Given that people with borderline personality disorder (BPD) features are vulnerable to emotion dysregulation, they might be particularly sensitive to the emotional impacts of poor sleep quality and low sleep quantity. In the present study, we evaluated whether BPD features moderate the relationship between daily sleep, measured objectively (total sleep time [TST]) and subjectively (perceived sleep quality), and self-reports of positive and negative affect (NA). A sample of 83 cohabitating couples ( = 166) were recruited for a 3-week daily diary study. Participants completed a BPD symptom measure at baseline, a perceived sleep quality assessment each morning, and a daily emotion assessment each evening. TST was assessed daily using a FitBit activity monitor. Mixed-model regression analyses revealed a significant interaction between subjective sleep quality and overall BPD features in predicting daily levels of NA, even after statistical control of depression. Participants with higher BPD features exhibited greater NA on days when they reported worse sleep quality, as compared to participants with lower BPD features. Secondary analyses showed that this interaction seemed to be particularly impactful for anger, but not anxiety or sadness. In contrast, there was no significant interaction effect between BPD features and objectively assessed TST in predicting daily emotion. These results suggest that the emotional impact of poor subjective sleep quality might be more pronounced for those with BPD features. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Distress tolerance (DT) is thought to be a transdiagnostic risk factor for psychopathology, especially borderline (BPD) and antisocial personality disorders (ASPD). However, most of the studies documenting the relationship of DT with BPD and ASPD have been cross-sectional, with few examining basic longitudinal patterns of change or interrelationships of these constructs. The present study examined longitudinal patterns of change and prospective reciprocal associations of DT with BPD and ASPD-related pathological personality traits (PPTs) in an adult clinical sample ( = 354) receiving inpatient treatment for substance use disorders and then reintegrating into the community across five time points (baseline, posttreatment, 1-, 3-, and 6-month follow-up). Results indicated high rank-order stability for DT and all PPTs, with significant mean level changes between baseline and follow-ups. Eleven bivariate random intercept cross-lagged panel models were fitted for the association of DT with PPTs. Within-person autoregressive effects were generally nonsignificant during treatment up until the posttreatment period but became significant during the community follow-up for both PPTs and DT. Within-person cross-lagged effects were generally nonsignificant, with only four brief and isolated reciprocal associations observed across disinhibition- and antagonism-related PPT models. Significant concurrent associations were replicated at both the within-person and between-person levels. These findings add to the limited literature on the longitudinal dynamics of DT and PPTs in clinical populations. They also underscore the potential value of targeting DT in interventions aimed at reducing emotional and behavioral dysregulation during the transition from treatment to community settings. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Despite the availability of effective treatments for personality disorders (PDs), recovery rates are modest. A better understanding is therefore needed of what patients, significant others and therapists consider to be impediments to PD treatment. We used concept mapping to create a conceptual framework of factors that impede PD treatment. The perspectives of patients, significant others, and therapists with respect to impediments were collected in brainstorm sessions and then formulated as statements by an expert team. The participants subsequently prioritized and sorted these statements prior to analysis with multidimensional scaling and grouping on a two-dimensional concept map using hierarchical cluster analyses. Fifty-four statements were defined and assigned to 11 clusters that were grouped in five metaclusters: (a) lack of trust in the therapeutic relationship, (b) perceived therapist incompetence (c) shortcomings in the mental health care system, (d) patient-related conflicting factors, and (e) insufficient involvement of significant others. This study provides a conceptual framework of factors that are perceived to impede PD treatment. Our findings potentially contribute to an awareness of impediments in clinical practice and suggest that therapists should actively inquire about the expectations, needs, and treatment difficulties of patients and their significant others. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

This study examined the existence and validity of variants of callous-unemotional (CU) traits. Data were available for 309 detained boys ( = 16.96) who completed self-reports, experimental tasks, and were administered a diagnostic interview. Two different methods were used to differentiate between participants with different constellations of CU traits and anxiety. Using a simple cutoff approach, participants were assigned to four groups: low CU traits and low anxiety ( = 148), low CU traits and high anxiety ( = 69), high CU traits and low anxiety ("primary CU variant"; = 68), and high CU traits and high anxiety ("secondary CU variant"; = 24). Latent profile analyses arrived at three classes but failed to find a "secondary CU variant" class. Group comparisons that were based on the simple cutoff approach showed that youth who fell in the secondary (vs. primary) CU variant group presented more depressive symptoms and were less able to differentiate between emotions. These two groups did not significantly differ in any of the other 36 correlates (e.g., impulsivity, maltreatment, and treatment engagement). Only a few significant differences emerged between the two CU variant groups and youth characterized by low CU traits and high anxiety. Taken together, we found limited support for the existence and utility of CU variants among detained boys. Not only did the identification of the CU variants depend upon the method that was used, the two CU variant groups rarely were significantly different in theoretically important features. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Obsessive-compulsive personality disorder (OCPD) is commonly comorbid with major depressive disorder, and their comorbidity is associated with worsened outcomes and treatment refraction. Radically open dialectical behavior therapy (RO DBT) is a novel transdiagnostic psychosocial intervention. RO DBT targets OCPD-related traits (e.g., maladaptive perfectionism, inflexibility) and has been theorized as an OCPD treatment. This study examined RO DBT efficacy for treatment-refractory depression (TRD), with and without comorbid OCPD. RefraMED was a multisite randomized controlled trial of treatment as usual (TAU) versus RO DBT + TAU for TRD ( = 250). In this secondary data analysis, linear regression predicted 7-month (end of treatment) and 12-month (follow-up) symptoms, controlling for baseline symptoms. Three models examined: (a) outcomes for participants with OCPD ( = 117) comparing RO DBT + TAU and TAU, (b) outcomes among participants receiving RO DBT ( = 162) comparing OCPD and no OCPD, and (c) OCPD diagnosis moderating treatment effects for all participants ( = 250). At 12 months, participants with OCPD had significantly improved emotional approach coping (emotion recognition and communication) and psychological flexibility in RO DBT + TAU (vs. TAU alone; false discovery rate-adjusted s = .008), with no significant differences observed for depression or interpersonal functioning. OCPD presence did not predict any outcomes within the RO DBT group, nor moderate the effect of treatment on outcomes, suggesting treatment effects were not significantly inhibited by OCPD presence. In conclusion, RO DBT shows promise as a potential evidence-based treatment for OCPD, particularly when comorbid with TRD. Treatment effects were equivalent for those with and without OCPD. Moreover, RO DBT may be particularly beneficial for improving emotional approach coping and flexibility. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Suicide is a leading cause of death worldwide and is often empirically examined in relation to internalizing psychiatric constructs, such as depression, but less commonly in relation to externalizing disorders. The purpose of this preregistered meta-analysis was to explore the relations between suicide-related variables (i.e., ideation, attempts, and self-harm) and psychopathy-a maladaptive personality construct falling under the externalizing umbrella. The results showed small-to-moderate associations between total psychopathy scores and suicidal ideation ( = .19), behavior ( = .12), and self-harm ( = .20). Psychopathy subscales and factor scores varied widely in their correlations with suicide-related variables, highlighting the utility of assessing psychopathy using a more nuanced, trait-based approach. Potential mechanisms underlying these relations and clinical implications of the findings are discussed. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Measures of psychopathic personality traits have been utilized in a variety of settings and are often weighed heavily in decision-making. Though there is evidence of testing bias in marginalized groups, no evaluation of potential bias has been conducted for bias among sexual orientation minorities. This study utilized a slope-intercept bias approach to evaluate the testing bias of three self-report psychopathy measures: the Triarchic Psychopathy Measure, the Comprehensive Assessment of Psychopathic Personality-Self-Report, and the Levenson Self-Report Psychopathy Scale. Broadly, the current findings suggest psychopathy measures predominantly overpredict personality psychopathology and related impairment in sexual minorities, especially detachment, and disinhibition. Reassuringly, although some measures and scales had significantly overpredicted antisocial behaviors, none of these differences reached a threshold of clinically meaningful implications. Nonetheless, the risk of both testing and clinician bias should continue to be assessed in sexual minority persons and other diverse groups to ensure equitable evaluations. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Increased prevalence of personality pathology, characterized by both personality disorder diagnoses and presentation of personality disorder traits, has been identified among sexual and gender minorities (SGMs) compared to their cisgender and heterosexual counterparts. Additionally, certain subgroups within the SGM community, namely bisexual and transgender populations, are found to have a prevalence of personality pathology elevated above that of other SGM subgroups. However, research on personality pathology prevalence across sexuality and gender identity is in its infancy, remaining scarce and inconclusive. Further, while literature has speculated that the increased levels of personality pathology observed within the SGM community may arise from manifestations of minority stress, this is yet to be explored empirically. This study examined self-reported personality pathology from SGM community members as well as their cisgender and heterosexual counterparts and explored potential relationships between personality pathology and minority stress. Using a cross-sectional survey design, 368 participants recruited within Australia completed measures of personality functioning, maladaptive personality traits, and, for SGM participants, minority stress. Greater presentation of personality pathology was identified among SGM participants, with higher mean scores across personality measures. Personality pathology scores were found to be highest among noncisgender individuals and sexuality groups other than heterosexual and gay/lesbian. As theorized, minority stress was positively correlated with increased personality pathology. Implications regarding the potential for overpathologizing of SGM populations are discussed. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Although a recent systematic review examined the relationship between mistrust and borderline personality disorder (BPD; Preti et al., 2023), it did not statistically quantify the strength of this association. This highlights the need for a meta-analytic review of mistrust in BPD. To address this gap, we conducted a meta-analysis comparing laboratory-based assessments of mistrust between individuals with BPD and control groups. This meta-analysis was preregistered with International Prospective Register of Systematic Reviews (CRD42023479031). The final database search was conducted on October 17, 2024, across Embase, MEDLINE, PsycINFO, Scopus, and Web of Science to identify relevant studies. We included studies published in English or translated into English that employed valid, reliable laboratory-based measures of mistrust and psychometrically sound tools for assessing BPD symptoms or features. A three-level meta-analytic model was used to assess mistrust differences between BPD and control groups. The risk of bias in the included records was evaluated using the Joanna Briggs Institute Critical Appraisal Checklists. Our search yielded 1,717 reports, of which 26 met the inclusion criteria ( = 3,716). Based on 70 effect sizes from these reports, the meta-analysis indicated a small-to-moderate effect size ( = 0.44, 95% confidence interval = [0.27, 0.61], < .001), demonstrating that individuals with BPD exhibited significantly higher levels of mistrust compared to controls. Subgroup analyses identified the mistrust paradigm as a statistically significant moderator. These results underscore the significant role of mistrust in BPD. We suggest that assessing mistrust and fostering interpersonal trust during treatment could lead to more effective interventions for BPD. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Due to conflicting evidence regarding gender-specific prevalence of borderline personality disorder (BPD), this systematic review aims to evaluate its occurrence in men within the general population to inform more responsive approaches in assessment and treatment. A systematic search was conducted in MEDLINE, PubMed, PsycINFO, PsycARTICLES, Embase, and Web of Science for English-language publications between 1980 and 2023. Inclusion criteria included peer-reviewed studies reporting original prevalence data for BPD in men in the general population. Study quality was assessed using Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, and data were synthesized using quantitative methods including meta-analysis. Eleven studies met the inclusion criteria ( = 2,027,764). Results indicated that the prevalence of BPD in men in the general population varied based on measurement method. Seven studies using clinical interviews reported a pooled prevalence of 0.9% and a men-to-women ratio of 43:100. In contrast, four studies using self-report measurements revealed a pooled prevalence of 8.1% and a men-to-women ratio of 73:100. The prevalence also differed according to sampling methods, participants age, as well as cultural and economic factors. This review suggests that BPD prevalence in men appears to vary according to multiple factors, with men meeting diagnostic criteria less frequently than women in the general population. The variations of prevalence may be influenced by gender bias in diagnostic criteria and clinical practice, as well as methodological and environmental factors. Future research should focus on refining measurement tools and improving clinical practice to better capture gender-specific and age-related manifestations of BPD, particularly across diverse cultural and economic contexts. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The Alternative DSM-5 Model for Personality Disorders and adopt a dimensional approach to personality disorders, defining them in terms of impairments in self-related (identity, self-direction) and interpersonal (empathy, intimacy) personality functions. This study examined the clinical utility of a clinician-rated global evaluation of personality functioning based on the Level of Personality Functioning Scale (LPFS). A total of 346 German mental health professionals provided LPFS ratings for 1,403 patients, stratified by 38 diagnostic categories, including, but not limited to, personality disorders. Clinicians reported on each patient's treatment outcome, recommended optimal treatment components for each patient, and provided their perspective on the clinical utility of the LPFS and its potential risk of stigmatizing patients. On average, clinicians rated the LPFS as "very useful," its applicability as "rather easy," and the risk of patient stigmatization as "rather low." Logistic and ordinal Bayesian multilevel models indicated meaningful associations between LPFS ratings and clinical judgments, highlighting its effectiveness in conveying clinical impressions. Greater impairments in personality functioning were associated with poorer clinician-rated treatment outcome and poorer prognosis. In addition, associations with optimal treatment components yielded a nuanced pattern, with clinicians typically recommending short-term outpatient psychotherapy for patients with mild impairments, long-term psychotherapy for patients with moderate to severe impairments, and intensive care interventions (e.g., outreach care, assisted living) for those with extreme impairments. The results indicate that German mental health professionals consider the LPFS to be a clinically useful concept and that it may be valuable in organizing and communicating information about patients. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The Level of Personality Functioning Scale-Brief Form 2.0 (LPFS-BF 2.0) is a brief measure for personality functioning based on the Alternative Model for Personality Disorders. Despite a strong emerging research base in support of the measure, most studies have been conducted in North America or Europe, and few studies have explored its association with theoretically relevant correlates such as mentalizing and attachment. The current study examined its factor structure, reliability, measurement invariance, and validity in Iranian samples using Exploratory Structural Equation Modeling. Two Iranian samples participated, composed of community-dwelling adults ( = 579, 58.9% female, = 33.47) and university students ( = 390, 70.8% female, = 27.09). Participants completed the LPFS-BF 2.0 alongside measures of categorical personality pathology, mentalizing, and attachment. Competing measurement models were contrasted, and invariance was tested across samples, sexes, age groups, and diagnostic status. A two-factor Exploratory Structural Equation Modeling model representing self and interpersonal functioning demonstrated optimal fit with good reliability and measurement invariance across all groups. Both domains showed strong associations with attachment insecurities, mentalizing deficits, and personality pathology. The mean score of self dysfunction was significantly higher in students, females, emerging adults, and diagnosed participants, while the interpersonal domain showed no significant group differences. The LPFS-BF 2.0 showed robust psychometric properties in Iranian samples, supporting its cross-cultural utility. Given that self dysfunction varied significantly by sample type, sex, age, and diagnostic status while interpersonal dysfunction did not, the self domain appears to better distinguish between demographic and clinical groups. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

It has been posited that extremely high or extremely low levels of any personality trait in the five-factor model can be maladaptive. However, the Alternative Model of Personality Disorders in Section III of the -fifth edition () is composed almost exclusively of unipolar maladaptive traits. The lack of maladaptively low neuroticism and high extraversion fails to fully cover psychopathy; the lack of maladaptively high extraversion fails to cover histrionic personality disorder; the lack of maladaptively high agreeableness fails to cover dependent personality disorder; and the lack of maladaptively high conscientiousness fails to cover obsessive-compulsive personality disorder. The goal of this study was to discern whether Five-Factor Model Personality Disorder (FFMPD) scales demonstrate incremental validity over the Personality Inventory for (PID-5) in capturing variance in symptom measures of each of these personality disorders. A combined sample of = 733 completed an online questionnaire battery that included the PID-5 and FFMPD scales for psychopathy, histrionic personality disorder, dependent personality disorder, and obsessive-compulsive personality disorder, along with symptom measures for each of these conditions. A series of hierarchical regression models was conducted in which each symptom measure was regressed on the PID-5 (entered in Step 1) and the corresponding FFMPD measure (entered in Step 2). Results suggest that adding the FFMPD measure to the models accounted for significantly more variance in its corresponding symptom measure than the PID-5 alone. Taken together, these results suggest that maladaptive variants of personality traits that are often considered healthy (e.g., low neuroticism, high extraversion) confer important information about personality disorder symptoms and functioning and should be included in the Alternative Model of Personality Disorders. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Dimensional models of personality disorders (PDs) define them by impairments in self and interpersonal functioning, with optional or mandatory) specification of maladaptive traits. While interpersonal dysfunction is central to the manifestation and treatment of PDs, it remains unclear whether maladaptive traits provide incremental value in predicting affective responses to interpersonal situations beyond PD severity. Across two preregistered experimental online studies (₁ = 548, ₂ = 192), we examined whether the maladaptive traits negative affectivity and detachment predict affective responses to interpersonal stimuli after adjusting for level of personality functioning. Stimuli were selected based on the results of a pilot study (₀ = 445). Participants rated their affect following exposure to audiorecorded interpersonal statements of positive, negative, or neutral valence. Results from both studies showed that negative affectivity was consistently associated with higher levels of negative affect across the paradigm, while detachment predicted lower levels of positive affect, consistent with their theoretical definitions. Contrary to expectations, detachment also predicted higher negative affect in both studies. No trait significantly predicted affective reactivity to positive stimuli, and only one study supported a reduced negative affect increase in response to negative stimuli among individuals high in detachment. All observed effects were incremental to level of personality functioning. These findings suggest that maladaptive traits capture meaningful variance in interpersonal affective responses beyond global personality dysfunction and may aid in individualizing case conceptualizations. However, inconsistencies in affective reactivity point to a need for improved trait operationalizations and greater attention to context in future research. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The alternative model for personality disorders (AMPD) constitutes a major shift in conceptualizing personality pathology and has gained considerable attention among both clinicians and personality pathology researchers. The AMPD has two core components: personality dysfunction (Criterion A) and maladaptive traits (Criterion B). As measures of these components are strongly correlated in self-report, cross-sectional data, some researchers question Criterion A's necessity. We used both self- and interviewer-reported methods to enhance understanding of these AMPD components through principal factors analysis (PFA) and bifactor analysis. Further, we investigated these factors' associations with psychopathology (e.g., mood and anxiety disorder symptoms, criteria for substance use disorders) and psychosocial functioning dimensions (e.g., life satisfaction, interpersonal and occupational problems, daily functioning), again using both self-reported and interviewer-rated measures of these constructs. Six hundred community adults, half each either screened-in as at-risk for personality pathology or currently in outpatient therapy, participated in the study. In both the PFA and bifactor analyses, a distress-and-pathology factor emerged (e.g., negative affectivity, poor self-dysfunction) along with two primarily interpersonal factors: antagonism-disinhibition and detachment. A key difference between the PFA and bifactor analyses was that the interpersonal factors emerged without distress in the bifactor analysis because of the extraction of a general factor and reflected distinct self versus interviewer perspectives. The distress-and-pathology factor consistently displayed meaningful associations with psychopathology symptoms, personality pathology, and psychosocial functioning, whereas the two interpersonal factors were more specifically associated with personality pathology. We discuss the findings' implications for conceptualizing personality pathology and its treatment. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

From 2010 to 2014, a series of events and publications revealed that much of the psychological literature was less robust than the field believed. Researchers have highlighted various issues underlying fragile findings in large swaths of psychological science. In response, the field has also proposed solutions to help build a more robust literature. Foremost among these solutions are a suite of Open Science practices, including preregistration, registered reports, and the posting of materials, data, and analytic scripts. While these solutions have primarily emerged outside of clinical science, there is some evidence that clinical science is beginning to adopt Open Science practices. The present study focuses on the use of Open Science practices in personality disorder research, specifically. We discuss the relevance of these practices to personality disorder research, and examine rates of Open Science practices in articles published between 2021 and 2023 in two personality disorder journals, (article = 150) and (article = 158). The rate of Open Science practices in these articles was compared to empirical articles from a select number of general personality journals published during the same time period (article range = 125-247). Overall, the personality disorder articles showed lower rates of Open Science practices compared to the general personality articles, while some practices (registered reports) were consistently low across all articles. In light of these findings, we discuss ways that personality disorder researchers can effectively implement Open Science practices to help facilitate a more transparent research literature. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

This study explores the structural properties of the Personality Inventory for the , fifth edition, Brief Form (PID-5-BF) by applying network analysis and community detection as a data-driven alternative to traditional factor models. Traditionally, the PID-5-BF assesses personality traits across five domains-Negative Affectivity, Detachment, Antagonism, Disinhibition, and Psychoticism-but has shown notable inconsistencies in item alignment and factorial coherence. To examine these issues, data were collected from 2,766 Italian participants (71.7% female, 28.3% male, = 32.94 years, = 13.2). The estimated network revealed a stable structure, supported by robust centrality measures (closeness = 0.59, expected influence = 0.75, strength = 0.75). Community detection identified five empirically coherent clusters-Disinhibition, Demoralization, Detachment and Irritability, Psychosocial Alienation, and Pathological Egocentrism-suggesting an alternative organization of maladaptive traits in this population. To assess generalizability, a second analysis was conducted on a Hungarian sample ( = 355), yielding a five-structure solution with different item compositions. While the network approach emphasizes item-level associations, the specific configurations varied across samples in ways that reflect contextual influences. Nonetheless, this method offers complementary insights to traditional factorial models, highlighting how personality traits may organize differently across populations and supporting the use of network-based approaches in refining dimensional models of personality pathology. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Investigations of the construct of emptiness often include vague, overlapping, and contradictory operationalizations that have impacted further theoretical and empirical understanding. This includes referring to emptiness as a static, trait-like phenomenon, without measurement of the individual instability that may exist in this experiential state. Furthermore, studies often restrict the examination of emptiness to those with borderline personality disorder, despite research supporting its relationship to other disorders and to personality functioning in general. The present study sought to explore emptiness at both its trait- and state-level determinants utilizing an experience sampling design in 120 community members. Specifically, this study investigated personality dysfunction in both interpersonal and self-domains, identity disturbance, and emotion dysregulation in predicting between-person mean and instability in emptiness, as well as within-person emptiness across a 14-day study period. Results supported strong relationships between within-person sadness and emptiness. Furthermore, mean-level emptiness was associated with both personality dysfunction and identity disturbance, while emptiness instability was additionally associated with emotion dysregulation. Implications for construct clarity are discussed. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The proposed model of personality disorder in the , 11th revision ) comprises ratings of the severity of self and interpersonal impairment, pathological trait domains, and a borderline pattern specifier. The incremental validity of the different components of the model has primarily been studied in relation to symptoms, traits, and psychosocial functioning, whereas associations with cognitive- and identity-related factors have not yet been characterized. The present study investigated the unique associations of each component of the model with overgeneral autobiographical memory, which reflects aspects of identity integration and episodic memory retrieval. Female general psychiatric patients ( = 196) completed self-report measures of the model (Level of Personality Functioning Scale-Brief Form 2.0, Personality Inventory for , and Borderline Pattern Scale) and the Autobiographical Memory Test. In bivariate analyses, overgeneral autobiographical memories were associated with more severe self and interpersonal impairment, higher pathological personality traits (except for lower Anankastia), and more severe borderline pattern scores. Hierarchical regressions indicated that both self and interpersonal impairments, pathological traits (especially negative affectivity), and maladaptive regulatory strategies (a component of the borderline pattern) were uniquely and incrementally associated with overgeneral memories. Overall, these findings reveal the personality disorder components that underlie overgeneral autobiographical memories within a transdiagnostic female psychiatric sample. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Alexithymia is a multifaceted construct encompassing difficulties identifying and describing feelings, limited imaginal capacity, and externally oriented thinking. Despite the high prevalence among borderline personality disorder (BPD) patients, less is known about symptom-level associations between alexithymia and BPD criteria. Prior studies highlight an elevated risk of self-injurious and suicidal behaviours associated with alexithymia. Understanding the symptom-level relationships with alexithymia may provide a more specific target for intervention. This study explored the associations between alexithymia and BPD symptom criteria in 478 psychiatric outpatients ( = 146 BPD, = 196 other personality disorders, and = 136 no personality disorder [PD]), assessed using the Structured Clinical Interview for fourth edition (), and Structured Interview for Personality Disorders. BPD symptoms were dichotomized as present if scored ≥ 1 (definitely present). Alexithymia was measured using the Toronto Alexithymia Scale (TAS-20). Depression severity was assessed using the Beck Depression Inventory (BDI-II). Logistic regression was used to examine relationships between alexithymia and BPD symptom criteria in each group. In the BPD group, identity disturbance ( = .0013) was significantly related to alexithymia using the Benjamini-Hochberg Procedure for multiple comparisons. The association remained when controlling for depression severity. Among those without any PD, alexithymia was significantly associated with chronic feelings of emptiness ( = .0024) before controlling for depression. In BPD, alexithymia was most strongly associated with identity disturbance. Previous studies have linked alexithymia and identity disturbance to suicidality. This study is the first to identify an association between alexithymia and identity disturbance in BPD, underscoring impairments in the self and self-mentalizing a potential target for suicide prevention in BPD. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

This is the introduction to a special section of Personality Disorders: Theory, Research, and Treatment. The special section concerns the treatment of the dimensional trait domain of antagonism. It begins with a target article concerning the lack of adequate training in the treatment of antagonism within clinical psychology training programs, followed by four invited commentaries providing suggestions for possible intervention programs. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

