Assessing Dimensions of Pathological Narcissism: Psychometric Properties of the Short Form of the Five-Factor Narcissism Inventory in a Sample of Italian University Students.

To evaluate the psychometric properties of the Italian translation of the Five-Factor Narcissism Inventory-Short Form (FFNI-SF), 1,063 Italian university students were administered the scale, along with the Pathological Narcissism Inventory (PNI) and the Measure of Disordered Personality Functioning (MDPF). In general, the FFNI-SF scales showed good internal consistency (median α = .76; median interitem r = .44) and structural analyses suggested a 3-component model of FFNI-SF scales that was similar to that reported by Sherman et al. (2015). FFNI-SF second-order scales yielded meaningful convergent and discriminant correlations with PNI second-order grandiose and vulnerable dimensions. Finally, FFNI-SF second-order scales correlated in expected ways with 2 dimensions of personality dysfunction.

On the relationships between DSM-5 dysfunctional personality traits and social cognition deficits: A study in a sample of consecutively admitted Italian psychotherapy patients.

This study aims at testing the hypothesis that the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5) alternative model of personality disorder (AMPD) traits may be significantly associated with deficits on 2 different social cognition tasks, namely, the Reading the Mind in the Eyes Test and the Movie for the Assessment of Social Cognition, in a sample of consecutively admitted inpatients and outpatients. The sample was composed of 181 consecutively admitted participants (57.5% women; mean age = 38.58 years). Correlation coefficients and partial correlation coefficients were computed in order to assess the associations among social cognition tasks, DSM-5 AMPD traits, and dimensionally assessed DSM-5 Section II personality disorders. Specific maladaptive traits listed in the DSM-5 AMPD were significantly associated with Reading the Mind in the Eyes Test scores and Movie for the Assessment of Social Cognition scores, even when the effect of selected DSM-5 Section II personality disorders was controlled for. Our results support the relevance of studying social cognitive functioning in subjects suffering from personality disorders.

Reliability and clinical usefulness of the personality inventory for DSM-5 in clinically referred adolescents: A preliminary report in a sample of Italian inpatients.

BACKGROUND: The DSM-5 Alternative Model of Personality Disorders (AMPD) provides the opportunity to integrate the needed developmental perspective in the assessment of personality pathology. Based on this model, Krueger and colleagues (2012) developed the Personality Inventory for DSM-5 (PID-5), which operationalizes the proposed DSM-5 traits. METHODS: Eighty-five consecutively admitted Italian adolescent inpatients were administered the Italian translation of the PID-5, in order to obtain preliminary data on PID-5 reliability and clinical usefulness in clinically referred adolescents. RESULTS: With the possible exception of the PID-5 Suspiciousness scale, all other PID-5 scales evidenced adequate internal consistency reliability (i.e., Cronbach's α values of at least .70, most being greater than .80). Our data seemed to yield at least partial support for the construct validity of the PID-5 scales also in clinical adolescents, at least in terms of patterns of associations with dimensionally assessed DSM-5 Section II PDs that were also included in the DSM-5 AMPD (excluding Antisocial PD because of the participants' minor age). Finally, our data suggested that the clinical usefulness of the PID-5 in adolescent inpatients may extend beyond PDs to profiling adolescents at risk for life-threatening suicide attempts. In particular, PID-5 Depressivity, Anhedonia, and Submissiveness trait scales were significantly associated with adolescents' history of life-threatening suicide attempts, even after controlling for a number of other variables, including mood disorder diagnosis. DISCUSSION: As a whole, our study may provide interesting, albeit preliminary data as to the clinical usefulness of PID-5 in the assessment of adolescent inpatients.

Borderline Personality Disorder and Narcissistic Personality Disorder Diagnoses From the Perspective of the DSM-5 Personality Traits: A Study on Italian Clinical Participants.

