Comparing the DSM-5 categorical model of personality disorders and the alternative model of personality disorders regarding clinician judgments of risk and outcome.

The goal of this study was to compare the predictive validity of the alternative model for personality disorders (AMPD) versus the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Section II categorical model regarding clinician judgments about mental health outcomes. To do so, we instructed a national sample of 136 mental health professionals to provide clinical judgments on a random subset of four (out of a possible 12) case vignettes. For each case, they made a variety of diagnostic judgments corresponding to each model, as well as clinical outcome judgments (e.g., prognosis). Our analyses included hierarchical and individual regressions to compare the predictive value of each diagnostic system toward these clinical outcome judgments. We found that the AMPD predictors consistently added unique variance beyond the Section II predictors, whereas the Section II predictors were rarely incremental above the AMPD. Further, the AMPD judgments predicted outcome judgments very consistently (98.3% of regressions) compared to the Section II predictors (70% of regressions), and the single Criterion A judgment (level of personality functioning) was the strongest overall predictor. Finally, the categorical borderline personality disorder diagnoses from the two systems performed similarly in predicting clinical outcomes and agreed in 79% of cases. We interpreted our results to suggest that the AMPD is at least as effective, and by some measures more effective, than the DSM-5 categorical model at predicting clinician's judgment of outcomes in clinical cases. We conclude by discussing the value of this evidence in relation to the broader AMPD literature, as well as possible paths forward for the diagnosis of personality disorders. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

When meaning in life protects against fear of death: The moderating role of self-alienation.

OBJECTIVE: A sense of meaning in life (MIL) is thought to help protect people against experiencing explicit anxiety about death. However, the experience of meaning is complex and subjective and may relate to death anxiety in nuanced ways. We examine how self-alienation-a feeling of not knowing/being disconnected from one's self-might moderate the relationship between MIL and death anxiety. METHOD: Across five studies, we tested the hypothesis that MIL would negatively predict death anxiety more strongly for people relatively low in self-alienation. These studies were similar in design and included exploratory, confirmatory, and pre-registered tests. RESULTS: A meta-regression across our five studies (N = 2001) provided clear evidence that MIL was most strongly associated with lower death anxiety at low self-alienation. We also observed that MIL was positively associated with death anxiety at high self-alienation. These effects were consistent in direction but inconsistent in strength. CONCLUSIONS: We interpreted these results as evidence that MIL is existentially protective when experienced in combination with a relatively strong, clear, and connected sense of self. In contrast, MIL may be existentially problematic when people feel relatively unaware and disconnected from themselves. These findings align with aspects of terror management theory and highlight the potentially complex ways that MIL might relate to death anxiety.

A crisis in college student mental health? Self-ratings of psychopathology before and after the COVID-19 pandemic.

The impact of the COVID-19 pandemic on the mental health of college students was investigated in a cross-sectional design using the Personality Assessment Inventory (PAI; Morey, 1991, 2007). Three large samples of college students were recruited for research purposes and given standard instructions: 825 students from two universities assessed in the 2021-2022 academic year (postpandemic), 558 students from three universities assessed between 2016 and 2019 (prepandemic), and 1,051 students from seven universities assessed in 1989 and 1990 (college norms). Comparisons of PAI scores with the prepandemic cohort revealed several significantly higher scores in the postpandemic cohort, especially for scales related to anxiety and depression. Comparisons with the college norms revealed significantly higher scores on several PAI scales in the prepandemic cohort, and these differences were largest for scales related to anxiety, depression, and somatic symptoms. PAI scales related to impulsivity, alcohol use, and other behavior problems showed no changes or decline from earlier to later cohorts. Taken together, the findings suggest that the COVID-19 pandemic has amplified problems with anxiety and depression that existed before the pandemic. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Temporal Stability of the Personality Assessment Inventory: Investigating Potential Predictors.

In this study, we explored the temporal stability of the Personality Assessment Inventory (PAI), which has not been comprehensively reexamined since it was first published. Our three specific aims were to determine the utility of PAI indicators of basic protocol validity (inconsistent responses [ICN] and highly unusual/unlikely responses [INF]) in identifying suspect responding; calculate the stability coefficients for each PAI scale and subscale across 3-, 6-, and 9-week spans; and explore whether profile stability across four measurements could be prospectively predicted. We administered the PAI to a sample of undergraduates (N = 579) at four separate timepoints. ICN and INF effectively identified likely attriters and inconsistent responders. All PAI full scales and subscales evidenced good test-retest reliability, with some small exceptions. Finally, all PAI clinical scales were correlated with profile instability although many of these correlations were no longer significant when controlling for mean clinical elevation of the profile. We interpreted these results as evidence for the utility of PAI validity scales, the temporal reliability of the PAI, and the role of psychopathology in response variability over time. We also discussed some preliminary evidence that this variability can be prospectively predicted, suggesting that it in part reflects substantive changes rather than random error variance.

