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Abstract: Borderline personality disorder (BPD) is characterized by high levels of arousal and perceived rejection by others. The temporal relation between these constructs, however, remains largely unclear. Based on predictions derived from the dynamic affect model and the rejection sensitivity model, we expected increases in arousal and perceived rejection to predict subsequent increases in perceived rejection and arousal, respectively. To investigate this topic, we assessed current self-reported affective arousal and perceived rejection in patients with BPD (n = 42), patients with depressive disorders (DDs; n = 43), and healthy controls (HCs; n = 40) for 52 times within 13 hr (ca. every 15 min). In line with previous studies, dynamic structural equation model results indicate significantly higher trait levels of arousal and perceived rejection in patients with BPD compared with participants in the DD and HC groups. In addition, we found substantial autoregressive and cross-lagged effects for arousal and perceived rejection. Other than expected, the magnitude of these effects did not significantly differ across diagnostic groups. Our findings suggest close temporal relations between arousal and perceived rejection. In patients with BPD, these effects unfold against the background of substantially elevated trait levels of arousal and perceived rejection. Future experience sampling studies should provide additional context information (e.g., through monitoring rejection events) to investigate how patients with BPD perceive rejection in everyday life and how this affects subsequent levels of arousal. (PsycInfo Database Record (c) 2022 APA, all rights reserved) PubDate: Thu, 07 Apr 2022 00:00:00 GMT DOI: 10.1037/per0000546
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Abstract: Understanding resilience has expanded our knowledge of certain risk and protective factors regarding the development of different forms of psychopathology. Particularly, a focus on resilience can be used to implement interventions and to target specific behaviors in hopes of mitigating the onset of a disorder or to alleviate symptoms. Less research on resilience has been done with individuals with psychosis, particularly schizophrenia spectrum disorders. Only 1 previous study has targeted individuals assessed for schizotypy. The current study examined associations between resilience and schizotypy features, assessed using self-report measures. Specifically, we compared 3 different resilience measures, social and occupational functioning, and 3 schizotypy measures in 3 different samples: undergraduate students (n = 878), adult community members (n = 120), and an Amazon Mechanical Turk adult community members (n = 329). Data analyses consisted of correlation and regression analyses, including tests for statistical moderation. Specifically, this study found negative associations between schizotypy and both psychosocial functioning and resilience. Although we predicted resilience would moderate the relations between schizotypy and psychosocial functioning, our analyses did not provide support for a moderating role for resilience. We discuss our findings in terms of understanding the relations among schizotypy, resilience, and psychosocial outcome constructs. (PsycInfo Database Record (c) 2022 APA, all rights reserved) PubDate: Mon, 14 Mar 2022 00:00:00 GMT DOI: 10.1037/per0000559
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Abstract: Antisocial behavior has been linked to an increased tolerance of painful stimuli; however, there is evidence that pain behavior is multidetermined. The current study used pain measures from 3 different modalities (pain tolerance, pain ratings, electrocortical reactivity) and assessed triarchic traits of boldness and meanness to clarify the dispositional basis of associations between pain processing and antisocial behavior. High boldness was significantly associated with blunted early neural response to painful and nonpainful stimuli as well as increased pain tolerance. High meanness was associated with blunted elaborative processing of painful images, lower ratings of perceived pain for self and others, and increased pain tolerance. Meanness also accounted for variance shared between pain processing and antisocial behavior. Findings demonstrate that boldness and meanness contribute to pain processing in different ways and suggest that meanness may uniquely account for the association between blunted pain processing and antisocial behavior. (PsycInfo Database Record (c) 2022 APA, all rights reserved) PubDate: Thu, 10 Mar 2022 00:00:00 GMT DOI: 10.1037/per0000556
