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Humans adapt to a dynamic environment while maintaining psychological equilibrium. Systems theories of personality hold that generalized processes control stability by regulating how strongly a person reacts to various situations. Research shows there are higher order traits of general personality function (stability) and dysfunction (general personality pathology [GPP]), but whether they capture individual differences in reactivity is largely theoretical. We tested this hypothesis by examining how general personality functioning manifests in everyday life in two samples ( Ns = 205 and 342 participants and 24,920 and 17,761 observations) that completed an ambulatory assessment protocol. Consistent with systems theories, we found that (a) there is a general factor reflecting reactivity across major domains of functioning and (b) reactivity is strongly associated with stability and GPP. Results provide insight into how people fundamentally adapt to their environments (or not) and lay the foundation for more practical, empirical models of human functioning.

Age and gender differences in narcissism have been studied often. However, considering the rich history of narcissism research accompanied by its diverging conceptualizations, little is known about age and gender differences across various narcissism measures. The present study investigated age and gender differences and their interactions across eight widely used narcissism instruments (i.e., Narcissistic Personality Inventory, Hypersensitive Narcissism Scale, Dirty Dozen, Psychological Entitlement Scale, Narcissistic Personality Disorder Symptoms from the , Version IV, Narcissistic Admiration and Rivalry Questionnaire-Short Form, Single-Item Narcissism Scale, and brief version of the Pathological Narcissism Inventory). The findings of Study 1 (N = 5,736) revealed heterogeneity in how strongly the measures are correlated. Some instruments loaded clearly on one of the three factors proposed by previous research (i.e., Neuroticism, Extraversion, Antagonism), while others cross-loaded across factors and in distinct ways. Cross-sectional analyses using each measure and meta-analytic results across all measures (Study 2) with a total sample of 270,029 participants suggest consistent linear age effects (random effects meta-analytic effect of r = -.104), with narcissism being highest in young adulthood. Consistent gender differences also emerged (random effects meta-analytic effect was -.079), such that men scored higher in narcissism than women. Quadratic age effects and Age × Gender effects were generally very small and inconsistent. We conclude that despite the various conceptualizations of narcissism, age and gender differences are generalizable across the eight measures used in the present study. However, their size varied based on the instrument used. We discuss the sources of this heterogeneity and the potential mechanisms for age and gender differences.

Background Previous research suggests that there is a bidirectional relationship between incidental affect (i.e., how people feel in day-to-day life) and physical activity behavior. However, many inconsistencies exist in the body of work due to the lag interval between affect and physical activity measurements. Purpose Using a novel continuous-time analysis paradigm, we examined the temporal specificity underlying the dynamic relationship between positive and negative incidental affective states and moderate-to-vigorous physical activity (MVPA). Methods A community sample of adults (n = 126, Mage = 27.71, 51.6% Male) completed a 14-day ambulatory assessment protocol measuring momentary positive and negative incidental affect six times a day while wearing a physical activity monitor (Fitbit). Hierarchical Bayesian continuous-time structural equation modeling was used to elucidate the underlying dynamics of the relationship between incidental affective states and MVPA. Results Based on the continuous-time cross-effects, positive and negative incidental affect predicted subsequent MVPA. Furthermore, engaging in MVPA predicted subsequent positive and negative incidental affect. Incidental affective states had a greater relative influence on predicting subsequent MVPA compared to the reciprocal relationship. Analysis of the discrete-time coefficients suggests that cross-lagged effects increase as the time interval between measurements increase, peaking at about 8 h between measurement occasions before beginning to dissipate. Conclusions The results provide support for a recursive relationship between incidental affective states and MVPA, which is particularly strong at 7–9 hr time intervals. Future research designs should consider these medium-term dynamics, for both theory development and intervention.

Sleep disturbance is associated with elevated suicidal ideation and negative affect. To date, however, no study has investigated the temporal relationship between sleep and suicidality among those diagnosed with borderline personality disorder (BPD). This preregistered (https://osf.io/4vugk) study tested whether nightly sleep (self-reported sleep duration, sleep onset latency, and subjective sleep quality) represents a (within-person) short-term risk factor for affective dysregulation and increases in suicide risk from day-to-day, as well as whether between-person differences in sleep, negative affect, and suicidality were associated. We used a 21-day ecological momentary assessment protocol in a sample of 153 people diagnosed with BPD, 105 of which had a history of serious suicide attempts, and 52 healthy controls (N = 4076 days). We found a within-person association between worse subjective sleep quality and greater next-day negative affect. At the between-person level, we found positive relationships between sleep latency and suicidal ideation, and a negative association between subjective sleep quality and negative affect. BPD severity did not significantly moderate the strength of any within-person associations, although BPD was positively associated with average levels of suicidal ideation, sleep latency, and negative affect, and negatively related to subjective sleep quality. These findings suggest that the association of sleep with suicidal ideation and BPD exists largely at the between-persons rather than the within-person level. Disturbed sleep, therefore, seems to largely coincide, rather than specifically contribute to, the exacerbation of suicidal crises in BPD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

College students are at heightened risk of engaging in unhealthy alcohol use that leads to negative consequences (e.g., motor vehicle accidents, poor academic performance). Understanding how individual differences, such as maladaptive personality traits, contribute to that risk could improve intervention efforts. A potential pathway through which personality confers risk for consequences is by influencing students' motivation to drink. In this study of 441 college students, we investigated whether different motivations to pregame, a particularly risky and common drinking practice on college campuses, accounts for links between maladaptive traits and alcohol-related consequences. Results of bivariate analyses showed that all pregaming motives and maladaptive traits (except detachment) were strongly correlated with negative consequences. In path analytic models that adjusted for shared variance between pregaming motives and between maladaptive traits, results showed that traits had indirect effects on total drinking consequences via individual differences in pregaming motives as well as direct effects that were independent of motives. Specifically, antagonism, disinhibition, and negative affectivity predicted more drinking consequences via stronger motives to pregame for instrumental reasons over and above the general motivation to pregame, whereas detachment predicted fewer consequences via weaker instrumental pregaming motives. Antagonism and disinhibition were also associated with more drinking consequences, and detachment with fewer consequences, over and above pregaming motives and general personality problems. Our study indicates that one way maladaptive personality traits may shape alcohol-related consequences in college students is by associations with their motivations to pregame. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