Detecting Attention Deficit Hyperactivity Disorder and its feigning using the Personality Assessment Inventory.

Attention Deficit Hyperactivity Disorder is a relatively common and often disabling disorder in adults. However, feigning ADHD symptomatology is both easy and potentially common. We explored the most effective strategies for A) identifying individuals who had been diagnosed with ADHD based on existing PAI symptom indicators, and B), discriminating between feigned and genuine ADHD symptoms using PAI negative distortion indicators. Our sample consisted of 463 college aged participants who had been diagnosed with ADHD (n = 60), were asked to feign ADHD (n = 71), and a control group (n = 333). Self-reported diagnosis and successful feigning were corroborated by the CAARS-S: E scale. We first compared two PAI-derived ADHD indicators to determine which best differentiated between our ADHD and Control groups. Next, we compared seven negative distortion indicators to determine which could best distinguish between real and feigned ADHD symptoms. Our results revealed that the PAI-ADHD scale was the most effective symptom indicator. Further, the Negative Distortion Scale (NDS) was the most effective for identifying feigners. When assessing ADHD based on the PAI, the PAI-ADHD scale appears promising as an indicator of symptomatology, while the NDS appears useful to rule-out feigning.

Parenting Practices and Authenticity in Mothers and Fathers.

We explored the relationship between parenting practices and the experience of subjective authenticity in the parenting role. Based on work showing that authenticity responds to violations of broad social expectations, we predicted that mothers would feel more authentic than fathers. We also predicted, however, that parenting practices that conflicted with broad gender norms would differentially predict authenticity for mothers and fathers. We tested this prediction in a single study of U.S. parents recruited from an internet research panel service (N = 529). Parents completed online measures of authenticity and parenting practices on three separate occasions. We assessed the within-person association between parenting practices and parent-role authenticity. Authoritarian parenting practices negatively predicted parent-role authenticity for mothers, whereas permissive practices negatively predicted parent-role authenticity for fathers. Authoritative practices positively predicted authenticity regardless of parent gender, and, overall, women felt more authentic in the parenting role than men. These findings contribute to emerging theoretical perspectives on authenticity and gender role congruence and highlight how different parenting practices relate to the well-being of mothers and fathers.

The self-reference effect as a behavioral indicator of identity disturbances associated with borderline personality features in a non-clinical sample.

BACKGROUND: Identity disturbances are a common feature of personality pathology and BPD. The Self-Reference Effect paradigm is a method used to measure the impact of self-relevant processing on encoding/memory, whereby self-relevant information is typically advantaged in cognitive processes. We postulated that difficulties with identity might impede the process by which one encodes self-relevant information. Based on this reasoning, we predicted that high levels of identity disturbance could be associated with atypical impact of the SRE. METHODS: Undergraduate participants were randomized into one of three groups where they were exposed to 60 trait adjectives for seven seconds each. Depending on condition, participants either indicated whether a word was/wasn't capitalized (Capitalization condition), whether it was a good synonym for "openness" (Synonyms condition), or whether it described them as a person (Self-reference condition). After a brief delay, all participants were asked to recall as many of the 60 words as possible. Finally, we measured identity disturbance using the Borderline Features-Identity Problems (BOR-I) scale from the Personality Assessment Inventory. RESULTS: We found significant but modest correlations between Recall and scores on the BOR-I subscale in the Self-Reference condition, but not the two control conditions. Contrary to expectations, the interaction between BOR-I and Condition was not a significant predictor of Recall, suggesting that identity disturbance did not significantly moderate the SRE. CONCLUSIONS: While our primary hypothesis was not supported, there is a need for multimethod approaches to studying personality pathology. Future research should continue to examine the extent to which behavioral paradigms like the SRE might be useful indicators of identity disturbance/personality pathology, with an emphasis on the use of clinical populations.

Meaning in Life and Pain: The Differential Effects of Coherence, Purpose, and Mattering on Pain Severity, Frequency, and the Development of Chronic Pain.

