Verification of five-factor models and reference scores for personality dysfunction and trait domains of the Personality Assessment Questionnaire for ICD-11 (PAQ-11), revised version.

A brief self-reported measure of the Personality Assessment Questionnaire for the 11th edition of the World Health Organization's International Classification of Disease (ICD-11) (PAQ-11) was developed to evaluate ICD-11 personality traits. The aim of this study was to investigate the validity of the revised PAQ-11 version (PAQ-11R) with an additional item in the Dissociality domain and thresholds for the severity of personality dysfunction and domains. Study 1 examined the construct validity of the PAQ-11R in 192 university students in Korea. Study 2 estimated tentative reference scores of personality dysfunction and domains of the PAQ-11R in 91 patients in Korea. In study 1, the PAQ-11R had a five-factor structure and the revised Dissociality scale had better convergent and discriminant validities than the previous version. In study 2, the receiver operating characteristic (ROC) curve of the PAQ-11R identified a threshold score of 35. Reference scores for domains were estimated as 15 for Negative Affectivity, 10 for Detachment, 8 for Anankastia, and 5 each for Disinhibition and Dissociality. These scores contribute to severity of personality disturbance but remain qualifiers only; they are not diagnostic. The results suggest that the PAQ-11R is useful as a quick assessment tool for identifying the domains of personality dysfunction in clinical practice in harmony with the ICD-11 guidelines.

Broader Issues in Test Translation and Validation: A Commentary Inspired by Macina et al. (2023).

Macina et al. (2023) recently reported mixed results on the German translation of the Self and Interpersonal Functioning Scale (SIFS). By focusing on suboptimal indices of structural validity, they recommended choosing other available instruments over the SIFS in future research on personality impairment. Reflecting on Macina et al.'s overall conclusions inspired us to consider broader issues in the field of personality impairment assessment. In this commentary, we discuss some issues regarding test translation and validity raised by Macina et al.'s article. We advise against assuming equivalence between original and translated versions of a test and discuss some caveats regarding comparison between different instruments based on structural validity. We also call into question whether the latter should be the litmus test for judging the quality of a measure. Finally, we discuss how the proliferation of personality impairment measures can benefit the broader field. Notably, this would allow moving toward a "what works for whom" approach that considers the match between psychometric property, desired use of the instrument, and characteristics of the target population.

Reliability and validity of the Personality Disorder Severity ICD-11 (PDS-ICD-11) scale and the Revised Personality Assessment Questionnaire for ICD-11 (PAQ-11R) in a Norwegian community sample.

In the ICD-11, a new model for the diagnosis of personality disorders is included, consisting of an assessment of the severity of personality impairment as well as an optional evaluation of pathological personality traits. This study aimed to examine the reliability, structural validity, and convergent and discriminant validity of the Norwegian versions of the Personality Disorder Severity ICD-11 (PDS-ICD-11) scale for the assessment of personality disorder severity and the Revised Personality Assessment Questionnaire for ICD-11 (PAQ-11R) for the assessment of the ICD-11 pathological personality traits in a Norwegian community sample. The sample consisted of 295 participants (75.9% female) with a mean age of 30.0 years (SD = 10.7 years). The participants answered the PDS-ICD-11, PAQ-11R, Level of Personality Functioning Scale-Brief Form 2.0 (LPFS-BF 2.0), and the Personality Inventory for DSM-5-Brief Form Plus Modified (PID5BF + M). The Norwegian PDS-ICD-11 showed good reliability. Support for a unidimensional model and a high convergent correlation with the LPFS-BF 2.0 was found. The reliability analysis of the Norwegian PAQ-11R scales yielded mixed findings with suboptimal reliability estimates for the PAQ-11R detachment, disinhibition, and dissociality scales. Analyzing the structure of the PAQ-11R items, four factors emerged (negative affectivity, detachment, disinhibition, and anankastia). The PAQ-11R scales showed good convergent and, overall, adequate discriminant validity with the PID5BF + M scales. The findings support the use of the PDS-ICD-11 for assessing severity in the ICD-11 PD model in Norway. The Norwegian PAQ-11R appears to be a useful screening tool for the ICD-11 PD trait domains.

