Surviving as a personality disorder service

Personality disorder services working along psychotherapeutic lines gained appeal with Health Care Commissioners following the publication of the National Institute for Health and Clinical Excellence (NICE) guidelines for Borderline & Antisocial Personality Disorders and the emerging successful application of psychoanalytically derived approaches. In parallel to this creative development, the economic downturn has faced the National Health Service (NHS) with considerable challenges in its ongoing survival. The potential for creative pursuit often then sits in competition, juxtaposed with the need to survive. We examine the impact of this dynamic upon the therapeutic efforts of a newly established personality disorder service. We suggest that both conscious and unconscious aspects stirred up within such encounters are demanding of the need for development of a capacity within each to bear contact with unfamiliar experiences. Through attention to that development, both patient and clinician may further enliven and enrich individual and collective identities, such that the potential to survive creatively is actualized.     

Deconstructing the construct: A network perspective on psychological phenomena

In psychological measurement, two interpretations of measurement systems have been developed: the reflective interpretation, in which the measured attribute is conceptualized as the common cause of the observables, and the formative interpretation, in which the measured attribute is seen as the common effect of the observables. We advocate a third interpretation, in which attributes are conceptualized as systems of causally coupled (observable) variables. In such a view, a construct like ’depression’ is not seen as a latent variable that underlies symptoms like ’lack of sleep’ or ’fatigue’, and neither as a composite constructed out of these symptoms, but as a system of causal relations between the symptoms themselves (e.g., lack of sleep → fatigue, etc.). We discuss methodological strategies to investigate such systems as well as theoretical consequences that bear on the question in which sense such a construct could be interpreted as real.     

Child Personality as Moderator of Outcome in a School‐based Intervention for Preventing Externalising Behaviour

Studying moderators of intervention effects is essential to elucidate what works for whom. The present study investigated whether child personality moderates short‐term and follow‐up effects of an individualised preventive school‐based intervention for children with externalising behaviour. The sample consisted of 48 schools, with 264 fourth‐grade children displaying externalising behaviour (M_age = 10.2 years), randomly assigned to the intervention (n = 191) or no intervention control (n = 73) condition. Teachers and children reported at pretest, posttest and follow‐up test about reactive and proactive aggression. Child personality was assessed by teachers at pretest. Child conscientiousness moderated short‐term intervention effects, indicating that more organised and planful children benefited more from the intervention. Child extraversion moderated both short‐term and follow‐up intervention effects, with low extraverted children showing larger effects. These results affirm the importance of including personality as moderator of intervention effects in future studies, as interventions adapted to specific child traits might yield larger effects. Copyright © 2012 John Wiley & Sons, Ltd.     

Confounding of Big Five Personality Assessments in Emotional Disorders by Comorbidity and Current Disorder

Foremost cross‐sectional studies of personality in common mental disorders show similar Big Five trait profiles [i.e. high neuroticism (N), low conscientiousness (C) and low extraversion (E)]. It remains undecided whether this lack of distinct personality profiles is partly due to comorbidity among disorders or contamination by current state. Using data from the Netherlands Study of Depression and Anxiety, we investigated 1046 participants with panic disorder (PD), social anxiety disorder (SAD) and/or major depressive disorder (MDD) and 474 healthy controls. Personality traits at baseline and two‐year follow‐up were assessed with the NEO‐Five Factor Inventory. The Composite International Diagnostic Interview was used to determine the presence of emotional disorders at baseline and at two‐year follow‐up; the Life Chart Interview determined symptom severity in the month prior to baseline and during follow‐up. By analysing pure cases and investigating the effects in remitted cases, PD participants were found to be higher in N, but not lower in E and C than controls. Pure PD participants were also lower in N and higher in E than SAD and MDD participants. Both SAD and MDD participants were characterized by high levels of N and low levels of E, irrespective of comorbidity or current disorder state. Future studies should be more attentive to confounding of personality profiles by comorbidity and state effects. Copyright © 2012 John Wiley & Sons, Ltd.     

