Predicting nonsuicidal self-injury and suicidal risk: A comparison between the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Section II personality disorder and alternative model of personality disorders dimensions.

The clinical relevance of nonsuicidal self-injury (NSSI) has received growing recognition, and NSSI represents a relevant risk factor for suicide. The present study aimed at running a head-to-head comparison between interview scores of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Section II personality disorders (PDs) criteria, and DSM-5 Alternative Model of Personality Disorder (AMPD) Criterion A and Criterion B measures in providing significant and relevant information for understanding NSSI and suicidal ideation and behavior among psychotherapy participants. To this aim, a clinical sample of 103 adult participants was administered the Clinician-Administered Nonsuicidal Self-Injury Disorder Index (CANDI), the Columbia Suicide Severity Rating Scale (C-SSRS), as well as the Structured Clinical Interview for DSM-5 Personality Disorders, the Structured Clinical Interview for the DSM-5 Alternative Model for Personality Disorders Module I, and a self-report measure of dysfunctional personality traits (i.e., the Personality Inventory for DSM-5 [PID-5]). Logistic ordinal regression dominance analysis results showed that, when compared to the 10 DSM-5 Section II PD symptom counts, the DSM-5 Section III PD measure scores provided the same amount of information in the CANDI Global Severity Index scores (Nagelkerke pseudo-R² value = .41), and a markedly larger information quantity in the case of the C-SSRS Suicidal Ideation (+35.1%), and Suicidal Behavior Index (+35.9%) levels. As a whole, our data suggested the clinical usefulness of the DSM-5 AMPD in understanding NSSI and suicidal ideation and behavior. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Are problem buying and problem gambling addictive, impulsive, or compulsive in nature? A network analysis and latent dimension analysis study in Italian community-dwelling adults.

Prominent scholars suggested that the impulsive-obsessive compulsive continuum may represent a framework to understand both substance and behavioral addictions. However, the characterization of pathological buying (PB) and problem gambling (PG) within the compulsive-impulsive spectrum has not been extensively investigated. To explore the relationships among PB, PG, alcohol and substance abuse, DSM-5 obsessive-compulsive and related disorders, and impulsive dimensions, a sample of 1,005 Italian community-dwelling adult participants (55.5% female), was administered self-reported measures of PB, PG, and other theoretically-relevant constructs. We expected to observe a multidimensional structure in our data; moreover, DSM-5 obsessive compulsive and related disorders were hypothesized to be accounted for by a common dimension. Three dimensions were identified and replicated across two different, non-redundant methods (i.e., exploratory graph analysis and exploratory factor analysis), namely, substance use and gambling, obsessive and compulsive phenomena, and impulsivity dimensions. Specifically, PG seemed to represent a behavioral variant of addiction vulnerability, PB seemed more akin to obsessive-compulsive spectrum disorders, and disinhibition dimension represented the common core of negative urgency, lack of premeditation, lack of perseverance, sensation seeking (SS), and positive urgency. Our findings may be helpful in improving our knowledge on the similarities and differences between PB and PG.

The joint hierarchical structure of psychopathology and dysfunctional personality domain indicators among community-dwelling adults.

To examine the hierarchical structure of psychopathology and dysfunctional personality domains, 2416 Italian community-dwelling adult volunteers were administered a set of psychometrically sound psychopathology measures and the Personality Inventory for DSM-5 Brief Form+ (PID-5-BF+). Parallel analysis, minimum average partial, and very simple structure results suggested that 1-6 principal components (PCs) should be retained. Goldberg's bass-ackwards model of the joint psychopathology measure and PID-5-BF+ ipsatized domain scale correlation matrix evidenced a hierarchical structure that was consistent with the working model proposed by the Hierarchical Taxonomy of Psychopathology (HiTOP) consortium. Hierarchical agglomerative cluster analysis around latent variables of the psychopathology indicators and PID-5-BF+ domain scales recovered four latent dimensions, which were akin to the corresponding bass-ackwards components and nicely reproduced the HiTOP Internalizing, Externalizing, Thought Disorder, and Eating Pathology dimensions.

