Recognizing Borderline Personality Disorder in Men: Gender Differences in BPD Symptom Presentation.

Women are predominantly diagnosed with BPD, with studies estimating a 3:1 female-to-male diagnostic ratio in clinical settings. Previous studies present conflicting findings regarding gender-level criterion differences, with some indicating differences in contradictory criteria. These studies primarily utilize outpatient samples, highlighting gaps in the literature. Thus, the current study investigates gender-level criterion differences, functioning, and impairment within a novel, partial hospital sample. Participants included (a) a sample of 1,153 individuals from the total population of partial hospital patients regardless of BPD diagnosis and (b) 365 BPD-positive patients who were assessed via semistructured clinical interview and provided consent for data collection during the intake process. Results indicated that (a) women endorsed higher relationship instability than men and (b) there were no significant differences in level of functioning across the gender subsamples. Examining gender differences in BPD symptomatology has clinical implications in improving recognition and addressing potential biases associated with men and mental health.

A Bridge Between DSM-5 Section II Personality Disorder Criteria and ICD-11 Personality Disorder Trait Domains.

The organization of personality pathology into trait domains (vs. specific disorders) in ICD-11 represents an important shift in personality disorder (PD) nosology. However, to facilitate clinical implementation, a bridge is needed between this system and the DSM-5 Section II system familiar to many researchers and clinicians. In this study, individual DSM-5 PD criteria were assigned to ICD-11 trait domains based on the published Clinical Descriptions and Diagnostic Requirements. This scoring scheme was examined empirically alongside DSM-5 PD dimensions (using SIDP ratings from the MIDAS project; N = 2,147 outpatients) in terms of descriptive properties and relations with psychosocial morbidity and functioning. Most PD criteria could be matched to at least one ICD-11 trait domain, indicating considerable cross-system continuity. However, points of incongruity are noteworthy for research and clinical applications. Results provide key information for bridging categorical and dimensional frameworks, indicating that the shift toward trait-based PD models need not be as disruptive as feared.

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.

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.

An Initial Investigation of the Joint Classification of Hypomania- and Neurodevelopmental Disorder-Relevant Dimensions Within the Hierarchical Taxonomy of Psychopathology.

We examined hierarchical structural models of psychopathology in samples of (a) adults recruited online and screened based on psychopathology history (N = 429) and (b) undergraduates (N = 529) to inform classification of neurodevelopmental disorder (NDD)- and hypomania-relevant dimensions within the Hierarchical Taxonomy of Psychopathology (HiTOP). Results differed across samples in some ways, but converged to indicate that some NDD- and hypomania-relevant dimensions aligned closely with different HiTOP spectra. For example, some hypomania-relevant dimensions (e.g., affective lability) overlapped strongly with the internalizing spectrum, whereas others (e.g., self-perceived charisma) were reverse-indicators of detachment. Examination of cross-sectional and prospective correlates for emergent factors also was informative in some ways. This included NDD-relevant and disinhibited externalizing dimensions associating robustly with treatment seeking history and recent experiences of distress. These results provide initial insights into classifying NDD- and hypomania-relevant dimensions within the HiTOP and indicate a need for future research in this area.

The Development of Preliminary HiTOP Internalizing Spectrum Scales.

As part of a broader project to create a comprehensive self-report measure for the Hierarchical Taxonomy of Psychopathology consortium, we developed preliminary scales to assess internalizing symptoms. The item pool was created in four steps: (a) clarifying the range of content to be assessed, (b) identifying target constructs to guide item writing, (c) developing formal definitions for each construct, and (d) writing multiple items for each construct. This yielded 430 items assessing 57 target constructs. Responses from a heterogeneous scale development sample (N = 1,870) were subjected to item-level factor analyses based on polychoric correlations. This resulted in 39 scales representing a total of 213 items. The psychometric properties of these scales replicated well across the development sample and an independent validation sample (N = 496 adults). Internal consistency analyses established that most scales assess relatively narrow forms of psychopathology. Structural analyses demonstrated the presence of a strong general factor. Additional analyses of the 35 nonsexual dysfunction scales revealed a replicable four-factor structure with dimensions we labeled Distress, Fear, Body Dysmorphia, and Mania. A final set of analyses established that the internalizing scales varied widely-and consistently-in the strength of their associations with neuroticism and extraversion.

Preliminary Scales for ICD-11 Personality Disorder: Self and Interpersonal Dysfunction Plus Five Personality Disorder Trait Domains.

The ICD-11 personality disorder model is the first fully dimensional assessment of personality pathology. It consists of a personality disorder (PD) dysfunction-severity dimension, which encompasses both self- and interpersonal dysfunction, and six optional qualifiers for five prominent personality traits-Negative Affectivity (NA), Detachment (DET), Dissociality (DSL), Disinhibition (DSN), and Anankastia (ANK)-plus a borderline pattern that is defined by the criteria of DSM-IV borderline PD. This article reports on the development of a new self-report measure to assess self- and interpersonal dysfunction and the five trait qualifiers. It is the first comprehensive measure of the ICD-11 PD model in that (a) it is the only one to include both PD dysfunction-severity as well as trait scales and because (b) it is based on the Clinical Description and Diagnostic Guidelines, which are more detailed than the "statistical" model description that is currently on the ICD-11 website. The authors wrote 992 items and then reduced the pool to 300 items by eliminating redundancy and selecting the consensus best few items for each subconstruct. Data were collected using an online sample of 383 Prolific workers. Using exploratory factor analysis, seven domain scales were developed, each of which contained two to four scales assessing components of the domain. These preliminary scales' psychometrics were excellent, as were the domains' and their components' convergent and discriminant validity, with a few generally minor exceptions. Structural analyses at the component level revealed a three-factor structure consisting of two moderately correlated Internalizing factors, one centered on Self Dysfunction with two NA components and a DSN component (Distractibility) and the other on Interpersonal Dysfunction with DET and ANK components; as well as an Externalizing factor with DSL and a DSN component (Reckless Impulsivity) that was uncorrelated with the other two factors. Two aspects of the results in particular are striking: (1) ANK was not the opposite end of a DSN dimension, but rather contributed to an Internalizing Interpersonal Dysfunction dimension and (2) DSN had both an Internalizing and an Externalizing component. Implications of the findings and study limitations are discussed.

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.

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).

Links between depression and openness and its facets.

Most studies on depression and personality have focused on the role of Neuroticism and Extraversion. Openness is a much less studied trait in this literature, as past studies investigating Openness and depression often have found non-significant correlations between them. However, past studies mostly have investigated Openness and depression at the domain level and used non-clinical samples. In the present study, the relationship between depression and Openness at the domain and facet levels was examined in a sample of 266 participants recruited from outpatient psychiatric settings. Findings showed that although the Openness domain was significantly related to depression, it did not account for a significant proportion of unique variance for depression. However, Openness did account for a significant proportion of unique variance for depression at the facet level, even after accounting for sex, age, Neuroticism and Extraversion. Specifically, unique effects emerged for the facets of Aesthetics positively predicting Depression and Values negatively predicting Depression and Anhedonia. Clinical and theoretical implications are discussed. Copyright © 2018 John Wiley & Sons, Ltd.