To evaluate the associations between Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) Alternative Model of Personality Disorder traits and domains and categorically diagnosed narcissistic personality disorder (NPD) and borderline personality disorder (BPD), respectively, 238 inpatient and outpatient participants who were consecutively admitted to the Clinical Psychology and Psychotherapy Unit of San Raffaele Hospital in Milan, Italy, were administered the Personality Inventory for DSM-5 (PID-5) and the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II). Based on SCID-II, the participants were assigned to the following groups: a) NPD (n = 49), b) BPD (n = 32), c) any other PD (n = 91), and d) no PD (n = 63). Emotional lability, separation insecurity, depressivity, impulsivity, risk taking, and hostility were significantly associated with BPD diagnosis. Attention seeking significantly discriminated participants who received an SCID-II categorical NPD diagnosis. Separation insecurity, impulsivity, distractibility, and perceptual dysregulation were the DSM-5 traits that significantly discriminated BPD participants. Domain-level analyses confirmed and extended trait-level findings.

The relationship between childhood history of ADHD symptoms and DSM-IV borderline personality disorder features among personality disordered outpatients: the moderating role of gender and the mediating roles of emotion dysregulation and impulsivity.

A number of studies have reported data suggestive of a significant association between attention-deficit/hyperactivity disorder (ADHD) and borderline personality disorder (BPD). However, the nature of this relation is not fully understood. This study aimed to evaluate if the relation between retrospectively assessed ADHD symptoms and adult BPD features is moderated by participants' gender and mediated by emotion dysregulation and impulsivity. Two hundred seventeen outpatients meeting DSM-IV criteria for at least one personality disorder (PD) consecutively admitted to the Clinical Psychology and Psychotherapy Unit of the Scientific Institute H San Raffaele of Milan, Italy, were administered Italian versions of the following instruments: Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II), Wender Utah Rating Scale (WURS), Difficulties in Emotion Regulation Scale (DERS), and the Barratt Impulsiveness Scale-11 (BIS-11). Moderation analyses revealed a significant association between ADHD and BPD symptoms among only female (vs. male) outpatients. Furthermore, in the female subsample, mediation analyses revealed that both impulsivity and emotion dysregulation fully mediated the relationship between retrospectively assessed ADHD symptoms and current BPD features.

The DSM-5 alternative model of personality disorders from the perspective of adult attachment: a study in community-dwelling adults.

To assess how the maladaptive personality domains and facets that were included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Alternative Model of Personality Disorders relate to adult attachment styles, 480 Italian nonclinical adults were administered the Personality Inventory for DSM-5 (PID-5) and the Attachment Style Questionnaire (ASQ). To evaluate the uniqueness of the associations between the PID-5 scales and the ASQ scales, the participants were also administered the Big Five Inventory (BFI). Multiple regression analyses showed that the ASQ scales significantly predicted both PID-5 domain scales and BFI scales; however, the relationships were different both qualitatively and quantitatively. With the exception of the PID-5 risk taking scale (adjusted R(2) = 0.02), all other PID-5 trait scales were significantly predicted by the ASQ scales, median adjusted R(2) value = 0.25, all ps < 0.001. Our findings suggest that the maladaptive personality domains and traits listed in the DSM-5 Alternative Model of Personality Disorders show meaningful associations with adult attachment styles.

On the relationship between retrospective childhood ADHD symptoms and adult BPD features: the mediating role of action-oriented personality traits.

A number of studies have reported data suggestive of a significant association between ADHD and BPD, nevertheless, the nature of this relation has not been fully understood yet. In our study, we tried to evaluate if the relationship between retrospectively assessed ADHD symptoms and adult BPD features could mediated by selected temperament/personality traits. Four hundred forty-seven in- and outpatients consecutively admitted to the Clinical Psychology and Psychotherapy Unit of the Scientific Institute H San Raffaele of Milan, Italy, were administered the Italian versions of the following instruments: Structured Clinical Interview for DSM-IV Axis II Personality Disorders, Version 2.0 (SCID-II), Wender Utah Rating Scale (WURS), Temperament and Character Inventory-Revised (TCI-R), Barratt Impulsiveness Scale-11 (BIS-11), and Aggression Questionnaire (AQ). Our mediation analyses showed that the combination of impulsivity, aggression, novelty seeking, and juvenile conduct problems completely mediate the relationship between retrospectively assessed ADHD symptoms and current BPD features.

