Psychological Assessment with the DSM-5 Alternative Model for Personality Disorders: Tradition and Innovation.
ABSTRACT: The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) Section III Alternative Model for Personality Disorders (AMPD; APA, 2013) represents an innovative system for simultaneous psychiatric classification and psychological assessment of personality disorders (PD). The AMPD combines major paradigms of personality assessment and provides an original, heuristic, flexible, and practical framework that enriches clinical thinking and practice. Origins, emerging research, and clinical application of the AMPD for diagnosis and psychological assessment are reviewed. The AMPD integrates assessment and research traditions, facilitates case conceptualization, is easy to learn and use, and assists in providing patient feedback. New as well as existing tests and psychometric methods may be used to operationalize the AMPD for clinical assessments.
Project description:The latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) bridges a significant gap in psychiatric nosology by providing trait-based characterizations of psychopathy along with antisocial personality disorder within the Section III alternative model for personality disorders (AMPD). However, the representation of psychopathy in the AMPD has met with some criticisms (Crego & Widiger, 2014; Few, Lynam, Maples, MacKillop, & Miller, 2015). The current study was undertaken to establish an improved means for characterizing psychopathy in DSM-5 Section III terms, by creating scale measures of triarchic psychopathy dimensions using items from the best-established assessment instrument for the AMPD, the Personality Inventory for DSM-5 (PID-5). Using data from a sample of community adults (N = 210), we employed a construct rating and psychometric refinement approach to develop item-based PID-5 Triarchic scales for measuring psychopathy dimensions of boldness, meanness, and disinhibition. The validity of the PID-5 Triarchic scales was then evaluated in relation to criteria including other scale measures of the triarchic constructs and psychopathy, self-reported antisocial behavior and substance use, empathy, internalizing and other clinical problems, and personality within the development sample and a separate independent sample of adults (N = 240) recruited to have elevated psychopathic traits. Results of this work provide a foundation for improved characterization of psychopathy in terms of the AMPD trait system and provide a mechanism for future research oriented toward clarifying the developmental interface between childhood conduct disorder and psychopathy, as well as identifying neurobiological correlates of dimensions of psychopathy. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Project description:This study investigates the topic of innovation strategies based on tradition in the wake of sustainability, in the agritourism sector, as derived from the phenomenon of multifunctionality in agriculture. The results reveal that the tangible and intangible resources that originate from tradition are drivers for innovation. The research highlights how tradition, as grounded on diverse foundations, is able to generate novel products and services stemming from an innovative arrangement of past events, particularly the identity of a place, which brings out its authenticity and makes it even more attractive. In this paper, we delve into the multifaceted outcomes that tangible and intangible traditions have on the innovation and distinctive standing of this rising accommodation offer with regard to post-productivism agriculture, and how this is accomplished while also looking for sustainability. The sourced dataset is based on a qualitative investigation of 10 cases in the Salento area of Puglia, a region of southern Italy. Tradition-grounded strategies proved to have several viable routes leading to innovation and bear positive impacts on the territory and the creation of value, yielding significant results both for scholars and practitioners.
Project description:Culture extends biology in that the setting of development shapes the traditions that individuals learn, and over time, traditions evolve as occasional variations are learned by others. In humans, interactions with others impact the development of cognitive processes, such as sustained attention, that shape how individuals learn as well as what they learn. Thus, learning itself is impacted by culture. Here, we explore how social partners might shape the development of psychological processes impacting learning a tradition. We studied bearded capuchin monkeys learning a traditional tool-using skill, cracking nuts using stone hammers. Young monkeys practice components of cracking nuts with stones for years before achieving proficiency. We examined the time course of young monkeys' activity with nuts before, during, and following others' cracking nuts. Results demonstrate that the onset of others' cracking nuts immediately prompts young monkeys to start handling and percussing nuts, and they continue these activities while others are cracking. When others stop cracking nuts, young monkeys sustain the uncommon actions of percussing and striking nuts for shorter periods than the more common actions of handling nuts. We conclude that nut-cracking by adults can promote the development of sustained attention for the critical but less common actions that young monkeys must practice to learn this traditional skill. This work suggests that in nonhuman species, as in humans, socially specified settings of development impact learning processes as well as learning outcomes. Nonhumans, like humans, may be culturally variable learners.
