The Dark Triad of personality: Narcissism, Machiavellianism, and psychopathy

Of the offensive yet non-pathological personalities in the literature, three are especially prominent: Machiavellianism, subclinical narcissism, and subclinical psychopathy. We evaluated the recent contention that, in normal samples, this ‘Dark Triad’ of constructs are one and the same. In a sample of 245 students, we measured the three constructs with standard measures and examined a variety of laboratory and self-report correlates. The measures were moderately inter-correlated, but certainly were not equivalent. Their only common Big Five correlate was disagreeableness. Subclinical psychopaths were distinguished by low neuroticism; Machiavellians, and psychopaths were low in conscientiousness; narcissism showed small positive associations with cognitive ability. Narcissists and, to a lesser extent, psychopaths exhibited self-enhancement on two objectively scored indexes. We conclude that the Dark Triad of personalities, as currently measured, are overlapping but distinct constructs.     

Recommending Interventions for a Borderline Personality Disorder Patient

Borderline personality disorder (BPD) is a severe personality disorder leading to unstable emotional state, impulsivity, disturbed relationships and personal distress. This paper suggests a 12-step intervention plan including Dialectical Behavior Therapy (DBT) to Mr. X, a 21 year old male psychiatric inpatient having BPD, to promote his mental health. Therapy could not be conducted as the patient dropped out of treatment and got himself discharged from the hospital. This paper outlines implications for treatment on the basis of the clinical presentation of Mr. X. Mr. X presents himself with the BPD features showing suicidal tendencies, substance abuse and disturbed emotions. In depth interview of the patient showed extreme emotional disturbance and difficulty in controlling emotions and suicidal ideations. He was admitted at the Nur Manzil Psychiatric Centre, Lucknow, India and was kept under close observation because of being obsessed with suicidal thoughts; he also tried to kill himself. The DBT skills training and problem solving approach along with contingency management and behavioral chain analysis are suggested according to the clinical profile of Mr. X in order to reduce his self mutilating acts and substance abuse. Thus a general feeling of personal well being can be achieved thereby reducing personal distress.     

Borderline Personality Disorder: towards a systemic formulation

The diagnostic label, Borderline Personality Disorder (BPD), is rapidly gaining currency in the UK. Although many systemic practitioners are skilled and experienced at working with the clinical difficulties associated with the diagnosis, there is little systemic literature on the topic. This paper discusses some of the difficulties for systemic practitioners in engaging with the concept of BPD and offers some pointers for the development of systemic practice in this area.     

Emotion Differentiation as a Protective Factor Against Nonsuicidal Self-Injury in Borderline Personality Disorder

Evidence that nonsuicidal self-injury (NSSI) serves a maladaptive emotion regulation function in borderline personality disorder (BPD) has drawn attention to processes that may increase risk for NSSI by exacerbating negative emotion, such as rumination. However, more adaptive forms of emotion processing, including differentiating broad emotional experiences into nuanced emotion categories, might serve as a protective factor against NSSI. Using an experience-sampling diary, the present study tested whether differentiation of negative emotion was associated with lower frequency of NSSI acts and urges in 38 individuals with BPD who reported histories of NSSI. Participants completed a dispositional measure of rumination and a 21-day experience-sampling diary, which yielded an index of negative emotion differentiation and frequency of NSSI acts and urges. A significant rumination by negative emotion differentiation interaction revealed that rumination predicted higher rates of NSSI acts and urges in participants with difficulty differentiating their negative emotions. The results extend research on emotion differentiation into the clinical literature and provide empirical support for clinical theories that suggest emotion identification and labeling underlie strategies for adaptive self-regulation and decreased NSSI risk in BPD.     

The MMPI,Prototypal Typology,and Borderline Personality Disorder

This study demonstrates inherent features in the DSM-III diagnostic criteria for personality disorders (i.e., overlapping diagnoses and heterogeneous symptomatology) that limit efforts to identify a sensitive and specific MMPI profile for the borderline personality disorder. A sample of 71 inpatients was administered an MMPI and a semistructured interview that systematically evaluated each of 81 symptoms for the 11 DSM-III personality disorders. Interrater reliability was substantially higher than has been obtained with unstructured interviews. The effect on the borderline MMPI profile of (a) variation in the number of borderline symptoms and (b) overlap with the schizotypal, histrionic, and antisocial diagnoses was demonstrated. We discuss implications with respect to a prototypal model of classification.     

