Examining the structure of personality dysfunction.

Personality impairment is a core feature of personality disorders in both current (i.e., Diagnostic and Statistical Manual of Mental Disorders, fifth edition [DSM-5] personality disorders, International Classification of Diseases,11th revision personality disorders) and emerging (i.e., DSM-5's alternative model of personality disorders) models of psychopathology. Yet, despite its importance within clinical nosology, attempts to identify its optimal lower-order structure have yielded inconsistent findings. Given its presence in diagnostic models, it is important to better understand its empirical structure across a variety of instantiations. To the degree that impairment is multifaceted, various factors may have different nomological networks and varied implications for assessment, diagnosis, and treatment. Therefore, participants were recruited from two large public universities in the present preregistered study (N = 574) to explore the construct's structure with exploratory "bass-ackward" factor analyses at the item level. Participants completed over 250 items from six commonly used measures of personality dysfunction. Criterion variables in its nomological network were also collected (e.g., general and pathological personality traits, internalizing/externalizing behavior, and personality disorders) using both self- and informant-reports. These factor analyses identified four lower-order facets of impairment (i.e., negative self-regard, disagreeableness, intimacy problems, and lack of direction), all of which showed moderate to strong overlap with traits from both general and pathological models of personality. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Is Personality Pathology Ego-Syntonic? Self- and Meta-Perception of Maladaptive Personality Traits.

Research has challenged the assumption that personality pathology is "ego-syntonic" or perceived favorably and consistent with one's self-image. The present study employed a community sample (n = 401) to examine relations between self-rated maladaptive personality and liking of maladaptive traits in self and others as well as meta-perception of personality pathology (i.e., how likable participants believe others find maladaptive traits). In general, individuals with higher self-rated maladaptive traits provided higher ratings of the likability of these traits in themselves and others. However, as hypothesized, comparison of liking ratings for high scorers and the rest of the sample revealed that individuals who score high on most pathological personality traits do not "like" these traits (or rate others as "liking" them) but simply dislike them less. Results support a dimensional view of ego-syntonicity.

Surveying veterans affairs mental health care providers on experiences working with veteran patients with antagonistic clinical presentations.

We surveyed N = 84 mental health care providers (i.e., psychiatrists, psychologists, social workers) working across two Veterans Affairs health care sites about their experiences working with Veteran patients with antagonism-based clinical presentations (e.g., callous, aggressive, grandiose features), as well as negative affect-based clinical presentations (e.g., depressive, anxious, self-conscious features). Providers reported on aspects of these clinical interactions, including assessments and interventions used, treatment outcomes, interpersonal experiences, and training and preparedness to treat this type of presentation in the future. Compared to treatment experiences with patients with predominant negative affect, providers reported that treatment experiences with antagonistic (ANT) patients tended to be shorter (d = -.60), less effective at improving psychological functioning (d = -.61), more emotionally draining (d = 1.03), and more often marked by relationship ruptures (instance of ≥1 rupture = 72.6% vs. 15.5%). Providers also reported less professional training to treat antagonism (d = -1.56) and less preparedness to treat ANT patients in the future (d = -1.81). These results highlight the important role of patient characteristics in providers' experiences and underscore the need for more training and resources to support mental health providers working with ANT patients. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Welcome to the Jangle: Comparing the Empirical Profiles of the "Dark" Factor and Antagonism.

This study examines the congruency between the recently introduced Dark Factor of Personality (D) and Antagonism (A; low Agreeableness) from the Five-Factor Model of personality. Using two samples (Ns of 365 and 600), we examined simple zero-order correlations between D and A (rs of .69 and .64). In addition, we used a range of relevant external criteria (e.g., antisocial behavior, aggression, domains and facets of personality, Diagnostic and Statistical Manual of Mental Disorders [DSM] personality disorders [PDs], impulsivity, and political skill) to examine the degree of absolute similarity in the relations that D and A bear to these criteria. These similarity coefficients were then compared with the similarities produced by measures of constructs different from D and A but similar among themselves (i.e., psychopathy and narcissism in both samples, plus depression in Sample 1). The degree of similarity between D and A (rICCs = .96 and .93) is consistent with what is observed between other measures of the same construct. We conclude that D and A yield largely identical empirical correlates and thus likely represents an instance of the jangle fallacy. We believe that future efforts would be better spent furthering the literature around the well-established Agreeableness versus Antagonism construct.

The problems with Criterion A: A comment on Morey et al. (2022).

