Personality-based latent classes of posttraumatic psychopathology: personality disorders and the internalizing/externalizing model

Prior research using the Brief Form of the Multidimensional Personality Questionnaire (MPQ-BF; Patrick, Curtin, & Tellegen, 2002) has shown evidence of 3 temperament-based subtypes--termed internalizing, externalizing, and simple PTSD--among individuals with symptoms of posttraumatic stress disorder (PTSD; Miller, Greif, & Smith, 2003). This study sought to replicate and extend research in this area by conducting a latent profile analysis of higher order temperament scales from the MPQ-BF using a new sample of 208 veterans with symptoms of PTSD. Results suggest that a 3-class solution reflecting internalizing, externalizing, and simple subtypes of posttraumatic psychopathology provided the best fit to the data. The externalizing subtype was characterized by features of antisocial, borderline, histrionic, and narcissistic personality disorders on the International Personality Disorder Examination (Loranger, 1999) as well as low levels of constraint and high levels of negative emotionality on the MPQ-BF. In contrast, individuals in the internalizing class exhibited features of schizoid and avoidant personality disorders, low levels of positive emotionality, and high levels of negative emotionality. The simple subtype was defined by low levels of comorbid personality disorder features and relatively normal personality profiles. Findings support the reliability of this typology and support the relevance of the internalizing and externalizing model to the structure of personality disorders.     

Common and specific correlates of preadolescent internalizing and externalizing psychopathology

The specificity of various child characteristics and environmental correlates of childhood internalizing and externalizing problems was examined using both cross-sectional and longitudinal analyses (from ages 2-3 and 4-5 years) in a general population sample of 10-11-year-olds. Specificity was defined according to a between-subjects and a within-subjects method, using parent and teacher reports of psychopathology. Temperamental withdrawal, parental internalizing psychopathology, and early single parenthood (for girls) were identified as correlates that are specific for internalizing problems, whereas temperamental high general activity level was identified as externalizing-specific. Further, parenting stress, poor school results (only for boys), and stressful life events (only for girls) were found to be common correlates of psychopathology. Research implications regarding the findings and the use of a within-subjects method are discussed.     

Validation of the dimensional factor structure of the personality psychopathology five in clinical and nonclinical samples

Confirmatory factor analysis (CFA) was used to determine whether the latent structure underlying the items composing the MMPI-2 Personality Psychopathology Five scales (PSY-5; Harkness, McNulty, & Ben-Porath, 1995) is representative of the theoretical model that informed their construction. Results from the CFA revealed a good fit between the hypothesized five-factor model and the obtained latent factor structure in both clinical (n = 284) and nonclinical (n = 351) samples. Moreover, the PSY-5 model proved to be a better fit than a random five-factor model and a one-factor model. Correlations between the PSY-5 scales and a set of MMPI-2 (DSM-IV) personality disorder scales provided additional evidence of convergent and discriminant validity.     

Platelet MAO-B, personality, and psychopathology

The article investigates the relationships between platelet monoamine oxidase-B (MAO-B) activity, personality, and psychopathology (Diagnostic and Statistical Manual of Mental Disorders [4th ed.; American Psychiatric Association, 1994] diagnoses. These relationships were assessed in 178 incarcerated male juvenile delinquents. Even after controlling for smoking, the authors found that both Internalizing and Externalizing Psychopathology were negatively related to MAO-B activity. In the final reduced model, novelty seeking fully mediated the relationships between MAO-B and Externalizing Psychopathology but not between MAO-B and Internalizing Psychopathology. It was hypothesized that low platelet MAO-B activity does not directly predispose individuals to psychopathology but is related to specific personality traits, which in turn represent a vulnerability factor for psychopathology. Future studies should help clarify the nature of the relationships between personality, biological markers, and psychopathology.     

