Contrasting social knowledge and theory of mind patterns in adults with personality disorders, schizophrenia spectrum disorders, and healthy controls.

INTRODUCTION: Personality disorders (PD) and schizophrenia spectrum disorders (SSD) are distinct conditions displaying common symptoms, like impairments in social cognition, that make them hard to distinguish, especially in severe cases. To date, few studies have compared theory of mind skills in these two disorders, and none have compared social knowledge skills. This study aims to compare the social cognitive abilities of patients with these conditions. METHOD: Non-parametric analyses of covariance were used to compare severe PD patients (n = 37), SSD patients (n = 44), and healthy controls (HC; n = 49) on the Social Knowledge Test and two measures of theory of mind: the Reading the Mind in the Eyes Test and the Combined Stories Test, which incorporates items from various widely used tests. RESULTS: While no significant group differences were found on the Social Knowledge Test, SSD patients performed lower than the HC group on both theory of mind tests. PD patients only had lower performance than the HC group on specific items from the Combined Stories Test. CONCLUSIONS: PD and SSD patients demonstrated distinctive patterns of social cognitive impairments, with items of greater complexity or with an affective orientation being the most discriminant for PD.

Profiles of theory of mind impairments and personality in clinical and community samples: integrating the alternative DSM-5 model for personality disorders.

Introduction: Deficits in theory of mind (ToM)-the ability to infer the mental states of others-have been linked to antagonistic traits in community samples. ToM deficits have also been identified in people with personality disorders (PD), although with conflicting evidence, partly due to the use of categorical diagnoses. The DSM-5 Alternative Model for Personality Disorders (AMPD) provides an opportunity for a more precise understanding of the interplay between ToM abilities and personality pathology. Therefore, the study aims to determine whether and how individuals with diverse ToM profiles differ regarding personality impairment (AMPD Criterion A) and pathological facets (AMPD Criterion B). Method: Adults with PD (n = 39) and from the community (n = 42) completed tests assessing ToM skills and self-reported questionnaires assessing AMPD Criteria A and B. Hierarchical agglomerative and TwoStep cluster analyses were consecutively computed using scores and subscores from ToM tests as clustering variables. Multivariate analyses of variance were subsequently performed to compare the clusters on both AMPD Criteria. Five clinically and conceptually meaningful clusters were found. The most notable differences across clusters were observed for Intimacy and Empathy dysfunctions (Criterion A), as well as for the Deceitfulness, Callousness, and Hostility facets from the Antagonism domain and the Restricted affectivity facet from the Detachment domain (Criterion B). Discussion: The results support the association between antagonistic personality facets and ToM deficits. However, clusters showing impairments in ToM abilities did not necessarily exhibit high levels of personality dysfunction or pathological facets, emphasizing that both constructs are not isomorphic. Nevertheless, specific profiles can help refine existing interventions to make them more sensitive and specific to the nature of ToM dysfunctions while considering personality functioning and facets.

Maladaptive Eating Behaviors and Childhood Trauma: A Focus on Food Addiction.

Background Many studies have highlighted the clinical relevance of food addiction (FA) by showing its association with psychopathological severity and even more when co-occurring with binge eating disorder. It was suggested that the association between FA and greater psychopathological severity could be accounted for by a history of traumatic experiences. The present study examined the relationship between childhood trauma (including peer victimization, abuse, and neglect) and maladaptive eating behaviors (FA, binge eating, and grazing) and explored whether childhood trauma predicts FA when controlling for binge eating, grazing, and other confounding variables. Methods One hundred fourteen adult women seeking psychological help for problems related to eating or weight completed questionnaires measuring FA, binge eating, grazing, depressive symptoms, peer victimization, and childhood abuse and neglect. Results FA showed significantly small to moderate positive correlations with all measures of childhood trauma, except for physical neglect. A hierarchical regression, including binge eating, grazing, depressive symptoms, age, and childhood trauma explained 55% of FA variance, with 7% of variance explained uniquely by childhood trauma. Conclusions This study supports that FA is related to childhood trauma and provides a potential explanation for the association of FA with greater psychopathological severity. From a clinical perspective, FA provides an accurate and quick assessment of psychopathological severity and represents an essential complement to the evaluation of eating disorders related to overweight. Future studies should attempt to estimate the impact of childhood trauma on treatment outcomes.

Childhood sexual abuse and food addiction severity in a clinical sample of individuals with overweight or obesity.

