Paul A Pilkonis

University of Pittsburgh | Pitt · Department of Psychiatry

Background Mindfulness meditation is ubiquitous in health care, education, and communities at large. Mindfulness-Based Interventions (MBIs) are the focus of hundreds of NIH-funded trials given the myriad health benefits associated with this practice across multiple populations. Notwithstanding, significant gaps exist in how mindfulness concepts are...

Objective: Interpersonal and emotional functioning are closely linked and reciprocally influence one another. Contemporary integrative interpersonal theory (CIIT) offers a useful framework to conceptualize these patterns and guide interventions in cases where these patterns result in dysfunction. Stress processes offer several dynamic frameworks to...

Objective: The Emotion Dysregulation Inventory (EDI) was designed and validated to quantify emotion dysregulation (ED) in ages 6+. The purpose of this study was to adapt the EDI for use in young children (EDI-YC). Method: Caregivers of 2139 young children (ages 2-5) completed 48 candidate EDI-YC items. Factor and item response theory (IRT) analy...

Objective: Interpersonal and emotional functioning are closely linked, and reciprocally influence one another. Contemporary Integrative Interpersonal Theory (CIIT) offers a useful framework to study these patterns. Stress processes offer several candidate targets for empirical investigation with methods that allow for fine-grained analyses in the c...

Interpersonal functioning involves an interplay of subjective perceptions and overt behavior. This study examines alignment between self and informant perceptions of momentary behavior to enrich the nomological networks for the domains of dominance and affiliation. We studied a sample of romantic couples ( N = 210 individuals) who rated their own a...

The field of personality disorder research has grown since the publication of the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, in 1980; with a notable evolution in the way that personality disorders are defined and operationalized. In evaluating this research, it is necessary to consider the range of sampling practices used...

Background Borderline personality disorder (BPD) is characterized by an elevated distress response to social exclusion (i.e., rejection distress), whose neural mechanisms remain unclear. fMRI studies of social exclusion have relied on the classic version of the Cyberball task, which is not optimized for fMRI. Our goal was to clarify the neural subs...

Perceptions of situations are a critical mechanism linking persons and situations. Many personality theories assume that the abstractness of situational attributes is a key dimension that magnifies or minimizes individual differences in how people respond to situation¬s. In this pre-registered study, we evaluated this basic property of situations a...

We conducted secondary analyses of existing data to examine the association between parent scores on the Knowledge of Effective Parenting Test (KEPT) and child symptoms of Conduct Disorder (CD) and Oppositional Defiant Disorder (ODD). Parent knowledge of behavior management skills and child behavior symptoms were assessed in a nationally representa...

The predominant focus in attachment research on trait-like individual differences has overshadowed investigation of the ways in which working models of attachment represent dynamic, interpersonally responsive socio-affective systems. Intensive longitudinal designs extend previous work by evaluating to what extent attachment varies over social inter...

Objective: Social relationships are a critical context for children's socioemotional development and their quality is closely linked with concurrent and future physical and emotional wellbeing. However, brief self-report measures of social relationship quality that translate across middle childhood, adolescence, and adulthood are lacking, limiting...

Interpersonal functioning involves an interplay of subjective perceptions and overt behavior. This study examines agreement between self and informant reports of behavior measured naturalistically to investigate the associations between observable behavior, self-perceptions, and others’ perceptions and to enrich the nomological networks for the dom...

Objective To provide national norms and percentiles for both research and clinical scoring modalities of the Vanderbilt Attention Deficit/Hyperactivity Disorder (ADHD) Diagnostic Parent Rating Scale (VADPRS) for a representative sample of children ages 5–12 in the United States. Method The five clinical subscales of the VADPRS were completed by 1,...

We previously developed a three-item screener for identifying respondents with any personality disorder (PD) using the Inventory of Interpersonal Problems (IIP). The current goal was to examine the convergent validity of the IIP-3 with other PD screeners and diagnostic tools and to investigate its relationship to measures of adult attachment and em...

Anxiety and depressive disorders are global public health concerns, and research suggests that these disorders are common in parents and can adversely influence family functioning. However, little is known about normative levels of anxiety and depressive symptoms in parents of school-age children. The present study reports on generalized anxiety an...

Objective: Emotion regulation (ER) is a multi-faceted and dynamic process relevant to both normative emotional development and transdiagnostic emotional dysfunction for a range of psychological disorders. There has been tremendous growth in ER research over the past decade, including the development of numerous new measures to assess ER. This Evide...

Questions persist in the parenting literature regarding how best to define positive and negative parenting behaviors. Are there optimal parenting behaviors shared by mothers and fathers, or among different racial and ethnic groups? This study draws from a nationally representative sample of US parents of school-age children, testing aspects of meas...

