Measuring maladaptive personality traits with the Structured Clinical Interview for DSM-IV Axis II Screening Questionnaire using a common metrics approach.

The classification of personality disorder (PD) is undergoing a paradigm shift in which categorically defined specific PDs are being replaced by dimensionally defined maladaptive trait domains. To bridge the classificatory approaches, this study attempts to use items from the categorical PD model in DSM-IV to measure the maladaptive trait domains described in DSM-5 Section III/ICD-11. A general population sample comprising 1228 participants completed the Screening Questionnaire of the Structured Clinical Interview for DSM-IV Axis II (SCID-II-SQ), the Personality Inventory for DSM-5 (PID-5), and the anankastia scale of the Personality Inventory for ICD-11 (PiCD). Using item response theory models and a psychometric linking technique, SCID-II-SQ items were evaluated for their contribution to measuring maladaptive trait domains. The best discriminating items were then selected to derive proxy scales. We found that convergent validity of these proxy scales was in a similar range to that of other self-report measures for PD, except for the proxy scale for PiCD anankastia. However, only the proxy scale for negative affectivity showed acceptable reliability that would allow its application in research settings. Future studies should seek to establish a common metric between specific PDs and maladaptive trait domains using self-report measures with higher specificity or semi-structured interviews.

Mindreading measures misread? A multimethod investigation into the validity of self-report and task-based approaches.

Mindreading ability-also referred to as cognitive empathy or mentalizing-is typically conceptualized as a relatively stable dimension of individual differences in the ability to make accurate inferences about the mental states of others. This construct is primarily assessed using self-report questionnaires and task-based performance measures. However, the validity of these measures has been questioned: According to rival interpretations, mindreading tasks may capture general cognitive ability, whereas mindreading self-reports may capture perceived rather than actual mindreading ability. In this preregistered multimethod study involving 700 participants from the U.S. general population, we tested the validity of mindreading measures by examining the nomological network of self-reports and task-based methods using structural equation modeling. Specifically, we contrasted the empirical associations with theoretical predictions that assume mindreading measures are valid versus invalid. More consistent with rival interpretations, mindreading tasks showed a negligible latent correlation with mindreading self-reports (.05) and a large one with general cognitive ability (.85), whereas mindreading self-reports were specifically associated with perceived performance in mindreading tasks (.29). Also more consistent with rival interpretations, neither mindreading self-reports nor task-based measures showed positive unique associations with psychosocial functioning when controlling for general cognitive ability and general positive self-evaluation. Instead, negative unique associations emerged for both methods, although this effect was not robust for tasks. Overall, the results cast doubt on the validity of commonly used mindreading measures and support their rival interpretations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Development and Validation of the Certainty About Mental States Questionnaire (CAMSQ): A Self-Report Measure of Mentalizing Oneself and Others.

The Certainty About Mental States Questionnaire (CAMSQ) is a self-report measure of the perceived capacity to understand mental states of the self and others (i.e., mentalizing). In two studies (total N = 1828), we developed the CAMSQ in both English and German as a two-dimensional measure of Self- and Other-Certainty, investigated associations with other measures of mentalizing, and explored relationships to personality functioning and mental health. The CAMSQ performed well in terms of convergent and discriminant validity, internal consistency, test-retest reliability, and measurement invariance across the United States and Germany. The present research indicates that the CAMSQ assesses maladaptive forms of having too little or too much certainty about mental states (consistent with hypomentalizing and hypermentalizing). A psychologically adaptive profile of perceived mentalizing capacity appears to be characterized by high Self-Certainty that exceeds Other-Certainty, suggesting that imbalances between Self-Certainty and Other-Certainty (Other-Self-Discrepancy) play an important role within personality pathology.

Validating the German version of the Personality Disorder Severity-ICD-11 Scale using nominal response models.

The International Classification of Diseases (ICD-11) features a new classification of personality disorders (PD), focusing on the severity of PD. Although there are numerous self-report measures that assess PD severity, to date only the Personality Disorder Severity-ICD-11 (PDS-ICD-11) is based on ICD-11's operationalization of PD. Initial results indicated that the PDS-ICD-11 measures a unidimensional construct, but the assumptions made for scoring its bipolar items had not been fully examined. The aim of this study is to fill this gap and investigate the latent structure of the German version of the PDS-ICD-11 using nominal response models (NRM), which allow for testing these assumptions. We applied the PDS-ICD-11 together with other self-report measures in a sample of 1,228 individuals from the general population. NRM indicated an acceptable fit of a unidimensional model, with only few deviations from the theoretically imposed scoring scheme. The total score was sufficiently reliable and correlated meaningfully with other self-report measures of PD severity. Regarding Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and ICD-11 maladaptive trait domains, the total score was found to be most strongly associated with negative affectivity, whereas associations with antagonism and anankastia were small or nonsignificant. We conclude that the proposed scoring scheme of the PDS-ICD-11 items is acceptable, and the examined psychometric properties of the German version largely correspond to the results from the English-language development study. The total score, however, depicts more internalizing than externalizing personality pathology. Future studies should investigate the diagnostic efficiency of the PDS-ICD-11 scale using multiple methods and time points as well as clinical and forensic samples. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Mapping established psychopathology scales onto the Hierarchical Taxonomy of Psychopathology (HiTOP).

