Personality disorders最新文献

{"title":"\"I am ashamed that I exist. I feel like apologizing for existing\": The phenomenology of shame in patients with borderline personality disorder: A qualitative study.","authors":"Carsten R Jørgensen, Rikke Bøye","doi":"10.1037/per0000655","DOIUrl":"10.1037/per0000655","url":null,"abstract":"<p><p>Shame is an essential affect in many patients with borderline personality disorder (BPD) and can be associated with most of the BPD diagnostic criteria. Severe shame is a highly aversive emotion with concomitant beliefs about the self as deeply inferior, insignificant, disgusting, and unloved. Shame and how it is manifested in the subjective experience and behavior in people diagnosed with BPD is remarkably under-researched, and our knowledge of the phenomenology of shame in BPD needs to be improved. Severe shame is often less accessible and available to conscious awareness, making it difficult to access via questionnaires and self-report measures. Therefore, this study is based on semi-structured interviews with 21 women Structural clinical interview for <i>DSM-5</i> disorders' diagnosed with BPD. All interviews were analyzed using the interpretive phenomenological approach. Based on the analysis, the participants' descriptions of how severe shame manifests itself in their subjective experience and behavior are classified into 10 themes: the self is deeply flawed and unlovable; self-hatred/self-contempt; eye contact is awkward and shameful; shameful over being mentally ill; shameful identity diffusion; hiding behind façade/social roles; pleasing others/performing to avoid shame; self-destructive behavior to mitigate shame; sex associated with shame; and shame during the therapy session. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":74420,"journal":{"name":"Personality disorders","volume":" ","pages":"181-192"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139708766","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 relationship between bullying victimization and impairment in personality functioning in a clinical adolescent sample.","authors":"Nora Seiffert, Marialuisa Cavelti, Stefanie J Schmidt, Elvira Fritz, Stefan Lerch, Corinna Reichl, Julian Koenig, Ines Mürner-Lavanchy, Michael Kaess","doi":"10.1037/per0000652","DOIUrl":"10.1037/per0000652","url":null,"abstract":"<p><p>Problematic interpersonal relationships may represent both, a risk factor for the development or trigger of personality disorder (PD) symptoms and its consequences. Since peer relationships become more and more important in adolescence, the current study explores the cross-sectional association between recent bullying experiences and levels of impairment in personality functioning according to the <i>Diagnostic and Statistical Manual of Mental Disorders</i> (5th ed.) alternative model of personality disorders (AMPD; Criterion A) in help-seeking adolescents (<i>N</i> = 493). Logistic and multiple regression analyses revealed that patients who were frequently bullied in the past 3 months (i.e., at least once a week) were more likely to reach the diagnostic threshold for PD according to the AMPD (<i>OR</i> = 1.71, <i>p</i> = .025) and showed higher levels of impairment in identity (β = .41, <i>p</i> < .001), empathy (β = .26, <i>p</i> = .002), and intimacy (β = .30, <i>p</i> = .001), but not self-direction, compared to patients who did not report any bullying experiences. Occasional bullying in the past 3 months (i.e., every few weeks) was neither associated with a greater likelihood to reach the diagnostic threshold for PD nor with greater impairments in identity, self-direction, empathy, or intimacy compared to no bullying. While the current study provides support for a correlation between bullying experiences and personality dysfunction (particularly in the elements identity and intimacy), longitudinal research is needed to clarify whether experiences of bullying cause or trigger personality dysfunction or/and vice versa. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":74420,"journal":{"name":"Personality disorders","volume":" ","pages":"173-180"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140178141","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":"Disinhibited attachment behavior among infants reared at home: Relations to maternal severe mental illness and personality disorder symptoms.","authors":"Sofie Stender, Kirstine A Davidsen, Karlen Lyons-Ruth, Susanne Harder","doi":"10.1037/per0000653","DOIUrl":"10.1037/per0000653","url":null,"abstract":"<p><p>Disinhibited attachment behavior (DAB) among infants is persistent and associated with behavioral and relational problems throughout childhood and adolescence. Little is known about risk factors for DAB among infants reared at home, although studies have linked DAB with maternal psychiatric hospitalization and maternal borderline personality disorder. The aim of the current study was to further assess the association between DAB, maternal severe mental illness (SMI; schizophrenia, bipolar disorder, and depression), and maternal PD symptoms. Ninety-three mothers and their infants participated in the study: 46.2% with SMI and 53.8% with no-diagnosis. During pregnancy, mothers were assessed on the Structured Clinical Interview for <i>DSM-5</i> and the Standardized Assessment of Personality Abbreviated Scale a validated measure of personality disorder (PD) symptoms. Infants were assessed for DAB at 1 year of age using the rating of infant stranger engagement, assessed during the strange situation procedure. Infants of mothers with clinical levels of PD symptoms were significantly more likely to display DAB (<i>OR</i> = 3.44) compared to infants of mothers without clinical levels of PD symptoms. Maternal SMI was not significantly associated with infant DAB. Because most mothers with clinical levels of PD symptoms also had comorbid diagnoses in this study, further work is needed to evaluate the role of comorbidity. These results add to the emerging literature indicating that maternal personality symptoms may be a risk factor for indiscriminate forms of attachment behavior among home-reared infants. