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Background Selected personality features may represent important predisposing as well as perpetuating factors for insomnia, and previous studies stressed the importance to assess personality disorders in insomnia patients. Methods In order to evaluate the relationships between DSM-IV Axis II/DSM-5 Section II Personality Disorders (PDs) and insomnia, a sample of 171 consecutively admitted insomnia patients and a sample of 171 psychotherapy patients, matched on age and gender were administered the Italian translation of the Structured Clinical Interview for DSM-IV Axis II Personality Disorders, Version 2.0 (SCID-II). Among insomnia patients, 52.0% (n = 89) received at least one DSM-IV Axis II/DSM-5 Section II PD diagnosis according to SCID-II assessment. Results Any PD base rate estimate in our insomnia patient sample was significantly and markedly higher than the median and mean base rate estimates for any PD in the general population. Within-group analyses showed that Narcissistic, Not otherwise specified PD, Histrionic PD, and Borderline PD represented the most frequently diagnosed-both dimensionally and categorically-DSM-IV Axis II/DSM-5 Section II PD features in our insomnia patient sample. When continuously-scored PDs were considered, insomnia patients showed a significantly lower number of Paranoid and Borderline PD features than psychotherapy patients; however, the corresponding effect size estimates suggested that these differences were modest. None of the categorically-scored PDs significantly differentiated insomnia patients from psychotherapy patients. Conclusions As a whole, our findings seemed to suggest that personality dysfunction may play a role in insomnia, while stressing the need for a dimensional approach to the assessment of maladaptive personality traits even in insomnia patients.

A number of studies have reported data suggestive of a significant association between attention-deficit/hyperactivity disorder (ADHD) and borderline personality disorder (BPD). However, the nature of this relation is not fully understood. This study aimed to evaluate if the relation between retrospectively assessed ADHD symptoms and adult BPD features is moderated by participants’ gender and mediated by emotion dysregulation and impulsivity. Two hundred seventeen outpatients meeting DSM-IV criteria for at least one personality disorder (PD) consecutively admitted to the Clinical Psychology and Psychotherapy Unit of the Scientific Institute H San Raffaele of Milan, Italy, were administered Italian versions of the following instruments: Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II), Wender Utah Rating Scale (WURS), Difficulties in Emotion Regulation Scale (DERS), and the Barratt Impulsiveness Scale-11 (BIS-11). Moderation analyses revealed a significant association between ADHD and BPD symptoms among only female (vs. male) outpatients. Furthermore, in the female subsample, mediation analyses revealed that both impulsivity and emotion dysregulation fully mediated the relationship between retrospectively assessed ADHD symptoms and current BPD features.

The interaction between biological and environmental factors (especially adverse childhood experiences, ACEs) plays a crucial role in the development and maintenance of borderline personality disorder (BPD). These factors act influencing BPD core features such as pervasive instability in affect regulation, impulse control, social cognition, and interpersonal relationships. In line with this perspective, abnormalities in social cognition and related neurobiological underpinnings could mediate the relationship between ACEs and psychopathological manifestations in adulthood. In a sample of 14 females, functional connectivity (FC) analyses were performed modeling the interaction between ACEs and corticolimbic dysregulation during emotional processing and its relationship with BPD symptom severity. ACEs were associated with a dampening of the negative FC between (1) the right amygdala (Amy) and right dorsolateral prefrontal cortex (DLPFC) and between (2) the left Amy and bilateral DLPFC, right precuneus, left cerebellum and left dorsomedial prefrontal cortex during emotional processing. The connectivity between right Amy and DLPFC mediates the relationship between childhood adversities and BPD symptomatology. Furthermore, the negative FC between Amy and DLPFC, postcentral gyrus, the vermis of cerebellum and precuneus was also associated with BPD symptom severity, with a weaker negative coupling between Amy and these regions being related to a worse BPD psychopathology. Our results confirm the role of ACEs in contributing to social cognition impairments in BPD and related symptomatology from a neurobiological perspective.

