scholarly journals Complementary approaches to the assessment of personality disorder

2000 ◽  
Vol 176 (5) ◽  
pp. 434-439 ◽  
Author(s):  
Jonathan Hill ◽  
Hazel Fudge ◽  
Richard Harrington ◽  
Andrew Pickles ◽  
Michael Rutter
Keyword(s):  
Personality Disorder ◽  
Personality Assessment ◽  
Social Role ◽  
Informant Agreement ◽  
Interpersonal Context ◽  
Personality Functioning ◽  
Adult Personality ◽  
Within Subjects ◽  
Functioning Assessment

BackgroundCurrent concepts and measures of personality disorder are in many respects unsatisfactory.AimsTo establish agreement between two contrasting measures of personality disorder, and to compare subject–informant agreement on each. To examine the extent to which trait abnormality can be separated from interpersonal and social role dysfunction.MethodFifty-six subjects and their closest informants were interviewed and rated independently. Personality functioning was assessed using a modified Personality Assessment Schedule (M–PAS), and the Adult Personality Functioning Assessment (APFA).ResultsSubject–informant agreement on the M–PAS was moderately good, and agreement between the M–PAS and the APFA, across and within subjects and informants, was comparable to that for the M–PAS. This was equally the case when M–PAS trait plus impairment scores and trait abnormality scores were used.ConclusionsThe M–PAS and the APFA are probably assessing similar constructs. Trait abnormalities occur predominantly in an interpersonal context and could be assessed within that context.

The Adult Personality Functioning Assessment (APFA): factors influencing agreement between subject and informant

1995 ◽  
Vol 25 (2) ◽  
pp. 263-275 ◽  
Author(s):  
J. Hill ◽  
H. Fudge ◽  
R. Harrington ◽  
A. Pickles ◽  
M. Rutter
Keyword(s):  
Social Role ◽  
Role Performance ◽  
Informant Agreement ◽  
Personality Functioning ◽  
Adult Personality ◽  
Factors Influencing ◽  
Moderate Agreement ◽  
Personality Dysfunction ◽  
Good Agreement ◽  
Functioning Assessment

SynopsisThe Adult Personality Functioning Assessment (APFA) provides ratings of interpersonal and social role performance in six domains over substantial periods of time. Ratings based on subject and informant accounts using the APFA were compared. There was good agreement for estimates of levels of dysfunction, and moderate agreement for type of dysfunction. An anticipated under-reporting of difficulties by subjects was not found. The extent of personality dysfunction was predictive of whether a close informant was available; however, closeness of informant was not consistently associated with subject–informant agreement.

Assessment of Personality Functioning in the Transition from Adolescent to Adult Life: Preliminary Findings

1996 ◽  
Vol 168 (1) ◽  
pp. 33-37 ◽  
Author(s):  
Mary Naughton ◽  
Audrey Oppenheim ◽  
Jonathan Hill
Keyword(s):  
Interrater Reliability ◽  
Social Role ◽  
Adult Life ◽  
Role Performance ◽  
High Agreement ◽  
Psychosocial Dysfunction ◽  
Personality Functioning ◽  
Adult Personality ◽  
The Relationship ◽  
Functioning Assessment

BackgroundThe Adolescent to Adult Personality Functioning Assessment (ADAPFA) a modification of the Adult Personality Functioning Assessment (APFA) is described. It may be used to assess specific and general social dysfunction in the transition from childhood to adult life.MethodTwo raters independently rated 38 audiotaped interviews to test the interrater reliability of the instrument. The relationship between dysfunction in specific domains and overall psychosocial dysfunction was examined.ResultsInterrater reliabilities for the total ADAPFA score and for the majority of the domains were high. Agreement on type of dysfunction and on categorical ratings indicating the presence of personality disorder were good.ConclusionThe ADAPFA is a useful measure of interpersonal and social role performance in the transition between adolescent and adult life.

scholarly journals Change in the Definition of Personality Disorder in Transition to ICD-11: A Look from Clinical and Developmental Perspectives

