Implementation of the DSM-5 and ICD-11 Dimensional Models of Maladaptive Personality Traits Into Pre-bariatric Assessment

Background: Personality pathology does not have to be a contraindication to a bariatric surgery if a proper pre-surgical assessment is done. Indicating subgroups of patients with their specific needs could help tailor interventions and improve surgical treatment outcomes.Objectives: Using the Alternative DSM-5 model for personality disorders (AMPD) and the ICD-11 model for PDs to detect subgroups of patients with obesity based on a specific constellation of maladaptive personality traits and the level of overall personality impairment.Methods: 272 consecutively consented patients who underwent a standard pre-surgical psychological assessment. The majority were women (58.0%), age range was 22–79 years (M = 48.06, SD = 10.70). Patients’ average body mass index (BMI) was 43.95 kg/m2. All participants were administered the Personality Inventory for DSM-5 (PID-5) from which Level of Personality Functioning Scale-Self Report (LPFS-SR) and Standardized Assessment of Severity of Personality Disorder (SASPD) scores were gained using the “crosswalk” for common metric for self-reported severity of personality disorder. The k-means clustering method was used to define specific subgroups of patients with obesity and replicated for equality testing to the samples of non-clinical respondents and psychiatric patients.Results: The cluster analysis detected specific groups in the sample of patients with obesity, which differed quantitatively from the samples of non-clinical respondents and psychiatric patients. A vast majority of patients with obesity showed above-average values in most of the PID-5 facets compared to the United States representative general community sample. In two out of the three clusters defined, patients demonstrated moderate (> M + 1.5 × SD) to severe (> M + 2.0 × SD) personality psychopathology within the Detachment and Negative Affectivity domains according to PID-5, which in one of the clusters corresponded to the mild overall impairment in both, LPFS-SR (M = 2.18, SD = 0.27) and SASPD (M = 8.44, SD = 2.38). Moreover, higher levels of psychopathology prove to be associated with higher age and use of psychiatric medication.Conclusions: The dimensional DSM-5 and ICD-11 trait models are suitable procedures for defining specific “characters” of patients in a pre-bariatric setting. As such, they help to identify subgroups of patients with obesity who are different from general population and psychiatric patients. Implications for clinical practice and further research are discussed.

Reassessing Fitness-to-Drive in Drinker Drivers: The Role of Cognition and Personality

Drunken driving is among the main challenges for road safety by causing worldwide motor-vehicle crashes with severe injuries and deaths. The reassessment of fitness-to-drive in drivers stopped for drunken driving includes mainly psychological examinations. The present study aimed to investigate the effectiveness and the consistency of selected variables of different psychological driving-related dimensions (i.e., cognitive skills and personality) in discriminating 90 male drinker drivers (DD) from matched non-drinkers controls. The Montreal Cognitive Assessment (MoCA), the Mental Rotation Test (MRT), and the Perspective-Taking Test (PT) were administered to assess overall cognitive functioning, and object- and self-based spatial transformation abilities, respectively. Participants completed a computerized test measuring resilience of attention (DT), reaction times (RT), and perceptual speed (ATAVT). The Personality Psychopathology Five scales (i.e., PSY-5: Aggressiveness-AGGR, Psychoticism-PSYC, Disconstraint-DISC, Negative-Emotionality-NEGE, and Introversion-INTR) the validity scale (L) and the dissimulation index (F-K) were scored from the Minnesota Multiphasic Personality Inventory (MMPI-2). A logistic binomial regression analysis (backward subtraction method) was used to identify discriminant predictors. A prediction analysis (ROC curve method) was performed on the final model. Results showed that the scores obtained in MRT, DT, and the personality measures of PSYC, DISC, NEGE, and INTR significantly discriminated DD from their matched controls with moderate-to-good values of accuracy (0.79), sensitivity (0.80), and specificity (0.79), as well as a good AUC value (0.89). In some cases, the personality dimensions provided—reliable—unexpected results. Low scores of PSYC, NEGE, and INTR were found to predict the membership to the DD group; results are discussed with reference to response management. Personality measures should be assessed with particular attention in a forensic context because they are more prone to be feigned than cognitive ones. Overall, the present study confirmed the relevance of integrating different driving-related psychological dimensions in the evaluation of fitness-to-drive showing the usefulness of standardized tools for the reassessment of drinker drivers.