PURPOSE: A higher risk of food addiction (FA) in individuals reporting childhood sexual abuse (CSA) has been well demonstrated with community samples, but studies including clinical samples failed to replicate this relation. This study examined, among individuals presenting eating and weight disorders, the risk of FA for those reporting CSA while considering the severity of CSA and other types of traumas. METHODS: Participants (N = 187) completed a DSM-5 diagnosis assessment and questionnaires on LimeSurvey evaluating FA, interpersonal traumas, depressive level, body esteem, dieting/weight preoccupations, and body mass index (BMI). Logistic regressions were used to calculate the odds ratio (OR) of FA using interpersonal traumas as risk factors, and t tests were used to compare individuals with FA and CSA and those with FA without CSA. RESULTS: Of all interpersonal traumas, CSA was associated with the highest risk of FA, with ORs of 1.73 (p = 0.094) and 2.07 (p = 0.034). The relationship with the abuser, the type of sexual abuse and the number of abuses were significant or marginally significant risk factors, with ORs ranging from 1.26 to 1.50. Finally, no significant difference was found between FA with CSA and FA without CSA. CONCLUSION: Using a clinical sample, this study showed a higher risk of FA in individuals reporting CSA and provided evidence that the relationship with the abuser, the type of sexual abuse, and the number of abuses are relevant factors. Additionally, in individuals with FA, the presence or absence of CSA did not influence depressive level, body esteem, dieting/weight preoccupations, or BMI. LEVEL OF EVIDENCE: Level V, cross-sectional, descriptive study.

Preliminary Steps Toward Extracting the Specific Alternative Model for Personality Disorders Diagnoses From Criteria A and B Self-Reports.

The Alternative DSM-5 Model for Personality Disorders (AMPD) retains six specific personality disorders (PDs) that can be diagnosed based on Criterion A level of impairment and Criterion B maladaptive facets. Those specific diagnoses are still underresearched, despite the preference expressed by most PD scholars for a mixed/hybrid classification. This study explores the possibility of using Criterion A and B self-report questionnaires to extract the specific AMPD diagnoses. Plausible prevalence estimates were found in three samples (outpatient PD, private practice, community; N = 766) using the facet score ≥ 2 and t score > 65 methods for determining the presence of a Criterion B facet; diagnoses had meaningful correlations with external variables. This study provides evidence-albeit preliminary-that the extraction of the specific AMPD PDs from self-report questionnaires might be a viable avenue. Ultimately, it could promote the use and dissemination of those diagnoses for screening purposes in clinical and research settings.

A latent profile analysis of romantic attachment anxiety and avoidance.

We conducted latent profile analyses on community (n = 1663) and clinical (n = 575) samples to determine whether continuous scores of attachment anxiety and avoidance would lead to the identification of theoretically consistent and clinically useful profiles. We then compared these profiles according to gender, relationship status, psychological distress, and relationship satisfaction. Analysis on the community sample yielded four profiles: secure, preoccupied, dismissive, and fearful individuals; whereas, the clinical sample yielded three profiles: secure, preoccupied, and fearful individuals. In the community sample, there was a higher proportion of women under the preoccupied profile and a higher proportion of men under the dismissive profile compared with the other profiles. Overall, insecure individuals reported higher levels of relationship dissatisfaction and psychological distress, and a relationship status reflecting lower commitment. Our findings suggest that the Experiences in Close Relationships scale could be useful in assisting therapists in conceptualizing their cases according to their patients' attachment profile.

Psychological Intimate Partner Violence and Childhood Cumulative Trauma: The Mediating Role of Affect Dysregulation, Maladaptive Personality Traits, and Negative Urgency.

The current study examined the mediating role of affect dysregulation, maladaptive personality traits, and negative urgency in the association between childhood cumulative trauma (CCT) and psychological intimate partner violence (IPV). A total of 241 men and women from the general population answered self-report questionnaires assessing these variables. Results indicated that 70% of participants reported at least two different types of childhood trauma, while, over the past year, 80% indicated having perpetrated or experienced psychological IPV. Path analyses of a sequential mediation model confirmed that the CCT-IPV association is explained by affect dysregulation, maladaptive personality traits, and negative urgency. These findings support the need to assess affect regulation and personality traits in CCT survivors. Psychosocial interventions should aim to increase self-soothing skills and decrease negative urgency to prevent psychological IPV.

Spousal Support and Relationship Happiness in Adults With Type 2 Diabetes and Their Spouses.