In this longitudinal study, we examined whether personality traits moderate the link between interpersonal dysfunction and suicidal behavior in a high-risk sample of 458 individuals diagnosed with borderline personality disorder. Participants were assessed annually for up to 30 years (mean number of follow-ups = 7.82). Using multilevel structural equation modeling, we examined (a) longitudinal, within-persons relationships among interpersonal dysfunction, suicidal ideation, and suicide attempts and (b) moderation of these relationships by negative affectivity and disinhibition. Negative affectivity predicted a stronger within-persons coupling between interpersonal dysfunction and suicidal ideation. Disinhibition predicted a stronger coupling between ideation and suicide attempts. Assessing negative affectivity and disinhibition in a treatment setting may guide clinician vigilance toward people at highest risk for interpersonally triggered suicidal behaviors.

In this commentary, we discuss questions and misconceptions about the Hierarchical Taxonomy of Psychopathology (HiTOP) raised by Haeffel et al. We explain what the system classifies and why it is descriptive and atheoretical, and we highlight benefits and limitations of this approach. We clarify why the system is organized according to patterns of covariation or comorbidity among signs and symptoms of psychopathology, and we discuss how it is designed to be falsifiable and revised in a manner that is responsive to data. We refer to the body of evidence for HiTOP’s external validity and for its scientific and clinical utility. We further describe how the system is currently used in clinics. In sum, many of Haeffel et al.’s concerns about HiTOP are unwarranted, and for those concerns that reflect real current limitations of HiTOP, our consortium is working to address them, with the aim of creating a nosology that is comprehensive and useful to both scientists and clinicians.

Narcissism is of great interest to behavioral scientists and the lay public. Research across the past 20 years has led to substantial progress in the conceptualization, measurement, and study of narcissism. This article reviews the current state of the field, identifying recent advances and outlining future directions. Advances include hierarchical conceptualizations of narcissism across one-factor (narcissism), two-factor (grandiose vs. vulnerable narcissism), and three-factor (agentic extraversion, antagonism, narcissistic neuroticism) levels; the development of measures to assess the components of narcissism; clarification of the relations between narcissism and self-esteem; an understanding of the behavioral and motivational dynamics underlying narcissistic actions and social outcomes; and insight regarding potential fluctuations between narcissistic states. Future directions point in general to increased research using the lower levels of the narcissism hierarchy, especially the three-factor level. At this level, more research on the etiology, heritability, stability, and centrality of the three components is required.

Traditional diagnostic systems went beyond empirical evidence on the structure of mental health. Consequently, these diagnoses do not depict psychopathology accurately, and their validity in research and utility in clinicalpractice are therefore limited. The Hierarchical Taxonomy of Psychopathology (HiTOP) consortium proposed a model based on structural evidence. It addresses problems of diagnostic heterogeneity, comorbidity, and unreliability. We review the HiTOP model, supporting evidence, and conceptualization of psychopathology in this hierarchical dimensional framework. The system is not yet comprehensive, and we describe the processes for improving and expanding it. We summarize data on the ability of HiTOP to predict and explain etiology (genetic, environmental, and neurobiological), risk factors, outcomes, and treatment response. We describe progress in the development of HiTOP-based measures and in clinical implementation of the system. Finally, we review outstanding challenges and the research agenda. HiTOP is of practical utility already, and its ongoing development will produce a transformative map of psychopathology.

The Hierarchical Taxonomy of Psychopathology (HiTOP) has emerged out of the quantitative approach to psychiatric nosology. This approach identifies psychopathology constructs based on patterns of co-variation among signs and symptoms. The initial HiTOP model, which was published in 2017, is based on a large literature that spans decades of research. HiTOP is a living model that undergoes revision as new data become available. Here we discuss advantages and practical considerations of using this system in psychiatric practice and research. We especially highlight limitations of HiTOP and ongoing efforts to address them. We describe differences and similarities between HiTOP and existing diagnostic systems. Next, we review the types of evidence that informed development of HiTOP, including populations in which it has been studied and data on its validity. The paper also describes how HiTOP can facilitate research on genetic and environmental causes of psychopathology as well as the search for neurobiologic mechanisms and novel treatments. Furthermore, we consider implications for public health programs and prevention of mental disorders. We also review data on clinical utility and illustrate clinical application of HiTOP. Importantly, the model is based on measures and practices that are already used widely in clinical settings. HiTOP offers a way to organize and formalize these techniques. This model already can contribute to progress in psychiatry and complement traditional nosologies. Moreover, HiTOP seeks to facilitate research on linkages between phenotypes and biological processes, which may enable construction of a system that encompasses both biomarkers and precise clinical description.

Background High trait conscientiousness is associated with lower cardiometabolic risk, and health behaviors are a putative but relatively untested pathway that may explain this association. Purpose To explore the role of key health behaviors (diet, physical activity, substance use, and sleep) as links between conscientiousness and cardiometabolic risk. Methods In a cross-sectional analysis of 494 healthy, middle-aged working adults (mean age = 42.7 years, 52.6% women, 81.0% White), participants provided self-reports of conscientiousness, physical activity, substance use, diet, and sleep, and wore monitors over a 7-day monitoring period to assess sleep (Actiwatch-16) and physical activity (SenseWear Pro3). Cardiometabolic risk was expressed as a second-order latent variable from a confirmatory factor analysis involving insulin resistance, dyslipidemia, obesity, and blood pressure. Direct, indirect, and specific indirect effect pathways linking conscientiousness to health behaviors and cardiometabolic risk were examined. Unstandardized indirect effects for each health behavior class were computed separately using bootstrapped samples. Results After controlling for demographics (sex, age, race, and education), conscientiousness showed the predicted, inverse association with cardiometabolic risk. Among the examined health behaviors, objectively-assessed sleep midpoint variability (b = −0.003, p = .04), subjective sleep quality (b = −0.003, p = .025), and objectively-assessed physical activity (b = −0.11, p = .04) linked conscientiousness to cardiometabolic risk. Conclusions Physical activity and sleep partially accounted for the relationship between conscientiousness and cardiometabolic risk.