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":74420,"journal":{"name":"Personality disorders","volume":" ","pages":"207-212"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139708767","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":"Ripples in the water: Fluctuations of narcissistic states in daily life.","authors":"Vanessa Lea Freund, Gudrun Vera Eisele, Frenk Peeters, Jill Lobbestael","doi":"10.1037/per0000650","DOIUrl":"10.1037/per0000650","url":null,"abstract":"<p><p>Narcissistic traits are traditionally viewed as consistent similar to the mirrorlike self-reflection of Narcissus in the water. However, evidence suggests that state levels of narcissism are more dynamic than previously believed. The current research explored fluctuations within and between grandiose and vulnerable narcissism in daily life. We investigated whether individuals' levels of grandiosity and vulnerability (a) vary, (b) are instable, and (c) display inertia and cross-lagged effects in their daily narcissistic expressions. Participants (<i>N</i> = 253; <i>M</i>_age = 22, 85% female) completed grandiose and vulnerable narcissistic trait questionnaires. Using ecological momentary assessment, they further completed up to 60 grandiose and vulnerable narcissistic state questionnaires over 6 days. The results showed that higher grandiose and vulnerable narcissistic traits led to more within-person variability within their corresponding states. Additionally, higher grandiose leadership/authority traits related to greater vulnerable within-person variability, while grandiose self-absorption/self-admiration reduced this. Similarly, all narcissistic traits, except for exploitativeness/entitlement and egocentrism, were positively related to increased instability in their corresponding state. Further, both grandiose and vulnerable narcissistic states demonstrated significant inertia, that is, lingering narcissistic endorsements within their own states. Overall, though the effect sizes were limited, the results showed that grandiosity and vulnerability include time-variant states that are intertwined and need to be acknowledged as additional moving, dimensional constructs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":74420,"journal":{"name":"Personality disorders","volume":" ","pages":"193-206"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139708768","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":"Predicting nonsuicidal self-injury and suicidal risk: A comparison between the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Section II personality disorder and alternative model of personality disorders dimensions.","authors":"A. Somma, Giulia Gialdi, Robert F. Krueger, K. Markon, A. Fossati","doi":"10.1037/per0000658","DOIUrl":"https://doi.org/10.1037/per0000658","url":null,"abstract":"The clinical relevance of nonsuicidal self-injury (NSSI) has received growing recognition, and NSSI represents a relevant risk factor for suicide. The present study aimed at running a head-to-head comparison between interview scores of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Section II personality disorders (PDs) criteria, and DSM-5 Alternative Model of Personality Disorder (AMPD) Criterion A and Criterion B measures in providing significant and relevant information for understanding NSSI and suicidal ideation and behavior among psychotherapy participants. To this aim, a clinical sample of 103 adult participants was administered the Clinician-Administered Nonsuicidal Self-Injury Disorder Index (CANDI), the Columbia Suicide Severity Rating Scale (C-SSRS), as well as the Structured Clinical Interview for DSM-5 Personality Disorders, the Structured Clinical Interview for the DSM-5 Alternative Model for Personality Disorders Module I, and a self-report measure of dysfunctional personality traits (i.e., the Personality Inventory for DSM-5 [PID-5]). Logistic ordinal regression dominance analysis results showed that, when compared to the 10 DSM-5 Section II PD symptom counts, the DSM-5 Section III PD measure scores provided the same amount of information in the CANDI Global Severity Index scores (Nagelkerke pseudo-R² value = .41), and a markedly larger information quantity in the case of the C-SSRS Suicidal Ideation (+35.1%), and Suicidal Behavior Index (+35.9%) levels. As a whole, our data suggested the clinical usefulness of the DSM-5 AMPD in understanding NSSI and suicidal ideation and behavior. (PsycInfo Database Record (c) 2024 APA, all rights reserved).","PeriodicalId":74420,"journal":{"name":"Personality disorders","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140714734","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":"Changes in mentalization in patients with personality disorders during sequential brief-Adlerian psychodynamic psychotherapy: The role of therapists' technique and countertransference.","authors":"Andrea Ferrero, Giulia Gagliardini, Barbara Simonelli, Simona Fassina, Silvana Lerda, Salvatore Gullo, A. Colli","doi":"10.1037/per0000659","DOIUrl":"https://doi.org/10.1037/per0000659","url":null,"abstract":"Mentalization, that is the capacity to understand our and others' behaviors in terms of intentional mental states, represents one of the core features of personality disorders (PDs) and can be related to therapists' countertransference (CT) and interventions.