The registration continuum in personality disorder studies: Theory, rationale, and template.

Registration is a tool to increase the rigor of personality disorder research and its ability to reduce human suffering through improving people's lives. This article details the problems that exist without registrations, which revolve around a study's outcomes' dependence on the data rather than on the theory being tested. Registrations exist on a continuum underpinned by bipolar timing and unipolar disclosure dimensions, the latter of which poses myriad points of decisions for researchers to register. The registration process provides memory aids and guideposts for researchers through the course of a study, transparently maintains public trust in the scientific enterprise, and preserves the severity of the tests used in the study. This article provides a template for personality disorder researchers to consider and examples of how researchers can use registered flexibility to plan for contingencies that might arise during a study. It also addresses challenges in evaluating registrations and implementing registration in a research workflow. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Psychometric properties of the eating disorder examination questionnaire: Factor analysis and measurement invariance by race/ethnicity and gender.

OBJECTIVE: The Eating Disorder Examination Questionnaire (EDE-Q) was originally validated in non-Hispanic White women and has become widely used as an assessment tool for research on eating pathology in college students. However, the original factor structure has generally failed to replicate across various samples, especially among diverse populations. The current study examined the factor structure and measurement invariance of the EDE-Q in a large sample of racially/ethnically diverse college men and women. METHOD: Participants included a diverse sample of men and women from two universities (N = 1981). Exploratory factory analysis (EFA) was conducted to examine the factor structure of the EDE-Q, followed by confirmatory factor analysis (CFA) to verify the factor structure, and establish the configural model. Furthermore, we explored the measurement invariance of the configural model by gender (i.e., men, women) and race/ethnicity (i.e., White, Black, Asian, Hispanic, and multiracial). RESULTS: EFA and CFA results suggested a three-factor, 10-item measure best fit the data, reflecting Dietary Restraint, Preoccupation and Eating Concern, and Shape/Weight Overvaluation. This measure achieved strict invariance by gender and race/ethnicity, indicating that mean comparisons across groups are meaningful. Women, relative to men, reported higher scores for all subscales. Significant differences across race/ethnicity emerged for Dietary Restraint and Shape/Weight Overvaluation in which Hispanic individuals endorsed the highest means compared to other racial/ethnic groups. DISCUSSION: The three-factor, 10-item measure is a brief, valid, and reliable measure of eating disorder psychopathology for U.S. college students.

Latent structure of cognitive tests is invariant in men and women with schizophrenia.

Studies comparing the cognitive functioning of men and women with schizophrenia have produced conflicting results which could arise from sex-based differences in the latent structure of cognitive abilities. The current study used multigroup confirmatory factor analysis to examine invariance in latent structure of cognitive abilities to between men and women with schizophrenia. Confirmatory factor analysis of an initial neurocognitive assessment (men n = 612, women n = 201) and cross-validation using second assessment (men n = 549, women n = 198) demonstrated that a bifactor seven-factor model fit the data best for both men and women. Invariance analyses further indicated this model was invariant across men and women at both assessments. Group comparisons indicated women had significantly higher scores for Semantic Memory, Verbal Memory, and General Cognitive factors, whereas men exhibited better performance on the Vigilance factor. Results indicate that cognition in SZ is characterized by both a general cognitive factor and specific domains for both men and women. Invariance analysis provides evidence that cognitive differences between men and women do not result from sex-based differences in the latent structure of cognitive abilities. Current results also indicate small but statistically significant neurocognitive differences between men and women with schizophrenia.

Auditory affective processing, musicality, and the development of misophonic reactions.

