Depressive thinking and depression: Relations with personality and social resources.

We studied depression, depressive cognitions, social supports, and self-esteem in a sample of 68 spouse-caregivers of patients with Alzheimer's Disease in an attempt to identify possible buffering mechanisms of the latter 2 variables. Specifically, we hypothesized that the well-known relation of depressive cognitions to depression would vary as a function of satisfaction with social supports and with level of self-esteem. Hierarchical multiple regression analyses conducted to predict depression revealed significant and independent main effects for depressive cognitions, social supports, and self-esteem, with depressive cognitions associated with higher depression and the other 2 variables associated with reduced depression. In addition, the relation of depressive cognitions with depression varied substantially depending on the level of social supports; caregivers with high levels of depressive cognitions had high levels of depression only if social supports were low. Self-esteem and depressive cognitions showed a similar interaction, but it failed to reach significance. Analyses to determine whether self-esteem and social supports were directly associated with lower depressive cognitive activity yielded a main effect for self-esteem only. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The construct validity of depressive personality disorder.

This study examined the construct validity of depressive personality disorder (DPD; American Psychiatric Association, 1994). Adult Psychiatric outpatients (N=900) underwent comprehensive Axis I and II evaluations and provided data on 4,768 of their 1st-degree relatives. Despite modest overlap, DPD was not redundant with any Axis I or II disorder. Participants with DPD exhibited more Axis I and Axis II comorbidity, and greater psychosocial dysfunction, than participants without DPD. Relatives of participants with DPD had higher rates of mood disorders, alcohol abuse, and antisocial personality. Results are consistent with findings of several other similar investigations. The authors argue that DPD is a valid construct and should be conceptualized as a personality disorder as opposed to a mood disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reliability of personality disorder symptoms and personality traits in substance-dependent inpatients.

The authors compared the internal consistency, 1-year temporal stability and self-informant agreement of ratings of personality trait (NEO Five-Factor Inventory; NEO-FFI; P. T. Costa & R. R. McCrae, 1992) and personality disorder symptom severity (Structured Clinical Interview for DSM-III-R personality Disorders Questionnaire; SCID-II-Q ; R. L. Spitzer, J. B. W. Williams, M. Gibbon, & M. First, 1990) in 131 substance-dependent inpatients. Internal consistency coefficients were acceptable to very good for most NEO-FFI and SCID-II-Q scales, and temporal stability correlations were significant for all measures. Agreement between patient and informant ratings was more modest. Substance abuse and depression symptom severity moderated the temporal stability and self-informant agreement of several personality trait and disorder ratings. The authors did not find that the five factors were more reliable than the Axis II symptoms. Issues related to the reliability of personality assessment in multiply diagnosed patients are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Borderline personality disorder and personality traits: A comparison of SCID-II BPD and NEO-PI.

62 hospitalized female patients (aged 18–43 yrs) with a clinical diagnosis of borderline personality disorder (BPD) were assessed for Axis II disorders by the SCID-II and for personality traits with the NEO-Personality Inventory (NEO-PI). The predominant personality trait profile for these patients involved a very high Neuroticism score and low Agreeableness score. Five of the 8 BPD criteria had significant correlations with NEO-PI scales. The combination of BPD severity and personality traits as measured on the NEO-PI had a significant relationship to the patients' social adjustment. The utility of gathering information on both borderline personality pathology and personality traits is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reliability and validity of depressive personality disorder

OBJECTIVE: Depressive personality disorder was introduced into DSM-IV's appendix amid controversy. While that disorder appears to be a reliable and valid one, the authors offer new data about its relationship to major depression, dysthymic disorder, and other personality disorders. METHOD: The authors assessed 54 subjects with early-onset, long-standing mild depressive features for depressive personality disorder, axis I and axis II disorders, family history, and treatment history; they conducted follow-up interviews 1 year after the baseline assessment. Subjects with (N=30) and without (N=24) depressive personality disorder were characterized and compared in terms of those variables. RESULTS: Although depressive personality disorder and dysthymia co-occurred in some subjects, 63% of subjects with depressive personality disorder did not have dysthymia, and 60% did not have current major depression. Although subjects with depressive personality disorder were more likely than the mood disorder comparison group to have another personality disorder, 40% had no such disorder. Contrary to study hypotheses, mood disorder was not more common in first-degree relatives of subjects with depressive personality disorder than in relatives of the comparison group. Subjects with and without depressive personality disorder had similar rates of past treatment with medication and psychotherapy; however, the duration of psychotherapy was significantly longer for subjects with than for those without depressive personality. The depressive personality diagnosis was relatively stable over the 1-year follow-up period. CONCLUSIONS: Depressive personality disorder appears to be a relatively stable condition with incomplete overlap with axis I mood disorders and personality disorders. Further studies are needed to better characterize its treatment response and relationship to axis I mood disorders.     

