The Predictive Validity of Consensual and Unique Facets of Neuroticism, Conscientiousness, and Agreeableness in Five Personality Inventories.

Consensual facet structures help to unify a highly fractured personality literature, but mask information obtained from unique personality facets assessed by individual personality inventories. The current study identifies the consensual and unique facets of neuroticism, conscientiousness, and agreeableness based on analyses of five widely used personality inventories (Disinhibition Inventory-I [DIS-I], Faceted Inventory for the Five-Factor model [FI-FFM], HEXACO Personality Inventory-Revised [HEXACO-PI-R], NEO Personality Inventory-3 [NEO-PI-3], and Temperament and Affectivity Inventory [TAI]) in a community sample (N = 440). Factor analyses revealed that neuroticism consisted of three consensual facets (distress/depression, anger, and sentimental anxiety) and four unique facets (shyness, regret/self-doubt, lassitude, and distractibility); conscientiousness consisted solely of four consensual facets (achievement striving, order, attentiveness, and responsibility); and agreeableness consisted solely of four consensual facets (prosociality, anger, venturesomeness, and trust). Regression analyses indicated that unique neuroticism facets predicted significant incremental variance across a range of psychological disorders. These results have significant implications for how neuroticism, conscientiousness, and agreeableness should be modeled at the lower order level in psychopathology research.

A prospective examination of health care costs associated with posttraumatic stress disorder diagnostic status and symptom severity among veterans.

Posttraumatic stress disorder (PTSD) is associated with increased health care costs; however, most studies exploring this association use PTSD diagnostic data in administrative records, which can contain inaccurate diagnostic information and be confounded by the quantity of service use. We used a diagnostic interview to determine PTSD diagnostic status and examined associations between PTSD symptom severity and health care costs and utilization, extracted from Veteran Health Administration (VHA) administrative databases. Using a nationwide longitudinal sample of U.S. veterans with and without PTSD (N = 1,377) enrolled in VHA health care, we determined the costs and utilization of mental health and non-mental health outpatient, pharmacy, and inpatient services for 1 year following cohort enrollment. Relative to veterans without PTSD, those with PTSD had higher total health care, B = 0.47; mental health clinic care, B = 0.72; non-mental health clinic care, B = 0.30; and pharmacy costs, B = 0.72, ps < .001. More severe PTSD symptoms were associated with mental health clinic care costs, B = 0.12; non-mental health clinic care costs, B = 0.27; and higher odds of inpatient, B = 0.63, and emergency service use, B = 0.39, p < .001-p = .012. These findings indicate that veterans' PTSD status, determined by a clinician-administered semistructured diagnostic interview, was associated with higher health care costs and increased use of mental health and non-mental health clinic services. The findings also suggest that more severe PTSD is associated with increased costs and utilization, including costly emergency and inpatient utilization.

Discrepancies between electronic records and clinical interview diagnosis of PTSD: Differences in mental health care utilization.

Prior research suggests that a significant number of veterans with posttraumatic stress disorder (PTSD) do not have this diagnosis recognized in the electronic health record (EHR). Unfortunately, such diagnostic errors can lead to improper allocation of already scarce health care services and resources. In this study, we examined concordance between PTSD diagnoses in the Veterans Affairs (VA) EHR and PTSD diagnoses based on a semistructured diagnostic interview and mental health service use in a sample of veterans (N = 1,299) enrolled in VA healthcare. Results from negative binomial regressions showed that veterans with PTSD based on the diagnostic interview and the EHR (true positives) used the most mental health care services. There were no significant differences between those without PTSD based on the interview and the EHR (true negatives) and those with PTSD based on interview that was not recognized in the EHR (false negatives) on total nonemergent outpatient mental health visits. However, veterans in the false negative group had more mental health-related emergent care visits (i.e., emergency room, urgent care, hospitalization) than veterans in the true negative group. Our findings suggest that veterans with PTSD who are not coded as such in the EHR may not be utilizing needed outpatient care but are seeking and receiving costly emergent care. Thus, accurate recognition of PTSD in the EHR is essential for connecting patients to outpatient mental health services. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Emotion regulation and the association between PTSD, diet, and exercise: a longitudinal evaluation among US military veterans.

