Personality disorders最新文献

{"title":"Prevalence of examinees screening positive on PID-5 validity scales and impact on scale scores, correlates, and reliability.","authors":"Philippe Leclerc, Yann Le Corff, Mélanie Lapalme, Vincent Bégin, Karine Forget, Martin Sellbom","doi":"10.1037/per0000761","DOIUrl":"10.1037/per0000761","url":null,"abstract":"<p><p>The <i>Diagnostic and Statistical Manual of Mental Disorders'</i> (5th ed.; <i>DSM-5</i>) official self-report instrument to assess personality disorders is the Personality Inventory for <i>DSM-5</i> (PID-5). To screen for response bias, three validity scales have been constructed from the PID-5 item pool to assess, respectively, inconsistency, overreporting, and underreporting. Nonetheless, the prevalence and impact of PID-5 response bias on diverse psychometric properties are largely underdocumented. Thus, this study aims at: (a) identifying the rates of positive screening of each validity scale, (b) identifying the degree of overlap between validity scales, and (c) documenting the impact of each bias on scale scores, criterion validity (correlations with self- and informant-assessed personality pathology), and internal consistency. Preregistered analyses were conducted among a large population-representative sample (<i>n</i> = 2,505, 51.2% females) and an at-risk sample of young adults (<i>n</i> = 321, 48.3% females). For each sample, respectively, plausible estimates were obtained for inconsistency (4.7% and 7.2%) and overreporting (2.9% and 5.6%), whereas the underreporting scale likely led to an overestimation of the prevalence (38.6% and 32.4%). Screening positive on two PID-5 validity scales was rare (<2% of cases). Each bias had distinctive impacts on scores, correlates, and reliability. Screening for multiple biases is paramount to replicating research findings and ensuring sound clinical conclusions. Recalibrating or developing a new PID-5 validity scale to detect underreporting among populations with low to medium levels of psychopathology, as well as a scale for acquiescent/counteracquiescent bias, would be warranted. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":74420,"journal":{"name":"Personality disorders","volume":" ","pages":"231-242"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and premature termination of inpatient dialectical behavior therapy for men and women with borderline personality disorder: A comparative study.","authors":"Leonie Strunk, Kathrin Dreyße, Christoph Kröger","doi":"10.1037/per0000766","DOIUrl":"10.1037/per0000766","url":null,"abstract":"<p><p>Fewer men than women with borderline personality disorder (BPD) may be found in clinical and research settings, and so the majority of dialectical behavior therapy (DBT) treatment studies have focused on women. Because of this, DBT has not been sufficiently studied for treating BPD in men. The aim of this study was to examine the influence of gender on symptom trajectory differences and on the frequency and reasons for premature termination of treatment during a 3-month certified inpatient DBT program. The treatment-seeking sample included <i>n</i> = 1,991 women and <i>n</i> = 295 men with BPD who received treatment in a psychosomatic care hospital. Self-rated BPD symptoms were the primary outcome. There was no substantial moderating effect of sex on symptom trajectories from pre- to posttreatment. The effect sizes for borderline symptoms were <i>g</i> = .16 for men and <i>g</i> = .37 for women, respectively. According to the reliable change index, 26.1% of men and 17.9% of women experienced a deterioration in borderline symptoms; conversely, 42.1% of the women reliably improved compared with 35.9% of the men. No differences were observed in either the frequency of premature treatment discontinuation or the reasons for it. Due to symptom deterioration or the absence of improvement, a larger subgroup of men seemed to benefit less from therapy compared with women. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":74420,"journal":{"name":"Personality disorders","volume":" ","pages":"266-276"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The proportionality hypothesis: Personality disorder traits weaken the link between impairment and change motivation.","authors":"William P Hart, Danielle E Wahlers","doi":"10.1037/per0000769","DOIUrl":"10.1037/per0000769","url":null,"abstract":"<p><p>Clinical theory has long characterized personality disorders (PDs) as difficult to treat, reflecting limited insight into impairment, and harmonious with the self-concept. However, recent evidence suggests that PD traits can diminish over time and that individuals higher in PD traits report greater impairment and motivation to change. We proposed the proportionality hypothesis to reconcile these seemingly contradictory perspectives on PDs. This hypothesis suggests that people elevated in PD traits do acknowledge impairment and express motivation to change, but their motivation is reduced relative to the extent of their acknowledged impairment. In Study 1, participants reported their PD traits, current life impairment, and change motivation. As expected, PD traits were associated with greater impairment and change motivation. However, consistent with the proportionality hypothesis, the positive association between impairment and change motivation was weakened with increments in psychoticism and antagonism, and this attenuation was also apparent for the global PD-trait composite. Study 2 included Study 1's domain-general indicators of impairment and change motivation along with trait-specific indicators of these two constructs. Largely consistent with Study 1, the positive association between domain-general impairment and change motivation was weakened with increments in all PD traits except detachment as well as the global composite; however, proportionality effects failed to clearly extend to the trait-specific measures. We speculate about potential mechanisms underlying these patterns and highlight potential clinical implications and directions for future research. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":74420,"journal":{"name":"Personality disorders","volume":" ","pages":"290-303"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Explaining the association between suicidal desire and borderline personality disorder traits: A test of the three-step theory of suicide.","authors":"Titania Dixon-Luinenburg, Boaz Y Saffer, David E Manuel, E David Klonsky","doi":"10.1037/per0000767","DOIUrl":"10.1037/per0000767","url":null,"abstract":"<p><p>The three-step theory of suicide (3ST) states that pain and hopelessness cause suicidal desire and that the extent to which pain exceeds connectedness determines the strength of suicidal desire. The ability of these premises to account for elevated suicidal desire in those with borderline personality disorder (BPD) traits was examined in 852 undergraduates oversampled for suicide risk (456 had histories of suicide ideation or attempts). Validated self-report questionnaires assessed BPD traits, current suicidal desire, psychological pain, hopelessness, and connectedness. Consistent with Step 1 of the 3ST, variance explained in suicidal desire by BPD traits was reduced from 16% to only 1% when controlling for pain and hopelessness. Consistent with Step 2, among those with suicidal desire, variance explained in the magnitude of that suicidal desire by BPD reduced from 6% to 0% when controlling for a pain-connectedness difference score. In a simpler model, controlling for pain, hopelessness, and connectedness reduced variance explained in suicidal desire by BPD from 16% to 0%. These findings suggest that the 3ST provides a useful lens to understand elevated suicidal desire in individuals with BPD and can inform suicide treatment and prevention strategies. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":74420,"journal":{"name":"Personality disorders","volume":" ","pages":"243-252"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical staging and risk profiling in borderline personality disorder: An evaluation of reliability and clinical utility.","authors":"Rosie Kidane, Jarco Wesdorp, Stefanie Duijndam, Andrew M Chanen, Barbara de Clercq, Joost Hutsebaut","doi":"10.1037/per0000760","DOIUrl":"10.1037/per0000760","url":null,"abstract":"<p><p>To address the need for a more dynamic assessment of the progress and severity of borderline personality disorder (BPD), as well as associated treatment needs, various models of clinical staging and risk profiling have been proposed. Clinical staging involves estimating disorder severity along a continuum, whereas risk profiling predicts progression across stages using known risk factors. This study examines these models' reliability and clinical utility in predicting dosage (total registered units of direct patient contacts) and outcome for BPD patients. We used anonymized information from patient records of 128 patients treated for (subthreshold) BPD in the Netherlands (<i>M</i> age = 30.51, <i>SD</i> = 11.85; range: 14-61 years). After establishing interrater reliability, a retrospective analysis of routine clinical data was used to examine the relationship between two clinical staging models and one risk profile model on total treatment dosage and outcome. The results showed that staging models and risk profiles could be reliably assessed and that patients in earlier stages required less treatment and achieved better outcomes compared with later stages. However, the contribution of risk profiling was minimal and insignificant. Furthermore, results suggest that the transition from Stage 1 to Stage 2 represents a critical turning point in BPD progression and underscores the importance of early intervention. Despite limitations, clinical staging models explained significant variance in treatment dosage and symptom reduction, offering valuable insights into BPD treatment needs. The study highlights the potential of these models to support early detection and intervention by improving prognosis and guiding more personalized treatment. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":74420,"journal":{"name":"Personality disorders","volume":" ","pages":"277-289"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does the severity of specific borderline personality disorder symptoms vary by sexual orientation? A differential item functioning analysis of self- and clinician-ratings.","authors":"Alexandra K Barnhill, Julia K Nicholas, Hannah E Croom, Troy Hubert, Sarah E Cecil, Caden J Maynard, Vincent J Buchenberger, Reagan A Franks, Megan J Hutchins, Matthew W Southward, Shannon Sauer-Zavala","doi":"10.1037/per0000764","DOIUrl":"10.1037/per0000764","url":null,"abstract":"<p><p>Although borderline personality disorder (BPD) is more frequently diagnosed among sexual minority individuals than heterosexual individuals, it is unclear the degree to which this disparity reflects differences in symptom expression, diagnostic bias, or some combination of the two. Among treatment-seeking adults with BPD (<i>N</i> = 121, <i>M</i>_age = 28.4; 76% female, 89% White, and 57% sexual minority), we examined differential item functioning (DIF) and group differences in symptom severity using self-reported and clinician-administered BPD measures (Zanarini Scale for Borderline Personality Disorder-Self-Rated, Zanarini Scale for Borderline Personality Disorder-Clinician-Rated, Structural Clinical Interview for <i>Diagnostic and Statistical Manual of Mental Disorders-Fifth edition</i>-Personality Disorders). Although there was no evidence of DIF for any self-reported item, sexual minority participants endorsed self-injurious behaviors (<i>B</i> = 0.63, <i>p</i> = .01), stress-related paranoia or dissociation (<i>B</i> = 0.62, <i>p</i> = .01), efforts to avoid abandonment (<i>B</i> = 0.53, <i>p</i> = .02), and unstable relationships (B = 0.54, p = .03) more often than heterosexual participants on average, contributing to greater past-week total symptomatology (<i>B</i> = 3.88, <i>p</i> < .01). Clinician-administered items assessing self-injurious behaviors exhibited uniform DIF and were \"easier\" to endorse for sexual minority participants. Furthermore, assessors rated self-injurious behaviors for sexual minority participants more often over the past week (<i>B</i> = 0.51, <i>p</i> < .01) and past 2 years (odds ratio = 3.58, <i>p</i> < .01) than heterosexual participants, and affective instability over the past 2 years (odds ratio = 4.00, <i>p</i> < .05). These results suggest that patients and assessors interpreted most BPD items similarly, while emphasizing the need for nuanced examination of symptomatology and cultural competence in clinical practice to ensure accurate evaluation of BPD across diverse groups. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":74420,"journal":{"name":"Personality disorders","volume":" ","pages":"253-265"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stand-alone dialectical behavior therapy skills training for borderline personality disorder: A systematic review and meta-analysis.","authors":"Maria Arqueros, Joaquim Soler, Juan C Pascual","doi":"10.1037/per0000774","DOIUrl":"https://doi.org/10.1037/per0000774","url":null,"abstract":"<p><p>Stand-alone dialectical behavior therapy skills training groups (DBT-ST) are widely used for borderline personality disorder (BPD), yet skills-specific benchmarks for symptom change and tolerability are unclear. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched PubMed, APA PsycARTICLES, APA PsycINFO, Psicodoc, and Psyke (English/Spanish) for adult stand-alone DBT-ST covering the four standard modules. Eligible designs were randomized clinical trials, controlled trials, and pre-post studies with standardized BPD diagnoses. Continuous outcomes were synthesized as standardized mean differences (Hedges-corrected <i>d</i>); within-arm pre-post effects used standardized mean change (assumed <i>r</i> = .50 when missing). Dropout was pooled on the logit scale and back transformed to retention. Random-effects model with Hartung-Knapp adjustments quantified heterogeneity and ran sensitivity/bias diagnostics. Seven studies met criteria; five entered meta-analysis. BPD clinical severity showed large within-arm improvement (<i>d</i> = -1.32, 95% confidence interval [CI; -1.99, -0.64]) with substantial heterogeneity. Depression decreased largely (<i>k</i> = 4; <i>d</i> = -1.04, 95% CI [-1.33, -0.75]); global psychopathology decreased moderately (<i>k</i> = 2; <i>d</i> = -0.73, 95% CI [-1.39, -0.08]). Pooled dropout was 29% (95% CI [23%, 36%]), implying 71% retention. Stand-alone DBT-ST is associated with large symptom reductions and acceptable retention, providing skills-specific benchmarks to inform implementation, whereas heterogeneity indicates the need for more robust comparative trials. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":74420,"journal":{"name":"Personality disorders","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining associations among positive and negative schizotypy, feedback-related learning, and attentional set switching.","authors":"Amelia M Pellegrini, Desmond J Spann, Kelsey T Straub, R Tyler Rogers, Megan Liew, John G Kerns","doi":"10.1037/per0000777","DOIUrl":"https://doi.org/10.1037/per0000777","url":null,"abstract":"<p><p>Positive schizotypy is a dimension of traits ranging from odd beliefs and experiences in the general population to the positive psychotic symptoms of schizophrenia (i.e., delusions and hallucinations), with high levels of positive schizotypy found in some personality disorders. Psychosis is related to increased dorsal striatal dopamine, suggesting that positive schizotypy might also reflect alterations in dorsal striatal functioning. The dorsal striatum is involved in reinforcement learning and cognitive flexibility. The current research examined whether positive schizotypy is related