MCMI-II profiles of women with eating disorders: a cluster analytic investigation

A three-factor model of personality pathology was investigated in a clinical sample of 183 female patients in an outpatient eating disorders treatment program. Cluster analysis of MCMI-II personality scales (Millon, 1987) yielded three distinct personality profiles, which were consistent with previous studies. First, 16.9% of the sample comprised a High Functioning cluster, which manifested no clinical elevations on the MCMI-II and had significantly lower scores on the Eating Disorder Inventory (EDI; Garner; 1991) scales than the other two clusters. Second, 49.1% of the sample comprised an Undercontrolled/Dysregulated cluster. Finally, the remaining 34% of the sample comprised an Overcontrolled/Avoidant cluster. This final cluster had significantly higher EDI Ineffectiveness scale scores than the Undercontrolled/Dysregulated cluster group. Cluster membership was not associated with eating disorder subtype, suggesting that there is considerable variance in personality pathology within eating disorder diagnostic categories.     

中国人善良人格量表的编制及信效度检验

中国的心理学研究充满了道德色彩,研究以善良人格概念及结构为基础,编制了中国人善良人格量表。研究根据已有的善良人格词汇对应编写具体条目,经过分析整合后初步保留29个善良人格条目,在此基础上研究招募960名被试,分别进行探索性因素分析和验证性因素分析,并建构了善良人格的二阶四因子结构。研究结果表明善良人格量表具有良好的信效度,是测量中国人善良人格的有效工具。     

Personality prototypes in eating disorders based on the Big Five model

A three factor model of personality pathology was investigated in a clinical sample of 335 female eating disordered patients. Cluster analysis of the Big Five NEO-FFI scales (Costa & McCrae, 1992) yielded three distinct personality profiles, which were consistent with previous studies: (1) a resilient/high functioning cluster with no clinical elevations on the NEO-FFI scales; (2) an undercontrolled/emotionally dysregulated cluster with elevated scores on the Neuroticism scale and low scores on Conscientiousness and Agreeableness; (3) an overcontrolled/constricted cluster showing high scores on Neuroticism and Conscientiousness and low scores on Openness to Experience. Comparing the three personality prototypes with respect to Axis I and Axis II disorders,resilients reported systematically less clinical and personality problems than both undercontrollers and overcontrollers. Compared to the latter, undercontrollers showed more impulsive personality features and behaviors. Finally, cluster membership was not clearly associated with eating disorder subtypes, suggesting that there is considerable variance in personality features and/or pathology within the various eating disorder categories.     

Dysfunctional beliefs and psychopathology in Borderline Personality Disorder

This study examined the factor structure of the Borderline Personality Disorder subscale of the Personality Beliefs Questionnaire (PBQ-BPD; Butler, Brown, Beck, & Grisham, 2002), and the relationships between the emergent factors and psychopathology. The sample comprised 184 patients diagnosed with borderline personality disorder (BPD). Exploratory factor analysis yielded three factors relating respectively to dependency, distrust, and the belief that one should act preemptively to avoid threat. Although the three factors were significantly associated with depression, only dependency and distrust significantly correlated with hopelessness. Distrust was the sole factor that correlated significantly with suicide ideation. These findings support the dimensional structure of the PBQ-BPD. Given its multidimensional structure, the scale can be used as a measure of belief profiles associated with BPD and as an aid to conceptualizing beliefs underlying a range of psychopathology associated with patients with BPD.     

Convergent validity of the MCMI-III personality disorder scales and the MMPI-2 scales

The MCMI-III personality disorder scales (Millon, 1994) were empirically validated in a sample of prisoners, psychiatric inpatients, and outpatients (N = 477). The scale intercorrelations were congruent with those obtained by Millon, Davis, and Millon (1997). We conclude that our Flemish/Dutch version shows no significant differences with the original version of the MCMI-III as far as intercorrelations are concerned. Convergent validity of the MCMI-III personality disorder scales was evaluated by the correlational data between the MCMI-III personality disorder scales and the MMPI-2 clinical (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) and personality disorder (Somwaru & Ben-Porath, 1995) scales. Improved convergence was obtained compared with previous versions of the MCMI-I. Only the compulsive MCMI-III personality disorder scale remains problematic. The scale even showed negative correlations with some of the related clinical scales and with the corresponding personality disorder scales of the MMPI-2.     