Misophonia can be characterized both as a condition and as a negative affective experience. Misophonia is described as feeling irritation or disgust in response to hearing certain sounds, such as eating, drinking, gulping, and breathing. Although the earliest misophonic experiences are often described as occurring during childhood, relatively little is known about the developmental pathways that lead to individual variation in these experiences. This literature review discusses evidence of misophonic reactions during childhood and explores the possibility that early heightened sensitivities to both positive and negative sounds, such as to music, might indicate a vulnerability for misophonia and misophonic reactions. We will review when misophonia may develop, how it is distinguished from other auditory conditions (e.g., hyperacusis, phonophobia, or tinnitus), and how it relates to developmental disorders (e.g., autism spectrum disorder or Williams syndrome). Finally, we explore the possibility that children with heightened musicality could be more likely to experience misophonic reactions and develop misophonia.

Examining relationships among thin-ideal internalization, eating pathology, and motivational reactions to high- and low-calorie food.

Motivational responses to food stimuli are relevant for eating disorders (EDs). Research examining reactions to food in EDs has been mixed, with some studies reporting enhanced appetitive responses, and others observing defensive responses, to food. Thin-ideal internalization, a socio-cognitive factor implicated in EDs, may relate to these mixed findings, as individuals with eating pathology may experience food as a threat to internalized ideals of thinness, despite its inherently appetitive qualities. In the present study, physiological reflexes measuring defensive (startle blink reflex) and appetitive (postauricular reflex) responding as well as self-report ratings were recorded while 88 women with and without eating pathology viewed images of high- and low-calorie food. Greater global eating pathology, but not thin-ideal internalization, was associated with negative self-report valence ratings and lower craving ratings of high-calorie food. In contrast, greater thin-ideal internalization and eating pathology both related to more positive self-report valence ratings of low-calorie food, with thin-ideal internalization accounting for some of the shared variance between low-calorie food ratings and eating pathology. Overall, thin-ideal internalization may represent a higher-order factor that may contribute to the relationship between conscious reactions to food and disordered eating.

The assessment of physical risk taking: Preliminary construct validation of a new behavioral measure.

Risk taking is a complex heterogeneous construct that has proven difficult to assess, especially when using behavioral tasks. We present an exploratory investigation of new measure-the Assessment of Physical Risk Taking (APRT). APRT produces a variety of different outcome scores and is designed as a comprehensive assessment of the probability of success and failure, and magnitude of reward and punishment of different types of simulated physically risky behaviors. Effects observed on the simulated behaviors are hypothesized to reflect similar effects on real world physical risks. Participants (N = 224) completed APRT in a laboratory setting, half of whom had a 1.5 s delay interposed between button presses. Exploratory analyses utilizing generalized estimating equations examined the main effects and two-way interactions among five within-subject factors, as well as two-way interactions between the within-subject factors and Delay across four APRT outcome scores. Results indicated that Injury Magnitude and Injury Probability exerted stronger effects than any of the other independent variables. Participants also completed several self-report measures of risk taking and associated constructs (e.g., sensation seeking), which were correlated with APRT scores to assess the preliminary convergent and divergent validity of the new measure. After correcting for multiple comparisons, APRT scores correlated with self-reported risk taking in thrilling, physically dangerous activities specifically, but only for those who did not have a delay between APRT responses. This promising exploratory investigation highlights the need for future studies comparing APRT to other behavioral risk taking tasks, examining the robustness of the observed APRT effects, and investigating how APRT may predict real-world physical risk taking.

A Comprehensive Examination of Factors Impacting Collegiate Athletes' Utilization of Psychological Assessment and Intervention Services.

Although collegiate athletes underutilize mental health programming, investigators have rarely examined factors that may influence their participation in such programs. The current study examined how structured interviews and demographic factors influence collegiate athletes to use psychological programming. Two-hundred and eighty-nine collegiate athletes were referred to the study. They were screened for mental health and randomly assigned to one of two semi-structured interviews based on experimental phase. Participants in Phase I received standard engagement (SE; N = 35) or SE+discussion of mental health (DMH; N = 44). Phase II participants received SE+DMH (N = 82) or SE+DMH + discussion of personal ambitions (DPA; N = 66). Phase III participants received SE+DMH+discussion about their culture of choice (DCC) (N = 25) or SE+DMH+discussion of sport culture (DSC) (N = 37). After receiving the respective interview participants were offered psychological assessment and intervention. Chi squared analyses revealed class standing, mental health symptom severity, referral type, and type of engagement interview influenced program commitment/utilization. Logistic regression analyses indicated SE+DMH+DPA and SE+DMH+DSC uniquely improved assessment attendance whereas referrals from the athletic department and coaches/teammates, participation in sport performance workshops, and senior status uniquely improved assessment and intervention attendance.