First psychometric evaluation of the Level of Personality Functioning Scale-Brief Form 2.0 in adolescents.

Reflecting the recent consensus that challenges in personality functioning often onsets in adolescence, and the move toward dimensional models of personality pathology such as the level of personality functioning (LPF) of the alternative model for personality disorders, it is important to have validated measures that can assess LPF in young people. The Level of Personality Functioning Scale-Brief Form 2.0 (LPFS-BF 2.0) is the briefest measure of LPF and may be particularly well suited for assessing LPF in youth; however, it has yet to be formally validated in youth. Therefore, the current investigation evaluated the psychometric properties of the LPFS-BF 2.0 in adolescents drawn from a community sample of ethnically diverse North American youth (N = 194, age 12-18; 58% female). Factor structure, gender invariance, reliability, convergent validity, incremental validity, and criterion validity were evaluated. Results demonstrated support for the LPFS-BF 2.0's unidimensional factor structure, as well as high internal consistency. Configural, metric, and scalar measurement invariance was supported across male and female genders, as well as convergent validity. Relative to the Personality Inventory for the DSM-5 Brief Form and Levels of Personality Functioning Questionnaire 12-18, the LPFS-BF 2.0 demonstrated additional variance in predicting borderline personality features, and internalizing and externalizing problems. Study findings support the English version of the LPFS-BF 2.0 as a brief and psychometrically sound instrument for assessing LPF in youth and adolescents. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Convergence of the dimensional assessment of personality pathology (DAPP-BQ) and the five-factor personality inventory for the international classification of diseases 11th edition (FFiCD) in the context of the five-factor model and personality disorders.

The current manuscript presents the convergence of the Dimensional Assessment of Personality Pathology (DAPP-BQ), using its short form the DAPP-90, and the Five-Factor Personality Inventory for International Classification of Diseases (ICD-11), the FFiCD, in the context of the five-factor personality model and the categorical approach of personality disorders (PDs). The current manuscript compares the predictive validity of both the FFiCD and the DAPP-90 regarding personality disorder scales and clusters. Results demonstrate a very high and meaningful convergence between the DAPP-90 and the FFiCD personality pathology models and a strong alignment with the FFM. The DAPP-90 and the FFiCD also present an almost identical predictive power of PDs. The DAPP-90 accounts for between 18% and 47%, and the FFiCD between 21% and 47% of PDs adjusted variance. It is concluded that both DAPP-90 and FFiCD questionnaires measure strongly similar pathological personality traits that could be described within the frame of the FFM. Additionally, both questionnaires predict a very similar percentage of the variance of personality disorders.

Examination of Construct Validity of ANX and DEP Scales of the PAI-A.

Anxiety and depression are the two most common psychiatric problems of adolescence. The Personality Assessment Inventory, Adolescent Version (PAI-A) is a broadband instrument designed to assist in the detection and differential diagnosis of common psychiatric disorders in adolescents, and it includes a Depression scale (DEP) to detect the presence of major depressive episodes and an Anxiety scale (ANX) designed to detect clinically significant anxiety. However, there is limited research on this measure. The current study examined both the convergent and discriminant validities of the PAI-A Anxiety and Depression scales by observing their relationships to other self-report measures (e.g., PAI-A scales, MMPI-A), observer ratings (e.g., HPRS), and performance-based measures (e.g., Rorschach CS). The sample consisted of 352 records of the psychological assessments of adolescent inpatients between the ages of 13 to 17; the sample was about equally male (51.6%) and female with a mean age of 15.5 years. The sample was ethnically diverse with 48.7% of individuals identifying as Caucasian, 12.9% Black, 16% Hispanic, 2.6% Asian, 3.2% Other, and 16.6% unknown. There is strong evidence for convergent validity for the PAI-A ANX and DEP scales with r's ranging from .11 to .78. There is moderate evidence for discriminant validity for these scales. Results demonstrated that PAI-A scales correlated strongest with self-report, followed by therapist rating scale, and then performance-based measures. Various strengths of the PAI-A for the assessment of anxiety and depression are discussed.

