Trauma exposure and transdiagnostic distress: Examining shared and posttraumatic stress disorder-specific associations.

We examined transdiagnostic and posttraumatic stress disorder (PTSD)-specific associations with multiple forms of trauma exposure within a nationwide U.S. sample (N = 1,649, 50.0% female) of military veterans overselected for PTSD. A higher-order Distress factor was estimated using PTSD, major depressive disorder (MDD), and generalized anxiety disorder (GAD) symptoms as indicators. A structural equation model spanning three assessment points over an average of 3.85 years was constructed to examine the unique roles of higher-order Distress and PTSD-specific variance in accounting for the associations between trauma exposure, measured using the Life Events Checklist (LEC) and Deployment Risk and Resiliency Inventory Combat subscale (DRRI-C), and psychosocial impairment. The results suggest the association between trauma exposure and PTSD symptoms was primarily mediated by higher-order distress (70.7% of LEC effect, 63.2% of DRRI-C effect), but PTSD severity retained a significant association with trauma exposure independent of distress, LEC: ß = .10, 95% CI [.06, .13]; DRRI-C: ß = .11, 95% CI [.07, .14]. Both higher-order distress, ß = .31, and PTSD-specific variance, ß = .36, were necessary to account for the association between trauma exposure and future impairment. Findings suggest that trauma exposure may contribute to comorbidity across a range of internalizing symptoms as well as to PTSD-specific presentations.

An Item Response Theory Analysis of the Clinician-Administered PTSD Scale for DSM-5 Among Veterans.

We used item response theory (IRT) analysis to examine Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) item performance using data from three large samples of veterans (total N = 808) using both binary and ordinal rating methods. Relative to binary ratings, ordinal ratings provided good coverage from well below to well above average within each symptom cluster. However, coverage varied by cluster, and item difficulties were unevenly distributed within each cluster, with numerous instances of redundancy. For both binary and ordinal scores, flashbacks, dissociative amnesia, and self-destructive behavior items showed a pattern of high difficulty but relatively poor discrimination. Results indicate that CAPS-5 ordinal ratings provide good severity coverage and that most items accurately differentiated between participants by severity. Observed uneven distribution and redundancy in item difficulty suggest there is opportunity to create an abbreviated version of the CAPS-5 for determining PTSD symptom severity, but not DSM-5 PTSD diagnosis, without sacrificing precision.

The structure of aggressive personality.

OBJECTIVE: We sought to factor analyze a broad array of aggression measures to identify a comprehensive, coherent factor structure for this construct. BACKGROUND: Measures and models of trait aggression have multiplied to the point of incoherence. METHOD: In Study 1, a diverse sample of 922 undergraduates completed a battery of items acquired from 42 self-report aggression questionnaires. In Study 2, we administered a curated item pool to another diverse sample of 1447 undergraduates, alongside criterion measures. RESULTS: We curated an initial item pool of 734 items down to 289 items that exhibited sufficient variability, were not redundant with other items, and possessed strong loadings onto a central 'trait aggression' factor. These remaining items were best characterized by a six-factor structure, which captured relational, angry, violent, retaliatory, intimate partner, and alcohol forms of aggression. We estimated their hierarchical structure, correlations with their original aggression scales, Five Factor Model trait dimensions, impulsivity facets, and found them to be robust to gender composition and the inclusion of alcohol-naive and intimate-partner-naive participants. CONCLUSIONS: This factor structure mostly supported widely-accepted models of aggressive personality that focus on its overt and relational forms and reactive functions, though proactive aggression only loosely emerged as a distinct entity. We retained the final items as the Comprehensive Aggression Scale (CAS).

Network analysis of reasons for and against changing alcohol use among veterans engaged in a web-based intervention for hazardous drinking and PTSD symptoms.

