Characterizing gender differences in nonsuicidal self-injury: Evidence from a large clinical sample of adolescents and adults.

While nonsuicidal self-injury (NSSI) is common in both men and women, research exploring the intersection of NSSI and gender has been limited by the use of small samples of males drawn primarily from non-clinical populations. To address these limitations, we analyzed data from a large sample of patients enrolled in an NSSI partial hospitalization program (PHP) to compare males and females across several variables, including NSSI characteristics, correlates, and pre-post treatment outcomes. Results indicated similar NSSI characteristics and treatment outcomes for males and females, with few exceptions. Males notably reported lower severity levels for most NSSI correlates (e.g., psychopathology, suicidality), highlighting the need to screen males for NSSI even when reporting comparatively less impairment. Finally, our results also suggest that PHP treatment for NSSI can be beneficial for both males and females. These findings have implications for the assessment, diagnosis, conceptualization, and treatment of NSSI in males and females.

The Importance of Considering Clinical Utility in the Construction of a Diagnostic Manual.

The development of major diagnostic manuals primarily has been guided by construct validity rather than clinical utility. The purpose of this article is to summarize recent research and theory examining the importance of clinical utility when constructing and evaluating a diagnostic manual. We suggest that construct validity is a necessary but not sufficient criterion for diagnostic constructs. This article discusses components of clinical utility and how these have applied to the current and forthcoming diagnostic manuals. Implications and suggestions for future research are provided.

Clinical utility of the Five-Factor Model of personality disorder.

There exists a great deal of research regarding the validity of the Five-Factor Model (FFM) of personality disorder. One of the most common objections to this model is concern regarding clinical utility. This article discusses clinical utility in terms of three fundamental components (i.e., ease of usage, communication, and treatment). In addition, a considerable number of recent empirical studies have examined whether the FFM compares well to personality disorder diagnostic categories with respect to all three components of clinical utility. The purpose of the current article is to provide a description of the implications of each component of clinical utility as it relates to the FFM and to acknowledge and address the empirical findings.

Clarifying the Definition of Nonsuicidal Self-Injury.

Background: Challenges and inconsistencies in defining nonsuicidal self-injury (NSSI) have persisted for decades, which significantly impact NSSI conceptualization and assessment in clinical and research settings and impede the field's progress. Aims: The present study aimed to solicit opinions from individuals with NSSI expertise so as to improve the operational definition and conceptualization of NSSI. Method: We asked researchers, clinicians, and graduate students with varying NSSI expertise to provide opinions on six NSSI definitional components (e.g., whether pain should be a required outcome), as well as to review 118 behaviors and indicate whether each is NSSI. Results: Responses (N = 159) revealed good agreement on specific NSSI definitional aspects and the classification of oft-cited NSSI behaviors. However, findings also demonstrated potential discrepancies in how clinicians and researchers define NSSI when compared with specific behaviors that might be classified as NSSI. Limitations: The opinions of the study's sample may not reflect the wider NSSI field. Conclusion: Findings suggest that there is an increased need for a clear and consistent definition of NSSI and specific NSSI behaviors. There is also a need to develop new assessment measures that capture the range of NSSI behaviors that received good-to-excellent agreement among self-injury experts.

Consideration of Clinician and Researcher Opinions on the Parameters of Nonsuicidal Self-Injury Disorder Diagnostic Criteria.

Nonsuicidal self-injury (NSSI) disorder represents an opportunity to address the significant costs associated with NSSI; however, there is a need to resolve the uncertainty regarding specific parameters of the diagnostic criteria to ensure clinical utility. As such, to better understand the clinical applicability, and guide future research in this area, clinicians and researchers in the field of NSSI (n=112) completed an anonymous online survey assessing their opinions regarding several aspects of NSSI disorder. Results highlight that past-month NSSI was the most frequently endorsed timeframe required for a NSSI disorder diagnosis. There was support for the clinical usefulness of several specifiers and general consensus regarding exclusion criterion. Finally, Disruptive, Impulse-Control and Conduct Disorders was considered to be the most appropriate diagnostic category. Our findings suggest that requiring four days of NSSI in the past one-month may enhance the clinical utility of NSSI disorder. Results also offer guidance on additional aspects of the diagnostic criteria to better describe and conceptualize NSSI disorder for research and clinical applications.

