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"Personality Problems"
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Genetic and environmental influences on conduct and antisocial personality problems in childhood, adolescence, and adulthood
Conduct problems in children and adolescents can predict antisocial personality disorder and related problems, such as crime and conviction. We sought an explanation for such predictions by performing a genetic longitudinal analysis. We estimated the effects of genetic, shared environmental, and unique environmental factors on variation in conduct problems measured at childhood and adolescence and antisocial personality problems measured at adulthood and on the covariation across ages. We also tested whether these estimates differed by sex. Longitudinal data were collected in the Netherlands Twin Register over a period of 27 years. Age appropriate and comparable measures of conduct and antisocial personality problems, assessed with the Achenbach System of Empirically Based Assessment, were available for 9783 9–10-year-old, 6839 13–18-year-old, and 7909 19–65-year-old twin pairs, respectively; 5114 twins have two or more assessments. At all ages, men scored higher than women. There were no sex differences in the estimates of the genetic and environmental influences. During childhood, genetic and environmental factors shared by children in families explained 43 and 44% of the variance of conduct problems, with the remaining variance due to unique environment. During adolescence and adulthood, genetic and unique environmental factors equally explained the variation. Longitudinal correlations across age varied between 0.20 and 0.38 and were mainly due to stable genetic factors. We conclude that shared environment is mainly of importance during childhood, while genetic factors contribute to variation in conduct and antisocial personality problems at all ages, and also underlie its stability over age.
Journal Article
Epistemic Petrification and the Restoration of Epistemic Trust: A New Conceptualization of Borderline Personality Disorder and Its Psychosocial Treatment
A new developmental model of borderline personality disorder (BPD) and its treatment is advanced based on evolutionary considerations concerning the role of attachment, mentalizing, and epistemic trust in the development of psychopathology. We propose that vulnerability to psychopathology in general is related to impairments in epistemic trust, leading to disruptions in the process of salutogenesis, the positive effects associated with the capacity to benefit from the social environment. BPD is perhaps the disorder par excellence that illustrates this view. We argue that this conceptualization makes sense of the presence of both marked rigidity and instability in BPD, and has far-reaching implications for intervention.
Journal Article
Characteristics of Borderline Personality Disorder in a Community Sample: Comorbidity, Treatment Utilization, and General Functioning
This study provides estimates of the prevalence and demographic features of borderline personality disorder (BPD) in a community sample as well as BPD comorbidity rates with Axis I and II disorders. In addition, the authors provide data on general functioning and treatment seeking among individuals with BPD. Data from 34,481 participants in the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were analyzed. Results suggest that 2.7% of adults in the United States meet diagnostic criteria for BPD, with slightly higher rates of the disorder in females, people in lower income brackets, people younger than 30, and individuals who are separated or divorced. Racial/ethnic differences were evident, with Native Americans (5.0%) and Blacks (3.5%) having significantly higher rates of the disorder, on average, and Asians having significantly lower rates (1.2%). Individuals with a BPD diagnosis were likely to have co-occurring lifetime mood disorders, anxiety disorders, substance use disorders, and other personality disorders. Specifically, 84.8% of individuals with BPD also had a lifetime anxiety disorder, 82.7% had a lifetime mood disorder/episode, and 78.2% were diagnosed with a lifetime substance use disorder. Individuals with BPD showed significant impairment in functioning and were highly likely to seek therapy or receive medication for mental health concerns.
Journal Article
Thinking Structurally About Narcissism: An Examination of the Five-Factor Narcissism Inventory and Its Components
The Five-Factor Narcissism Inventory (FFNI) is a self-report measure of the traits linked to grandiose and vulnerable narcissism, as well as narcissistic personality disorder (NPD), from a five-factor model perspective (FFM). In the current studies, the factor structure of the FFNI was explored and the results supported the extraction of three factors: Antagonism (e.g., Arrogance), Neuroticism (e.g., Need for Admiration), and Agentic Extraversion (e.g., Authoritativeness). In Study 2, the FFNI factors manifested convergent validity with their corresponding Big Five domains and diverging relations with measures of grandiose and vulnerable narcissism, NPD, and self-esteem. Ultimately, the FFNI factors help explicate the differences between various expressions of narcissism such that all are related to Antagonism but differ with regard to Neuroticism (relevant to vulnerable narcissism and NPD) and Agentic Extraversion (relevant to grandiose narcissism and NPD). The results also highlight the complex relation between self-esteem and the traits that comprise narcissism measures.
