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Journal of Clinical Psychology Jun 2024Personality disorders (PD) are based not just on maladaptive ideas about self and others, they also are grounded on embodied patterns of behaviors and reactions to...
Personality disorders (PD) are based not just on maladaptive ideas about self and others, they also are grounded on embodied patterns of behaviors and reactions to interpersonal stressors. There is growing interest in working with the body and through the body so to address automatisms that lead to suffering and dysfunctional social action. In this issue of the Journal of Clinical Psychology: In-Session the use of art and psychomotor therapies for these patients was explored by seven different clinical perspectives. Patients described presented with different PD and associated symptoms. The arts and psychomotor therapies deployed in personality disorder treatment are: (visual) art therapy, music therapy, drama therapy, dance (movement) therapy, and psychomotor therapy making psychotherapeutic use of the different modalities: art, music, play, role-play, performance, improvisation, dance, body awareness and movement. Interventions provide kinesthetic, sensory, perceptual, and symbolic opportunities to invite alternative modes of meaning-making, accessing own needs and wishes, and communicating them to others. In this commentary we summarize some of the different topics covered by the clinical-based papers, including working mechanisms of arts and psychomotor therapies, the importance of bottom-up emotion regulation processes, how to treat trauma in the presence of a PD, how to integrate art and psychomotor therapies in a fine-grained formulation and how to understand the process of change. Although there is a need for more empirical research, we hope this issue makes a solid case that clinicians can effectively include art and psychomotor therapies when treating the full range of PD.
PubMed: 38941072
DOI: 10.1002/jclp.23730 -
Journal of Psychiatric and Mental... Jun 2024
Review
'Throw me a life buoy, please': A systematic review and thematic synthesis of qualitative evidence regarding nurses' experiences of caring for inpatients with borderline personality disorder and/or non-suicidal self-injury.
PubMed: 38940193
DOI: 10.1111/jpm.13077 -
Case Reports in Psychiatry 2024This case report examines the unexpected increase in suicidal ideation following ketamine infusion therapy in a 75-year-old female with a history of treatment-resistant...
This case report examines the unexpected increase in suicidal ideation following ketamine infusion therapy in a 75-year-old female with a history of treatment-resistant depression. Despite ketamine's established efficacy in treating depression and acute suicidality, this patient's condition deteriorated posttreatment. The report delves into the patient's complex background, including psychosocial stressors, genetic predisposition to depression, and a history of personality traits that may have influenced her response to ketamine. This case underscores the importance of cautious administration of ketamine, especially in patients with personality disorders, and calls for deeper understanding and individualized treatment plans in mental health care. It is a reminder of the complexities involved in treating mental health conditions and the varying effects of treatments like ketamine on different individuals.
PubMed: 38939043
DOI: 10.1155/2024/2143372 -
PloS One 2024The Level of Personality Functioning Scale-Self-Report (LPFS-SR) operationalizes Criterion A of the DSM-5 Alternative Model for Personality Disorders. The current study...
The Level of Personality Functioning Scale-Self-Report (LPFS-SR) operationalizes Criterion A of the DSM-5 Alternative Model for Personality Disorders. The current study aimed 1) to examine the internal consistency of the Portuguese version of the LPFS-SR in a community sample and a clinical sample, 2) to compare non-clinical participants (N = 282, Mage = 48.01, SD = 10.87) with two samples of clinical participants, one composed of patients with a personality disorder diagnosis (PD sample, n = 40, Mage = 46.18, SD = 13.59) and the other of patients with other psychiatric diagnoses (OD sample, n = 148, Mage = 49.49, SD = 11.88), with respect to LPFS-SR dimensions and total score, 3) to examine the capacity of the LPFS-SR to discriminate between samples through the ROC curve analyses, and 4) to examine the factor structure of the Portuguese version of the LPFS-SR. The Portuguese version of the LPFS-SR revealed adequate internal consistency results, akin to the original data, in the community and clinical samples. The community sample differed significantly from both clinical samples in all the LPFS-SR dimensions and total score. The ROC curve analysis indicated an optimal cut-off for the total score of 272.00, corresponding to a sensitivity of 75% and a specificity of 89%, in the PD vs. community samples. The LPFS-SR total score discriminative capacity between the PD and OD samples was lower, albeit also significant (area-under-the-curve of .63; p = .027; 95% CI: .52-.74). The current study provided evidence of the LPFS-SR's unidimensionality in both community and clinical samples. Although this study has limitations, its findings contribute to a deeper understanding of the LPFS-SR construct, as well as to its cross-cultural validation.
