{"title":"Clinical Confidence in Personality Disorder Care Requires Team-Based Formulation.","authors":"Lien-Chung Wei","doi":"10.1002/pmh.70092","DOIUrl":"10.1002/pmh.70092","url":null,"abstract":"<p><p>This letter responds to Pingani et al.'s validation of a questionnaire on clinical confidence and psychodynamic skills in personality disorder care. It argues that confidence should be interpreted at the team level, where formulation, boundaries, risk communication, and emotional containment shape the patient's experience of care.</p>","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":"20 3","pages":"e70092"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Criterion A as Developmental Severity: Reclaiming the Psychodynamic Core of Personality Functioning.","authors":"Kimberly J Gilbert","doi":"10.1002/pmh.70059","DOIUrl":"10.1002/pmh.70059","url":null,"abstract":"<p><p>The Alternative Model for Personality Disorders (AMPD) distinguishes severity of personality dysfunction (Criterion A) from maladaptive trait expression (Criterion B). Debates about whether the Level of Personality Functioning Scale (LPFS) is unidimensional or multidimensional have attracted considerable attention but largely miss the point. Personality functioning, as conceived within psychodynamic developmental theory, is singular by definition-not because factor analyses extract a dominant factor but because psychological development itself is one process. The DSM-5 Work Group constructed Criterion A from psychodynamic instruments that interpret personality pathology as failures to develop a stable, coherent sense of self, and the capacity for meaningful relationships. Evidence for this developmental achievement appears in identity, self-direction, empathy, and intimacy, but these domains reflect facets of a single capacity rather than separable dimensions. This commentary traces the psychodynamic roots of Criterion A, integrates contemporary trait research to clarify how Criteria A and B differ conceptually, addresses key psychometric critiques, and outlines treatment implications.</p>","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":"20 1","pages":"e70059"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vijay Kumar K V, Pankaj Kshirsagar, Mansi Mishra, Surbhi Panwar
{"title":"Comment on \"Personality Pathology and Functional Outcomes During Pharmacological Treatment of Adult ADHD\".","authors":"Vijay Kumar K V, Pankaj Kshirsagar, Mansi Mishra, Surbhi Panwar","doi":"10.1002/pmh.70078","DOIUrl":"10.1002/pmh.70078","url":null,"abstract":"<p><p>This manuscript evaluates how dimensional personality pathology shapes functional outcomes in adults receiving pharmacological treatment for ADHD. It addresses construct overlap between measures, temporal variability in longitudinal modeling, and psychometric limitations. The analysis refines interpretation of treatment response by emphasizing interactions between personality-related processes and real-world functional recovery beyond symptom improvement.</p>","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":"20 2","pages":"e70078"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Personality Functioning Cannot Only Be One Thing: A Call for Theoretical Pluralism.","authors":"Orestis Zavlis","doi":"10.1002/pmh.70085","DOIUrl":"10.1002/pmh.70085","url":null,"abstract":"<p><p>Since its origins in recent diagnostic perspectives, the concept of personality functioning has been exclusively defined as a general factor of personality (pathology). Researchers have justified this definition by appealing to descriptive empirical findings (e.g., positive correlations among various personality disorder indicators) or traditional psychoanalytic theories (e.g., ego psychology). In this review, I argue that this monopoly of interpretive viewpoints is currently impeding progress in the field of personality functioning. To begin with, I review seminal psychoanalytic theories and show how all of them run contrary to the view of personality functioning as a 'single, underlying capacity'. Subsequently, I review the empirical literature on personality functioning and argue that this construct could be interpreted in either a descriptive way (in which case it is theoretically empty) or an explanatory way (in which case it is fundamentally incompatible with the kinds of psychoanalytic theories typically invoked to justify it). Finally, I present three alternative ways of conceptualising personality functioning (viz., a configurational way, a dialectic way and a relational way) and conclude the paper by suggesting that the future of this line of inquiry lies in formally articulating and empirically scrutinising as many such competing theoretical viewpoints as possible.</p>","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":"20 3","pages":"e70085"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13248573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comment on 'Coercive Control and Intimate Partner Violence: Relationship With Personality Disorder Severity and Pathological Narcissism'.","authors":"Yusheng Zhu, Zihan Ye","doi":"10.1002/pmh.70079","DOIUrl":"10.1002/pmh.70079","url":null,"abstract":"","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":"20 2","pages":"e70079"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nikola Doubková, Radek Heissler, Veronika Juríčková, Pavel Mohr, Marek Preiss, Gina Rossi
