The DAPP-BQ in The Netherlands: factor structure and relationship with basic personality dimensions

After discarding eight items in the Dutch translation of Livesley's DAPP-BQ that showed item-total correlations < 0.20 in a sample of 223 normal subjects. Cronbach's alpha coefficients were calculated for the remaining items in the 18 scales of this instrument. The 'Dutch' alpha coefficients proved to be satisfactory. Furthermore, the Dutch DAPP-BQ scales were factor analyzed, retaining four factors. Three of these factors proved to be identical (Emotional Dysregulation and Dissocial) or nearly identical (Compulsivity) to the Canadian factors. However, the original factor Inhibition was not the same as the remaining Dutch factor Intimacy Problems. In a sample of 115 students, the estimated scores for the Dutch Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ) factors were correlated with the scales of Van Kampen's Four-Dimensional Personality Test. As expected, Emotional Dysregulation was found to correlate with Neuroticism, Dissocial with Insensitivity, and Compulsivity with Orderliness. The Intimacy Problems factor proved to be negatively correlated with Extraversion. The results obtained are embedded in the context of the evidence favoring a dimensional model of personality disorder. Furthermore, Livesley's proposal that separate diagnostic criteria for the existence of a personality disorder must be formulated to supplement the assessment by means of the DAPP-BQ is critically discussed.     

DAPP-BQ: factor structure in French Canadians

Personality traits may be involved in predisposition to a range of clinical and behavioral phenotypes. Given their importance, it is necessary to establish the extent to which different levels of personality traits are applicable to and reproducible across cultures and sexes. In a well-characterized, longitudinal sample of young French Canadians, we examined structural equivalence of broad personality traits using the Diagnostic Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ). We also investigated sex-based patterns of item-endorsement, scale reliabilities, and factor solutions. Our four-factor solution closely resembles the structure reported in the source population of British Columbians, especially in terms of Factors I through III. In contrast to the original study, however, together with compulsivity, rejection rather than passive aggression, defined Factor IV. We, furthermore, observed sex-based differences in item endorsement and both broad and narrow personality trait scores. Subtle differences notwithstanding, our results offer additional evidence for structural stability of broad DAPP-BQ personality traits across sociodemographic and cultural contexts.     

The structure of traits delineating personality disorder in a Chinese sample

The present study examined the factorial structure of a Chinese language version of the self-report Dimensional Assessment of Personality Pathology Questionnaire in 581 adults. Four factors were extracted (Emotional Dysregulation, Dissocial, Inhibition, and Compulsivity) that are similar to the factors extracted in the scales' normative clinical and general population samples from North America (factor comparability coefficients range from .88 to .96), supporting the idea that this trait structure is invariant across diverse populations. The internal consistency of the scales (Cronbach's alpha) was satisfactory across age and gender groups with the exception of the Intimacy Problems scale. Possible explanations for the poor internal consistency of the Intimacy Problems scale, such as cultural differences in social factors influencing marital and romantic relationships in Chinese populations, as opposed to other populations are discussed.     

Childhood maltreatment and adult personality disorder symptoms in a non‐clinical sample

It can be argued that the well‐substantiated relationship between childhood maltreatment and adult personality disorder (PD) symptoms may be confounded by comorbid symptoms of depression, anxiety or dysfunctional childhood family environments. Therefore, the current study was designed to test the hypothesis that retrospective reports of childhood maltreatment would still be significantly related to reports of more PD symptoms when statistically controlling for these factors. One hundred and seventy‐eight non‐clinical participants were divided into groups reporting childhood maltreatment (n = 54) or not (n = 124) according to scores on the Childhood Trauma Questionnaire. Participants also completed questionnaires measuring current depression, anxiety, and PD symptoms as well as retrospective reports of their childhood environment. Results showed that individuals reporting childhood maltreatment reported more symptoms of PD than those not reporting childhood maltreatment, even when statistically controlling for depression, anxiety and retrospective reports of dysfunctional family environment. These findings underscore the relevance and independent contribution of childhood maltreatment to the development of PDs, with important implications for further research and clinical practice.     