OBJECTIVES: The purpose of this study was to examine the association between the perceptions of spousal support self-efficacy in terms of dietary self-care and relationship happiness. METHODS: Forty-six couples, in which only one spouse has type 2 diabetes, completed questionnaires on perceptions of spousal support self-efficacy and relationship happiness. RESULTS: Using an actor‒partner interdependence model, we found that, when persons with type 2 diabetes were more confident in their spouse's ability to provide them with support regarding their dietary self-care, they reported more relationship happiness. We also found that, when their spouse without diabetes was more confident in their own abilities to provide such support to their partner, they reported more relationship happiness. However, the person with diabetes' confidence in their spouse's support abilities and the spouse's confidence in their own support abilities were not associated with the other partner's relationship happiness. CONCLUSIONS: This study offers a unique dyadic perspective on the determinants of happiness for couples in which one spouse has type 2 diabetes. The perceived quality of spousal support appears to be associated with relationship happiness in committed couples managing diabetes, regardless of the actual support received or provided.

Child Maltreatment and Polyvictimization as Predictors of Intimate Partner Violence in Women From the General Population of Quebec.

This study aimed to (a) evaluate the prevalence of intimate partner violence (IPV) and revictimization among a representative sample of 1,001 women living in Quebec, Canada; (b) examine whether IPV was predicted by experiences of child maltreatment; and (c) explore the role of polyvictimization on IPV beyond the effect of any type of exposure. Results indicate the prevalence rates of lifetime IPV (10.5%), IPV over the last year (2.5%), and revictimization (7.2%). All forms of child maltreatment predicted an increased risk of IPV victimization, yet polyvictimization was related to IPV beyond the effects of specific forms of child maltreatment.

Subclinical Psychopathic Traits and Romantic Attachment in Treatment-Seeking Couples.

Subclinical psychopathic personality traits have been associated with multiple indicators of couple distress and romantic attachment insecurities but essentially in community samples. This study examined dyadic associations between primary and secondary psychopathy and attachment anxiety and avoidance, assessed with self-reported measures, in 183 French-Canadian cohabiting partners seeking couple therapy. Two Actor-Partner Interdependence Models were tested: Model 1 considered psychopathic traits as independent variables and Model 2 treated attachment insecurities as independent variables. Analyses revealed that in both partners, secondary psychopathy was associated with attachment anxiety and avoidance (Models 1 and 2), while primary psychopathy was not only associated with attachment anxiety (Model 2; actor associations). Partner effects between primary and secondary psychopathy in men and women's attachment anxiety were also found in both models. These findings complement those reported in community samples and have clinical implications for treatment-seeking couples.

Intimate Partner Violence in Male Survivors of Child Maltreatment: A Meta-Analysis.

Intimate partner violence (IPV) is a major public health concern. Yet, despite an increasingly extensive literature on interpersonal violence, research on male victims of IPV remains sparse and the associations between different forms of child maltreatment (CM) and IPV victimization and perpetration in men remains unclear. The present meta-analysis evaluated five different forms of CM (sexual, physical, and psychological abuses, neglect, and witnessing IPV) as they predicted sexual, psychological, and physical IPV perpetration and victimization in men. Overall, most available studies examined men as perpetrators of IPV, whereas studies of victimization in men were relatively scarce. Results reveal an overall significant association ( r = .19) between CM and IPV. The magnitude of this effect did not vary as a function of type (perpetration vs. victimization) or form (sexual, psychological, or physical) of IPV. Although all forms of CM were related to IPV, with effect sizes ranging from .05 (neglect and IPV victimization) to .26 (psychological abuse and IPV victimization), these associations varied in magnitude according to the type of CM. Findings suggest the importance of expanding research on CM and IPV to include a range of different kinds of abuse and neglect and to raise concerns about the experience of men as both victims and perpetrators of IPV.

Intimacy Mediates the Relation Between Maltreatment in Childhood and Sexual and Relationship Satisfaction in Adulthood: A Dyadic Longitudinal Analysis.

Trauma theories suggest that childhood maltreatment (CM) may partly explain intimacy problems in romantic relationships. However, empirical studies have yielded conflicting findings, likely due to the varying conceptualizations of intimacy. Findings that support long-term negative effects of CM on sexual and relationship satisfaction are almost exclusively based on cross-sectional intra-individual data, precluding the examination of mediating pathways and of dyadic interactions between individuals reporting CM and their partners. This study used a dyadic perspective to examine the associations between CM and the different components of intimacy based on the interpersonal process model of intimacy: self-disclosure, perceived partner disclosure, and perceived partner responsiveness. We also tested the mediating role of these intimacy components at Time 1 in the relations between CM and sexual and relationship satisfaction 6 months later. A sample of 365 heterosexual couples completed self-report questionnaires. Results of path analyses within an actor-partner interdependence framework showed that women and men's higher levels of CM did not affect self-disclosure, but was negatively associated with their own perception of partner disclosure and responsiveness. In turn, women and men's perception of partner responsiveness at Time 1 was positively associated with their own sexual satisfaction, as well as their own and their partner's relationship satisfaction at Time 2. Thus, perception of partner responsiveness mediated the associations between CM and poorer sexual and relationship satisfaction. The overall findings may inform the development of couple intervention that targets the enhancement of intimacy to promote sexual and relationship well-being in couples where one partner experienced CM.