Better understanding of reasons for and against change may be an effective strategy for supporting drinking reduction or abstinence among Iraq and Afghanistan veterans. The current study explored connections between reasons for and against changing hazardous alcohol use, as well as the relative importance of a given reason. Data from 366 veterans (86% male, 77% White) between the ages of 21 and 56 (M = 31.8, SD = 7.3) were obtained from a nationwide web-based alcohol and posttraumatic stress disorder randomized clinical trial. Participant-generated reasons for and against change were used to estimate two separate network models. The network of motives for changing alcohol use was generally well connected with predominately positive associations. Veterans reporting motivation to change alcohol use to improve functioning, enhance self-worth, and decrease alcohol-related consequences tended to have higher than average motivation to reduce or abstain from alcohol use. Alternatively, the network structure of motives against changing alcohol use demonstrated a nearly equal number of positive and negative associations. Whereas reasons to cope and sleep may imply higher than average motivation to continue drinking the same, veterans reporting reasons to reduce anxiety and have fun tended to have lower than average motivation to continue drinking. The current study may inform content modifications to self-help tools to more quickly and effectively target users' motivations from the beginning. Capitalizing on intervention users' motivations early may promote sustained engagement or improve therapeutic impact among those who only use the intervention for a short period of time.

Longitudinal PTSD network structure: measuring PTSD symptom networks over 5 years.

BACKGROUND: Network modeling has been applied in a range of trauma-exposed samples, yet results are limited by an over reliance on cross-sectional data. The current analyses used posttraumatic stress disorder (PTSD) symptom data collected over a 5-year period to estimate a more robust between-subject network and an associated symptom change network. METHODS: A PTSD symptom network is measured in a sample of military veterans across four time points (Ns = 1254, 1231, 1106, 925). The repeated measures permit isolating between-subject associations by limiting the effects of within-subject variability. The result is a highly reliable PTSD symptom network. A symptom slope network depicting covariation of symptom change over time is also estimated. RESULTS: Negative trauma-related emotions had particularly strong associations with the network. Trauma-related amnesia, sleep disturbance, and self-destructive behavior had weaker overall associations with other PTSD symptoms. CONCLUSIONS: PTSD's network structure appears stable over time. There is no single 'most important' node or node cluster. The relevance of self-destructive behavior, sleep disturbance, and trauma-related amnesia to the PTSD construct may deserve additional consideration.

Borderline personality disorder symptom networks across adolescent and adult clinical samples: examining symptom centrality and replicability.

BACKGROUND: Numerous theories posit different core features to borderline personality disorder (BPD). Recent advances in network analysis provide a method of examining the relative centrality of BPD symptoms, as well as examine the replicability of findings across samples. Additionally, despite the increase in research supporting the validity of BPD in adolescents, clinicians are reluctant to diagnose BPD in adolescents. Establishing the replicability of the syndrome across adolescents and adults informs clinical practice and research. This study examined the stability of BPD symptom networks and centrality of symptoms across samples varying in age and clinical characteristics. METHODS: Cross-sectional analyses of BPD symptoms from semi-structured diagnostic interviews from the Collaborative Longitudinal Study of Personality Disorders (CLPS), the Methods to Improve Diagnostic Assessment and Service (MIDAS) study, and an adolescent clinical sample. Network attributes, including edge (partial association) strength and node (symptom) expected influence, were compared. RESULTS: The three networks were largely similar and strongly correlated. Affective instability and identity disturbance emerged as relatively central symptoms across the three samples, and relationship difficulties across adult networks. Differences in network attributes were more evident between networks varying both in age and in BPD symptom severity level. CONCLUSIONS: Findings highlight the relative importance of affective, identity, and relationship symptoms, consistent with several leading theories of BPD. The network structure of BPD symptoms appears generally replicable across multiple large samples including adolescents and adults, providing further support for the validity of the diagnosis across these developmental phases.

Factor Structure of the FFM ATM: Antagonism, Emotional Stability, Impulsivity, and Agency.

