搜索结果：Journal of personality

With the increasing prominence of the alternative, dimensional model of personality disorders, developmental aspects have also gained importance in the diagnosis of personality disorders. Researchers and practicing clinicians are paying growing attention to adolescents showing signs of disharmonious personality development. Although the study of personality pathology in adolescence remains a debated area both domestically and internationally, timely and appropriate diagnostics can form the basis for adequate therapy. The Structured Clinical Interview for DSM-5 Alternative Model for Personality Disorders (SCID-5-AMPD) is recommended for assessing adolescents with signs of disharmonious personality development. However, to the best of our knowledge, the SCID-5-AMPD has not yet been applied in adolescent populations in Hungary. The aim of our study is to administer the SCID-5-AMPD to a psychiatric adolescent sample at risk for disharmonious personality development aged 14 and older, as well as to a control group without psychiatric diagnoses. Our study has been approved by the Scientific and Research Ethics Committee of the Health Scientific Council (reference number: BM/9184-1/2024). Considering the developmental characteristics of adolescence, our research focuses on a dimensional approach, i.e., exploring the functioning of personality and the degree of maladaptive personality traits. Therefore, the first and second modules of the SCID-5-AMPD were administered. After obtaining written informed consent from both the guardian and the adolescent, the adolescents and their parents completed a questionnaire package, followed by the administration of the first two modules of the SCID-5-AMPD with the adolescent. Written notes were taken during the interviews. The clinical sample included 14 participants, while the control group consisted of 17 participants. The study involved 8 boys (25.8%) and 23 girls (74.2%), with a mean age of 16.06 years (SD = 1.24 years). The items proved to be understandable and relevant for adolescents. Feedback from adolescents with disharmonious personality development indicated that the structured format of the interview and the coherence created by the standardized questions helped them better understand their otherwise hard-to-define difficulties. The duration of the interviews varied widely. Interviewers were able to learn how to administer a structured clinical interview, apply the concepts of the SCID-AMPD, and gain a closer understanding of the dimensional approach to personality disorders and its practical application. Based on our preliminary experience, the first two modules of the SCID-5-AMPD may be applicable for assessing adolescents. Further investigation of its psychometric properties among Hungarian adolescents is essential for future use.

Both personality traits and personality disorders have been linked to suicide risk in youth. The DSM-5 Alternative Model of Personality Disorders (AMPD) allows dimensional assessment of personality pathology, which may enhance prediction of suicide attempts. A recent study found that personality dysfunction (Criterion A of the AMPD) is associated with past suicide attempts in adolescents. Building on this, the present study aimed to investigate the longitudinal relationship between AMPD personality pathology and suicide attempts in adolescents. Data were drawn from a consecutive clinical cohort study including adolescent patients aged 12 to 18 years (N = 252, 85% female) engaging in risk-taking and self-harming behaviors. Personality dysfunction, maladaptive personality traits, suicide attempts, and depression severity were assessed using standardized interviews and questionnaires at baseline and at two annual follow-ups. 66% of participants completed any follow-up. A Bayesian Structural Equation Modeling framework was used for data analysis. Personality dysfunction predicted suicide attempts over the two-year follow-up (β = 0.38, 95% CI [0.01; 0.73], p = .046). Adding maladaptive personality traits did not add predictive value, while depression severity emerged as a slightly stronger predictor. The effect of personality dysfunction remained stable after accounting for these variables. These findings highlight the value of assessing personality dysfunction in adolescent suicide risk evaluation. Within the AMPD framework, personality dysfunction may be more important than maladaptive traits in predicting suicide attempts. However, analyzing distinct personality functioning domains or maladaptive traits may provide further insight into suicide attempt prediction.

The clinical utility of the DSM-5's Alternative Model of Personality Disorders (AMPD) depends on how well it encodes diagnostic concepts recognized in clinical descriptions of PDs. The present study examined the AMPD's coverage of borderline personality features identified in the clinical literature. In three independent samples (total N = 1166), community adults and university students rated their borderline features, level of personality functioning (AMPD Criterion A), and maladaptive personality traits (AMPD Criterion B). We observed that, collectively, the AMPD dimensions accounted for 76%-82% of borderline PD variance across samples. In supplemental analyses that adjusted for measurement error, the variance-explained range climbed to 84%-96%. Some domains of borderline pathology were better represented than others in the AMPD, highlighting areas for improvement in future iterations of the AMPD and related dimensional nosologies. We conclude that, at least in the populations studied here, the AMPD is a serviceable model of longstanding borderline constructs, providing a bridge from categorical to dimensional conceptualizations of borderline PD.

