Trajectories of adaptive and disturbed identity dimensions in adolescence: developmental associations with self-esteem, resilience, symptoms of depression, and borderline personality disorder features.

To advance our understanding of adolescents' identity formation and how it may play into their psychological functioning, this study investigated developmental trajectory classes of adaptive and disturbed dimensions of identity formation, and whether adolescents belonging to different trajectory classes develop differently on self-esteem, resilience, symptoms of depression, and borderline personality disorder (BPD) features. Three-wave longitudinal data from 2,123 Flemish adolescents was used (54.2% girls; Mage = 14.64, range = 12-18 at T1). Results pointed to four trajectory classes of identity formation: adaptive identity, identity progression, identity regression, and diffused identity. The adaptive identity class presented with stable high levels of self-esteem and resilience, and stable low levels of symptoms of depression and BPD, whereas opposite results were obtained for the diffused identity class. The identity progression class reported an increase in self-esteem and resilience as well as a decrease in symptoms of depression and BPD, whereas opposite results were obtained for the identity regression class. These results emphasize that adaptive and disturbed dimensions of identity formation are closely related to markers of well-being and psychopathology among adolescents, and could help identify adolescents with an increased risk for negative psychological functioning or increased opportunity for positive psychological functioning.

Age and sex differences of the PID-5-100 maladaptive personality traits throughout adulthood.

In this cross-sectional study including a heterogeneous Belgian community sample of adults (N = 1,930), two central questions were addressed pertaining to age differences of self-reported Personality Inventory for DSM-5 (PID-5) maladaptive personality traits: (a) What kind of mean-level changes occur in the PID-5 traits from age 21 to 65? and (b) What kind of variance-level changes occur in the PID-5 traits from age 21 to 65? In exploring these research questions, we also aimed to examine potential sex differences. With regard to latent mean-level age differences of the PID-5 traits, changes across adulthood were overall small to moderate and included a mix of decreasing, flat, and increasing age trends. Regarding the decreasing trends, quadratic regressions showed that the initial downward trend often either stagnated at a certain age, or subtly started increasing again from a certain age onwards. In more than half of the PID-5 traits (15/25), small but significant sex differences were found in the latent mean-level changes across adulthood. In these cases, men tended to score overall higher, except for the negative affectivity facets, on which women tended to score higher. Furthermore, variance stability was found for the majority of the PID-5 personality traits (17/25), indicating that the magnitude of individual differences in PID-5 traits is relatively stable across adulthood. Implications for individual assessment and evaluation of PID-5 scores are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Self-Concept and Identity Measure in Patients with Personality Disorders: A Psychometric Evaluation and Associations With Identity Processes, Core Domains of Self-Functioning, and Personality Disorder Symptoms.

As developmental and clinical research on identity has largely developed in disconnect, scholars recommend adopting a developmental psychopathology perspective on identity, which considers adaptive and pathological identity functioning. Such a perspective has also been introduced in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) Alternative Model for Personality Disorders (AMPD), which suggests that all personality disorders (PDs) are marked by moderate to extreme deficits in self-functioning (i.e., identity and self-direction). The present study aims to validate the Dutch Self-Concept and Identity Measure (SCIM), a 27-item self-report questionnaire that assesses consolidated identity, disturbed identity, and lack of identity, in 153 psychiatric inpatients with PDs (75.2% female; Mage = 31.73). We investigated the factor structure and reliability of the SCIM, and examined associations of SCIM scales with typical identity processes, AMPD domains of self-functioning, and symptoms of all PDs. Results indicated that a 23-item Dutch SCIM produced valid and reliable scores among patients with PDs. Furthermore, SCIM scales were significantly and differentially related to identity commitment processes, ruminative identity exploration, domains of self-functioning, and symptoms of all PDs. Moreover, findings indicated that PDs varied regarding the severity of identity impairment.

A person-centered perspective on the combined DSM-5 AMPD/ICD-11 personality model: Utility, relationship with the categorical personality disorder model, and capacity to differentiate between levels of identity functioning.