We recently wrote an article comparing the conclusions that followed from two different approaches to quantifying the reliability and replicability of psychopathology symptom networks. Two commentaries on the article have raised five core criticisms, which are addressed in this response with supporting evidence. 1) We did not over-generalise about the replicability of symptom networks, but rather focused on interpreting the contradictory conclusions of the two sets of methods we examined. 2) We closely followed established recommendations when estimating and interpreting the networks. 3) We also closely followed the relevant tutorials, and used examples interpreted by experts in the field, to interpret the bootnet and NetworkComparisonTest results. 4) It is possible for statistical control to increase reliability, but that does not appear to be the case here. 5) Distinguishing between statistically significant versus substantive differences makes it clear that the differences between the networks affect the inferences we would make about symptom-level relationships (i.e., the basis of the purported utility of symptom networks). Ultimately, there is an important point of agreement between our article and the commentaries: All of these applied examples of cross-sectional symptom networks are demonstrating unreliable parameter estimates. While the commentaries propose that the resulting differences between networks are not genuine or meaningful because they are not statistically significant, we propose that the unreplicable inferences about the symptom-level relationships of interest fundamentally undermine the utility of the symptom networks.

While Diagnostic and Statistical Manual of Mental Disorders–Fifth edition ( DSM-5) Section III and ICD-11 (International Classification of Diseases 11th–Revision) both allow for dimensional assessment of personality pathology, the models differ in the definition of maladaptive traits. In this study, we pursued the goal of developing a short and reliable assessment for maladaptive traits, which is compatible with both models, using the item pool of the Personality Inventory for DSM-5 (PID-5). To this aim, we applied ant colony optimization algorithms in English- and German-speaking samples comprising a total N of 2,927. This procedure yielded a 34-item measure with a hierarchical latent structure including six maladaptive trait domains and 17 trait facets, the “Personality Inventory for DSM-5, Brief Form Plus” (PID5BF+). While latent structure, reliability, and criterion validity were ascertained in the original and in two separate validation samples ( n = 849, n = 493) and the measure was able to discriminate personality disorders from other diagnoses in a clinical subsample, results suggest further modifications for capturing ICD-11 Anankastia.

BackgroundSuicide rates are high in borderline personality disorder (BPD) where interpersonal problems trigger intense affective dysregulation and impulses to act on suicidal thoughts. To date, however, no study has examined how interpersonal stressors contribute to momentary within-person links among affect and impulsivity with suicidal ideation (SI), and how those links vary over time in people's daily lives.MethodsA total of 153 individuals diagnosed with BPD and 52 healthy controls completed a 21-day ecological momentary assessment protocol. Of these 153 individuals with BPD, 105 had a history of suicide attempts. Multilevel structural equation modeling was used to examine dynamic links among interpersonal perceptions, affect, state impulsivity, and suicidal intent.ResultsAggregated across interactions, lower perceived warmth in others was associated with SI. This direct relationship, however, did not extend to momentary within-person associations. Instead, interpersonal conflicts were linked to SI indirectly via greater negative affect and lower positive affect. While a robust within-person link between interpersonal perceptions and impulsivity emerged, impulsivity did not account for the relationship between interpersonal perceptions and SI.ConclusionThis intensive longitudinal study illustrates momentary interpersonal signatures of an emerging suicidal crisis. Among people with BPD at high risk for suicide, interpersonal triggers initiate a cascade of affective dysregulation, which in turn gives rise to SI.

Author(s): Hopwood, Christopher J; Krueger, Robert F; Watson, David; Widiger, Thomas A; Althoff, Robert R; Ansell, Emily B; Bach, Bo; Bagby, R Michael; Blais, Mark A; Bornovalova, Marina A; Chmielewski, Michael; Cicero, David C; Conway, Christopher; De Clerq, Barbara; De Fruyt, Filip; Docherty, Anna R; Eaton, Nicholas R; Edens, John F; Forbes, Miriam K; Forbush, Kelsie T; Hengartner, Michael P; Ivanova, Masha Y; Leising, Daniel; Lukowitsky, Mark R; Lynam, Donald R; Markon, Kristian E; Miller, Joshua D; Morey, Leslie C; Mullins-Sweatt, Stephanie N; Ormel, Johan; Patrick, Christopher J; Pincus, Aaron L; Ruggero, Camilo; Samuel, Douglas B; Sellbom, Martin; Tackett, Jennifer L; Thomas, Katherine M; Trull, Timothy J; Vachon, David D; Waldman, Irwin D; Waszczuk, Monika A; Waugh, Mark H; Wright, Aidan GC; Yalch, Mathew M; Zald, David H; Zimmermann, Johannes

Despite a plethora of research, the link between digital-technology use and psychological distress among young adults remains inconclusive. Findings in this area are typically undermined by methodological limitations related to measurement, study design, and statistical analysis. Addressing these limitations, we examined the prospective, within-persons associations between three aspects of objectively measured digital-technology use (duration and frequency of smartphone use, duration of social-media use) and three aspects of psychological distress (depression, anxiety, and social isolation) among a sample of young adults ( N = 384). Across 81 different model specifications, we found that most within-persons prospective effects between digital-technology use and psychological distress were statistically nonsignificant, and all were very small—even the largest effects were unlikely to register a meaningful impact on a person’s psychological distress. In post hoc subgroup analyses, we found scant evidence for the claim that digital-technology use is more harmful for women and/or younger people.