Chronic pain and personality disorders frequently co-occur. This co-occurrence may pose challenges in pain management and should be addressed by clinicians to optimize outcomes. The Level of Personality Functioning Scale - Brief Form 2.0 (LPFS-BF) is a time-efficient screening tool for impairments in personality functioning based on the Alternative DSM-5 Model for Personality Disorders. This cross-sectional study evaluates the psychometric properties of the LPFS-BF in a sample of adults with chronic pain. Data was retrieved from the Oslo University Hospital Pain Registry and includes 892 participants referred to outpatient pain management. The psychometric properties of the LPFS-BF were investigated in terms of factor structure, scale reliability, and concurrent validity with anxiety and depression, health-related quality of life, and past week usual pain intensity. Mean age was 49 years and 64 % were female. A bifactor structure showed best model fit: Comparative fit index=0.995, Tucker-Lewis index=0.993, root mean square error of approximation=0.023, standardized root mean square residual=0.030. Scale reliability was good for the general factor (ω t =0.89, ω h =0.79), poor for the self domain (ω t =0.25, ω h =0.05), and questionable for the interpersonal domain (ω t =0.68, ω h =0.40). Explained common variance for the general factor was 68 % which supported essential unidimensionality. The magnitudes of the associations between the LPFS-BF and the investigated variables were comparable to previous research, thus supporting its concurrent validity. The results suggest that the LPFS-BF is best viewed as a unidimensional scale in the current sample and support the LPFS-BF as a valid and reliable screening tool for impairments in personality functioning among individuals with chronic pain.

There is tension between theories and empirical evidence linking affective instability to obsessive-compulsive personality disorder (OCPD) and OCPD diagnostic tools emphasizing restricted affect. Contextual stressors, including unexpected routine disruption and interpersonal discord, may help reconcile this apparent contradiction. High environmental control in OCPD should, on average, correspond to reduced affect, with infrequent lapses alternatively producing acute, short-term elevations. The current study examined affective processes of OCPD in daily life using ecological momentary assessment (n = 34,915) in a combined clinical/community sample (N = 245). Preregistered hypotheses were partially supported. Endorsing any OCPD symptoms was associated with greater momentary intensity, instability, and acuteness of anxiety, as well as greater momentary instability and acuteness of hostility. Low but non-zero OCPD symptomatology was associated with lower average intensity and instability of anxiety in the context of routine disruptions. However, as OCPD symptoms increased, routine disruptions predicted stronger intensity and instability of anxiety. In contrast, individuals with more symptoms reported weaker average intensity of hostility in the context of interpersonal stressors. Our findings suggest that instability of negative affect in OCPD is emotion specific and better captured by acute sporadic changes rather than consistent consecutive deviations. Additionally, the association between OCPD symptoms and negative affect might be nonlinear, consistent with functional accounts. This work sheds light on the affective mechanisms underlying OCPD symptomatology and highlights the importance of examining constructs that are dynamic in nature beyond the average level. Specifically, when temporality is considered, theories of both restricted and heightened affectivity can operate in tandem.

Chronic orofacial pain (COP) is a complex condition often resistant to treatment and associated with psychological comorbidities. Yet, its neuropsychological profile remains under-investigated. This case-control study aims to identify the cognitive, behavioral, and psychological profiles of COP and their associations with clinical symptoms, with a focus on persistent idiopathic facial pain (PIFP), a condition particularly underexplored. A cohort of 42 patients (COPc), including 23 with PIFP, and 42 healthy controls (HCs) underwent a comprehensive assessment of mood, coping strategies, personality traits, cognitive functioning, and social well-being. Between-group and correlation analyses were performed, and Bonferroni correction was applied to account for multiple comparisons. The psychological framework of COPc was marked by depressive symptoms, loneliness, alexithymia, poor quality of life, and low physical and mental well-being. Personality assessment indicated worthlessness. Catastrophizing was a dominant coping strategy, characterized by helplessness and rumination. Cognitive assessments revealed deficits in attention and executive functions. PIFP patients exhibited particularly psychological vulnerabilities, namely, catastrophizing thinking and difficulties in describing their own feelings. Correlation analyses showed complex relationships between cognitive, behavioral, and psychological impairments in COPc, and a strong association between the negative impact of pain symptoms on social life and psychological, catastrophizing, and cognitive functioning. This is the first study to characterize the neuropsychological profile of PIFP and COP conditions, revealing a complex interplay of cognitive, behavioral, and psychological vulnerabilities. These findings underscore the importance of addressing both neuropsychological and social functioning in the management of chronic pain to improve patient well-being.