Project description:Humans often follow the choices of others, even when profitable alternatives exist, leading to the maintenance of arbitrary traditions. Arbitrary traditions have also been shown to persist in captive groups of other animals, but it is unclear whether they do so in the wild where there are ample opportunities for exploring alternatives. We conducted the first experiment examining the maintenance of arbitrary traditions in wild mammal groups. We trained 'demonstrators' in seven meerkat groups to obtain rewards from one out of the two distinctive landmarks. Two control groups had no trained demonstrators. Naive individuals initially ignored the landmarks, but were more likely to approach them and obtain rewards following encounters with demonstrators. Individuals in control groups were less likely to obtain rewards. While control groups showed no landmark preference, experimental groups initially preferred the landmark chosen by demonstrators, even though an equally rewarding alternative was nearby, leading to the establishment of local traditions. However, individuals that learned that one landmark was profitable began to explore the other rather than conforming to the majority behaviour, so traditions collapsed over time. This suggests that where conformist tendencies are lacking, the maintenance of traditions in natural populations depends on the relative influence of social and individual learning.
Project description:Here we introduce a new assessment of emotion regulation called the Mentalized Affectivity Scale (MAS). A large online adult sample (N = 2,840) completed the 60-item MAS along with a battery of psychological measures. Results revealed a robust three-component structure underlying mentalized affectivity, which we labeled: Identifying emotions (the ability to identify emotions and to reflect on the factors that influence them); Processing emotions (the ability to modulate and distinguish complex emotions); and Expressing emotions (the tendency to express emotions outwardly or inwardly). Hierarchical modeling suggested that Processing emotions delineates from Identifying them, and Expressing emotions delineates from Processing them. We then showed how these components are associated with personality traits, well-being, trauma, and 18 different psychological disorders (including mood, neurological, and personality disorders). Notably, those with anxiety, mood, and personality disorders showed a profile of high Identifying and low Processing compared to controls. Further, results showed how mentalized affectivity scores varied across psychological treatment modalities and years spent in therapy. Taken together, the model of mentalized affectivity advances prior theory and research on emotion regulation and the MAS is a useful and reliable instrument that can be used in both clinical and non-clinical settings in psychology, psychiatry, and neuroscience.
Project description:Personality disorders are defined in the current psychiatric diagnostic system as pervasive, inflexible, and stable patterns of thinking, feeling, behaving, and interacting with others. Questions regarding the validity and reliability of the current personality disorder diagnoses prompted a reconceptualization of personality pathology in the most recent edition of the psychiatric diagnostic manual, in an appendix of emerging models for future study. To evaluate the construct and discriminant validity of the current personality disorder diagnoses, we conducted a quantitative synthesis of the existing empirical research on associations between personality disorders and interpersonal functioning, defined using the interpersonal circumplex model (comprising orthogonal dimensions of agency and communion), as well as functioning in specific relationship domains (parent-child, family, peer, romantic). A comprehensive literature search yielded 127 published and unpublished studies, comprising 2,579 effect sizes. Average effect sizes from 120 separate meta-analyses, corrected for sampling error and measurement unreliability, and aggregated using a random-effects model, indicated that each personality disorder showed a distinct profile of interpersonal style consistent with its characteristic pattern of symptomatic dysfunction; specific relationship domains affected and strength of associations varied for each personality disorder. Overall, results support the construct and discriminant validity of the personality disorders in the current diagnostic manual, as well as the proposed conceptualization that disturbances in self and interpersonal functioning constitute the core of personality pathology. Importantly, however, contradicting both the current and proposed conceptualizations, there was not evidence for pervasive dysfunction across interpersonal situations and relationships. (PsycINFO Database Record