\u0000\u0000\u0000AIMS\u0000The aim of the present work was to study the relationship between therapists' technique, therapists' CT, and patients' mentalization, in a sample of patients with PDs undergoing a 40-session program of sequential brief-adlerian psychodynamic psychotherapy, a psychodynamic therapeutic model specifically developed for the treatment of PDs in public mental health services.\u0000\u0000\u0000METHOD\u0000Eighty-seven patients with PD and their therapists completed ratings of mentalization (mentalization imbalances scale and reflective functioning questionnaire), CT (therapist response questionnaire), and therapists' intervention (comparative psychotherapy process scale) at five different time points (Sessions 5, 10, 20, 30, and 40).\u0000\u0000\u0000RESULTS\u0000Results showed that patients' mentalizing problematics decreased over time. Moreover, we found a reduction of therapists' disengaged CT, and an increase in positive CT over time. Regarding therapists' techniques, psychodynamic-interpersonal interventions were on average higher than cognitive-behavioral, but both techniques were used increasingly over time. Our results also showed significant and clinically coherent interactions between therapist's CT and techniques and between patient's mentalization imbalance and therapist's response. Our results highlighted the importance of early stages in therapy, since the most significant relationships between the various process variables (patient's mentalizing imbalances, therapist's techniques, and emotional responses) are observed between t₁ and t₂, corresponding to the initial phases of the treatments. Clinical implications will be discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).","PeriodicalId":74420,"journal":{"name":"Personality disorders","volume":"13 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140743450","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":"Identity pathology and mentalization deficits: An attempt to support clinical theory with data.","authors":"Alexandra L Vizgaitis, Mark F Lenzenweger","doi":"10.1037/per0000654","DOIUrl":"10.1037/per0000654","url":null,"abstract":"<p><p>An extensive theoretical literature links identity pathology with deficits in mentalization, which is the ability to understand the internal mental states of self and others. However, only a few investigations have attempted to bridge theory and data by empirically testing the relation between mentalization and identity pathology, and none have done so with mentalization measured using a laboratory task. The current study investigated the association between mentalization deficits and identity pathology in a large, nonclinical sample. Participants (<i>N</i> = 305) completed a self-report measure assessing identity pathology and a laboratory task assessing mentalization ability. Whereas the existing theoretical literature would argue for a robust association between identity pathology and mentalization impairment, our results revealed essentially no association between identity pathology and mentalization impairment. Moreover, we found essentially no association between identity pathology and any of a number of specific mentalization deficits in our sample. Our findings failed to provide empirical support for the clinical and theoretical literature linking mentalization and identity pathology. Given our adequate statistical power to detect even relatively small associations, we offer these findings to advance theoretical and methodological discussion in this important area. We discuss the implications of these null findings, particularly attuned to the possibility that a link between mentalization impairment and identity pathology may be more complicated than hypothesized. We also consider that these results might be related to methodological features of our study (e.g., self-report and laboratory measures; the range of mentalization impairment in our sample). (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":74420,"journal":{"name":"Personality disorders","volume":" ","pages":"128-133"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139486766","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":"Clinician-rated ICD-11 trait domains and personality disorder types.","authors":"Bastian Lambrecht, Jonatan Simon, Bo Bach","doi":"10.1037/per0000646","DOIUrl":"10.1037/per0000646","url":null,"abstract":"<p><p>The <i>International Classification of Diseases</i> (11th edition; <i>ICD-11</i>) has adopted a classification of personality disorders (PDs) that abolishes the established <i>International Classification of Diseases</i> (10th edition; <i>ICD-10</i>) PD types in favor of global severity and stylistic trait domain specifiers. The goal of the current study was to describe the empirical