The role of clinical and Personological features in predicting high lethality suicide attempts: A study among mood disorder patients.

Suicidal attempts (SA) represent heterogeneous behaviours ranging in their seriousness from fatal and near-fatal (high-lethality) cases to those that do not require medical attention (low lethality). These considerations stress the need to identify high-risk individuals for high lethality SA in order to target suicide preventive interventions. The present study aims at evaluating the role of sociodemographic and clinical variables and examining personality pathological features in predicting high lethality SA. The sample was composed by 94 patients who were consecutively admitted to the Mood Disorders Unit of the San Raffaele Turro Hospital in Milan. The results of binary logistic regression analyses showed that previous SA and current suicide ideation play a role in predicting serious SA. Considering the DSM-5 personality dysfunctional domains assessed by the Personality Inventory for DSM-5, our logistic regression analyses suggested that high lethality SA was associated with Detachment PID-5 domain. Finally, binary hierarchical regression analysis showed that Detachment domain remained a significant predictor of serious SA over and above the effect of previous SA and suicide ideation. As a whole, our results highlight the importance of a multidimensional approach to develop adequate assessment, effective treatments and prevention of high lethality SA risk.

The Co-Occurrence of Trauma Related Disorder and Borderline Personality Disorder: AQ Study on a Clinical Sample of Patients Seeking Psychotherapy Treatment.

The nature of the relationship between borderline personality disorder (borderline PD), post-traumatic stress disorder (PTSD) and complex PTSD remains controversial. In this study we attempted to investigate the association between traumatic events and borderline PD and the co-occurrence of complex PTSD, PTSD and borderline PD. Finally, we tested the association between complex PTSD and PTSD diagnoses and other DSM-5 Section II personality disorders. In a sample of 416 patients, we administered the International Trauma Questionnaire (ITQ) to evaluate the PTSD/complex PTSD diagnoses and the Structured Clinical Interview for DSM-5 Personality Disorders (SCID-5-PD) and the Personality Diagnostic Questionnaire- 4+ (PDQ-4+) to assess borderline PD and other PDs. One hundred-twenty-three participants reported experiencing one or more traumatic events. Our findings show that the presence of adverse events does not represent a risk factor for borderline PD assessed using both SCID-5-PD and PDQ4+. A co-occurrence of borderline PD diagnoses and complex PTSD/PTSD diagnoses has not been observed. We found a significant association only between complex PTSD and schizoid personality disorder assessed using PDQ4+. Our findings suggest relevant clinical implications for the development of effective treatment for complex PTSD, PTSD and borderline PD.

Assessing Mental Representation as an Indicator of Self and Interpersonal Functioning in Psychotherapy Patients.

The goal of this study was to test in a clinical sample the interrater reliability and convergent validity of the Differentiation-Relatedness Scale (D-RS), a measure that evaluates mental representations based on open-ended descriptions of self and significant others. The study also investigated the ability of the D-RS to predict personality disorders (PDs) from Section II of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and the dysfunctional trait domains presented in the Alternative DSM-5 Model for Personality Disorders Criterion B in Section III of the DSM-5. We also evaluated if the D-RS predicts observed Section II PDs over and above Criterion B of the Alternative DSM-5 Model for Personality Disorders. We found that the interrater reliability of the D-RS was good on the basis of the mean scores of 6 independent raters and that it showed moderate convergent validity. Results of dominance analyses indicated that the D-RS is a significant predictor of Section II borderline PD and of the overall number of DSM-5 PDs. When we considered the Section III Criterion B for PDs, the D-RS was not able to predict any of the Personality Inventory for DSM-5 domains, suggesting that the D-RS may be more related to personality functioning behind mental representations than to maladaptive personality traits. Finally, results of hierarchical regression analyses suggested that the D-RS produced a significant but modest increase in the prediction of borderline PD traits and the overall number of PDs traits even when the effect of the Personality Inventory for DSM-5 domains were controlled for.

Assessing dark triad dimensions from the perspective of moral disengagement and DSM-5 alternative model of personality disorder traits.