The neuropsychological correlates of (sluggish) cognitive tempo scales in school-aged children.

Sluggish Cognitive Tempo (SCT) is a neuropsychiatric construct including lethargy, behavioral sluggishness, and confusion. A growing number of studies in the literature suggest that this set of symptoms refers to neuropsychological constructs such as sustained attention. However, studies focusing on SCT and its neuropsychological correlates in developmental age are scarce. The present study aims to fill this gap. The Child and Adolescent Behavior Inventory (CABI - Teacher and Parent versions, also including the school functioning scale, and the Child Concentration Inventory (CCI-2) were administered to a sample of 128 Italian primary-school children (57.6% F, mean age 8.81, SD 1.07); the neuropsychological constructs involved in the study were sustained attention and reaction times to two computerized tasks. Bivariate non-parametric correlation analyses yielded significant negative associations between teacher-referred SCT and measures of sustained attention (e.g., the Attentional Network Test and the Hearts and Flowers task) as well as CABI-T school-functioning scale; a small-to-moderate positive correlation was found between CABI-T SCT scores and mean reaction times, as a measure of the slowness of behavioral responses on the Attentional Network Test: this result would appear to represent a fine operationalization of the SCT-characteristic of behavioral sluggishness. Implications of these results for operationalizing the SCT construct in developmental age are discussed.

Post-traumatic disorder symptom severity in the perspective of hierarchical taxonomy of psychopathology spectra and dysfunctional personality domains among trauma-exposed community-dwelling women.

To assess the relationships between post-traumatic stress disorder (PTSD) components, Hierarchical Taxonomy of Psychopathology (HiTOP) spectra, and dysfunctional personality domains, the Post-Traumatic Checklist for DSM-5 (PCL-5); the Personality Inventory for DSM-5-Brief Form+ (PID-5BF+); and self-report measures of HiTOP Internalizing, Thought Disorders, and Externalizing spectra were administered to 387 trauma-exposed Italian community-dwelling women. Before structural equation modeling (SEM), measurement components of models were assessed using confirmatory factor analyses. Both taxometric and Gaussian mixture analysis results were consistent with a dimensional representation of the PCL-5 scores. SEM results showed that PTSD components, at least as they were operationalized by the PCL-5 scores, were positively, significantly, and substantially associated with HiTOP Internalizing and Thought Disorder Spectra latent dimensions, as well as with Negative Affectivity, Detachment, and Psychoticism personality domains.

COVID-19 pandemic preventive behaviors and causal beliefs among Italian community dwelling adults.

In an online sample of 1054 Italian community-dwelling adults, we assessed the relationships between the frequency of implementation of practices intended to prevent COVID-19 infection, degree of agreement with theories about the origin of the infections, and the frequency of use of different sources of information concerning the COVID-19 pandemic. The results showed that participants' COVID-19-related preventive behaviors and causal beliefs were significantly associated with selected demographic variables and frequency of use of specific sources of information (e.g. scientific journals vs social media).

Reliability, Factor Validity, and Neuropsychological Correlates of the Child Concentration Inventory-2 in a Community Sample of Italian Adolescents.

Sluggish Cognitive Tempo (SCT) has been less frequently studied in adolescents compared with school-aged youth, few studies have examined youth self-report of SCT, and no study has examined SCT in Italy. The present study examined the reliability and validity of the Child Concentration Inventory-Version 2 (CCI-2), a youth self-report measure of SCT, in 452 Italian adolescent high school students (37.8% female; mean age = 15.92 years). Adolescents were administered Italian translations of the CCI-2 and the attention deficit hyperactivity disorder (ADHD) Self-Report Scale (ASRS). School performance variables (i.e., teacher-rated grades and teachers' disciplinary ratings) were also collected. A random subsample (n = 88) of participants was also administered the Mackworth Clock Test, a short version of the Attention Network Test, and the Stop-Signal Task. In our study, all CCI-2 items showed adequate convergent-discriminant validity, and the CCI-2 scale score showed adequate internal consistency reliability. Confirmatory factor analysis results suggested the adequacy of a one-factor model of the CCI-2 items, which showed to be invariant across sex. Confirmatory factor analyses supported the dissociability of SCT from ADHD-Inattention and ADHD-Impulsivity. SCT was significantly and negatively associated with adolescents' average school grades, whereas ADHD was also significantly and negatively associated with adolescents' disciplinary ratings. In the random subsample, the CCI-2 total score was positively, significantly, and uniquely associated with overall reaction time on the Attention Network Task, but not other neurocognitive variables. This study provides further support for the reliability and validity of self-reported SCT in adolescence.

