Exploring the complexity of the childhood trait-psychopathology association: Continuity, pathoplasty, and complication effects.

Four different models have been generally proposed as plausible etiological explanations for the relation between personality and psychopathology, namely, the vulnerability, complication, pathoplasty, and spectrum or continuity model. The current study entails a joint investigation of the continuity, pathoplasty, and complication models to explain the nature of the associations between early maladaptive traits and psychopathology over time in 717 referred and community children (54.4% girls), aged from 8 to 14 years. Across a 2-year time span, maladaptive traits and psychopathology were measured at three different time points, thereby relying on comprehensive and age-specific dimensional operationalizations of both personality symptoms and psychopathology. The results demonstrate overall compelling evidence for the continuity model, finding more focused support for pathoplasty and complication effects for particular combinations of personality symptoms and psychopathology dimensions. As expected, the continuity associations were found to be more robust for those personality-psychopathology associations that are conceptually closer, such as the emotional instability/introversion-internalizing problems association and the disagreeableness-externalizing problems association. Continuity associations were also stronger when personality was considered from a maladaptive rather than from a general trait perspective. The implication of the findings for the treatment of psychopathology and personality symptoms are briefly discussed.

The emergence of sex differences in personality traits in early adolescence: A cross-sectional, cross-cultural study.

Although large international studies have found consistent patterns of sex differences in personality traits among adults (i.e., women scoring higher on most facets), less is known about cross-cultural sex differences in adolescent personality and the role of culture and age in shaping them. The present study examines the NEO Personality Inventory-3 (McCrae, Costa, & Martin, 2005) informant ratings of adolescents from 23 cultures (N = 4,850), and investigates culture and age as sources of variability in sex differences of adolescents' personality. The effect for Neuroticism (with females scoring higher than males) begins to take on its adult form around age 14. Girls score higher on Openness to Experience and Conscientiousness at all ages between 12 and 17 years. A more complex pattern emerges for Extraversion and Agreeableness, although by age 17, sex differences for these traits are highly similar to those observed in adulthood. Cross-sectional data suggest that (a) with advancing age, sex differences found in adolescents increasingly converge toward adult patterns with respect to both direction and magnitude; (b) girls display sex-typed personality traits at an earlier age than boys; and (c) the emergence of sex differences was similar across cultures. Practical implications of the present findings are discussed. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Latent classes of nonresponders, rapid responders, and gradual responders in depressed outpatients receiving antidepressant medication and psychotherapy.

BACKGROUND: We used growth mixture modeling (GMM) to identify subsets of patients with qualitatively distinct symptom trajectories resulting from treatment. Existing studies have focused on 12-week antidepressant trials. We used data from a concurrent antidepressant and psychotherapy trial over a 6-month period. METHOD: Eight hundred twenty-one patients were randomized to receive either fluoxetine or tianepine and received cognitive-behavioral therapy, supportive therapy, or psychodynamic therapy. Patients completed the Montgomery-Åsberg depression rating scale (MADRS) at the 0, 1, 3, and 6-month periods. Patients also completed measures of dysfunctional attitudes, functioning, and personality. GMM was conducted using MADRS scores and the number of growth classes to be retained was based on the Bayesian information criterion. RESULTS: Criteria supported the presence of four distinct latent growth classes representing gradual responders of high severity (42% of sample), gradual responders of moderate severity (31%), nonresponders (15%), and rapid responders (11%). Initial severity, greater use of emotional coping strategies, less use of avoidance coping strategies, introversion, and less emotional stability predicted nonresponder status. Growth classes were not associated with different treatments or with proportion of dropouts. CONCLUSIONS: The longer time period used in this study highlights potential overestimates of nonresponders in previous research and the need for continued assessments. Our findings demonstrate distinct growth trajectories that are independent of treatment modality and generalizable to most psychotherapy patients. The correlates of class membership provide directions for future studies, which can refine methods to predict likely nonresponders as a means to facilitate personalized treatments.

The hierarchical structure and construct validity of the PID-5 trait measure in adolescence.