OBJECTIVE: Meaning in life is consistently associated with better health outcomes across a range of mental and physical domains. However, meaning in life is a complex construct involving three distinct facets: coherence, purpose, and mattering. While these facets have been studied individually in relation to pain, they have not been assessed concurrently to parse out their potential distinct contributions to pain outcomes. We sought to identify the unique relationships of these individual facets of meaning with pain experiences and specify the components associated with pain-related resilience. METHODS: The associations of coherence, purpose, and mattering with pain outcomes were examined across three studies. Study 1 used data from the Midlife in the United States National Survey to determine associations between facets and the frequency of various recently experienced pains, and the development of chronic pain nine years later. Study 2 cross-sectionally observed the association between facets and recent pain severity in young adults. Using a diary-type approach, Study 3 captured fluctuations of pain severity in relation to the facets across the span of four weeks. RESULTS: Coherence was uniquely associated with less headache, backache, joint, and extremities pain frequency in Study 1, over and above purpose and mattering, controlling for other health variables. Coherence was also associated with lower odds of developing chronic pain. In Study 2, coherence was associated with less pain severity and fully mediated the relationship between global meaning in life and pain. Study 3 found that coherence predicted the most unique variance in weekly pain fluctuations. CONCLUSION: Across three studies and timescales, coherence was uniquely associated with fewer and less severe pain experiences over and above purpose and mattering. These findings provide support for the value of coherence as a resilience factor in the context of pain and suggest a potential benefit for coherence-specific interventions in clinical settings.

True self-attributions shape judgments of blame in the context of addiction-relevant crime.

In three studies, we examined how attributing the criminal actions of a drug-addicted offender to their "true self" influences perceptions of their blameworthiness. Study 1 revealed that attributing a drug-addicted offender's crime (theft) to his true self positively predicted judgments of the offender's blameworthiness for the crime. Study 2 employed an experimental design and revealed that information connecting a crime (vs. not connecting) to an addicted offender's true self led to greater judgments of blame, whereas learning that the offender had (vs. did not have) a genetic predisposition to addiction mitigated blame. In Study 3, participants read a vignette about a drug-addicted thief whose addiction began with a doctor's prescription, a drug-addicted thief whose addiction began with recreational drug use, or a thief with no mention of addiction. Participants in the prescription condition, but not the recreational use condition, attributed theft to the offender's true self less and ascribed less blame for the crime, relative to the no addiction condition. Furthermore, participants attributed the addiction less to the offender's true self and assigned less blame to the offender for his addiction in the prescription (vs. recreation) condition. Overall, our studies suggest that lay intuitions about true selves robustly guide people's judgments about blame in the context of crimes involving drug-addicted offenders.

The Effect of True Self-Attributions on the Endorsement of Retributive and Restorative Justice.

We examined how the attribution of criminal behavior to an individual's "true" self influences justice preferences. In Study 1 (N = 521), the extent to which undergraduates attributed a crime to a target's true self positively predicted their endorsement of a retributive form of punishment and negatively predicted their endorsement of a restorative form of punishment. Study 2 (N = 404) was preregistered and replicated these associations, even when controlling for other perceived causes (e.g., personality, environment). In Study 3 (N = 282), undergraduates rated retributive punishment more favorably and restorative punishment less favorably when induced to think that the crime was (vs. was not) reflective of the target's true self. Study 4 (N = 935) was preregistered and replicated these experimental effects across different types of crime vignettes in an online sample. These results highlight the ways that intuitions about "true" selves shape punishment preferences.

Mental health inequalities increase as a function of COVID-19 pandemic severity levels.

RATIONALE: Current evidence suggests that mental health across the globe has suffered significantly during the COVID-19 global pandemic, and that disadvantaged communities are suffering these impacts more acutely. Lower income, female gender, and younger age have all been associated with worse psychopathology during COVID-19. OBJECTIVE AND METHODS: The goal of this study was to determine whether these disparities are more pronounced in places where the pandemic is more severe. We analyzed self-report data and objective metrics from a large global sample (N = 11,227) in order to test the hypothesis that country-level severity of COVID-19 moderates the relationship between the target demographic variables (Subjective SES, gender and age) and psychopathology indicators. RESULTS: Severity of the pandemic emerged as a significant moderator of the relationship between these demographic variables and mental health outcomes. This pattern was extremely consistent for Subjective SES and gender, but slightly more nuanced for age. CONCLUSION: Overall, we interpreted our data as suggesting that mental health disparities are greater in countries with more severe COVID-19 outbreaks. These findings are critical for understanding the ways that the ongoing pandemic is affecting global mental health, and contribute to the broader literature surrounding collective trauma.