Assessment of self-related problems in functioning: Intrapersonal Problems Rating Scales.

This article describes the development and validation of the Intrapersonal Problems Rating Scales (IPRS), a multidimensional measure of self-related problems in personality functioning. Results from a series of factor analyses performed on self-ratings of over 200 problems revealed seven distinct but interrelated domains of intrapersonal problems: Emotion Dysregulation, Internalizing, Lack of Will, Externalizing, Scrupulousness, Fantasy Proneness, and Apathy. Items were selected and scales built for an efficient assessment of each problem area. The psychometric properties of the resulting scales were then evaluated in an independent sample. Convergent and discriminant validity support for the IPRS was obtained via correlations with respect to three measures of social, emotional, and behavioral problems. The scales associated with a range of personal styles and dispositions and predicted diverse self-reported attitudinal and behavioral criteria even after the effects of normal and maladaptive-range personality traits were removed. Two scoring systems (normative and ipsative, or person-centered, scoring) revealed a differential pattern of associations both internally and with external measures. Interpretive differences between the two scoring procedures are highlighted and potential practical applications of the IPRS are discussed. The instrument can provide additional information not fully accounted for by measures of traits or social functioning and be useful to researchers and practitioners alike to identify, understand, and track changes in a range of intrapersonal problems. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Disinhibition as a unifying construct in understanding how personality dispositions undergird psychopathology.

Disinhibition has been a construct of interest for decades, as evidenced by its inclusion in most prominent models of general personality functioning and its link to personality pathology, other psychopathology, health behaviors, and public health concerns. Disinhibition is manifest in behavioral, task based, and physiological measures, and common etiologies are a major reason for the coherence of the domain across a variety of assessment modalities. The current review will provide a summary of the conceptualization of the construct across prominent models, its link to psychopathology and maladaptive behaviors, and its etiology. Finally, we provide discussion on its clinical application utilizing disinhibition to aid in understanding comorbid psychopathology and through a description of its potential use in treatment.

The importance and acceptability of general and maladaptive personality trait computerized assessment feedback.

Personality traits are a useful component of clinical assessment, and have been associated with positive and negative life outcomes. Assessment of both general and maladaptive personality traits may be beneficial practice, as they may complement each other to comprehensively and accurately describe one's personality. Notably, personal preferences regarding assessment feedback have not been studied. The current study examined the acceptability of personality assessment feedback from the perspective of the examinee. Treatment-seeking participants from a university (n = 72) and Amazon.com MTurk (n = 101) completed measures of the 5-factor model and the DSM-5 alternative model of personality disorder, and were then provided feedback on their general and maladaptive personality traits. Individuals then provided feedback on which aspects they found most useful. Results demonstrated strong participant agreement that the personality trait feedback was accurate and relevant. (PsycINFO Database Record

Humor styles moderate borderline personality traits and suicide ideation.

The way individuals use humor to interact interpersonally has been associated with general personality, depression, and suicidality. Certain humor styles may moderate the risk for suicide ideation (SI) in individuals who are high in specific risk factors (e.g., thwarted belongingness, perceived burdensomeness). Previous research suggests a relationship between humor styles and borderline personality disorder (BPD) and an increased risk of suicidality and suicide completion in individuals with BPD. Participants (n =176) completed measures of BPD traits, SI, and humor styles. It was hypothesized that BPD traits would be positively correlated with negative humor styles and negatively correlated with positive humor styles, and that humor styles would significantly moderate BPD traits and SI. Results showed that BPD traits were negatively correlated with self-enhancing humor styles and positively correlated with self-defeating humor styles, but that they were not significantly correlated with affiliative or aggressive humor styles. Bootstrapping analyses demonstrated that the affiliative, self-enhancing, and self-defeating humor styles significantly moderated BPD traits and SI, while the aggressive humor style did not.