Project description:The dimensional pathological personality trait model proposed in the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5), Section III Criterion B, has shown promising results for its validity and utility in conceptualizing personality pathology. However, as its structural equivalence across sex is yet to be tested, the validity for the model across males and females remains uncertain. In the present article, we examined sex measurement invariance of the DSM-5 trait model in a large undergraduate sample using the Personality Inventory for DSM-5. A series of confirmatory and exploratory factor analyses suggested that, although the exact facet-domain relationships as specified in the DSM-5 were not observed, the facets generally organize into a model with five latent factors similar to those listed in the DSM-5 Section III Criterion B. Further, these five factors were fully measurement invariant across sex at the configural, metric, and scalar levels. Examination of the latent trait mean levels suggests that females tend to have higher scores on latent Negative Affectivity, whereas males tend to have higher scores on latent Antagonism, Detachment, Psychoticism, and Disinhibition. These results indicate that the DSM-5 Section III pathological personality trait model is fully structurally equivalent across sex, a property that is lacking in the traditional categorical model in Section II. This further validates the use of the dimensional DSM-5 trait model for personality disorder assessment and conceptualization in both research and clinical settings. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Project description:Theorists have long argued that personality disorder (PD) is best understood in terms of general impairments shared across the disorders as well as more specific instantiations of pathology. A model based on this theoretical structure was proposed as part of the DSM-5 revision process. However, only recently has this structure been subjected to formal quantitative evaluation, with little in the way of validation efforts via external correlates or prospective longitudinal prediction. We used the Collaborative Longitudinal Study of Personality Disorders dataset to: (a) estimate structural models that parse general from specific variance in personality disorder features, (b) examine patterns of growth in general and specific features over the course of 10 years, and (c) establish concurrent and dynamic longitudinal associations in PD features and a host of external validators including basic personality traits and psychosocial functioning scales. We found that general PD exhibited much lower absolute stability and was most strongly related to broad markers of psychosocial functioning, concurrently and longitudinally, whereas specific features had much higher mean stability and exhibited more circumscribed associations with functioning. However, both general and specific factors showed recognizable associations with normative and pathological traits. These results can inform efforts to refine the conceptualization and diagnosis of personality pathology. (PsycINFO Database Record
Project description:<h4>Objective</h4>A subgroup of parents of children who have been treated for childhood cancer report high levels of psychological distress. To date there is no empirically supported psychological treatment targeting cancer-related psychological distress in this population. The aim of the current study was to test the feasibility and preliminarily evaluate the effect of individualized face-to-face cognitive behavior therapy (CBT) for parents of children after the end of treatment for childhood cancer. A secondary aim was to present a cognitive behavioral conceptualization of cancer-related distress for these parents.<h4>Methods</h4>An open trial was conducted where 15 parents of children who had completed successful treatment for cancer three months to five years earlier and who reported psychological distress related to a child's previous cancer disease were provided CBT at a maximum of 15 sessions. Participants were assessed at baseline, post-intervention, and three-month follow-up using self-reported psychological distress (including posttraumatic stress symptoms (PTSS), depression, and anxiety) and the diagnostic Mini-International Neuropsychiatric Interview. Feasibility outcomes relating to recruitment, data collection, and delivery of the treatment were also examined. Individual case formulations for each participant guided the intervention and these were aggregated and presented in a conceptualization detailing core symptoms and their suggested maintenance mechanisms.<h4>Results</h4>A total of 93% of the participants completed the treatment and all of them completed the follow-up assessment. From baseline to post-assessment, parents reported significant improvements in PTSS, depression, and anxiety with medium to large effect sizes (Cohen's <i>d</i> = 0.65-0.92). Results were maintained or improved at a three-month follow-up. At baseline, seven (47%) participants fulfilled the diagnostic criteria for major depressive disorder and four (29%) fulfilled the criteria for posttraumatic stress disorder, compared to none at a post-assessment and a follow-up assessment. The resulting cognitive behavioral conceptualization suggests traumatic stress and depression as the core features of distress, and avoidance and inactivity is suggested as the core maintenance mechanisms.<h4>Conclusion</h4>The treatment was feasible and acceptable to the participants. Significant improvements in distress were observed during the study. Overall, results suggest that the psychological treatment for parents of children after end of treatment for childhood cancer used in the current study is promising and should be tested and evaluated in future studies.