Do normal personality traits connect to the dynamic processes of psychopathology?

Abstract

The purpose of this article is to reveal whether traits can predict the core processes constituting borderline personality disorder (BPD). A large sample, including many with BPD, completed personality questionnaires and reported trigger and symptom experiences 5 times per day for 2 weeks. Multilevel modeling revealed first that symptoms were strongly contingent upon concurrent triggers and that BPD's association to symptoms was largely due to this contingency. Second, personality traits predicted all components of this process: trigger experiences, symptom intensity, and the contingency of the symptoms on triggers. However, normal personality traits only partially accounted for the heightened experience of triggers, elevated symptoms, and magnified reactivity to triggers among those with BPD. Thus, normal personality traits are capable of explaining the dynamic processes characteristic of clinical disorders, meaning that normal traits can elucidate even complex dynamic clinical processes. However, traits appear to only partially contain the active ingredients responsible for the core process in BPD. Aspects of the disorder other than traits may account for the heightened trigger experience, elevated symptom intensity, and magnified reactivity to triggers in those with BPD.

Traits are dynamic.

“…However, the b value dropped way down to .10 for the relationship of BPD with the contingency of symptoms on triggers. In sum, the conclusions from Miskewicz et al (2022) are the strong relationship of BPD to intensity of triggers and symptoms, these relationships being well accounted for by the maladaptive traits, and the considerable reduction for BPD when considering the relationship with the contingency of symptoms on triggers.…”

“…In this case, as to whether traits can adequately account for moment-to-moment contingencies within everyday life, more specifically, trigger experiences, symptom intensity, and the contingency of the symptoms on the triggers. There are though a number of fundamental conceptual, methodological, and empirical problems that should dampen enthusiasm for Miskewicz et al (2022).…”

“…The debate though is now shifting away from the coverage of the Diagnostic and Statistical Manual of Mental Disorders , Fifth Edition , Section II personality disorders to the coverage of moment-to-moment contingencies within everyday life. Miskewicz et al (2022) reported that trait models do account well for the intensity of triggers and the symptomatic response to these triggers but not for the contingency of the symptoms on the triggers. However, there are fundamental conceptual, methodological, and empirical problems that should question its apparent critique of the 5-factor model of personality disorder.…”

Personality lives in the intersubjective space between people: Comment on Miskewicz et al. (2022).

“…In this intriguing and methodologically sophisticated study, Miskewicz et al (2022) ask to what extent baseline normal traits (HEXACO) and/or maladaptive traits Personality Inventory for DSM-5 (PID-5) and borderline personality disorder (BPD) diagnosis Structured Interview for DSM-IV Personality (SIDP-IV) predict the core processes of BPD manifestation in daily life. "Core processes of BPD manifestation" are operationalized as trigger-symptom contingencies in an ecological momentary assessment design in which 282 participants, oversampled for BPD, were asked over a 2-week period, five times per day, whether they experienced BPD-relevant triggers in the last 60 min (rejection, abandonment, interpersonal offense, boredom, betrayal, chaos, major events, failures, isolation, disappointment, and identity threat).…”

Where are the active ingredients for borderline personality disorder? The importance of heightened triggers, two arguments for traits, and two arguments for Criterion A.

“…We were delighted by theuniversal agreement that the Miskewicz et al (2022) approach is vital to resolving the connection between traits and disorders. Clinical phenomena are dynamic, but psychologists have very little knowledge about the dynamics of traits.…”