An expanded childhood anxiety sensitivity index: its factor structure, reliability, and validity in a non-clinical adolescent sample

Anxiety sensitivity refers to the fear of anxiety-related bodily sensations that are interpreted as having potentially harmful somatic, psychological, or social consequences. The current study examined the factor analytic structure of anxiety sensitivity in a large sample of normal adolescents (N=518) using the revised childhood anxiety sensitivity index (CASI-R). Confirmatory factor analysis indicated that anxiety sensitivity as measured by the CASI-R can best be conceptualised as a hierarchical construct with four lower-order factors loading on a single higher-order factor. The lower-order factors were 'fear of cardiovascular symptoms', 'fear of publicly observable anxiety reactions', 'fear of cognitive dyscontrol', and 'fear of respiratory symptoms'. An additional aim of the present study was to investigate the psychometric properties of the CASI-R. Results showed the CASI-R to be a reliable scale in terms of internal consistency. Furthermore, CASI-R scores were substantially related to levels of anxiety sensitivity as measured by the original index, trait anxiety, symptoms of anxiety disorders, in particular 'panic disorder and agoraphobia', and depression. Finally, some evidence was found for the validity of the CASI-R factor scores. That is, all factors convincingly loaded on symptoms of 'panic disorder and agoraphobia', whereas the factor 'fear of publicly observable anxiety reactions' was also strongly associated with symptoms of 'social phobia'.     

Depressive personality disorder: rates of comorbidity with personality disorders and relations to the five-factor model of personality

Depressive personality disorder (DPD) is listed in the DSM-IV as one of the "Disorders for Further Study." In this investigation we examined (1) the rates of comorbidity of DPD with the 10 personality disorders (PDs) in the main text of DSM-IV, and (2) the convergent and discriminant validity of DPD in its relation to the 30 facet traits of the Five-Factor Model of personality (FFM). One hundred and sixty-nine participants with psychiatric diagnoses were interviewed with the Structured Clinical Interview for DSM-IV Personality Disorders Questionnaire (SCID-II) and completed the Revised NEO Personality Inventory (NEO PI-R). A total of 26 (15%) of the participants met diagnostic criteria for at least one of the 10 main text PDs, and 15 (9%) met criteria for DPD. Of those who met criteria for DPD, 10 (59%) of the participants also met criteria for one or more of the 10 main text PDs. Regression analyses indicated a four-facet trait set derived from the NEO PI-R thought to be uniquely associated with DPD accounted for a significant amount of variance in DPD SCID-II PD scores and was significantly larger for DPD than it was for the 9 of the 10 main text PDs; the sole exception was for avoidant PD. Diagnostically, DPD overlaps significantly with other PDs but is distinguishable in its unique relation with traits from the FFM.     

Assessing the DSM-IV structure of personality disorder with a sample of Chinese psychiatric patients

The validity of the three-cluster system of personality disorders (PDs) in the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; APA, 1994) was examined in a sample of Chinese psychiatric patients (n = 227), who completed the self-report Personality Disorders Questionnaire for DSM-IV (PDQ-4; Hyler, 1994) and who were also administered the clinician-rated Personality Disorders Interview-IV (PDI-IV; Widiger, Mangine, Corbit, Ellis, & Thomas,). Using confirmatory factor analysis, a three-factor model corresponding to the DSM-IV clusters was tested and compared statistically to a one-factor model and a set of random, three-factor models. Only the clinician-rated instrument supported the DSM-IV three-cluster model, and then only when the factors were allowed to correlate. Results from the theoretically more rigorous uncorrelated model testing did not support the DSM-IV model for either assessment modality.     

Reliability of personality disorder symptoms and personality traits in substance-dependent inpatients

The authors compared the internal consistency, 1-year temporal stability, and self-informant agreement of ratings of personality trait (NEO Five-Factor Inventory; NEO-FFI; P. T. Costa & R. R. McCrae, 1992) and personality disorder symptom severity (Structured Clinical Interview for DSM-III-R Personality Disorders Questionnaire; SCID-II-Q; R. L. Spitzer, J. B. W. Williams, M. Gibbon, & M. First, 1990) in 131 substance-dependent inpatients. Internal consistency coefficients were acceptable to very good for most NEO-FFI and SCID-II-Q scales, and temporal stability correlations were significant for all measures. Agreement between patient and informant ratings was more modest. Substance abuse and depression symptom severity moderated the temporal stability and self-informant agreement of several personality trait and disorder ratings. The authors did not find that the five factors were more reliable than the Axis II symptoms. Issues related to the reliability of personality assessment in multiply diagnosed patients are discussed.     