Assessing Emotion Regulation across Asian and Western Cultures: Psychometric Properties of Three Common Scales across Singaporean and Australian Samples.

Given the differences in emotion regulation across cultures, it is paramount to ensure that measures of emotion regulation measure the same construct and that conceptualizations of emotion regulation are valid across cultures. Therefore, the present study assessed the measurement invariance (alongside other psychometric properties) of three popular emotion regulation questionnaires, the Emotion Regulation Questionnaire (ERQ), Difficulties in Emotion Regulation Scale (DERS), and the Perth Emotion Regulation Competency Inventory (PERCI), across 434 Singaporeans and 489 Australians. Our study showed that all three questionnaires were measurement invariant, had excellent internal consistency, and relatively good concurrent validity with psychopathology and alexithymia across our Singaporean and Australian sample, justifying their use in comparing Asian and Western cultures. Our findings suggest that measures of emotion regulation have utility across both individualistic and collectivistic cultures. Our findings supports the use of these measures in cross-cultural research and provides support for the utility for personality assessments across cultures.

Client and Clinical Utility of the Assessment of Personality Disorders.

ABSTRACT: Clinical utility and client utility are important desirable properties when developing and evaluating a new classification system for mental disorders. This study reports on four focus groups followed up by a Delphi study among clinicians working with clients with personality disorders (PD) and clients with PD themselves to harness both user groups' perspectives on the utility of PD diagnosis. Our findings show that the client and clinician views of the concept of utility were closely aligned and include aspects of transparency of communication and the ability of an assessment to enhance hope, curiosity, motivation, and insight into a client's personality patterns. Unique to clinicians' appraisal was the ability of an assessment to capture both vulnerabilities and resilience of clients and to give information about the prognosis in treatment. Unique to clients' appraisal was the ability of an assessment to be destigmatizing and collaborative. These findings may serve to expand our definition and measurement of clinical utility, in that collaborative and nonstigmatizing procedures likely promote client acceptability. To capture both aspects, we offer two preliminary questionnaires (i.e., item sets open to further empirical testing) based on the data derived from the Delphi procedure.

Cross-sectional and prospective association between personality traits and IADL/ADL limitations.

Prior research has shown that personality traits are associated with activities of daily living (ADLs) and instrumental ADLs (IADLs). To advance research on the psychological factors related to aging-related functional limitations, this study examined the relation between personality traits and both concurrent and incident functional limitations, tested whether these associations are similar across IADLs and ADLs, and tested potential mediators of these associations. Participants were drawn from eight longitudinal samples from the U.S., England, and Japan. Participants provided data on demographic variables, the five major personality traits, and on the Katz ADL-scale and Lawton IADL-scales. IADL/ADL limitations were assessed again 3-18 years later. A consistent pattern of associations was found between personality traits and functional limitations, with associations slightly stronger for IADLs than ADLs, and robust across samples that used different measures and from different cultural contexts. The meta-analysis indicated that higher neuroticism was related to a higher likelihood of concurrent and incident IADL/ADL limitations, and higher conscientiousness, extraversion, and openness were associated with lower risk. Higher agreeableness was associated with lower risk of concurrent IADL/ADL, but unrelated to incident limitations. Physical activity, disease burden, depressive symptoms, self-rated health, handgrip strength, falls, and smoking status mediated the relation between personality traits and incident IADL/ADL limitations. The present study indicates that personality traits are risk factors for both IADL and ADL limitations across multiple national cohorts, identifies potential mediators, and informs conceptual models on psychological risk factors for functional decline. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A preliminary study: designing and validating projective images of Young's early maladaptive schema (EMS) domains.