In order to evaluate the nomological network of associations between psychopathy and its sub-dimensions, and Big Five domains and dispositional aggression in adolescence, and its consistency across ...

In order to Test Fonagy's (Fonagy & Bateman, 2008) hypotheses on the relationships among borderline personality disorder (BPD), mentalization, and attachment, nonclinical adolescents were assigned to a high-BPD group (n = 29), an average- BPD group (n = 31) and a low-BPD group (n = 29). Participants in the three groups were administered the Reading the Mind in the Eyes Test (RET), the Lack of Emotional Clarity Scale from the Difficulties in Emotion Regulation Scale, and the Attachment Style Questionnaire (ASQ). High-BPD adolescents scored significantly lower than low-BPD adolescents on the RET (d= -0.66), and significantly higher than both other groups on the DERS LEC. When the effect of the ASQ scales was controlled for, the high-BPD group did not show any significant difference from the other groups on mentalization measures. These findings were consistent with Fonagy's (Fonagy & Bateman, 2008) model of BPD.

In order to assess the internal consistency, factor structure, and ability to recover DSM-IV personality disorders (PDs) of the Personality Inventory for DSM-5 (PID-5) scales, 710 Italian adult community dwelling volunteers were administered the Italian translation of the PID-5, as well as the Italian translation of the Personality Diagnostic Questionnaire–4+ (PDQ-4+). Cronbach’s alpha values were >.70 for all PID-5 facet scales and greater than .90 for all PID-5 domain scales. Parallel analysis and confirmatory factor analysis supported the theoretical five-factor model of the PID-5 trait scales. Regression analyses showed that both PID-5 trait and domain scales explained a substantial amount of variance in the PDQ-4+ PD scales, with the exception of the Passive-Aggressive PD scale. When the PID-5 was administered to a second independent sample of 389 Italian adult community dwelling volunteers, the basic psychometric properties of the scale were replicated. In this second sample, the PID-5 trait and domain scales proved to be significant predictors of psychopathy measures. As a whole, the results of the present study support the hypothesis that the PID-5 is a reliable instrument which is able to recover DSM-IV PDs, as well as to capture personality pathology that is not included in the DSM-IV (namely, psychopathy).

Several authors have studied dissociation within the borderline personality disorder (BPD) population and postulated 3 dissociative subgroups. Conversely, other authors suggest that dissociation may play a central role in the development of trauma-related disorders and specifically in BPD. Nevertheless, the role of dissociation in BPD seems to be controversial. Our aim is to perform a meta-analytic review of the literature to evaluate the extent of dissociation in BPD compared to other psychopathological disorders to clarify its role in this specific condition. Ten eligible studies resulted in a total of 2,035 subjects. Results show that levels of dissociation are higher in BPD than in other psychiatric disorders in general, although this difference is moderate and the heterogeneity of effect sizes is large. In particular, individuals with BPD seem to show higher levels of dissociation than those with several psychiatric and personality disorders but not dissociative disorders or posttraumatic stress disorder. These findings support the fact that dissociation is not specifically a core feature of BPD and, in addition, sustain the existence of a continuum of severity within the psychiatric population. Nevertheless, the current work has several limitations related to the paucity of studies included, the heterogeneity of control groups, their clear definition, and the statistical robustness of the results. In addition, our conclusions require future research in order to explain the role of different forms of dissociation and their etiological factors among the psychiatric population. Eventually, we invite clinicians and researchers to systematically evaluate dissociation in order to reach a better diagnosis for a more specific treatment indication.

The aim of the study was to test the mediator role of impulsivity, sensation seeking, and proactive and reactive aggression on the relationship between childhood Attention Deficit/Hyperactivity Disorder (ADHD) symptoms and antisocial behavior in a sample of 729 Italian high school students. Although significant mediation effects were observed for impulsivity and sensation seeking, a complete mediation effect was observed only for proactive aggression. The results of this study confirm and extend previous findings suggesting that selected personality traits may represent risk factors for developing antisocial behavior in adolescence/adulthood in subjects with a history of ADHD.