Background: Both the ICD-11 classification of Personality Disorders and the DSM-5 Alternative Model for Personality Disorders (DSM-5 AMPD) conceptualize personality pathology in a dimensional way, but differ in the way they carve up their respective pathological personality domains. Recently, a combination of ICD-11 and DSM-5 AMPD descriptive pathological personality traits, the Modified Personality Inventory for DSM-5-Brief Form Plus (PID5BF + M), was developed. The current study: We investigated the utility of the additional ANANKASTIA domain (not represented in the DSM-5 AMPD) as well as of the additional PSYCHOTICISM domain (not represented in the ICD-11 model) in the identification of meaningful pathological personality domain clusters based on the PID5BF + M. Next to the classical 2- and 3-cluster solutions, we examined whether the presence of the additional ANANKASTIA domain would also gave rise to a meaningful 4-cluster solution. We then validated these clusters by investigating differences between them in mean DSM-5 Section II cluster A, B, and C personality disorder scores. Finally, we investigated whether cluster membership was able to differentiate between levels of identity functioning, a key feature of personality disorder severity in both the ICD-11 model and the DSM-5 AMPD. Materials and methods: We used a Flemish community sample of 242 participants, and applied k-means cluster analyses in a two-step manner on PID5BF + M domains to investigate 2-, 3-, and 4-cluster solutions. We used MANOVAs to examine differences between clusters in PID5BF + M domains, DSM-IV/DSM-5 Section II Assessment of Personality disorders (ADP-IV) cluster A, B, and C scores, and Self-Concept and Identity Measure (SCIM) scores. Results: Cluster analyses on PID5BF + M pathological personality domains (1) revealed meaningful 2-, 3-, and 4-cluster solutions, with the 4-cluster solution explaining the most variance in the clustering variables, (2) allowed to identify a classical Overcontrolled cluster which DSM-5 AMPD PID-5 does not, and (3) demonstrated the utility of representing ANANKASTIA and DISINHIBITON as separate pathological personality domains. PID5BF + M clusters (5) were informative of DSM-5 Section II cluster A, B, and C personality disorder scores and (6) showed different levels of clinical-developmental Identity functioning. Conclusion: Current results demonstrate the utility of a combined ICD-11/DSM-5 AMPD view from a person-centered perspective.

Case Report: Pathological Personality Traits Through the Lens of the ICD-11 Trait Qualifiers and the DSM-5 Section III Trait Model: Two Patients Illustrating the Clinical Utility of a Combined View.

We report on two individuals presenting for treatment as part of everyday clinical practice, comparing their pathological personality traits through the lens of the ICD-11 trait qualifiers and the DSM-5 Section III personality trait model. We compare higher order pathological personality domains and lower order pathological personality trait facets of patient M (diagnosed with borderline personality traits according to DSM-5 Section II), and patient L (diagnosed with obsessive-compulsive personality traits according to DSM-5 Section II) with normative data and with each other. Findings highlight the clinical utility of a ICD-11/DSM-5 combined view, including: (1) the Disinhibition/Anankastia personality domain distinction as advocated in the ICD-11 model, (2) the Psychoticism personality domain as conceptualized in the DSM-5 Section III personality trait model, as well as (3) the use of lower order personality trait facets within each higher order personality domain.

Identity synthesis and confusion in early to late adolescents: Age trends, gender differences, and associations with depressive symptoms.

INTRODUCTION: Research on identity development has primarily studied over-time trends in identity status change and exploration and commitment processes among late adolescents and emerging adults. Identity development in early and mid-adolescents has generally been overlooked. Hence, little is known about how a sense of identity synthesis and confusion evolves from early to late adolescence for boys and girls. METHODS: The present cross-sectional study examined gender-moderated age trends in identity synthesis and confusion from ages 12 to 25 among 5860 Belgian adolescents (56.1% girls; Mage = 16.09). In addition, using a subsample of 2782 participants, we investigated associations of identity synthesis and confusion with depressive symptoms in early, mid-, and late adolescents. RESULTS: Mean scores on identity synthesis decreased from ages 12 to 15, subsequently increased from ages 15 to 23, and decreased again later on. Mean scores on identity confusion followed a parallel but opposite cubic trend. Gender differences in these age trends were dependent upon the developmental period. For all age groups, identity synthesis scores were negatively associated with depressive symptoms, whereas positive associations emerged between identity confusion and depressive symptoms. CONCLUSIONS: From 12 to 25 years old, individuals experience an increasing sense of identity synthesis and less identity confusion, despite fluctuations that appear to be dependent upon the developmental period. Identity synthesis and confusion seem to be strongly negatively and positively associated with depressive symptoms in early, mid-, and late adolescents.