Construct validity of the five factor borderline inventory.

The Five Factor Borderline Inventory (FFBI) is a new self-report measure developed to assess traits of borderline personality disorder (BPD) from the perspective of the Five Factor Model of general personality. The current study sought to first replicate initial validity findings for the FFBI and then to further validate the FFBI with predispositional risk factors of the biosocial theory of BPD and with commonly associated features of BPD (e.g., depression, low self-esteem) utilizing two samples of young adults (N = 87; 85) who have engaged in nonsuicidal self-injury. The FFBI showed strong convergent and discriminant validity across two measures of the Five Factor Model and also correlated strongly with measures of impulsivity, emotion dysregulation, and BPD. The FFBI also related to two measures of early childhood emotional vulnerability and parental invalidation and measures of depression, anxiety, and self-esteem. Overall, the results provide support for the FFBI as a measure of BPD.

Let me hear of your mercy in the mourning: forgiveness, grief, and continuing bonds.

Clarity about the utility of continuing bonds (CB) continues to be evasive in the research. In 2 different correlational studies, the authors explored the relationship between CB and 2 other variables: 1 representing mental health (forgiveness of the deceased) and the other representing psychological distress (prolonged grief). Although researchers have addressed the latter relationship in the literature, assessing the relationship between CB and forgiveness has not been undertaken. Results suggest that forgiveness in general, and affective aspects of forgiveness in particular, predict psychological forms of CB. Results related to grief depended on how CB was assessed. These findings provide evidence of the relative health of certain types of relationship with deceased persons and also suggest that forgiveness interventions may be a way of promoting such healthy bonds.

Nonsuicidal self-injury disorder: clinician and expert ratings.

Nonsuicidal self-injury (NSSI) is a growing clinical and public health problem that affects individuals from all age groups, most prominently young adults. NSSI involves numerous methods and functions. NSSI has long been associated with borderline personality disorder (BPD), and in fact, it is only referenced among the diagnostic criteria of BPD in the DSM-IV-TR. However, recent studies have provided strong evidence that NSSI occurs outside of BPD. For these reasons, a diagnosis of nonsuicidal self-injury is included in DSM-5 Section-III as a condition that requires further study. The primary purpose of the present study was to identify whether the proposed DSM-5 NSSI criteria adequately reflect the symptoms of a prototypic individual who engages in self-injury. Clinicians in private practice and expert NSSI researchers (n=119) were asked to describe their familiarity and agreement with the proposed DSM-5 NSSI criteria, as well as the degree to which each proposed criterion is a prototypic symptom. Overall, most participants reported that the proposed DSM-5 criteria for NSSI accurately captured the behavior of the prototypic self-injurer. The results of this study provide incremental support for the proposed DSM-5 NSSI diagnostic criteria.

Non-suicidal self-injury: the contribution of general personality functioning.

Non-suicidal self-injury (NSSI) is a public health problem of increasing significance. The purpose of the present study was to determine if individuals with and without a history of NSSI would differ significantly on the domains and facets of the Five Factor Model (FFM) as well as the facets from the UPPS-P Impulsive Behaviour Scale. Self-report measures of personality, borderline personality disorder and NSSI were administered to an undergraduate sample (n = 211). Individuals who had engaged in NSSI had significantly elevated levels of FFM facets of neuroticism (i.e. anxiousness, angry hostility, depressiveness, self-consciousness, impulsiveness and vulnerability) and openness (i.e. aesthetics, feelings and values) and significantly lower levels of conscientiousness (i.e. order, achievement, self-discipline and deliberation). Additionally, those with an NSSI history scored higher on UPPS-P negative urgency, lack of premeditation and lack of perseverance. The knowledge gained from this study provides further support for personality's role in NSSI. This information may aid in the identification of risk factors for NSSI and assist in efforts examining interventions for NSSI that are targeted toward personality-relevant strategies.