The Dark Triad (DT) refers to three socially aversive personality constructs: psychopathy, narcissism, and Machiavellianism. In response to concerns with existing self-report questionnaires measuring these constructs, we created the Five Factor Model Antagonistic Triad Measure (FFM ATM), which uses 46 items to assess multidimensional, faceted versions of the three DT constructs. The current pre-registered study used two large samples (Ns = 600 and 1,247) to explore the structure of the FFM ATM using bass-ackward factor analyses. Participants completed the FFM ATM as well as measures of the five-factor model, aggression, antisocial behavior, and other criteria. A series of factor analyses identified four meaningful and replicable factors (i.e., Antagonism, Emotional Stability, Impulsivity, and Agency). The authors discuss the item composition of each of these factors, their relations to relevant criteria, and implications of conceptualizing the Antagonistic Triad as combinations of elemental traits (factors) as opposed to the multidimensional constructs of psychopathy, narcissism, and Machiavellianism.

Network analysis of mild traumatic brain injury, persistent neurobehavioral and psychiatric symptoms, and functional disability among recent-era United States veterans.

Recent-era U.S. veterans are clinically complex, with a high prevalence of co-occurring mild traumatic brain injury (mTBI), psychiatric conditions, and behavioral dysfunction. The current study examined the direct and indirect associations between mTBI and persistent neurobehavioral, psychiatric, and functional disability symptoms among recent-era U.S. veterans and service members (n = 648). We evaluated the postconcussive syndrome (PCS) potential causal model with two network analysis modeling approaches. Separate analyses were conducted for military mTBI and lifetime mTBI. An exploratory factor analysis was conducted to limit topological overlap in the network analysis. The most influential symptoms (i.e., the unique variables most strongly associated with the rest of the network) in the military mTBI network were behavioral disengagement, expected influence (EI) = 1.10; cognitive difficulties, EI = 1.08; agitation/irritability, EI = 1.05; and PTSD-related reexperiencing and avoidance symptoms, EI = 0.98. After accounting for other symptoms, mTBI was only minimally informative, EI = 0.34. Additionally, military mTBI did not moderate the association between symptoms or the overall connectivity of the network. The results for lifetime mTBI were consistent with those for military mTBI. The present analyses identified a variety of behavioral, cognitive, and emotional symptoms that play an important role in understanding comorbidity and daily functioning among recent-era U.S. veterans. Associations between cumulative mTBI that occurred in civilian or military settings were indirect and relatively small in magnitude. The current results add to a growing literature raising doubts about the PCS model.

Narcissism and the DSM-5 alternative model of personality disorder.

In the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Section III alternative model of personality disorder, narcissistic personality disorder (NPD) is assessed via required elevations on 2 of 4 Criterion A domains of personality dysfunction (i.e., self-direction, identity, empathy, intimacy) and 2 personality traits (Criterion B: attention seeking and grandiosity). Evidence to date suggests that these 2 traits successfully account for variance in scores in traditionally (i.e., Section II) assessed NPD and grandiose narcissism but leave substantial variance unaccounted for in the more broadly psychopathological construct of vulnerable narcissism. When tested simultaneously in the statistical prediction of NPD and narcissism scores, the Criterion B trait composite accounts for much greater unique variance than the Criterion A personality functioning domains. In general, the crIterion B traits associated with NPD are robustly related to narcissism, although several other traits also demonstrate substantial correlations with various narcissism measures (e.g., manipulativeness, callousness, deceitfulness) that may warrant further attention when assessing for narcissistic psychopathology. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Support for the three-factor model of narcissism and its personality underpinnings through the lens of the network psychometrics.

Recent literature on narcissism argues that there are three factors covering the construct: agentic, antagonistic, and neurotic. Within the current study, we aim to (a) empirically test whether this hypothesized structure reproduces using, for the first time, network psychometrics with eight distinct narcissism measures as well as reanalysing data from eleven narcissism measures from Crowe et al. (2019) and (b) scrutinize the personality underpinnings of the differentiated facets through the lens of the circumplex of personality metatraits (CPM) model. Within the study, N = 465 Polish adults were administered eight distinct narcissism measures, comprising 13 scales capturing different aspects of narcissistic personality and a measure of personality metatraits. Results revealed that the three-factor structure reproduces well in the network approach across both data sets. The circumplex analyses provided further evidence for the personality underpinnings of the three factors. We discuss the role of pathological narcissism within the three-factor conceptualization of narcissism. Findings of the current article facilitate the understanding of narcissistic personality. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

An empirically based power primer for laboratory aggression research.