Dimensional personality traits and the prediction of DSM-IV personality disorder symptom counts in a nonclinical sample

The third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III; APA, 1980) set forth a categorical system of personality psychopathology that is composed of discrete personality disorders (PDs), each with a distinct set of diagnostic criteria. Although this system is widely accepted and highly influential, alternative dimensional approaches to capturing personality psychopathology have been proposed. Three dimensional models of personality have garnered particular attention-the Five-Factor Model (FFM; Costa & McCrae, 1992), the Seven-Factor Psychobiological Model of Temperament and Character (Seven-Factor Model; Cloninger, Svrakic, & Przybeck, 1993); and the 18-factor model of personality pathology (18-factor model; Livesley, 1986). Although the personality traits from each of these models has been examined in relation to the ten personality disorders in the DSM-IV, no study has examined the comparative and incremental validity of these models in predicting PD symptoms for these ten disorders. Using self-report instruments that measure these models and the ten DSM-IV PDs, correlation and linear regression analyses indicate that traits from all three models had statistically significant associations with PD symptom counts. Hierarchical regressions revealed that the 18-factor model had incremental predictive validity over the FFM and Seven-Fac-tor Model in predicting symptom counts for all ten DSM-IV PDs. The FFM had incremental predictive validity over the Seven-Factor Model model for all ten disorders and the Seven-Factor was able to add incremental predictive validity over the 18-factor model for five of the ten PDs and for eight of the ten disorders relative to the FFM.     

The Anxiety Sensitivity Index for Children: factor structure and relation to panic symptoms in an adolescent sample

This study examines the factor structure underlying the Anxiety Sensitivity Index for Children (ASIC. J Anxiety Disord, 12 (1998) 307) in an adolescent sample. Three-hundred-and-eight adolescents, aged 12 to 18, completed the ASIC and measures of anxiety and depression. Factor analysis of the ASIC items resulted in a two-factor structure that is similar to that reported by Laurent et al. These two factors included a physical concerns dimension and a mental concerns dimension similar to those found in studies of adult anxiety sensitivity. Subscales measuring these two factors demonstrated concurrent validity, showing particularly close associations with measures of panic symptoms. In addition, both of these subscales showed incremental validity in predicting panic symptoms after controlling for the other anxiety sensitivity subscale and a measure of depression. These results provide evidence that the anxiety sensitivity construct is applicable during adolescence and support the use of the ASIC.     

Self- and other-reports of traits from the five-factor model: relations to personality disorder

The current study used a psychiatric sample (N = 69) to examine: (1) the correspondence between self- and other-reports of general personality, as measured by the Five-Factor Model (FFM; Costa & McCrae, 1990), and personality disorder (PD) traits, as measured by a structured interview, (2) the relations between these two sets of ratings (FFM and PD traits) and consensus ratings of PD and impairment, and (3) the incremental validity of other-rated personality scores. Agreement between raters for the five domains of the FFM ranged from .23 (agreeableness) to .71 (openness); for the PD traits agreement ranged from .37 (avoidant) to .69 (antisocial). At both the domain and facet level, the personality profiles reflected in the correlations between the FFM scores and PD criteria were consistent across raters with the exception of narcissistic PD. Substantial evidence was found for the incremental validity of other-rated personality scores, with these ratings accounting for an additional 8 to 20% of the overall variance in PD features. The other-rated FFM scores also accounted for more variance in consensus ratings of impairment in the domains of romance, work, and social relations.     

