{"title":"Head-to-head comparisons of Diagnostic and Statistical Manual of Mental Disorders, fifth edition, Section II and Section III personality disorder in predicting clinical outcomes.","authors":"Carla Sharp, Joshua D Miller","doi":"10.1037/per0000691","DOIUrl":"10.1037/per0000691","url":null,"abstract":"<p><p>In 2022, <i>PDs: Theory, Research, and Treatment</i> published a 10-year retrospective on the <i>Diagnostic and Statistical Manual of Mental Disorders,</i> fifth edition (DSM-5), Section III, Alternative Model for PDs (AMPD; American Psychiatric Association, 2013). The articles of the 10-year retrospective provided evidence in support of the validity, reliability, and clinical utility of the AMPD. Specifically, it provided evidence in support of the unidimensional factor structure of the LPF and the five-dimensional structure of the pathological trait domains. In addition, evidence in support of the construct validity of the LPF in its association with psychiatric severity, functional outcomes, traditional PDs, cognitive, emotional, and contextual correlates, and other indices of maladaptive self- and interpersonal functioning was provided. Despite this evidence, a significant gap has since been identified related to how the American Psychiatric Association (APA) decides to accept proposed revisions to diagnostic criteria. The goal of the current special issue is to address this gap. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":74420,"journal":{"name":"Personality disorders","volume":"15 5","pages":"275-281"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141927","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}
Personality disordersPub Date : 2024-09-01Epub Date: 2024-07-29DOI: 10.1037/per0000676
Alexandra Hines, Madeline L Kushner, Nicole Stumpp, Stephen Semcho, Eric Bridges, Hannah Croom, Abrar Rahman, Sarah Cecil, Caden Maynard, Matthew W Southward, Thomas A Widiger, Shannon Sauer-Zavala
{"title":"Different routes to the same destination? Comparing Diagnostic and Statistical Manual of Mental Disorders, fifth edition Section II- and alternative model of personality disorder-defined borderline personality disorder.","authors":"Alexandra Hines, Madeline L Kushner, Nicole Stumpp, Stephen Semcho, Eric Bridges, Hannah Croom, Abrar Rahman, Sarah Cecil, Caden Maynard, Matthew W Southward, Thomas A Widiger, Shannon Sauer-Zavala","doi":"10.1037/per0000676","DOIUrl":"10.1037/per0000676","url":null,"abstract":"<p><p>Borderline personality disorder (BPD) is defined by the presence of at least five of nine symptoms in Section II of the <i>Diagnostic and Statistical Manual of Mental Disorders</i>, fifth edition. In the <i>Diagnostic and Statistical Manual of Mental Disorders,</i> fifth edition, Section III Alternative Model of Personality Disorders (AMPD), BPD is defined by deficits in self and/or interpersonal functioning (Criterion A), elevated negative affectivity, and elevated antagonism and/or disinhibition (Criterion B). However, it is unclear if these definitions describe the same people and if the AMPD criteria explain unique variability in treatment outcomes in this population. In a treatment-seeking sample of adult participants diagnosed with BPD according to Section II criteria (<i>n</i> = 65, <i>M</i><sub>age</sub> = 27.60, 70.8% female, 76.9% White), we found a majority (66.2%) would have also received the diagnosis based on AMPD criteria. Those meeting AMPD criteria reported more severe Section II BPD symptoms than those who did not, <i>p</i>s < .02, <i>d</i>s > 0.60, and the presence or severity of Section II fears of abandonment and inappropriate anger uniquely predicted AMPD BPD diagnoses, <i>p</i>s < .03, <i>OR</i>s ≥ 2.31. Changes in AMPD dimensions explained 34% of the variability in change in work/social adjustment (<i>p</i> = .13) and quality of life (<i>p</i> = .22), respectively, over and above changes in Section II symptoms during a novel cognitive-behavioral treatment for BPD. These results suggest that AMPD criteria capture a more severe subset of BPD than Section II criteria and may be important predictors of treatment outcomes. We discuss the potential trade-offs of this shift in diagnosis. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":74420,"journal":{"name":"Personality disorders","volume":" ","pages":"352-360"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141790203","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}
R Michael Bagby, Sharlane C L Lau, Carolyn A Watters, Lena C Quilty, Martin Sellbom
{"title":"A comparison of the associations of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, Section II personality disorders and Section III personality domains with clinical dysfunction in a psychiatric patient sample.","authors":"R Michael Bagby, Sharlane C L Lau, Carolyn A Watters, Lena C Quilty, Martin Sellbom","doi":"10.1037/per0000687","DOIUrl":"https://doi.org/10.1037/per0000687","url":null,"abstract":"<p><p>In this study, we compare the incremental predictive capacities of the <i>Diagnostic and Statistical Manual of Mental Disorders</i>, <i>Fifth Edition, Text Revision (DSM-5-TR)</i> Section II personality disorders (SII-PDs) with Section III trait domains of the Alternative Model of Personality Disorders (AMPD) in a psychiatric outpatient sample (<i>N</i> = 185). To this end, a series of hierarchical regression analyses was conducted in which the 10 SII-PDs and the five AMPD trait domains served as the predictor variables and five areas of