Background Childhood socioeconomic disadvantage is associated with increased risk for chronic inflammation and cardiometabolic disease at midlife. Purpose As it is presently unknown whether inflammation mediates the relationship between childhood socioeconomic status (SES) and adulthood cardiometabolic risk, we investigated associations between retrospectively reported childhood SES, circulating levels of inflammatory markers, and a latent construct of cardiometabolic risk in midlife adults. Methods Participants were 1,359 healthy adults aged 30–54 (Adult Health and Behavior Iⅈ 52% women, 17% Black) who retrospectively reported childhood SES (parental education, occupational grade). Measures included plasma interleukin (IL)-6, C-reactive protein (CRP), and cardiometabolic risk factors. Structural equation modeling was conducted, with cardiometabolic risk modeled as a second-order latent variable with adiposity, blood lipids, glucose control, and blood pressure as first-order components. Results Lower childhood SES was associated with greater risk for cardiometabolic disease at midlife (β = −0.08, CI[−0.04, −0.01], p = .01) in models adjusted for demographics, but this association was attenuated in models that adjusted for adulthood SES and health behaviors. In fully-adjusted models, the relationship between lower childhood SES and adult cardiometabolic risk was partially explained by higher circulating levels of CRP (β = −0.05, CI[−0.02, −0.01], p = .001), but not by IL-6. In an exploratory model, lower adulthood SES was also found to independently contribute to the association between childhood SES and adult cardiometabolic risk (β = −0.02, CI[−0.01, −0.001], p = .02). Conclusions The current study provides initial evidence that systemic inflammation may contribute to childhood socioeconomic disparities in cardiometabolic risk in midlife. Future work would benefit from prospective investigation of these relationships.

Several personality traits increase the risk for atherosclerotic cardiovascular disease. Because many of these traits are correlated, their associations with disease risk could reflect shared variance, rather than unique contributions of each trait. We examined a higher-order personality trait of Stability as related to preclinical atherosclerosis and tested whether any such relationship might be explained by correlated variation in cardiometabolic risk factors.Among 798 community volunteers, lower-order traits of Neuroticism, Agreeableness, and Conscientiousness were modeled as latent variables (from self- and informant ratings) and used to estimate the second-order factor, Stability. Cardiometabolic risk was similarly modeled from indicators of glycemic control, blood pressure, adiposity, and lipids. Carotid artery atherosclerosis was measured as intima-media thickness (IMT) by duplex ultrasonography.A structural equation model incorporating direct and indirect effects showed lower Stability associated with greater IMT, and this relationship was accounted for by the indirect pathway via cardiometabolic risk. Secondary analyses showed that: (1) Neuroticism, Agreeableness, and Conscientiousness were unrelated to IMT independent of Stability; and (2) Stability predicted variation in IMT when estimated from informant-, but not self-rated, traits.Personality traits may associate with atherosclerotic burden through their shared, rather than unique, variance, as reflected in Stability.

Like diagnostic status, clinically relevant thought remains overwhelmingly conceptualized in terms of discrete categories (e.g., worry, rumination, obsessions). However, definitions can vary widely. The area of perseverative thought (or clinically relevant thought more broadly) would benefit substantially from a consensus-based, empirically grounded taxonomy similar to the Hierarchical Taxonomy of Psychopathology (Kotov et al., 2017) or the Big Five for personality. This article addresses three major barriers to establishing such a taxonomy: (a) a lack of research explicitly comparing categorical (subtype) versus dimensional models, (b) primary reliance on between-person measures rather than modeling at the level of the thought (within person), and (c) insufficient emphasis on replication and refinement. Participants included an unselected crowdsourced sample (790 observations from 286 participants) and an independent anxious-depressed replication sample (808 observations from 277 participants). Participants made dimensional ratings for three idiographic clinically relevant thoughts on a range of features. Multilevel latent class analysis and multilevel exploratory factor analysis were applied to identify and extract natural patterns of covariation among features at the level of the thought, controlling for person-level tendencies. A consistent five-dimension solution emerged across both samples and reliably outperformed the best-fitting categorical solution in terms of fit, replicability, and explanatory power. Identified dimensions were dyscontrol, self-focus, valence, interpersonal, and uncertainty. Findings support a five-factor latent structure of perseverative thought. Theoretical, empirical, and clinical implications and future directions are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Hierarchical Taxonomy of Psychopathology (HiTOP) is an empirically and quantitatively derived dimensional classification system designed to describe the features of psychopathology and, ultimately, to replace categorical nosologies. Among the constructs that HiTOP organizes are "symptom components" and "maladaptive traits," but past HiTOP publications have not fully explicated the distinction between symptoms and traits. We propose working definitions of symptoms and traits and explore challenges, exceptions, and remaining questions. Specifically, we propose that the only systematic difference between symptoms and traits in HiTOP is one of time frame. Maladaptive traits are dispositional constructs that describe persistent tendencies to manifest features of psychopathology, whereas symptoms are features of psychopathology as they are manifest during any specific time period (from moments to days to months). This has the consequence that almost every HiTOP dimension, at any level of the hierarchy, can be assessed as either a trait or a symptom dimension, by adjusting the framing of the assessment. We discuss the implications of these definitions for causal models of the relations between symptoms and traits and for distinctions between psychopathology, normal personality variation, and dysfunction.