Bifactor model of cognition in schizophrenia: Evidence for general and specific abilities.

BACKGROUND: Despite extensive study of cognition in schizophrenia, it remains unclear as to whether cognitive deficits and their latent structure are best characterized as reflecting a generalized deficit, specific deficits, or some combination of general and specific constructs. METHOD: To clarify latent structure of cognitive abilities, confirmatory factor analysis was used to examine the latent structure of cognitive data collected for the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) for Schizophrenia study. Baseline assessment data (n = 813) were randomly divided into calibration (n = 413) and cross-validation samples (n = 400). To examine whether generalized or specific deficit models provided better explanation of the data, we estimated first-order, hierarchical, and bifactor models. RESULTS: A bifactor model with seven specific factors and one general factor provided the best fit to the data for both the calibration and cross-validation samples. CONCLUSIONS: These findings lend support for a replicable bifactor model of cognition in schizophrenia, characterized by both a general cognitive factor and specific domains. This suggests that cognitive deficits in schizophrenia might be best understood by separate general and specific contributions.

Latent variable modeling of item-based factor scales: Comment on Triarchic or septarchic?-Uncovering the Triarchic Psychopathy Measure's (TriPM) Structure, by Roy et al.

We critique Roy et al.'s (2020; this issue) approach to characterizing the item-level factor structure of the three scales of the Triarchic Psychopathy Measure (TriPM), in light of the manner in which the TriPM scales were developed, the purposes they were designed to serve, and the growing body of evidence supporting their construct validity. We focus on three major points: (1) The TriPM scales are item-based factor scales - i.e., item sets designed to index broad factors of larger multi-scale (parent) inventories; (2) item-level structural analysis can be useful for representing broad dimensions tapped by such scales, but it cannot be expected to provide an accurate picture of narrower subdimensions (facets) assessed by their parent inventories; and (3) it is critical to consider the nomological networks of the TriPM scales (and other triarchic scale measures) in appraising their effectiveness as operationalizations of the triarchic model constructs. We illustrate the first and second of these points by applying Roy et al.'s analytic approach to the trait scales of the NEO-FFI, which were developed to index broad personality dimensions of the multi-scale NEO-PI-R. We address the third point with reference to the growing body of literature supporting the construct validity of the TriPM scales and demonstrating their utility for advancing an integrative understanding of psychopathy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Implicit and explicit motivational responses to high- and low-calorie food in women with disordered eating.

Eating disorders and their symptoms are thought to be associated with altered motivational responding to food. Binge eating may relate to increased reward reactivity, restrictive eating may be associated with increased threat and/or decreased reward reactivity, and the combination of these symptoms within an individual may be linked to motivational conflict to food. Using both implicit (i.e., physiological) and explicit (i.e., self-reported) measures, we tested these hypotheses in 88 women with binge eating only, restrictive eating only, both binge eating and restrictive eating, or no eating pathology. Participants viewed and rated high-calorie food, low-calorie food, and emotional images while startle eye blink and postauricular reflexes were measured. Arousal and craving, but not valence, ratings were significantly greater for high- than low-calorie food. Startle blink reflexes during all food images were significantly lower than during neutral images, whereas only high-calorie foods related to greater postauricular reactivity than neutral images. Eating pathology group did not predict implicit and explicit motivational reactions to food. Exploratory dimensional analyses revealed that rating low-calorie foods as lower on craving predicted endorsement of restrictive eating, while rating low-calorie foods as lower on valence and arousal, and experiencing lower postauricular reactivity to high-calorie foods minus neutral images, predicted greater frequency of restrictive eating episodes. Decreased implicit and explicit appetitive motivation to high- and low-calorie food may relate to the presence and frequency of restrictive eating. Future longitudinal research should investigate whether decreased appetitive responding to food is a risk factor for, versus consequence of, restrictive eating.

