The Dutch DAPP-BQ: improvements, lower- and higher-order dimensions, and relationship with the 5DPT

After modifying 53 items in a previous Dutch translation of the Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ; Livesley & Jackson, 2002), the present DAPP-BQ scales (with or without Self-Harm included) were subjected to a principal components analysis with oblimin or varimax rotation in a general population sample of 478 subjects, retaining four factors. All four (higherorder) factors (Emotional Dysregulation, Dissocial, Inhibition, and Compulsivity) proved identical to the factors originally derived in Canada, with Tucker coefficients of factor similarity approaching unity. Particularly the (unexpected) finding that the present Dutch version of the DAPP-BQ also resulted in an Inhibition factor (and not, like the former Dutch version, in an Intimacy Problems factor) was considered positive. In addition, a principal components analysis with oblimin rotation was conducted on the 282 items contained in the 18 DAPP-BQ scales, investigating the lower-order structure of the DAPP-BQ; in this case, 18 factors were retained. Although the structure originally derived by Livesley and colleagues could not be recovered completely, the degree of similarity was of such a magnitude that the 18 DAPP-BQ scales were considered to give a dependable account of the "true" lower-order structure of disordered personality. Moreover, based on the finding that the 18 scales are sufficiently reliable (Cronbach's alpha) and correlate as predicted in a subsample of 284 subjects with the normal personality scales of Van Kampen's 5DPT (or, Five-Dimensional Personality Test), the DAPP-BQ appears to be a valuable instrument.     

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.     

Structure of personality pathology in normal and clinical samples: Spanish validation of the DAPP-BQ

Given that the DSM taxonomy of personality disorders is flawed by severe classificatory problems, the development of alternative classificatory systems, such as the Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ), has now become a priority. This study examined the internal consistency, second-order factor structure, and criterion validity of a Spanish translation of the DAPP-BQ in two samples: subjects with personality disorder (n = 155) and subjects from the general population (n = 300). Alpha coefficients ranged satisfactorily from .75 to .93. Four second-order factors of Emotional Dysregulation, Dissocial Behavior, Inhibitedness, and Compulsivity were obtained, which were replicable between samples and identical to those reported in the literature. Finally, disordered subjects scored significantly higher than normal subjects on 17 of the 18 DAPP-BQ traits. Some pending issues in the construction of an alternative taxonomy of personality disorders are discussed.     

Factorial structure of the German version of the dimensional assessment of personality pathology-basic questionnaire in clinical and nonclinical samples.

The Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ) assesses 18 traits to provide a systematic representation of the overall domain of personality disorders. We tested the cross-cultural stability of the prediction that four higher-order factors (Emotional Dysregulation, Dissocial Behavior, Inhibitedness, and Compulsivity) underlie the 18 basic traits. A total of 81 patients who were primarily treated for an Axis II personality disorder and N = 166 healthy control patients completed the German version of the DAPP-BQ. Results clearly confirmed cross-cultural stability of the postulated four-factor structure in both samples, accounting for 74.7% (clinical sample), and 65.7% (nonclinical sample) of the total variance. All four higher-order factors showed specific correlational relationships with dimensional assessments of DSM-IV 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.     

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.     

Factorial structure of traits delineating personality disorders in clinical and general population samples.

Categorical and dimensional models for classifying personality disorders were evaluated by comparing the structure of personality pathology in a clinical sample (n = 158) with the structure in a general population sample (n = 274). Subjects completed 100 personality scales. Separate factor analyses revealed similar structures in the 2 samples. An underlying structure in a combined sample showed limited agreement with the concepts of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1987). Fifteen factors were retained: Generalized Distress, Rejection, Restricted Expression, Compulsivity, Stimulus Seeking, Insecure Attachment, Diffidence, Intimacy Problems, Oppositionality, Interpersonal Disesteem, Conduct Problems, Cognitive Dysfunction, Affective Reactivity, Narcissism, and Social Apprehensiveness. The results are consistent with a dimensional representation of personality disorder.     

A dimensional model of personality disorder: incorporating DSM Cluster A characteristics

The authors articulate an expanded dimensional model of personality pathology to better account for symptoms of DSM-defined Cluster A personality disorders. Two hundred forty participants (98 first-degree relatives of probands with schizophrenia or schizoaffective disorder, 92 community control participants, and 50 first-degree relatives of probands with bipolar disorder) completed a dimensional personality pathology questionnaire, a measure of schizotypal characteristics, and Chapman measures of psychosis proneness. Scales from all questionnaires were subjected to an exploratory factor analysis with varimax rotation. A 5-factor structure of personality pathology emerged from the analyses, with Peculiarity forming an additional factor to the common 4-factor structure of personality pathology (consisting of Introversion, Emotional Dysregulation, Antagonism, and Compulsivity). These results support a 5-factor dimensional model of personality pathology that better accounts for phenomena encompassed by the Cluster A personality disorders in DSM-IV-TR (4th ed., text revised; American Psychiatric Association, 2000). This study has implications for the consideration of a dimensional model of personality disorder in DSM-V by offering a more comprehensive structural model that builds on previous work in this area.     