This study examines the validity and reliability of the Turkish version of the Level of Personality Functioning Scale-Self-Report (LPFS-SR-TR) and its associations with personality disorder (PD) categories and Axis I comorbidities. The cross-sectional study included 720 participants aged 18-65. From a consecutive sample of 732 patients who presented to the outpatient psychiatry clinic, experienced psychiatrists suspected 207 of having PD. They were further diagnosed using the structured clinical interview for DSM-III-R personality disorders (SCID-II). Patients were also investigated for Axis I disorders using the SCID-5 clinical version. A community-based control group of 513 participants recruited through convenience sampling received self-assessment-based SCID-II without a clinical interview. Both groups underwent the Big Five Inventory (BFI) and LPFS-SR-TR. The six-factor model provided the best statistical fit. Significant correlations between the LPFS-SR-TR and BFI indicate concurrent validity. Patients scored higher on the LPFS-SR-TR. Using a total score threshold of greater than 277.5 resulted in 93.2% sensitivity and 83.0% specificity (AUC = 0.94) for identifying PDs, indicating discriminant validity. Serial logistic models suggested incremental validity. The scale demonstrated strong internal consistency (Cronbach's α = 0.96) and test-retest reliability (ICC = 0.86). The LPFS-SR-TR is valid and reliable for assessing the presence and severity of PDs. The hypothesized one-dimensional factor structure may be supported given its ability to distinguish PDs from a community sample. Axis I comorbidities are common and diverse without any discernible pattern.

Selecting a college major is a critical decision with long-term implications. While personality assessments like the Myers-Briggs Type Indicator (MBTI) explore person-career fit, radiographers' personality profiles and their relationship with professional quality of life remain uninvestigated. This study aims to identify predominant MBTI types among radiographers and examine their correlation with career satisfaction facets, including compassion satisfaction, burnout, and secondary traumatic stress. Cross-sectional, quantitative study was conducted among radiographers in public healthcare setups in Bahrain. Participants (n = 98) completed an online MBTI assessment and a survey comprising demographic questions and the Professional Quality of Life Scale (ProQOL). Data were analyzed for descriptive statistics and one-way ANOVA. The most prevalent personality types were ESTJ (21.1 %) and ESFJ (18.4 %), with the Sentinel (SJ) temperament group comprising 50 % of the sample. The sample was characterized by preferences for Extraversion (60.5 %), Sensing (63 %), Feeling (63.2 %), and Judging (76.3 %). No statistically significant relationships were found between the 16 MBTI types and the ProQOL subscales of Compassion Satisfaction, Burnout or Secondary Traumatic Stress. A distinct MBTI profile is prevalent among radiographers, yet no significant association with ProQOL-measured career satisfaction was found. This suggests satisfaction is influenced by factors beyond personality. The findings provide a foundational typology and call for longitudinal studies on the personality-profession interplay. The common profile (ESTJ/ESFJ) does not predict job satisfaction, refining recruitment into a guide rather than a filter. This informs tailored education and career mentoring, enhancing support for all profession members beyond typological constraints.