Forms, Importance, and Ineffability of Factor Interactions to Define Personality Disorders.

The emergent interpersonal syndrome (EIS) approach conceptualizes personality disorders as the interaction among their constituent traits to predict important criterion variables. We detail the difficulties we have experienced finding such interactive predictors in our empirical work on psychopathy, even when using uncorrelated traits that maximize power. Rather than explaining a large absolute proportion of variance in interpersonal outcomes, EIS interactions might explain small amounts of variance relative to the main effects of each trait. Indeed, these interactions may necessitate samples of almost 1,000 observations for 80% power and a false positive rate of .05. EIS models must describe which specific traits' interactions constitute a particular EIS, as effect sizes appear to diminish as higher-order trait interactions are analyzed. Considering whether EIS interactions are ordinal with non-crossing slopes or disordinal with crossing slopes, or entail nonlinear threshold or saturation effects may help researchers design studies, sampling strategies, and analyses to model their expected effects efficiently.

Associations between self-report and physiological measures of emotional reactions to food among women with disordered eating.

Individuals with eating disorders have exhibited both positive and negative emotional responses to food when assessed via self-report and psychophysiology. These mixed findings may be explained by a lack of association between self-report and physiological measures, and the degree of association may differ based on core eating disorder symptoms like dietary restriction and binge eating. Women from the community (N = 82) were recruited based on the presence or absence of dietary restriction and binge eating. We examined the startle eyeblink reflex, a physiological measure of defensive motivation, in relation to self-reported valence, arousal, and craving ratings of emotional (positive, neutral, negative) and food (high- and low-calorie) images. Dietary restriction and binge eating were investigated as moderators of self-report/physiology relationships. Replicating extant literature, valence ratings of emotional images were correlated with startle blink reflex magnitude, with more unpleasant ratings related to higher startle eyeblink reflex magnitudes. Increased craving, but not valence, ratings of food images were related to lower startle blink reflex magnitudes. Dietary restriction and binge eating did not moderate the relationship between self-report ratings and startle blink magnitude to food. Our findings suggest that self-reported appetitive motivation towards food relates to a decrease in physiologically measured aversion towards food. Future research should examine the extent to which self-report ratings correlate with physiological indices of positive emotion (e.g., postauricular reflex, zygomaticus major) during the viewing of food images in both patients with eating disorders and healthy controls.

The registration continuum in clinical science: A guide toward transparent practices.

Clinical scientists can use a continuum of registration efforts that vary in their disclosure and timing relative to data collection and analysis. Broadly speaking, registration benefits investigators by offering stronger, more powerful tests of theory with particular methods in tandem with better control of long-run false positive error rates. Registration helps clinical researchers in thinking through tensions between bandwidth and fidelity that surround recruiting participants, defining clinical phenotypes, handling comorbidity, treating missing data, and analyzing rich and complex data. In particular, registration helps record and justify the reasons behind specific study design decisions, though it also provides the opportunity to register entire decision trees with specific endpoints. Creating ever more faithful registrations and standard operating procedures may offer alternative methods of judging a clinical investigator's scientific skill and eminence because study registration increases the transparency of clinical researchers' work. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Formulation of a measurement model for the boldness construct of psychopathy.

