Understanding the association between normal and maladaptive personality traits: Replication and extension of Morey et al. (2020).

BACKGROUND/OBJECTIVE: The Alternative Model for Personality Disorders (AMPD) within the DSM-5 includes separable components representing general personality dysfunction (Criterion A) and maladaptive personality traits (Criterion B). Some critique Criterion A for accounting for little incremental variance in PD beyond Criterion B. However, Morey et al. (2020) hypothesized that personality dysfunction is a key mechanism through which normal-range traits account for the maladaptive component of personality traits, justifying its inclusion. We sought to replicate and extend this work in a psychiatric sample with mixed methods. METHOD: In total, 152 participants recruited from mental health clinics completed multiple measures of personality dysfunction and normal-range and maladaptive traits. RESULTS: Replication was only partially achieved. The degree of incremental prediction of maladaptive traits and the extent to which personality dysfunction explained the relations between normal-range and maladaptive traits varied significantly across traits, and those effects that reached significance were small in magnitude. Removing variance due to personality dysfunction reduced intercorrelations among maladaptive traits by only a small amount. CONCLUSION: Counter to Morey et al. (2020), our results failed to support maladaptive traits as composites of normal-range traits and personality dysfunction, suggesting that other methods of distinguishing personality pathology severity and style are needed.

Structure of Pathological Personality Traits Through the Lens of the CAT-PD Model.

Personality pathology is increasingly conceptualized within hierarchical, dimensional trait models. The Comprehensive Assessment of Traits Relevant to Personality Disorders (CAT-PD) is a pathological-trait measure with potential to improve on currently prevailing instruments because it has wider content coverage; however, its domain-level structure, which is of scientific and clinical interest, is not established. In this study, we investigated the structure and construct validity of the CAT-PD's domain level to facilitate wider use of the measure. We estimated five- and six-factor models with exploratory factor analysis in a pooled sample of eight independent subsamples (N = 3,987) and found that both models fit the data well; each had interpretable factors that were invariant across gender, sample type, and Black/White racial groups; and the factors had good convergent validity with other measures of maladaptive traits, Big Five personality, and interpersonal problems. Our results support the validity of the CAT-PD for assessing multiple levels of the pathological trait hierarchy.

Symptoms as rapidly fluctuating over time: Revealing the close psychological interconnections among borderline personality disorder symptoms via within-person structures.

Despite the clinical emphasis on processes happening within individuals, investigations into the psychological, structural connections between mental health symptoms have almost exclusively analyzed differences between people. These investigations have revealed important findings; however, they do not reveal the close connections among symptoms in an individuals' psychology. This study thus examined the psychological connections between symptoms directly, using borderline personality disorder (BPD) symptoms as an example. Participants (252; 74 with BPD) reported their momentary BPD symptoms five times daily, and 165 did so again 18 months later. In support of personalized medicine (Wright & Woods, 2020), individuals' BPD symptom structures differed considerably from each other and from the between-person structure. A novel technique revealed that differences were greater than expected by chance. Within-person structures tended to exhibit more symptom granularity (more factors and lower variance explained) and differing symptom meanings (patterns of loadings). For example, some individuals exhibited close connections between relationship turmoil and identity uncertainty, whereas other individuals exhibited close connections between relationship turmoil and impulsivity. Thus, conceptions of any given person's psychopathological processes using between-person structural findings will most likely be inaccurate. (PsycInfo Database Record (c) 2021 APA, all rights reserved).