Borderline Personality Disorder and Development: Counseling University Students

Students with borderline personality disorders are difficult to counsel and present problems in consultation. Providing these students with structure through consistent limit setting can produce positive changes in their behavior.     

Borderline Personality Disorder and childhood sexual abuse: a meta-analytic study.

A meta-analysis of the published literature was performed to evaluate the common effect size (r) of the association between childhood sexual abuse (CSA) and Borderline Personality Disorder (BPD). An online search from 1980 to 1995 was used to gather published papers. r coefficient was used as an effect size measure, and 21 studies were retrieved. A moderate pooled r (.279) for the association between CSA and BPD was observed. Pooled effect size estimates were also obtained for CSA parameters. No significant effect of moderators was evidenced. The results of this study did not support the hypothesis that CSA is a major psychological risk factor or a causal antecedent of BPD.     

Dialectical Behavior Therapy: An Emotion-Focused Treatment for Borderline Personality Disorder

Dialectical Behavior Therapy (DBT) is a cognitive-behavioral treatment for borderline personality disorder (BPD) that is based on the theory that emotion dysregulation is the core feature of BPD. This article focuses on aspects of DBT theory and techniques that specifically address emotion. The dialectical and biosocial theories that underlie DBT are reviewed with an emphasis on how each relates to emotional experiencing in BPD. Selected treatment strategies that address emotion dysregulation and their hypothesized mechanisms of change are also described. Relevant research findings are incorporated throughout to provide an empirical foundation for the DBT theories and strategies that are discussed.     

Borderline Personality Disorder in 3-D: Dimensions,Symptoms, and Measurement Challenges

Borderline personality disorder (BPD) is a pervasive pattern of psychopathology characterized by unstable affect, suicidal behaviors, and identity problems (Diagnostic and statistical manual of mental disorders. Washington, DC: Author; 2000). BPD is heterogeneous in nature, highly prevalent in clinical settings, and increasingly studied by clinical and social psychologists. This review highlights affective instability, impulsivity, and interpersonal hypersensitivity, the interaction of which we believe accounts for the symptoms of BPD, the BPD criteria most associated with these features, and the interrelationships among these underlying dimensions. We also discuss difficulties in measurement of these dimensions. Real-world assessment methods will assist in the measurement of time-dependent processes and identify causes, covariates, or consequences of these processes to determine how these features manifest themselves in real life.     

Borderline Personality Disorder,Divorce and Family Therapy: The Need for Family Crisis Intervention Strategies

Recent literature reviews, point out the lack of crisis intervention and crisis prevention programs that are in existence to address crises experienced by first-degree and divorced family members of Borderline Personality Disorder (BPD) probands. The focus of such intervention programs should be to facilitate the improved ability of the first-degree and divorced family members to manage and transcend the unstable family environment. Correlations between personal instability and frequency of psychosocial crises have been examined, as well as the ripple effect of frequent individual crises on family environments. Reviews of current therapeutic interventions, as well as a synthesis of practical family therapy interventions focusing on breaking the cycle of dysfunctional multi-generational family environments are also examined.     

Between Subjugation and Survival: Women, Borderline Personality Disorder and High Security Mental Hospitals

Women in high security mental health care are frequently diagnosed with borderline personality disorder. Such women commonly report histories of child abuse, in particular child sexual abuse, and the vast majority also self-harm. In this paper, we draw on social constructionist theory to develop a framework for understanding these women, the effects of abuse and the reasons they self-harm. We demonstrate how a social model of intervention provides a comprehensive framework for identifying and exploring relevant factors within therapy. We argue that diagnostic categorisation has limited utility in directing therapeutic work with this particular group of women, because it directs attention away from the social world to internal pathology. We demonstrate that it is with reference to women's past and current relationships that borderline behaviour can be understood to be meaningful and partially adaptive. We conclude that treatment is more usefully organised around and directed towards those factors, such as abuse and self-harm, that are implicated in women's ongoing relationship difficulties.     