The DSM-5 may be the first edition that enables a developmental perspective on personality disorders because of its proposal to include a trait assessment in the Axis II section. The current study explores the reliability, structure, and construct validity of the Personality Inventory for DSM-5 (PID-5; Krueger, Derringer, Markon, Watson, & Skodol, 2012) in adolescents, a measure that assesses the proposed DSM-5 traits. A community sample of Flemish adolescents (N = 434; 44.7% male) provided self-reports on the PID-5 and the Dimensional Personality Symptom Itempool (DIPSI; De Clercq, De Fruyt, Van Leeuwen, & Mervielde, 2006). Results indicate an acceptable reliability for the majority of the PID-5 facets and a tendency toward structural convergence of the adolescent PID-5 structure with the adult proposal. Convergent validity with age-specific facets of personality pathology was generally supported, but discriminant validity appeared to be low. Beyond the findings that support the applicability of the PID-5 in adolescents, developmental issues may be responsible for specific differences in the adolescent PID-5 structure, the rather poor discriminant validity of the PID-5, and the lower reliability of a small number of PID-5 facets. These results indicate that further research on the validity of the PID-5 in younger age groups is required.

A general and maladaptive personality perspective on youth obsessive-compulsive symptoms.

Based on Krueger's (2005) conceptual model of the personality-psychopathology relationship, this study examines how personality predicts different youth obsessive-compulsive symptoms, comparing the relative contribution of general and maladaptive personality traits. Three-hundred forty-four adolescents provided self-reports on an obsessive-compulsive scale, and their mothers rated their child's general and maladaptive personality. Hierarchical regression analyses revealed that personality differentially predicts obsessive-compulsive symptomatology, and that the relative significance of general versus maladaptive personality predictors differs across various forms of obsessive-compulsive pathology. The results are discussed in terms of the value of including both general and maladaptive personality measures in the assessment of early obsessive-compulsive difficulties.

The Inaccuracy of National Character Stereotypes.

Consensual stereotypes of some groups are relatively accurate, whereas others are not. Previous work suggesting that national character stereotypes are inaccurate has been criticized on several grounds. In this article we (a) provide arguments for the validity of assessed national mean trait levels as criteria for evaluating stereotype accuracy; and (b) report new data on national character in 26 cultures from descriptions (N=3,323) of the typical male or female adolescent, adult, or old person in each. The average ratings were internally consistent and converged with independent stereotypes of the typical culture member, but were weakly related to objective assessments of personality. We argue that this conclusion is consistent with the broader literature on the inaccuracy of national character stereotypes.

Is relational aggression part of the externalizing spectrum? a bifactor model of youth antisocial behavior.

The primary purpose of the present study was to examine support for the inclusion of relational aggression (RAgg) alongside physical aggression (Agg) and rule-breaking behaviors (RB) as a subfactor of antisocial behavior (ASB). Caregiver reports were collected for 1,087 youth (48.9% male) ages 6-18. Results indicated that all three subfactors of ASB demonstrated substantial loadings on a general ASB factor. Using a bifactor model approach, specific factors representing each ASB subfactor were simultaneously modeled, allowing for examination of common and specific correlates. At the scale level, results demonstrated consistently strong connections with high Neuroticism and low Agreeableness across all 3 ASB subfactors, a pattern which was replicated for the general ASB factor in the bifactor approach. Specific factors in the bifactor model demonstrated connections with personality and psychopathology correlates, primarily for Agg. These findings provide some support for an overall grouping of RAgg with other ASB subfactors in youth, and further distinguish Agg as potentially representing a more potent variant of youth ASB relative to both RB and RAgg.

General and maladaptive traits in a five-factor framework for DSM-5 in a university student sample.

The relationships between two measures proposed to describe personality pathology, that is the Revised NEO Personality Inventory (NEO-PI-3) and the Personality Inventory for DSM-5 (PID-5), are examined in an undergraduate sample (N = 240). The NEO inventories are general trait measures, also considered relevant to assess disordered personality, whereas the PID-5 measure is specifically designed to assess pathological personality traits, as conceptualized in the DSM-5 proposal. A structural analysis of the 25 PID-5 traits confirmed the factor structure observed in the U.S. derivation sample, with higher order factors of Negative Affectivity, Detachment, Antagonism, Disinhibition, and Psychoticism. A joint factor analysis of, respectively, the NEO domains and their facets with the PID-5 traits showed that general and maladaptive traits are subsumed under an umbrella of five to six major dimensions that can be interpreted from the perspective of the five-factor model or the Personality Psychopathology Five. Implications for the assessment of personality pathology and the construction of models of psychopathology grounded in personality are discussed.