OBJECTIVE The present study evaluated distinct facets of impulsivity related to cardiometabolic risk (CMR) to identify specific behavioral mechanisms driving these relationships. METHOD Community adults (N = 1,295) between 30 and 54 years old (53% female, 84% White) completed a battery of impulsivity measures, reported their engagement in health behaviors over the past week (i.e., cigarette smoking, alcohol use, physical activity, and dietary intake), and were assessed for CMR factors (i.e., blood pressure, insulin resistance, adiposity, and blood lipids). Structural equation modeling was used to estimate previously established hierarchical models of distinct facets of impulsivity and CMR. Indirect effects through the observed health behaviors were examined for each association between the latent impulsivity factors identified and the latent CMR factor. RESULTS Neuroticism/negative emotionality was the only latent impulsivity factor directly related to heightened CMR (β = 0.09, 95% confidence interval [CI] [0.01, 0.16], p = .020). Extraversion/positive emotionality indirectly related to lower CMR through greater physical activity (β = -0.04, 95% CI [-0.06, -0.02], p < .001), and measures of inhibition (β = 0.02, 95% CI [0.001, 0.04], p = .045) and delay discounting (β = 0.08, 95% CI [0.001, 0.15], p = .049) indirectly related to CMR through saturated fat intake. CONCLUSIONS These findings indicate that distinct facets of impulsivity differentially relate to CMR through varied behavioral pathways and identify physical activity and saturated fat intake as being particularly important health behaviors to target when tailoring treatment approaches to the unique behavioral characteristics of individuals high on certain facets of impulsivity. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Objective Psychopathology research has relied on discrete diagnoses, which neglects the unique manifestations of each individual's pathology. Borderline personality disorder combines interpersonal, affective, and behavioral regulation impairments making it particularly ill-suited to a "one size fits all" diagnosis. Clinical assessment and case formulation involve understanding and developing a personalized model for each patient's contextualized dynamic processes, and research would benefit from a similar focus on the individual. Method We use group iterative multiple model estimation, which estimates a model for each individual and identifies general or shared features across individuals, in both a mixed-diagnosis sample (N = 78) and a subsample with a single diagnosis (n = 24). Results We found that individuals vary widely in their dynamic processes in affective and interpersonal domains both within and across diagnoses. However, there was some evidence that dynamic patterns relate to transdiagnostic baseline measures. We conclude with descriptions of 2 person-specific models as an example of the heterogeneity of dynamic processes. Conclusions The idiographic models presented here join a growing literature showing that the individuals differ dramatically in the total patterning of these processes, even as key processes are shared across individuals. We argue that these processes are best estimated in the context of person-specific models, and that so doing may advance our understanding of the contextualized dynamic processes that could identify maintenance mechanisms and treatment targets. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

The Diagnostic and Statistical Manual of Mental Disorders’ (5th Edition) Alternative Model of Personality Disorders includes a dimensional trait model to describe individual differences in the manifestation of personality pathology. Empirically derived quantitative trait models of psychopathology address many of the structural problems of classical diagnostic schemes (e.g., nonbinary distributions, excessive comorbidity, and diagnostic heterogeneity). However, they are largely based on the structure of individual differences in the manifestation of psychopathology. In contrast, clinical theories of personality disorder, which are the foundation of intervention efforts, are based on the function of maladaptive behavior. This distinction is akin to the difference between morphology and physiology in the broader biological sciences. A structure-function divide in the focus of empirical and clinical work contributes to a lack of integration and difficulties with translation. Here we discuss this tension and argue for the need to bridge this divide and adopt research efforts that integrate structure and function of personality traits. Specifically, we suggest that between-person structure identifies the principal domains of functioning, but to understand dysfunction personality must be conceptualized and studied as an ensemble of contextualized dynamic processes.

Are five-factor traits and borderline personality symptoms the same features with different names? The existing literature offers reasons to think they are the same and reasons to think they are different. We examined longitudinal associations between these variables in a sample of patients assessed 12 times over 24 years using latent curve models with structured residuals. Mean trajectories for all variables were in the direction of symptom reduction/personality maturation and could be parsed into an initial, rapid improvement phase and a subsequent, gradual improvement phase. We found robust between-person associations among intercepts and long-term slopes of traits and symptoms. Specifically, higher levels of neuroticism as well as lower levels of extraversion, agreeableness, and conscientiousness were associated with higher levels of borderline personality symptoms, and changes in these traits were correlated with reduction in symptoms over time. Associations among time-structured residuals allowed for examinations of within-person deflections from these general trends at briefer (two year) intervals. All variables exhibited robust within-person carry-over effects. Other within-person effects were more specific to certain traits. These results suggest that, despite their distinct theoretical and methodological bases, normal trait and psychiatric diagnostic approaches largely converged on a similar conception of borderline personality.

This study reexamined the factor structure of drinking motives using 205 unique items from 18 drinking motives scales with the inclusion of social tension reduction motives, which have been largely neglected in the literature. A new scale was created and compared with the Drinking Motives Questionnaire-Revised (DMQ-R) to predict alcohol use/problems. Young adults ( N = 1,049) completed questionnaires assessing drinking motives and alcohol use/problems. A subset ( N = 368) of participants completed a 6-month follow-up. Hierarchical factor analyses informed the creation of a four-factor (i.e., coping, social, enhancement, and social tension reduction) scale (i.e., the Young Adult Alcohol Motives Scale [YAAMS]). In general, the YAAMS performed similarly to the DMQ-R in predicting concurrent and prospective alcohol consumption (i.e., typical drinking quantity and frequency) and alcohol problems (i.e., Alcohol Use Disorder Identification Test [AUDIT] and Brief Young Adult Alcohol Consequences Questionnaire [B-YAACQ] scores), but there were some notable differences, including that the novel social tension reduction scale of the YAAMS was particularly relevant in predicting drinking frequency in those with social anxiety. Results suggest that drinking motives can be described by multiple factor structures and predict alcohol-related outcomes.