Risk-reducing mastectomy substantially reduces breast cancer risk in women at increased genetic or familial risk; however, it may have an impact on quality-of-life. The aim of this longitudinal study was to analyze differences in quality-of-life over time in women at increased risk of breast cancer who underwent risk-reducing mastectomy. A total of 55 cisgender women at increased risk of breast cancer, due to BRCA1/2 pathogenic variants or a significant family history, participated in the study. Some of them had a prior diagnosis of breast cancer. Quality-of-life was assessed using EORTC Quality-of-Life Questionnaire Core 30 (QLQ-C30) and the Breast Cancer-Specific Module (BR23). Assessments were conducted 15-30 days immediately before and 15-30 days immediately after the risk-reducing mastectomy, and at long-term follow-up. The follow-up assessment ranged from 1 to 15 years post-surgery (mean = 5.24 years). Changes over time were analyzed using repeated measures General Linear Models (GLM). Results indicated decreases in functional scales of quality-of-life and worsening of symptom scales following the risk-reducing mastectomy. However, quality-of-life scores returned to baseline levels at long-term follow-up. Worries regarding future perspective decreased following surgery and continued to improve over time. Although risk-reducing mastectomy was associated with short-term deterioration in selected domains, findings indicate recovery and long-term stabilization of quality-of-life. Additionally, risk-reducing mastectomy appears to alleviate future-oriented cancer concerns. This longitudinal evidence strengthens the basis for anticipatory guidance in genetic counseling and supports more balanced, evidence-informed decision-making.

More studies are fulfilling the need to investigate listening effort in individuals with hearing loss in everyday life, and their outcomes have shown that there is a link between ambient acoustics and subjective and objective measures of listening effort. Individual characteristics presumably play an important role in which activities a listener chooses to participate in during daily life. However, no studies have investigated how individual characteristics influence the association between ambient acoustics and indices of listening effort in everyday life. To address this, the present study investigated whether personality traits, cognitive ability, and degree of hearing loss affect the association of ambient acoustics with self-reported listening effort and heart rate. Sixty-seven hearing aid users participated in a four-week field trial, where sound pressure level and signal-to-noise ratio were logged every 20 seconds by the participants' own hearing aids, and heart rate was recorded continuously via Empatica EmbracePlus wristbands. Listening effort was rated via an ecological momentary assessment smartphone app. Personality traits, cognitive ability, and degree of hearing loss were assessed using the NEO Five-Factor Inventory-3, the Intelligenz-Struktur-Test 2000, and pure tone audiometry respectively. Outcomes of linear mixed effects models showed that higher conscientiousness and degree of hearing loss were associated with higher self-reported listening effort with increasing sound pressure level. Additionally, higher conscientiousness and lower cognitive ability were associated with higher heart rate with increasing signal-to-noise ratio. This study underscores the importance of considering individual characteristics when translating research to real-world contexts and optimizing hearing loss rehabilitation in clinical practice.

Understanding the psychological characteristics of contemporary medical students is essential for effective educational design and learner support. This study aimed to identify medical students' personality types using a geometric personality assessment tool (GEOPIA), determine whether differences exist by gender, age, or academic level, and explore the practical utility of such profiling for supporting educational practices in medical school settings. The 40-item Korean Geometric Psychological Assessment (GEOPIA) was administered to 1,173 students across 5 Korean medical schools. GEOPIA classifies individuals into 4 primary types-Round (sociable, relationship-oriented), Triangle (task-oriented, challenging), Box (prudent, stability-seeking), and Curve (creative, sensitive). Frequency analyses and χ2 tests were conducted. Of the 1,016 respondents (response rate, 86.61%), 981 were included in the final analysis. The most common primary type was Round (40.3%), followed by Box (31.7%), Triangle (15.2%), and Curve (12.8%). Across the 12 combined profiles, Round-Box (21.9%) was the most prevalent, followed by Box-Round (19.0%) and Round-Triangle (9.7%). No significant differences were observed by gender (χ2=6.360, P=0.095, Cramer's V=0.082), age (χ2=8.314, P=0.091, Cramer's V=0.065), or academic level (χ2=18.044, P=0.260, Cramer's V=0.078). GEOPIA may provide a practical tool for identifying learner characteristics and supporting educational decision-making in medical school settings. In instructional design, personality-type data can inform group formation, activity planning, and assignment structure. In student support, the tool offers instructors and advisors a quick way to understand learners' characteristics, which may help guide individualized counseling and promote effective learning experiences.