The alternative model of personality disorder (American Psychiatric Association, 2013), introduced in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, represents a significant advancement in our understanding of personality disorders. Despite this advancement, nearly 10 years after its introduction, considerable debate remains regarding the conceptualization, operationalization, and ultimately the utility of personality impairment (i.e., Criterion A). Morey et al. (2022) review the impetus for, conceptualization of, the current state of our understanding of Criterion A, and conclude that Criterion A is a valid and clinically useful component of the alternative model of personality disorder. In our commentary, we present a more pessimistic view and review literature critical of Criterion A not included in the main text of their review. We conclude that Criterion A, as currently operationalized by the Level of Personality Functioning Scale, does not provide the functionality or utility as suggested by Morey and colleagues in their review. Instead, we suggest that pathological traits are well-positioned to capture severity of dysfunction and likely carry the most clinically useful information. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Understanding individuals' desire for change, perceptions of impairment, benefits, and barriers of change for pathological personality traits.

Despite clinical theory suggesting that individuals are largely unaware of personality-related problems (Gallrein et al., 2013; Oltmanns & Powers, 2012); work in this area shows that individuals possess insight into their pathological traits and the impairment they may cause. Individuals generally dislike pathological traits and desire change in the direction of greater adaptivity (Lamkin et al., 2018; Miller et al., 2018). Individuals may also be able to make small, intentional changes in some personality domains (e.g., neuroticism; Hudson & Fraley, 2015; Hudson & Roberts, 2014) but not others (no positive change in conscientiousness or agreeableness). It remains unclear why many individuals exhibit relatively little change in their pathological traits (e.g., antagonism), given their awareness of the problems these traits cause and their desire for change. The goal of the present study was to explore the relation between personality disorder (PD) traits and desire for change, perceived impairment and benefits, and barriers to change among an online sample (N = 497). Findings suggest that most individuals were uninterested in changing their trait levels; however, individuals with elevated PD traits were more interested in change than those with lower levels. Pathological traits were generally perceived as impairing rather than beneficial; however, mean level analyses revealed similar levels of perceived impairment and benefits for those relatively high on antagonism. Individuals reported that personality change was stymied in part because it was too hard, they were unmotivated to make the changes, or they did not know how to go about making such changes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Uncovering the structure of antagonism.

Despite the advances in our understanding of the structure of personality and psychopathology (see Kotov et al., 2017), less attention has been paid to empirically examining their underlying facet structure. To gain a more nuanced understanding of the structure of personality, it is important to identify empirically derived lower order structures of these trait domains; thus, the present study sought to examine the structure of antagonism as represented by items from commonly used measures of pathological personality traits. Participants were recruited from a large, southeastern university (N = 532) and completed 234 antagonism items selected from seven measures of pathological personality traits. Criterion variables measuring interpersonal adjectives, aggression, substance use, depression, and anxiety were also collected. A series of factor analyses were conducted to examine the structure of antagonism at a range of specificities. A seven-factor solution emerged as being both comprehensive and reasonably parsimonious with factors labeled Callousness, Grandiosity, Domineering, Manipulation, Suspiciousness, Aggression, and Risk Taking. The present findings demonstrate how trait Antagonism unfolds at varying levels of specificity as well as how the emergent factors differentially relate to outcomes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

DSM-5 alternative model for personality disorders trait domains and PTSD symptoms in a sample of highly traumatized African American women and a prospective sample of trauma center patients.

Posttraumatic stress disorder (PTSD) has a specified precipitant (i.e., trauma), and thus, is particularly well-suited to examine risk and maintenance factors for the development of the disorder. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) alternative model of personality disorder (AMPD) is based, in part, on a dimensional trait model; previous research suggests that personality traits are related to PTSD symptoms. To date, there is little research examining this model with regard to PTSD symptoms, and such research could elucidate new strategies for identification and prevention. The present study investigates associations between AMPD traits and PTSD symptoms in a cross-sectional high-risk sample (N = 490; 100% female; 97.8% African American) and in a prospective, longitudinal sample of Level 1 trauma center patients (N = 185; 46.8% female; 72.5% African American). The Personality Inventory for DSM-5 Brief Form domains were significantly associated with PTSD total symptom severity and symptom clusters across both self-report and clinical interview measures. Personality Inventory for DSM-5 Negative Affectivity and Psychoticism emerged as significant predictors of concurrent PTSD. When prospectively predicting PTSD symptoms in the longitudinal cohort, Negative Affectivity and Psychoticism were significant predictors of PTSD symptom severity. These findings indicate how the DSM-5 AMPD pathological traits are associated with risk for stress-related disorders cross-sectionally and prospectively. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Evaluating the Instantiation of Narcissism Components in Contemporary Measures of Psychopathy.