Author(s): Ruggero, Camilo J; Kotov, Roman; Hopwood, Christopher J; First, Michael; Clark, Lee Anna; Skodol, Andrew E; Mullins-Sweatt, Stephanie N; Patrick, Christopher J; Bach, Bo; Cicero, David C; Docherty, Anna; Simms, Leonard J; Bagby, R Michael; Krueger, Robert F; Callahan, Jennifer L; Chmielewski, Michael; Conway, Christopher C; De Clercq, Barbara; Dornbach-Bender, Allison; Eaton, Nicholas R; Forbes, Miriam K; Forbush, Kelsie T; Haltigan, John D; Miller, Joshua D; Morey, Leslie C; Patalay, Praveetha; Regier, Darrel A; Reininghaus, Ulrich; Shackman, Alexander J; Waszczuk, Monika A; Watson, David; Wright, Aidan GC; Zimmermann, Johannes | Abstract: ObjectiveDiagnosis is a cornerstone of clinical practice for mental health care providers, yet traditional diagnostic systems have well-known shortcomings, including inadequate reliability, high comorbidity, and marked within-diagnosis heterogeneity. The Hierarchical Taxonomy of Psychopathology (HiTOP) is a data-driven, hierarchically based alternative to traditional classifications that conceptualizes psychopathology as a set of dimensions organized into increasingly broad, transdiagnostic spectra. Prior work has shown that using a dimensional approach improves reliability and validity, but translating a model like HiTOP into a workable system that is useful for health care providers remains a major challenge.MethodThe present work outlines the HiTOP model and describes the core principles to guide its integration into clinical practice.ResultsPotential advantages and limitations of the HiTOP model for clinical utility are reviewed, including with respect to case conceptualization and treatment planning. A HiTOP approach to practice is illustrated and contrasted with an approach based on traditional nosology. Common barriers to using HiTOP in real-world health care settings and solutions to these barriers are discussed.ConclusionsHiTOP represents a viable alternative to classifying mental illness that can be integrated into practice today, although research is needed to further establish its utility. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The scientific study of narcissism has accelerated in recent years. However, this literature has primarily been cross-sectional and descriptive in nature, making it difficult to integrate with theories of narcissism, which instead emphasize various dynamics. Theoretical work construes narcissism as a complex dynamical system with processes that interact to contribute to narcissism expression and maintenance. We begin by reviewing theoretical accounts of narcissism and what they suggest about dynamic processes. We then review research that examines processes associated with narcissism in naturalistic settings. Integrating clinical theories with empirical work, we highlight remaining tensions in the field and discuss major conceptual considerations. For example, we discuss the role of entitlement and antagonistic behavior within narcissism and the need to identify the temporal ordering of various processes (e.g., self-esteem fluctuations and fluctuations in grandiosity and vulnerability). In light of limitations of the existing literature, we then discuss methodological barriers that currently limit the ability to fully align empirical research with theorized processes within narcissism.

Acute risk of death by suicide manifests in heightened suicidal ideation in certain contexts and time periods. These increases are thought to emerge from complex and mutually reinforcing relationships between dispositional vulnerability factors and individually suicidogenic short-term stressors. Together, these processes inform clinical safety planning and our therapeutic tools accommodate a reasonable degree of idiosyncrasy when we individualize interventions. Unraveling these multifaceted factors and processes on a quantitative level, however, requires estimation frameworks capable of representing idiosyncrasies relevant to intervention and psychotherapy. Using, data from a 21-day ambulatory assessment protocol that included six random prompts per day, we developed personalized (i.e., idiographic) models of interacting risk factors and suicidal ideation via Group Iterative Multiple Model Estimation (GIMME) in a sample of people diagnosed with borderline personality disorder (N = 95) stratified for a history of high lethality suicide attempts. Our models revealed high levels of heterogeneity in state risk factors related to suicidal ideation, with no features shared among the majority of participants or even among relatively homogenous clusters of participants (i.e., empirically derived subgroups). We discuss steps toward clinical implementation of personalized models, which can eventually capture suicidogenic changes in proximal risk factors and inform safety planning and interventions.

Researchers have held a long-standing debate regarding the validity of discrete emotions versus global affect. The current article tries to integrate these perspectives by explicitly examining the structures of state emotions and trait affect across time. Across three samples (Sample 1: N = 176 U.S. undergraduates in a 50 day daily diary study-total observations = 7,504; Sample 2: N = 2,104 in a 30 day daily diary study within a community sample in Germany-total observations = 28,090; Sample 3: N = 245, ecological momentary assessment study within the United States from an outpatient psychiatry clinic completing five measurements per day for 21 days-total observations = 29,950), participants completed the Positive and Negative Affect Schedule. An exploratory multilevel factor analysis in Sample 1 allowed for the simultaneous estimation of state factors (i.e., within-person factor analysis) and trait factors (i.e., between-persons factor analysis). Confirmatory multilevel factor models examined the generalizability of the multilevel factor solutions to Samples 2 and 3. Across all samples, the results suggested strong support for a two-factor solution for trait affect and a seven-factor solution for state emotion. Taken together, these results suggest that positive affect and negative affect can be used to describe differences across people, but at least seven differentiated emotions are experienced within persons across time. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Data-driven model searches provide the opportunity to quantify person-specific processes using ambulatory assessment data. Here, the search space typically includes all potential relations among variables, meaning that all variables can potentially explain variability in all other variables. Oftentimes, this is unrealistic. For example, weather is unlikely to be predicted by someone’s emotional state, whereas the reverse might be true. Allowing for specification of exogenous variables, or variables that are not predicted within the system, permits more realistic models and allows the researcher to model contextual change processes via the use of moderation variables. We use two sets of daily diary data to demonstrate the capabilities of allowing for the specification of exogenous variables in GIMME (Group Iterative Multiple Model Estimation), a model search algorithm that allows for models with idiographic, individual-level as well as subgroup- and group-level processes with intensive longitudinal data. First, using data collected from individuals diagnosed with personality disorders, we show results where weather-related and temporal basis variables are specified as exogenous, and reports on affect and behavior are endogenous. Next, we demonstrate the modeling of treatment effects in an intervention study, looking at data from a 6-week meditation workshop in midlife adults. Finally, we use the meditation intervention data to demonstrate modeling moderation effects, where relationships between two endogenous variables are dependent on the current stage of the study for a given participant (i.e., currently attending meditation classes or not). We end by presenting adaptive LASSO as a method for probing results obtained from GIMME.