"\"The aim of this study was to assess whether mindfulness mediates the association. between attachment dimensions and features of Borderline Personality Disorder. (BPD) in a sample of 501 Italian high-school students. Low scores on Confidence. and high scores on Need for Approval and Preoccupation with Relationships. attachment scales was significantly related to the number of BPD features (adjusted. R2 ¼ .21, p 5 .001). Further, mindfulness scores were negatively associated with. Need for Approval and Relationships as Secondary attachment scales (adjusted. R2 ¼ .14, p 5 .001). Finally, mindfulness scores were negatively associated with. the number of BPD features (adjusted R2 ¼ .15, p 5 .001). Mediation analyses. showed that the relationship between Need for Approval and BPD was completely. mediated by the mindfulness effects. Our results in non-clinical adolescents are. consistent with Bateman and Fonagy’s (2004) hypothesis that the link between. attachment disturbances and BPD features may be mediated by deficits in. mentalization, at least as these are operationalized by low mindfulness.\""

This study used a multi-sample, multiple-instrument strategy to evaluate the hypothesis that schizotypal personality disorder (SPD) is taxonic. In Study 1, 721 consecutively admitted inpatients and outpatients were evaluated with the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II) and the Personality Diagnostic Questionnaire-4+ (PDQ-4+). The data from both questionnaire types were submitted to multivariate normal mixture analysis, which was carried out on factor scores obtained from a three-factor model of SPD criteria; these results supported the hypothesis that SPD is taxonic. The same was true of Study 2, which administered the Semi-structured Interview for DSM-III-R Personality Disorders (SIDP-R) to an independent sample of 537 consecutively admitted outpatients. Similar findings were observed in Study 3, in which the SIDP-R was administered to 225 non-clinical subjects. The results show that the typology of DSM III-R and -IV SPD diagnosis is consistent with the latent structure of SPD features.

This study examines impulsivity and aggressiveness dimensions as predictors of borderline (BPD) and antisocial (ASPD) personality disorder symptoms in nonclinical subjects. A total of 747 undergraduate university students were administered the Personality Diagnostic Questionnaire-4+, the Barratt Impulsiveness Scale-11, and the Buss-Durkee Hostility Inventory. Hierarchical regression analysis showed that motor impulsiveness, irritability, resentment, and guilt predicted BPD symptoms among university students after controlling for the effect of ASPD and depressive symptoms. ASPD symptoms were predicted by motor impulsiveness, physical aggression, indirect aggression, and negativism. These results indicate that in nonclinical subjects BPD and ASPD symptoms share a common impulsivity dimension but are linked to different aggressiveness facets.

The aim of this study was to evaluate the structure of pathological narcissism and its relationships with adult attachment styles in 394 Italian nonclinical volunteers and in 103 consecutively admitted Italian outpatients. All participants were administered the Pathological Narcissism Inventory (PNI) and the Attachment Style Questionnaire (ASQ). Confirmatory factor analyses replicated the 2-factor model of the PNI found in English-speaking samples in both nonclinical and clinical samples. Structural equation models showed that adult attachment insecurities were characteristically associated with the PNI Narcissistic Vulnerability scale, whereas the PNI Narcissistic Grandiosity scale was positively associated with the ASQ Confidence scale in both samples. Overall, our findings support the hypothesis that pathological narcissists are both vulnerable and grandiose and suggest that assessing adult attachment may be important in understanding pathological narcissism in adults. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