Stereotypes of age differences in personality traits: universal and accurate?

Age trajectories for personality traits are known to be similar across cultures. To address whether stereotypes of age groups reflect these age-related changes in personality, we asked participants in 26 countries (N = 3,323) to rate typical adolescents, adults, and old persons in their own country. Raters across nations tended to share similar beliefs about different age groups; adolescents were seen as impulsive, rebellious, undisciplined, preferring excitement and novelty, whereas old people were consistently considered lower on impulsivity, activity, antagonism, and Openness. These consensual age group stereotypes correlated strongly with published age differences on the five major dimensions of personality and most of 30 specific traits, using as criteria of accuracy both self-reports and observer ratings, different survey methodologies, and data from up to 50 nations. However, personal stereotypes were considerably less accurate, and consensual stereotypes tended to exaggerate differences across age groups.

General personality and psychopathology in referred and nonreferred children and adolescents: an investigation of continuity, pathoplasty, and complication models.

This study investigated the continuity, pathoplasty, and complication models as plausible explanations for personality-psychopathology relations in a combined sample of community (n = 571) and referred (n = 146) children and adolescents. Multivariate structural equation modeling was used to examine the structural relations between latent personality and psychopathology change across a 2-year period. Item response theory models were fitted as an additional test of the continuity hypothesis. Even after correcting for item overlap, the results provided strong support for the continuity model, demonstrating that personality and psychopathology displayed dynamic change patterns across time. Item response theory models further supported the continuity conceptualization for understanding the association between internalizing problems and emotional stability and extraversion as well as between externalizing problems and benevolence and conscientiousness. In addition to the continuity model, particular personality and psychopathology combinations provided evidence for the pathoplasty and complication models. The theoretical and practical implications of these results are discussed, and suggestions for future research are provided.

Childhood personality types: vulnerability and adaptation over time.

BACKGROUND: Substantial evidence suggests that a Five-Factor Model personality assessment generates a valid description of childhood individual differences and relates to a range of psychological outcomes. Less is known, however, about naturally occurring profiles of personality and their links to psychopathology. The current study explores whether childhood personality characteristics tend to cluster in particular personality profiles that show unique associations with psychopathology and quality of life across time. METHODS: Latent class analysis was conducted on maternal rated general personality of a Flemish childhood community sample (N = 477; mean age 10.6 years). The associations of latent class membership probability with psychopathology and quality of life 2 years later were examined, using a multi-informant perspective. RESULTS: Four distinguishable latent classes were found, representing a Moderate, a Protected, an Undercontrolled and a Vulnerable childhood personality type. Each of these types showed unique associations with childhood outcomes across raters. CONCLUSIONS: Four different personality types can be delineated at young age and have a significant value in understanding vulnerability and adaptation over time.

The relevance of personality assessment in patients with hyperventilation symptoms.

OBJECTIVE: Relatively few data are available concerning the relations between hyperventilation symptoms and general personality traits in clinical populations. A clear picture of the personality traits associated with hyperventilation symptoms could enhance early detection of those individuals who are at risk for developing hyperventilation. The aim of this study was to investigate the role of general personality in hyperventilation syndrome. METHOD: Patients (N = 364) with symptoms not explained by an organic disease and supposedly caused by hyperventilation completed the NEO Five-Factor Inventory, the General Health Questionnaire--12, and the Nijmegen Questionnaire. Patients were also subjected to a hyperventilation provocation test and transcutaneous carbon dioxide (TcPCO(2)) values were registered. RESULTS: The results showed that patients with hyperventilation obtained mean Neuroticism scores above the normative mean. Moreover, only Neuroticism was positively linked with self-reported hyperventilation symptoms, and personality traits were more strongly related to self-reported complaints than to objective physical information. Neuroticism clearly differentiated between different diagnostic groups on the basis of Nijmegen Questionnaire and TcPCO(2) values, and an additional small effect of Agreeableness was observed. CONCLUSIONS: The present study contributes to the evidence that Neuroticism is strongly associated with self-reported hyperventilation symptoms, and provides substantial evidence that Neuroticism is a vulnerability factor in the development of hyperventilation. Therefore, personality assessment may be helpful in advancing the understanding and the early detection of hyperventilation symptoms.