Dimensional personality profiles of borderline personality disorder in comparison with other personality disorders and healthy controls

The present study examined the sensitivity and clinical specificity of dimensional personality profiles associated with borderline personality disorder (BPD) by comparing three groups of patients: (a) patients with BPD according to DSM-IV criteria (n = 31); (b) patients with other DSM-IV PD (n = 31); and (c) general population controls (n = 31). All three samples were matched for age and gender and the two patient samples were matched for chronicity and depressive symptoms. All patients were given the Six-Factor Test measuring the five-factor model of personality (FFM), the Temperament and Character Inventory (TCI), and the Dimensional Assessment of Personality Pathology (DAPP). Nonparametric statistics were applied to analyze the data (Mann-Whitney-U-tests for group comparisons; Spearman's coefficients for correlational analyses). Neuroticism (FFM), Self-Directedness (TCI), and Emotional Dysregulation (DAPP) were identified as general markers of personality pathology, which were significantly interrelated in all three samples. BPD patients also showed a specific profile compared with other PD patients with lower scores on Agreeableness (FFM), higher scores on Novelty Seeking and Self-Transcendence (TCI), and higher scores on the DAPP higher-order dimensions of Emotional Dysregulation, Dissocial Behavior, and Inhibitedness. Results support the assumption that BPD can be characterized by dimensional approaches with sufficient sensitivity in comparison with healthy controls and specificity in comparison with other PD patients.     

The relation between dimensions of normal and pathological personality and childhood maltreatment in incarcerated boys

The relation between subtypes of maltreatment and dimensions of personality and personality pathology was investigated in a representative sample of 142 incarcerated Dutch male juveniles. Normal personality dimensions were assessed with the Big Five Inventory, the Dimensional Assessment of Personality Pathology-Basic Questionnaire for Adolescents was used to measure pathological personality dimensions, and the Childhood Trauma Questionnaire was used to assess childhood maltreatment. The five maltreatment subtypes were found to be differentially and uniquely related to the normal and pathological personality dimensions in juvenile delinquents. The association between the abusive subtypes and Emotional Dysregulation depended on the co-occurrence of neglect. It was concluded that subtypes of maltreatment are distinctively related to dimensions of personality and personality pathology, possibly due to specific gene-environment interactions. Further research on this interplay is needed to be able to recognize genetic vulnerability. Early identification of children at risk could aid to limit the long-term consequences of maltreatment.     

The MMPI-2 as a predictor of symptom change following treatment for posttraumatic stress disorder

This study sought to examine the impact of personality factors on symptom change following treatment for 141 Vietnam veterans with chronic combat-related posttraumatic stress disorder (PTSD) using the Minnesota Multiphasic Personality Inventory-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989). A series of partial correlation and linear multivariate regression analyses identified social alienation, associated with anger and substance use, as the most potent negative predictor of symptom change. Of the scales assessing personality disorder, Borderline Personality was identified as the strongest negative predictor of outcome. Regression analyses examining the most salient scales identified 5 items that contributed 14% of the variance in the prediction of change scores independently of the 21% accounted for by pretreatment PTSD severity.     

Assessing adolescents' personality with the NEO PI-R

The suitability of the Revised NEO Personality Inventory (NEO PI-R) to assess adolescents' personality traits was investigated in an unselected heterogeneous sample of 469 adolescents aged 12 to 17 years. They were further administered the Hierarchical Personality Inventory for Children (HiPIC) to allow an examination of convergent and discriminant validity. The adult NEO PI-R factor structure proved to be highly replicable in the sample of adolescents, with all facet scales primarily loading on the expected factors, independent of the age group. Domain and facet internal consistency coefficients were comparable to those obtained in adult samples, with less than 12% of the items showing corrected item-facet correlations below absolute value .20. Although, in general, adolescents reported few difficulties with the comprehensibility of the items, they tend to report more problems with the Openness to Ideas (05) and Openness to Values (06) items. Correlations between NEO PI-R and HiPIC scales underscored the convergent and discriminant validity of the NEO facets and HiPIC scales. It was concluded that the NEO PI-R in its present form is useful for assessing adolescents' traits at the primary level, but additional research is necessary to infer the most appropriate facet level structure.     