Facebook Use, Facebook Jealousy, and Intimate Partner Violence Perpetration.

Social networking sites (SNS) are now deeply ingrained in our interpersonal world. Past research has shown various impacts of SNS on intimate relationships, from facilitation of relationship initiation to new sources of conflicts between romantic partners. In two studies, we examined Facebook-related jealousy as a risk factor for the perpetration of intimate partner violence (IPV) in adolescents and young adults. In study 1, 1508 participants completed an online survey assessing Facebook use, Facebook jealousy, and IPV perpetration. Facebook jealousy emerged as a significant mediator of the association between Facebook use and IPV. In study 2, we used a dyadic perspective to investigate the joint contribution of both partners' Facebook jealousy to IPV perpetration. In a sample of 92 youth (46 couples), results showed a significant interaction between own and partner Facebook jealousy. More specifically, own Facebook jealousy was associated with IPV perpetration only at high levels of partner Facebook jealousy. These findings suggest that online behaviors have meaningful implications for offline conflicts and aggression in intimate relationships.

Emotion suppression and food intake in the context of a couple discussion: A dyadic analysis.

Using dyadic analysis, this study examined whether emotion suppression is a valid mediator in the relationship between mood change following a stressful couple discussion and subsequent food intake among cohabiting couples. In a laboratory setting, 80 heterosexual couples were presented with a bogus taste test immediately after discussing aspects that they would like each other to change. Mood change, emotion suppression and appetite perceptions were self-reported using visual analogue scales, and BMI was calculated based on objective measures. The moderated-mediation Actor-Partner Interdependence Model revealed a significant indirect conditional effect, showing that mood worsening was significantly associated with higher emotion suppression and that emotion suppression was significantly associated with more food intake among spouses with a high BMI. For spouses with a low BMI, the reverse effect was found, i.e., mood worsening was significantly associated with less food intake through the indirect effect of emotion suppression. Furthermore, an indirect partner effect was observed regardless of BMI, i.e., mood worsening was related to more food intake, which was mediated by the partner's emotion suppression. These results highlight the key role of emotion suppression in the relationship between mood change and food intake in the context of a stressful couple discussion.

When Pornography Use Feels Out of Control: The Moderation Effect of Relationship and Sexual Satisfaction.

There is an understudied, meaningful distinction between high frequency of pornography use and the subjective feeling that this behavior is out of control. We examined whether the quality of a couple's relationship and sex life can strengthen or weaken the association between frequency of Internet pornography use and perceived lack of control over this behavior. In a sample of 1,036 participants, results showed that frequency of pornography use was more strongly associated with feeling out of control when relationship and sexual satisfaction were lower. Findings suggest that couple dissatisfaction puts the individual at risk of reporting out-of-control pornography use.

Whose fault is it? Blame predicting psychological adjustment and couple satisfaction in couples seeking fertility treatment.

Infertility bears psychological and relational consequences for couples who face this problem. Few studies have examined the role of self- and partner blaming to explain psychological and relationship adjustment in couple presenting with a fertility problem. This study used a dyadic approach to explore the links between blaming oneself and one's partner and both partners' symptoms of depression and anxiety, and couple satisfaction in 279 couples enrolled in fertility treatments. Partners were questioned about the extent to which they blamed themselves and their partner for the fertility problem. They also completed the Dyadic Adjustment Scale and the Index of Psychological Symptoms. Path analyses based on the Actor-Partner Interdependence Model showed that self-blame predicted anxiety and depression symptoms in both men and women. Men's self-blame also predicted their own lower relationship satisfaction, whereas women's self-blame predicted more depression and anxiety in their partner. Partner blame in women predicted their own and their partner lower relationship satisfaction. Women's tendency to blame their partner also predicted their own depression symptoms. Clinical implications of these findings are discussed.

Adult Profiles of Child Sexual Abuse Survivors: Attachment Insecurity, Sexual Compulsivity, and Sexual Avoidance.