Experimental Manipulation of NEO-PI-R Items

Research assessing the relationship of the Five-factor model (FFM) of personality to personality disorder symptomatology has generally been consistent with theoretical expectations. Three exceptions, however, have been failures to confirm predicted associations of the NEO-Personality Inventory-Revised (NEO-PI-R; Costa & McCrae, 1992b) Conscientiousness scale with obsessive-compulsive personality disorder symptomatology, the NEO-PI-R Agreeableness scale with dependent symptomatology, and the NEO-PI-R Openness scale with schizotypal symptomatology. It was the hypothesis of this study that these findings might be due in part to a relative emphasis on adaptive rather than maladaptive variants of these domains of personality functioning within the NEO-PI-R. This hypothesis was tested by experimentally altering NEO-PI-R items to reverse their implications for maladaptiveness. The predicted correlations of the FFM were confirmed with the experimentally altered items in a sample of 86 adult psychiatric outpatients.     

Conduct disorder and personality

A sample of children with a diagnosis of conduct disorder and a sample of children from a London comprehensive school were investigated. Three questionnaires were administered to assess personality, impulsiveness and anxiety. Of the personality measures contained within the Junior Eysenck Personality Questionnaire only Psychoticism was found to significantly differentiate the conduct disorder and normal control samples. The Impulsiveness scale of the I₆ also differentiated the two samples. There were no significant differences between the two samples in their scores on the anxiety scale of the “What I Think and Feel”. The findings are discussed in relation to theories of personality proposed by Eysenck and Eysenck (1969), Gray (1987) and Quay (1988).     

The structure of axis II disorders in adolescents: a cluster- and factor-analytic investigation of DSM-IV categories and criteria

The aim of this study was to ascertain whether the structure of personality disorder (PD) symptoms in adolescents assessed using DSM-IV diagnoses and diagnostic criteria resembles the structure intended for the diagnosis of PDs in adults. A national sample of clinicians rated DSM-IV Axis II criteria on 294 adolescent patients in treatment for enduring maladaptive personality patterns. Cluster analysis replicating procedures used in an adult sample by Morey (1988) identified considerable similarity between adult and adolescent PDs, as did exploratory factor analysis of ratings of diagnostic criteria, which yielded ten empirically derived factors that resembled the ten DSM-IV PDs. Cluster analysis and confirmatory factor analysis with indicators of Axis II symptoms produced mixed results in replicating the DSM-IV hierarchical structure of PDs (Clusters A, B, and C), although hierarchical models generally fared better than models specifying only first-order factors or clusters. The structure of personality pathology as assessed by Axis II criteria in adolescents resembles that outlined in DSM-IV Axis II for adults, suggesting that PDs can be assessed in adolescents as in adults. Whether this is an optimal way of diagnosing personality pathology in adolescence, however, requires further investigation.     

Total number of MMPI-2 clinical scale elevations predicts premature termination after controlling for intake symptom severity and personality disorder diagnosis

Premature termination of therapy by patients is a common phenomenon that can be deleterious to treatment outcome for patients and also negatively affect therapists, treatment centers, and research programs. Therefore, a method of identifying patients at risk for premature termination could have widespread benefits. This study investigated whether patients’ MMPI-2 profiles, including clinical scale elevations and Negative Treatment Indicator (TRT) scores, could predict premature termination in an outpatient sample, controlling for personality disorder diagnosis and symptom severity at intake. Results indicated that while TRT scores were not incrementally predictive of premature termination, the total number of clinical scale elevations was significantly incrementally predictive of dropout. Clinical implications are discussed.     

Two-year stability of Psychosis Proneness Scales and their relations to personality disorder traits

Two-year stability of Physical Anhedonia (PhA), Perceptual Aberration (PER), and Magical Ideation (MI) scale scores and their relation to personality disorder traits were examined. Additionally, the effects of a time-lagged (prospective) versus concurrent measurement of psychosis proneness and personality disorder traits were studied to examine the specificity of MI, PER, and PhA. With a non-college-student sample (n = 404), stability for PhA was sufficiently high, but for PER and MI, stability was moderate to low. The correlations between personality disorder traits and psychosis proneness scales demonstrate that simultaneous assessment leads to a more nonspecific pattern of associations for MI and PER, although the correlation to schizotypal personality disorder traits were the highest. However, prospectively only MI, but neither PER nor PhA, emerged as a significant predictor for schizotypal and paranoid personality disorder traits in multiple-regression analysis. This suggests that MI may allow for a more specific assessment of psychosis proneness than PER.     