Psichologija ◽  
2021 ◽  
Vol 65 ◽  
pp. 8-21
Author(s):  
Rasa Barkauskienė ◽  
Elena Gaudiešiūtė ◽  
Gabrielė Skabeikytė
Keyword(s):  
Personality Disorder ◽  
Personality Assessment ◽  
Personality Pathology ◽  
Self Assessment ◽  
Personality Functioning ◽  
Fundamental Limitations ◽  
General Signs ◽  
Definition Of ◽  
Assessment Scales ◽  
Pathological Personality Traits

The recent body of research reveals fundamental limitations to the categorical concept of a personality disorder that has led researchers to adopt a new personality disorder concept. During the last decade DSM-5 and ICD-11 diagnostic classifications have accepted the dimensional view towards personality pathology. Despite the differences between the two classifications, the joint aspect of both models is the construct of Levels of personality functioning. The construct of personality functioning involves personality (dys)function in the self and interpersonal domains. This two-step conceptualization includes (a) impairments of self and interpersonal functioning, indicating general signs and severity of personality disorder, and (b) pathological personality traits, reflecting ‘stylistic’ differences in the expression of personality disorder. The new conceptualization of personality disorder reflects the innovative multi-theoretical integration of known, empirically-based personality assessment paradigms. The relationship between personality functioning and interpersonal, psychodynamic, and personological paradigms provides the theoretical integrity and empirically-based structure necessary to understand the overall severity of personality pathology. Many methods (interviews, self-assessment scales, and questionnaires) have already been developed for the assessment of personality functioning, and their development will be encouraged by the ICD-11 classification established in 2022. At present, only one instrument has been developed in Lithuania for assessing the level of personality functioning in young people aged 12–18 (Barkauskienė & Skabeikytė, 2020). The empirical data about the validity of this construct and its capability to differentiate between the normal and impaired personality in adults and adolescents provide promising results, but are still accumulating. Research suggests that adolescence is a stage in development when personality pathology can fully unfold and be validly confirmed, which opens up opportunities for early intervention. Although the dimensional personality disorder model needs to further prove its importance, there is already evidence that it is less stigmatizing and returns psychology and personality into the concept of a personality disorder. This review presents changes in the conceptualization of personality disorders by discussing them from both clinical and developmental perspectives and highlighting the results of key research in recent years.

Adult Personality Functioning Assessment (APFA)

1989 ◽  
Vol 155 (1) ◽  
pp. 24-35 ◽  
Author(s):  
J. Hill ◽  
R. Harrington ◽  
H. Fudge ◽  
M. Rutter ◽  
A. Pickles
Keyword(s):  
Intraclass Correlation ◽  
Social Dysfunction ◽  
Social Contacts ◽  
Rater Reliability ◽  
Love Relationships ◽  
Personality Functioning ◽  
Adult Personality ◽  
Social Domains ◽  
Functioning Assessment

The development of an investigator-based standardised interview to assess patterns of specific and general social dysfunction is described. It covers six domains of functioning: work; love relationships; friendships; non-intimate social contacts; negotiations; and everyday coping. Inter-rater reliability was tested by three investigators rating 21 audiotaped interviews, and was shown to be high, with an intraclass correlation of 0.87 for the total score. The pattern of associations between specific and general social dysfunction was examined through determination of sensitivities and specificities and through LISREL modelling. The findings varied across social domains but it was concluded that the total APFA score provided a reasonable measure of general social dysfunction.