Background: Posttraumatic stress disorder (PTSD) is associated with premature onset of chronic health conditions such as cardiovascular disease. Diet and exercise are behavioural contributors to physical health, and research suggests they are influenced by psychiatric symptoms, including PTSD. Objectives: The aim of this study was to examine longitudinal associations between PTSD and exercise and diet quality and to test if emotion regulation strategies contribute to the link between PTSD and these health behaviours. Method: A representative sample of US military veterans (n = 860 at Time 1, n = 503 at Time 2, mean age = 63 years, 91.5% male) were assessed twice over the course of approximately three years. Results: Mediation models revealed that the association between baseline PTSD symptom severity and subsequent diet quality was mediated by emotion suppression (measured at Time 2; indirect B = -.03; 95% CI: -.059 to -.002). Trauma exposure also directly predicted diet quality (B = -.31; p = .003). There were no significant direct or indirect associations between PTSD severity or trauma exposure and exercise engagement. Conclusions: These results suggest that PTSD symptoms are associated with worse diet quality and that the consumption of unhealthy food may be driven by efforts to suppress emotion. This carries implications for understanding and treating medical comorbidities among those with traumatic stress.

Antecedentes: El trastorno de estrés postraumático (TEPT) está asociado con el inicio prematuro de condiciones crónicas de salud, como la enfermedad cardiovascular. La dieta y el ejercicio son contribuyentes conductuales para la salud física y las investigaciones sugieren que están influenciados por los síntomas psiquiátricos, incluyendo al TEPT.Objetivos: El objetivo de este estudio fue el de evaluar las asociaciones longitudinales entre el TEPT y el ejercicio y la calidad de la dieta; asimismo, evaluar si las estrategias de regulación emocional contribuyen al vínculo entre el TEPT y estas conductas de salud.Métodos: Se evaluó a una muestra representativa de veteranos de guerra estadounidenses (n = 860 en el Tiempo 1, n = 503 en el Tiempo 2, edad promedio = 63 años, 91,5% varones) en dos oportunidades en un periodo de tres años.Resultados: Los modelos de mediación mostraron que la asociación entre la severidad de los síntomas del TEPT de base y la calidad subsecuente de la dieta estaba mediada por la supresión de emociones (medidos en el Tiempo 2; B indirecta = −.03; 95% CI: − .059 to − .002). La exposición al trauma también predijo la calidad de la dieta de manera directa (B = = −.31; p = .003). No se encontraron asociaciones, directas o indirectas, entre la severidad del TEPT o la exposición al trauma con el compromiso con el ejercicio.Conclusiones: Estos resultados sugieren que los síntomas del TEPT están asociados a una peor calidad de la dieta y que el consumo de alimentos no saludables puede estar impulsado por esfuerzos para suprimir las emociones. Esto conlleva a implicaciones para comprender y tratar las comorbilidades médicas entre aquellos con estrés traumático.

Beyond Distress and Fear: Differential Psychopathology Correlates of PTSD Symptom Clusters.

BACKGROUND: Research suggests that re-experiencing and avoidance are "core" PTSD symptoms, but there has been little research explicating their unique connections to psychopathology other than internalizing conditions such as depression and anxiety. We aim to unpack symptom heterogeneity within PTSD by exploring associations between re-experiencing and avoidance clusters and major psychopathology domains in a dimensional metastructural framework (e.g., the Hierarchical Taxonomy of Psychopathology, or HiTOP). METHOD: We used a trauma-exposed community sample (n = 233, 66.1% female, mean age = 45 years) to compare re-experiencing and avoidance's associations with factor-analytically derived dimensions generally corresponding to HiTOP structure: Distress, Fear, Detachment, Antagonism, Disinhibition, Thought Disorder, and Compulsivity. RESULTS: Both re-experiencing and avoidance were robustly related to Fear. Re-experiencing was particularly related to Distress and Thought Disorder, whereas avoidance was related to domains involving overinhibition (e.g., Compulsivity). Relative to avoidance, re-experiencing had broader and more substantial associations with psychopathology, partly as a function of its greater saturation with dysphoria. LIMITATIONS: Coverage of PTSD symptoms was limited to questionnaire measurement of re-experiencing and avoidance clusters. Results need to be replicated in samples selected for posttraumatic psychopathology. CONCLUSION: Although they are strongly intercorrelated and both are robustly related to Fear, re-experiencing and avoidance differ substantially in their unique relations with other forms of psychopathology, and re-experiencing may be less specific to PTSD than previously thought. These differences can be used to understand the etiology and phenomenology of re-experiencing and avoidance in greater depth to inform more targeted and effective interventions for posttraumatic psychopathology.

Examining the Criterion Validity and Diagnostic Specificity of Self-Report Measures of Narcissism and Mania.