International Assessment of DSM-5 and ICD-11 Personality Disorder Traits: Toward a Common Nosology in DSM-5.1.

INTRODUCTION: The DSM-5 Alternative Model of Personality Disorders (AMPD) and the ICD-11 classification of personality disorders (PD) are largely commensurate and, when combined, they delineate 6 trait domains: negative affectivity, detachment, antagonism/dissociality, disinhibition, anankastia, and psychoticism. OBJECTIVE: The present study evaluated the international validity of a brief 36-item patient-report measure that portrays all 6 domains simultaneously including 18 primary subfacets. METHODS: We developed and employed a modified version of the Personality Inventory for DSM-5 - Brief Form Plus (PID5BF+). A total of 16,327 individuals were included, 2,347 of whom were patients. The expected 6-factor structure of facets was initially investigated in samples from Denmark (n = 584), Germany (n = 1,271), and the USA (n = 605) and subsequently replicated in both patient- and community samples from Italy, France, Switzerland, Belgium, Norway, Portugal, Spain, Poland, Czech Republic, the USA, and Brazil. Associations with interview-rated DSM-5 PD categories were also investigated. RESULTS: Findings generally supported the empirical soundness and international robustness of the 6 domains including meaningful associations with familiar interview-rated PD types. CONCLUSIONS: The modified PID5BF+ may be employed internationally by clinicians and researchers for brief and reliable assessment of the 6 combined DSM-5 and ICD-11 domains, including 18 primary subfacets. This 6-domain framework may inform a future nosology for DSM-5.1 that is more reasonably aligned with the authoritative ICD-11 codes than the current DSM-5 AMPD model. The 36-item modified PID5BF+ scoring key is provided in online supplementary Appendix A see www.karger.com/doi/10.1159/000507589 (for all online suppl. material).

The Relationship Between the Personality Inventory for the DSM-5 (PID-5) and the Psychotic Disorder in a Clinical Sample.

Recent studies have successfully investigated the validity of the DSM-5 Alternative Model for Personality Disorders. In a final sample of 174 psychiatric patients, the present study examined the relationship between the Personality Inventory for the DSM-5 (PID-5) and syndromal psychosis. Results showed that patients diagnosed with versus without a psychotic disorder significantly differed on all PID-5 domains except Antagonism. Discriminant function analysis indicated that lower Detachment, lower Negative Affect, lower Disinhibition, and higher Psychoticism best discriminated patients with a psychotic disorder from patients with other psychiatric conditions. Subsequent stepwise discriminant analysis on all facet scales of the contributing PID-5 domains revealed that higher Unusual Beliefs, lower Depressivity, and lower Distractibility contributed the most to this differentiation. PID-5 Psychoticism scores showed moderate correlations with current psychotic symptoms and were not influenced by dose of antipsychotic medication. Our results support the ability of the PID-5 to discriminate between patients with and without psychotic disorder.

Self-Reported Cognitive Biases Are Equally Present in Patients Diagnosed With Psychotic Versus Nonpsychotic Disorders.