Borderline personality traits and disorder: Predicting prospective patient functioning.

Objective: Decisions about the composition of personality assessment in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM–V) will be heavily influenced by the clinical utility of candidate constructs. In this study, we addressed 1 aspect of clinical utility by testing the incremental validity of 5-factor model (FFM) personality traits and borderline personality disorder (BPD) symptoms for predicting prospective patient functioning. Method: FFM personality traits and BPD features were correlated with one another and predicted 2-, 4-, 6-, 8-, and 10-year psychosocial functioning scores for 362 patients with personality disorders. Results: Traits and symptom domains related significantly and pervasively to one another and to prospective functioning. FFM extraversion and agreeableness tended to be most incrementally predictive of psychosocial functioning across all intervals; cognitive and impulse action features of BPD features incremented FFM traits in some models. Conclusions: These data suggest that BPD symptoms and personality traits are important long-term indicators of clinical functioning that both overlap with and increment one another in clinical predictions. Results support the integration of personality traits and disorders in DSM–V. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The stability of personality traits in individuals with borderline personality disorder.

Although stability and pervasive inflexibility are general criteria for Diagnostic and Statistical Manual of Mental Disorders, 4th edition (American Psychiatric Association, 1994) personality disorders (PDs), borderline PD (BPD) is characterized by instability in several domains, including interpersonal behavior, affect, and identity. The authors hypothesized that such inconsistencies notable in BPD may relate to instability at the level of the basic personality traits that are associated with this disorder. Five types of personality trait stability across 4 assessments over 6 years were compared for BPD patients (N = 130 at first interval) and patients with other PDs (N = 302). Structural stability did not differ across groups. Differential stability tended to be lower for 5-factor model (FFM) traits in the BPD group, with the strongest and most consistent effects observed for Neuroticism and Conscientiousness. Growth curve models suggested that these 2 traits also showed greater mean-level change, with Neuroticism declining faster and Conscientiousness increasing faster, in the BPD group. The BPD group was further characterized by greater individual-level instability for Neuroticism and Conscientiousness in these models. Finally, the BPD group was less stable in terms of the ipsative configuration of FFM facet-level profiles than was the other PD group over time. Results point to the importance of personality trait instability in characterizing BPD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Symptoms and traits of personality disorder: Two new methods for their assessment.

Examines the reliability and validity of 2 dimensional methods for the assessment of personality disorder symptoms and traits. In Study 1, 3 groups that varied in personality pathology level completed the Schedule for Nonadaptive and Adaptive Personality (SNAP; L. A. Clark, 1993), a self-report questionnaire that measures traits relevant to Axis II pathology. Differences among the groups, which were patterned in theoretically interesting ways, are discussed. In Study 2, 2 independent judges rated 22 clusters of Axis II symptoms in 56 state hospital inpatients based on chart information. Good interrater reliability was obtained (median coefficient?=?.71), and personality-related pathology was quite prevalent. Relations among symptom ratings, SNAP scores, and chart diagnoses were generally systematic, but anomalous findings also emerged. Implications for the dimensional assessment of personality-related pathology are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Obsessional personality traits and risk for bipolar affective disorder: An offspring study.

Explored the potential utility of obsessionality as a differential risk index among relatives of bipolar patients by examining the relation between obsessional traits and cyclothymia, a precursor form of bipolar illness, in 41 15–21 yr old offspring of parents with bipolar affective disorder. Ss completed 2 measures of obsessional personality traits and were administered a general behavior inventory (a case identification inventory for cyclothymia) and a structured diagnostic interview. Cyclothymic offspring obtained significantly higher scores than did noncyclothymes on the superego-strength measure of obsessional traits. Moreover, obsessionality was significantly correlated with affective symptom ratings but was not related to nonaffective behavior disturbances. Although a long-term follow-up is necessary to confirm these findings, these data suggest that obsessional traits may be associated with risk for bipolar disorder in the offspring of bipolar probands. (61 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sex-role and socialization patterns: Some personality concomitants and environmental antecedents.