The present study examined the possibility of different groups of child sexual abuse (CSA) survivors based on their different patterns of attachment and sexual problems. A sample of 324 CSA survivors and 484 participants who did not report any child maltreatment experiences completed online questionnaires. A cluster analysis on attachment and sexual outcomes revealed that CSA survivors formed two distinct profiles. The first profile included CSA survivors with elevated attachment anxiety and low to moderate scores on attachment avoidance, sexual compulsion, and sexual avoidance. The second profile comprised CSA survivors with high scores on attachment anxiety, attachment avoidance, sexual compulsion, and sexual avoidance. These groups were then compared on CSA severity, gender differences, and other child maltreatment experiences. As compared to CSA survivors of the first profile, survivors from the second profile reported more intrusive and extrafamilial CSA, higher rates of psychological maltreatment and witnessed parental violence, and experienced more personal and couple distress. These results suggest that CSA survivors form a heterogeneous population and that sexual abuse is differentially associated with the complex unfolding of the attachment and sexual systems within two distinct subgroups.

Cumulative Adverse Childhood Experiences and Sexual Satisfaction in Sex Therapy Patients: What Role for Symptom Complexity?

INTRODUCTION: Patients consulting for sexual difficulties frequently present additional personal or relational disorders and symptoms. This is especially the case when they have experienced cumulative adverse childhood experiences (CACEs), which are associated with symptom complexity. CACEs refer to the extent to which an individual has experienced an accumulation of different types of adverse childhood experiences including sexual, physical, and psychological abuse; neglect; exposure to inter-parental violence; and bullying. However, past studies have not examined how symptom complexity might relate to CACEs and sexual satisfaction and even less so in samples of adults consulting for sex therapy. AIM: To document the presence of CACEs in a sample of individuals consulting for sexual difficulties and its potential association with sexual satisfaction through the development of symptom complexity operationalized through well-established clinically significant indicators of individual and relationship distress. METHODS: Men and women (n = 307) aged 18 years and older consulting for sexual difficulties completed a set of questionnaires during their initial assessment. MAIN OUTCOME MEASURES: (i) Global Measure of Sexual Satisfaction Scale, (ii) Dyadic Adjustment Scale-4, (iii) Experiences in Close Relationships-12, (iv) Beck Depression Inventory-13, (v) Trauma Symptom Inventory-2, and (vi) Psychiatric Symptom Inventory-14. RESULTS: Results showed that 58.1% of women and 51.9% of men reported at least four forms of childhood adversity. The average number of CACEs was 4.10 (SD = 2.23) in women and 3.71 (SD = 2.08) in men. Structural equation modeling showed that CACEs contribute directly and indirectly to sexual satisfaction in adults consulting for sex therapy through clinically significant individual and relational symptom complexities. CONCLUSION: The findings underscore the relevance of addressing clinically significant psychological and relational symptoms that can stem from CACEs when treating sexual difficulties in adults seeking sex therapy. Bigras N, Godbout N, Hébert M, Sabourin S. Cumulative Adverse Childhood Experiences and Sexual Satisfaction in Sex Therapy Patients: What Role for Symptom Complexity? J Sex Med 2017;14:444-454.

Early exposure to violence, relationship violence, and relationship satisfaction in adolescents and emerging adults: The role of romantic attachment.

OBJECTIVE: Violence in romantic relationships is highly prevalent in adolescence and early adulthood and is related to a wide array of negative outcomes. Although the scientific literature increasingly highlights potential risk factors for the perpetration of violence toward a romantic partner, integrative models of these predictors remain scarce. Using an attachment framework, the current study examines the associations between early exposure to violence, perpetration of relationship violence, and relationship satisfaction. We hypothesized that exposure to family violence fosters the development of attachment anxiety and avoidance, which in turn are related to relationship violence and low relationship satisfaction. METHOD: At Time 1, a sample of 1,252 (72.3% women) adolescents and emerging adults were recruited from high schools and colleges. Participants completed measures of exposure to family violence, attachment, perpetrated relationship violence and relationship adjustment. Three years later (Time 2), 234 of these participants agreed to participate in a follow-up assessment. Structural equation modeling was used to test cross-sectional and longitudinal models. RESULTS: The findings suggest that exposure to family violence predicts relationship violence both directly and indirectly through attachment anxiety, whereas attachment avoidance and relationship violence are predictors of relationship satisfaction. Longitudinal analyses also show that changes in romantic attachment are associated with changes in relationship violence and satisfaction. CONCLUSIONS: Romantic attachment is a significant target for the prevention and treatment of violence in intimate relationships involving adolescents or emerging adults. (PsycINFO Database Record