The present study aimed to test the relationships of Dark Triad constructs with propensity toward moral disengagement and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Alternative Model of Personality Disorder (AMPD) maladaptive personality traits. A total of 279 community-dwelling adult participants (41.6% male; Mage = 32.27 years) were administered the Two-Dimensional Mach-IV Scale, Five-Factor Narcissism Inventory-Short Form, Triarchic Psychopathy Measure, Personality Inventory for DSM-5, and Moral Disengagement Scale. Multiple regression results showed differential associations between Dark Triad construct traits and propensity toward moral disengagement. Correlation analyses showed that all Dark Triad trait dimensions could be substantially described in terms of AMPD maladaptive trait profile. When the effect of Moral Disengagement Scale scores was taken into account in relative importance weights analysis (Radjusted2 = .66), DSM-5 AMPD maladaptive trait profile explained 27% of the variance in the "Dark Triad" latent factor over and above the effect of moral disengagement. As a whole, our findings supported the idea that the Dark Triad personality constructs are likely to share a common core of antagonistic maladaptive personality traits. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

The Inter-Rater Reliability and Validity of the Italian Translation of the Structured Clinical Interview for DSM-5 Alternative Model for Personality Disorders Module I and Module II: A Preliminary Report on Consecutively Admitted Psychotherapy Outpatients.

To evaluate the reliability and convergent validity of the Structured Clinical Interview for DSM-5 Alternative Model for Personality Disorders (SCID-5-AMPD) Module I and Module II, 88 adult psychotherapy participants were administered the Italian translations of the SCID-5-AMPD Module I and Module II, Level of Personality Functioning Scale-Brief Form (LPFS-BF), Level of Personality Functioning Scale-Self Report (LPFS-SF), Personality Inventory for DSM-5 (PID-5), Personality Diagnostic Questionnaire-4+ (PDQ-4+), and Structured Clinical Interview for DSM-5 Personality Disorders (SCID-5-PD) relying on a Williams crossover design. SCID-5-AMPD Module I and Module II showed excellent inter-rater reliability. In terms of convergent validity, meaningful associations were observed between SCID-5-AMPD Module I scores and self-report measures of Criterion A; similarly, SCID-5-AMPD Module II trait scores were meaningfully related to PID-5 trait scores. As a whole, our preliminary findings supported the clinical utility of DSM-5 AMPD.

Assessing the relationships between self-reports of childhood adverse experiences and DSM-5 alternative model of personality disorder traits and domains: A study on Italian community-dwelling adults.

A body of research suggests that child maltreatment may not represent an uncommon phenomenon. Adverse childhood experiences have been consistently linked to a variety of mental disorders, including personality disorder. Starting from these considerations, we aimed at testing the associations between retrospective self-reports of childhood abuse and Personality Inventory for DSM-5 (PID-5) traits and domains in a sample of community-dwelling adult participants (N = 369; 41.2% male). PID-5 scales yielded 63 (52.5%) rank-order correlations with self-reports of childhood abuse that were significant at Bonferroni-corrected p level (i.e. p < 0.00042), with values ranging from 0.18 to 0.36. According to Fisher's z-test for correlation coefficient homogeneity, the wide majority of the correlations were reproduced across male participants and female participants. Partial rank-order correlation analyses highlighted specific personality profiles that were uniquely, albeit modestly associated with memories of childhood abuse. Confirming and extending previous findings, our results showed that retrospective reports of childhood abuse are significantly, albeit moderately associated with different dysfunctional personality traits, at least in Italian community-dwelling adults. As a whole, our data seemed to stress the importance of PID-5 traits and domains in improving our understanding of the relationships between self-reports of childhood abuse and dysfunctional personality dimensions in adulthood. © 2019 John Wiley & Sons, Ltd.

Construct validity and diagnostic accuracy of the Italian translation of the 18-Item World Health Organization Adult ADHD Self-Report Scale (ASRS-18) Italian translation in a sample of community-dwelling adolescents.