A nine-month study on the course of COVID-19 related perceived post-traumatic stress disorder among Italian community-dwelling adults.

The present study aimed to evaluate base rate estimates, course of, and psychopathology and personality risk factors for COVID-19-related post-traumatic stress disorder (PTSD) in community-dwelling adults during the pandemic. 203 participants from a sample of 811 Italian community-dwelling adults agreed to participate in a nine-month, three-wave (Wave 1: March 2020; Wave 2: June 2020; Wave 3: December 2020) longitudinal study. Participants in the longitudinal study did not differ from the cross-sectional original sample on age, gender, civil status, educational level, occupation, and Italian area of residence. At each wave, participants were administered the PTSD scale of the International Trauma Questionnaire (ITQ), DSM-5 measures of acute stress, dissociation, depression and anxiety, as well as a maladaptive personality domain measure at Wave 1. Participants were instructed to answer to the ITQ items based only on COVID-19 pandemic and related containment measures. The point prevalence estimates of COVID-19 related PTSD at each wave ranged from 11% to 13%; however, up to roughly 23% of our participants experienced clinically relevant PTSD features during nine months of the COVID-19 pandemic in Italy. Multiple logistic regression results showed that experiencing internalizing symptoms (i.e., mostly acute stress) and selected personality features (i.e., Negative Affectivity and Psychoticism) at Wave 1 represent risk factors for PTSD symptoms at later waves. These findings extend previous knowledge on COVID-19 related PTSD and support the need for preventive and treatment interventions for PTSD during the COVID-19 pandemic.

Reliability and validity of the Diagnostic Scales of the Schedule for Nonadaptive and Adaptive Personality-2 (SNAP-2) in Italian community-dwelling adults and psychiatric patients.

To evaluate the psychometric properties of the Italian translation of the Schedule for Nonadaptive and Adaptive Personality-2 (SNAP-2) diagnostic scales, 837 Italian community-dwelling adults and 429 consecutively admitted Italian psychiatric adults were administered the SNAP-2. The 12 SNAP-2 diagnostic scales yielded reliable scores in both community (median ω value = .90) and psychiatric (median ω value = .92) samples. The 6-month temporal stability was adequate for all SNAP-2 diagnostic scales (median test-retest r-value = .84) in a subsample of the community-dwelling adults (n = 97). When we examined the correlations between the SNAP-2 diagnostic scales and the Five-Factor Model Rating Form trait scales among the community-dwelling adults, the double-entry intraclass correlation values (median ICCDE = .94) indicated a marked similarity between our correlation profiles and the correlation profiles that were reported in Samuel and Widiger (2008) meta-analysis. In our psychiatric-adult sample, the SNAP-2 diagnostic scales showed adequate convergent-validity coefficients (median r-value = .61) with criterion measures of DSM-IV axis II/DSM-5 Section II personality disorders (PDs). Finally, relative-weight analysis results showed that selected Personality Inventory for DSM-5 trait-scale scores explained a substantial amount of variance in SNAP-2 antisocial, avoidant, borderline, narcissistic, obsessive-compulsive, and schizotypal PD scale scores (median R 2 value = .55). As a whole, our data suggest that the Italian SNAP-2 diagnostic scales have adequate reliability and construct validity in the Italian culture. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The Validity of the World Health Organization Adult Attention-Deficit/Hyperactivity Disorder Self-Report Screening Scale for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition in Adolescence.