Attentional Tendencies That Impact Emotion Regulation Success Within a Borderline Personality Disorder Framework

2021 ◽  
pp. 1-14
Author(s):  
Cheyene K. Horner ◽  
Eric S. Allard
Keyword(s):  
Emotion Regulation ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Assessment ◽  
Personality Assessment Inventory ◽  
Borderline Personality ◽  
Affective Responses ◽  
Interpersonal Context ◽  
Attentional Engagement

Emotion regulation difficulties are key to borderline personality disorder (BPD) symptomatology. Literature indicates that attentional distraction, particularly within an interpersonal context, is common in BPD. Conversely, reappraisal tactics are less prevalent. The goal of the current study was to examine whether this discrepancy is observed when individuals reporting varying levels of BPD tendencies are given the choice of a preferred emotion regulation tactic when confronted with BPD-relevant stressors. Attentional engagement patterns, affective responses, and strategy success were also examined. Participants (N = 103) reported BPD tendencies as assessed by the Personality Assessment Inventory and were instructed to choose either to “distract” or to “reappraise” in response to affective images. Results revealed more instances of failing to implement distraction among individuals with higher BPD tendencies, which was also reflected in greater fixation biases to distressing content within those images. Results are discussed in terms of the malleability of emotion regulation in BPD contexts.

Diagnostic Concordance Between Categorical and Dimensional Instruments to Assess Personality Disorder in Chronic Fatigue Syndrome

2017 ◽  
Vol 33 (3) ◽  
pp. 158-165
Author(s):  
Natalia Calvo ◽  
Naia Sáez-Francàs ◽  
Sergi Valero ◽  
Jesús Castro-Marrero ◽  
José Alegre Martín ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Chronic Fatigue Syndrome ◽  
Personality Assessment ◽  
Chronic Fatigue ◽  
Specific Pattern ◽  
Harm Avoidance ◽  
Assessment Instrument ◽  
Compulsive Disorder ◽  
Fatigue Syndrome ◽  
Self Transcendence

Abstract. The study examines the relationship between a categorical and a dimensional personality assessment instrument in patients with Chronic Fatigue Syndrome (CFS). A total of 162 CFS patients were included in the study (91.4% women; mean age 47.5 years). All subjects completed the Spanish versions of the Personality Diagnostic Questionnaire-4+ (PDQ-4+) and the Temperament and Character Inventory-Revised (TCI-R). Results: 78 (48.1%) of the patients presented a Personality Disorder (PD), the most frequent being Cluster C, specifically Obsessive-compulsive disorder, followed by Avoidant disorder. PDs showed a specific pattern of correlation with temperament scales. All PD clusters correlated positively with Harm Avoidance and Self-Transcendence, and negatively with Reward Dependence, Self-Directedness, and Cooperativeness. In a logistic regression analysis, Self-Directedness and Cooperativeness predicted PD presence. The findings are consistent with previous studies in non-CFS samples and suggest that the combination of the Temperament and Character dimensions (low Self-Directedness and Cooperativeness and high Harm Avoidance and Self-Transcendence) correlates with PD severity, and that Self-Directedness and Cooperativeness are associated with PD presence in CFS patients. The integration of these two perspectives expands the current comprehension of personality pathology in CFS patients.

scholarly journals The Relationship between Affect Integration and Psychopathology in Patients with Personality Disorder: A Cross-Sectional Study

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 627
Author(s):  
Christina Frederiksen ◽  
Ole André Solbakken ◽  
Rasmus Wentzer Licht ◽  
Carsten René Jørgensen ◽  
Maria Rodrigo-Domingo ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Interpersonal Problems ◽  
Symptom Distress ◽  
Central Component ◽  
Psychotherapeutic Treatment ◽  
Cross Sectional ◽  
Personality Functioning ◽  
Emotional Dysfunction ◽  
The Relationship

Background and Objectives: Emotional dysfunction is considered a key component in personality disorders; however, only few studies have examined the relationship between the two. In this study, emotional dysfunction was operationalized through the Affect Integration Inventory, and the aim was to examine the relationships between the level of affect integration and the levels of symptom distress, interpersonal problems, and personality functioning in patients diagnosed with personality disorder according to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition. Materials and Methods: Within a hospital-based psychiatric outpatient setting, 87 patients with personality disorder referred for treatment were identified for assessment with the Affect Integration Inventory and other measures (e.g., the Symptom Checklist-90, Revised, the Inventory of Interpersonal Problems 64 circumplex version, and the Severity Indices of Personality Problems). Results: The analyses revealed that problems with affect integration were strongly and statistically significantly correlated with high levels of symptom distress, interpersonal problems, and maladaptive personality functioning. Additionally, low scores on the Affect Integration Inventory regarding discrete affects were associated with distinct and differentiated patterns of interpersonal problems. Conclusion: Taken together, emotional dysfunction, as measured by the Affect Integration Inventory, appeared to be a central component of the pathological self-organization associated with personality disorder. These findings have several implications for the understanding and psychotherapeutic treatment of personality pathology. Furthermore, they highlight the importance of considering the integration of discrete affects and their specific contributions in the conceptualization and treatment of emotional dysfunction in patients with personality disorders.