Aim of this prospective study was to evaluate the factor structure, internal consistency, and diagnostic efficacy of the Italian translation of the Adult ADHD Self-Report Scale (ASRS-18; Kessler et al., 2005, 2007) in a sample of community-dwelling sample of adolescents. Three hundred eight Italian adolescents attending professional high schools were administered the ASRS-18; the adolescence ADHD module of the MINI interview was administered to obtain ADHD criterion diagnoses. Robust maximum likelihood confirmatory factor analysis results identified a bifactor model of the ASRS-18 items as the best-fitting model, RMSEA = 0.029, p > 0.99, TLI = 0.93, CFI = 0.95. Further analyses showed that 77.9% of the ASRS-18 reliable (ω = 0.78) score variance was due to the total score. In our study the ASRS-18 proved to be able to effectively differentiate adolescents who received a MINI ADHD diagnosis (n = 80) from adolescents who did not receive a MINI ADHD diagnosis (n = 163), area under the curve = 0.80, 95% confidence interval = 0.74, 0.86. Our data suggest that the ASRS-18 may represent an effective self-report measure to screen for ADHD in community-dwelling adolescents, at least in its Italian translation.

Item Response Theory Analyses, Factor Structure, and External Correlates of the Italian Translation of the Personality Inventory for DSM-5 Short Form in Community-Dwelling Adults and Clinical Adults.

To assess the psychometric properties of the Italian translation of the 100-item short form of the Personality Inventory for DSM-5 (PID-5-SF), 2,143 community-dwelling adults (59.6% female), and 706 adult clinical participants (52.4% female) were administered the Italian translation of the PID-5. Clinical participants were also administered the Structured Clinical Interview for DSM-IV (SCID-II), and the Personality Diagnostic Questionnaire-4+ (PDQ-4+). Item response theory analysis showed that all proposed PID-5-SF items showed adequate item discrimination parameters in both community-dwelling adults and clinical adults. All PID-5-SF trait scales showed satisfactory internal consistency estimates. PID-5-SF five-factor structure closely matched the factor structure of the PID-5 in both community-dwelling participants and clinical participants and was invariant across the two samples that participated in this study. Moreover, the factor structure of the PID-5-SF closely replicated the factor of the PID-5-SF that was originally reported in Maples et al.'s study. In our clinical sample, dominance analysis results showed that PID-5-SF scales explained a nonnegligible and significant amount of variance in both SCID-II and PDQ-4+ ratings of selected DSM-5 Section II personality disorder, and the use of the PID-5-SF did not result in a substantial loss of information as compared with the original PID-5.

Modeling the Structure of the Triarchic Psychopathy Measure: Conceptual, Empirical, and Analytic Considerations.

This study sought to characterize the factor structure of the Triarchic Psychopathy Measure (TriPM) using data from a sample of 1,082 community-dwelling Italian adults. Exploratory structural equation modeling (ESEM) was used to compare the fit of a bifactor model for each TriPM scale, in which specific-content factors were specified along with a general factor, with the fit of a single, general-factor model. Robust weighted least square (WLSMV) ESEM supported a bifactor latent structure of the TriPM items for all individual scales. When we jointly factor analyzed the 58 TriPM items, a WLSMV ESEM three-factor structure showed adequate fit; the three ESEM factors were akin to TriPM Boldness, Meanness, and Disinhibition theoretical dimensions, respectively, and could be effectively replicated across gender subgroups. Our findings support the three-factor structure of TriPM items, at least in Italian community-dwelling adults, and provide further evidence for the construct validity of the TriPM.

Further evidence for the validity of a response inconsistency scale for the Personality Inventory for DSM-5 in Italian community-dwelling adolescents, community-dwelling adults, and clinical adults.

Response inconsistency represents a major component of careless responding. Keeley, J. W., Webb, Peterson, Roussin, and Flanagan (2016) proposed a measure of response inconsistency for the Personality Inventory for DSM-5 (PID-5-VRIN). In order to evaluate the ability of the PID-5-VRIN scale to detect inconsistent responding, we examined 3 independent archival samples of Italian community-dwelling adolescents (N = 1,264), community-dwelling adults (N = 2,143), and clinical adults (N = 706) who were administered the PID-5. The impact of PID-5-VRIN scores on the associations with interview-based personality disorder (PD) scores was also assessed among clinical adults. PID-5-VRIN item pairs showed correlational values of at least medium size by conventional standards. Moreover, the PID-5-VRIN seemed to be efficient in discriminating real data from random responses in all samples. In line with Keeley and colleagues' findings, a PID-5-VRIN total score of 17 represented the best balance between sensitivity and specificity in all samples. Clinical adult participants who met this threshold for invalidity also obtained significantly higher scores on the majority of PID-5 trait scales. When the correlations between selected PID-5 trait scale scores and the corresponding interview-based ratings of DSM-5 Section II PDs were considered, appreciable differences in the magnitude and/or direction of association were observed between participants scoring below the PID-5-VRIN cutoff and those meeting the threshold for invalidity (≥17). As a whole, our data suggest that the PID-5-VRIN represents an efficient means of assessing inconsistent responding on the PID-5. (PsycINFO Database Record