The role of clinical and Personological features in predicting high lethality suicide attempts: A study among mood disorder patients.

Suicidal attempts (SA) represent heterogeneous behaviours ranging in their seriousness from fatal and near-fatal (high-lethality) cases to those that do not require medical attention (low lethality). These considerations stress the need to identify high-risk individuals for high lethality SA in order to target suicide preventive interventions. The present study aims at evaluating the role of sociodemographic and clinical variables and examining personality pathological features in predicting high lethality SA. The sample was composed by 94 patients who were consecutively admitted to the Mood Disorders Unit of the San Raffaele Turro Hospital in Milan. The results of binary logistic regression analyses showed that previous SA and current suicide ideation play a role in predicting serious SA. Considering the DSM-5 personality dysfunctional domains assessed by the Personality Inventory for DSM-5, our logistic regression analyses suggested that high lethality SA was associated with Detachment PID-5 domain. Finally, binary hierarchical regression analysis showed that Detachment domain remained a significant predictor of serious SA over and above the effect of previous SA and suicide ideation. As a whole, our results highlight the importance of a multidimensional approach to develop adequate assessment, effective treatments and prevention of high lethality SA risk.

Are the DSM-IV personality disorders related to mindfulness? An Italian study on clinical participants.

OBJECTIVES: This study aims to assess the relationships between measures of mindfulness, self-report, and interview measures of personality disorders (PDs) in a sample of 111 consecutively admitted adult outpatients. RESULTS: When PDs were assessed using the Structured Clinical Interview for DSM-IV Axis II Personality Disorders, Version 2.0, borderline and histrionic PD, as well as the overall number of PD criteria met by each participant, were significantly predicted by mindfulness measures. When the Personality Diagnostic Questionnaire-4+ (PDQ-4+) scale scores were entered in the regression equations as dependent variables, only the obsessive-compulsive PD seemed to be unrelated with mindfulness. The Mindful Attention Awareness Scale total score and the Five Facet Mindfulness Questionnaire Act with Awareness scale were consistent, negative, and nonredundant predictors of PDQ-4+ dimensionally assessed PDs. CONCLUSION: As a whole, our findings support the hypothesis that low levels of mindfulness play a significant role in personality psychopathology, and particularly in borderline PD.

Does mindfulness mediate the association between attachment dimensions and Borderline Personality Disorder features? A study of Italian non-clinical adolescents.

The aim of this study was to assess whether mindfulness mediates the association between attachment dimensions and features of Borderline Personality Disorder (BPD) in a sample of 501 Italian high-school students. Low scores on Confidence and high scores on Need for Approval and Preoccupation with Relationships attachment scales was significantly related to the number of BPD features (adjusted R(2) = .2, p < .001). Further, mindfulness scores were negatively associated with Need for Approval and Relationships as Secondary attachment scales (adjusted R(2) = .14, p < .001). Finally, mindfulness scores were negatively associated with the number of BPD features (adjusted R(2) = .15, p < .001). Mediation analyses showed that the relationship between Need for Approval and BPD was completely mediated by the mindfulness effects. Our results in non-clinical adolescents are consistent with Bateman and Fonagy's (2004) hypothesis that the link between attachment disturbances and BPD features may be mediated by deficits in mentalization, at least as these are operationalized by low mindfulness.

The Co-Occurrence of Trauma Related Disorder and Borderline Personality Disorder: AQ Study on a Clinical Sample of Patients Seeking Psychotherapy Treatment.