BACKGROUND: This study aims to design and validate ten projective images of Young's Early Maladaptive Schema (EMS) domains. For this purpose, two questions are to be addressed. (1) How is the factorial structure of the projective images of EMS domains? (2) Do the images designed in the domains of disconnection and rejection, impaired autonomy and performance, impaired limits, other-directedness, and over-vigilance and inhibition have sufficient validity? METHODS: This is an applied mixed-methods exploratory study, in which the statistical population consisted of psychologists from Tehran Province in the qualitative section (n = 8) as well as other individuals aged between 18 and 65 years (mean age = 33) from Qazvin in the quantitative section (n = 102) in 2018. The research questions were analyzed through principal axis factoring with a varimax rotation, confirmatory factor analysis, Pearson correlation coefficient, and Cronbach's alpha. RESULTS: According to the results, ten images and five domains of Young's EMSs contribute to a simple structure. Accounting for 70.35% of the total variance of EMSs, the five dimensions include disconnection and rejection, impaired autonomy and performance, impaired limits, other-directedness, and over-vigilance and inhibition. CONCLUSIONS: The results indicated that the designed projective images yielded acceptable construct validity.

Understanding At-Risk Youths: Average PAI-A Scores and Their Associations with Impulsivity-Related Constructs.

The purpose of this study was to extend research on the Personality Assessment Inventory-Adolescent (PAI-A; Morey, 2007) to include an examination of mean PAI-A results and associations between the PAI-A and indicators of impulsivity in a large sample of at-risk adolescents (Mage = 16.75; 79% male; 64% Caucasian) in a military-style residential program. Included in this study are archival records for a diverse sample of 497 youths who participated in the program during a 2-year period. Average T scores on PAI-A scales ranged from 44.67 to 65.41. Moderate to large positive associations (rs = .30-.65) were found between relevant PAI-A scales and both UPPS-P scales and self-reported substance use. There were smaller effects (r = .17) for associations between the PAI-A and program disciplinary infractions. Small to large group differences (ds = .19-.93) on PAI-A scales differentiated youths who had experience with arrests or NSSI from those who did not. This study provides information about the under-studied but vulnerable youths occupying the space between the normative population and youths with identified clinical or legal problems. It also clarifies how impulsivity and impulsivity-related behaviors may be represented on the PAI-A.

Does the Rorschach Performance Assessment System (R-PAS) Differ from the Comprehensive System (CS) on Variables Relevant to Interpretation?

We examined the impact of the changes in administration and coding introduced by the Rorschach Performance Assessment System (R-PAS) relative to the Comprehensive System (CS) on the Rorschach response process, as manifested in variables relevant to interpretation. We also examined the efficiency of each system to obtain protocols in an optimal range of responses (R) for interpretation. As hypothesized, when comparing 50 CS and 50 R-PAS nonpatient protocols, R-PAS produced many more protocols in the optimal R range (18-27) than the CS (78% vs. 24%) and it eliminated the need for re-administration, which was required for five CS protocols. As expected, R was less variable with R-PAS, as were two variables derived from it, R8910% and Complexity. In addition, as expected because of different Form Quality tables, R-PAS showed notably fewer and less variable perceptual distortions than the CS, and an increase in more conventional perceptions. The other 58 variables showed no reliable differences in means or standard deviations, though modest power precluded definitive inferences about equivalence. Overall, our results support previous findings about the benefit of R-PAS to obtain protocols in an optimal range for interpretation, while keeping the core manifestations of the response process unchanged.

Using a Thin Slice Coding Approach to Assess Preschool Personality Dimensions.

A large literature assessing personality across the lifespan has used the Big Five as an organizing framework, with evidence that variation along different dimensions predicts aspects of psychopathology. Parent reports indicate that these dimensions emerge as early as preschool, but there is a need for objective, observational measures of personality in young children, as parent report can be confounded by the parents' own personality and psychopathology. The current study observationally coded personality dimensions in a clinically enriched sample of preschoolers. A heterogeneous group of preschoolers oversampled for depression (N = 299) completed 1-8 structured observational tasks with an experimenter. Big Five personality dimensions of extraversion, agreeableness, conscientiousness, neuroticism, and openness to experience were coded using a "thin slice" technique with 7,820 unique ratings available for analysis. Thin slice ratings of personality dimensions were reliably observed in preschoolers ages 3-6 years. Within and across-task, consistency was also evident, with consistency estimates higher than found in adult samples. Divergent validity was limited, with coders distinguishing between three (extraversion/openness; agreeableness/conscientiousness; and neuroticism) rather than five dimensions. Personality dimensions can be observationally identified in preschool-age children and offer reliable estimates that stand across different observational tasks. Study findings highlight the importance of observational approaches to assessing early personality dimensions, as well as the utility of the thin slice approach for meaningful secondary data analysis.