Background: The Childhood Trauma Questionnaire (CTQ) is a widely used tool for the retrospective assessment of childhood trauma (CT). However, evidence on its long-term stability remains limited, especially in diagnostically complex populations such as individuals with borderline personality disorder (BPD). Given the disorder's characteristic emotional instability and altered self-perception, assessing the stability of CTQ scale scores in this group is particularly important.Methods: In a longitudinal design, CTQ and the Borderline Symptom List-23 (BSL-23) scores were collected at two timepoints (T0: n = 417; T1: n = 195) from individuals with current or past BPD. The interval between assessments ranged from 4-11 years (mean 7.72 years).Results: CTQ total scores showed excellent internal consistency (McDonald's ω = .95) and high long-term stability (intraclass correlation coefficient = .82), regardless of assessment interval. Subscale stabilities ranged from moderate to high (Sexual Abuse = .86; Physical Abuse = .81; Emotional Neglect = .77; Physical Neglect = .76; Emotional Abuse = .75). Changes in CTQ subscale scores showed small to moderate positive associations with changes in BPD symptom severity (β = .23 -.33), indicating that increases in perceived childhood trauma were accompanied by increases in symptom severity, except for Physical Neglect (β = .16, p = .078).Conclusions: The CTQ scales demonstrated strong long-term stability over up to 11 years in a heterogeneous BPD sample. Individual changes in perceived childhood trauma were associated with corresponding changes in BPD symptom severity. These results support the CTQ's utility as a retrospective measure of childhood trauma. Reported childhood trauma remains highly stable over several years in individuals with current/past borderline personality disorder.Changes in perceived childhood trauma were linked to changes in borderline personality disorder symptom severity, underscoring the clinical relevance of retrospective trauma assessments.Findings support the Childhood Trauma Questionnaire as a retrospective measure of childhood trauma for both research and clinical practice. Antecedentes: El Cuestionario de Trauma Infantil (CTQ por sus siglas en inglés) es una herramienta ampliamente utilizada para la evaluación retrospectiva del trauma infantil (TI). Sin embargo, las pruebas sobre su estabilidad a largo plazo siguen siendo limitadas, especialmente en poblaciones con diagnósticos complejos, como las personas con trastorno límite de la personalidad (TLP). Dada la inestabilidad emocional y la alteración de la autopercepción características de este trastorno, es especialmente importante evaluar la estabilidad de las puntuaciones de la escala CTQ en este grupo. Métodos: En un diseño longitudinal, se recopilaron las puntuaciones del CTQ y de la Lista de Síntomas Límite-23 (BSL-23 por sus siglas en inglés) en dos momentos (T0: n = 417; T1: n = 195) de personas con TLP actual o pasado. El intervalo entre las evaluaciones osciló entre 5 y 11 años (media de 7,72 años). Resultados: Las puntuaciones totales del CTQ mostraron una excelente consistencia interna (ω de McDonald = 0,95) y una alta estabilidad a largo plazo (coeficiente de correlación intraclase = 0,82), independientemente del intervalo de evaluación. La estabilidad de las subescalas osciló entre moderada y alta (abuso sexual = 0,86; abuso físico = 0,81; Negligencia emocional = 0,77; Negligencia física = 0,76; Abuso emocional = 0,75). Los cambios en las puntuaciones de la subescala CTQ mostraron asociaciones positivas de pequeñas a moderadas con los cambios en la gravedad de los síntomas del TLP (β = 0,23–0,33), lo que indica que el aumento del trauma infantil percibido se acompañó de un aumento de la gravedad de los síntomas, excepto en el caso de negligencia física (β = 0,16, p = 0,078). Conclusiones: Las escalas del CTQ demostraron una fuerte estabilidad a largo plazo durante un periodo de hasta 11 años en una muestra heterogénea de pacientes con TLP. Los cambios individuales en el trauma infantil percibido se asociaron con cambios correspondientes en la gravedad de los síntomas del TLP. Estos resultados respaldan la utilidad del CTQ como medida retrospectiva del trauma infantil.