{"title":"The Personality Disorder Severity ICD-11 (PDS-ICD-11) Scale: Psychometric Properties and Incremental Predictive Validity for Trait Domains in Czech Community and Treatment-Seeking Groups.","authors":"Nikola Doubková, Radek Heissler, Veronika Juríčková, Pavel Mohr, Marek Preiss, Gina Rossi","doi":"10.1002/pmh.70050","DOIUrl":"10.1002/pmh.70050","url":null,"abstract":"<p><p>The 11th revision of the International Classification of Diseases defines the severity of dysfunction as a core diagnostic criterion for personality disorders. This study examined the psychometric properties of the Czech adaptation of the Personality Disorder Severity-ICD-11 (PDS-ICD-11) scale. The sample consisted of 1704 participants (72.4% women) in community (n = 612) and treatment-seeking (n = 1092) groups. Results supported the unidimensionality of the PDS-ICD-11, good internal consistency, and expected associations with a validated measure of severity (Levels of Personality Function Scale-Brief Form 2.0; LPFS-BF 2.0), as well as with pathological traits and quality of life measures. Compared with the LPFS-BF 2.0, the PDS-ICD-11 demonstrated stronger associations with quality of life (small effect size) and was a better predictor of treatment-seeking status; however, it explained less variance in pathological traits, except for negative affectivity. Neither severity measure showed a balanced representation of trait domains, suggesting a need for refinement. Overall, the Czech PDS-ICD-11 offers a valid and efficient tool for screening the severity of personality dysfunction, with utility in both research and clinical settings.</p>","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":"19 4","pages":"e70050"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145589408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nicholas J S Day, David Kealy, Marko Biberdzic, Ava Green, Georgia Denmeade, Brin F S Grenyer
{"title":"Coercive Control and Intimate Partner Violence: Relationship With Personality Disorder Severity and Pathological Narcissism.","authors":"Nicholas J S Day, David Kealy, Marko Biberdzic, Ava Green, Georgia Denmeade, Brin F S Grenyer","doi":"10.1002/pmh.70038","DOIUrl":"10.1002/pmh.70038","url":null,"abstract":"<p><p>Intimate partner violence (IPV) is a global health concern, with increasing efforts focused on detection and prevention. Coercive control has been identified as a 'golden thread' linking risk profiles and violence perpetration. Narcissistic pathology is often implicated in control and violence, but research linking narcissism with aggression and abuse has been inconsistent. Most research on narcissism focuses on symptomatology, whereas contemporary diagnostic frameworks emphasise a dimensional approach to personality disorder 'severity'. No study has examined the association between pathological narcissism, violence and coercive control while accounting for overall personality pathology. Individuals in relationships with relatives high in narcissism (N = 135; 71% romantic partners, 22% family members; average relationship length = 20 years) completed informant measures of pathological narcissism and personality disorder severity, as well as self-report measures of abuse and coercive control. Relatives were rated highly in both grandiose and vulnerable narcissism features, as well as displaying prominent impairments in personality functioning. Correlation analysis indicated dimensional personality disorder severity was significantly and moderately associated with both abuse and coercive control. Pathological narcissism was significantly associated with coercive control but not abuse. Specific narcissism subfactors (exploitativeness, grandiose fantasy and entitlement rage) showed positive, weak associations with either coercive control or abuse. Within the context of high narcissistic symptomatology, personality disorder severity may be a risk factor for coercive control and IPV. Clinical implications suggest the relevance of incorporating a focus on personality in psychological interventions targeted at reducing IPV and coercive control.</p>","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":"19 4","pages":"e70038"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12411753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Callous-Unemotional Trait Prosocial Limitations Are Moderated by Cognitive Control Impacting Theory of Mind in Adolescents.","authors":"Drew E Winters, Joseph T Sakai","doi":"10.1002/pmh.70037","DOIUrl":"10.1002/pmh.70037","url":null,"abstract":"<p><p>Although callous-unemotional (CU) traits are linked with antisocial behavior, affected youth still engage in some prosocial behaviors. The factors contributing to prosocial behavior in these youth are relatively unknown. Relevant factors (known to inversely associate with CU traits and positively associated with prosocial behavior) are complex affective theory of mind (aToM) and cognitive control. In line with recent work demonstrating that cognitive control influences complex aToM in youth with CU traits, we investigated whether its impact moderates the association between CU traits and both a behavioral measure of prosocial behavior and a self-reported measure of prosocial motivation (prosocial rewards). Participants (n = 81, 52% female) completed self-reports and a behavioral paradigm to assess prosocial motivations and behavior alongside CU traits. Results revealed that CU traits were negatively associated with prosocial rewards and goals. And, of primary interest, cognitive control's impact on aToM moderated the association between CU traits and both prosocial rewards and prosocial behavior. Findings suggest that vulnerability to cognitive load-reflected by decrements in aToM-predicts lower prosocial behavior, whereas those that are more resilient to cognitive demands are more likely to engage in prosocial behavior. This demonstrates that the level of resilience to cognitive demands on complex aToM accuracy is an important contextual factor for understanding prosocial behavior in youth with CU traits.</p>","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":"19 4","pages":"e70037"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}