Acetaminophen Reduces Distrust in Individuals With Borderline Personality Disorder Features

2017 ◽  
Vol 6 (1) ◽  
pp. 145-154 ◽  
Author(s):  
Ian D. Roberts ◽  
Ian Krajbich ◽  
Jennifer S. Cheavens ◽  
John V. Campo ◽  
Baldwin M. Way
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Assessment ◽  
Personality Assessment Inventory ◽  
Borderline Personality ◽  
Trust Game ◽  
Placebo Condition ◽  
Double Blind ◽  
Adult Participants ◽  
Interpersonal Difficulties

People with borderline personality disorder (BPD) tend to distrust others. We hypothesized that acetaminophen might reduce distrust in people with high BPD features because disordered affective responses are partially responsible for the interpersonal difficulties of people with BPD features, and acetaminophen has been shown in multiple studies to reduce negative affect. Using a double-blind, parallel-arm design, 284 young adult participants were administered either acetaminophen (1,000 mg; acute) or placebo and subsequently completed an economic trust game. BPD features were assessed with the Personality Assessment Inventory–Borderline Features scale. Participants with elevated BPD features showed less trust in their partners in the placebo condition but increased trust in the acetaminophen condition. Acetaminophen did not change expectations of trustee’s trustworthiness and did not impact trusting behavior in participants low in BPD features. Our results indicate that acetaminophen may reduce the behavioral distrust exhibited at high levels of BPD features.

Transference-Focused Psychotherapy for Pathological Narcissism and Narcissistic Personality Disorder (TFP-N)

2021 ◽  
Vol 49 (2) ◽  
pp. 244-272
Author(s):  
Diana Diamond ◽  
Frank Yeomans ◽  
John R. Keefe
Keyword(s):  
Personality Disorder ◽  
Sense Of Self ◽  
Assessment Process ◽  
Narcissistic Personality Disorder ◽  
Object Relations Theory ◽  
Pathological Narcissism ◽  
Personality Functioning ◽  
Therapeutic Interaction ◽  
Narcissistic Personality ◽  
Transference Focused Psychotherapy

In this article, we provide an overview of transference-focused psychotherapy for patients with pathological narcissism and narcissistic personality disorder (TFP-N). In TFP-N we have modified and refined the tactics and techniques of TFP, an evidence-based treatment for borderline personality disorder, to meet the specific challenges of working with patients with narcissistic personality pathology whose retreat from reality into an illusory grandiosity makes them particularly difficult to engage in treatment. We first describe a model of narcissistic pathology based on considerations of psychological structure stemming from object relations theory. This model provides a unifying understanding of the core structure of narcissistic pathology, the pathological grandiose self, that underlies the impairments in self and interpersonal functioning of those with narcissistic pathology across the levels of personality organization (from high functioning to borderline to malignant). We then delineate the clinical process of working with patients with pathological narcissism and narcissistic personality disorder. Starting with the assessment process, using a detailed clinical example, we guide the reader through the progression of TFP-N as it helps the patient move from the distorted, unintegrated sense of self underlying the narcissistic presentation to the more integrated, realistic sense of self that characterizes healthier personality functioning. In TFP-N the focus on the disturbed interpersonal patterns of relating in the here and now of the therapeutic interaction is the vehicle to diminish grandiosity and improve relatedness, thereby effecting enduring changes in mental representation and real-world functioning.

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