Characteristics of illness intrusions in a non-clinical sample

This study examines whether illness intrusions can be distinguished from obsessional intrusions and worries. It also assesses the relationship between strategies, thought characteristics, and appraisal of illness intrusions. Two hundred and forty-three non-clinical participants identified an obsessive intrusive thought, a worry, and an illness intrusion. They evaluated each thought using items from the Cognitive Intrusions Questionnaire. The comparisons of intrusions showed that illness intrusions share characteristics of worries and obsessional intrusions, but also have their own characteristics. Illness intrusions seem to be particularly egosyntonic. The relationships between the strategies used to counter illness intrusions and their appraisal were also tested. Results support the idea that there are specific links between the evaluation of cognitive intrusions and the way they are processed. It demonstrated that escape/avoidance strategies are associated with the egodystonic nature of the thought and that problem-focused strategies are associated with the thought's basis in reality. Illness intrusions may be conceptualised as either obsessions or worries. This study demonstrated that the category of an intrusive thought might not be as important as the way it is processed. It seems more important to consider appraisal of the disturbing thought and the way in which the person subsequently reacts and behaves.     

The Personal Disturbance Scale (sAD): normative data and latent structure in a large non-clinical sample

The Personal Disturbance Scale [sAD; Bedford & Foulds (1978) Delusions–Symptoms–States Inventory State of Anxiety and Depression. Windsor: NFER-Nelson] is widely used in diverse settings and yet there are unresolved issues concerning its psychometric properties and normative data for the English speaking version are limited. The sAD was administered to a large sample of the general adult population (N=758). Demographic variables (gender, age, years of education and occupational status) had only very modest influences on sAD scores. Tables are presented for conversion of raw scores on the Anxiety, Depression and Total scales to percentiles. The sAD scales possessed adequate convergent and discriminant validity, as demonstrated by their pattern of correlations with two other measures of depression and anxiety (the DASS and the HADS). Ten competing models of the latent structure of the sAD were derived from theoretical and empirical sources. These models were evaluated using confirmatory factor analysis. The best fitting model (CFI=0.96) had a tripartite structure, and consisted of a general factor of psychological distress/negative affectivity (all items loaded on this factor) plus orthogonal specific factors of anxiety and depression. Correlated errors specified according to previous empirical findings were permitted. The theoretical and practical implications of this latent structure are discussed.     

Gender differences in a clinical sample of patients with borderline personality disorder

The aim of the study was to investigate gender differences and similarities in patients with borderline personality disorder (BPD) with respect to Axis I comorbidity, Axis II comorbidity, general psychopathology (Symptom Checklist 90-Revised), and dimensional personality traits (NEO-Personality-Inventory Revised [NEO-PI-R] and the Dimensional Assessment of Personality Profile Basic questionnaire [DAPP-BQ]). Fifty-seven men and 114 women with BPD were included in the study. Regarding Axis I and II disorders in an exploratory analysis, men with BPD more often fulfilled the diagnostic criteria for binge eating disorder, antisocial personality disorder, narcissistic personality disorder, and conduct disorder in childhood, whereas women had higher frequencies of bulimia nervosa, posttraumatic stress disorder, and panic disorder with agoraphobia. After correcting for multiple tests, only the gender differences in narcissistic and antisocial personality disorder remained significant. In the SCL-90-R profile, no significant gender differences could be identified. In the exploratory analysis of the dimensional personality traits, women showed higher rates on the NEO-PI-R main factors (Neuroticism and Agreeableness) compared to men. In the DAPP-BQ profile, men reached higher sores on the main factor, Dissocial Behavior. When correcting for multiple tests, gender differences still existed for Neuroticism and Dissocial Behavior. Our results argue for gender differences in Axis I and II comorbidity and dimensional personality traits in BPD. However, in general, more similarities than differences were shown in this study.     

The Perceived Stress Scale: Factor structure and relation to depression symptoms in a psychiatric sample

The present study sought to examine the factor structure and psychometric properties of the Perceived Stress Scale (PSS) when administered to psychiatric patients. We also examined predictive validity of the PSS by assessing the association between the Perceived Stress Scale and the Beck Depression Inventory. A heterogeneous sample of 96 psychiatric patients (48 men, 48 women) completed the Perceived Stress Scale (PSS) and the Beck Depression Inventory. Factor analysis of the PSS established that the scale consisted of two factors. The first factor was comprised primarily of items reflecting adaptational symptoms. In contrast, the second factor consisted of items reflecting coping ability. Both factors had an adequate degree of internal consistency. Finally, a series of regression analyses predicting depression found that both factors accounted for unique variance in depression scores in women, but only the first factor accounted for unique variance in men. It is concluded that the PSS is a multidimensional and internally consistent measure of perceived stress.This research was supported by Grant 410-91-1690 from the social sciences and Humanities Research Council of Canada as well as by grants from the Research and Program Evaluation Committee Brockville Psychiatric Hospital.     