In this article, we describe the collaborative process that is underway to develop measures for the Hierarchical Taxonomy of Psychopathology (HiTOP). The HiTOP model has generated much interest in the psychiatric literature in recent years, but research applications and clinical translation of the model require measures that are specifically keyed to the model. To that end, the Measures Development Workgroup of HiTOP has been engaged in a collaborative effort to develop both questionnaire and interview methods that (a) are specifically tied to the elements of the HiTOP structure, and (b) provide one means of testing that structure. The work has been divided among five subgroups that are focused on specific HiTOP spectra. Our scale development methods are rooted in the principles of construct valid scale development. This report describes Phase 1 of this project, summarizes the methods and results thus far, and discusses the interplay between measurement and HiTOP model revisions. Finally, we discuss future phases of the scale development and the steps we are taking to improve clinical utility of the final measures.

Despite enthusiasm for using intensive longitudinal designs to measure day-to-day manifestations of personality underlying differences between people, the validity of personality state scales has yet to be established. In this study, we evaluated the psychometrics of 20-item and 10-item daily, Big Five personality state scales in three independent samples ( N = 1,041). We used multilevel models to separately examine the validity of the scales for assessing personality variation at the between- and within-person levels. Results showed that a five-factor structure at both levels fits the data well, the scales had good convergent and discriminative associations with external variables, and personality states captured similar nomological nets as established global, self-report personality inventories. Limitations of the scales were identified (e.g., low reliability, low correlations with external criterion) that point to a need for more, systematic psychometric work. Our findings provide initial support for the use of personality state scales in intensive longitudinal designs to study between-person traits, within-person processes, and their interrelationship.

BackgroundAn ongoing challenge in understanding and treating personality disorders (PDs) is a significant heterogeneity in disorder expression, stemming from variability in underlying dynamic processes. These processes are commonly discussed in clinical settings, but are rarely empirically studied due to their personalized, temporal nature. The goal of the current study was to combine intensive longitudinal data collection with person-specific temporal network models to produce individualized symptom-level structures of personality pathology. These structures were then linked to traditional PD diagnoses and stress (to index daily functioning).MethodsUsing about 100 daily assessments of internalizing and externalizing domains underlying PDs (i.e. negative affect, detachment, impulsivity, hostility), a temporal network mapping approach (i.e. group iterative multiple model estimation) was used to create person-specific networks of the temporal relations among domains for 91 individuals (62.6% female) with a PD. Network characteristics were then associated with traditional PD symptomatology (controlling for mean domain levels) and with daily variation in clinically-relevant phenomena (i.e. stress).ResultsFeatures of the person-specific networks predicted paranoid, borderline, narcissistic, and obsessive-PD symptom counts above average levels of the domains, in ways that align with clinical conceptualizations. They also predicted between-person variation in stress across days.ConclusionsRelations among behavioral domains thought to underlie heterogeneity in PDs were indeed associated with traditional diagnostic constructs and with daily functioning (i.e. stress) in person-specific networks. Findings highlight the importance of leveraging data and models that capture person-specific, dynamic processes, and suggest that person-specific networks may have implications for precision medicine.

Objective Mindfulness interventions have been shown to reduce stress; however, the mechanisms driving stress resilience effects are not known. Mindfulness interventions aim to teach individuals how to: (a) use attention to monitor present moment experiences; with (b) an attitude of acceptance and equanimity. A randomized controlled dismantling trial (RCT) was conducted to test the prediction that the removal of acceptance skills training would eliminate stress-reduction benefits of a mindfulness intervention. Method This preregistered RCT randomly assigned stressed community adults to 1 of 3 conditions: (a) Monitor and Accept (MA) mindfulness training, a standard 8-week Mindfulness-Based Stress Reduction (MBSR) intervention that provided explicit instruction in developing both monitoring and acceptance skills; (b) Monitor Only (MO) mindfulness training, a well-matched 8-week MBSR intervention that taught monitoring skills only; or (c) No Treatment (NT) control. Stress and nonjudgment were measured using ecological momentary assessment (EMA) for 3 days at baseline and 3 days at postintervention. Results Consistent with predictions, MA participants increased in nonjudgment and decreased in both stress ratings and the proportion of assessments that they reported experiencing feelings of stress in daily life, relative to both MO and NT participants. Conclusions This RCT provides one of the first experimental tests of the mechanisms linking mindfulness interventions with stress resilience. These findings suggest that acceptance skills training may be a necessary active ingredient and support the value of integrating acceptance skills training into stress-reduction interventions. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Calls have increased to place interpersonal and self-disturbance as defining features of personality disorders (PDs). Findings from a methodologically diverse set of studies suggest that a common factor undergirds all PDs. The nature of this core of PDs, however, is not clear. In the current study, interviews were completed for DSM-IV PD diagnosis and interpersonal dysfunction independently with 272 individuals (PD = 191, no-PD = 91). Specifically, we evaluated interpersonal dysfunction across social domains. In addition, we empirically assessed the structure of self-dysfunction in PDs. We found dysfunction in work and romantic domains, and unstable identity uniquely predicted variance in the presence of a PD. Using receiver operating characteristic analysis, we found that the interpersonal dysfunction and self-dysfunction scales each predicted PDs with high accuracy. In combination, the scales resulted in excellent sensitivity (.90) and specificity (.88). The results support interpersonal and self-dysfunction as general factors of PD.