Gambling Disorder (GD) is an addictive disorder resulting in significant impairment in occupational and social functioning. The aim of the present study was to investigate the relationship of GD risk to adaptive and maladaptive personality dimensions in a sample of nonreferred Italian gamblers. The authors found the risk for GD to show significant associations with the Openness and Conscientiousness scales of the Big Five Inventory (BFI); however, these effects were not significant after controlling for alcohol and drug use. GD risk showed significant associations with the Detachment and Antagonism domains of the Personality Inventory for DSM-5 (PID-5), as well as with the PID-5 facet scales of Hostility, Callousness, Deceitfulness, Manipulativeness, Irresponsibility, and (low) Rigid Perfectionism, even when controlling for alcohol and drug use. Maladaptive personality dispositions may serve as risk factors for pathological gambling, even beyond their impact on frequently concomitant problems with alcohol and other drugs.

The aim of this study was to assess the specificity of the association between temperamental vulnerability, character deficits, and Borderline personality disorder (BPD), controlling for the effects of attachment patterns. A total of 44 BPD patients were compared with 98 non-BPD patients with other cluster B Personality Disorder (PD) diagnoses, 39 patients with any cluster A or cluster C PD diagnoses, 70 patients with no PD diagnosis, and 206 nonclinical patients. All patients were administered the Temperament and Character Inventory, the Parental Bonding Instrument, and the Attachment Style Questionnaire. Multivariate and univariate tests showed that BPD patients differed significantly from all control groups on Novelty Seeking and Cooperativeness. These differences remained significant when controlling for the effect of attachment.

To assess the reliability and validity of the Wender Utah Rating Scale (WURS), 759 Italian undergraduate students were administered the Italian version of the WURS. In this sample, the WURS showed good internal consistency reliability (Cronbach alpha = .888). Both 1-week (r = .981, P < .001) and 2-month (r = .924, P < .001) retest reliabilities were satisfactory. The mother/subject agreement on the WURS total score was large: intraclass r = .883, P < .001. The principal component (PC) analysis showed the presence of three positively correlated first-order PCs, and one second-order PC. This PC structure of the WURS was replicated in an independent sample of 300 consecutively admitted psychiatric inpatients and outpatients. Finally, in a sample of 132 secondary school students, the WURS showed a moderate correlation with the Conners Abbreviated Parent and Teacher Questionnaire (CAPTQ): r = .307, P < .001. In this sample, the WURS total score was negatively correlated with school performance (rho = −.460, P < .001) and conduct (rho = −.293, P < .005) indexes.

The covariation patterns of DSM-IV personality disorders (PDs) were studied in 431 consecutively admitted psychiatric patients. The co-occurrence rate was greater than 50% for all DSM-IV PDs. Both bivariate association tests and loglinear models showed distinct significant covariation patterns among PDs which were stable across confounder strata. DSM-IV PD clusters were not replicated, with the exception of cluster A. Principal-component analysis (PCA) showed the presence of 3 latent dimensions, thus explaining the DSM-IV PD covariation patterns. These results seem to stress the inadequacy of the DSM-IV categorical model of PD assessment. The need for a reduction of axis II categories and the inclusion of a dimensional model in the diagnostic assessment of DSM-IV PDs are discussed.

A number of studies have reported data suggestive of a significant association between ADHD and BPD, nevertheless, the nature of this relation has not been fully understood yet. In our study, we tried to evaluate if the relationship between retrospectively assessed ADHD symptoms and adult BPD features could mediated by selected temperament/personality traits. Four hundred forty-seven in- and outpatients consecutively admitted to the Clinical Psychology and Psychotherapy Unit of the Scientific Institute H San Raffaele of Milan, Italy, were administered the Italian versions of the following instruments: Structured Clinical Interview for DSM-IV Axis II Personality Disorders, Version 2.0 (SCID-II), Wender Utah Rating Scale (WURS), Temperament and Character Inventory-Revised (TCI-R), Barratt Impulsiveness Scale-11 (BIS-11), and Aggression Questionnaire (AQ). Our mediation analyses showed that the combination of impulsivity, aggression, novelty seeking, and juvenile conduct problems completely mediate the relationship between retrospectively assessed ADHD symptoms and current BPD features.