relationship between traditional PD types and the <i>ICD-11</i> trait domains, which is anticipated to inform and guide clinicians in this profound transition. A total of 246 patients were rated by their clinicians. The Informant-Personality Inventory for <i>ICD-11</i> was used to rate <i>ICD-11</i> trait domains while PD types were assigned categorically according to <i>ICD-10</i>. Empirical associations were investigated by means of bivariate correlation and logistic regression analyses with bootstrapping. Results overall showed expected and conceptually meaningful associations between <i>ICD-11</i> trait domains and categorical <i>ICD-10</i> PD types, with only a few unexpected deviations. Findings suggest that <i>ICD-11</i> trait domains capture stylistic features of the established PD types in a conceptually coherent manner. These findings may facilitate continuity and guide translation between categorical PD types (i.e., <i>ICD-10</i> and <i>Diagnostic and Statistical Manual of Mental Disorders</i> [fifth edition]) and the new <i>ICD-11</i> classification in mental health care. Future research should seek to replicate these findings in various clinical settings while also integrating the essential PD severity classification. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":74420,"journal":{"name":"Personality disorders","volume":" ","pages":"122-127"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92158055","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 role of mindfulness and emotion regulation in dialectical behavioral therapy for borderline personality disorder.","authors":"Philippa Hood, Michael Maraun, Shelley F McMain, Janice R Kuo, Alexander L Chapman","doi":"10.1037/per0000640","DOIUrl":"10.1037/per0000640","url":null,"abstract":"<p><p>Despite nearly 30 years of research demonstrating its effectiveness in the treatment of borderline personality disorder (BPD) and related problems, few studies have investigated mechanisms of change for dialectical behavior therapy (DBT; Linehan, 1993a). Improvements in mindfulness and emotion regulation have been highlighted as key potential mechanisms of change in DBT (Lynch et al., 2006). The present study examined the time course of and associations between mindfulness, emotion regulation, and BPD symptoms during DBT. Participants were 240 repeatedly and recently self-harming adults (<i>M</i>_age = 27.75) with BPD who were randomly assigned to receive either 6 or 12 months of standard DBT. Primary hypotheses were that: (a) changes in mindfulness would occur before changes in emotion regulation, and (b) changes in emotion regulation would mediate the association of changes in mindfulness with changes in BPD symptoms. Results from changepoint analysis illuminated the proportion of participants for whom first changes occurred in emotion regulation (40.7%), mindfulness (32.4%), or both (26.9%). Contrary to hypotheses, five-wave, cross-lagged analyses did not indicate mediational effects of either mindfulness or emotion regulation on the association of either variable with change in BPD symptoms. Supplemental analyses, however, suggested that changes in emotion regulation mediated the inverse association of changes in mindfulness with changes in BPD symptoms. Findings highlight patterns of change in key, proposed mechanisms of change in DBT and suggest important future research directions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":74420,"journal":{"name":"Personality disorders","volume":" ","pages":"134-145"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138500434","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":"Psychological and neural correlates of social affect and cognition in narcissism: A multimethod study of self-reported traits, experiential states, and behavioral and brain indicators.","authors":"Emanuel Jauk, Charlotte Blum, Malin Hildebrandt, Konrad Lehmann, Lara Maliske, Philipp Kanske","doi":"10.1037/per0000645","DOIUrl":"10.1037/per0000645","url":null,"abstract":"<p><p>\"Lack of empathy\" is a diagnostic criterion of narcissism, but the nature of interpersonal functioning in narcissism is still being debated. Both, empathy and narcissism, are multidimensional constructs, and their relation might depend upon contextual factors. We investigated social affect and cognition in narcissism spanning self-reported traits and experiential states (Ecological Momentary Assessment) as well as behavioral and brain indicators (task-related functional magnetic resonance imaging). <i>N</i> = 140 individuals were selected to cover the full dimensional range of grandiose and vulnerable narcissism, including their constituent self-regulatory dimensions of agentic, antagonistic, and neurotic narcissism. Grandiose narcissism was associated with lower social affect at almost all analysis levels. The associations can be attributed to antagonistic self-regulatory dynamics, and are associated with lower brain activation during subjective experiencing of social affect in regions of the salience network. Social cognition was habitually lowered but not impaired in antagonistic narcissism. Our findings do not support a general \"lack of empathy.\" (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":74420,"journal":{"name":"Personality disorders","volume":" ","pages":"157-171"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138814029","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}