We describe efforts to formulate a quantitative measurement model for boldness, a construct that has been intensively discussed and investigated in the psychopathy literature in recent years. Although the Fearless Dominance factor of the Psychopathic Personality Inventory (PPI-FD) has served as a major referent for studying this dispositional construct, boldness was not explicitly targeted in developing the PPI, creating the need for a formal measurement model for this construct. Using an exploratory approach to test construction and multiple waves of data collection and analysis involving 1,791 participants, we created nine unidimensional scales (comprising a total of 130 items) for assessing correlated but thematically distinct facets of boldness, and characterized their higher-order structure. Overall scores on this new Boldness Inventory correlated highly with PPI-FD (positively) and dispositional fear (negatively), and negligibly with disinhibitory proclivities, in validation samples consisting of undergraduates (N = 767) and male prisoners (N = 326). The structural model of this new inventory, encompassing a general factor on which all facet scales loaded and two subordinate factors defined by residual variances of certain scales, effectively accommodated the constituent scales of PPI-FD. The model development work reported here establishes a valuable foundation for further, more fine-grained investigation of boldness as it relates to psychopathy and other clinical conditions as well as to adaptive functioning and performance. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Divergences among Three Higher-Order Self-Report Psychopathology Factors in Normal-Range Personality and Emotional Late Positive Potential Reactivity.

Personality is related to psychopathology and its higher-order structures, but there is little research regarding neurobiological associations of higher-order psychopathology factors. This study examined the factor structure of a wide range of psychopathology and its associations with both personality and emotional reactivity revealed through the late positive potential (LPP) in a sample of 275 undergraduates. A three-factor structure of psychopathology emerged comprising Internalizing (INT), Externalizing (EXT), and Aberrant Experiences (ABX). EXT predicted aggressive disconstraint, whereas both INT and ABX predicted Alienation and Stress Reaction. INT uniquely predicted low Well-Being, and ABX predicted a rigid absorption combined with interpersonal detachment. ABX correlated with reduced parietal emotional LPP reactivity, whereas INT correlated with stronger frontal LPP reactivity to emotional versus neutral pictures.

Effort expenditure for rewards task modified for food: A novel behavioral measure of willingness to work for food.

OBJECTIVE: Binge eating and associated eating disorders are characterized by abnormalities in reward processing. One component of reward is willingness to expend effort to obtain a reinforcer. The Effort Expenditure for Rewards Task (EEfRT) is a widely used behavioral measure of willingness to work for money. We sought to modify the EEfRT to examine willingness to work for food reward and to preliminarily examine the association between binge eating and effort expenditure for food. METHOD: Participants were 63 females recruited to span the spectrum of binge-eating severity. The modified EEfRT required participants to make a series of choices between an easier, low-reward option (one portion of food) and a harder, high-reward option (between two to five portions of food). Each trial also varied on probability of winning. RESULTS: Participants self-reported engagement in the task, working hard at easy and hard tasks, and making choices based on reward probability and magnitude. As with the original EEfRT, probability, reward magnitude, and their interaction predicted the likelihood of choosing the hard task. Across two different measures, binge-eating symptoms interacted with reward magnitude, such that those with high binge eating used reward magnitude more to make trial choices than those with low binge eating. DISCUSSION: These data provide initial support for the validity of the EEfRT modified for food as a behavioral measure of willingness to work for food reward. The impact of binge eating on effort expenditure must be replicated in samples of patients with eating disorders.

Psychopathy in the Medical Emergency Department.

Psychopathy is a personality disorder representing an admixture of a fearless and dominant temperament with an impulsive and antisocial orientation. A sample of 1,026 participants in the waiting room of the medical emergency department of a city hospital exhibited levels of fearless dominance similar to university undergraduates and federal inmates; their levels of impulsive antisociality fell between those of federal and state inmates. Both psychopathy factors were correlated with male gender, younger age, and more frequent average alcohol consumption. Fearless dominance was associated with agentic success (e.g., being employed, higher household income), fewer psychological problems, and less use of psychotropic medications, including anxiolytics. Impulsive antisociality was negatively related to both agentic and communal (e.g., ever being married) success and positively correlated with substance use and self-reported bipolar, ADHD, and psychotic psychiatric conditions. Further, only impulsive antisociality was associated with presenting to the emergency department for physical injury or psychological disturbance.