"\"The aims of this study were to assess whether Borderline Personality Disorder (BPD) features could be predicted by Big Five traits, impulsivity, identity orientation, and adult attachment patterns in a sample of 1,192 adult nonclinical participants, and to evaluate the consistency of these regression models across four age groups (50 years, respectively). In the full sample, measures of neuroticism (N), impulsivity, and anxious insecure attachment were substantial predictors of BPD features (adjusted R² = .38, p < .001). Attachment scales were significant predictors of BPD features across all age groups, but different scales were relevant in different age groups. Our results suggest that in nonclinical populations, BPD may represent a complex constellation of personality traits and disturbed attachment patterns.\""

In recent years, there has been increasing acknowledgement of the multidimensionality of narcissism and that different types of narcissism may relate differently to other domains of functioning. Similarly, aggression—a frequently discussed correlate of narcissism--is a heterogeneous construct. In the present study, the relations of proactive and reactive aggression with overt and covert manifestations of narcissism were examined in a sample of 674 Italian high school students (mean age = 15.5 years, SD = 2.1 years). Overt narcissism was positively related to both proactive and reactive subtypes of aggression, whereas covert narcissism related only to reactive aggression. Vanity, Authority, Exhibitionism, and Exploitativeness were the components of overt narcissism related to Proactive Aggression (all remained unique correlates when controlling for Reactive Aggression), whereas Reactive Aggression was associated with the Exhibitionism, Superiority, and Entitlement subscales (only the latter was uniquely related when controlling for Proactive Aggression).

The aim of the study was to assess the reliability and the validity of the Italian translation of the Hypersensitive Narcissism Scale (HSNS) in a sample of consecutively admitted psychiatric outpatients (N = 366) and in an independent sample of non-clinical volunteers (N = 385). In both samples, data from the HSNS had adequate internal consistency, considering its limited length. Consistent with our hypothesis, a two-factor structure explained the HSNS item intercorrelations. Among clinical participants, the HSNS and the Narcissistic Personality Inventory (NPI) showed radically different patterns of correlations with the fourth edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV) Personality Disorder diagnoses. In both samples, the HSNS and the NPI showed distinct and theoretically consistent correlations with temperament and character dimensions. As a whole, these findings seem to support the reliability and the validity of the HSNS as a measure of hypersensitive narcissism. Copyright © 2009 John Wiley & Sons, Ltd.

The aims of this study were to develop a new measure of impulsive aggressiveness, and to assess whether this measure was associated with deficits in mentalized affectivity and adult attachment styles in a sample of 637 non-clinical participants. Extending Fonagy and Bateman's (2004) hypothesis, the mediating role of poor affectivity mentalization in the relationship between insecure attachment styles and impulsive aggression was also evaluated. Selected insecure attachment styles (R 2 adjusted = .18, p

Recent literature has shown that adherence to HAART is a multi-faceted phenomenon, which involves both behavioural and psychological features. Therefore, the results obtained so far, though promising, have not yet unambiguously identified the factors that could predict non-adherence. Since any support for strengthening the adherence should take into account the HIV+ patients' perception of both their state of health and their relational style, this study tried to identify some psychological characteristics involved in the adherence phenomenon. A self-administered battery of tests including the Attachment Style Questionnaire (ASQ) and the Multidimensional Health Locus of Control Form-C (MHLC-C) was administered to an Italian sample. Results showed significant gender differences between non-adherent and adherent subjects. Specifically, the psychological profile of non-adherent males seemed focused less on relational aspects and perceived relevance of physicians and of 'significant other people', whilst that of non-adherent females seemed more 'relationship-oriented'. This study means to encourage clinicians to plan specific, gender-focused support for enhancing adherence.

