Intrinsic Traits Such as Personality and Decision-Making Style are Predictive of Stress in Surrogate Decision-Makers.

Introduction: Despite its prominence in psychology, little is known about how personality traits play a role in the stress experiences of surrogate decision-makers. We tested the hypothesis that intrinsic traits (personality and decision-making styles) would be related to surrogates' stress in order to learn whether screening or tailoring interventions based on personality traits could help support surrogate decision-makers. Methods: This pre-specified secondary analysis evaluated data from an interventional study with dyads of patients with advanced chronic illness and their spokespersons. Measures included stress after decision-making or patient death (Impact of Events-Revised), personality (Big Five Index; BFI) and decision-making style (maximization and regret scales). Multivariate linear regressions explored the impact of personality on the stress experience; linear regressions independently modeled the impact of maximization and regret on the stress experience. Results: Of 38 spokespersons, 89.5% were women, 97.4% non-Hispanic, and 29.0% had a college degree or higher. In univariate analyses, total stress was correlated with neuroticism (r = .56, P < .01), higher scores on the regret (r = .55, P < .01) and maximization (r = .48, P < .05). In adjusted models, BFI was significantly associated with total stress (R2 = 27.08, P = .02). However, only neuroticism was independently associated with total stress. Conclusions: Personality traits, particularly neuroticism, and decision-making styles predicted heightened stress in spokespersons of patients with advanced chronic illness. If ACP interventions are intended to reduce spokesperson stress, personality and decision-making style scales may help identify spokespersons most likely to benefit from ACP interventions.

Trading Patients: Applying the Alternative Model for Personality Disorders to Two Cases of DSM-5 Borderline Personality Disorder Over Time and Across Therapists.

The DSM-5 Alternative Model for Personality Disorders (AMPD) dimensionally defines personality pathology using severity of dysfunction and maladaptive style. As the empirical literature on the clinical utility of the AMPD grows, there is a need to examine changes in diagnostic profiles and personality expression in treatment over time. Assessing these changes in individuals diagnosed with borderline personality disorder (BPD) is complicated by the tendency for patients to cycle through multiple therapists over the course of treatment leaving the potential for muddled diagnostic clarity and disjointed case conceptualizations. Following patient trajectories across therapists offers a unique opportunity to examine the AMPD's sensitivity to and utility for capturing personality stability and change over time for patients with BPD. This article demonstrates the utility of the AMPD for two clinical cases in three distinct ways: (i) highlighting heterogeneity in BPD between patients, (ii) comparing improvements in personality severity and style over time, and (iii) elucidating profile change across therapist ratings. We present two patients diagnosed with DSM-5 Section II BPD, crossing between two therapists over the course of 3 years of psychodynamic psychotherapy. Treating clinicians rated patients for their respective treatment phases using the Level of Personality Functioning Scale (LPFS), capturing severity, and the Personality Inventory for the DSM-5 (PID-5), capturing style. AMPD diagnostic profiles differentiated patients with BPD in both severity and style, and captured within-patient change beyond within-therapist response bias. Results indicated greater improvements in personality severity while personality style remained more stable. Implications for the patients' treatment progress and associated challenges are discussed, as are considerations for the utility of the AMPD in therapy.

Examining the Structure and Validity of Self-Report Measures of DSM-5 Alternative Model for Personality Disorders Criterion A.

The Level of Personality Functioning Scale (LPFS) operationalizes Criterion A of the DSM-5 Alternative Model for Personality Disorders. Despite progress in LPFS measurement development and validation, there is a lack of research, and some disagreement, concerning structural, convergent, and incremental validity of LPFS self-report measures. The present study aimed to compare the LPFS Self-Report, LPFS Self-Report of Criterion A, and LPFS Brief Form. Internal structure was assessed through principal component analyses, factor analyses, and bifactor analyses of unidimensionality. Associations with both pathological and basic personality characteristics among the LPFS measures were explored. Incremental validity of LPFS severity in predicting pathological personality outcomes controlling for basic personality traits, and the reverse, were examined. Results suggest a unidimensional structure robustly associated with other pathological personality assessments. LPFS severity and basic personality traits mutually offered unique explanatory power. We discuss the implications of assessing personality pathology using LPFS self-report measures.