The nature of the relationship between borderline personality disorder (borderline PD), post-traumatic stress disorder (PTSD) and complex PTSD remains controversial. In this study we attempted to investigate the association between traumatic events and borderline PD and the co-occurrence of complex PTSD, PTSD and borderline PD. Finally, we tested the association between complex PTSD and PTSD diagnoses and other DSM-5 Section II personality disorders. In a sample of 416 patients, we administered the International Trauma Questionnaire (ITQ) to evaluate the PTSD/complex PTSD diagnoses and the Structured Clinical Interview for DSM-5 Personality Disorders (SCID-5-PD) and the Personality Diagnostic Questionnaire- 4+ (PDQ-4+) to assess borderline PD and other PDs. One hundred-twenty-three participants reported experiencing one or more traumatic events. Our findings show that the presence of adverse events does not represent a risk factor for borderline PD assessed using both SCID-5-PD and PDQ4+. A co-occurrence of borderline PD diagnoses and complex PTSD/PTSD diagnoses has not been observed. We found a significant association only between complex PTSD and schizoid personality disorder assessed using PDQ4+. Our findings suggest relevant clinical implications for the development of effective treatment for complex PTSD, PTSD and borderline PD.

Relations of proactive and reactive dimensions of aggression to overt and covert narcissism in nonclinical adolescents.

In recent years, there has been increasing acknowledgment of the multidimensionality of narcissism and that different types of narcissism may relate differently to other domains of functioning. Similarly, aggression-a frequently discussed correlate of narcissism-is a heterogeneous construct. In this study, the relations of proactive and reactive aggression with overt and covert manifestations of narcissism were examined in a sample of 674 Italian high school students (mean age=15.5 years, SD=2.1 years). Overt narcissism was positively related to both proactive and reactive subtypes of aggression, whereas covert narcissism related only to reactive aggression. Vanity, Authority, Exhibitionism, and Exploitativeness were the components of overt narcissism related to Proactive Aggression (all remained unique correlates when controlling for Reactive Aggression), whereas Reactive Aggression was associated with the Exhibitionism, Superiority, and Entitlement subscales (only the latter was uniquely related when controlling for Proactive Aggression).

Assessing Mental Representation as an Indicator of Self and Interpersonal Functioning in Psychotherapy Patients.

The goal of this study was to test in a clinical sample the interrater reliability and convergent validity of the Differentiation-Relatedness Scale (D-RS), a measure that evaluates mental representations based on open-ended descriptions of self and significant others. The study also investigated the ability of the D-RS to predict personality disorders (PDs) from Section II of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and the dysfunctional trait domains presented in the Alternative DSM-5 Model for Personality Disorders Criterion B in Section III of the DSM-5. We also evaluated if the D-RS predicts observed Section II PDs over and above Criterion B of the Alternative DSM-5 Model for Personality Disorders. We found that the interrater reliability of the D-RS was good on the basis of the mean scores of 6 independent raters and that it showed moderate convergent validity. Results of dominance analyses indicated that the D-RS is a significant predictor of Section II borderline PD and of the overall number of DSM-5 PDs. When we considered the Section III Criterion B for PDs, the D-RS was not able to predict any of the Personality Inventory for DSM-5 domains, suggesting that the D-RS may be more related to personality functioning behind mental representations than to maladaptive personality traits. Finally, results of hierarchical regression analyses suggested that the D-RS produced a significant but modest increase in the prediction of borderline PD traits and the overall number of PDs traits even when the effect of the Personality Inventory for DSM-5 domains were controlled for.

Assessing dark triad dimensions from the perspective of moral disengagement and DSM-5 alternative model of personality disorder traits.