Topics: Humans; Female; Male; Self Report; Middle Aged; Adult; Diagnostic and Statistical Manual of Mental Disorders; Personality Disorders; Portugal; Personality; Psychometrics; ROC Curve; Reproducibility of Results
PubMed: 38935649
DOI: 10.1371/journal.pone.0300706 -
Personality Disorders Jun 2024Despite substantial evidence in support of the alternative model for personality disorder (AMPD) that has accumulated over the last decade, a gap remains in terms of...
Prospective prediction of treatment outcomes in adolescents: A head-to-head comparison of alternative model for personality disorder versus borderline personality disorder.
Despite substantial evidence in support of the alternative model for personality disorder (AMPD) that has accumulated over the last decade, a gap remains in terms of head-to-head comparisons of the predictive power of Section II categorical diagnoses versus Section III AMPD diagnoses for clinical outcomes. The current study uses archival data from a naturalistic treatment outcome study in an adolescent psychiatric inpatient sample to compare the predictive power of the Section III AMPD (combined Criterion A and B assessment) versus Section II borderline personality disorder (BPD) in predicting treatment outcomes from admission to discharge. Outcomes in general psychiatric severity and emotion dysregulation were assessed in a sample of 59 adolescents (76.3% female, = 15.27, = 1.17) at admission and at discharge on average about a month later. Results showed that, on average, predictive power of both AMPD measures and BPD were relatively modest. However, the AMPD, operationalized through combined measures of identity diffusion and maladaptive traits, was a stronger predictor of reduction in general psychiatric severity than a measure of BPD. The findings of the study add to a growing body of literature pointing to the advantages of Section III AMPD over Section II categorical diagnosis for clinical utility in predicting treatment response. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
PubMed: 38934910
DOI: 10.1037/per0000675 -
Personality Disorders Jun 2024Reflecting the recent consensus that challenges in personality functioning often onsets in adolescence, and the move toward dimensional models of personality pathology...
Reflecting the recent consensus that challenges in personality functioning often onsets in adolescence, and the move toward dimensional models of personality pathology such as the level of personality functioning (LPF) of the alternative model for personality disorders, it is important to have validated measures that can assess LPF in young people. The Level of Personality Functioning Scale-Brief Form 2.0 (LPFS-BF 2.0) is the briefest measure of LPF and may be particularly well suited for assessing LPF in youth; however, it has yet to be formally validated in youth. Therefore, the current investigation evaluated the psychometric properties of the LPFS-BF 2.0 in adolescents drawn from a community sample of ethnically diverse North American youth ( = 194, age 12-18; 58% female). Factor structure, gender invariance, reliability, convergent validity, incremental validity, and criterion validity were evaluated. Results demonstrated support for the LPFS-BF 2.0's unidimensional factor structure, as well as high internal consistency. Configural, metric, and scalar measurement invariance was supported across male and female genders, as well as convergent validity. Relative to the Personality Inventory for the DSM-5 Brief Form and Levels of Personality Functioning Questionnaire 12-18, the LPFS-BF 2.0 demonstrated additional variance in predicting borderline personality features, and internalizing and externalizing problems. Study findings support the English version of the LPFS-BF 2.0 as a brief and psychometrically sound instrument for assessing LPF in youth and adolescents. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
PubMed: 38934909
DOI: 10.1037/per0000674 -
Personality Disorders Jun 2024We aimed to determine and compare the longitudinal predictive power of ) two models of personality disorder (PD) for multiple clinically relevant outcomes. A sample of...
Longitudinal prediction of psychosocial functioning outcomes: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Section-II personality disorders versus alternative model personality dysfunction and traits.
We aimed to determine and compare the longitudinal predictive power of ) two models of personality disorder (PD) for multiple clinically relevant outcomes. A sample of 600 community-dwelling adults-half recruited by calling randomly selected phone numbers and screening-in for high-risk for personality pathology and half in treatment for mental health problems-completed an extensive battery of self-report and interview measures of personality pathology, clinical symptoms, and psychosocial functioning. Of these, 503 returned for retesting on the same measures an average of 8 months later. We used Time 1 interview data to assess personality pathology, both the Section-II PDs and the alternative () model of personality disorder's (AMPD) Criterion A (impairment) and Criterion B (adaptive-to-maladaptive-range trait domains and facets). We used these measures to predict 20 Time 2 functioning outcomes. Both PD models significantly predicted functioning-outcome variance, albeit modestly-averaging 12.6% and 17.9% (Section-II diagnoses and criterion counts, respectively) and 15.2% and 23.2% (AMPD domains and facets, respectively). Each model significantly augmented the other in hierarchical regressions, but the AMPD domains (6.30%) and facets (8.62%) predicted more incremental variance than the Section-II diagnoses (3.74%) and criterion counts (3.31%), respectively. Borderline PD accounted for just over half of Section II's predictive power, whereas the AMPD's predictive power was more evenly distributed across components. We note the predictive advantages of dimensional models and articulate the theoretical and clinical advantages of the AMPD's separation of personality functioning impairment from how this is manifested in personality traits. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
PubMed: 38934908
DOI: 10.1037/per0000673 -
Zhurnal Nevrologii I Psikhiatrii Imeni... 2024To investigate the relationship between symptoms of trait anxiety, state anxiety and symptoms of insomnia and the degree of their influence on daytime functioning...