Distinguished between sex-role typing, socialization, and identification in 66 male and 69 female 30-40 yr old Ss using the Femininity and Socialization scales of the California Psychological Inventory. Ss were grouped according to their sex-role and socialization pattern: sex appropriate-socialized, sex appropriate-unsocialized, sex inappropriate-socialized, and sex inappropriate-unsocialized. The personality correlates of these patternings were highly informative, as were the family and childhood data available for these Ss. The relationships were interpreted employing an articulated version of the concept of identification. It is noted that sex-role typing for men appears to expand the personal options available to them; for women, sex-role typing seems to restrict the alternatives of action and expression that are available. (51 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patients' and informants' reports of personality traits during and after major depression.

The influence of major depression on patients' and informants' reports of personality traits was examined using the Structured Interview for DSM-III Personality Disorder, both before and after successful antidepressant or placebo treatment (N?=?58). According to patients' reports, Cluster A and C traits decreased significantly from pre- to posttreatment, but Cluster B traits were unchanged, excluding an increase in histrionic traits. According to informants' reports, Cluster A and B traits did not change from pre- to posttreatment, but Cluster C traits decreased significantly after treatment, not including passive-aggressive traits. Moreover, informants generally reported much higher levels of maladaptive personality traits than patients themselves. These results suggest that informants should be used in future research on personality disorders until better assessment techniques are developed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Malevolent object representations in borderline personality disorder and major depression.

To study malevolent representations, earliest memories were reliably coded on scales of affect tone. Ss were diagnosed with borderline personality disorder: 31 without and 30 with concurrent major depression. Nonborderline comparison Ss had either major depressive disorder (n?=?26) or no psychiatric diagnosis (n?=?30). Borderline Ss were discriminated from comparison Ss by their more malevolent representations; they more frequently produced memories involving deliberate injury, and they portrayed potential helpers as less helpful. Results suggest the diagnostic significance of malevolent representations, which need to be explained by any theory of borderline personality disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Convergence of two systems for assessing specific traits of personality disorder.

Two samples of normal-range individuals (N?=?237) completed the Schedule for Nonadaptive and Adaptive Personality (L. A. Clark, 1993a) and the Dimensional Assessment of Personality Pathology—Basic Questionnaire (W. J. Livesley & D. Jackson, in press), each of which assesses traits relevant to personality disorder. Convergence between the 2 instruments was examined at both the level of broad factors and the level of specific scales that had been matched previously on a conceptual basis (L. A. Clark & W. J. Livesley, 1994). Four of 5 higher order factors resembled dimensions of the 5-factor approach to personality, and a strong convergent and discriminant pattern was found between matched scales of the 2 instruments. Moreover, considerable specific trait variance remained after nonspecific (higher order) variance was accounted for. The results are interpreted as supporting a replicable structure of maladaptive personality traits at both levels of the hierarchy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Unique roles of antisocial personality disorder and psychopathic traits in distress tolerance.

Previous research indicates that individuals with antisocial personality disorder (ASPD) evidence low distress tolerance, which signifies impaired ability to persist in goal-directed behavior during an aversive situation, and is associated with a variety of poor interpersonal and drug use outcomes. Based on theory and research indicating that psychopathic traits are associated with hypo-reactivity in emotional responding, a unique hypothesis emerges where psychopathic traits should have the opposite effect of ASPD and be related to high levels of distress tolerance. In a sample of 107 substance-dependent patients in an inner-city substance use residential treatment facility, this hypothesis was supported. ASPD was related to lower distress tolerance, while psychopathic traits were related to higher distress tolerance, with each contributing unique variance. Findings are discussed in relation to different presentations of distress tolerance as a function of psychopathic traits among those with an ASPD diagnosis. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Interpersonal concomitants and antecedents of depression among college students.

Depressed college students were compared with other-psychopathology and normal controls regarding the relationship they developed with dormitory roommates during a 9-month period. Diagnostic status was periodically assessed via SADS interviews, thus also permitting identification of new cases of depression during the year. Psychosocial characteristics found to be uniquely associated with current depression were: (a) low social contact with roommates, (b) low enjoyability of these contacts, and (c) high life-event stress. Roommates of depressives reported low enjoyability of the relationship and high levels of aggressive behavior towards the depressive. No features were found to be uniquely associated with new cases before they became depressed; however, several antecedents of general psychopathology were identified. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment of multiple personality disorder: a survey of current practices

OBJECTIVE: Reported cases of multiple personality disorder have increased dramatically in the last decade. Few data are available on the treatment of multiple personality disorder. Current recommendations are based on the experience of individual clinicians rather than on systematic research. METHOD: A questionnaire study of 305 clinicians representing a spectrum of mental health professionals was conducted to survey the types and relative efficacy of treatment modalities currently used with cases of multiple personality disorder. RESULTS: Individual psychotherapy facilitated by hypnosis was uniformly endorsed as the primary treatment by all practitioner groups. The average patient was in twice-weekly psychotherapy facilitated by hypnosis for 3.8 years. Antidepressant and anxiolytic medications were reported to be moderately useful adjunctive treatments. CONCLUSIONS: These findings support current impressionistic treatment recommendations for multiple personality disorder regarding the primacy of psychotherapy and the moderate benefits of psychopharmacology with antidepressant and antianxiety agents.     