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Abstract: There remains considerable debate as to what are the core traits of psychopathy. One approach to addressing this question is to identify the traits that are present in persons said to be actual or even prototypic examples of psychopathy. Ted Bundy, Clyde Barrow, Bernie Madoff, James Bond, Chuck Yeager, and Sherlock Holmes have all been described as being a psychopath. The current study conducted nine data collections, obtaining ratings on these six persons. Biographical summaries of each person were provided. In addition, for 3 cases (Bundy, Bond, and Holmes), participants who indicated that they knew the person well provided ratings without the biographical history. Each person was described with respect to the five-factor model, the Cleckley criteria, and additional traits from more recent models of psychopathy (e.g., boldness and fearlessness). Traits evident across all six persons were fearlessness, boldness, feels invulnerable, thrill-seeking, and excitement-seeking. However, this includes persons who would not be said to be psychopaths. The traits that were most specific to psychopathy were traits of antagonism, such as callousness, manipulativeness, dishonesty, arrogance, and cruelty. The results are discussed with respect to historical and current models of psychopathy. (PsycInfo Database Record (c) 2022 APA, all rights reserved) PubDate: Mon, 07 Feb 2022 00:00:00 GMT DOI: 10.1037/per0000550
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Abstract: Recent work has examined the computational mechanisms underlying borderline personality (BP). However, this research has been confined to specific tasks. A computational analysis of BP’s mental processes as they broadly unfold in everyday life is lacking. Here, a computational model of BP is proposed, which describes patients’ everyday-life mental experience at large. Grounded on Bayesian inference, the proposal is that BP sufferers attribute excessive weight to cues considered to infer life contexts (e.g., to infer whether a cooperation or competition context is ongoing). Remarkably, model simulations demonstrate that this idea accounts for several characteristics of BP, from extreme oscillations in identity, affect, and behavior, to dysfunctional interpersonal cycles. Altogether, the article offers a framework to interpret the broad, everyday life computational mechanisms underlying BP. This can inspire theoretical and empirical research and can help understanding how clinical interventions for BP work, thus contributing to refine such interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved) PubDate: Thu, 27 Jan 2022 00:00:00 GMT DOI: 10.1037/per0000549
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Abstract: Research on dimensional models of personality pathology has achieved a good deal of consensus on the 5 broad constructs that span adaptive and maladaptive personality traits. Nonetheless, connections between the 5th domain, typically called openness to experience within general personality measures and psychoticism or schizotypy on maladaptive measures, have proven more challenging to integrate. Using experiential permeability as a guiding framework, the current study seeks to develop a hierarchical, empirically derived lower order structure with these concepts. Using a top-down “Bass-Ackward” approach, we examined the item-level structure of adaptive and maladaptive components of high experiential permeability. Results showed support for a hierarchical model with a 6-component solution including mystical beliefs/experiences, oddity, intellect, openness to aesthetics, openness to ideas, and introspection. These components from items drawn from general and maladaptive measures related to one another within and across levels, specifically oddity and openness to aesthetics. Findings also highlight the importance of using lower level analyses when examining larger, heterogeneous constructs such as schizotypal thinking and perception and openness. (PsycInfo Database Record (c) 2022 APA, all rights reserved) PubDate: Thu, 23 Dec 2021 00:00:00 GMT DOI: 10.1037/per0000537
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Abstract: Methods for studying therapeutic alliance have primarily examined the impact of the early alliance on outcomes. This does not allow for an understanding of the contributions of client, therapist, and dyadic factors to the alliance. Also, the alliance may change over time, highlighting the need for longitudinal methods. Efforts have been made to develop approaches that decompose the contributing factors and their impact on outcomes, but these findings may not apply to clients with borderline personality disorder (BPD). Our study extends previous research by replicating Baldwin et al.’s (2007) approach to disentangling therapist versus client–therapist dyad effects while using a time-varying framework. Participants (n = 156) were individuals diagnosed with BPD randomized to 1 year of dialectical behavior therapy or general psychiatric management. Outcomes were general psychiatric severity and interpersonal functioning measured at baseline and every 4 months. Client-rated alliance was measured at these time points. Early alliance predicted interpersonal functioning (p = .0132) with a significant contribution from clients (p = .0248) but not therapists (p = .2854). In the time-varying analysis, client contribution to the alliance was significant (p = .0022). For general psychiatric severity, client contributions to the alliance were significant (p < .0001) but not therapist contributions (p = .6779). Client contribution to the alliance was significant (p = .0168) in the time-varying model. Results suggest that in a BPD sample, time-varying alliance is a better predictor of rate of change in outcomes compared with the alliance measured at a single time point. In contrast to other studies, client, not therapist, contributions to alliance were significant in predicting outcomes. (PsycInfo Database Record (c) 2022 APA, all rights reserved) PubDate: Mon, 20 Dec 2021 00:00:00 GMT DOI: 10.1037/per0000526
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Abstract: Criterion B of the alternative model of personality disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM–5), outlines maladaptive trait dimensions that characterize personality disorders. Emerging evidence from bifactor confirmatory factor analyses suggest these traits are related at a higher order level by a general factor of personality disorder (g-PD). Further, emerging evidence points to traits most closely related to borderline personality disorder as underpinnings of g-PD. Further investigation is required to better understand the shared basis of personality disorder, with attention to the reliability and validity of g-PD. The g-PD theory was examined in a clinical (n = 242), and community sample (n = 252) of adults, using a brief form of the Personality Inventory for DSM–5 (PID-5). Structural analyses supported a correlated 6-factor model and a bifactor solution, validating the g-PD structure. Reliability indices supported the unidimensionality, reliability, and replicability of the g-PD factor. The strongest loading and most unidimensional items on the g-PD factors were from the Negative Affectivity and Disinhibition trait domains, partially replicating the trait profile of borderline personality disorder traits. In validity analyses, the nomological network of the general and specific factors were examined. g-PD was more strongly correlated with internalizing measures and impairment than specific factors, but specific factors were more strongly correlated with thought disorder and externalizing measures than g-PD. Our results support the nature and reliability of a general factor characterized by Negative Affectivity and Disinhibition unifying personality disorder traits in a brief form of the PID-5. Implications for the alternative model of personality disorder, PID-5, and g-PD theory are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved) PubDate: Mon, 20 Dec 2021 00:00:00 GMT DOI: 10.1037/per0000539
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Abstract: To improve understanding of emerging psychosis, researchers have identified potential precursory mechanisms that may momentarily precede psychotic-like experiences, including aberrant salience and anomalous self-experiences. Aberrant salience is the misattribution of significance to neutral stimuli and may be linked to atypical dopamine transmission. Anomalous self-experiences include changes in the experience of the self, which may alter top-down cognitive processes. The present study extends previous research on these phenomena by examining the momentary dynamics of aberrant salience, anomalous self-experiences, and psychotic-like experiences in daily life. Participants were 246 young adults who were prompted to complete 6 smartphone surveys daily for 7 days. Baseline measures of aberrant salience and anomalous self-experiences each predicted occurrence of the same phenomena in daily life, supporting the use of these measures to examine within-subject changes. Dynamic structural equation modeling was used to examine lagged effects. Both aberrant salience and anomalous self-experiences exhibited carryover effects across timepoints. Furthermore, aberrant salience and anomalous self-experiences were each associated with psychotic-like experiences at subsequent timepoints, above and beyond the carryover effects of psychotic-like experiences. These temporal relationships provide preliminary support consistent with social-cognitive models of psychosis and support further examination of the within-subject dynamics of aberrant salience and anomalous self-experiences at the momentary scale. (PsycInfo Database Record (c) 2022 APA, all rights reserved) PubDate: Mon, 29 Nov 2021 00:00:00 GMT DOI: 10.1037/per0000530