Recent reviews suggest that, like much of the psychological literature, research studies using laboratory aggression paradigms tend to be underpowered to reliably locate commonly observed effect sizes (e.g., r = ~.10-.20, Cohen's d = ~0.20-0.40). In an effort to counter this trend, we provide a "power primer" that laboratory aggression researchers can use as a resource when planning studies using this methodology. Using simulation-based power analyses and effect size estimates derived from recent literature reviews, we provide sample size recommendations based on type of research question (e.g., main effect vs. two-way vs. three-way interactions) and correlations among predictors. Results highlight the large number of participants that must be recruited to reach acceptable (~80%) power, especially for tests of interactions where the recommended sample sizes far exceed those typically employed in this literature. These discrepancies are so substantial that we urge laboratory aggression researchers to consider a moratorium on tests of three-way interactions. Although our results use estimates from the laboratory aggression literature, we believe they are generalizable to other lines of research using behavioral tasks, as well as psychological science more broadly. We close by offering a series of best practice recommendations and reiterating long-standing calls for attention to statistical power as a basic element of study planning.

Uncovering the structure of antagonism.

Despite the advances in our understanding of the structure of personality and psychopathology (see Kotov et al., 2017), less attention has been paid to empirically examining their underlying facet structure. To gain a more nuanced understanding of the structure of personality, it is important to identify empirically derived lower order structures of these trait domains; thus, the present study sought to examine the structure of antagonism as represented by items from commonly used measures of pathological personality traits. Participants were recruited from a large, southeastern university (N = 532) and completed 234 antagonism items selected from seven measures of pathological personality traits. Criterion variables measuring interpersonal adjectives, aggression, substance use, depression, and anxiety were also collected. A series of factor analyses were conducted to examine the structure of antagonism at a range of specificities. A seven-factor solution emerged as being both comprehensive and reasonably parsimonious with factors labeled Callousness, Grandiosity, Domineering, Manipulation, Suspiciousness, Aggression, and Risk Taking. The present findings demonstrate how trait Antagonism unfolds at varying levels of specificity as well as how the emergent factors differentially relate to outcomes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Psychometric Properties of the Personality Inventory for DSM-5-Brief Form in a Community Sample with High Rates of Trauma Exposure.

In the current study, we used a sample of predominantly African-American women with high rates of trauma exposure (N = 434) to examine psychometric properties of the Personality Inventory for DSM-5-Brief Form (PID-5-BF). We compared model fit between a model with five correlated latent factors and a higher-order model in which the five latent factors were used to estimate a single "general pathology" factor. Additionally, we computed estimates of internal consistency and domain interrelations and examined indices of convergent/discriminant validity of the PID-5-BF domains by examining their relations to relevant criterion variables. The expected five-factor structure demonstrated good fit indices in a confirmatory factor analysis, and the more parsimonious, higher-order model was retained. Within this higher-order model, the first-order factors accounted for more variance in the criterion variables than the general pathology factor in most instances. The PID-5-BF domains were highly interrelated (rs = .38 to .66), and convergent/discriminant validity of the domains varied: Negative Affectivity and Detachment generally showed the hypothesized pattern of relations with external criteria, while Antagonism and Disinhibition displayed less consistent and discriminant relations. Results are discussed in terms of the costs and benefits of using brief pathological trait measures in samples characterized by high levels of psychopathology.

Fearless Dominance/Boldness Is Not Strongly Related to Externalizing Behaviors: An Item Response-Based Analysis.