No information is available on the validation of the Jefferson Scale of Attitudes Toward Interprofessional Collaboration in Spanish (JeffSATIC-S). Few studies have examined attitudes toward collaborative work among medical residents, and research focusing specifically on medical residents in Mexico is currently absent. We evaluated the validity and reliability of the JeffSATIC-S. We then examined attitudes toward interprofessional collaboration among medical residents and their associations with empathy, personality traits - including covert narcissism - and affective - cognitive dysregulation. All medical residents at a public tertiary care teaching hospital were invited to participate in the survey; 213 completed the anonymous online questionnaire (77% response rate). Exploratory factor and reliability analyses were performed. Partial Spearman's correlation coefficients (rs) were calculated, adjusting for sex, age, specialty, and year of residence. The factor structure resembled the original instrument. Cronbach's alpha was 0.90 for working relationships and 0.73 for accountability. Empathy was significantly and positively correlated with the two domains (working relationships: rs&#x2009;=&#x2009;0.557; accountability: rs&#x2009;=&#x2009;0.495; p&#x2009;<&#x2009;.001). In contrast, aggression - hostility (rs&#x2009;=&#x2009; -0.212 and -0.241, respectively; p&#x2009;<&#x2009;.001) and affective - cognitive dysregulation (rs=-0.328 and -0.347, respectively; p <0.001) were significantly negatively correlated. Covert narcissism, impulsive sensation seeking, and neuroticism-anxiety were significantly and negatively linked to accountability, but not to working relationships. The JeffSATIC-S is valid and reliable. Individual factors influence teamwork attitudes in different ways: some affect both working relationships and accountability, whereas others affect only the latter. Medical educators should anticipate interpersonal variability when designing training to enhance attitudes toward interprofessional collaboration. At the organizational level, teamwork-supportive cultures and learning environments should benefit all learners while accommodating additional support when needed.

Cluster-C personality disorders (PDs) are common in the general population but often overlooked in scientific research and clinical practice. An important step to increase awareness for timely diagnosis and treatment of cluster-C PDs is to investigate the burden of disease in terms of quality of life (QoL), daily functioning and the associated costs to society. In addition, a comparison between these patients and a control group can give insight into (1) the actual societal costs that are associated to cluster-C PD problems and (2) potential societal savings to be made from therapeutic interventions. This study included a total of 375 treatment seeking individuals from 10 mental health sites for outpatient treatment in the Netherlands and 104 individuals without severe mental health issues from the general population. Both QoL (EQ-5D-5L and the MHQoL-7D) and general functioning (WHODAS) were assessed as well as a comprehensive cost-interview to measure relevant costs considering a societal perspective. Results indicate that individuals with a cluster-C PD have severely impaired QoL and functioning compared to the control group. The annual costs associated with cluster-C PD were estimated ranging from &#x20ac;27,355 to &#x20ac;60,454 per patient per year depending on the valuation method used. These costs equate 2.8-4.2 times more than those of control group. Looking at the subgroup in cluster-C PD, no differences in QoL, functioning or societal costs were found between individuals with avoidant, dependent and obsessive-compulsive PD. Overall, the findings advocate for more financial resources to study, prevent and treat cluster-C PDs.

Cross-cultural moral psychology requires robust, validated measures. The Moral Foundations Questionnaire-2 (MFQ-2) is a recent revision of the original MFQ that offers improved assessment of moral intuitions; however, a validated German version is unavailable, limiting moral psychology research in German-speaking populations. This Stage 1 Registered Report Protocol describes the methodology for developing and psychometrically validating a German version of the MFQ-2, with a target sample size of N&#x2009;&#x2248;&#x2009;1,200. Its primary aim is to assess the instrument's factor structure using Exploratory Structural Equation Modeling/Confirmatory Factor Analysis, reliability and measurement invariance. A secondary aim is to provide initial construct validity by examining associations with psycho-social correlates, including political ideology, religiosity, personality, and ethics positions. We will test whether theoretically predicted patterns emerge in the German context. By providing a methodologically validated tool, this research will enable investigation of moral belief structures in German-speaking countries and facilitate cross-cultural comparisons in moral psychological science.

The Alternative Model for Personality Disorders in DSM-5 conceptualizes personality pathology using dimensional trait domains, yet the cognitive mechanisms underlying these traits remain insufficiently understood. Early maladaptive schemas (EMSs) represent enduring cognitive-affective structures that may contribute to both personality pathology and general psychological distress. However, it remains unclear whether all schemas function as broadly transdiagnostic vulnerability factors or whether their relevance varies across symptom- and trait-based outcomes. In this study, we examined associations between 18 EMSs, DSM-5 pathological personality traits, and general psychopathological symptoms in a nonclinical sample (N&#x2009;=&#x2009;489). Each schema was examined separately in regression analyses, and only associations with large standardized effects (|&#x3b2;|&#x2009;&#x2265;&#x2009;0.50) were interpreted following Bonferroni correction. The results revealed substantial heterogeneity among EMSs. Rather than all schemas demonstrating comparable transdiagnostic relevance, only a limited subset showed strong associations across multiple outcome domains. Schemas characterized by heightened threat sensitivity and negative expectancy patterns (Vulnerability to Harm, Negativity/Pessimism) exhibited the broadest and most consistent associations with affective, anxiety-related, and psychoticism-related symptoms, as well as with Negative Affectivity at the trait level. In contrast, other schemas showed more circumscribed, domain-specific associations, mapping preferentially onto either symptom dimensions or personality trait domains. These findings indicate that EMSs differ meaningfully in the scope and strength of their associations with psychopathology. Rather than constituting a uniform transdiagnostic substrate, schemas appear to operate at different levels of the psychopathological hierarchy, with some functioning as broad cognitive-affective vulnerability factors and others reflecting more specific regulatory or interpersonal processes.