Narcissistic traits figure prominently in classical conceptualizations of psychopathy and bear substantial empirical overlap with components of psychopathy. Yet the degree to which various widely used self-report measures of psychopathy include relevant narcissistic content has not been evaluated, especially in relation to new, multidimensional models of narcissism. Using a large undergraduate sample (N = 432) and self- and informant-ratings of narcissism, the present study examined narcissism's instantiation in several commonly used self-report psychopathy measures. A modern conceptualization of narcissism at three levels of hierarchical organization (i.e., Trifurcated Model of Narcissism) was applied to comprehensively evaluate narcissism's instantiation in these psychopathy measures. Although narcissistic traits related to self-centered antagonism were well-instantiated across psychopathy self-report measures, narcissistic traits related to agentic extraversion were represented more modestly by most (i.e., Triarchic Psychopathy Measure, Self-Report Psychopathy Scale: Version III, Levenson Self-Report Psychopathy Scale), but not all (i.e., Elemental Psychopathy Assessment [EPA]) psychopathy measures. Only the EPA contained substantial representation of all narcissism components. Given the theoretical and empirical overlap between psychopathy and narcissism, it behooves researchers to be aware of the degree to which psychopathy measures capture narcissistic content.

Psychometric Properties of the Personality Inventory for DSM-5-Brief Form in a Community Sample with High Rates of Trauma Exposure.

In the current study, we used a sample of predominantly African-American women with high rates of trauma exposure (N = 434) to examine psychometric properties of the Personality Inventory for DSM-5-Brief Form (PID-5-BF). We compared model fit between a model with five correlated latent factors and a higher-order model in which the five latent factors were used to estimate a single "general pathology" factor. Additionally, we computed estimates of internal consistency and domain interrelations and examined indices of convergent/discriminant validity of the PID-5-BF domains by examining their relations to relevant criterion variables. The expected five-factor structure demonstrated good fit indices in a confirmatory factor analysis, and the more parsimonious, higher-order model was retained. Within this higher-order model, the first-order factors accounted for more variance in the criterion variables than the general pathology factor in most instances. The PID-5-BF domains were highly interrelated (rs = .38 to .66), and convergent/discriminant validity of the domains varied: Negative Affectivity and Detachment generally showed the hypothesized pattern of relations with external criteria, while Antagonism and Disinhibition displayed less consistent and discriminant relations. Results are discussed in terms of the costs and benefits of using brief pathological trait measures in samples characterized by high levels of psychopathology.

Insight Regarding the Presence of Antagonism-Related Traits and Their Subsequent Impairment in Relation to Psychopathy, Narcissism, and Machiavellianism.

Clinical theory is skeptical of individuals' ability to recognize the presence, severity, and impact of clinical symptoms and pathological traits (Oltmanns & Powers, 2012); however, empirical work has found moderate self-other convergence for reports of pathological traits and for Antagonism-related personality disorder (PD) constructs (i.e., psychopathy, narcissism, and Machiavellianism), which are characterized by low insight. Nevertheless, empirical examinations of insight into perceptions of impairment are scant. Thus, the present study sought to examine individuals' insight regarding pathological traits and related impairment in two samples. In Sample 1, more psychopathic, narcissistic, and Machiavellian individuals reported higher levels of pathological traits and were aware of related impairment. In Sample 2, individuals reported higher levels of pathological traits and, albeit to a lesser degree, more Antagonism-related impairment. Thus, more psychopathic, narcissistic, and Machiavellian individuals possess a reasonable degree of insight into their trait levels and associated impairment.

Fearless Dominance/Boldness Is Not Strongly Related to Externalizing Behaviors: An Item Response-Based Analysis.

There is substantial and ongoing debate regarding the centrality of Fearless Dominance/Boldness (FD/B) to psychopathic personality due, in part, to its generally weak relations with externalizing behaviors. In response to these findings, proponents of FD/B have offered two hypotheses. First, FD/B may have nonlinear associations with externalizing outcomes such that FD/B may lead to resilience at moderate levels, but an overabundance of FD/B will yield maladaptive behavioral outcomes. Second, FD/B may be related to antisocial outcomes when paired with high scores on other psychopathic traits such as self-centered impulsivity, meanness, or disinhibition. The current study tests these two possibilities using two large samples (Study 1: 787 undergraduates; Study 2: 596 Amazon's Mechanical Turk participants). An item response theory scoring approach particularly sensitive to curvilinearity was used to maximize our ability to find a true curvilinear effect, if present. No evidence in favor of the curvilinearity hypothesis was found. Only a single significant interaction predicting substance use was observed between boldness and meanness. These findings contribute to a growing literature raising concerns regarding the relevance of FD/B to psychopathy.