There is substantial and ongoing debate regarding the centrality of Fearless Dominance/Boldness (FD/B) to psychopathic personality due, in part, to its generally weak relations with externalizing behaviors. In response to these findings, proponents of FD/B have offered two hypotheses. First, FD/B may have nonlinear associations with externalizing outcomes such that FD/B may lead to resilience at moderate levels, but an overabundance of FD/B will yield maladaptive behavioral outcomes. Second, FD/B may be related to antisocial outcomes when paired with high scores on other psychopathic traits such as self-centered impulsivity, meanness, or disinhibition. The current study tests these two possibilities using two large samples (Study 1: 787 undergraduates; Study 2: 596 Amazon's Mechanical Turk participants). An item response theory scoring approach particularly sensitive to curvilinearity was used to maximize our ability to find a true curvilinear effect, if present. No evidence in favor of the curvilinearity hypothesis was found. Only a single significant interaction predicting substance use was observed between boldness and meanness. These findings contribute to a growing literature raising concerns regarding the relevance of FD/B to psychopathy.

Components of the Triarchic Model of Psychopathy and the Five-Factor Model Domains Share Largely Overlapping Nomological Networks.

The triarchic model of psychopathy is a recently developed model of psychopathy that identifies three primary domains: Boldness, Meanness, and Disinhibition. These traits overlap substantially with general and pathological five-factor model of personality (Boldness = low Neuroticism + high Extraversion; Meanness = low Agreeableness; Disinhibition = low Conscientiousness). In the current study (total N = 1,266), we compare domains from the triarchic model of psychopathy and five-factor model in relation to self- and informant-report of external criteria (e.g., pathological traits, antisocial behavior), and quantified their absolute similarity using a profile-matching approach. The corresponding traits from these models show large interrelations and very similar convergent and divergent relations, suggesting that unaltered traits from one can be considered excellent representations of the other. Results are discussed in terms of the benefits of using a unifying trait-based model to study psychopathy, as well as personality disorders more broadly.

The quandary of covarying: A brief review and empirical examination of covariate use in structural neuroimaging studies on psychological variables.

Although covarying for potential confounds or nuisance variables is common in psychological research, relatively little is known about how the inclusion of covariates may influence the relations between psychological variables and indices of brain structure. In Part 1 of the current study, we conducted a descriptive review of relevant articles from the past two years of NeuroImage in order to identify the most commonly used covariates in work of this nature. Age, sex, and intracranial volume were found to be the most commonly used covariates, although the number of covariates used ranged from 0 to 14, with 37 different covariate sets across the 68 models tested. In Part 2, we used data from the Human Connectome Project to investigate the degree to which the addition of common covariates altered the relations between individual difference variables (i.e., personality traits, psychopathology, cognitive tasks) and regional gray matter volume (GMV), as well as the statistical significance of values associated with these effect sizes. Using traditional and random sampling approaches, our results varied widely, such that some covariate sets influenced the relations between the individual difference variables and GMV very little, while the addition of other covariate sets resulted in a substantially different pattern of results compared to models with no covariates. In sum, these results suggest that the use of covariates should be critically examined and discussed as part of the conversation on replicability in structural neuroimaging. We conclude by recommending that researchers pre-register their analytic strategy and present information on how relations differ based on the inclusion of covariates.

An evaluation of DSM-5 Section III personality disorder Criterion A (impairment) in accounting for psychopathology.