The Hierarchical Taxonomy of Psychopathology (HiTOP) organizes phenotypes of mental disorder based on empirical covariation, offering a comprehensive organizational framework from narrow symptoms to broader patterns of psychopathology. We argue that established self-report measures of psychopathology from the pre-HiTOP era should be systematically integrated into HiTOP to foster cumulative research and further the understanding of psychopathology structure. Hence, in this study, we mapped 92 established psychopathology (sub)scales onto the current HiTOP working model using data from an extensive battery of self-report assessments that was completed by community participants and outpatients (N = 909). Content validity ratings of the item pool were used to select indicators for a bifactor-(S-1) model of the p factor and five HiTOP spectra (i.e., internalizing, thought disorder, detachment, disinhibited externalizing, and antagonistic externalizing). The content-based HiTOP scales were validated against personality disorder diagnoses as assessed by standardized interviews. We then located established scales within the taxonomy by estimating the extent to which scales reflected higher-level HiTOP dimensions. The analyses shed light on the location of established psychopathology scales in HiTOP, identifying pure markers and blends of HiTOP spectra, as well as pure markers of the p factor (i.e., scales assessing mentalizing impairment and suspiciousness/epistemic mistrust).

Passing patients' tests-But how? An analysis of therapists' helping skills in response to patient testing.

According to control mastery theory, patients in psychotherapy try to master their problems by disconfirming their pathogenic beliefs. This can be done by testing the therapist. So far, there is hardly any evidence on what concrete interventions or statements of therapists are specifically helpful in passing those tests. In our study, we analyzed the verbal utterances of therapists in test situations to determine whether there is a difference in statements used for passing or failing tests. A total of 168 session transcripts of 21 patients were selected from a total of six therapists, two each in psychoanalytic therapy, psychodynamic therapy, and cognitive behavioral therapy. Test situations were identified, and therapist responses were coded using the helping skills system. There were significant differences in the therapists' reactions to test situations. In particular, closed questions, approval, interpretation, and reflection of the patients' feelings by therapists were associated with a high probability of passing tests. These findings can especially support therapists-in-training to obtain an orientation on how to deal with their patients' test situations that may be perceived as challenging and are important for therapy success while respecting the individuality of their patients. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A Critical Evaluation of the Reflective Functioning Questionnaire (RFQ).

The Reflective Functioning Questionnaire (RFQ) is an 8-item self-report measure of reflective functioning that is presumed to capture individual differences in hypo- and hypermentalizing. Despite its broad acceptance by the field, we argue that the validity of the measure is not well-established. The current research elaborates on problems of the RFQ related to its item content, scoring procedure, dimensionality, and associations with psychopathology. We tested these considerations across three large clinical and non-clinical samples from Germany and the US (total N = 2289). In a first study, we found that the RFQ may assess a single latent dimension related to hypomentalizing but is rather unlikely to capture maladaptive forms of hypermentalizing. Moreover, the RFQ exhibited very strong associations with measures of personality pathology, while associations with measures of symptom distress were less strong. In a second preregistered study focused on convergent and discriminant validity, however, a commonality analysis indicated that associations with indicators of personality pathology are inflated because some of the RFQ items tap into emotional lability and impulsivity rather than mentalizing. Our findings demonstrate limitations of the RFQ. We discuss key challenges in assessing mentalizing via self-report.

[The German Version of the Reflective Functioning Questionnaire (RFQ): A Psychometric Evaluation in the General Population]. / Die deutsche Version des Reflective Functioning Questionnaire (RFQ): Eine teststatistische Überprüfung in der Allgemeinbevölkerung.

The concept of mentalization has attracted broad clinical and scientific interest, particularly because of its high clinical and therapeutic relevance. To make this concept accessible for empirical research, the 8-item Reflective Functioning Questionnaire (RFQ-8) was developed, which comprises 2 subscales tapping into uncertainty about mental states (or hypomentalizing), and certainty about mental states (i. e. hypermentalizing). Although first psychometric examinations have evaluated the RFQ-8 positively, these findings must be interpreted with caution for methodological reasons. The aim of this study was the psychometric evaluation of the German version of the RFQ-8 in a large general population sample (n=2477). Various confirmatory and exploratory factor analyses indicated that the originally introduced 2-factor solution is mis-specified. Instead, the RFQ-8 seems to cover a unidimensional construct. Having excluded 2 items due to their insufficient psychometric qualities, the 6-item measure (RFQ-6) showed high internal consistency (McDonald's ω=0,88) as well as significant rank correlations with depression, anxiety and bodily complaints. Considering the psychometric limitations of the RFQ-8, its use in clinical routine and research should be viewed very critically, particularly with respect to its ability to assess hypermentalizing.

The latent structure of interpersonal problems: Validity of dimensional, categorical, and hybrid models.

Interpersonal problems are key transdiagnostic constructs in psychopathology. In the past, investigators have neglected the importance of operationalizing interpersonal problems according to their latent structure by using divergent representations of the construct: (a) computing scores for severity, agency, and communion ("dimensional approach"), (b) classifying persons into subgroups with respect to their interpersonal profile ("categorical approach"). This hinders cumulative research on interpersonal problems, because findings cannot be integrated both from a conceptual and a statistical point of view. We provide a comprehensive evaluation of interpersonal problems by enlisting several large samples (Ns = 5,400, 491, 656, and 712) to estimate a set of latent variable candidate models, covering the spectrum of purely dimensional (i.e., confirmatory factor analysis using Gaussian and nonnormal latent t-distributions), hybrid (i.e., semiparametric factor analysis), and purely categorical approaches (latent class analysis). Statistical models were compared with regard to their structural validity, as evaluated by model fit (corrected Akaike's information criterion and the Bayesian information criterion), and their concurrent validity, as defined by the models' ability to predict relevant external variables. Across samples, the fully dimensional model performed best in terms of model fit, prediction, robustness, and parsimony. We found scant evidence that categorical and hybrid models provide incremental value for understanding interpersonal problems. Our results indicate that the latent structure of interpersonal problems is best represented by continuous dimensions, especially when one allows for nonnormal latent distributions. (PsycINFO Database Record (c) 2019 APA, all rights reserved).