The dimensional pathological personality trait model proposed in the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5), Section III Criterion B, has shown promising results for its validity and utility in conceptualizing personality pathology. However, as its structural equivalence across sex is yet to be tested, the validity for the model across males and females remains uncertain. In the present article, we examined sex measurement invariance of the DSM-5 trait model in a large undergraduate sample using the Personality Inventory for DSM-5. A series of confirmatory and exploratory factor analyses suggested that, although the exact facet-domain relationships as specified in the DSM-5 were not observed, the facets generally organize into a model with five latent factors similar to those listed in the DSM-5 Section III Criterion B. Further, these five factors were fully measurement invariant across sex at the configural, metric, and scalar levels. Examination of the latent trait mean levels suggests that females tend to have higher scores on latent Negative Affectivity, whereas males tend to have higher scores on latent Antagonism, Detachment, Psychoticism, and Disinhibition. These results indicate that the DSM-5 Section III pathological personality trait model is fully structurally equivalent across sex, a property that is lacking in the traditional categorical model in Section II. This further validates the use of the dimensional DSM-5 trait model for personality disorder assessment and conceptualization in both research and clinical settings. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

We evaluated the utility of a nonverbal, “visceral” measure of cigarette craving (squeezing a handheld dynamometer). Nicotine-deprived daily smokers ( N = 202) underwent a cued (lit cigarette) cigarette-craving manipulation and recorded smoking urge in one of four conditions: (a) report urge using a traditional self-report rating scale (verbal measure) and then indicate urge by squeezing a dynamometer, (b) indicate urge by squeezing and then report urge verbally, (c) indicate urge only by squeezing, or (d) report urge only verbally. As hypothesized, the squeeze measure detected increases in urge during cue exposure, correlated with verbal urge, and predicted subsequent smoking motivation as indexed by smoking latency. Order effects were not observed, indicating that the squeeze measure was predictive of smoking motivation regardless of whether it was administered before or after a verbal urge measure. Squeeze measures may be viable additions to the measurement toolkit for assessing urge and other visceral states.

Purpose of review Definitions of narcissism have traditionally differed across psychiatry and subfields of psychology. This review aims to highlight emerging points of consensus and suggest further directions needed to obtain a more comprehensive and cohesive conceptualization of the construct. Recent findings An emerging consensus is that stable individual differences in the phenotypic expression of narcissism are best captured with a taxonomy that includes the core traits of entitlement, grandiosity, and vulnerability. Recent work has also begun to conceptualize and assess narcissistic states matched with these dimensions. We combine emerging taxonomic knowledge with principles from Whole Trait Theory to propose a multilevel conceptualization of narcissism that focuses on its manifestation at the trait level, state level, and within-situation level. Summary Efforts to understand the phenotypic structure of the core traits associated with narcissism have been successful. As the field moves forward, it will become critical for researchers studying narcissism at multiple levels to align and integrate these perspectives so that a more comprehensive and cohesive conceptualization of the construct can be developed.

Study Objectives Sleep quantity and continuity vary across the lifespan. Actigraphy is a reliable and widely used behavioral measure of sleep in research and personal health monitoring. This meta-analysis provides a novel examination of whether age (in years) is associated with actigraphy-assessed sleep across the lifespan. Methods A systematic search of PubMed, Embase.com, Cochrane CENTRAL, and PsycINFO using “actigraphy” and “sleep” terms provided 7079 titles/abstracts; studies of individuals with known psychiatric or medical comorbidities were excluded. Ninety-one articles (N = 23 365) provided data for six meta-analyses examining sleep duration (k = 89), sleep efficiency (k = 58), bedtime (k = 19) and waketime (k = 9) for individuals ages 6–21, and bedtime (k = 7) and waketime (k = 7) for individuals ages 22 and older. Results At older ages, sleep duration was shorter (r = −0.12) and sleep efficiency was lower (r = −0.05). Older age was associated with later bedtime (r = 0.37) and wake-up time (r = 0.24) from ages 6–21, whereas older age was associated with earlier bedtime (r = −0.66) and wake-up time (r = −0.59) for ages 22 and above. The strength of these associations was modified by study continent, but not by any other moderator. Conclusions Age was negatively associated with actigraphy-assessed sleep duration and efficiency, but the effects were small in magnitude. On the other hand, large associations were observed between age and sleep timing, despite a smaller literature and the absence of analyzable data for ages 30–60. Changes in sleep timing, rather than changes in sleep duration or continuity, may better characterize the effects of age on human sleep.

Advances in methods for longitudinal data collection and analysis have prompted a surge of research on psychological processes. However, decisions about how to time assessments are often not explicitly tethered to theories about psychological processes but are instead justified on methodological (e.g., power) or practical (e.g., feasibility) grounds. In many cases, methodological decisions are not explicitly justified at all. The disconnect between theories about processes and the timing of assessments in longitudinal research has contributed to misspecified models, interpretive errors, mixed findings, and nonspecific conclusions. In this article, we argue that higher demands should be placed on researchers to connect theories to methods in longitudinal research. We review instances of this disconnect and offer potential solutions as they pertain to four general questions for longitudinal researchers: how time should be scaled, how many assessments are needed, how frequently assessments should occur, and when assessments should happen.

Individuals with personality disorders (PDs) have higher morbidity and mortality than the general population, which may be due to maladaptive health behaviors such as smoking. Previous studies have examined the links between categorical PD diagnoses/personality traits and smoking/nicotine dependence, but little is known about how the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition alternative model for personality disorders relates to smoking and nicotine dependence. The current study examined this question in a sample of 500 participants using the Levels of Personality Functioning Scale to assess general personality pathology, the Personality Inventory for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition to measure specific traits, the Fagerstrom test for Nicotine Dependence to assess nicotine dependence, and questions about current and past smoking to assess smoking status (i.e., current, former, never). Multinomial logistic regression results demonstrated that general personality pathology (Criterion A) was not related to smoking status, and there were no reliable associations between traits (Criterion B) and smoking status. However, correlations showed that higher negative affectivity and disinhibition were related to higher levels of nicotine dependence within smokers. Findings are discussed in regard to previous findings linking personality pathology to smoking/nicotine dependence as well as the general validity of this new personality disorder diagnostic system. (PsycInfo Database Record (c) 2021 APA, all rights reserved).