We investigated the relation between subjective cognitive biases measured with the Dutch Davos Assessment of Cognitive Biases (DACOBS-NL) and (1) the presence of a psychotic versus nonpsychotic psychiatric disorder, (2) the current dose of antipsychotic medication and current psychotic symptoms, and (3) the Personality Inventory for the DSM-5 (PID-5) Psychoticism personality trait. Results showed that DACOBS-NL subjective cognitive biases (1) were equally present in patients diagnosed with nonpsychotic disorders compared with patients with a psychotic disorder, (2) could not be explained by the current dose of antipsychotic medication, nor by current psychotic symptoms, and (3) significantly correlated with all PID-5 Personality domains. Moreover, in predicting membership of the psychotic versus nonpsychotic psychiatric disorder group, the addition of the PID-5 domains in step 2 rendered the contribution of the DACOBS-NL subjective cognitive biases in step 1 nonsignificant. Further research is needed to clarify the interplay between cognitive biases and aberrant salience in the prediction of psychotic disorders.

DSM-5 section III personality traits and section II personality disorders in a Flemish community sample.

The Personality Inventory for DSM-5 (PID-5; Krueger et al., 2012) is a dimensional self-report questionnaire designed to measure personality pathology according to the criterion B of the DSM-5 Section III personality model. In the current issue of DSM, this dimensional Section III personality model co-exists with the Section II categorical personality model derived from DSM-IV-TR. Therefore, investigation of the inter-relatedness of both models across populations and languages is warranted. In this study, we first examined the factor structure and reliability of the PID-5 in a Flemish community sample (N=509) by means of exploratory structural equation modeling and alpha coefficients. Next, we investigated the predictive ability of section III personality traits in relation to section II personality disorders through correlations and stepwise regression analyses. Results revealed a five factor solution for the PID-5, with adequate reliability of the facet scales. The variance in Section II personality disorders could be predicted by their theoretically comprising Section III personality traits, but additional Section III personality traits augmented this prediction. Based on current results, we discuss the Section II personality disorder conceptualization and the Section III personality disorder operationalization.

The Construct Validity of the Dutch Personality Inventory for DSM-5 Personality Disorders (PID-5) in a Clinical Sample.

The factor structure and the convergent validity of the Personality Inventory for DSM-5 (PID-5), a self-report questionnaire designed to measure personality pathology as advocated in the fifth edition, Section III of Diagnostic and Statistical Manual of Mental Disorders (DSM-5), are already demonstrated in general population samples, but need replication in clinical samples. In 240 Flemish inpatients, we examined the factor structure of the PID-5 by means of exploratory structural equation modeling. Additionally, we investigated differences in PID-5 higher order domain scores according to gender, age and educational level, and explored convergent and discriminant validity by relating the PID-5 with the Dimensional Assessment of Personality Pathology-Basic Questionnaire and by comparing PID-5 scores of inpatients with and without a DSM-IV categorical personality disorder diagnosis. Our results confirmed the original five-factor structure of the PID-5. The reliability and the convergent and discriminant validity of the PID-5 proved to be adequate. Implications for future research are discussed.

The Cognitive Biases Questionnaire for Psychosis (CBQ-P) and the Davos Assessment of Cognitive Biases (DACOBS): validation in a Flemish sample of psychotic patients and healthy controls.

OBJECTIVE: A large body of research has demonstrated the importance of cognitive biases in the development and maintenance of psychosis. Self-report scales for routine clinical practice have been developed only recently. Two new instruments on cognitive biases are evaluated: the Cognitive Biases Questionnaire for Psychosis and the Davos Assessment of Cognitive Biases Scale. METHODS: In a Flemish sample of 98 patients diagnosed with schizophrenia and 152 healthy controls, we investigated (1) the factor structure, (2) the reliability (internal consistency), (3) the discriminative power and (4) the convergent validity of the Dutch CBQ-P and the DACOBS. RESULTS: Using Confirmatory Factor Analysis, a 1-factor solution provided the best fit for the CBQ-P, and a 3-factor solution for the DACOBS. The CBQ-P Total Scale and the three scales of the DACOBS showed good internal consistencies. The CBQ-P Total Scale and all three DACOBS subscales were able to differentiate between healthy controls and patients diagnosed with schizophrenia, when controlling for age and years of education. The CBQ-P and DACOBS scales showed moderate correlations, confirming the convergent validity of both scales. CONCLUSIONS: The CPQ-P and DACOBS appear to be psychometrical sound instruments to assess general thinking bias in psychosis within a Flemish population. Implications for future research are discussed.