated with never having dated. Disorganized schizotypy was associated with impaired functioning, disorganized schizotypic experiences, attentional deficits, and schizotypal, paranoid, borderline, and avoidant personality traits, as well as depression. Overall, we successfully replicated findings from five previous schizotypy interview studies, supporting the construct validity of the multidimensional model of schizotypy and the Multidimensional Schizotypy Scale. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Daily manifestations of caregiver- and self-reported maladaptive personality traits in adolescent girls.

Establishing maladaptive personality traits at a younger age in a developmentally appropriate and clinically tangible way may alert clinicians to dysfunction earlier, and thus reduce the risk of significant impairment later in life. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) Alternative Model for Personality Disorders (AMPD) provides a set of traits useful for organizing behavioral and experiential patterns central to daily personality functioning. The goal of the present study was to evaluate manifestations indicative of AMPD traits via ambulatory assessments in the daily lives of adolescent girls. Caregivers and girls (N = 129; age: M = 12.27, SD = 0.80) provided baseline assessments of girls' trait vulnerabilities (negative affectivity, detachment, antagonism, disinhibition, psychoticism) and girls additionally completed a 16-day ecological momentary assessment protocol (N = 5,036 observations), rating social behaviors and experiences in their daily lives. Multilevel structural equation models revealed that trait vulnerabilities were linked to more extreme shifts in interpersonal experiences and behaviors from one moment to the next, suggesting that maladaptive personality traits were linked to greater variability. Furthermore, AMPD traits were positively and strongly related to negative affect in daily interpersonal situations. More specifically, girls' trait ratings were associated with elevated mean-levels of boredom, as well as interpersonal tension. Caregiver-reports complemented this perspective of dissatisfying social interactions, suggesting that especially detachment and antagonism accounted for lower levels of social connectedness and more variability in social activities in girls' daily lives. Results are discussed in terms of the short-term dynamics and related intervention targets of developmental personality pathology. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Retrospective reports of perceived parental invalidation and borderline personality traits: The indirect effect of personality functioning.

This study examined the indirect effect via Criterion A (personality functioning) of the Alternative Model for Personality Disorders (AMPD) in the relationship between retrospective reports of perceived parental invalidation and borderline personality traits measured by Criterion B (pathological personality traits). A total of 3,019 college students completed self-report scales of the Chinese Invalidating Family Scale, Level of Personality Functioning Scale-Brief Form 2.0, and Personality Inventory for DSM-5. It was found that the indirect effect of personality functioning was significant for the association between levels of perceived overall-B = 0.52, 95% CI [0.47, 0.57], maternal-B = 0.83, [0.75, 0.91], and paternal-B = 0.97, [0.87, 1.08] invalidation, and BPD traits. The outcomes of the research suggested the critical role of personality functioning as a potential mediator in the pathological effect of perceived parental invalidation on the development of borderline personality disorder features. While the study is limited by the use of self-report measurement, retrospective responding, and cross-sectional design, significant implications on the biosocial model and AMPD were discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Schema therapy in the diagnosis of eating disorder: features of early maladaptive schemas

The article is devoted to the study of early maladaptive schemas in patients with eating disorders. Patients with eating disorders represent a heterogeneous group, with a variety of mental pathologies, most often represented by patients’ personal characteristics. The present study analyzes deeper impairments in communication with close ones at an early age, predisposing to the onset of mental pathology. On the basis of the Psychiatric Clinical Hospital No. 1 named after N. A. Alekseev, 131 patients diagnosed with anorexia nervosa and bulimia nervosa were examined. In the course of the study, the Young Schema Questionnaire (YSQ-S3R) was utilized. Non-adaptive schemas were identified in the domain «disconnection and rejection» in all patients with eating disorders. In the patients with bulimia nervosa, the early schemas in the impaired autonomy domain were most pronounced, in contrast to the patients with anorexia nervosa. The schema of insufficient self-control in the impaired limits domain was also detected in these patients, while in the patients with anorexia nervosa, this indicator was not manifested. The hypervigilance and inhibition domain was manifested by maladaptive schemas in both groups, with the negativity schema expressed in patients with bulimia nervosa. The domain of focus on others is characteristic of all patients with eating disorders. A comparative analysis of the indicators of early maladaptive schemas in patients with anorexia nervosa and bulimia nervosa and the results of a group of healthy people was carried out. In the healthy group, the expressed early maladaptive schemas were not observed. Violations in satisfying basic needs at an early age can be triggers in the mechanism of development and maintenance of eating disorders and personality pathology in this group of patients.

Adverse childhood experiences in patients with schizophrenia: related factors and clinical implications.

The relationship between adverse childhood experiences (ACEs) and the development of psychotic symptoms is not well understood. Therefore, this study aimed to investigate the frequency and distribution of ACEs among patients with schizophrenia and their potential correlation with symptomatology and personality pathology. We conducted a cross-sectional study involving 571 patients with schizophrenia in Shanghai, China. Symptomatology was assessed using the Positive and Negative Symptoms Scale (PANSS) and personality pathology was assessed using the Personality Diagnostic Questionnaire Fourth Edition Plus (PDQ-4+). ACEs were assessed using the Child Trauma Questionnaire-Short Form (CTQ-SF). ACEs were highly prevalent, with 80.8% of the patients with schizophrenia reporting at least one ACE. The three most common types of ACE were physical neglect (69.8%), emotional neglect (28.2%), and emotional abuse (22.9%). For specific ACE, emotional abuse was significantly associated with PD traits, whereas emotional and physical neglect types of ACE was significantly associated with negative symptoms. A higher level of physical abuse was more commonly reported by men, younger individuals, and those with a higher level of antisocial PD traits. Higher levels of physical neglect were associated with more severe negative symptoms. ACEs are commonly observed in patients with schizophrenia. Therefore, it is strongly recommended that this clinical population be provided with a comprehensive assessment and individualized intervention for those exposed to specific ACEs.