Longitudinal intergroup contact effects on prejudice using self- and observer-reports.

Longitudinal effects of intergroup contact on prejudice were investigated in a sample of 65 young adults (Sample 1) and a sample of their close friends (Sample 2, N= 172), adopting a full cross-lagged panel design. We first validated the self-report measure of intergroup contact from Sample 1 with observer ratings from Sample 2 by demonstrating that self-reports and observer ratings of contact were highly correlated. Moreover, we obtained significant cross-lagged effects of intergroup contact on prejudice with both contact measures, thereby providing a second validation for the use of self-reports of intergroup contact. Finally, by the use of latent change modelling, we demonstrated that, although no overall significant change in contact and prejudice over time was found, there was meaningful variation in absolute change in the individual levels of intergroup contact and prejudice. In particular, some individuals showed increases while others showed decreases in contact or prejudice across time. Moreover, higher levels of intergroup contact at Time 1 were followed by larger subsequent decreases in prejudice between Time 1 and Time 2, and changes in contact were significantly and negatively related to changes in prejudice. Methodological implications of the findings are discussed.

General and maladaptive personality dimensions and the assessment of callous-unemotional traits in adolescence.

Associations between callous-unemotional traits and general and maladaptive personality dimensions are examined in adolescence. More specifically, it was investigated to what extent general and maladaptive personality dimensions can account for the variance in callous-unemotional (CU) scores. Adolescents (N = 509) and their mothers completed the Inventory of Callous-Unemotional Traits (ICU; Frick, 2003), the Hierarchical Personality Inventory for Children (HiPIC; Mervielde & De Fruyt, 1999, 2002), and the Dimensional Personality Symptom Item Pool (DIPSI; De Clercq, De Fruyt, Van Leeuwen, & Mervielde, 2006). Both personality measures accounted for substantial variance in ICU scores and the overall CU profile in terms of the HiPIC and DIPSI was consistent with psychopathy conceptualizations and consistent across informant. Implications for the assessment of early externalizing trait pathology are discussed.

General and maladaptive traits and anger in a combined forensic psychiatric and general population sample.

The present study examines the associations between anger and general and maladaptive traits in a combined forensic psychiatric and community sample of men. Thirty-four male forensic psychiatric patients and 219 men from the general population completed the Novaco Anger Scale (NAS; Novaco, 1994), the NEO-PI-R (Costa & McCrae, 1992), the ADP-IV (Schotte & De Doncker, 1994) and the VKP (Duijsens, Haringsma, & EurelingsBontekoe, 1999) at two measurement occasions with a one-year interval. The results of a series of multiple regression analyses showed that general and maladaptive traits accounted for a substantial amount of variance in anger scores. Neuroticism, Agreeableness and Externalizing traits were most prominent in the prediction of anger, while Conscientiousness was acting as a suppressor variable in the regression models. Strengths and limitations of the present study and implications for further research and clinical practice are discussed.

Affective determinants of anxiety and depression development in children and adolescents: an individual growth curve analysis.

The tripartite model (in Clark and Watson, J Abnorm Psychol 100:316-336, 1991) comprises Negative Affect (NA), Positive Affect (PA), and Physiological Hyperarousal (PH), three temperamental-based dimensions. The current study examined the tripartite model's assumptions that (a) NA interacts with PA to predict subsequent depressive (but not anxiety) symptom developments and (b) NA interacts with PH to predict subsequent anxiety (but not depressive) symptom developments in a sample of 243 community and referred children and adolescents (42.8% boys; M age = 10.87 years, SD = 1.83). Results confirmed that individuals with a combined high NA/low PA profile display the least favorable course of depressive -but not anxiety- symptoms. In contrast with the model, the combination of NA and PH influenced the development of depression, but not anxiety. Relations were not moderated by sex or sample. Results revealed that the assessment of the tripartite components is warranted as it can help to identify children at risk for an unfavorable depressive symptom course.

Does personality disorder co-morbidity impact treatment outcome for patients with major depression? A multi-level analysis.