Assessing Dimensions of Pathological Narcissism: Psychometric Properties of the Short Form of the Five-Factor Narcissism Inventory in a Sample of Italian University Students.

To evaluate the psychometric properties of the Italian translation of the Five-Factor Narcissism Inventory-Short Form (FFNI-SF), 1,063 Italian university students were administered the scale, along with the Pathological Narcissism Inventory (PNI) and the Measure of Disordered Personality Functioning (MDPF). In general, the FFNI-SF scales showed good internal consistency (median α = .76; median interitem r = .44) and structural analyses suggested a 3-component model of FFNI-SF scales that was similar to that reported by Sherman et al. (2015). FFNI-SF second-order scales yielded meaningful convergent and discriminant correlations with PNI second-order grandiose and vulnerable dimensions. Finally, FFNI-SF second-order scales correlated in expected ways with 2 dimensions of personality dysfunction.

On studying narcissism in personality inventories rather than the Narcissistic Personality Inventory: Reply to Miller and Lynam (2017).

Miller and Lynam's (2017) commentary proved to be very helpful in clarifying that ralerting-CV and rcontrast-CV coefficient values reported in our study indicated that the Narcissistic Personality Inventory (NPI) yielded a trait profile much more closely aligned with expert ratings of Diagnostic and Statistical Manual of Mental Disorders (4th edition; DSM-IV) narcissistic personality disorder (NPD) than did other measures. The commentary gives us the opportunity to make it clear that our study was designed to demonstrate the clinical usefulness of Personality Inventory for DSM-5 (PID-5) domain and trait scales in profiling pathological narcissism. Thus, demonstrating the superiority/inferiority of the Pathological Narcissism Inventory (PNI) over the NPI was not among the aims of our study. The publication of the commentary also gives us the opportunity to clarify the reasons why we think that the interpretation of the ralerting-CV and rcontrast-CV coefficients deserves some cautions. As a final remark, we think that the time has come to move from personality disorder classifications based on "clinical wisdom" to a redefinition of personality pathology in terms of systems of traits. (PsycINFO Database Record

On the relationships between DSM-5 dysfunctional personality traits and social cognition deficits: A study in a sample of consecutively admitted Italian psychotherapy patients.

This study aims at testing the hypothesis that the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5) alternative model of personality disorder (AMPD) traits may be significantly associated with deficits on 2 different social cognition tasks, namely, the Reading the Mind in the Eyes Test and the Movie for the Assessment of Social Cognition, in a sample of consecutively admitted inpatients and outpatients. The sample was composed of 181 consecutively admitted participants (57.5% women; mean age = 38.58 years). Correlation coefficients and partial correlation coefficients were computed in order to assess the associations among social cognition tasks, DSM-5 AMPD traits, and dimensionally assessed DSM-5 Section II personality disorders. Specific maladaptive traits listed in the DSM-5 AMPD were significantly associated with Reading the Mind in the Eyes Test scores and Movie for the Assessment of Social Cognition scores, even when the effect of selected DSM-5 Section II personality disorders was controlled for. Our results support the relevance of studying social cognitive functioning in subjects suffering from personality disorders.

Reliability, Factor Structure, and Associations With Measures of Problem Relationship and Behavior of the Personality Inventory for DSM-5 in a Sample of Italian Community-Dwelling Adolescents.