Severity Indices of Personality Problems (SIPP-118) in adolescents: reliability and validity

The Severity Indices of Personality Problems (SIPP-118; Verheul et al., 2008) is a self-report questionnaire focusing on core components of (mal)adaptive personality functioning. The SIPP-118 was developed and validated in an adult population. In adult populations, the 16 facets of the SIPP-118 fit into 5 higher order domains: self-control, identity integration, relational capacities, social concordance, and responsibility. In this study we present the 1st psychometric properties of the SIPP-118 in adolescents. We compared the SIPP-118 scores of a patient and a nonpatient sample of adolescents, and compared personality disordered and non-personality disordered adolescents. In addition, the relationship between scores on the SIPP-118 and other clinical instruments (Symptom Checklist-90-Revised; SCL-90-R; Derogatis, 1975; Dimensional Assessment of Personality Pathology-Basic Personality; DAPP-BQ; Livesley & Jackson, 2002) was investigated. The questionnaires were completed by 378 adolescent patients and 389 adolescents in the community. Facets appeared to be homogeneous, as alpha coefficients ranged from .62 to .89, indicating moderate to acceptable reliability. Also, more pathological SIPP-118 scores were found in the patient sample, and more specifically in the personality disordered sample, suggesting that the facet scores of the SIPP-118 can discriminate between various populations (divergent validity). Correlation with other clinical instruments was moderate to high (-.82 to .10). Taken together, the SIPP-118 seems to be a promising instrument measuring personality pathology in adolescents.     

THE CONSTANCY OF STRUCTURE OF PERCEIVED PARENTAL REARING STYLE IN GREEK AND SPANISH SUBJECTS AS COMPARED WITH THE DUTCH

To be able to contribute to the cross-cultural study of child-rearing practices and psychopathology, this study sought to examine the cross-national generalizability of parental rearing constructs by analyzing self-report data on the EMBU, an instrument designed to assess memories of one's parents' rearing behavior. Of the four primary factors identified originally with Dutch individuals, namely Rejection, Emotional Warmth, Overprotection and Favoring Subject, the first three were replicated in a similar form in a Greek and a Spanish sample of normal research volunteers. Other properties of the factors, their corresponding scales, and the items constituting the scales were such that it would be warranted to carry out mean scale level or pattern comparisons between subjects from the respective countries on the three constructs evidencing cross-national constancy. Scale-level factor analysis of these constructs produced identical two- factor compositions (CARE and PROTECTION) across the Greek, the Spanish and the Dutch samples which further supported this conclusion.     

The Rorschach Technique (Book)

Minnesota Multiphasic Personality Inventory-2 (MMPI-2) overlapping and nonoverlapping scales were demonstrated to perform comparably to their original MMPI forms. They were then evaluated for convergent and discriminant validity with the Millon Clinical Multiaxial Inventory-II (MCMI-II) personality disorder scales. The MMPI-2 and MCMI-II personality disorder scales demonstrated convergent and discriminant coefficients similar to their original forms. However, the MMPI-2 personality scales classified significantly more of the sample as Dramatic, whereas the MCMI-II diagnosed more of the sample as Anxious. Furthermore, single-scale and 2-point code type classification rates were quite low, indicating that at the level of the individual, the personality disorder scales are not measuring comparable constructs. Hence, each instrument is providing similar and unique information, justifying their continued use together for the purpose of diagnosing personality disorders.     

The predictive power of Cattell's personality questionnaires: An eighteen month prospective study

An 18 month prospective study of personality traits (as assessed by Cattell's Children's Personality Questionnaire and Sixteen Personality Factor Questionnaire) was conducted on twin pairs and their parents. The primary personality trait scores for both the adults and children had relatively low stability over the 18 month interval; in addition, in some cases, the inter-factor stability coefficients exceeded the intra-factor coefficients. This finding, coupled with the lack of parent/offspring similarity for the primary personality traits, places in question the predictive power of Cattell's personality questionnaires. A factor analysis on the original items indicated that 5 oblique factors for the children and 6 oblique factors for the adults need be retained. These factors were not only more stable than the primary trait scores, but they also did not have such high inter-factor stability coefficients. Except for Neuroticism and IQ, the adult and juvenile factors do not show structural similarities.     

Why do measures of normal and disordered personality correlate? A study of genetic comorbidity

The genetic and environmental correlations between measures of normal (NEO-FFI) and abnormal personality (Dimensional Assessment of Personality Pathology: DAPP-BQ) were estimated in a sample of 545 volunteer general population twin pairs (269 monozygotic and 276 dizygotic pairs). The largest genetic correlations were observed between the 18 DAPP-BQ dimensions and NEO-FFI neuroticism (range = .05 to .81; median = .48), extraversion (range = -.65 to .33; median = -.28), agreeableness (range = -.65 to .00; median = -.38), and conscientiousness (range = -.76 to .52; median = -.31). The smallest genetic correlations were found between the DAPP-BQ dimensions and NEO-FFI openness (range = -.17 to .20; median = -.04). The environmental correlations are lower in magnitude but show the same pattern of correlations between DAPP-BQ and NEO-FFI scales. These results indicate that these two scales share a common broad-based genetic architecture, whereas the environmental influences show greater scale specificity.