clinical dysfunction as the criterion variables. Two models for each criterion were tested. In Model A, the 10 PDs were entered as a block, followed by the block entry of trait domains; in Model B, the block entry of these predictors was reversed. As the AMPD was designed to address the shortcomings of the SII-PDs, it was hypothesized that the AMPD trait domains would show greater predictive capacity vis-à-vis the latter by (a) explaining more overall variance for each criterion variables when entered first into the model versus when SII-PDs was entered first and (b) explaining more incremental variance than SII-PDs when block was entered second. These hypotheses were partially supported. Overall, the AMPD trait domains predicted more variance than SII-PDs and demonstrated better model fit and more predictive power for three of the criterion variables. Similarly, the AMPD domains predicted a significant but modest incremental increase in variance over that of the SII-PDs for three of the criterion variables. We conclude that more work needs to be done to improve the AMPD, particularly in the assessment of externalizing psychopathology as it relates to clinical dysfunction. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":74420,"journal":{"name":"Personality disorders","volume":"15 5","pages":"322-331"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141925","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}
Personality disordersPub Date : 2024-09-01Epub Date: 2024-05-09DOI: 10.1037/per0000663
Whitney R Ringwald, William C Woods, Aidan G C Wright
{"title":"Comparing the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, personality disorder models scored from the same interview.","authors":"Whitney R Ringwald, William C Woods, Aidan G C Wright","doi":"10.1037/per0000663","DOIUrl":"10.1037/per0000663","url":null,"abstract":"<p><p>The alternative model of personality disorders (AMPD) traits were designed to maintain continuity with the Section II personality disorder (PD) diagnoses by retaining the same clinical information. Whether the AMPD traits achieve this is not well established. Prior work testing incremental validity of AMPD traits and Section II diagnoses is limited by the fact each model was measured by a different instrument or rater, making it unclear whether discrepancies are due to the constructs or methods. Here, we compare the incremental validity of AMPD traits versus Section II PDs assessed by the same instrument and rater. Participants (<i>N</i> = 311, 50% received past-year mental health treatment) completed a clinical interview, baseline self-reports, and 14-day ambulatory assessment protocol. Interviewers rated AMPD domains, facets, and Section II criteria from the same interview (Structured Interview for <i>DSM-IV</i> Personality). We used hierarchical regression models to evaluate the variance predicted in 17 clinically relevant cross-sectional and momentary variables by the AMPD traits and Section II PDs. Incremental <i>R</i>² showed that Section II PDs account for little variance in outcomes over and above the AMPD domains/facets, whereas the AMPD facets were generally more predictive of outcomes than the Section II PDs. Results add novel evidence that dimensional PD traits-not a particular assessment method-are equivalent or superior to PD categories for predicting social, emotional, and behavioral functioning. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":74420,"journal":{"name":"Personality disorders","volume":" ","pages":"371-378"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140900544","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":"Exploring personality correlates of psychiatric hospitalization: A cross-sectional comparison of section ii personality disorder model and alternative model for personality disorders.","authors":"Dominika Górska, Monika Olga Jańczak","doi":"10.1037/per0000682","DOIUrl":"https://doi.org/10.1037/per0000682","url":null,"abstract":"<p><p>Our cross-sectional study provides a head-to-head comparison of Section II and Section III of <i>Diagnostic and Statistical Manual of Mental Disorders</i>, fifth edition (DSM-5) diagnostic models of personality disorders (PDs) in identifying significant personality correlates of psychiatric hospitalization (PH). PH is an indicator of a breakdown in one's existing ability to manage mental crisis. The sample was recruited from psychiatric clinical services (<i>N = 60</i>) as well as universities and the local community (<i>N = 49</i>). We used the Structured Clinical Interview for <i>DSM-5</i> PD (SCID-5-PD) for Section II <i>DSM-5</i> diagnosis, the Self and Interpersonal Functioning Scale (SIFS) for Criterion A and the Personality Inventory for <i>DSM-5</i> (PID-5) for Criterion B. Separate logistic regressions analyses showed high discriminative utility for all diagnostic models: the number of Section II diagnosis, level of personality functioning, and five maladaptive traits (AUC between .89 and .97). Binomial logistic regression with a forward stepwise procedure showed that Section II number of diagnoses revealed incremental utility over Criteria A and B in distinguishing between individuals experiencing a mental health crisis requiring PH and those not requiring immediate intervention. We conclude that each diagnostic model, when considered individually, exhibits a high degree of discriminatory performance. However, employing all these models concurrently for identifying personality correlates of PH proves impractical. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":74420,"journal":{"name":"Personality disorders","volume":"15 5","pages":"304-314"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141926","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}
