Alexithymia and attachment insecurities in impulsive aggression.

The aims of this study were to develop a new measure of impulsive aggressiveness, and to assess whether this measure was associated with deficits in mentalized affectivity and adult attachment styles in a sample of 637 non-clinical participants. Extending Fonagy and Bateman's (2004) hypothesis, the mediating role of poor affectivity mentalization in the relationship between insecure attachment styles and impulsive aggression was also evaluated. Selected insecure attachment styles (R2(adjusted) = .18, p < .001) and deficits in mentalized affectivity (R(2)(adjusted) = .25, p < .001) were significantly associated with impulsive aggressiveness. The overall regression model accounted for roughly 33% of the variance in impulsive aggressiveness. Mentalization deficits significantly mediated the effects of attachment styles on impulsive aggressiveness, although effect size measures suggested that only partial mediation occurred.

Reliability and validity of the Italian version of the Temperament and Character Inventory-Revised in an outpatient sample.

OBJECTIVE: The aim of this study was to evaluate the reliability and validity of the Temperament and Character Inventory-Revised (TCI-R) in an outpatient sample. METHOD: The TCI-R was administered to 404 consecutively admitted subjects. The TCI-R scale 1-month test-retest reliability and TCI-R/TCI convergent validity were assessed in 2 independent subsamples. RESULTS: The TCI-R scales showed adequate Cronbach alpha values and acceptable 1-month test-retest reliability coefficients. Although many TCI-R facets showed factorial complexity, factor analysis results were consistent with the 7-factor structure of the TCI-R scales. The predictive validity of TCI-R profiles for personality disorder diagnoses was confirmed, with different combinations of temperament dimensions being associated with specific personality disorders. CONCLUSIONS: The TCI-R was a reliable and valid instrument for assessing temperament and character features, at least among Italian outpatients. The TCI-R psychometric properties support its clinical usefulness in the assessing of personality psychopathology.

Impulsivity, aggressiveness, and DSM-IV personality disorders.

The aim of this study is to assess whether impulsive and aggressive traits can be placed on a continuum with DSM-IV Cluster B Personality Disorders (PDs) and to determine if different aspects of these personality traits are specifically associated with individual Cluster B PDs. The study group comprised 461 outpatients admitted consecutively to a clinic that specializes in the diagnosis and treatment of PDs. Principal component analyses clearly suggested a five-factor structure of both normal and psychopathological personality traits. Importantly, measures of impulsivity, aggressiveness and novelty seeking formed a part of the principal component that clustered all Cluster B PDs. Regression analyses indicated that impulsive traits were selectively associated with Borderline PD whereas different aspects of aggressiveness were useful in discriminating Narcissistic PD from Antisocial PD. Sensation seeking traits formed a part of Histrionic PD. These results indicate that impulsive/aggressive traits may be useful in explaining both why Cluster B PDs tend to covary, and why they frequently differ in clinical pictures and courses.

Confirmatory factor analyses of DSM-IV Cluster C personality disorder criteria.

Notwithstanding its research and clinical relevance, the dimensionality and validity of the DSM-IV avoidant, dependent, and obsessive-compulsive personality disorders (PDs) criteria is still a largely unexplored topic. The aim of this study was to test the factor structure for DSM-IV Cluster C PD criteria in a sample of 641 consecutively admitted outpatients. Factor analysis results suggested that avoidant, dependent, and obsessive-compulsive PDs share a common latent dimension, and supported the three-factor structure of both observer and self-report ratings of DSM-IV Cluster C PD criteria. The pattern of factor loadings, however, was different from the one expected according to the DSM-IV classification.

Taxonic structure of schizotypal personality disorder: a multiple-instrument, multi-sample study based on mixture models.

This study used a multi-sample, multiple-instrument strategy to evaluate the hypothesis that schizotypal personality disorder (SPD) is taxonic. In Study 1, 721 consecutively admitted inpatients and outpatients were evaluated with the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II) and the Personality Diagnostic Questionnaire-4+ (PDQ-4+). The data from both questionnaire types were submitted to multivariate normal mixture analysis, which was carried out on factor scores obtained from a three-factor model of SPD criteria; these results supported the hypothesis that SPD is taxonic. The same was true of Study 2, which administered the Semi-structured Interview for DSM-III-R Personality Disorders (SIDP-R) to an independent sample of 537 consecutively admitted outpatients. Similar findings were observed in Study 3, in which the SIDP-R was administered to 225 non-clinical subjects. The results show that the typology of DSM III-R and -IV SPD diagnosis is consistent with the latent structure of SPD features.

A latent structure analysis of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Narcissistic Personality Disorder criteria.

The aim of this study was to examine the latent structure of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), Narcissistic Personality Disorder (NPD) criteria in a group of 641 outpatients. The consecutively admitted outpatients were administered the Structured Clinical Interview for DSM-IV Axis II Personality Disorders, Version 2.0, and the Personality Questionnaire. Both confirmatory and exploratory factor analyses (CFA and EFA, respectively) were used to evaluate whether the NPD criteria measure a single latent trait. Latent class analysis was used to assess the diagnostic accuracy of the individual DSM-IV NPD criteria. Mean above minus below a cut (MAMBAC) and maximum covariance (MAXCOV) taxometric analyses were used to evaluate whether the latent distribution of the DSM-IV NPD features is actually discrete. Both CFA and EFA results showed that the 9 DSM-IV NPD criteria loaded on 2 correlated factors. The latent class analysis results suggested a 3-class solution for NPD criteria; relevant differences in diagnostic efficiency were observed among the NPD criteria. MAMBAC and MAXCOV analyses provided consistent evidence of taxonic (ie, discrete) latent structure for NPD. This study gave only partial support to the validity of the DSM-IV NPD construct. Taxometric analyses indicated that a typological model is appropriate for describing NPD, but CFA and EFA suggested the existence of 2 distinct-albeit correlated-clusters of narcissistic features. As a whole, the DSM-IV criteria discriminated NPD from other personality disorders, but diagnostic accuracy statistics did not replicate the rank order of diagnostic efficiency of NPD criteria proposed by the DSM-IV.

Predicting borderline and antisocial personality disorder features in nonclinical subjects using measures of impulsivity and aggressiveness.

This study examines impulsivity and aggressiveness dimensions as predictors of borderline (BPD) and antisocial (ASPD) personality disorder symptoms in nonclinical subjects. A total of 747 undergraduate university students were administered the Personality Diagnostic Questionnaire-4+, the Barratt Impulsiveness Scale-11, and the Buss-Durkee Hostility Inventory. Hierarchical regression analysis showed that motor impulsiveness, irritability, resentment, and guilt predicted BPD symptoms among university students after controlling for the effect of ASPD and depressive symptoms. ASPD symptoms were predicted by motor impulsiveness, physical aggression, indirect aggression, and negativism. These results indicate that in nonclinical subjects BPD and ASPD symptoms share a common impulsivity dimension but are linked to different aggressiveness facets.