Associations of Identity Dimensions with Big Five Personality Domains and Facets

Personality is among the most important factors contributing to individual differences in identity formation. However, previous studies mainly focused on broad personality domains and neglected more specific facets. In addition, it has only recently been recognized that identity formation is guided by multiple types of commitment and exploration. The present study aimed to remedy these limitations by relating the 30 personality facets of the NEO‐PI‐3 to five identity dimensions. In general, identity formation was especially facilitated by high levels of Conscientiousness and, to a lesser extent, also by high levels of Extraversion and low levels of Neuroticism. Openness and Agreeableness predicted greater involvement in both the positive side (i.e. exploration in breadth and depth) and negative side (i.e. ruminative exploration) of the exploration process. Personality facets and their overarching domains, as well as facets underlying the same domain, were often differentially associated with identity dimensions. Additionally, we found that some personality facets both have bright and dark sides, as they predicted both proactive identity work and a weakened sense of identity. Overall, the present study underscores the utility of multidimensional models of identity formation and points to the benefits of considering personality facets in addition to broad domains. Copyright © 2012 John Wiley & Sons, Ltd.     

Personality Traits and Body Weight Measures: Concurrent and Across‐Time Associations

We tested the possibility that the five‐factor model of personality is associated with three measures of body weight and with changes in their levels over time and that these associations are gender specific. The study was conducted at two points of time, Time 1 (2664 participants) and Time 2 (1492 participants), over approximately 4 years, controlling for gender, age, education, and having a chronic disease. Body weight was assessed by body mass index, waist circumference, waist‐to‐hip ratio, and the five‐factor model by Saucier's Mini‐Markers. Cross‐sectional regression results indicated that conscientiousness was negatively associated with the three body weight measures, whereas neuroticism and extraversion were positively associated with the three body weight measures. The longitudinal regression results indicate that extraversion was associated with an increase in two of the body weight measures. Neuroticism was associated with increase in all three body weight measures and more strongly for women than for men. Openness was associated with a decrease in all three body weight measures for women, but this association was not significant for men. These findings help identify personality traits that lead to risk of weight gain and point to the modifying role of gender. Copyright © 2013 John Wiley & Sons, Ltd.     

Psychological Well-Being of Canadian Forces Officer Candidates: The Role of Personality and Coping Strategies

Previous research has suggested that personality influences the coping strategies an individual uses to deal with stressors, which, in turn, influences psychological well-being. This study examines whether coping strategies mediate the relationship between neuroticism and the psychological well-being of Canadian Forces officer candidates undergoing basic training. Only partial evidence was found for the mediating role of coping strategies between neuroticism and psychological well-being. These findings suggest that coping strategies and personality may constitute two independent constructs, both of which have significant contributions to well-being among military personnel.     

Mental Health Services Use Intentions Among Canadian Military Recruits

Identifying the factors associated with mental health services use (MHSU) is an important step in developing strategies to improve services access and delivery. The aims of the present study were to (a) identify personality and individual difference characteristics associated with MHSU intentions within the framework of the Theory of Planned Behavior (TPB) and (b) explore complex relationships that might exist between these characteristics and determinants of MHSU intentions identified in TPB, including attitudes, subjective norms, and perceived behavioral control. Data for 244 Canadian Armed Forces recruits who completed a MHSU questionnaire following mental health training were linked to personality data collected earlier. Multivariate analyses showed that the relationship between agreeableness and MHSU intentions was mediated by instrumental attitudes and subjective norms. The relationship between hardiness and MHSU intentions was mediated by subjective norms and self-efficacy. Findings suggest it may be worthwhile to consider mental health education initiatives to improve MHSU.     

Modeling Interactions Between Latent Variables in Research on Type D Personality: A Monte Carlo Simulation and Clinical Study of Depression and Anxiety

Several approaches exist to model interactions between latent variables. However, it is unclear how these perform when item scores are skewed and ordinal. Research on Type D personality serves as a good case study for that matter. In Study 1, we fitted a multivariate interaction model to predict depression and anxiety with Type D personality, operationalized as an interaction between its two subcomponents negative affectivity (NA) and social inhibition (SI). We constructed this interaction according to four approaches: (1) sum score product; (2) single product indicator; (3) matched product indicators; and (4) latent moderated structural equations (LMS). In Study 2, we compared these interaction models in a simulation study by assessing for each method the bias and precision of the estimated interaction effect under varying conditions. In Study 1, all methods showed a significant Type D effect on both depression and anxiety, although this effect diminished after including the NA and SI quadratic effects. Study 2 showed that the LMS approach performed best with respect to minimizing bias and maximizing power, even when item scores were ordinal and skewed. However, when latent traits were skewed LMS resulted in more false-positive conclusions, while the Matched PI approach adequately controlled the false-positive rate.