Personality disorders最新文献

{"title":"\"I feel like so much more of myself\": The experience of modifying appearance in borderline personality disorder.","authors":"Katherine G Jones, Tatiana Allan, Laura Furtado Fernandes, Sophia Zhang, Nyla Conaway, Ada Umeugo, Sara Rose Masland, Sharon Nelson, Sarah K Fineberg","doi":"10.1037/per0000765","DOIUrl":"10.1037/per0000765","url":null,"abstract":"<p><p>Body modifications such as tattoos and piercings have known identity-affirming functions. Despite this, as a subject of psychological research, they are mainly studied in relation to self-injurious behavior. Given the frequency of both self-damaging behavior and unstable identity in borderline personality disorder (BPD), and informed by a sample of 17 pilot interviews, we hypothesized that for people with BPD, body modifications provide relief from internal and aversive identity-related concerns. The present study takes a qualitative approach to examine body modification and related emotional and intrapersonal experiences in BPD. Participants with BPD (<i>N</i> = 47) participated in a semistructured interview targeting appearance-modification experiences. Rapid qualitative analysis methods were used to sort interview content into five domains of interest: physical sensations, affect regulation, sense of self, emptiness and identity disturbance, and impulsivity. Participants described a wide range of body modifications and associated experiences. Results substantiated the potential for appearance modifications to positively impact sense of self in BPD-mitigating identity disturbance and emptiness-and revealed complex emotional consequences when these modifications do not \"work.\" The results also challenge inferred causal relationships between nonsuicidal self-injury history and appearance modification: Although participants reported sensory similarities between the behaviors, appearance modifications carried specific positive connotations and consequences that nonsuicidal self-injury did not. This study reveals a complex and nuanced picture of appearance modification in BPD, with particular implications for identity affirmation and mood induction. The results identify common themes across highly variable and personal narratives, opening a window into BPD lived experience. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":74420,"journal":{"name":"Personality disorders","volume":" ","pages":"319-328"},"PeriodicalIF":4.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13249013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disentangling paranoia and social anxiety: Overlap and differentiation in daily life.","authors":"Yunlai Gui, Leslie E Horton, Alysia M Berglund, Laura M Hernández, Molly A Walsh, Paul J Silvia, Neus Barrantes-Vidal, Thomas R Kwapil","doi":"10.1037/per0000781","DOIUrl":"https://doi.org/10.1037/per0000781","url":null,"abstract":"<p><p>Paranoia, the unfounded belief and mistrust about other people's intentions as threatening, and social anxiety, the intense worry and fear regarding social interactions, share a number of phenomenological features. Furthermore, both can be conceptualized as traits ranging from mild or subclinical to severe clinical expressions. However, few studies have examined how these trait-level vulnerabilities differentially map onto individuals' daily experiences. The present study used experience sampling methodology to disentangle the overlap and differentiation of trait-level social anxiety and paranoia in daily life. A total of 238 young adults were prompted 8 times daily for 1 week to complete experience sampling methodology questionnaires that assessed affect, cognitive appraisals, suspicious thoughts, activities, and social behaviors. As hypothesized, paranoia and social anxiety were both independently associated with negative affect and negative self- and other-related appraisals. However, after controlling for shared variance, only paranoia was uniquely associated with anger, intense feelings, and threat-related suspicious thoughts, whereas only social anxiety was uniquely associated with feeling not cared for, preference to be alone while with others, and among participants who were alone, interpreting being alone as due to others' dislike. Cross-level interactions further showed that only social anxiety exacerbated the inverse association between momentary reports of feeling close to others and the preference to be alone. Overall, these findings suggest that although paranoia and social anxiety are closely intertwined in daily life, they may reflect partially distinct interpersonal processing: paranoia involving heightened threat detection and suspiciousness, and social anxiety involving heightened sensitivity to rejection and unease. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":74420,"journal":{"name":"Personality disorders","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802203","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 the relationship between sleep disturbance and ICD-11 personality disorder in a community sample.","authors":"Martin Sellbom, Sean P A Drummond","doi":"10.1037/per0000784","DOIUrl":"10.1037/per0000784","url":null,"abstract":"<p><p>There is a substantial literature on the associations between personality disorder (PD) and sleep dysfunction, but the majority of studies have focused on borderline PD. Studies that have taken a broader perspective have indicated that associations between PD and sleep problems are diffuse. The current study examined associations between the <i>International Classification of Diseases</i>, 11th revision <i>(ICD-11</i>) PD (severity and traits) with a diverse set of sleep problems as well as the role of adverse childhood experiences (ACEs) and executive functioning in explaining the overlap between PD and sleep dysfunction. Participants were 503 individuals with mental health histories recruited via Prolific Academic from six English-speaking countries and completed a battery of self-report questionnaires targeting the constructs of interest. The results show that <i>ICD-11</i> PD severity and negative affectivity were both distinctly associated with insomnia severity and presleep arousal. To a lesser degree, disinhibition was primarily associated with an eveningness chronotype and daytime sleepiness. Although both ACEs and executive dysfunction explained the overlap of the PD constructs with insomnia severity and presleep arousal, the latter was associated with a much larger effect size. The findings indicate that a dimensional PD model such as the one included in <i>ICD-11</i> can be useful in elucidating how PD is related to sleep problems, and this overlap should also signal to clinicians to assess for and intervene with sleep problems in clients with PDs. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":74420,"journal":{"name":"Personality disorders","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802392","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":"Two operationalizations of a single construct: Overlap between borderline personality disorder and the level of personality functioning.","authors":"Rachael C Martin, Awal Kuer, Martin Sellbom","doi":"10.1037/per0000780","DOIUrl":"10.1037/per0000780","url":null,"abstract":"<p><p>Scholarly debate continues regarding whether borderline personality disorder (BPD) represents a distinct categorical disorder or primarily reflects elevated levels of personality functioning (LPFs) as conceptualized in the <i>Diagnostic and Statistical Manual of Mental Disorders</i>, fifth ed., Alternative Model of Personality Disorders. The present study examined the overlap between measures of LPF and BPD by analyzing archival data from 289 adults receiving community-based mental health treatment. Participants completed both clinician-rated and self-report measures assessing BPD symptoms, LPF, and relevant psychopathology and personality constructs. Results indicated substantial overlap between measures of BPD and LPF, with confirmatory factor analyses and bifactor modeling supporting a dominant general factor that accounted for most shared variance between the 2 constructs. Concurrently, BPD retained modest yet consistent unique variance, primarily associated with externalizing domains. Together, these findings indicate that BPD largely reflects LPF with some stylistic features remaining unique that are likely artifacts of the behavioral focus of BPD in the <i>Diagnostic and Statistical Manual of Mental Disorders,</i> fifth ed. This observation suggests that resources currently directed toward BPD-specific frameworks may be more effectively invested in dimensional models targeting general personality impairment, with benefits extending across broader personality pathology. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":74420,"journal":{"name":"Personality disorders","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581572","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":"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}