An alternative diagnostic model of personality disorders (AMPD) was introduced in DSM-5 that diagnoses PDs based on the presence of personality impairment (Criterion A) and pathological personality traits (Criterion B). Research examining Criterion A has been limited to date, due to the lack of a specific measure to assess it; this changed, however, with the recent publication of a self-report assessment of personality dysfunction as defined by Criterion A (Levels of Personality Functioning Scale-Self-report; LPFS-SR; Morey, 2017). The aim of the current study was to test several key propositions regarding the role of Criterion A in the AMPD including the underlying factor structure of the LPFS-SR, the discriminant validity of the hypothesized factors, whether Criterion A distinguishes personality psychopathology from Axis I symptoms, the overlap between Criterion A and B, and the incremental predictive utility of Criterion A and B in the statistical prediction of traditional PD symptom counts. Neither a single factor model nor an a priori four-factor model of dysfunction fit the data well. The LPFS-SR dimensions were highly interrelated and manifested little evidence of discriminant validity. In addition, the impairment dimensions manifested robust correlations with measures of both Axis I and II constructs, challenging the notion that personality dysfunction is unique to PDs. Finally, multivariate regression analyses suggested that the traits account for substantially more unique variance in DSM-5 Section II PDs than does personality impairment. These results provide important information as to the functioning of the two main components of the DSM-5 AMPD and raise questions about whether the model may need revision moving forward. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Difficulties with the conceptualization and assessment of Criterion A in the DSM-5 alternative model of personality disorder: A reply to Morey (2019).

The DSM-5 introduced an alternative model of personality disorders that is predicated on the presence of personality dysfunction (Criterion A) and pathological personality traits (Criterion B). Recently, a member of the DSM-5 Personality and Personality Disorder Work Group-Morey-published a measure of Criterion A. Our study (Sleep, Lynam, Widiger, Crowe, & Miller, 2019, this issue) examined the performance of Morey's (2017) Levels of Personality Functioning Scale-Self-Report (LFPS-SR) by testing its factor structure, relations with Axis I and II symptoms, and its incremental validity in predicting traditional personality disorders in comparison to Criterion B traits. In his response, Morey raised a number of issues regarding our examination of the LPFS-SR in relation to its factor structure, discriminant validity, and incremental validity. Moreover, he suggested our approach (i.e., pitting Criterion A vs. B) is emblematic of problems in the field that contributed to the relegating of the AMPD to Section III (on emerging measures and models). In our response, we answer his criticisms. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Examining hypothesized interactive and curvilinear relations between psychopathic traits and externalizing problems in an offender sample using item response-based analysis.

Fearless dominance (FD) generally manifests null to small relations with externalizing problems, leading some researchers to propose alternative paths by which FD features may relate to these problems. The current study provides a test of two possibilities, namely that FD (a) interacts statistically with self-centered impulsivity (SCI) such that FD is associated with externalizing problems only at high levels of SCI and (b) demonstrates curvilinear relations with externalizing problems such that FD is more strongly associated with these problems at high levels. We used a large correctional sample and item-response theory-related statistics to precisely estimate individuals' scores at the extremes of each major psychopathic trait. FD was not significantly associated with externalizing problems in interaction with SCI or at higher levels of FD, suggesting that psychopathic traits linked to boldness are not especially relevant to generalized externalizing behavior. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

A day in the life of Narcissus: Measuring narcissistic grandiosity and vulnerability in daily life.

There is growing interest in understanding the fluctuations in grandiose and vulnerable narcissistic states over time. Momentary data collection is vital in facilitating this new area of inquiry. Two narcissism adjective scales, the Narcissistic Grandiosity Scale and the Narcissistic Vulnerability Scale, have recently been developed for this purpose. In the present study, the validity of these 2 scales was examined across 3 different samples. Results indicate that these measures perform well psychometrically at both the momentary- and trait-level. Multilevel exploratory factor analyses reveal a clear 2-factor structure at both the within- and between-person level. Within-person correlations between these scales and other momentary scales (e.g., the Positive and Negative Affect Schedule) are consistent with theoretical expectations. Finally, individual differences in endorsement of both of these scales correlated with other dispositional measures, including existing narcissism measures (e.g., The Pathological Narcissism Inventory and The Five Factor Narcissism Inventory), at the between-person level in the expected manner. We conclude these scales are well-suited for momentary narcissism assessment in studies wishing to examine fluctuations in grandiosity and vulnerability. (PsycINFO Database Record (c) 2019 APA, all rights reserved).