Recovery and replication of internalizing and externalizing dimensions within the personality assessment inventory

In this study, we examined the internal structure of 13 Personality Assessment Inventory (PAI; Morey, 1991, 2007) scales in a corrections sample (N = 1,099). Previous findings regarding the PAI internal structure have been somewhat inconsistent. We investigated the utility of a 2-dimensional model comprised of internalization and externalization to organize the 11 PAI clinical scales and 2 additional scales, Suicidal Ideation and Aggression. We randomly divided the sample, and a factor analysis revealed a 2-dimensional model representing internalization and externalization. Confirmatory factor analyses conducted with an independent subsample revealed acceptable fit when the model was revised to include correlated error terms between mood and anxiety disorder scales. The revised model exhibited acceptable fit when cross-validated, had better fit than a 1-dimension model, and demonstrated preliminary construct validity in relation to extratest variables.     

On stability of the structure of implicit personality theory over situations

In the present study, the following (hitherto unaddressed) question was posed: “Is the structure of implicit personality theory stable over situations?”. In order to answer this question, correlation coefficients were computed between different aspects of two trait-structures obtained under different situational conditions. The results seem to indicate that the structure of IPT is stable over situations. The results are discussed in the light of some methodological considerations.     

Temperament, personality, and developmental psychopathology as childhood antecedents of personality disorders

To contribute to the case for a dimensional conceptualization of psychopathology in general and maladaptive personality or personality disorders in particular, the present paper reviews the evidence for a dimensional representation of childhood temperament and personality. The review of temperament and variable-centered as well as person-centered approaches to childhood personality leads us to propose five broadband dimensions that capture individual differences in children and adolescents: extraversion, emotional stability, agreeableness, conscientiousness, and openness/intellect. Our analysis of the CBCL (Achenbach, 1991) and the DIPSI (currently under development at Ghent University), two dimensional models for childhood psychopathology, suggests two common broadband factors, internalizing and externalizing. The relations between the dimensional representation of childhood temperament/personality and psychopathology are documented with data from general population and clinical samples of children and adolescents. The article concludes with a proposal on how the higher-order dimensions emerging from studies of adaptive and maladaptive individual differences in childhood could be integrated in a common dimensional model.     

Temperament as a unifying basis for personality and psychopathology

Personality and psychopathology long have been viewed as related domains, but the precise nature of their relations remains unclear. Through most of the 20th century, they were studied as separate fields; within psychopathology, clinical syndromes were separated from personality disorders in 1980. This division led to the revelation of substantial overlap among disorders both within and across axes and to the joint study of normal and abnormal personality. The author reviews these literatures and proposes an integrative framework to explain personality-psychopathology relations: Three broad, innate temperament dimensions--negative affectivity, positive affectivity, and disinhibition--differentiate through both biologically and environmentally based developmental processes into a hierarchical personality trait structure and, at their extremes, are risk factors (diatheses) for psychopathology, especially given adverse life experiences (stress).     

Progress and innovation: personality disorders and the vanguard of psychopathology research

Important progress in our understanding of the natural course of personality disorders (PDs) is documented in the articles for this special section. This progress could set the stage for ideas developed in the study of PDs to play a central role in research on psychopathology more broadly conceived. The Collaborative Longitudinal Personality Disorders Study (Skodol et al., this issue), the Children in the Community Study (Cohen, Crawford, Johnson, & Kasen, this issue), and the McLean Study of Adult Development (Zanarini, Frankenburg, Hennen, Reich, & Silk, this issue) reveal the importance of personality in understanding psychopathology, and point toward a dimensional approach to conceptualizing psychopathology that could also frame categorical clinical decision making processes.     

Childhood loss and disharmony: later effects on personality and psychopathology

In a comparison of psychiatric inpatients and medical controls parental loss in childhood was not a differentiating factor. Psychiatric inpatients, however, had more disturbance in their home background.In the psychiatric group a disturbed childhood background was associated, on the Eysenck Personality Questionnaire, with abnormal scoring on P in both sexes, and N in males. There was, however, no specific association with psychiatric diagnosis.     

