Personality disorder traits: Testing insight regarding presence of traits, impairment, and desire for change.

Abstract

Mixed findings exist as to whether personality pathology involves a critical lack of awareness and insight. Research questions about insight and awareness in personality pathology are typically assessed via comparing self- and informant reports of traits. However, recent studies have measured insight by asking individuals to evaluate additional questions about impairment and desire to change. The present study uses a variety of approaches to examine these issues, including investigations of convergence between self- and informant reports ( = 197 dyads; correlations and comparisons of means) of personality psychopathology, desired trait levels, and perceptions of impairment. Convergence was observed between levels of self- and informant-reported traits, desired traits, and impairment. However, individuals rated themselves higher on pathological trait levels and impairment than did their informants. Furthermore, individuals with relatively higher pathological traits desired higher levels of these traits (but lower than their actual scores) than individuals with lower scores; on the actual measurement scale, however, these higher scorers rated their desired level below the neutral point. Overall, individuals with pathological personality traits possess a reasonable degree of insight into their actual trait levels and associated impairment. (PsycINFO Database Record

The Development of the Informant Five-Factor Borderline Inventory

“…Previous research also has found higher self-informant agreement on low agreeableness traits. For example, Sleep et al (2019) found that antagonism (low agreeableness) had the highest self-informant agreement among the personality pathology domains based on the DSM-5 AMPD.…”

Self-Ratings of Personality Pathology: Insights Regarding Their Validity and Treatment Utility

“…For example, ambulatory assessment research using self-ratings, informant-ratings and audio recordings of real-world interactions indicates that individuals appear to show good awareness of how sociable and conscientious they are acting over the course of everyday interactions [23]; however, awareness may be poorer regarding how considerately and kindly one is behaving moment-to-moment. This latter finding is interesting given other research reviewed indicating that individuals possess considerable insight into their antagonistic tendencies [16,17]. Therefore, although self-rated assessment may be more valid than previously recognized, it will be important for future research integrating multiple assessment methods to determine ways in which PD self-ratings may be inaccurate or biased (e.g., determining the extent to which self-ratings of antagonism are accurate across contexts).…”

“…For example, one recent study found that clients report higher levels of many trait dimensions assessed by the PID-5 than their therapists [8], which would be unexpected if clients lacked insight. Other research indicates that individuals report higher levels of pathological traits and psychosocial impairment than do their informants [16], and individuals with elevated PD traits appear to show some capacity to recognize that these traits require intervention [7]. To provide an example involving specific PD traits, studies examining self-awareness of narcissistic traits indicate that individuals who are narcissistic describe themselves as arrogant and recognize that they behave narcissistically (e.g., by bragging and being exhibitionistic) [6,17].…”

A Brief but Comprehensive Review of Research on the Alternative DSM-5 Model for Personality Disorders

“…First, several studies have investigated self-other agreement with regard to trait domains and facets, mostly showing acceptable results with average correlations around 0.40 ( [41, 67, 89, 150, 153-158]; see [159], for a recent metaanalysis). Notably, participants tended to rate themselves as higher in maladaptive trait levels than their informants or therapists reported [157,158]. Second, convergent and discriminant validity with regard to alternative measures of maladaptive traits such as the Dimensional Assessment of Personality Pathology -Basic Questionnaire (DAPP-BQ) [160] or the Computer Adaptive Test of Personality Disorder (CAT-PD) [161] were high, as suggested by strong associations of PID-5 domain scores with conceptually similar trait domains and lower associations with conceptually unrelated trait domains [59, 75,145,147,[162][163][164][165][166][167][168][169].…”

“…Other examples are studies showing that individual differences in trait facets are relatively stable across periods of 2 weeks [57, 235], 4 months [285], and more than 1 year [286]. Further issues that have been addressed include measurement invariance or item bias due to age [287,288], gender [217,289], and clinical status [290]; response styles in PID-5 self-reports [154,155,291,292]; heritability and familial aggregation of maladaptive traits [39,289,[293][294][295]; and perceived likability, impairment, functionality, as well as desire and ability for change of maladaptive traits [68,158,[296][297][298].…”