Emotional Reactivity and Appraisal of Food in Relation to Eating Disorder Cognitions and Behaviours: Evidence to Support the Motivational Conflict Hypothesis.

Eating disorders are associated with both negative and positive emotional reactions towards food. Individual eating disorder symptoms may relate to distinct emotional responses to food, which could necessitate tailored treatments based on symptom presentation. We examined associations between eating disorder symptoms and psychophysiological responses to food versus neutral images in 87 college students [mean (SD) age = 19.70 (2.09); mean (SD) body mass index = 23.25(2.77)]. Reflexive and facial electromyography measures tapping negative emotional reactivity (startle blink reflex) and appraisal (corrugator muscle response) as well as positive emotional reactivity (postauricular reflex) and appraisal (zygomaticus muscle response) were collected. Eating disorder cognitions correlated with more corrugator activity to food versus neutral images, indicating negative appraisals of food. Binge eating was associated with increased postauricular reflex reactivity to food versus neutral images, suggesting enhanced appetitive motivation to food. The combination of cognitive eating disorder symptoms and binge eating may result in motivational conflict towards food. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

The Multidimensional Personality Questionnaire's inconsistency scales identify invalid profiles through internal statistics and external correlates.

Inconsistency scales represent a promising method for separating valid and invalid personality profiles. In a sample of 1,258 participants in the waiting room of the emergency department of an urban university hospital, we examined whether data from participants with profiles flagged as invalid (n = 132) using the Variable Response Inconsistency (VRIN) or True Response Inconsistency (TRIN) scales of the Multidimensional Personality Questionnaire's brief form (MPQ-BF) differed from those that did not exceed any validity cutoffs (n = 1,026). Invalid profiles' scores on many scales were less internally consistent and had less variability than those from valid profiles, especially for random and acquiescent response styles. Scores on MPQ-BF primary trait scales from profiles featuring random responses appeared more psychologically maladjusted than those on valid profiles. Compared to primary trait scores on valid profiles, acquiescent profiles generally had higher scores, and counteracquiescent profiles had lower scores. The higher order component structure of invalid profiles was less consistent with published MPQ-BF component structures than that of valid profiles, though negative emotionality was generally reasonably well-preserved. Scores on primary traits associated with negative emotionality generally had larger correlations with demographic criteria for valid profiles than invalid profiles. These results argue that inconsistency scales meaningfully identify invalid profiles in normal-range personality assessment. (PsycINFO Database Record

Reduced positive emotion and underarousal are uniquely associated with subclinical depression symptoms: Evidence from psychophysiology, self-report, and symptom clusters.

Multiple models of aberrant emotional processing in depression have been advanced. However, it is unclear which of these models best applies to emotional disturbances in subclinical depressive symptoms. The current study employed a battery of psychophysiological measures and emotional ratings in a picture-viewing paradigm to examine whether the underarousal, low positive emotion, heightened negative emotion, or emotion context insensitivity model of emotional dysfunction in subclinical depressive symptoms received greatest support. Postauricular reflex and skin conductance response potentiation for pleasant minus neutral pictures (measuring low positive emotion), overall skin conductance magnitude and late positive potential (LPP) amplitude (measuring underarousal), and pleasant minus aversive valence ratings (measuring emotion context insensitivity) and aversive minus neutral arousal ratings (measuring heightened negative emotionality) were all negatively related to depressive symptomatology. Of these, postauricular reflex potentiation and overall LPP amplitude were incrementally associated with depressive symptoms over the other measures. Postauricular reflex potentiation, overall skin conductance magnitude, and aversive minus neutral arousal ratings were incrementally associated with depressive symptomatology after controlling for other symptoms of internalizing disorders. Though no model was unequivocally superior, the low positive emotion and underarousal models received the most support from physiological measures and symptom reports, with self-report data matching patterns consistent with the emotion context insensitivity model.