Experimental manipulation of NEO-PI-R items.

Research assessing the relationship of the Five-factor model (FFM) of personality to personality disorder symptomatology has generally been consistent with theoretical expectations. Three exceptions, however, have been failures to confirm predicted associations of the NEO-Personality Inventory-Revised (NEO-PI-R) Conscientiousness scale with obsessive-compulsive personality disorder symptomatology, the NEO-PI-R Agreeableness scale with dependent symptomatology, and the NEO-PI-R Openness scale with schizotypal symptomatology. It was the hypothesis of this study that these findings might be due in part to a relative emphasis on adaptive rather than maladaptive variants of these domains of personality functioning within the NEO-PI-R. This hypothesis was tested by experimentally altering NEO-PI-R items to reverse their implications for maladaptiveness. The predicted correlations of the FFM were confirmed with the experimentally altered items in a sample of 86 adult psychiatric outpatients.     

The Validation of a Five-Item Screening Scale for Personality Disorders in Dutch-Speaking Community Adolescents and Adults

In Section III of the Diagnostic and Statistical Manual of Mental Disorders – fifth edition (DSM-5), an Alternative Model for Personality Disorders (AMPD) is proposed, including a criterion for personality functioning impairment (Criterion A) to assess severity of personality pathology. The present study examined the structure, reliability, and convergent validity of the Dutch version of a five-item screening scale for Criterion A—the Five-Item Screening Scale for Personality Disorders (FISSPD; Skodol et al., in Personality Disorders: Theory, Research, and Treatment, 2, 4-22, 2011)—in a community sample of 1,477 adolescents and 546 adults. To assess convergent validity, identity and personality (pathology) questionnaires were completed by adolescents and adults. Confirmatory factor analysis yielded a single factor structure for the FISSPD, which proved to be (partially) invariant across age and gender. Adequate reliability coefficients were obtained for the FISSPD. In both the adolescent and adult sample, significant correlations were found between the FISSPD and consolidated identity (negative) and disturbed identity/lack of identity (positive). In the adult sample, the FISSPD showed significant correlations with several personality disorders (and especially with the borderline personality disorder), maladaptive personality traits (Criterion B of the AMPD), and general personality impairment. In the adolescent sample, the FISSPD was positively correlated with borderline personality disorder characteristics. Furthermore, significant correlations were found with the Big-Five personality traits in the adolescent sample: the FISSPD correlated significantly positive with neuroticism, and negative with extraversion, agreeableness, and conscientiousness. In sum, the present study supports the reliability and validity of the FISSPD to screen for (severity of) personality pathology.

     

Integrating psychopathology and personality disorders conceptualized by the MMPI-2-RF and the MCMI-III: a structural validity study

The Minnesota Multiphasic Personality Inventory-2-Restructured Form (Ben-Porath & Tellegen, 2008 ) Restructured Clinical scales and Higher Order scales were linked to the Millon Clinical Multiaxial Inventory-III (Millon, Millon, Davis, & Grossman, 2009 ) personality disorder scales and clinical syndrome scales in a Flemish/Dutch sample of psychiatric inpatients and outpatients, substance abuse patients, correctional inmates, and forensic psychiatric patients (N = 968). Structural validity of psychopathology and personality disorders as conceptualized by both instruments was investigated by means of principal component analysis. Results reveal a higher order structure with 4 dimensions (internalizing disorders, externalizing disorders, paranoid ideation/thought disturbance, and pathological introversion) that parallels earlier research on pathological personality dimensions as well as research linking pathological personality traits with mental disorders. Theoretical and clinical implications are considered.     

Aesthetic preference and DSM-IIIR personality disorders

This report tested whether those individuals with a cluster B DSM-IIIR personality disorder (narcissistic, borderline, antisocial or histrionic) had higher scores for aesthetic preference for visually complex drawings using the Barron-Welch Art Scale. In a sample of 141 patients and controls, the 56 subjects who met the criteria for one of the cluster B personality disorder diagnoses displayed higher Barron-Welch Art Scale Scores. A multiple regression analysis showed that narcissistic and borderline personality disorder contributed positively, while dependent personality disorder, negatively to preference for complexity. The findings support the notion that aesthetic choices and values reflected through the dimension of openness to experience may contribute to the behavioral manifestations of the personality disorders.     