The Development and Validation of a Multidimensional Forced-Choice Format Character Measure: Testing the Thurstonian IRT Approach.

There has been reemerging interest within psychology in the construct of character, yet assessing it can be difficult due to social desirability of character traits. Forced-choice formats offer one way to address response bias, but traditional scoring methods (i.e., ipsative) associated with this format makes comparing scores between people problematic. Nevertheless, recent advances in modeling item responding (Thurstonian IRT) enable scoring that recovers absolute standing on latent traits and allows for score comparisons between people. Based on recent work in character measurement (CIVIC), we developed a multidimensional forced-choice measure of character (CIVIC-MFC) and scored it using Thurstonian IRT. Initial validation using a sample of 798 participants demonstrated good support for factorial, convergent, and concurrent validity for scores on the CIVIC-MFC, although they did not demonstrate more faking resistance than scores on a Likert-type format version. Potential explanations are discussed.

Robustness of the Maladaptive Personality Plaster: An Investigation of Stability of the PSY-5-r in Adults over 20 Years.

The long-term stability of maladaptive personality traits in the general population has been under-investigated. The current study examined the longitudinal 20-year mean-level stability and rank-order consistency of five maladaptive personality traits-as measured with the Personality Psychopathology-5-r scales. Correlations and regression analysis were conducted to test both types of stability comparing raw scores of scale administrations in a general population sample in both 1992 and 2012 (N = 65). Repeated measures analysis of variance demonstrated significant mean-level stability of the PSY-5-r traits over 20 years. The PSY-5-r scales demonstrated significant rank-order consistency as evidenced by correlational analyses and reliability coefficients. The scales Aggressiveness-r (r = .73), Neuroticism/Negative Emotionality-r (r = .65), Introversion/Low Positive Emotionality-r (r = .63), and Disconstraint-r (r = .56), evidenced strong rank-order stability, whereas Psychoticism-r (r = .3) showed moderate rank-order consistency. The results of the present study indicate that maladaptive personality traits as measured with the PSY-5-r scales are relatively stable over 20 years in an adult community population.

BIS and BAS Sensitivities at Different Levels of Personality Description: A Latent-Variable Approach with Self- and Informant-Ratings.

We examine the structural overlap of the Behavioral Inhibition System (BIS) and the Behavioral Approach System (BAS) with Stability and Plasticity, the two higher-order factors encompassing the Big Five. Carver and White's BIS/BAS and the Big Five Inventory were administered to a sample of 330 adults, serving both as targets and informants. Self- and other-ratings were modeled by using the Correlated Trait-Correlated Method model. BIS and BAS correlated highly with metatraits, after method variance and measurement error were partialled out: BIS was positively related to Stability, while BAS was positively related to Plasticity and negatively related to Stability. After the higher-order factors were controlled, the BIS was highly and positively related to Emotional stability, whereas the BAS had a small but significant relationship with Extraversion. Findings are discussed with regard to the most appropriate level of generality/specificity at which the personality correlates of BIS and BAS can be investigated.

Personality Assessment and Psychotherapy Preferences: Congruence between Client Personality and Therapist Personality Preferences.

Consideration of client preferences has been emphasized as important to therapeutic outcomes, such as treatment engagement and retention. Although studies have investigated several client and therapist characteristics associated with client preferences, few have considered whether people have preferences regarding a potential therapist's personality. The current study extended prior research on client preferences by examining the influence of participants' Big Five personality traits on preferences for therapist personality characteristics utilizing latent profile analysis. We expected congruence between client personality traits and preferred psychotherapist personality traits. In both undergraduate and community samples, results indicated that participants generally prefer a psychotherapist with personality characteristics similar to their own. Our findings establish the presence of preferences based on personality factors and have implications for future research directions and the role of personality assessment in routine clinical practice.