The search for dimensional structure differences between normality and abnormality: a statistical review of published data on personality and psychopathology

A statistical review of published data for 37 personality and psychopathology inventories was conducted to determine whether there are dimensional structure differences between clinical and nonclinical respondents. Correlation and factor-loading matrices from multiscale inventories and from specialized measures were tested for structural invariance across populations. There was relatively consistent evidence for high levels of similarity between normal and abnormal populations both in the number of factors that exist in the data matrices and in the factor patterns. The dimensional universes of normality and abnormality are apparently the same, at least according to data derived from contemporary assessment instruments. Categorical-taxonic differences between clinical and nonclinical populations, which were not examined, may nevertheless exist within contexts of dimensional structure similarity.     

The association between psychopathology in fathers versus mothers and children's internalizing and externalizing behavior problems: a meta-analysis

In light of the selective focus on maternal (vs. paternal) psychopathology as a risk factor for child development, this meta-analysis examines the relative strength of the association between psychopathology in mothers versus fathers and the presence of internalizing and externalizing disorders in children. Associations were stronger between maternal than paternal psychopathology and the presence of internalizing (but not externalizing) problems in children, with all average effect sizes being small in magnitude. Relations were moderated by variables that highlight theoretically relevant differences between psychopathology in mothers versus fathers (e.g., age of children studied, type of parental psychopathology) and by variables related to methodological differences across studies (e.g., method of assessing psychopathology in parents and children, type of sample recruited, familial composition).     

Maladaptive personality traits and psychopathology in childhood and adolescence: the moderating effect of parenting

This study examines child and adolescent psychopathology from a maladaptive trait perspective, incorporating both parental and child ratings of parenting as a moderator of the personality-psychopathology association. Hierarchical moderated regression analyses were conducted on a combined sample of referred and nonreferred children and adolescents (N=862, parental ratings of parenting and N=396, child ratings of parenting). The results indicated positive main effects of maladaptive traits on externalizing and internalizing problems, and positive main effects of parental negative control on externalizing problems. Significant interactions were found for Disagreeableness and Emotional Instability with parental Negative Control and for Disagreeableness x Positive Parenting in explaining externalizing problems. The discussion focuses on the contribution of these findings to a better understanding of the trait-psychopathology relationship at young age.     

Level and form of psychopathology and the structure of group therapy

Drawing upon concepts derived from ego psychological and object relations psychoanalytic theories of individual development and from a depth group psychology, the present empirical study, a naturalistic field investigation, explored hypothesized relationships between aspects of patients' psychological boundaries and structural features of inpatient therapy groups. More specifically, patients were assessed in terms of their level (i.e., psychotic vs. borderline organization) and form (i.e., anaclitic vs. introjective) of psychopathology. Their perceptions of themselves and of their therapy groups were measured following participation in two kinds of small group treatment designed to differ in terms of degree of internal structuring. Findings, generally supporting the hypotheses, showed the anaclitic borderline patients, in particular, to be most sensitive to structural variations and most adversely affected by an impersonal and highly structured treatment climate. Theoretical and practical implications of these findings were discussed.     

Longitudinal stability of personality characteristics1

An empirical study, based on a longitudinal sample of approximately 1,000 boys and girls, investigated whether ratings of personality traits show longitudinal stability. A reformulation of the Campbell and Fiske (1959) multitrait-multimethod criteria in terms of stability across time was employed to give a more profound analysis of longitudinal stability. The results point to considerable stability across a period of three years (from 10 to 13 years of age) in ratings of personality traits, performed by independent raters. These results are discussed in relation to views, put forward by several researchers, that ratings mainly mirror implicit personality theories of the raters, and therefore are less useful as data in psychological research and application.     

Attributions of stability and relevance of personality traits

This experiment tested a number of hypotheses derived from trait theory, attribution theory and interactional psychology. Forty subjects rated the stability and relevance of 60 pre-selected traits of three role-related people and themselves in four specific social situations. The traits were categorized beforehand in terms of their structural, motivational and content properties, and whether they were positive or negative. There was a significant difference in the perceived stability of positive and negative traits between liked and disliked people; positive traits being seen as significantly more stable in liked people and less stable in disliked people. However, subjects did not attribute significantly less stability to their own behavioural traits than to those of others in the same situations. It was also demonstrated that trait labels are seen to be differentially relevant for describing people in different social situations. The results are discussed in terms of the work on stability and cross-situational consistency in trait and attribution theory and person-situation research.