Criterion A of the DSM-5 Alternative Model for Personality Disorders in MMPI-2/RF Personality Disorder Scales

The Minnesota Multiphasic Personality Inventory (MMPI) instruments are frequently used to assess personality and psychopathology. Recent publications of personality disorder (PD) spectra scales for dimensionalized PD syndromes with MMPI instruments may advance PD assessment. To this end, we examined MMPI-Second Edition (2) and MMPI-2-Restructured Form (-RF) PD Spectra scales within the lens of a contemporary dimensional model of PDs, the alternative model for personality disorders (AMPD). The core dimension of PD, Criterion A of the AMPD or level of personality functioning (LPF), was characterized quantitatively within the PD Spectra scales. By sequentially factor analyzing the scales of the Severity Indices of Personality Problems (SIPP-118) to a common general factor of PD, an index of LPF external to the MMPI item pool was established. This LPF dimension was strongly represented across most PD Spectra scales. LPF variances within the PD Spectra scales were deconstructed using measures of general demoralization (RCdemoralization) and maladaptive personality traits indexed by the Personality Psychopathology-5 (PSY-5). Nuanced LPF and PD Spectra scale relationships were discerned. Dimensionalized Antisocial PD, Borderline PD, Dependent PD, and Paranoid PD showed meaningful association with LPF after demoralization, and maladaptive trait variances were removed. The examination of the MMPI-3 item pool reveals that the existing PD Spectra scale item sets are largely carried forward in the new edition of the MMPI. This suggests PD Spectra scale correlates, including LPF relationships, may be discernable in the newest edition of the MMPI, pending future study.

On studying the relationship between personality and mental disorder - Suggestions for further study

<p>Links between traits and mental disorders have been postulated off and on for centuries, but since a recent revival of interest within psychology, there has been a consistent and expanding field of research concerned with studying what is now widely accepted as the ‘personality- psychopathology relationship’. This thesis explores that field of research, considering what has led to its stagnation and apparent difficulty in reaching robust and useful conclusions. In doing so, I provide an overview and critique of the study of the personality-psychopathology relationship. Several limitations of recent research are identified and explored, specifically concerning its focus of inquiry, statistical methodology and conceptual foundations. Throughout the thesis, I discuss the appropriate scientific method(s) and necessary conceptual considerations involved in studying the relationship between personality and mental disorder, and make some suggestions about what is required for robust and reliable research in this area.</p>

On studying the relationship between personality and mental disorder - Suggestions for further study

<p>Links between traits and mental disorders have been postulated off and on for centuries, but since a recent revival of interest within psychology, there has been a consistent and expanding field of research concerned with studying what is now widely accepted as the ‘personality- psychopathology relationship’. This thesis explores that field of research, considering what has led to its stagnation and apparent difficulty in reaching robust and useful conclusions. In doing so, I provide an overview and critique of the study of the personality-psychopathology relationship. Several limitations of recent research are identified and explored, specifically concerning its focus of inquiry, statistical methodology and conceptual foundations. Throughout the thesis, I discuss the appropriate scientific method(s) and necessary conceptual considerations involved in studying the relationship between personality and mental disorder, and make some suggestions about what is required for robust and reliable research in this area.</p>

What makes a terrorist? Muslims’ and non-Muslims’ lay perceptions of risk factors and their consequences for counter-terrorism policy support

The question of why people become terrorists has preoccupied scholars and policy makers for decades. Yet, very little is known about how lay people perceive individuals at risk of becoming terrorists. In two studies conducted in the U.K., we aimed to fill this gap. Study 1 showed that Muslims and non-Muslims perceived a potential minority-group terrorist in terms of both structural (e.g., life-history, social) and individual risk factors (e.g., personality, psychopathology, ideology). In Study 2, Muslims and non-Muslims perceived a potential right-wing majority-group terrorist as having more individual predispositions to terrorism than a potential left-wing terrorist. Importantly, in both studies, individualist perceptions such as psychopathology were positively associated with support for stricter law enforcement, whereas structuralist perceptions such as adverse childhood experiences were positively associated with support for social interventions. Lay people seem to have multifactorial understandings of individuals at risk of becoming terrorists, which influence their counter-terrorism policy support.