Maternal borderline personality disorder symptoms and adolescent psychosocial functioning

Borderline personality disorder (BPD) is characterized by severe disruption of interpersonal relationships, yet very little research has examined the relationship between maternal BPD and offspring psychosocial functioning. The present study examined 815 mothers and their 15-year-old children from a community-based sample to determine (1) if there is an association between mothers' BPD symptoms and the interpersonal functioning, attachment cognitions, and depressive symptoms of their offspring, and (2) if the association of maternal BPD and youth outcomes is independent of maternal and youth depression. Measures of youth psychosocial functioning included self, mother, interviewer rated, and teacher reports. Results indicated that there was a significant association between maternal BPD symptoms and youth outcomes, and that this association remained even after controlling for maternal lifetime history of major depression, maternal history of dysthymic disorder, and youth depressive symptoms. This study provides some of the first empirical evidence for a link between mother's BPD symptoms and youth psychosocial outcomes.     

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.     

Replicating the five factor model of personality in a psychiatric sample

In this study we examined whether the factor structure and traits of the five-factor model of personality (FFM), derived from non-clinical samples, could be replicated in a sample of psychiatric patients. The revised NEO Personality Inventory (NEO PI-R) was administered to a study group of psychiatric patients (n=176). The test scores from these patients were intercorrelated, factor analyzed and the obtained factor structure was then compared to the factor structure of the normative data from the NEO PI-R. The factor structure from the psychiatric study group and that from the normative sample were virtually identical, with all five factors showing significant congruence. These results argue favorably for the clinical applicability of the FFM with psychiatric patients.     

Agoraphobia in women: factor analysis of symptoms and personality correlates of factor scores in a clinical population

One hundred and sixty female patients with a DSM-III diagnosis of agoraphobia completed a measure of fears and general symptoms (FSS) and personality (HDHQ). Many patients had significant psychological symptoms in addition to their agoraphobia. FSS scores were factor analysed. First-order analysis revealed agoraphobia as a heterogeneous clinical entity occurring independently of a large General Symptoms factor which included panic attacks. Second-order analysis revealed a General Symptoms/Social Phobia factor and a well-defined but heterogeneous Agoraphobia factor comprising the lower-order factors Claustrophobia, Travel Fears and Agoraphobia (fear of crowded public places). Correlations of first- and second-order factors with HDHQ scores showed that the Travel Fears factor was not associated with abnormal personality traits, whereas the Claustrophobia and Agoraphobia factors were. This suggested that travel fears should respond well to behaviour therapy per se, whereas additional treatment aimed at modifying abnormal personality traits may sometimes be indicated for claustrophobia and fear of crowded places. The heterogeneous nature of agoraphobia and the large size of the independent General Symptoms factor underlined the desirability of a multi-modal approach to treatment and research.     

Dramatic-erratic personality disorder symptoms: II. Developmental pathways from early adolescence to adulthood

This study examined the relationship over time between Cluster B personality disorder symptoms (borderline, histrionic, and narcissistic symptoms) and comorbid internalizing and externalizing symptoms in a community sample of 407 adolescents. Cross-lagged longitudinal models tested (a) the hypothesis that Cluster B symptoms reflect primary disturbances that give rise to co-occurring internalizing and externalizing symptoms; and (b) the alternative hypothesis that these Axis I symptom clusters reflect primary problems that interfere with normal personality development. Internalizing and externalizing symptoms each predicted subsequent Cluster B symptoms in girls, although these effects occurred only at specific developmental stages. Cluster B symptoms in boys and girls at ages 10 to 14 years predicted externalizing symptoms two years later. Instead of clearly supporting one hypothesis over the other, longitudinal models suggested gender-specific developmental effects that were partially consistent with both hypotheses.