Borderline personality: Traits and disorder.

Although the 5-factor model (FFM) has been advocated as an alternative to representing the construct of borderline personality, some argue that this diagnosis carries essential information that is not well captured by the FFM. The present study examined antecedent, concurrent, and predictive markers of construct validity in a sample of 362 patients with personality disorders. The results indicated that neuroticism best distinguished borderline and nonborderline patients, whereas the FFM as a whole captured a sizable proportion of the variance in the borderline diagnosis. However, the residual of the borderline diagnosis that was not explained by the FFM was found to be significantly related to childhood abuse history, family history of mood and substance use disorders, concurrent symptoms, and 2-year and 4-year outcomes. Thus, some elements of the borderline diagnosis may not be fully captured in a 5-factor representation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Classification of personality traits.

In this article, empirical and conceptual classifications of personality traits are reviewed and discussed. A new classification is proposed that uses three sets of crosscutting variables: instrumental, affective, and cognitive; social versus nonsocial; and self versus nonself. The resulting table reveals which traits are most frequently studied and which need more attention. The patterning of traits that show sex differences suggests their origin. Adult traits are classified as well as those occurring in childhood and infancy, and implications are drawn for personality development. In addition to content traits, stylistic traits are classified. Compared to extant organizations of traits, this one is more detailed and more closely linked to variables outside the classification. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental state decoding abilities in young adults with borderline personality disorder traits.

Previous studies have demonstrated that patients with borderline personality disorder (BPD) tend to misattribute malevolence to benign social stimuli, including facial expressions. Yet, facial emotion recognition studies examining those with BPD have yielded mixed results, with some studies showing impaired accuracy and others demonstrating enhanced accuracy in the recognition of emotions or mental states. The current study examined the ability to decode mental states from photographs of just the eye region of faces in a nonclinical sample of young adults who exhibited BPD traits (high BPD) compared with those who did not (low BPD). Group differences in mental state decoding ability depended on the valence of the stimuli. The high-BPD group performed better for negative stimuli compared with the low-BPD group, but did not perform significantly different from the low-BPD group for stimuli of neutral or positive valence. The high-BPD group also demonstrated a response bias for attributing negative mental states to facial stimuli. In addition, findings suggested that the group difference in accuracy for negative stimuli could not be explained by response bias, because the group difference in response bias for negative stimuli did not reach significance. These findings suggest that BPD traits may be associated with enhanced ability to detect negative emotions and a bias for attributing negative emotions to nonnegative social stimuli. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Linking “big” personality traits to anxiety, depressive, and substance use disorders: A meta-analysis.

We performed a quantitative review of associations between the higher order personality traits in the Big Three and Big Five models (i.e., neuroticism, extraversion, disinhibition, conscientiousness, agreeableness, and openness) and specific depressive, anxiety, and substance use disorders (SUD) in adults. This approach resulted in 66 meta-analyses. The review included 175 studies published from 1980 to 2007, which yielded 851 effect sizes. For a given analysis, the number of studies ranged from three to 63 (total sample size ranged from 1,076 to 75,229). All diagnostic groups were high on neuroticism (mean Cohen's d = 1.65) and low on conscientiousness (mean d = ?1.01). Many disorders also showed low extraversion, with the largest effect sizes for dysthymic disorder (d = ?1.47) and social phobia (d = ?1.31). Disinhibition was linked to only a few conditions, including SUD (d = 0.72). Finally, agreeableness and openness were largely unrelated to the analyzed diagnoses. Two conditions showed particularly distinct profiles: SUD, which was less related to neuroticism but more elevated on disinhibition and disagreeableness, and specific phobia, which displayed weaker links to all traits. Moderator analyses indicated that epidemiologic samples produced smaller effects than patient samples and that Eysenck's inventories showed weaker associations than NEO scales. In sum, we found that common mental disorders are strongly linked to personality and have similar trait profiles. Neuroticism was the strongest correlate across the board, but several other traits showed substantial effects independent of neuroticism. Greater attention to these constructs can significantly benefit psychopathology research and clinical practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)