Objectives: Short, self-report screening measures for adolescent and adult attention-deficit/hyperactivity disorder (ADHD) would greatly enhance the likelihood of ADHD subjects to be correctly diagnosed and treated. This study aimed at testing the reliability, factor structure, convergent validity, external validity, and diagnostic accuracy of the official Italian translation of the ADHD Self-Report Screening Scale for DSM-5 (ASRS-5) in a sample of community-dwelling adolescents, extending previous data on adult participants to adolescent participants. Methods: Five hundred sixty-four community-dwelling male adolescents (mean age ≅15) were administered the ASRS-5, the Adult ADHD Self-Report Scale 18-item and 6-item versions (ASRS-18 and ASRS-6), the Wender Utah Rating Scale (WURS), and the Structured Clinician Interview for DSM-5-Clinician Version ADHD Module (SCID-5-CV-ADHD). School performance variables were also collected. Results: The item response theory (IRT) reliability of ASRS-5 was adequate. Dimensionality analyses strongly supported the unidimensional structure of ASRS-5 items; confirmatory factor analysis fit indices supported the adequacy of the one-factor model of ASRS-5. In terms of convergent validity, the ASRS-5 total score was significantly and positively associated with self-report and interview-based ADHD dimensional scores, as well as with school performance variables. Roughly 8.0% of our male adolescents met SCID-5-CV-ADHD criteria for categorical ADHD diagnosis. Ten-fold cross-validated receiver operating curve value was 0.843; precision-recall curve analysis suggests that an ASRS-5 total score >12 may be preferred for screening purposes in adolescence. Conclusions: Our data showed that the ASRS-5 may represent a psychometrically sound self-report instrument to reliably screen for DSM-5 ADHD, extending the range of application of ASRS-5 from adulthood to adolescence, suggesting that the ASRS-5 could be safely used for screening purposes also in community-dwelling adolescents, at least in its official Italian translation.

A longitudinal study on clinically relevant self-reported depression, anxiety and acute stress features among Italian community-dwelling adults during the COVID-19 related lockdown: Evidence of a predictive role for baseline dysfunctional personality dimensions.

BACKGROUND: Although necessary for public health, quarantine has been documented to cause post-traumatic stress symptoms, anxiety, and depression. We designed the present longitudinal study to evaluate the psychological impact of quarantine in Italian community-dwelling adult participants. METHODS: A sample of 304 Italian community-dwelling adult participants (75.7% female; mean age = 35.28 years) was administered self-reported measures of depression, anxiety and acute stress symptoms at the beginning and at the end of the lockdown. Potential predictors of clinically relevant symptoms at the end of the lockdown were assessed. Specifically, data on gender, civil status, education level, occupation, and area of residence, as well as maladaptive personality domains were collected. RESULTS: More than 43% of participants suffered from the early impact of the lockdown; at the end of the lockdown roughly 32% of participants still reported any clinically relevant depression anxiety, and/or acute stress disorder condition. Clinically relevant acute stress reaction at the beginning of lockdown was a particularly important risk factor for experiencing clinically relevant acute stress, depression, and anxiety at the end of the lockdown. Maladaptive personality domains represent non-trivial predictors of participants' self-reports of clinically relevant depression, anxiety, and acute stress conditions at the end of the lockdown. LIMITATIONS: Excess of female participants and the impossibility of evaluating if participants suffered from any internalizing disorder before the COVID-19 quarantine represent major limitations of our study. CONCLUSIONS: Our findings suggest assessment of internalizing disorder symptoms during quarantine may be helpful in identifying people who may benefit from early treatment interventions.

The relationship between obsessive-compulsive spectrum disorders and DSM-5 dysfunctional personality domains in a nonclinical sample of Italian women.