In order to assess the reliability, factorial validity, and criterion validity of the Personality Inventory for DSM-5 (PID-5) among adolescents, 1,264 Italian high school students were administered the PID-5. Participants were also administered the Questionnaire on Relationships and Substance Use as a criterion measure. In the full sample, McDonald's ω values were adequate for the PID-5 scales (median ω = .85, SD = .06), except for Suspiciousness. However, all PID-5 scales showed average inter-item correlation values in the .20-.55 range. Exploratory structural equation modeling analyses provided moderate support for the a priori model of PID-5 trait scales. Ordinal logistic regression analyses showed that selected PID-5 trait scales predicted a significant, albeit moderate (Cox & Snell R2 values ranged from .08 to .15, all ps < .001) amount of variance in Questionnaire on Relationships and Substance Use variables.

Profiling pathological narcissism according to DSM-5 domains and traits: A study on consecutively admitted Italian psychotherapy patients.

[Correction Notice: An Erratum for this article was reported in Vol 29(11) of Psychological Assessment (see record 2016-56886-001). In the article, several values were reversed and the mean was misreported in Table 2. The corrected table is present in the erratum.] Pathological narcissism represents a clinically relevant, albeit controversial personality construct, with multiple conceptualizations that are operationalized by different measures. Even in the recently published Diagnostic and Statistical Manual for Mental Disorders-Fifth Edition (DSM-5), 2 different views of narcissistic personality disorder (NPD) are formulated (i.e., Section II and Section III). The DSM-5 Section III alternative PD model diagnosis of NPD is based on self and interpersonal dysfunction (Criterion A) and a profile of maladaptive personality traits (Criterion B), specifically elevated scores on Attention Seeking and Grandiosity. Given the diversity of conceptualizations of pathological narcissism, we evaluated the convergences and divergences in DSM-5 trait profiles characterizing multiple measures of narcissism in a clinical sample of 278 consecutively admitted Italian psychotherapy patients. Patients were administered the Italian versions of the Personality Inventory for DSM-5 (PID-5) and 4 measures of NPD, (a) the Narcissistic Personality Inventory (NPI); (b) the NPD scale of the Personality Diagnostic Questionnaire-4+; (c) the Structured Clinical Interview for Axis II Personality Disorders, Version 2.0 (SCID-II) as an observer-rated measure of NPD; and (d) the Pathological Narcissism Inventory (PNI). Multiple regression analyses showed that PID-5 traits explained from 13% to more than 60% of the variance in the different NPD measures. Attention Seeking was consistently associated with all measures of NPD, whereas Grandiosity was associated with some of the NPD measures. All measures of NPD were also significantly related to additional DSM-5 maladaptive traits. (PsycINFO Database Record

Testing relationships between DSM-5 Section III maladaptive traits and measures of self and interpersonal impairment in Italian community dwelling adults.

In order to study the relationships between DSM-5 Section III maladaptive personality traits and personality dysfunction, 312 Italian community dwelling adults completed the Italian translations of the Personality Inventory for DSM-5 (PID-5) and the Measure of Disordered Personality Functioning Scale (MDPF); participants were also administered the Iowa Personality Disorder Screen (IPDS). Consistent with previous findings, 22 (88.0%) PID-5 maladaptive trait scales showed moderate and significant correlations with MDPF Non Coping (median r value = .32), and Non Cooperativeness, (median r value = .24) scales. Regression analyses showed that PID-5 trait scales explained roughly 59% and 35% of the variance in MDPF Non Coping and Non Cooperativeness scales, respectively. PID-5 traits were significantly associated also with the IPDS total score, adjusted R2 = .45, p < .001. As a whole, our data seemed to indicate that the wide majority of the PID-5 scales showed significant relationships of at least moderate size with a self-report measure of personality dysfunction, lending further support to the criterion validity of the PID-5. (PsycINFO Database Record

Differentiating Community Dwellers at Risk for Pathological Narcissism From Community Dwellers at Risk for Psychopathy Using Measures of Emotion Recognition and Subjective Emotional Activation.

