Modes: Cohesive personality states and their interrelationships as organizing concepts in psychopathology.

Abstract

We propose a transdiagnostic approach that centers on modes, state-like manifestations of personality that function as cohesive organizational units. Modes are characterized by specific profiles of affects, behaviors, cognitions, and desires that tend to be coactivated. Each mode is typically experienced as having its own distinct experiential and agentic qualities. A mode-based approach to psychopathology builds on recent analytic and methodological developments which demonstrate the value of modeling personality states dynamically, as well as on longstanding theoretical and empirical traditions that highlight the pragmatic clinical utility of such conceptualizations. We seek to illustrate how the conceptualization of psychopathology in terms of modes and their dynamic interrelations holds considerable transdiagnostic promise. As background, we review both theory and research from philosophical accounts of selfhood, developmental psychology, social and personality psychology, and diverse psychotherapy models that lay the foundation for this mode-based approach to psychopathology. We elaborate on this foundation and (in ) provide examples of the approach’s explicit or implicit relevance to several classes of psychopathology, including dissociative, trauma-related, mood, anxiety, obsessional, substance, psychotic, and personality disorders. After addressing the clinical utility of mode-based conceptualizations, we lay out a research blueprint for assessing and modeling modes, and (in ) present a broader research agenda highlighting intriguing empirical questions regarding modes in psychopathology. We conclude by noting that the time seems ripe for modes to be (re-)introduced as an organizing construct for understanding psychopathology and personality.

A bibliometric analysis of the quantitative schema therapy literature

“…However, this questionnaire was initially developed to measure modes in individuals with personality disorders and lacks subscales for modes known clinically to be important in other presentations, such as the over-controller mode in eating disorders (Simpson et al, 2018). Although a key target of schema therapy is developing the capacity to recognize and regulate modes, empirical support for the schema modes concept appears to be limited, particularly in terms of how modes develop and their neurological correlates (Lazarus & Rafaeli, 2021).…”

Theories of psychopathology: Potential to promote clinical science, empowerment, and justice.

“…The concept of multiplicity of personality has not been widely adopted in academic psychology as a basis for understanding psychopathology, despite its longstanding role across diverse literature and its reputation among clinicians as a transformative tool in psychotherapy (Heller et al, 2006). The Lazarus and Rafaeli (2023) article notes that “modes have received very little empirical scrutiny, and have been underemphasized in contemporary research on psychopathology” (p. 244). The framework presented by Lazarus and Rafaeli provides a fresh foundation for such research.…”

Heterotypic patterns, psychopathology beyond symptomatology, and the legacy constructs of the DSM-ICD.

“…Interestingly, our conceptualization of these phenotypes could potentially be supplemented psychologically by thinking of them as what Lazarus and Rafaeli (2023) call “modes.” The phenotypes are stress-related constellations of cognitions, emotions, and behaviors, but as modes each one also has distinct experiential and agentic qualities. If so, changes in one’s subjective sense of self-in-the-world may be important pathoplastic factors in symptom formation.…”