A Comparison of the Validity of Very Brief Measures of the Big Five/Five-Factor Model of Personality.

Personality is of great lay, clinical, and research interest with important functional implications. The field has largely settled on five- or six-factor models as being largely sufficient for descriptive purposes, at least in W.E.I.R.D settings and, as such, numerous measures have been created of varying length and breadth. For a number of reasons, however, super-short forms have come to be quite popular in research endeavors with a number created in the past 20 years. The goal of the present study was to compare the time with completion and general psychometric properties of these measures, as well as examine their convergence with one another and with longer measures in an online community sample (N = 494). Generally, the psychometric properties of the measures varied considerably in terms of internal consistency and convergence with one another. The brief measures demonstrated mostly adequately convergence with longer measures. Despite this convergence, longer measures were found to contain considerably more variance that was not accounted for by brief measures. We consider the advantages and disadvantages of these measures and suggest that longer measures be prioritized whenever possible.

The DSM-5 section III personality disorder criterion a in relation to both pathological and general personality traits.

Following the introduction of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), section III alternative model of personality disorder, much of the empirical attention has been directed toward testing the performance of Criterion B (i.e., pathological traits). Much more recently, with the development of assessment tools related to Criterion A (i.e., personality impairment), a burgeoning literature base is forming for it as well. A closer look at the Criterion A component, however, reveals disagreements around its structure, discriminant validity, ability to distinguish between personality-based and nonpersonality-based forms of psychopathology, overlap between the two criteria, and incremental validity. The goal of the current study (N = 365 undergraduates) was to test Criterion A in relation to both pathological personality traits, as specified in the DSM-5, and general personality traits, as some scholars suggested that might be more appropriate. The results suggest that impairment domains overlap substantially with pathological and general traits, and these traits account for considerable variance in impairment domains. Most importantly, the findings suggest that general and pathological traits functioned in nearly identical ways, as evidenced by the similar relations that they evinced with traditional DSM-5 personality disorder constructs. In line with previous work, the present findings demonstrate limited discriminant validity among impairment domains and an inability to distinguish between Axis I and II symptoms. Further research on the alternative model of personality disorder is needed to test the necessity and sufficiency of its constituent components. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

An evaluation of DSM-5 Section III personality disorder Criterion A (impairment) in accounting for psychopathology.

An alternative diagnostic model of personality disorders (AMPD) was introduced in DSM-5 that diagnoses PDs based on the presence of personality impairment (Criterion A) and pathological personality traits (Criterion B). Research examining Criterion A has been limited to date, due to the lack of a specific measure to assess it; this changed, however, with the recent publication of a self-report assessment of personality dysfunction as defined by Criterion A (Levels of Personality Functioning Scale-Self-report; LPFS-SR; Morey, 2017). The aim of the current study was to test several key propositions regarding the role of Criterion A in the AMPD including the underlying factor structure of the LPFS-SR, the discriminant validity of the hypothesized factors, whether Criterion A distinguishes personality psychopathology from Axis I symptoms, the overlap between Criterion A and B, and the incremental predictive utility of Criterion A and B in the statistical prediction of traditional PD symptom counts. Neither a single factor model nor an a priori four-factor model of dysfunction fit the data well. The LPFS-SR dimensions were highly interrelated and manifested little evidence of discriminant validity. In addition, the impairment dimensions manifested robust correlations with measures of both Axis I and II constructs, challenging the notion that personality dysfunction is unique to PDs. Finally, multivariate regression analyses suggested that the traits account for substantially more unique variance in DSM-5 Section II PDs than does personality impairment. These results provide important information as to the functioning of the two main components of the DSM-5 AMPD and raise questions about whether the model may need revision moving forward. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Difficulties with the conceptualization and assessment of Criterion A in the DSM-5 alternative model of personality disorder: A reply to Morey (2019).

The DSM-5 introduced an alternative model of personality disorders that is predicated on the presence of personality dysfunction (Criterion A) and pathological personality traits (Criterion B). Recently, a member of the DSM-5 Personality and Personality Disorder Work Group-Morey-published a measure of Criterion A. Our study (Sleep, Lynam, Widiger, Crowe, & Miller, 2019, this issue) examined the performance of Morey's (2017) Levels of Personality Functioning Scale-Self-Report (LFPS-SR) by testing its factor structure, relations with Axis I and II symptoms, and its incremental validity in predicting traditional personality disorders in comparison to Criterion B traits. In his response, Morey raised a number of issues regarding our examination of the LPFS-SR in relation to its factor structure, discriminant validity, and incremental validity. Moreover, he suggested our approach (i.e., pitting Criterion A vs. B) is emblematic of problems in the field that contributed to the relegating of the AMPD to Section III (on emerging measures and models). In our response, we answer his criticisms. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

An examination of the Triarchic Model of psychopathy's nomological network: A meta-analytic review.