The Italian translations of the Pathological Narcissism Inventory (PNI) and Triarchic Psychopathy Measure (TriPM) were administered to 609 community dwelling adults. Participants who scored in the upper 10% of the distribution of the PNI total score were assigned to the group of participants at risk for pathological narcissism, whereas participants who scored in the upper 10% of the distribution of the TriPM total score were assigned to the group of participants at risk for psychopathy. The final sample included 126 participants who were administered the Reading the Mind in the Eyes Test (RMET) and emotion-eliciting movie clips. Participants at risk for pathological narcissism scored significantly lower on the RMET total score than participants who were not at risk for pathological narcissism. Participants at risk for psychopathy showed a significant reduction in the subjective experience of disgust, fear, sadness, and tenderness compared to participants who were not at risk for psychopathy.

Borderline personality disorder features, emotion dysregulation and non-suicidal self-injury: Preliminary findings in a sample of community-dwelling Italian adolescents.

In order to assess the relationships among borderline personality disorder features, non-suicidal self-injury (NSSI) and emotion dysregulation, 122 community-dwelling Italian adolescents were administered by the Italian translations of the Borderline Personality Features Scale for Children-11, the Deliberate Self-Harm Inventory and the Difficulties in Emotion Regulation Scale (DERS). Regression models showed that both Deliberate Self-Harm Inventory (DSHI) and DERS scores significantly predicted Borderline Personality Features Scale for Children-11 total score; moreover, the DSHI total score significantly predicted the DERS total score. Our findings suggest that borderline personality features in adolescence are moderately, albeit significantly related to NSSI, and that emotion dysregulation does not completely account for the association between borderline personality features and NSSI, although it seems to explain a non-trivial proportion of this relationship. Copyright © 2016 John Wiley & Sons, Ltd.

The Personality Inventory for DSM-5 Brief Form: Evidence for Reliability and Construct Validity in a Sample of Community-Dwelling Italian Adolescents.

To assess the reliability and construct validity of the Personality Inventory for DSM-5 Brief Form (PID-5-BF) among adolescents, 877 Italian high school students were administered the PID-5-BF. Participants were administered also the Measure of Disordered Personality Functioning (MDPF) as a criterion measure. In the full sample, Cronbach's alpha values for the PID-5-BF scales ranged from .59 (Detachment) to .77 (Psychoticism); in addition, all PID-5-BF scales showed mean interitem correlation values in the .22 to .40 range. Cronbach's alpha values for the PID-5-BF total score was .83 (mean interitem r = .16). Although 2-month test-retest reliability could be assessed only in a small ( n = 42) subsample of participants, all PID-5-BF scale scores showed adequate temporal stability, as indexed by intraclass r values ranging from .78 (Negative Affectivity) to .97 (Detachment), all ps <.001. Exploratory structural equation modeling analyses provided at least moderate support for the a priori model of PID-5-BF items. Multiple regression analyses showed that PID-5-BF scales predicted a nonnegligible amount of variance in MDPF Non-Cooperativeness, adjusted R2 = .17, p < .001, and Non-Coping scales, adjusted R2 = .32, p < .001. Similarly, the PID-5-BF total score was a significant predictor of both MDPF Non-Coping, and Non-Cooperativeness scales.

Item Response Theory Modeling and Categorical Regression Analyses of the Five-Factor Model Rating Form: A Study on Italian Community-Dwelling Adolescent Participants and Adult Participants.

To extend the evidence on the reliability and construct validity of the Five-Factor Model Rating Form (FFMRF) in its self-report version, two independent samples of Italian participants, which were composed of 510 adolescent high school students and 457 community-dwelling adults, respectively, were administered the FFMRF in its Italian translation. Adolescent participants were also administered the Italian translation of the Borderline Personality Features Scale for Children-11 (BPFSC-11), whereas adult participants were administered the Italian translation of the Triarchic Psychopathy Measure (TriPM). Cronbach α values were consistent with previous findings; in both samples, average interitem r values indicated acceptable internal consistency for all FFMRF scales. A multidimensional graded item response theory model indicated that the majority of FFMRF items had adequate discrimination parameters; information indices supported the reliability of the FFMRF scales. Both categorical (i.e., item-level) and scale-level regression analyses suggested that the FFMRF scores may predict a nonnegligible amount of variance in the BPFSC-11 total score in adolescent participants, and in the TriPM scale scores in adult participants.