Courtland S Hyatt, Nathaniel L Phillips, Chelsea E Sleep, Donald R Lynam, Joshua D Miller
{"title":"Graduate student perspectives on training and clinical experiences with antagonism treatment.","authors":"Courtland S Hyatt, Nathaniel L Phillips, Chelsea E Sleep, Donald R Lynam, Joshua D Miller","doi":"10.1037/per0000688","DOIUrl":"https://doi.org/10.1037/per0000688","url":null,"abstract":"<p><p>The objective of this preregistered study was to gather evidence on training and clinical experiences offered by clinical psychology doctoral programs on the treatment of antagonism-a construct from the personality and psychopathology literature that captures individual differences in aggressiveness, callousness, grandiosity, domineering, and manipulativeness. We surveyed current graduate students (<i>N</i> = 376) in APA-accredited clinical psychology doctoral programs (<i>M</i><sub>age</sub> = 28.4; 83.2% female; 65.2% White) about their experiences in training and treatment of antagonistic patients (ANT-patients) as well as experiences with patients with predominant negative affect (NA; e.g., anxious and depressed). Students reported significantly less training to treat antagonism compared to NA (|<i>ds</i>| = 0.43-2.88), as well as lower rates of direct clinical experience, generally poorer treatment experiences, and stronger countertransference reactions (|<i>ds</i>| = 0.53-1.40). These discrepancies were especially large for adult-focused students compared to child/adolescent-focused students. In fact, adult-focused students reported a mean competency rating of <i>M</i> = 1.71, between the scalar points <i>not competent at all</i> (1) and <i>a little bit competent</i> (2). Overall, these results indicate a lack of training and competence to treat antagonism among current graduate students, especially adult-focused students. We believe the crux of this issue is a field-wide lack of robust empirical work on antagonism treatments (for adults). Moving forward, we implore researchers and funding agencies to help address this substantial gap, which is both an ethical and practical imperative. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":74420,"journal":{"name":"Personality disorders","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989706","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}
William Hart, Braden T Hall, Joshua T Lambert, Charlotte K Cease, Danielle E Wahlers
{"title":"Antagonistic but holier than thou: Antagonistic people think they are (way) better-than-average on moral character.","authors":"William Hart, Braden T Hall, Joshua T Lambert, Charlotte K Cease, Danielle E Wahlers","doi":"10.1037/per0000685","DOIUrl":"https://doi.org/10.1037/per0000685","url":null,"abstract":"<p><p>Although clinical psychologists have long speculated that antagonistic individuals may lack insight into their moral deficits, some evidence has shown that more (vs. less) antagonistic people view moral traits as somewhat desirable and rate themselves as lower on moral characteristics (suggestive of some insight). But, we suggest that antagonistic people's struggles with insight can be detected as part of a basic social-cognitive bias that entails believing the self is better-than-average on socially desirable characteristics (i.e., the \"better-than-average effect\" [BTAE]). Specifically, although antagonistic people may rate themselves lower on moral characteristics than less antagonistic people, they may still believe that their relative standing on moral characteristics compares favorably to others. Participants (<i>N</i> = 515) completed indicators of the Dark Tetrad (D4) constructs (narcissism, Machiavellianism, psychopathy, and sadism) and rated themselves in relation to others on moral and immoral character traits. Overall, participants exhibited very large BTAEs (i.e., rated the self as \"better-than-average\" on moral character traits); only psychopathy and sadism consistently related negatively to BTAEs, but people with elevations in each D4 construct (or any D4 facet) still exhibited large-to-very-large BTAEs. Such antagonistic participants viewed themselves as possessing substantially greater amounts of moral than immoral character traits but viewed average others as possessing an equal mix of these traits. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":74420,"journal":{"name":"Personality disorders","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141790201","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}
Personality disordersPub Date : 2024-07-01Epub Date: 2024-05-16DOI: 10.1037/per0000664
Jessica R Atkinson, Kolbrun H Kristinsdottir, Tennyson Lee, Mark C Freestone