A Rorschach Study of Narcissism Defense,and Aggression in Borderline,Narcissistic, and Cluster C Personality Disorders

We examined the differences between narcissism, mode of defense, and level of aggression on the Rorschach. We also investigated differences in borderline, narcissistic, and Cluster C personality disorders by examining responses to Rorschach content variables. The Lerner Defense Scale (P. Lerner & H. Lerner, 1980), the aggressive content section of the Holt (1977) method for assessing primary process manifestations, a modified version of Exner's (1986a) Egocentricity Index, Wagner's (1965) exhibitionistic M score, and grandiosity were scored on the Rorschach protocols of 17 borderline, I7 narcissistic, and 17 Cluster C personality disorders. Borderlines were found to employ primitive defensive structures to a greater degree and severity, show more intense and overall aggression as welt as more responses on the three forms of aggression in the Holt method, and have higher levels of grandiosity. Narcissists evinced significantly higher levels of egocentricity than borderlines and higher levels of idealization than the Cluster C group. Convergent validity was found on the measures of defense and aggression, which showed a strong relationship between primitive aggression and primitive defense.     

Amygdalar Volume in Borderline Personality Disorder With and Without Comorbid Post-traumatic Stress Disorder: A Meta-analysis

IntroductionFour studies have found a smaller amygdalar volume in patients with borderline personality disorder (BPD) relative to controls, whereas four other studies have found similar amygdalar volume in BPD patients relative to controls. This study aims to compare amygdalar volumes of BPD patients with controls, and also to compare BPD patients with and without post-traumatic stress disorder (PTSD) with controls in order to determine whether PTSD can explain the heterogeneity of findings.MethodSystematic review and meta-analysis of magnetic resonance imaging studies that measured amygdalar volumes in BPD patients and healthy controls.FindingsA significant reduction of amygdalar volumes in BPD patients was confirmed (p < .001). However, data from the studies that discriminated BPD patients with and without PTSD indicated that amygdalar volumes were significantly smaller in BPD patients without PTSD relative to controls (left: p = .02; right: p = .05), but not in BPD patients with PTSD relative to controls (left: p = .08; right: p = .20).ConclusionThis meta-analysis suggests that amygdalar volumes are reduced in patients with BPD. This pattern is confirmed in BPD patients without PTSD, but not in BPD patients with PTSD, raising the possibility that reduced amygdalar volume in BPD patients cannot be explained by comorbid PTSD.     

Associations Between Symptoms of Borderline Personality Disorder,Externalizing Disorders,and Suicide-Related Behaviors

Borderline personality disorder and externalizing disorders are associated with suicide-related behaviors. The present study examined whether symptoms of borderline personality disorder mediate the relationship between externalizing disorders and suicide-related behaviors. Diagnostic interviews were administered to 344 participants (n = 233 women). Results indicated that symptoms of antisocial personality disorder, alcohol use disorders, and drug use disorders each were significantly associated with suicide threats and self-injurious behavior in women and symptoms of antisocial personality disorder were associated with suicide attempts in women. With the exception of the association between symptoms of alcohol dependence and self-injurious behaviors, borderline personality disorder symptoms mediated or partially mediated all associations between externalizing disorders and suicide-related behaviors in women. These results highlight the importance of assessment and treatment of borderline personality disorder symptoms in individuals with externalizing disorders, particularly in the presence of suicide-related behaviors.

Affect Dysregulation in Individuals With Borderline Personality Disorder: Persistence and Interpersonal Triggers

We hypothesized that affect dysregulation among individuals with borderline personality disorder (BPD) would involve greater persistence of negative affect between interpersonal events and heightened reactivity to stimuli indicating risk of rejection or disapproval, specifically perceptions of others’ communal (agreeable-quarrelsome) behaviors. A total of 38 participants with BPD and 31 controls collected information about affect and perceptions of the interaction partner's behavior during interpersonal events for a 20-day period. Negative and positive affect persisted more across interpersonal events for individuals with BPD than for controls. In addition, individuals with BPD reported a greater increase in negative affect when they perceived less communal behavior and a smaller increase in positive affect when they perceived more communal behavior in others. Findings indicate the importance of interpersonal perceptions in the affect dysregulation of individuals with BPD.     