In literature, there exists disagreement regarding the impact of comorbid personality disorder(s) (PD[s]) on treatment outcome for patients with major depressive disorder (MDD). The aim of this paper was to investigate whether statistical heterogeneity and inter-dependency are potential moderators of the effect of co-morbid PDs on outcome for patients with MDD. Clinician-rated MADRS scores and DSM-IV Axis II personality disorder diagnoses were obtained from 562 outpatients with MDD who received 6 months of combined psycho- and pharmacotherapy. Single-level regression showed significantly worse treatment outcome among patients with co-morbid PD, as compared to patients with no PD. After controlling for statistical heterogeneity and interdependency, treatment outcome was no longer significantly worse for patients with co-morbid PD. In conclusion, heteroscedasticity and inter-dependency should be considered as potentially compelling explanations for inconsistencies in findings on treatment outcome for depressed patients with co-morbid PDs.

General and maladaptive personality dimensions in pediatric obsessive-compulsive symptoms.

Obsessive-compulsive disorder (OCD) is a chronic and impairing clinical disorder in childhood, often characterized by a heterogeneous symptomatic profile and high co-occurrence with other disorders. The present study introduces a new perspective on the description of OCD symptoms in youth, and empirically examines the value of a personality framework (e.g. Five Factor of Personality; FFM) for understanding early OCD symptomatology in a referred sample of 274 children and adolescents, relying on age-specific measures of general and maladaptive personality. Differences in general and maladaptive personality traits for high versus low-scoring children and adolescents on the Obsessive-Compulsive Scale of the Child Behavior Checklist (CBCL-OCS) were explored. The discriminant validity of both higher-and lower-order personality traits was supported, showing that high CBCL-OCS scorers are characterized by specific personality features ranging from adaptive to pathological, especially in terms of Conscientiousness. In addition, personality traits contributed to the accurate classification of high- versus low-scorers on the CBCL-OCS. Implications for clinical practice and recommendations for future research are discussed.

Personality pathology comorbidity in adult females with eating disorders.

Personality pathology is examined in 100 female in-patients diagnosed with eating disorders. The Eating Disorder Inventory-II and the NEO-PI-R were self-administered and personality pathology was assessed using a structured interview. Clinicians additionally evaluated patients' global functioning. The results indicated sizeable personality disorder comorbidity, and two dimensions of personality pathology, for example, an internalizing and an externalizing factor, could be identified. Patients' global functioning was primarily associated with dimensions of personality pathology, but not with eating disorder symptoms. Assessment and therapeutic interventions should focus on this co-occurring pathology in order to improve patients' functioning.

Patient and clinician perceptions of therapeutic alliance as predictors of improvement in depression.

BACKGROUND: Meta-analyses have consistently concluded that a positive therapeutic alliance is associated with better clinical outcomes and progress. To date, however, very few studies have focused on sociodemographic or clinical patient characteristics as moderators of alliance. METHOD: A multicenter longitudinal treatment outcome study was conducted to investigate the associations of patient and clinician perceptions of the therapeutic alliance with improvement in depression, and to investigate whether these associations were influenced by sociodemographic or clinical characteristics of the patient. Clinician-rated Montgomery Åsberg Depressive Rating Scale scores and both patient- and therapist-rated Helping Alliance Questionnaire (HAQ-I) scores were obtained from 567 outpatients with major depressive disorder who received 6 months of combined psycho- and pharmacotherapy. RESULTS: Multilevel repeated-measures analyses indicated that patient- and therapist-rated HAQ-I scores, 4 weeks after treatment began, positively predicted subsequent clinical change, controlling for the effect of early improvement and a range of patient characteristics. Next to alliance, early improvement, initial depressive symptom severity, a history of psychiatric disorders, and occupational status affected the rate of clinical improvement. Personality pathology comorbidity, marital and occupational status, and the atypical character of the major depressive episode (MDE) moderated the alliance-outcome relationship, depending on the informant (patient or therapist) of therapeutic alliance. CONCLUSIONS: The present findings suggest that therapist and patient ratings of therapeutic alliance predict therapeutic progress, and that this relation may be moderated by client characteristics, including personality pathology comorbidity, marital status, occupational status, and the atypical character of the MDE.