Sharp Carla, Dong Fanghong, Boone Kiran, Gilbert Kirsten E, Tillman Rebecca, Barch Deanna M, Luby Joan L, Whalen Diana J
Department of Psychology, University of Houston.
Department of Psychiatry, Washington University School of Medicine in St. Louis.
J Psychopathol Clin Sci. 2025 Aug 21. doi: 10.1037/abn0001044.
The Alternative Model for Personality Disorders is a dimensional model of personality disorder that describes difficulties in self- and interpersonal functioning as the common core of personality disorder and its hypothesized developmental pathway. However, empirical evidence in support of this developmental pathway is lacking, and the unique developmental relevance of self- and interpersonal functioning for the emergence of personality pathology independent from internalizing and externalizing psychopathology remains unknown. The aim of this preregistered study (which can be found in the additional online materials at https://osf.io/xqc4u) was to leverage data from the 17-year prospective Preschool Depression Study including 348 participants, oversampled for depression, to evaluate the respective predictive utility of self and interpersonal functioning for the later development of personality pathology (in a subsample of 187 participants). Self- and interpersonal functioning were operationalized with self and interpersonal items from the Preschool Age Psychiatric Assessment and Child and Adolescent Psychiatric Assessment. The final model included seven time points ( = 4.5-12.2, = 0.8-1.1) for self-functioning and four time points (age 8 onward) for interpersonal functioning. Personality pathology in late adolescence was operationalized with the borderline personality disorder Features Scale for Children at Time Points 9 and 10 ( = 16.3-18.6, = 1.1-1.2; = 187). When considered separately, bivariate growth curve modeling demonstrated significant intercepts and slopes for self-functioning (standardized intercept estimate = 0.206, standardized slope estimate = 0.357), and marginally significant slopes for interpersonal trajectories with borderline personality disorder (standardized slope estimate = 0.233). When considered together, using a reduced model for trajectories, multivariate growth curve modeling showed predictive utility for self-functioning (standardized intercept estimate = 0.436, standardized slope estimate = 0.301) only, independent of internalizing and externalizing symptoms. Results point to the importance of incorporating explicit consideration of self-functioning in the conceptualization of personality, especially from a developmental point of view in service of prevention and early intervention for personality disorder. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
人格障碍替代模型是一种人格障碍的维度模型，它将自我和人际功能方面的困难描述为人格障碍及其假定发展路径的共同核心。然而，缺乏支持这一发展路径的实证证据，而且自我和人际功能对于人格病理学出现的独特发展相关性，独立于内化和外化精神病理学之外，仍然未知。这项预先注册的研究（可在https://osf.io/xqc4u的附加在线材料中找到）的目的是利用来自为期17年的学前抑郁研究的数据，该研究包括348名参与者，因抑郁而进行了过度抽样，以评估自我和人际功能对人格病理学后期发展的各自预测效用（在187名参与者的子样本中）。自我和人际功能通过学前年龄精神病学评估以及儿童和青少年精神病学评估中的自我和人际项目来操作化。最终模型包括自我功能的七个时间点（年龄 = 4.5 - 12.2岁，标准差 = 0.8 - 1.1）和人际功能的四个时间点（8岁及以后）。青少年晚期的人格病理学通过时间点9和10的儿童边缘型人格障碍特征量表来操作化（年龄 = 16.3 - 18.6岁，标准差 = 1.1 - 1.2；样本量 = 187）。单独考虑时，双变量增长曲线模型显示自我功能有显著的截距和斜率（标准化截距估计值 = 0.206，标准化斜率估计值 = 0.357），人际轨迹与边缘型人格障碍有边缘显著的斜率（标准化斜率估计值 = 0.233）。综合考虑时，使用简化的轨迹模型，多变量增长曲线模型仅显示自我功能有预测效用（标准化截距估计值 = 0.436，标准化斜率估计值 = 0.301），独立于内化和外化症状。结果表明在人格概念化中明确考虑自我功能的重要性，特别是从发展的角度来看，以服务于人格障碍的预防和早期干预。（《心理学文摘数据库记录》（c）2025美国心理学会，保留所有权利）