Personality Disturbances as Emergent Phenomena Reflective of Underlying Neurobehavioral Systems: Beyond Dimensional Measurement, Phenotypic Trait Descriptors, and Factor Analysis.

BACKGROUND AND OVERVIEW: The conceptualization of personality pathology, or personality disturbance, is now at a substantive crossroads. Some researchers (and clinicians) prefer a focus on the domains of personality pathology that are well-described and captured in traditional categorical diagnostic approaches that, in some instances, abut normal personality constructs. Other workers argue to move the study of personality disorder (PD) closer to personality science seeking continuous connections between PD and established dimensions of healthy-range, normal personality. Most of the latter efforts revolve around correlational and factor analytic study of phenotypic expressions of PD features and normal personality dimensions. It is notable, however, that both visions of the PD/personality interface are essentially unlinked to an understanding of shared neurobiological underpinnings (i.e., neurotransmitter-influenced neurobehavioral systems) of both personality disturbance and normal personality1. Here, we present a nontechnical, conceptual overview of our approach to this problem, advancing a neurobehavioral approach that seeks to anchor both normal personality and personality disturbance within a matrix of brain-based neurobiological systems, incorporating genetic, epigenetic, and environmental inputs. In this brief paper, we seek only to provide a necessarily cursory introduction to how we conceptualize this area and illustrate, in broad outline, our effort to characterize both personality and personality disturbance anchored in neurobehavioral systems. Our approach, which we began developing in the middle 1990s, can be juxtaposed with the more recently proposed DSM-5 Alternative Model of Personality Disorders as well as the well-established five-factor approach to PD.

Forensic assessment may be based on common sense assumptions rather than science.

Forensic assessments must be scientifically founded, because courts should obtain expert evidence with acceptable evidential value. In Slovenia, professional guidelines of forensic personality assessment are too general and not always in line with international professional recommendations. Thus, experts have no strict guidelines which would lead them to scientifically grounded expert opinions. The aim of the research was to establish which tests are employed in forensic assessment in Slovenia and to what extent the professional guidelines for expert opinions are followed. A total of 166 forensic personality assessments were reviewed, representing the majority of expert opinions issued in the period 2003-2018. The results of the analysis revealed that questionable projective tests are most commonly used. Typically, an expert opinion was rendered based on two tests, at least one of which was projective. What is more, expert opinions did not include hypotheses, in-text citations, reference lists, or proof of the expert witness's competence. The tests and their results were mentioned briefly and inadequately, without mention of their reliability and validity. Possible malingering of the person being evaluated was not detected. Professional guidelines were not followed and non-standardized tests without normative values and of questionable scientific merit were predominantly used, despite lack of proof that they truly measure what they claim to be measuring. These findings significantly differ from the results of similar research, raising serious concerns over the credibility of expert opinions in Slovenia.

Scripting the DSM-5 Alternative Model for Personality Disorders assessment procedure: A clinically feasible multi-informant multi-method approach.

Published case studies on the DSM-5 (section III) Alternative Model for Personality Disorders (AMPD) generally utilized unstandardized assessment procedures or mono-method approaches. We present a case from clinical practice to illustrate a standardized, clinically feasible procedure for assessing personality pathology according to the full AMPD model, using a multi-method approach. We aim to present a procedure that can guide and inspire clinicians that are going to work with dimensional models as presented in DSM-5 and ICD-11. Specifically, we show how questionnaire and interview data from multiple sources (i.e. patient and family) can be combined. The clinical case also illustrates how Criterion A (i.e. functioning) and B (i.e. traits) are interrelated, suggesting that the joint assessment of both Criterion A and B is necessary for a comprehensive and clinically relevant case formulation. It also highlights how multi-method information can enhance diagnostic formulations. Finally, we show how the AMPD model can serve treatment planning and provide suggestions for how patient feedback might be delivered. © 2020 John Wiley & Sons, Ltd.