To evaluate the usefulness of the DSM-5 maladaptive personality domains in explaining the similarities and differences among four disorders included in the obsessive-compulsive spectrum, 428 Italian community-dwelling women (mean age = 31.96 years, SD = 12.30 years) were administered the Obsessive-Compulsive Spectrum Disorder Scales and the Personality Inventory for DSM-5-Short Form as part of an ongoing online survey on women's health. Multiple Indicators Multiple Causes (MIMIC) confirmatory bifactor analysis results showed that the OCSD general factor (i.e., obsessive-compulsive spectrum factor) was positively associated with Negative Affectivity, whereas Body Dysmorphic Disorder (BDD), Hoarding Disorder (HD), and Skin-Picking Disorder (SPD) specific factors showed significant and substantial differential relationships with dysfunctional personality domains. Specifically, BDD was positively associated with Negative Affectivity, Detachment and Psychoticism domains; HD was associated with high Negative Affectivity and Psychoticism; and SPD was associated with Detachment. © 2020 John Wiley & Sons, Ltd.

The Co-Occurrence of Trauma Related Disorder and Borderline Personality Disorder: AQ Study on a Clinical Sample of Patients Seeking Psychotherapy Treatment.

The nature of the relationship between borderline personality disorder (borderline PD), post-traumatic stress disorder (PTSD) and complex PTSD remains controversial. In this study we attempted to investigate the association between traumatic events and borderline PD and the co-occurrence of complex PTSD, PTSD and borderline PD. Finally, we tested the association between complex PTSD and PTSD diagnoses and other DSM-5 Section II personality disorders. In a sample of 416 patients, we administered the International Trauma Questionnaire (ITQ) to evaluate the PTSD/complex PTSD diagnoses and the Structured Clinical Interview for DSM-5 Personality Disorders (SCID-5-PD) and the Personality Diagnostic Questionnaire- 4+ (PDQ-4+) to assess borderline PD and other PDs. One hundred-twenty-three participants reported experiencing one or more traumatic events. Our findings show that the presence of adverse events does not represent a risk factor for borderline PD assessed using both SCID-5-PD and PDQ4+. A co-occurrence of borderline PD diagnoses and complex PTSD/PTSD diagnoses has not been observed. We found a significant association only between complex PTSD and schizoid personality disorder assessed using PDQ4+. Our findings suggest relevant clinical implications for the development of effective treatment for complex PTSD, PTSD and borderline PD.

The assessment of personality pathology in adolescence from the perspective of the Alternative DSM-5 Model for Personality Disorder.

Applying personality disorder diagnosis to adolescents is still a controversial topic. Notwithstanding there is now general agreement that personality disorders have its roots in childhood and adolescence, skepticism with regard to personality disorder diagnoses in adolescence seem to continue among clinicians. The aim of the present review is to summarize the available emerging literature on the assessment of personality pathology in adolescence according to the Alternative DSM-5 Model for Personality Disorders (AMPD). Specifically, we will provide an overview of the available instruments for assessing AMPD Criterion A and Criterion B, with a particular focus on their measurement properties in adolescence. Finally, suggestions for future researches are provided.

Latent variable modeling of item-based factor scales: Comment on Triarchic or septarchic?-Uncovering the Triarchic Psychopathy Measure's (TriPM) Structure, by Roy et al.

We critique Roy et al.'s (2020; this issue) approach to characterizing the item-level factor structure of the three scales of the Triarchic Psychopathy Measure (TriPM), in light of the manner in which the TriPM scales were developed, the purposes they were designed to serve, and the growing body of evidence supporting their construct validity. We focus on three major points: (1) The TriPM scales are item-based factor scales - i.e., item sets designed to index broad factors of larger multi-scale (parent) inventories; (2) item-level structural analysis can be useful for representing broad dimensions tapped by such scales, but it cannot be expected to provide an accurate picture of narrower subdimensions (facets) assessed by their parent inventories; and (3) it is critical to consider the nomological networks of the TriPM scales (and other triarchic scale measures) in appraising their effectiveness as operationalizations of the triarchic model constructs. We illustrate the first and second of these points by applying Roy et al.'s analytic approach to the trait scales of the NEO-FFI, which were developed to index broad personality dimensions of the multi-scale NEO-PI-R. We address the third point with reference to the growing body of literature supporting the construct validity of the TriPM scales and demonstrating their utility for advancing an integrative understanding of psychopathy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Impact of COVID-19 lockdown on sleep quality in university students and administration staff.

