Serena Borroni

Impulsivity, aggressiveness, and DSM-IV personality disorders

The aim of this study is to assess whether impulsive and aggressive traits can be placed on a continuum with DSM-IV Cluster B Personality Disorders (PDs) and to determine if different aspects of these personality traits are specifically associated with individual Cluster B PDs. The study group comprised 461 outpatients admitted consecutively to a clinic that specializes in the diagnosis and treatment of PDs. Principal component analyses clearly suggested a five-factor structure of both normal and psychopathological personality traits. Importantly, measures of impulsivity, aggressiveness and novelty seeking formed a part of the principal component that clustered all Cluster B PDs. Regression analyses indicated that impulsive traits were selectively associated with Borderline PD whereas different aspects of aggressiveness were useful in discriminating Narcissistic PD from Antisocial PD. Sensation seeking traits formed a part of Histrionic PD. These results indicate that impulsive/aggressive traits may be useful in explaining both why Cluster B PDs tend to covary, and why they frequently differ in clinical pictures and courses.

Psychometric characteristic of the Italian version of the Temperament and Character Inventory—Revised, personality, psychopathology, and attachment styles

In this article, we described the psychometric characteristics of the revised version of the Cloningers personality Temperament and Character Inventory (TCI-R), Italian translation. Two independent samples, which were composed of 355 and 385 nonclinical mother-language Italian subjects, respectively, completed the TCI-R. A further sample of psychiatric outpatients was compared with community samples. We analyzed the internal consistency of each dimension, the test-retest reliability and the factorial structure of the questionnaire. Furthermore, we explored the potential association between personality, psychopathologic indicators (evaluated by the Symptom Checklist-90), behavior dyscontrol measures, and adaptive and maladaptive interpersonal styles. As a whole, the internal consistency of the TCI-R scales was adequate, although some differences in Cronbach alpha values were observed between the 2 samples in some TCI-R subfacets. The factorial structure was consistent with the original hypothesis of Cloninger and test-retest showed a good stability of the scores over the time. Normal data for the Italian population were also calculated. Furthermore, the character dimensions of self-directedness and cooperativeness were related with some psychopathologic domains in our sample and negatively with impulsiveness, anger, and hostility. Novelty seeking was associated with impulsiveness, whereas harm avoidance was associated with anger and hostility. On the contrary, persistence and reward dependence were inversely correlated with such traits. Harm avoidance, reward dependence, self-directedness, and cooperativeness were strongly related with measures of attachment. Finally, significant differences were observed in both temperament and character traits between community subjects and psychiatric outpatients. In the present study, the validity of the Italian translation of the TCI-R is therefore supported. Personality features are also confirmed as risk factors for specific psychopathologic domains, impulsivity, anger, and hostility. Furthermore, we found attachment styles of nonclinical subjects correlated with personality features.

A cross-cultural study of the psychometric properties of the Reactive-Proactive Aggression Questionnaire among Italian nonclinical adolescents

Five independent studies were used to test the hypothesis that a reliable 2-factor structure underlies the Reactive-Proactive Aggression Questionnaire (RPQ) items and that the 2 scales show distinct patterns of association with personality and bullying behavior measures. Study 1 (N = 1,447) gave evidence of a clear 2-factor structure of RPQ items with factor loading matrices closely matching reactive (congruence coefficient = .90) and proactive (congruence coefficient = .91) models of item assignment. The RPQ 2-factor structure was consistently replicated in Study 2 (N = 662), as well as across the remaining 3 studies. In Study 3 (N = 536), Neuroticism differentiated reactive and proactive forms of aggression. In Study 4 (N = 674), self-reports of bullying behaviors were selectively correlated with proactive aggression. Findings confirm and extend the differential correlates of proactive-reactive aggression and also support the psychometric properties of the RPQ in a different cultural context. Finally, in Study 5 (N = 347), the RPQ scales showed adequate 2-month test-retest reliability. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

Reliability and Validity of the Personality Inventory for DSM-5 (PID-5) Predicting DSM-IV Personality Disorders and Psychopathy in Community-Dwelling Italian Adults

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

Relations of proactive and reactive dimensions of aggression to overt and covert narcissism in nonclinical adolescents.

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

Alexithymia and attachment insecurities in impulsive aggression

The aims of this study were to develop a new measure of impulsive aggressiveness, and to assess whether this measure was associated with deficits in mentalized affectivity and adult attachment styles in a sample of 637 non-clinical participants. Extending Fonagy and Batemans (2004) hypothesis, the mediating role of poor affectivity mentalization in the relationship between insecure attachment styles and impulsive aggression was also evaluated. Selected insecure attachment styles (R 2 adjusted = .18, p < .001) and deficits in mentalized affectivity (R 2 adjusted = .25, p < .001) were significantly associated with impulsive aggressiveness. The overall regression model accounted for roughly 33% of the variance in impulsive aggressiveness. Mentalization deficits significantly mediated the effects of attachment styles on impulsive aggressiveness, although effect size measures suggested that only partial mediation occurred.

Taxonic structure of schizotypal personality in nonclinical subjects: Issues of replicability and age consistency

To assess the replicability and age consistency of the taxonic structure and base-rate of schizotypy, 803 university students (21.9 years) and 929 high school students (16.4 years) were administered three self-report measures of schizotypal personality. The two groups came from the same town and were matched on gender. MAXCOV analyses were consistent with a low base-rate taxon of approximately 10% only in the university student group; in the younger group, the three schizotypal personality measures did not show clear evidence of taxonicity. These findings support the hypothesis of the taxonic structure of schizotypal personality in adult subjects, but they raise questions concerning the identification of schizotypy in younger samples.

On the relationship between retrospective childhood ADHD symptoms and adult BPD features: the mediating role of action-oriented personality traits.

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

Taxonic structure of schizotypal personality disorder: a multiple-instrument, multi-sample study based on mixture models.

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

Does mindfulness mediate the association between attachment dimensions and Borderline Personality Disorder features? A study of Italian non-clinical adolescents

The aim of this study was to assess whether mindfulness mediates the association between attachment dimensions and features of Borderline Personality Disorder (BPD) in a sample of 501 Italian high-school students. Low scores on Confidence and high scores on Need for Approval and Preoccupation with Relationships attachment scales was significantly related to the number of BPD features (adjusted R 2 = .21, p < .001). Further, mindfulness scores were negatively associated with Need for Approval and Relationships as Secondary attachment scales (adjusted R 2 = .14, p < .001). Finally, mindfulness scores were negatively associated with the number of BPD features (adjusted R 2 = .15, p < .001). Mediation analyses showed that the relationship between Need for Approval and BPD was completely mediated by the mindfulness effects. Our results in non-clinical adolescents are consistent with Bateman and Fonagys (2004) hypothesis that the link between attachment disturbances and BPD features may be mediated by deficits in mentalization, at least as these are operationalized by low mindfulness.