{"title":"Comparing the symptom presentation similarities and differences of complex posttraumatic stress disorder and borderline personality disorder: A systematic review.","authors":"Jessica R Atkinson, Kolbrun H Kristinsdottir, Tennyson Lee, Mark C Freestone","doi":"10.1037/per0000664","DOIUrl":"10.1037/per0000664","url":null,"abstract":"<p><p>Complex posttraumatic stress disorder (CPTSD) is characterized in the <i>International Classification of Diseases-11</i> by affect dysregulation, negative self-concept, and relationship impairments, symptoms also presented in borderline personality disorder (BPD). Some research shows CPTSD as a distinct disorder, others as a subgroup or a replacement for BPD. No review currently amalgamates the findings on whether CPTSD presents too similarly to BPD to be a standalone disorder. This article systematically reviewed similarities and differences in symptom presentations of the two disorders. Six databases were searched (PsycINFO, EMBASE, PubMed, Web of Science, PsycEXTRA, and Open Access Theses and Dissertations) and identified papers were summarized narratively. The majority of studies found distinct profiles for CPTSD and BPD. One study found no differences between the constructs; however, this used a population without severe trauma. CPTSD and BPD can present comorbidly, these individuals will have likely experienced earlier and more frequent interpersonal trauma and display greater functional impairment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":74420,"journal":{"name":"Personality disorders","volume":" ","pages":"241-253"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946662","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}
Personality disordersPub Date : 2024-07-01Epub Date: 2024-05-02DOI: 10.1037/per0000665
Alyssa A Di Bartolomeo, Ashley Siegel, Lindsay Fulham, Skye Fitzpatrick
{"title":"Borderline personality disorder and social connectedness: A systematic review.","authors":"Alyssa A Di Bartolomeo, Ashley Siegel, Lindsay Fulham, Skye Fitzpatrick","doi":"10.1037/per0000665","DOIUrl":"10.1037/per0000665","url":null,"abstract":"<p><p>Borderline personality disorder (BPD) is a debilitating disorder characterized by deficits in social connectedness, which is a multifaceted construct with structural (i.e., the number, diversity, or frequency of social relationships), functional (i.e., the actual or perceived resources relationships provide), and quality (i.e., the positive and negative aspects of social relationships) elements (Holt-Lunstad, 2018). However, the literature is sparse and lacks integration regarding which specific elements of social connectedness are deficient in BPD and why. This systematic review synthesized the literature on the bidirectional relationship of social connectedness and BPD. Electronic searches of three databases (i.e., PsycInfo, PsycArticles, and PubMed) identified 1,962 articles which underwent title and abstract screening and, if potentially eligible, full-text review. Sixty two articles met the eligibility criteria and underwent data extraction and risk of bias assessment. Cross-sectional research supported associations between BPD and problems in structural, functional, and quality social connectedness, with most research underscoring deficits in quality social connectedness. Preliminary longitudinal research suggested that BPD pathology predicts problems across these domains, but little to no research exists testing the reverse direction. Although people with BPD may not have difficulties forming relationships, they exhibit a range of problems within those relationships. BPD may elicit such problems in social connectedness, but it is unclear whether such issues reciprocally exacerbate and elicit BPD, and longitudinal research investigating such directionality is needed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":74420,"journal":{"name":"Personality disorders","volume":" ","pages":"213-225"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140857597","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":"Associations between borderline personality disorder symptoms and personality functioning in adolescents: A brief report.","authors":"Sofie Diondet, Laura C Weekers, Joost Hutsebaut","doi":"10.1037/per0000671","DOIUrl":"10.1037/per0000671","url":null,"abstract":"<p><p>Borderline personality disorder (BPD) is a serious mental disorder, which has been linked to a number of negative outcomes in adolescents and adults. BPD is generally linked to more severe impairments in personality functioning. The (differential) association of specific BPD symptoms with severity level, however, has not been explored yet. The present study explores the relationship between all nine BPD symptoms and impairments in personality functioning in adolescents using a cross-sectional design. A total of 116 treatment-seeking adolescents were administered semistructured interviews for <i>DSM-IV</i> Axis I and Axis II disorders and the semistructured interview for personality functioning <i>DSM-5</i> (STiP-5.1). Furthermore, the potential association of symptom disorders, and more specifically mood disorders, with level of personality functioning was assessed. Together, the nine BPD criteria were significantly related to STiP-5.1 total score, even when controlling for the presence of a mood disorder. However, when taking the effect of number of symptom disorders and the other BPD symptoms into account, only the presence of recurrent self-harm and/or suicidal behavior and intense anger, were associated with a higher level of impairment in personality functioning. These findings emphasize the diagnostic importance of repeated self-harm and suicidality and provide additional evidence for the value of using BPD criteria to easily identify teenagers at risk. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":74420,"journal":{"name":"Personality disorders","volume":"15 4","pages":"264-268"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592328","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}