Psychopathy is characterized by a constellation of traits including callousness, superficial charm, grandiosity, exploitativeness, irresponsibility, and impulsivity (e.g., Cleckley, 1941/1955; Hare, 2003). Despite longstanding interest, the nature and scope of the construct as well as the centrality and sufficiency of its components remain debated (i.e., Fearless Dominance/Boldness; Miller & Lynam, 2012; Lilienfeld et al., 2012). Recently, the Triarchic Model of Psychopathy (TriPM; Patrick, Fowles, & Krueger, 2009) has garnered considerable interest, positing that psychopathy can be characterized by three partially overlapping, phenotypic domains: Boldness, Meanness, and Disinhibition. The present meta-analysis sought to examine the relations between these domains and other well-validated psychopathy measures and theoretically relevant outcomes in its nomological network. Across outcomes, Meanness and Disinhibition demonstrated robust convergent and criterion validity with other models of psychopathy as well as with pathological traits and externalizing outcomes; however, they manifested limited discriminant validity in relation to one another. In addition, empirical evidence for Boldness in relation to maladaptive outcomes was much weaker. Specifically, Boldness evinced the most robust relations with markers of adaptive functioning and only small relations with central criterion variables (e.g., externalizing behavior).

Using Item Response Theory to Develop a 60-Item Representation of the NEO PI-R Using the International Personality Item Pool: Development of the IPIP-NEO-60.

Given advantages of freely available and modifiable measures, an increase in the use of measures developed from the International Personality Item Pool (IPIP), including the 300-item representation of the Revised NEO Personality Inventory (NEO PI-R; Costa & McCrae, 1992a ) has occurred. The focus of this study was to use item response theory to develop a 60-item, IPIP-based measure of the Five-Factor Model (FFM) that provides equal representation of the FFM facets and to test the reliability and convergent and criterion validity of this measure compared to the NEO Five Factor Inventory (NEO-FFI). In an undergraduate sample (n = 359), scores from the NEO-FFI and IPIP-NEO-60 demonstrated good reliability and convergent validity with the NEO PI-R and IPIP-NEO-300. Additionally, across criterion variables in the undergraduate sample as well as a community-based sample (n = 757), the NEO-FFI and IPIP-NEO-60 demonstrated similar nomological networks across a wide range of external variables (rICC = .96). Finally, as expected, in an MTurk sample the IPIP-NEO-60 demonstrated advantages over the Big Five Inventory-2 (Soto & John, 2017 ; n = 342) with regard to the Agreeableness domain content. The results suggest strong reliability and validity of the IPIP-NEO-60 scores.

Personality disorder traits: Testing insight regarding presence of traits, impairment, and desire for change.

Mixed findings exist as to whether personality pathology involves a critical lack of awareness and insight. Research questions about insight and awareness in personality pathology are typically assessed via comparing self- and informant reports of traits. However, recent studies have measured insight by asking individuals to evaluate additional questions about impairment and desire to change. The present study uses a variety of approaches to examine these issues, including investigations of convergence between self- and informant reports (N = 197 dyads; correlations and comparisons of means) of personality psychopathology, desired trait levels, and perceptions of impairment. Convergence was observed between levels of self- and informant-reported traits, desired traits, and impairment. However, individuals rated themselves higher on pathological trait levels and impairment than did their informants. Furthermore, individuals with relatively higher pathological traits desired higher levels of these traits (but lower than their actual scores) than individuals with lower scores; on the actual measurement scale, however, these higher scorers rated their desired level below the neutral point. Overall, individuals with pathological personality traits possess a reasonable degree of insight into their actual trait levels and associated impairment. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Narcissism and self-esteem: A nomological network analysis.

Similarity between narcissism and self-esteem seems intuitive, as both capture positive perceptions of the self. In the current undertaking, we provide a broad comparison of the nomological networks of grandiose narcissism and explicit self-esteem. Pooling data from 11 existing samples (N = 4711), we compared the relations of narcissism and self-esteem to developmental experiences, individual differences, interpersonal functioning, and psychopathology. Both constructs are positively related to agentic traits and assertive interpersonal approaches, but differ in relation to agreeableness/communion. Self-esteem emerged as a wholly adaptive construct negatively associated with internalizing psychopathology and generally unrelated to externalizing behaviors. Unlike self-esteem, narcissism was related to callousness, grandiosity, entitlement, and demeaning attitudes towards others that likely partially explain narcissism's links to maladaptive outcomes.