Advancing the Assessment of Personality Pathology With the Cognitive-Affective Processing System

The Cognitive-Affective Processing System (CAPS) is a dynamic and expansive model of personality proposed by Mischel and Shoda (1995) Mischel, W., & Shoda, Y. (1995). A cognitive-affective system theory of personality: Reconceptualizing situations, dispositions, dynamics, and invariance in personality structure. Psychological Review, 102, 246–268.[Crossref], [PubMed], [Web of Science ®] , [Google Scholar] that incorporates dispositional and processing frameworks by considering the interaction of the individual and the situation, and the patterns of variation that result. These patterns of cognition, affect, and behavior are generally defined through the use of if … then statements, and provide a rich understanding of the individual across varying levels of assessment. In this article, we describe the CAPS model and articulate ways in which it can be applied to conceptualizing and assessing personality pathology. We suggest that the CAPS model is an ideal framework that integrates a number of current theories of personality pathology, and simultaneously overcomes a number of limits that have been empirically identified in the past.     

Healthy and Maladaptive Dependency and Its Relationship to Pain Management and Perceptions in Physical Therapy Patients

This study examined the association among healthy and maladaptive aspects of interpersonal dependency and the management of pain in physical therapy outpatients. Ninety-eight patients were administered the Relationship Profile Test, West Haven-Yale Multidimensional Pain Inventory, and Pain Catastrophizing Scale. Results indicated that Destructive Overdependence was positively associated with an increased number of office visits, pain interference in one’s daily life, pain severity, affective distress, and receiving positive partner responses. Dysfunctional Detachment was associated with affective distress, pain interference in one’s daily life, and rumination about pain. Healthy Dependency was only associated with receiving distracting responses from others. Believing that a spouse/partner is supportive and caring about one’s pain partially mediated the relationship between overdependency and pain interfering in one’s life. These results support the clinical utility of assessing interpersonal dependency for its relationship to managing one’s pain and health care utilization.     

Introduction to the special issue on personality assessment in the DSM-5

The DSM-5 is poised to dramatically reshape the way clinicians and researchers assess personality by reconfiguring the conceptualization of DSM-IV personality disorders. This special issue brings together leading scholars in personality pathology, including members of the DSM-5 Personality and Personality Pathology Work Group, as well as personality assessors operating from a variety of theoretical perspectives, to describe various facets of these changes and their potential impacts and in some cases to propose alternative solutions. As we describe in this brief introductory article, the articles in this special issue highlight several important and controversial issues in the transition to DSM-5 personality assessment.     

Contributions from personality- and psychodynamically oriented assessment to the development of the DSM-5 personality disorders

Advances in personality assessment over the past 20 years have notably influenced the proposed assessment and classification of personality disorders in the Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM-5]). However, a considerable body of personality assessment and psychodynamically oriented assessment research has significant relevance to the way in which personality disorders are evaluated that appears to have gone unrecognized in the current proposals for DSM-5. In this article, I discuss the ways in which some of these 2 bodies of literature can and should inform the DSM-5 so that the diagnostic nomenclature can be more scientifically and comprehensively informed and consequently improve the clinical utility of a diagnostic system in need of considerable revision.     

Proposals for DSM-5: introduction to special section of Journal of Personality Disorders

On February 10, 2010, the official proposals for the personality disorders section of the fifth edition of the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM-5) were posted (see www.dsm5.org ). The posting by the DSM-5 Personality and Personality Disorders Work Group has been helpful in informing the field of the possible changes that may occur with DSM-5. Their presence allows for and encourages persons to provide their suggestions and concerns. The extent of the proposals is considerable. As expressed on the website, "the work group recommends a major reconceptualization of personality psychopathology" (Skodol, 2010, "Reformulation of personality disorders in DSM-5," para. 1). The proposals have generated some controversy. The Journal of Personality Disorders has always sought to be a participant in the crucial debates in our field. The purpose of this special issue is to provide members of the Work Group the opportunity to further articulate the rationale for the proposals, and to provide others an opportunity to articulate their concerns. Copies of this special issue were distributed to interested persons when the complete set of final papers were received (October of 2010).     

Baroreflex responses to the stress of severe hemorrhage in the rat.

In two groups of anesthetized (sodium pentobarbital), mature Sprague-Dawley rats, 1) aged 2 years and weighing 300-400 grams, 2) aged 6 months weighing 200-300 grams, baroreflex-induced circulatory responses to pressor (graded doses phenylephrine) and depressor (graded doses nitroglycerine) agents were compared to those occurring during progressive hemorrhage in the same animals. Graded withdrawals of blood from the femoral artery elicited progressive hypotension accompanied by bradycardia rather than expected tachycardia. Graded doses of phenylephrine (2.5 ug to 40 ug bolus, via femoral vein) regularly induced elevations in arterial blood pressure with associated reflex bradycardia. Similarly graded doses of nitroglycerine induced a marked decline in arterial blood pressure, without expected tachycardia. As hypotension became more severe (during hemorrhage), atrioventricular conduction slowed and A-V block developed, resulting in statistically greater slowing in ventricular than in atrial excitation and contractile cycles. Heart failure during hemorrhage in the rat is characterized sequentially by severe bradycardia, depressed atrial contractile force, impaired conduction and A-V block, terminating in ventricular, atrial, and finally, in pacemaker failure. Baroreceptor reflexes were blunted or even absent in both young and old animals during induced hypotension.     

The two-week and five-week dependability and stability of the depressive personality disorder inventory and its association with current depressive symptoms

Within the psychometric framework of assessing a measure's dependability (Watson, 2004), this study considered the 2-week and 5-week test-retest correlations of the Depressive Personality Disorder Inventory (DPDI; Huprich, Margrett, Barthelemy, & Fine, 1996). DPDI scores were compared with the test-retest reliability (i.e., dependability) of the Beck Depression Inventory-II (BDI-II; Beck, Steer, & Brown, 1996). Three-hundred sixty-three undergraduates completed the DPDI and BDI-II and were reevaluated at either a 2- or 5-week interval. Two- and 5-week test-retest correlations for the DPDI were .89 and .82, respectively, and test-retest correlations for the BDI-II were .88 and .75. The effect sizes of the mean scores' changes in the measures across time were larger for the DPDI (ds = .48, .23) than the BDI-II (ds = .28, -.21), with mean BDI-II scores not significantly differing at the 5-week assessment from the baseline mean. Although the 5-week retest correlation for the BDI-II trended toward decreasing reliability from baseline, it did not significantly differ from the DPDI 5-week retest correlation. It is concluded that both measures are dependable and assess latent propensities toward depressive thoughts and feelings, along with the current influence of depressive states.