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Abstract: Childhood invalidation has been postulated to be implicated in the development of borderline personality disorder (BPD), according to the biosocial model. Despite its significance, most systematic reviews and meta-analyses have focused on examining the associations between extreme forms of invalidation, such as sexual abuse, and BPD. Nonetheless, individuals could experience mild-to-severe levels of parental invalidation, with or without abuse. This study examined the relationship between parental invalidation as an overall construct and BPD symptoms, synthesized across 21 studies (total N = 7,198). As most reviewed studies utilized retrospective self-report measures, the effect sizes derived pertained largely to the association between reported childhood parental invalidation and BPD symptoms. We conducted a multivariate meta-analysis to account for the dependence of multiple effect sizes obtained from a single study and to maintain precision in obtained effect sizes. Maternal, paternal, and overall parental invalidation were positively associated with BPD symptoms, with small-to-moderate effect sizes of .26, .23, and .25, respectively. The mean effect size of maternal invalidation was greater than that of paternal invalidation. We also investigated if the parental invalidation–BPD associations were moderated by child gender, age, and culture (degree of individualism). Only overall parental invalidation and BPD symptoms association was moderated by child’s gender, with larger effect sizes found for samples with a greater proportion of males. Age and culture did not moderate the parental invalidation–BPD association. Risk of publication bias was low. Our findings provide support for the invalidating childhood environment component of the biosocial model. (PsycInfo Database Record (c) 2022 APA, all rights reserved) PubDate: Thu, 11 Nov 2021 00:00:00 GMT DOI: 10.1037/per0000523
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Abstract: Among veterans in Veterans Health Administration (VHA) care, patients with mental health and substance use conditions experience elevated suicide rates. However, despite previously demonstrated high rates of suicidal behavior, little is known regarding suicide rates among veteran VHA users with personality disorders (PDs) as a whole, or by PD clusters (A: Eccentric; B: Dramatic; C: Fearful; and PD-not otherwise specified). PD prevalence and suicide rates were assessed through 2017; overall and by clusters for 5,517,024 veterans alive as of 12/31/2013 and with more than 2 VHA encounters in 2012–2013. In all, 46,050 (.83%) had a PD diagnosis in 2012–2013. Suicide risk was examined using proportional hazards regressions adjusted for age, sex, veteran status, clustering within a geographic region, and other mental health diagnoses. Patients with PDs had greater suicide risk than those without (156.5 vs. 46.7 per 100,000 person-years). Individuals in Cluster B, which includes borderline and antisocial PDs, were at the highest risk (178.5 per 100,000 person-years), followed by PD-not otherwise specified and Cluster C (152.6 and 121.4 per 100,000 person-years, respectively). Rates of PDs in the VHA system were lower than those usually found in community samples. Veterans with a PD diagnosis had an increased risk of suicide, which was especially elevated for those with Cluster B diagnoses. Study findings document the importance of enhancing diagnosis and treatment for veterans with PDs and targeted suicide prevention services. (PsycInfo Database Record (c) 2022 APA, all rights reserved) PubDate: Thu, 28 Oct 2021 00:00:00 GMT DOI: 10.1037/per0000521
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Abstract: Young adults presenting with personality disorders (PDs) featuring overcontrol and social inhibition urgently require effective psychological interventions to help them navigate important life transitions. metacognitive interpersonal therapy–group (MIT-G) is a time-limited group program designed to enable individuals to find adaptive solutions to their social difficulties. A small randomized clinical trial (RCT) of MIT-G versus treatment as usual (TAU) was conducted with the primary outcomes of improvements in social and interpersonal functioning and global psychological symptoms. Secondary outcomes were specific symptoms of anxiety and depression and changes in alexithymia and emotion dysregulation. From 40 participants, 20 were randomized to 16 weekly sessions of MIT-G, plus 3 individual sessions and 20 to TAU + waiting list. All 20 patients allocated to MIT-G completed treatments, while 2 dropped-out in the TAU arm. Patients in the MIT-G arm reported significant improvements on primary outcomes of functioning, interpersonal problems and global symptoms of medium magnitude, medium effect sizes for changes in depression and anxiety, and large magnitude changes for alexithymia. However, other than alexithymia no significant differences were observed between groups at treatment end. A Time × Condition interaction, indicated that MIT-G was associated with more rapid and larger magnitude improvements in functioning and alexithymia. MIT-G is a well-tolerated treatment option for young adults with overcontrolled PD. Further effectiveness studies in larger samples are underway. (PsycInfo Database Record (c) 2022 APA, all rights reserved) PubDate: Thu, 12 Aug 2021 00:00:00 GMT DOI: 10.1037/per0000497
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