My problem or yours? Interpersonal problems and marital quality.

OBJECTIVE: Research has consistently illustrated the impact of personality on marital quality. Given the inherent dyadic nature of relationships, recent investigations have integrated spouse-rated personality to account for both spouses' perspectives. Grounded in Contemporary Integrative Interpersonal Theory, we viewed personality through an interpersonal lens and conceptualized maladaptive interpersonal functioning as interpersonal problems. The present study examined the incremental validity of spouse-rated interpersonal problems beyond self-reported interpersonal problems to predict marital quality within an expanded actor-partner interdependence model (APIM). METHOD: Within a community sample of heterosexual, married couples (N = 110), we used expanded APIMs, integrating both self-report and spouse-rating, to test the incremental validity of spouse-perceived interpersonal problems over self-perceived interpersonal problems on marital quality through a model comparison approach. We tested for possible gender differences in effects. RESULTS: Spouse perception, notably spouse-rated partner effects, appears to be the most frequent predictor of marital quality, and self-perception had less impact. CONCLUSION: Given the implications marital quality has on health and well-being, intervention efforts capitalizing on acceptance of spouses' perspectives are likely to lead to greater improvements in quality and overall health.

Construction and Validation of the Interpersonal Influence Tactics Circumplex (IIT-C) Scales.

Assessment of interpersonal dispositions (e.g., traits, problems) commonly employs self- and informant-report measures that conform to the two-dimensional interpersonal circumplex (IPC) model. Here, we adopted the IPC and interpersonal theory as a framework for mapping the universe of content of interpersonal influence. Although there are existing measures of influence tactics used in influence research, this literature is divided among disciplines with varying construct definitions and no unifying theory. Here, we define interpersonal influence as the conscious maneuvering of one's behavior to engender desired responses from others in interpersonal situations. The current article details the construction and validation of the Interpersonal Influence Tactics Circumplex (IIT-C) Scales in two samples (Ns = 862, 608). The 64-item IIT-C assesses a comprehensive taxonomy of interpersonal influence tactics conforming to the structure of the IPC. Circumplex structure of the IIT-C was confirmed and replicated. Using the structural summary method for circumplex data, associations with other IPC measures, existing measures of influence, normal personality traits, and pathological personality traits supported the validity of IIT-C scores. The IIT-C assesses a theoretically based and empirically derived set of interpersonal influence tactics and provides a common language for integrating distinct streams of influence research by conforming to the IPC.

The Symbolic Nature of Trust in Heterosexual Adolescent Romantic Relationships.

Trust contributes to young people's capacity for sustaining current and future successful relationships. To date, research has yet to examine the meaning of trust in early dating relationships and reasons for its deterioration. The present study focused on video-recorded conversations about trust between 34 heterosexual adolescent couples in dating relationships living in the U.S. Transcripts from these conversations were qualitatively analyzed using thematic analysis to identify adolescents' meanings of trust and reasons they provided for a lack of trust in their romantic partners. All 34 couples identified concerns specifically related to infidelity. Six major themes for not trusting romantic partners emerged. Results suggested that the lack of trust in romantic relationships might stem from several areas that are directly and indirectly related to the current relationship, including low self-esteem, the experience of betrayal in past romantic relationships, partners' extradyadic behaviors, and gossip among peers. Importantly, peers can play a defining role in influencing young people's perceptions of their romantic partners and developing or sustaining trust in their romantic relationships.

Emotion Dysregulation, Gender, and Intimate Partner Violence Perpetration: An Exploratory Study in College Students.

Intimate partner violence (IPV) is a prevalent problem, as it is bidirectional and perpetrated by both men and women. Emotion dysregulation may influence IPV perpetration among men and women. This cross-sectional survey study of 598 college students investigated the associations between two important factors related to IPV perpetration: gender and emotion dysregulation. Findings illustrated an association between emotion dysregulation and IPV perpetration. The bivariate association between physical violence and one facet of emotion dysregulation differed by gender, such that lack of emotional awareness was associated with violence perpetrated by women, but not men; however, this was not supported in multivariate analyses. These preliminary findings suggest that future work should examine how different emotion regulation deficits may increase IPV by gender.