Obsessive-compulsive symptoms in young women affected with anorexia nervosa and their relationship with personality, psychopathology and attachment style

Purpose Obsessive-compulsive symptoms (OC) are associated with greater morbidity and worse prognosis in anorexia nervosa (AN). We assessed the presence of non-eating OC in participants with AN and related them with their psychopathology, personality, and attachment style features. Methods Young women with AN (N = 41, 30 restricter and 11 binge-purging type) were assessed on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Participants with AN and 82 healthy controls (HC) completed the Temperament and Character Inventory (TCI), Eating Disorder Inventory-2 (EDI-2), Symptom Checklist-90 (SCL- 90), Toronto Alexithymia Scale (TAS-20), and Attachment Style Questionnaire (ASQ), and were compared to underscore the AN features. Y-BOCS scores were correlated to psychopathology, personality, and attachment features in AN participants. Results AN had significantly higher scores than HC on EDI-2, SCL-90, TAS-20, ASQ-Need for Approval, and TCI-Harm Avoidance and Self-directedness. The Y-BOCS scores were significantly correlated with ASQ-Need for Approval, TAS-20-Difficulty in Describing Feelings, SCL-90-Phobic Anxiety, and Anxiety, EDI-2-Drive to Thinness and Asceticism. Need for Approval displayed the strongest and broadest correlation pattern with OC symptoms. Difficulty in describing feelings displayed the strongest correlation with compulsive OC symptoms. Conclusions OC traits in participants with AN are primarily associated with measures of insecure attachment rather than to their eating and general psychopathology. Therapeutic approaches to correcting insecure attachment may be considered a possible choice to treat OC symptoms in AN. The study suggests a new psychopathological perspective to understand the meaning of obsessive-compulsive symptoms in AN.

Six Assumptions of Contemporary Integrative Interpersonal Theory of Personality and Psychopathology

Contemporary Integrative Interpersonal Theory is an evidence-based model of personality, psychopathology, and intervention. In this paper, we review six assumptions of CIIT that distinguish it from other frameworks and suggest five particularly promising and important areas for future research.

Problematic Smartphone Use—Comparison of Students With and Without Problematic Smartphone Use in Light of Personality

Background: As a device with multiple functions, a smartphone become more and more relevant in everyday life. However, this goes along with an increase in reports about smartphone addiction and its unwanted consequences. One of the most important variables in the etiopathogenesis of addictive smartphone use is personality.Objective: This study aimed to investigate predictors of problematic smartphone use. Clinically relevant differences in personality, psychopathology, and social support between students with and without problematic smartphone use were investigated.Method: All currently enrolled students at the Sigmund Freud University in Vienna (N = 1,836) were surveyed. Response rate was 27.07% (N = 497, age: M = 19.6, SD = 8.04). The Smartphone Addiction Scale (SPAS), the 10-Item Big Five Inventory (BFI-10), the Brief Symptom Inventory (BSI-18), and a questionnaire on social support (F-SozU-K-14) were used.Results: A total of 75 students (15.1% of the total sample) showed problematic smartphone use. In terms of personality, respondents with problematic smartphone use showed significantly higher values for extraversion and neuroticism compared than non-addicted users. Students with problematic smartphone use showed significantly higher levels in terms of depression and anxiety. Contrary to expectations, individuals with problematic smartphone use showed significantly higher values for perceived social support than with individuals without problematic smartphone use.Discussion: Therapy for problematic smartphone use should be carried out taking into account discussed, important etiological factors, such as personality.