to impaired learning from probabilistic positive and negative feedback and to impaired attentional set switching. Participants included a group with extreme levels of positive schizotypy, a positive schizotypy control group, and a group with extreme levels of negative schizotypy. They completed feedback-related learning tasks and an attentional set-switching task. They also completed a response inhibition task to help assess for generalized task performance deficits. To further assess specificity, they also completed a range of mood and other measures. Overall, there was evidence that positive schizotypy was associated with poor feedback-related learning, perhaps especially and specifically with poorer learning from positive feedback. Positive schizotypy was also associated with poorer attentional set switching, but not with poorer response inhibition. Overall, the current study provides further evidence that positive schizotypy is associated with poor performance on reinforcement learning and cognitive flexibility tasks thought to involve the dorsal striatum. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":74420,"journal":{"name":"Personality disorders","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences between personality functioning, normal-range traits, and maladaptive traits: Replication in a longitudinal Norwegian sample.","authors":"Yuping Liu, Eivind R Strand, Henrik Nordahl, Christopher J Hopwood","doi":"10.1037/per0000778","DOIUrl":"https://doi.org/10.1037/per0000778","url":null,"abstract":"<p><p>The alternative model of personality disorders has gained widespread recognition, yet the degree of conceptual and empirical overlap among personality functioning, maladaptive traits, and normal-range personality traits-and its implications for clinical assessment-remains debated. Recent studies have begun to examine these associations in a more systematic manner; however, longitudinal evidence is still limited, and the generalizability of existing findings remains insufficiently tested. In this preregistered study, we conducted a conceptual replication of 11 preregistered hypotheses originally examined in a recent longitudinal study of Chinese offenders. Using a Norwegian community sample, we investigated associations and distinctions among personality functioning, normal-range traits, and maladaptive traits across 4 waves of data collected over 6 months (<i>N</i> = 1,418). Overall, we largely replicated the pattern of findings reported in the original study. Results revealed systematic differences in the distributions and longitudinal properties of personality functioning and personality traits. Across time, maladaptive traits were jointly predicted by impairments in personality functioning and normal-range personality traits, indicating both shared and unique contributions. Taken together, these findings provide further longitudinal support for both similarities and distinctions between personality functioning and trait dimensions within the alternative model of personality disorders framework. By extending prior work to a different population and methodological context, this replication study strengthens the evidence for the robustness and generalizability of existing conclusions. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":74420,"journal":{"name":"Personality disorders","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining suicidal thoughts and behaviors across levels of personality functioning: A generalized additive model approach.","authors":"Jessica La Rocca, Paulina A Kulesz, Carla Sharp","doi":"10.1037/per0000763","DOIUrl":"10.1037/per0000763","url":null,"abstract":"<p><p>Suicide is a leading cause of death among emerging adults in the United States. Despite decades of research attempting to target risk factors, our ability to predict suicide remains insufficient. The objective of our examination was to investigate the utility of Criterion A of the Alternative Model for Personality Disorders in predicting suicide outcomes by identifying the level-specific contribution of levels of personality functioning (LPF) to suicidal thoughts and behaviors. To address our research questions, we employed generalized additive modeling in subsamples of 145 young adults endorsing suicidal ideation, and 158 young adults endorsing at least one lifetime suicide attempt who were recruited from college and clinical settings. Clinical participants endorsed past or current, confirmed or subthreshold borderline personality disorder. Results indicated a nonlinear trend in suicidal ideation with the sharpest increase at Level 2 of the LPF scale, operationalized via the Semistructured Interview for Personality Functioning. In addition, the increase in lifetime attempt history was nonuniform, with the greatest increase in odds ratio ratios occurring between Level 1 and Level 2. Findings support Level 2 of LPF as a potential inflection point for suicide risk detection and further challenge the notion of linear relationships between personality pathology severity and suicide risk. Implications of these findings are discussed. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":74420,"journal":{"name":"Personality disorders","volume":" ","pages":"200-209"},"PeriodicalIF":4.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}