Self-administration of outpatient parenteral antimicrobial therapy (S-OPAT) aligns with the growing emphasis on patient and caregiver engagement in healthcare. Despite its potential benefits, S-OPAT use varies widely, suggesting that many eligible patients are not offered this option. Insight into S-OPAT decision-making is needed to improve its broader implementation and quality. The objectives of this study were to identify determinants that (i) influence healthcare professionals' (HCPs) decisions to offer S-OPAT and (ii) affect patients' and caregivers' acceptance or refusal of S-OPAT. Semi-structured interviews were performed with HCPs involved in S-OPAT and with patients and caregivers who either self-administered OPAT or declined S-OPAT. Participants were recruited from four hospitals and six home care organizations. Transcripts were analysed using thematic analysis. Fifty-one interviews were conducted with HCPs, patients and caregivers. The determinants reported were related to cognitions or affect (e.g. emotions or personality traits, such as patients' reluctance to accept help), skills and capabilities (e.g. patients' perceived skills for S-OPAT, or the ability of HCPs to explain what S-OPAT entails) and collaboration and communication (e.g. between healthcare organizations and between patients and caregivers). Decisions regarding S-OPAT are influenced by cognitive, skill-related, and collaborative determinants shaping inter-stakeholder cooperation. Addressing these determinants may help create a more person-centred approach and support further expansion of S-OPAT. We recommend increasing HCP awareness of S-OPAT, discussing S-OPAT with all patients or their caregivers, emphasizing the freedom to try S-OPAT, and tailoring the content, timing, and location of the S-OPAT offer to individual needs.

Objective: This is the first systematic review on the prevalence and clinical characteristics of 14 syndromes included in the Diagnostic Criteria for Psychosomatic Research (DCPR) across different settings. Data Sources: A systematic search was conducted using Web of Science to identify all English-language citing articles for DCPR key references (from 1995 to 2025). A manual search of the literature was also performed. Study Selection: Studies were eligible if they reported the prevalence and clinical characteristics of the DCPR syndromes. The initial search identified 604 reports. After removing duplicates, 524 reports were screened, and 375 full-text articles were examined. Ninety-six studies met the criteria for inclusion in the systematic review. Data Extraction and Synthesis: Data on sample size, number of cases and prevalence of each DCPR syndrome, setting, assessment methods and time(s), and overlaps between DCPR and DSM/ICD were extracted. Studies were grouped according to clinical domains (ie, stress and psychological manifestations, illness behavior and somatization, personality features). Results were reported as median prevalence and range for each DCPR syndrome based on available studies. Results: DCPR syndromes were found to be common in clinical settings, with higher prevalence than psychiatric diagnoses. The DCPR allowed identification of allostatic overload, demoralization, irritable mood, illness behavior, and various manifestations of somatization that otherwise would have gone undetected using standard diagnostic methods. Conclusions: Findings from this systematic review indicate that the DCPR are an essential integration to the customary psychiatric taxonomy, particularly in the setting of medical disease, with prognostic and therapeutic implications. The DCPR provide a unique clinimetric framework for optimal use of clinical judgment.