We examined the validity of self-report measures of narcissism and mania by relating them to interview-based ratings of psychopathology. Narcissism scales were taken from the Narcissistic Personality Inventory (NPI), the Personality Diagnostic Questionnaire-4+, and the Short Dark Triad. Mania measures included the Altman Self-Rated Mania Scale (ASRM) and scales taken from the Hypomanic Personality Scale (HPS) and Expanded Version of the Inventory of Depression and Anxiety Symptoms. Our analyses addressed two key issues. The first issue was whether these scales demonstrated significant criterion validity (e.g., whether the HPS scales correlated significantly with interview ratings of mania). The second issue was whether they displayed specificity to their target constructs (e.g., whether the NPI scales correlated more strongly with ratings of narcissistic personality disorder than with other forms of psychopathology). All of the narcissism scales-including all three NPI subscales-correlated significantly with interview ratings of narcissistic personality disorder and showed considerable evidence of diagnostic specificity. Most of the mania scales also displayed good criterion validity and diagnostic specificity. However, two measures-the ASRM and the HPS Social Vitality subscale-had weak, nonsignificant associations with interview ratings of manic episodes; these findings raise concerns regarding their validity as specific indicators of mania.

Psychometric Performance of the Miller Forensic Assessment of Symptoms Test (M-FAST) in Veteran PTSD Assessment.

This study examined the psychometric properties of a widely used measure of symptom exaggeration, the Miller Forensic Assessment of Symptoms Test (M-FAST, Miller, 2001), in a sample of 209 (83.7% male) trauma-exposed veterans (57.9% probable current posttraumatic stress disorder; PTSD). M-FAST total scores evidenced acceptable internal consistency, but several subscales showed poor internal consistency. Factor analytic and item-response theory analyses identified seven poorly performing items. Comparisons with other measures of psychopathology and response validity (including subscales from the Minnesota Multiphasic Personality Inventory-2 Restructured Form) revealed that M-FAST scores were highly correlated with indices of psychopathology while less strongly associated with measures of symptom over-reporting. Empirically and clinically-derived (using a follow-up testing-the-limits procedure) revised M-FAST scores failed to improve the measure's psychometric performance. Results raise concerns about the validity of the M-FAST for identifying malingering in veterans with PTSD and carry implications for access to care and forensic evaluations in this population.

Aspects of extraversion and their associations with psychopathology.

Extraversion shows both negative and positive associations with psychopathology. Previous work in this area has focused largely on either a broad higher order extraversion domain score or on specific lower-order extraversion facets. The goal of this study was to explicate how two intermediate aspects of the trait-communal extraversion and agentic extraversion-relate to psychopathology. We examined these relations using the Communal Extraversion (e.g., enjoy spending time with people, would describe myself as cheerful, like places that are crowded and exciting) and Agentic Extraversion (e.g., speak my mind, take charge in a group of people, like the sensation of going really fast) scales from the Faceted Inventory of the Five-Factor Model (FI-FFM; Watson, Nus, & Wu, 2019). As expected, Communal Extraversion generally showed negative associations with psychopathology; it had particularly strong links to indicators of internalizing, including depression symptoms (correlations generally ranged from -.40 to -.60) and various forms of social dysfunction (most correlations ranged from -.35 to -.60). In marked contrast, Agentic Extraversion tended to have positive associations with psychopathology; it displayed particularly substantial links to indicators of mania, narcissism/narcissistic personality disorder, and traits related to externalizing (correlations generally ranged from .25 to .50). Regression results demonstrated that aspect-level analyses generated substantial increases in predictive power over the FI-FFM Extraversion domain score. This basic pattern of results replicated over time, across gender, and across both self-rated and interview-based indicators of psychopathology. These findings establish the value of examining relations with extraversion at the aspect level. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Anxious, but not depressive, symptoms are associated with poorer prospective memory performance in healthy college students: Preliminary evidence using the tripartite model of anxiety and depression.

Prospective memory (PM) - or memory for tasks to be completed in the future - is essential for daily functioning. Although depression and anxiety have been shown to impair PM performance, few studies have explored the relative contributions of different symptom domains. Here, we examined the relation between anxiety, depression, negative mood, and PM performance using the tripartite model. The tripartite model attributes the substantial overlap between anxiety and depression to general distress/negative affect. Twenty-seven non-diagnosed undergraduate participants first completed self-report measures of depression (Beck Depression Inventory-II), anxiety (Beck Anxiety Inventory [BAI], State Trait Anxiety Inventory [STAI]), and affect (Positive and Negative Affect Schedule). They were then given an event-based PM instruction to be completed during three ongoing cognitive tasks. Depressive symptoms and positive affect were unrelated to PM performance. Higher anxiety symptoms (BAI, r = -0.62; STAI, r = -0.41) and negative affect (r = -0.45) were associated with poorer PM performance, with anxiety doubling the variance explained over-and-above negative affect ( Δ R2 = 0.20). These preliminary results suggest that anxiety symptoms may be uniquely related to impairments in PM function, and highlight the need for future studies to consider the individual contributions of symptoms to understand changes in cognition and behavior.

