Decoding personality functioning: the impact of DSM-5 pathological traits mediated by emotion dysregulation and metacognition.

Background: Personality disorders (PDs) have long been studied in adulthood, with relatively limited attention to their developmental course during adolescence. Recent research, however, underscores the importance of early identification and intervention in youth, as personality pathology can be reliably detected in this period and is associated with significant functional impairments. Grounded in the DSM-5 Alternative Model for Personality Disorders (AMPD), the present study explores potential intrapsychic mechanisms linking maladaptive trait domains to global personality functioning in adolescents. Drawing on developmental theories that emphasize the role of self-regulatory and reflective capacities in personality development, we examined whether emotion dysregulation and metacognitive difficulties help explain the relationship between pathological traits and functioning.

Methods: A sample of 470 Iranian adolescents aged 14-17 years completed validated measures of personality traits, emotion regulation, metacognition, and personality functioning. Data were analyzed using Pearson correlation coefficient and mediation analysis.

Results: All trait domains except antagonism were significantly associated with poorer functioning. Mediation analyses suggested that both emotion dysregulation and metacognition partially accounted for these associations, particularly for negative affectivity, detachment, disinhibition, and psychoticism.

Conclusions: These findings support developmental models of personality by highlighting the interplay between emotion regulation and metacognition in shaping adolescent personality functioning. While the cross-sectional design and reliance on self-report measures limit causal interpretations, the study emphasizes the importance of incorporating emotion regulation and metacognitive processes into early assessments and interventions. Future research should employ longitudinal and multi-method approaches to further clarify the developmental pathways underlying personality pathology in adolescence.