OBJECTIVE
To investigate the relationship between symptoms of trait anxiety, state anxiety and symptoms of insomnia and the degree of their influence on daytime functioning disorders in adolescent girls.
MATERIAL AND METHODS
The study included 50 healthy adolescent girls, senior school students, aged 15-17 years, selected as simple random sample. Insomnia symptoms and their impact on daytime functioning were assessed using the SLEEP-50 (S-50) questionnaire. Trait and state anxiety were assessed using the Spielberger questionnaire. The method of path analysis was used to identify significant associations.
RESULTS
There was a positive association of the severity of daytime functioning disorders with the severity of insomnia symptoms (β=0.45; <0.001) and the level of trait anxiety (β=0.34; =0.004). Trait anxiety was also a significant predictor of state anxiety (<0.001), with a direct relationship between these parameters (β=0.62). Positive covariation of insomnia symptoms severity and state anxiety was found (β=0.53; <0.001).
CONCLUSION
Improving sleep quality and daytime functioning in adolescents with insomnia symptoms should take into account personality characteristics. High levels of trait anxiety increase the negative effects of insomnia on the impaired daytime functioning.
Topics: Humans; Adolescent; Female; Sleep Initiation and Maintenance Disorders; Anxiety; Surveys and Questionnaires; Sleep Quality; Severity of Illness Index; Personality
PubMed: 38934668
DOI: 10.17116/jnevro202412405266 -
Journal of Personality Assessment Jun 2024The Alternative Model for Personality Disorders provides a dimensional framework for the conceptualization of personality disorders where Criterion A concerns the...
The Alternative Model for Personality Disorders provides a dimensional framework for the conceptualization of personality disorders where Criterion A concerns the assessment of one's level of personality functioning (LPF). This study examines the psychometric properties of the English translation of the Semi-Structured Interview for Personality Functioning (STiP-5.1) to validate this translation for the assessment of LPF in English-speaking populations; and examine whether this measure increments self-report measures of LPF and personality pathology in predicting general functioning. The sample consisted of 129 emerging adults between 18 and 25 years of age ( = 20.54, SD = 2.08) from a mixed college and clinical sample. Results support a unidimensional factor structure of the STiP-5.1, good internal consistency, and high inter-rater reliability. Construct validity was supported through associations of the STiP-5.1 with self-report measures of LPF and personality pathology. The STiP-5.1 incremented self-report measures of personality pathology in predicting functional impairment, though additional variance explained was modest. Finally, STiP-5.1 scores differentiated individuals who obtained a score at or above the clinical cutoff from those below on self-report measures of personality pathology and LPF with large effect sizes. Findings support the validity of the English translation of the STiP-5.1 for the assessment of LPF.
PubMed: 38934551
DOI: 10.1080/00223891.2024.2365325 -
Frontiers in Psychology 2024The Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSRQ) is a self-report tool widely used to assess individuals' level of reinforcement...
Exploratory and confirmatory factor analysis of the sensitivity to punishment and sensitivity to reward questionnaire-revised and its psychometric evaluation among Chinese person with substance use disorder.
The Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSRQ) is a self-report tool widely used to assess individuals' level of reinforcement sensitivity. Drug addiction is strongly associated with reinforcement sensitivity, but there is a lack of measurement tools to assess reinforcement sensitivity in drug users, necessitating the revision and application of the SPSRQ among drug users. This study recruited 819 drug users (mean age = 34.74; 56.41% female) from five compulsory rehabilitation centers in Hunan Province, China. The applicability of the SPSRQ among person with substance use disorder was assessed by conducting reliability analyses and validity analyses, with retesting performed by 127 individuals after 6 weeks. Exploratory factor analysis for the SPSRQ showed a stable two-factor structure in person with substance use disorder. Confirmatory factor analysis indicated acceptable goodness of fit indexes for the two-factor structure. The SPSRQ also demonstrated good reliability and convergent and discriminant validity evidence. The two-factor structure of the SPSRQ also demonstrated measurement invariance across gender. Further comparative analysis found that the degree of reward sensitivity was higher for males than for females. Generally, the SPSRQ has shown evidence of good reliability and validity in Chinese drug-dependent populations, and it is suitable for research and application with Chinese person with substance use disorder. These findings about the personality traits of people with substance use disorder provide a solid basis for further research.
PubMed: 38933588
DOI: 10.3389/fpsyg.2024.1351450