The present study aimed to test the relationships of Dark Triad constructs with propensity toward moral disengagement and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Alternative Model of Personality Disorder (AMPD) maladaptive personality traits. A total of 279 community-dwelling adult participants (41.6% male; Mage = 32.27 years) were administered the Two-Dimensional Mach-IV Scale, Five-Factor Narcissism Inventory-Short Form, Triarchic Psychopathy Measure, Personality Inventory for DSM-5, and Moral Disengagement Scale. Multiple regression results showed differential associations between Dark Triad construct traits and propensity toward moral disengagement. Correlation analyses showed that all Dark Triad trait dimensions could be substantially described in terms of AMPD maladaptive trait profile. When the effect of Moral Disengagement Scale scores was taken into account in relative importance weights analysis (Radjusted2 = .66), DSM-5 AMPD maladaptive trait profile explained 27% of the variance in the "Dark Triad" latent factor over and above the effect of moral disengagement. As a whole, our findings supported the idea that the Dark Triad personality constructs are likely to share a common core of antagonistic maladaptive personality traits. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

The Inter-Rater Reliability and Validity of the Italian Translation of the Structured Clinical Interview for DSM-5 Alternative Model for Personality Disorders Module I and Module II: A Preliminary Report on Consecutively Admitted Psychotherapy Outpatients.

To evaluate the reliability and convergent validity of the Structured Clinical Interview for DSM-5 Alternative Model for Personality Disorders (SCID-5-AMPD) Module I and Module II, 88 adult psychotherapy participants were administered the Italian translations of the SCID-5-AMPD Module I and Module II, Level of Personality Functioning Scale-Brief Form (LPFS-BF), Level of Personality Functioning Scale-Self Report (LPFS-SF), Personality Inventory for DSM-5 (PID-5), Personality Diagnostic Questionnaire-4+ (PDQ-4+), and Structured Clinical Interview for DSM-5 Personality Disorders (SCID-5-PD) relying on a Williams crossover design. SCID-5-AMPD Module I and Module II showed excellent inter-rater reliability. In terms of convergent validity, meaningful associations were observed between SCID-5-AMPD Module I scores and self-report measures of Criterion A; similarly, SCID-5-AMPD Module II trait scores were meaningfully related to PID-5 trait scores. As a whole, our preliminary findings supported the clinical utility of DSM-5 AMPD.

A cross-cultural study of the psychometric properties of the Reactive-Proactive Aggression Questionnaire among Italian nonclinical adolescents.

Five independent studies were used to test the hypothesis that a reliable 2-factor structure underlies the Reactive-Proactive Aggression Questionnaire (RPQ) items and that the 2 scales show distinct patterns of association with personality and bullying behavior measures. Study 1 (N = 1,447) gave evidence of a clear 2-factor structure of RPQ items with factor loading matrices closely matching reactive (congruence coefficient = .90) and proactive (congruence coefficient = .91) models of item assignment. The RPQ 2-factor structure was consistently replicated in Study 2 (N = 662), as well as across the remaining 3 studies. In Study 3 (N = 536), Neuroticism differentiated reactive and proactive forms of aggression. In Study 4 (N = 674), self-reports of bullying behaviors were selectively correlated with proactive aggression. Findings confirm and extend the differential correlates of proactive-reactive aggression and also support the psychometric properties of the RPQ in a different cultural context. Finally, in Study 5 (N = 347), the RPQ scales showed adequate 2-month test-retest reliability. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

Alexithymia and attachment insecurities in impulsive aggression.

The aims of this study were to develop a new measure of impulsive aggressiveness, and to assess whether this measure was associated with deficits in mentalized affectivity and adult attachment styles in a sample of 637 non-clinical participants. Extending Fonagy and Bateman's (2004) hypothesis, the mediating role of poor affectivity mentalization in the relationship between insecure attachment styles and impulsive aggression was also evaluated. Selected insecure attachment styles (R2(adjusted) = .18, p < .001) and deficits in mentalized affectivity (R(2)(adjusted) = .25, p < .001) were significantly associated with impulsive aggressiveness. The overall regression model accounted for roughly 33% of the variance in impulsive aggressiveness. Mentalization deficits significantly mediated the effects of attachment styles on impulsive aggressiveness, although effect size measures suggested that only partial mediation occurred.