An Integrative Analysis of the Narcissistic Personality Inventory and the Hypomanic Personality Scale: Implications for Construct Validity.

The primary goal of this study was to explicate the construct validity of the Narcissistic Personality Inventory (NPI) and the Hypomanic Personality Scale (HPS) by examining their relations both to each other and to measures of personality and psychopathology in a community sample ( N = 255). Structural evidence indicates that the NPI is defined by Leadership/Authority, Grandiose Exhibitionism, and Entitlement/Exploitativeness factors, whereas the HPS is characterized by specific dimensions reflecting Social Vitality, Mood Volatility, and Excitement. Our results establish that (a) factor-based subscales from these instruments display divergent patterns of relations that are obscured when relying exclusively on total scores and (b) some NPI and HPS subscales more clearly tap content specifically relevant to narcissism and mania, respectively, than others. In particular, our findings challenge the construct validity of the NPI Leadership/Authority and HPS Social Vitality subscales, which appear to assess overlapping assertiveness content that is largely adaptive in nature.

A transdiagnostic approach to examining the incremental predictive power of emotion regulation and basic personality dimensions.

Although personality and emotion regulation abilities appear to overlap considerably, few studies have adopted an integrative approach by examining personality and emotion regulation together. Therefore, it is unclear how much incremental power emotion regulation demonstrates in predicting psychopathology beyond personality traits, and vice versa. Results from a community sample characterized by high levels of psychopathology (N = 299) indicated that personality and emotion regulation represent strongly related but distinguishable constructs, with both showing incremental power beyond the other in many cases in predicting self-reported and interview-rated psychopathology. More specifically, difficulties in responding adaptively to negative emotional experiences displayed predictive power beyond neuroticism and other personality traits in predicting internalizing psychopathology and psychoticism. Conversely, neuroticism displayed substantial incremental predictive power beyond emotion regulation and other five-factor model traits, especially for anxiety and other internalizing psychopathology. Other five-factor model traits also showed incremental predictive power in specific cases (e.g., agreeableness and conscientiousness showed specificity in predicting antagonism and disinhibition, respectively). These data provide a starting point for developing a finer-grained understanding of how emotion dysregulation and personality traits are implicated in a range of psychopathology, highlighting the value of adopting an integrative approach of examining emotion regulation and personality traits concurrently. (PsycINFO Database Record

Extraversion and psychopathology: A facet-level analysis.

The goal of this study was to explicate how the lower order facets of extraversion are related to psychopathology. We used a "bottom-up" approach in which specific extraversion scales from 3 comprehensive personality inventories were used to model these facets as latent factors. We collected both self-report and interview measures of a broad range of psychopathology from a large community sample. Replicating previous findings using a similar approach (Naragon-Gainey & Watson, 2014; Naragon-Gainey, Watson, & Markon, 2009), structural analyses yielded four factors: Positive Emotionality, Sociability, Assertiveness, and Experience Seeking. Scores on these latent dimensions were related to psychopathology in correlational analyses and in two sets of regressions (the first series used the four facets as predictors; the second included composite scores on the other Big Five domains as additional predictors). These results revealed a striking level of specificity. As predicted, Positive Emotionality displayed especially strong negative links to depressive symptoms and diagnoses. Sociability also was negatively related to psychopathology, showing particularly strong associations with indicators of social dysfunction and the negative symptoms of schizotypy (i.e., social anxiety, social aloofness, and restricted affectivity). Assertiveness generally had weak associations at the bivariate level but was negatively related to social anxiety and was positively correlated with some forms of externalizing. Finally, Experience Seeking had substantial positive associations with a broad range of indicators related to externalizing and bipolar disorder; it also displayed negative links to agoraphobia. These differential correlates demonstrate the importance of examining personality-psychopathology relations at the specific facet level.

Pathological eating behaviors, BMI, and facet-level traits: the roles of conscientiousness, neuroticism, and impulsivity.

The current study examined the bivariate and multivariate associations of personality with Body Mass Index (BMI) and several eating behavior inventories, focusing on facets of Neuroticism, Conscientiousness, and Impulsivity. Simultaneous multiple regressions showed that the facets Traditionalism, Urgency, and low Vulnerability were significant predictors of BMI. A factor analysis of the eating behavior scales revealed two dimensions: (a) Food and Body Preoccupation and (b) Cued Eating; Neuroticism, low Conscientiousness, and Perfectionism were significant predictors of both eating behavior factors. In addition, the Depression facet predicted Food and Body Preoccupation, and low Temperance predicted Cued Eating. Implications are discussed for the structure of eating pathology and the specificity of facet traits to eating behaviors and obesity.