A recent survey of clinical doctoral students found that emerging clinicians feel ill-equipped to treat antagonism-related disorders and that they perceive inferior treatment outcomes (as compared to those with neuroticism-based disorders). That said, the clinician is only one half of the therapeutic relationship-and client qualities, such as motivation, are also important predictors of treatment success. The present article integrates insights from the personality development literature regarding whether nonclinical populations want to change with respect to agreeableness/antagonism, and whether interventions can help them do so. To that end, although people express goals to change all Big Five personality traits, the research literature consistently indicates that these desires are weakest for agreeableness (and openness) as compared to extraversion, conscientiousness, and emotional stability. Moreover, interventions that have successfully increased extraversion, conscientiousness, and emotional stability have struggled to help individuals become more agreeable. These findings are discussed, and future research directions are outlined. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The treatment of populations with antagonistic traits and disorders, particularly psychopathic personalities, poses a significant challenge for mental health practitioners and trainees. This commentary reviews Hyatt, Phillips, et al. (2025), highlighting the critical clinical training gaps related to working with individuals exhibiting externalizing and antagonistic behaviors. Hyatt, Phillips, et al.'s (2025) findings reveal that graduate students receive less training and experience working with these populations compared to clients with internalizing disorders, contributing to lower self-efficacy and greater emotional strain in therapeutic encounters. This commentary discusses the urgent need for enhanced training, including exposure to structured evidence-based interventions for child conduct disorders, such as Parent-Child Interaction Therapy and its adaptation for children with callous-unemotional traits. It also discusses possible reasons for Hyatt, Phillips, et al.'s (2025) findings, including the pervasive underfunding of research on conduct disorders and psychopathy, which contributes to the scarcity of effective treatments. Finally, future training initiatives are considered, including the potential of novel training techniques such as deliberate practice and simulation-based education to improve psychology trainee's clinical competence in working with clients with antagonism. This commentary emphasizes the importance of equipping future clinicians with the skills needed to address the complex needs of these challenging populations to help reduce their societal burden. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Comments on the article by C. S. Hyatt et al. (see record 2025-13493-001), which describes how therapists feel about treating antagonistic patients. The findings clearly reflect all the difficulties one can have with these cases. It is not surprising that many students felt they needed more supervision to address these problems. That might have made a difference. But what is even more necessary is conducting research into which methods work best. If experienced therapists find these cases problematic and may even avoid treating these patients, why should students have an easier time? In summary, teaching students how to deal with their most difficult cases needs to be guided by data. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Antagonism, a personality trait implicated in the development of a range of externalizing disorders, has the potential to significantly impact the course of therapy given its relevance for interpersonal functioning. This commentary describes the process of developing cognitive behavioral modules for personality symptoms, a short-term intervention for borderline personality disorder that directly addresses the personality traits associated with this condition: negative affectivity, disinhibition, and antagonism. Antagonism, as it manifests in the context of borderline personality disorder, is operationalized and putative functional mechanisms associated with its maintenance are suggested. Specific cognitive-behavioral skills are linked to maintaining processes and preliminary evidence of their efficacy for reducing antagonism is presented. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The factor structure of personality disorder (PD) criteria has long been debated, but due to previous heterogeneous findings, a common structure to represent covariation among the fourth edition Section II PD criteria remains an open question. This study integrated individual participant data from 25 samples ( = 30,545) to conduct factor analyses of PD criteria. Measurement invariance tests across gender, clinical status, and assessment method indicated substantial structural differences between interview-based and self-report measures. In interviews, a confirmatory 10-factor model with factors representing specific PDs showed a major misfit, with results from exploratory factor analyses suggesting that this was due to a relatively small number of substantial secondary loadings. In self-reports, a confirmatory 10-factor model showed greater misfit than in interviews, and exploratory solutions were more complex. When five factors were extracted, the factors showed some similarity to maladaptive trait domains such as Negative Affectivity and Disinhibition, but there were substantial differences in factor content between interviews and self-reports. In bifactor models, a general factor explained more common variance in self-reports, whereas the content of general factors was similar in both assessment methods. Our findings suggest that interview and self-report measures of PD criteria are not structurally equivalent. To advance research on the structure of PD, it may be useful to consequently focus on the shared variance of multiple methods. For this purpose, future multimethod studies should combine interviews and self-reports with other assessment methods such as informant reports. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The Five-Factor Obsessive-Compulsive Inventory (FFOCI) provides an assessment of personality traits relevant to obsessive-compulsive personality disorder. Obsessive-compulsive personality disorder is the most prevalent personality disorder within community samples, and the literature marks that some demographic groups are more at risk than others. The FFOCI, however, has never been explored to demonstrate that it assesses these traits in the same way across groups. The current study adds to the literature by evaluating its measurement invariance across gender, education, and age via the alignment method in a sample of 500 U.S. census-matched adults. A novel contribution of the study is the use of the alignment method, which suggested that the FFOCI demonstrated invariance across groups, allowing for mean-level comparison in traits related to overcontrol. Analyses demonstrated that invariance of the FFOCI held across age, gender, and educational level. Mean-level comparisons between groups showed that college-educated individuals were not significantly higher than noncollege-educated on traits relating to overcontrol. There were nuanced differences between men and women, and differences between age groups were more complicated than originally anticipated. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Psychoeducation, delivering up-to-date information about mental illness is crucial for supporting patients' recovery. While recognized for various disorders, its role in borderline personality disorder (BPD) lacks review. This study synthesizes the current evidence about psychoeducational interventions for BPD. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, this scoping review consulted databases (PubMed, PsychINFO, Web of Science, Cumulative Index to Nursing and Allied Health Literature, and Información Científica y Técnica en Salud de América Latina y el Caribe), and grey literature (ProQuest Dissertations and Theses Global and Google Scholar). A Complementary search (contacting relevant researchers and including relevant references from included articles) was included. Two reviewers screened and extracted the data using the Template for Intervention Description and Replication checklist. Seven studies were analyzed, and positive effects were found on diverse outcomes: BPD symptoms, coping strategies, well-being, communication, quality of life, social functioning, perceived stress, mental health symptoms, and stigma. Psychoeducational interventions for BPD can help people who experience BPD to optimize their recovery process. However, replication and improvements are to yield sustained effects and reach more to this population. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

There are currently three models for diagnosing personality disorders for practitioners to choose from in the formal diagnostic classification systems and (ICD): the categorical model retained from , a dimensional model in the and the Alternative Model for Personality Disorders (AMPD) that is a hybrid of categorical and dimensional methods. We used a sequential mixed-methods approach to explore how psychologists and psychiatrists decide which model to use for diagnosing personality pathology. In Study 1, we elicited eight themes and seven subthemes that capture the factors that psychologists and psychiatrists ( = 18) consider when deciding whether or not to use the AMPD. In Study 2, these themes were converted to 16 statements reflecting factors that practitioners might consider when deciding which diagnostic model to use when working in a therapeutic role. Psychiatrists ( = 13) and psychologists ( = 70) rated each of the 16 factors according to the degree to which they influence deciding which diagnostic model to use. The most important factors were those pertaining to usefulness in communicating personality information, knowledge about and training in each model, usefulness of the model for describing clients' difficulties and pathology, and level of acceptance of the model by peers and experts in the field. While our data do not identify which model lends itself best to clear communication about personality functioning, or which model is most scientifically sound and accepted within the field, our data indicate that practitioners consider those things important, so clear guidance about those matters based on empirical evidence is needed. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Personality disorders (PDs) are well characterized by deficits in interpersonal and emotional functioning, highlighting the importance of examining their intersection, such as interpersonal emotion regulation (IER). Given the dyadic nature of IER, characterizing the individuals who help regulate emotions, and their perceptions of these interactions, may further elucidate the process of IER in individuals with personality pathology. We aimed to directly characterize network partners that aid in IER and compare perceptions between both IER seekers and regulators. Primary participants, who were recruited for elevated levels of personality pathology, including some evidence of elevated borderline personality features, nominated members of their social network (i.e., secondary participants) to participate. The final sample included 165 secondary participants (115 of whom were identified as IER partners by primary participants) associated with 73 primary participants. We examined the association between dimensions of primary and secondary personality pathology and measures of the primary participant's IER. Primary and secondary participants tended to agree on measures of IER frequency; however, there was less agreement on more subjective measures, such as the efficacy of IER and the willingness of the secondary participant. Additionally, disinhibition of the primary participant was associated with IER outcomes from both partner's perspectives, including reduced willingness and perceived efficacy from the secondary's perspective and increased efficacy and underestimation of the secondary's IER use from the primary's perspective. These results highlight the value of examining both individuals involved in IER. (PsycInfo Database Record (c) 2025 APA, all rights reserved).