Facial Emotion Processing in Borderline Personality Disorder: A Systematic Review and Meta-Analysis

A body of work has developed over the last 20 years that explores facial emotion perception in Borderline Personality Disorder (BPD). We identified 25 behavioural and functional imaging studies that tested facial emotion processing differences between patients with BPD and healthy controls through a database literature search. Despite methodological differences there is consistent evidence supporting a negative response bias to neutral and ambiguous facial expressions in patients. Findings for negative emotions are mixed with evidence from individual studies of an enhanced sensitivity to fearful expressions and impaired facial emotion recognition of disgust, while meta-analysis revealed no significant recognition impairments between BPD and healthy controls for any negative emotion. Mentalizing studies indicate that BPD patients are accurate at attributing mental states to complex social stimuli. Functional neuroimaging data suggest that the underlying neural substrate involves hyperactivation in the amygdala to affective facial stimuli, and altered activation in the anterior cingulate, inferior frontal gyrus and the superior temporal sulcus particularly during social emotion processing tasks. Future studies must address methodological inconsistencies, particularly variations in patients’ key clinical characteristics and in the testing paradigms deployed.     

The Dark Triad and animal cruelty: Dark personalities,dark attitudes,and dark behaviors

Research examining the interpersonal interactions of those high on the Dark Triad has proliferated in recent years. Extant research, however, has not examined other types of relationships such as attitudes and behaviors towards animals. Further, there has been limited research examining the associations between personality and attitudes and behaviors towards animals generally. In this study, participants (N = 227) completed an online survey measuring the Dark Triad, attitudes towards animals, and acts of animal cruelty. The results revealed that individuals with higher levels of the Dark Triad demonstrated less positive attitudes towards animals and reported engaging in more acts of animal cruelty. Age and sex were found to be significant predictors of less positive attitudes and behaviors towards animals, independent of the Dark Triad. These results suggest that those callous and manipulative behaviors and attitudes that have come to be associated with the Dark Triad are not just limited to human-to-human interactions, but are also consistent across other interactions.     

Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD): a continuous measure of DSM-IV borderline psychopathology

The purpose of this study was to assess the psychometric properties of the Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD), the first clinician-administered scale for the assessment of change in DSM-IV borderline psychopathology. The questions for the measure were adapted from the BPD module of the Diagnostic Interview for DSM-IV Personality Disorders (DIPD-IV) to reflect a 1-week time frame and each of the nine criteria for BPD is rated on a five-point anchored rating scale of 0 to 4, yielding a total score of 0 to 36. Two diagnostic interviews that assess the presence of BPD were administered to 200 nonpsychotic patients: the BPD module of the DIPD-IV and the Revised Diagnostic Interview for Borderlines (DIB-R). The ZAN-BPD was also administered, blind to diagnostic information. In addition, each patient filled out a self-report measure of general psychopathology that is often used in borderline treatment studies, the Symptom Checklist 90 (SCL-90). The convergent validity of the ZAN-BPD and relevant scales of the SCL-90 and the DIB-R was assessed and found to be highly significant. The discriminant validity of the various scores of the ZAN-BPD was also found to be highly significant, easily discriminating the 139 patients who met the DSM-IV criteria for BPD from the 61 patients who did not. In addition, internal consistency of the ZAN-BPD was found to be high (Cronbach's alpha=0.85). The interrater reliability of the ZAN-BPD was assessed using 32 conjoint interviews, while same day test-retest reliability was assessed in a separate sample of 40 patients. All reliability raters were blind to all previously collected information concerning each subject. All intraclass correlations were in the good to excellent range. Finally, the sensitivity of the ZAN-BPD to change was assessed using a third sample of 41 patients who were reinterviewed by a blind rater 7 to 10 days after the ZAN-BPD was first administered. The SCL-90 was also readministered at this time. The correlations between difference scores of the ZAN-BPD and difference scores of the SCL-90 were found to be significant, indicating that the ZAN-BPD measures change in a clinically meaningful manner. Taken together, the results of this study suggest that the ZAN-BPD is a promising clinician-administered scale for the assessment of change in borderline psychopathology over time.