Journal Article
The Challenge of Transforming the Diagnostic System of Personality Disorders
While the DSM-5 alternative model of personality disorder (PD) diagnosis allows the field to systematically compare categorical and dimensional classifications, the ICD-11 proposal suggests a radical change by restricting the classification of PDs to one category, deleting all specific types, basing clinical service provision exclusively upon a severity dimension, and restricting trait domains to secondary qualifiers without defining cutoff points. This article reflects broad international agreement about the state of PD diagnosis. It is argued that diagnosis according to the ICD-11 proposal is based on broad, potentially stigmatizing descriptions of impaired functioning and ignores much of the impressive body of research and treatment guidelines that have advanced the care of adults and adolescents with borderline and other PDs. Before radically changing classification, which highly impacts the provision of health care, head-to-head field trials coupled with the views of patients as well as thorough debate among scientists are urgently needed.
Journal Article
Integrating Alternative Conceptions of Psychopathic Personality: A Latent Variable Model of Triarchic Psychopathy Constructs
This study undertook confirmatory factor analyses (CFAs) of data from 567 participants to quantify constructs specified by the triarchic model of psychopathy (Patrick, Fowles, & Krueger, 2009)-boldness, meanness, and disinhibition-as latent variables. Indicators for the CFAs consisted of subscales of the Triarchic Psychopathy Measure along with triarchic scales derived from items of the Psychopathic Personality Inventory, Youth Psychopathic Traits Inventory, and Multidimensional Personality Questionnaire. A modified three-factor model provided good fit to the data and outperformed alternative two- and one-factor models. Multiple-group CFAs demonstrated gender differences (male > female) in factor means and covariances, but not in factor loadings or intercepts. These findings support the idea that the triarchic model dimensions are embedded in differing models and measures of psychopathy and comprise essential building blocks for this clinical condition. Implications for understanding the structure of psychopathy, gender differences in psychopathic traits, and applications of latent variable modeling in future research are discussed.
Journal Article
Suicidality and Personality Pathology in Adolescence: A Systematic Review
This work presents a review of research papers examining the role of emerging personality pathology in suicidal ideation and behaviours in adolescence. Initially, 226 studies were selected in line with PRISMA guidelines, and 33 articles were finally included in this review. The data show percentages of any personality disorder diagnosis ranging from 19.5 to 22.8% in suicide attempters, while in autopsy studies, the rate of personality disorder diagnosis varied between 29.6 and 42.1%. The overwhelming majority of the studies focus on the role of borderline personality disorder (BPD) in suicidal behaviours, also highlighting its predictive role at a longitudinal level. Furthermore, the literature review shows that personality traits supposed to underlie BPD, such as affective instability, impulsivity and identity diffusion, have specific predictive links with suicidal conduct. Other personality pathology dimensions, such as aggressiveness, sadism and perfectionism that are associated with other personality disorders, namely, antisocial and narcissistic personality disorders, have also shown a significant mediating role for suicidal risk. Overall, these results seem to parallel the role of personality pathology in predicting suicide in adulthood and point to the relevance of assessing the presence of emerging patterns of personality disorders for the clinical management of suicidal risk in adolescence.
Journal Article
Psychopathic Personality in the General Population: Differences and Similarities Across Gender
This study aimed to identify distinct subgroups of adults in a general population sample (N = 2,500; 52.6% females) based on their scores on three psychopathy dimensions. Using latent profile analysis, five groups were identified among males and females separately, including a psychopathic personality group. Multivariate analyses of variance showed that this latter group had higher levels of aggression, offending, substance use, attention-deficit/hyperactivity symptoms, internalizing problems, and maltreatment than most of the other groups. Associated features of males and females with a psychopathic personality were very similar; however, salient gender differences did emerge. Specifically, females with a psychopathic personality were more frequently exposed to sexual abuse, expressed more emotional difficulties, and engaged in higher levels of relational aggression. In conclusion, person-oriented analyses identified adults with a personality that looks like psychopathy, and furthered our understanding of gender similarities and differences in these adults.
Journal Article