Construct validity and diagnostic accuracy of the Italian translation of the 18-Item World Health Organization Adult ADHD Self-Report Scale (ASRS-18) Italian translation in a sample of community-dwelling adolescents.

Aim of this prospective study was to evaluate the factor structure, internal consistency, and diagnostic efficacy of the Italian translation of the Adult ADHD Self-Report Scale (ASRS-18; Kessler et al., 2005, 2007) in a sample of community-dwelling sample of adolescents. Three hundred eight Italian adolescents attending professional high schools were administered the ASRS-18; the adolescence ADHD module of the MINI interview was administered to obtain ADHD criterion diagnoses. Robust maximum likelihood confirmatory factor analysis results identified a bifactor model of the ASRS-18 items as the best-fitting model, RMSEA = 0.029, p > 0.99, TLI = 0.93, CFI = 0.95. Further analyses showed that 77.9% of the ASRS-18 reliable (ω = 0.78) score variance was due to the total score. In our study the ASRS-18 proved to be able to effectively differentiate adolescents who received a MINI ADHD diagnosis (n = 80) from adolescents who did not receive a MINI ADHD diagnosis (n = 163), area under the curve = 0.80, 95% confidence interval = 0.74, 0.86. Our data suggest that the ASRS-18 may represent an effective self-report measure to screen for ADHD in community-dwelling adolescents, at least in its Italian translation.

Item Response Theory Analyses, Factor Structure, and External Correlates of the Italian Translation of the Personality Inventory for DSM-5 Short Form in Community-Dwelling Adults and Clinical Adults.

To assess the psychometric properties of the Italian translation of the 100-item short form of the Personality Inventory for DSM-5 (PID-5-SF), 2,143 community-dwelling adults (59.6% female), and 706 adult clinical participants (52.4% female) were administered the Italian translation of the PID-5. Clinical participants were also administered the Structured Clinical Interview for DSM-IV (SCID-II), and the Personality Diagnostic Questionnaire-4+ (PDQ-4+). Item response theory analysis showed that all proposed PID-5-SF items showed adequate item discrimination parameters in both community-dwelling adults and clinical adults. All PID-5-SF trait scales showed satisfactory internal consistency estimates. PID-5-SF five-factor structure closely matched the factor structure of the PID-5 in both community-dwelling participants and clinical participants and was invariant across the two samples that participated in this study. Moreover, the factor structure of the PID-5-SF closely replicated the factor of the PID-5-SF that was originally reported in Maples et al.'s study. In our clinical sample, dominance analysis results showed that PID-5-SF scales explained a nonnegligible and significant amount of variance in both SCID-II and PDQ-4+ ratings of selected DSM-5 Section II personality disorder, and the use of the PID-5-SF did not result in a substantial loss of information as compared with the original PID-5.

Modeling the Structure of the Triarchic Psychopathy Measure: Conceptual, Empirical, and Analytic Considerations.

This study sought to characterize the factor structure of the Triarchic Psychopathy Measure (TriPM) using data from a sample of 1,082 community-dwelling Italian adults. Exploratory structural equation modeling (ESEM) was used to compare the fit of a bifactor model for each TriPM scale, in which specific-content factors were specified along with a general factor, with the fit of a single, general-factor model. Robust weighted least square (WLSMV) ESEM supported a bifactor latent structure of the TriPM items for all individual scales. When we jointly factor analyzed the 58 TriPM items, a WLSMV ESEM three-factor structure showed adequate fit; the three ESEM factors were akin to TriPM Boldness, Meanness, and Disinhibition theoretical dimensions, respectively, and could be effectively replicated across gender subgroups. Our findings support the three-factor structure of TriPM items, at least in Italian community-dwelling adults, and provide further evidence for the construct validity of the TriPM.