Dimensional assessment of personality pathology in female and male juvenile delinquents

A developmental perspective implies similar personality pathology dimensions for adolescents and adults. The present study examined the applicability of a dimensional approach in incarcerated delinquent female and male juveniles using the Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ). A sample of detained adolescents (n = 146) was compared to adolescent students (n = 98) and a healthy control group of adults (n = 82). Additionally, psychopathology was assessed in the incarcerated juveniles using the Youth Self Report (YSR). Analyses of variance revealed higher scores on personality disorder traits for juveniles compared to adult controls; the highest scores were observed in criminal juveniles. Hypothesized relationships could be confirmed within the criminal sample between the DAPP factor Emotional Dysregulation and the YSR Internalization syndrome scale, and between the DAPP factor Dissocial Behavior and the YSR Externalization syndrome scale. Moreover, gender differences in the criminal sample are discussed. Results indicate that the DAPP-BQ can assess personality disorder traits in delinquent and nondetained juveniles with sufficient group and criterion validity.     

Confirmatory factor analysis of eating disorder symptoms in college women

Recent studies have found that the eating disorders can best be conceptualized as multidimensional. Four factors have consistently emerged from factor analytic studies of eating disorder symptoms: dietary restraint, bulimic behaviors, neurotic personality characteristics, and body image/body dysphoria. Confirmatory factor analysis was utilized to determine if this four-factor structure of eating disorder symptoms would be found in a sample of college women. Principal components analysis extracted four factors which were supported with a confirmatory factor analysis procedure. These four factors were negative affect and body dysphoria, bulimic behaviors, restrictive eating, and body image. The negative affect and body dysphoria factor was positively correlated with the other factors (i.e., bulimic behaviors, restrictive eating, and body image). This factor structure was similar to the factor structure found in samples of patients with bulimia and anorexia nervosa, except that the factors were more highly intercorrelated in the nonclinical sample. Results suggest that the measures of eating disorder symptoms used in this investigation are measuring the same multidimensional constructs in clinical and nonclinical subjects.This paper is partially based upon the master's thesis of the first author.     

Psychodynamische Kurzzeittherapie bei dependenter und vermeidender Persönlichkeitsstörung

Although dependent and avoidant personality disorders are frequent in patient populations, there are only few studies in which the efficacy of psychotherapeutic interventions for these two personality disorders was reviewed. The purpose of this study was to examine whether psychodynamic short-term therapy based on the model of the cyclic maladaptive pattern (CMP) is effective for reducing the mental impairment of patients diagnosed with a dependent or an avoidant personality disorder. Data were collected via a self-report scale (Symptom-Checklist, SCL) and expert ratings by therapists [Global Assessment of Functioning (GAF) Scale and Severity of Impairment-Score (Beeinträchtigungsschwere-Score, BSS)]. In the study 20 patients received 25 sessions of outpatient therapy. Mental impairment decreased significantly from the beginning to the end of the therapy; moreover this decrease remained stable over a 2-year period following completion of the therapy. The findings show that psychodynamic short-term therapy can lead to an enduring improvement in the mental health of patients with a dependent or an avoidant personality disorder.     

The Roots of Psychology (Book)

Individual scale characteristics and the inventory structure of the Personality Assessment Inventory (PAI; Morey, 1991) were examined by conducting internal consistency and factor analyses of item and scale score data from a large group (N = 301) of alcohol-dependent patients. Alpha coefficients, mean interitem correlations, and corrected item-total scale correlations for the sample paralleled values reported by Morey for a large clinical sample. Minor differences in the scale factor structure of the inventory from Morey's clinical sample were found. Overall, the findings support the use of the PAI in the assessment of personality and psychopathology of alcohol-dependent patients.     

DAPP-BQ: factor structure and relations to personality disorder symptoms in a non-clinical sample

We assessed the factor structure of the DAPP-BQ (Livesley & Jackson, in press), as well as the relations between DAPP-BQ higher- and lower-order personality trait scores and DSM-IV (APA, 2000) personality disorder symptoms in a sample of approximately 300 nonclinical young adults. The four-factor structure of the DAPP-BQ was replicated, and DAPP-BQ higher-order and lower-order scores were related to personality disorder symptoms in predictable ways. Finally, regression analyses revealed that specific DAPP-BQ traits accounted for variance in individual personality disorder scores above and beyond comorbid personality disorder symptoms.