INTRODUCTION: In Italy, lockdown due to COVID-19 health emergency started on March 10 and partially ended on May 3rd, 2020. There was a significant increase of psychological distress and symptoms of mental illness, and worsening of quality of sleep in the general population. METHODS: Participants completed an anonymous web-based survey that include questionnaires about sleep and anxiety and depression symptoms. Our sample included 400 subjects: 307 students (mean age 22.84 ± 2.68) and 93 university administration staff workers (mean age 37.02 ± 12.46). RESULTS: we found an increase in Bed Time hour, Sleep Latency, and Wake-Up time between before and during COVID-19 emergency and a worsening of sleep quality and of insomnia symptoms. In particular, during the lockdown, the impact of the delay in Bed Time and in Wake-Up was more pronounced in students. In workers, we observed a prevalence of maintenance insomnia before COVID-19 of 24% that significantly increase during COVID-19 reaching 40%, while workers with difficulties in sleep initiation were only 15% that increased to 42%. In our sample, 27.8% showed depressive symptoms, while 34.3% showed anxious symptoms, in particular in students. CONCLUSION: The impact of lockdown was greater in students than in workers, and in females than in males. Concerning the psycho-emotional aspects, about one-third of our sample showed depressive or anxious symptoms. The results of our study may provide support for the implementation of some interventions for well-being in pandemic condition.

Assessing Mental Representation as an Indicator of Self and Interpersonal Functioning in Psychotherapy Patients.

The goal of this study was to test in a clinical sample the interrater reliability and convergent validity of the Differentiation-Relatedness Scale (D-RS), a measure that evaluates mental representations based on open-ended descriptions of self and significant others. The study also investigated the ability of the D-RS to predict personality disorders (PDs) from Section II of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and the dysfunctional trait domains presented in the Alternative DSM-5 Model for Personality Disorders Criterion B in Section III of the DSM-5. We also evaluated if the D-RS predicts observed Section II PDs over and above Criterion B of the Alternative DSM-5 Model for Personality Disorders. We found that the interrater reliability of the D-RS was good on the basis of the mean scores of 6 independent raters and that it showed moderate convergent validity. Results of dominance analyses indicated that the D-RS is a significant predictor of Section II borderline PD and of the overall number of DSM-5 PDs. When we considered the Section III Criterion B for PDs, the D-RS was not able to predict any of the Personality Inventory for DSM-5 domains, suggesting that the D-RS may be more related to personality functioning behind mental representations than to maladaptive personality traits. Finally, results of hierarchical regression analyses suggested that the D-RS produced a significant but modest increase in the prediction of borderline PD traits and the overall number of PDs traits even when the effect of the Personality Inventory for DSM-5 domains were controlled for.

Body Dysmorphic Disorder in the Perspective of the Alternative DSM-5 Model for Personality Disorder: A Study on Italian Community-Dwelling Women.

To evaluate the relationships between body dysmorphic disorder (BDD) and Alternative DSM-5 Model for Personality Disorder (AMPD) criterion A and dysfunctional personality trait (i.e., criterion B) measures, 420 Italian community-dwelling women were administered three measures of BDD (i.e., the Body Dysmorphic Disorder Questionnaire, the Body Dysmorphic Disorder-Dimensional Scale, and the Appearance Anxiety Inventory), as well as the Level of Personality Functioning Scale-Brief Form (LPFS-BF) and the Personality Inventory for DSM-5-Short Form (PID-5-SF). The three BDD measures showed substantial convergent validity correlations and could be reliably cumulated to obtain the BDD Cumulative Index (BDDCI). Several significant, nonnegligible correlations were observed between the BDDCI as well as the LPFS-BF scale scores and PID-5-SF personality trait scale scores. Relative importance weight analysis results showed that LPFS-BF scale scores and PID-5-SF trait scale scores were substantial predictors of the BDDCI scores (R = 0.42, f = 0.72). In particular, AMPD criterion A impairment in self-functioning and AMPD criterion B depressivity, anhedonia, perseveration, separation insecurity, and cognitive and perceptual dysregulation were core components of the dysfunctional personality profile associated with BDD.