Background: The dissociative subtype of posttraumatic stress disorder (D-PTSD) was introduced in the DSM-5 to identify individuals with PTSD who experience dissociative symptoms, such as derealization and depersonalization. The Dissociative Subtype of PTSD Scale (DSPS) was developed to assess these symptoms but has yet to be validated in Ukrainian, a necessity due to the psychological impact of the ongoing conflict in Ukraine.Objective: This study aimed to develop and validate the Ukrainian version of the DSPS, examining its psychometric properties in a sample of trauma-exposed Ukrainian individuals.Methods: 1,119 Ukrainian participants, recruited using convenience and snowball sampling, took part in an online study assessing dissociative symptoms with the DSPS as well as symptoms of PTSD, depression, generalized anxiety disorder, somatic symptom disorder, and fear of sleep with established questionnaires. DSPS factor structure, internal consistency, and convergent and discriminant validity were assessed.Results: Confirmatory factor analysis confirmed the three-factor structure of the DSPS (derealization/depersonalization, loss of awareness, and psychogenic amnesia) with acceptable model fit indices for both lifetime and current severity items. Internal consistency was high for lifetime and current total scales (Cronbach's alpha&#x2009;=&#x2009;0.83-0.87). Significant correlations with PTSD, depression, anxiety, and somatic symptoms were in the expected size-ranges, supporting convergent and discriminant validity.Conclusions: The Ukrainian DSPS demonstrated robust psychometric properties, validating its use as a reliable and valid tool for assessing dissociative symptoms in individuals exposed to war-related trauma. Its adaptation fills a critical gap in the diagnostic landscape, enabling timely intervention for trauma-exposed populations in Ukraine. First Ukrainian validation of the DSPS among 1,119 trauma-exposed adults.CFA confirmed the three-factor structure for lifetime and current symptoms.Scale shows high internal consistency and strong convergent validity.Dissociation strongly correlates with somatic symptoms in war-affected samples.DSPS is a reliable tool for identifying D-PTSD in ongoing conflict settings. Antecedentes: El subtipo disociativo del trastorno de estr&#xe9;s postraum&#xe1;tico (TEPT-D) se introdujo en el DSM-5 para identificar individuos con TEPT que experimentan s&#xed;ntomas disociativos, como desrealizaci&#xf3;n y despersonalizaci&#xf3;n. La Escala de TEPT Subtipo Disociativo (DSPS) se desarrollo para evaluar estos s&#xed;ntomas, pero aun tiene que validarse en ucraniano, una necesidad debida al impacto psicol&#xf3;gico del conflicto en curso en Ucrania. Objetivo: Este estudio tuvo como objetivo desarrollar y Validar la versi&#xf3;n ucraniana de la DSPS, examinar sus propiedades psicom&#xe9;tricas en una muestra de individuos ucranianos expuestos a trauma. M&#xe9;todos: 1.119 participantes ucranianos, reclutados mediante muestreo por conveniencia y por bola de nieve, tomaron parte en un estudio en l&#xed;nea que evalu&#xf3; los s&#xed;ntomas disociativos con la DSPS, as&#xed; como los s&#xed;ntomas de TEPT, depresi&#xf3;n, trastorno de ansiedad generalizada, trastorno de s&#xed;ntomas som&#xe1;ticos y temor a dormir con cuestionarios establecidos. Se evaluaron la estructura factorial de la DSPS, la consistencia interna, la validez convergente y discriminante. Resultados: El an&#xe1;lisis factorial confirmatorio confirm&#xf3; la estructura trifactorial de la DSPS (desrealizaci&#xf3;n/despersonalizaci&#xf3;n, perdida de conciencia y amnesia psicog&#xe9;nica) con &#xed;ndices de ajuste del modelo aceptables tanto para los &#xed;tems de gravedad actual como para los de gravedad a lo largo de la vida. La consistencia interna fue alta para las escalas totales de por vida y actual (&#x3b1; de Cronbach&#x2009;=&#x2009;0,83-0,87). Las correlaciones significativas con el TEPT, depresi&#xf3;n, ansiedad y s&#xed;ntomas som&#xe1;ticos se mantuvieron dentro de los rangos esperados, lo que respalda la validez convergente y discriminante. Conclusiones: La DSPS ucraniana demostr&#xf3; s&#xf3;lidas propiedades psicom&#xe9;tricas, lo que valida su uso como un instrumento fiable y valido para evaluar s&#xed;ntomas disociativos en individuos expuestos a trauma relacionado con la guerra. Su adaptaci&#xf3;n cubre una brecha critica en el panorama diagn&#xf3;stico, permitiendo una intervenci&#xf3;n oportuna para poblaciones expuestas a trauma en Ucrania.