This study was designed to explore selected personality features of patients that are associated with clinicians' judgments about whom to refer to dynamic group psychotherapy versus individual therapy. Results suggested that an aspect of patients' adult attachment style, namely level of confidence and level of hostility, may have influenced the clinicians' judgments and decision making about treatment referrals.

Objective To conduct an exploratory investigation of possible relationships between individual levels of social anxiety and the ability to classify emotional expressions in a group of schoolchildren observing pictures of children of similar age. Method One hundred forty-nine second- and third-grade schoolchildren underwent a facial expression discrimination trial. Children were characterized on the basis of the number of spontaneous comments they made during a pause in the trial, and on their scores on the Liebowitz Social Anxiety Scale, the Stevenson-Hinde and Glover Shyness-to-the-Unfamiliar Scale, and the Cloninger Harm Avoidance scale. The scales were filled in by appropriately trained teachers. Results The overall rate of correct identification was 72%, without gender-associated differences. Regression analyses showed that higher rates of misidentifications were significantly associated with higher scores on the Liebowitz scale and fewer spontaneous comments. Misidentifications of the “anger” expressions (most often misclassified as “disgust”) were associated with higher ratings on the Liebowitz scale when children were exposed to a boy's picture and by fewer spontaneous comments when children were exposed to a girl's picture. Misidentification of a neutral expression of a girl's picture (most often misclassified as “sadness”) was significantly associated with fewer spontaneous comments. Conclusions These pilot results suggest that a child's ability to correctly identify other children's basic emotions is partially associated with his or her level of observed social shyness.

The associations between personality disorders and adult attachment dimensions were assessed in a sample of 487 consecutively admitted psychiatric subjects. Canonical correlation analysis showed that two sets of moderately correlated canonical variates explained the correlations between personality disorders and adult attachment patterns. The first and second attachment variates closely resembled the avoidance and anxiety attachment dimensions, respectively. The first personality disorder variate was mainly characterized by avoidant, depressive, paranoid, and schizotypal personality disorders, whereas dependent, histrionic, and borderline personality disorders loaded on the second canonical variate. However, these linear combinations of personality disorders were different from those obtained from principal component analysis. The results extend previous studies linking personality disorders and attachment patterns and suggest the importance of focusing on specific constellations of symptoms associated with dimensions of insecurity.

BACKGROUND: Contemporary theorists have suggested that impulsivity and emotion dysregulation are two of the core features of BPD. The aim of this study was to evaluate the relationships between Borderline Personality Disorder (BPD) features, impulsivity, and emotion dysregulation in adolescence. METHODS: 1,157 nonclinical adolescents were administered the Borderline Personality Inventory, following which three groups of adolescents with high (high-BPD; n = 29), average (average-BPD; n = 31), and low (low-BPD; n = 31) levels of BPD features were selected. Participants in these three groups were administered the UPPS-P Impulsive Behavior Scale (UPPS-P) and the Difficulties in Emotion Regulation Scale (DERS). RESULTS: UPPS-P Negative and Positive Urgency scales, as well as the DERS total score, significantly discriminated high-BPD adolescents from both other groups. The differences in UPPS-P Negative and Positive Urgency between high-BPD adolescents and both control groups remained significant when partialing out the variance associated with the DERS; However, when partialing out the variance associated with Positive and Negative Urgency, high-BPD adolescents reported significantly higher DERS scores than only the low-BPD control group (and not the average-BPD group). Finally, although the differences in Positive Urgency between high-BPD adolescents and both control groups remained significant when partialing out the variance associated with Negative Urgency, the between group differences in Negative Urgency did not remain significant when controlling for the variance associated with Positive Urgency. CONCLUSIONS: These findings highlight the relevance of both emotion dysregulation and two dimensions of impulsivity (negative and positive urgency) to BPD features in adolescence, providing evidence for a unique association between BPD features and Positive Urgency in particular. These findings add to the literature in this area, suggesting that the tendency to act rashly in the context of intense positive affect may have unique relevance to BPD features in adolescence.