The predominant focus in attachment research on trait-like individual differences has overshadowed investigation of the ways in which working models of attachment represent dynamic, interpersonally responsive socio-affective systems. Intensive longitudinal designs extend previous work by evaluating to what extent attachment varies over social inter...

Individuals with personality disorders often experience romantic relationship dysfunction and have an insecure attachment style. Here, we examined attachment dynamics in dyadic interactions, focusing specifically on the role of physiological coregulation in state attachment processes in couples oversampled for personality pathology. A total of 121...

We previously developed a three-item screener for identifying respondents with any personality disorder (PD) using the Inventory of Interpersonal Problems (IIP). The current goal was to examine the convergent validity of the IIP-3 with other PD screeners and diagnostic tools and to investigate its relationship to measures of adult attachment and em...

A model of personality pathology including both general and specific components distinguishes severity of personality dysfunction from the characteristic style of its expression. This model has been proposed as an empirically based, dimensional alternative to categorical models. In this study, we evaluated this conceptual structure by examining ass...

A model of personality pathology including both general and specific components distinguishes severity of personality dysfunction from the characteristic style of its expression. Whether and how general and specific features of personality pathology relate to momentary dynamics of affect and interpersonal behavior remain open questions. We explored...

Insecure attachment and borderline personality disorder (BPD) are defined by similar affective and interpersonal processes. Individuals diagnosed with BPD, however, represent only a subset of those described as insecurely attached, suggesting that attachment may hold broader relevance for socio-affective functioning. Based on a 21-day ecological mo...

Researchers are increasingly interested in the affect dynamics of individuals for describing and explaining personality and psychopathology. Recently, the incremental validity of more complex indicators of affect dynamics (IADs; e.g. autoregression) has been called into question (Dejonckheere et al., 2019), with evidence accumulating that these mig...

Interpersonal dysfunction is a core feature of personality disorders, often affecting close relationships. Nevertheless, little is known about the moment-to-moment dynamic processes by which personality pathology contributes to dysfunctional relationships. Here, we investigated the role of physiological attunement during a conflict discussion in ro...

Researchers are increasingly interested in the affect dynamics of individuals for describing and explaining personality and psychopathology. Recently, the incremental validity of more complex indicators of affect dynamics (IADs; e.g., autoregression) has been called into question (Dejonckheere et al., 2019), with evidence accumulating that those mi...

Little is known about pathogenic affective processes that cut across diverse mental disorders. We examine how dynamic features of positive and negative affect differ or converge across internalizing and externalizing disorders in a diagnostically diverse urban sample using bivariate dynamic structural equation modeling. One-hundred fifty-six young...

Objective: Psychopathology research has relied on discrete diagnoses, which neglects the unique manifestations of each individual's pathology. Borderline personality disorder combines interpersonal, affective, and behavioral regulation impairments making it particularly ill-suited to a "one size fits all" diagnosis. Clinical assessment and case fo...

Objective: We describe the development and psychometric properties of an instrument designed to assess the use of effective parenting skills reported with a daily diary. The Parenting Skill Use Diary (PSUD) was developed iteratively relying on a “common elements” approach to quantify the use of evidence-based parenting techniques for responding to...

Objective: The Emotion Dysregulation Inventory (EDI) is an informant questionnaire developed based on the Patient-Reported Outcomes Measurement Information System (PROMIS®) Scientific Standards and refined through factor analyses and item response theory (IRT) analyses. Although it was developed to improve measurement of emotion dysregulation in yo...

Insecure attachment and borderline personality disorder (BPD) are defined by similar affective and interpersonal processes. Individuals diagnosed with BPD, however, represent only a subset of those described as insecurely attached, suggesting that attachment may hold broader relevance for socio-affective functioning. Based on a 21-day ecological mo...

Interpersonal dysfunction is considered a cornerstone of borderline personality disorder (BPD). Relationships are described as intense and unstable, with individuals with BPD alternating between idealization and devaluation of relationship partners. Furthermore, a lack of stable and supportive relationships may be related to symptom maintenance and...

A model of personality pathology including both general and specific components distinguishes severity of personality dysfunction from the characteristic style of its expression. Whether and how general and specific features of personality pathology relate to momentary dynamics of affect and interpersonal behavior remain open questions. We explored...

Interpersonal problems are key transdiagnostic constructs in psychopathology. In the past, investigators have neglected the importance of operationalizing interpersonal problems according to their latent structure by using divergent representations of the construct: (a) computing scores for severity, agency, and communion (“dimensional approach”),...

Interpersonal problems are key transdiagnostic constructs in psychopathology. In the past, investigators have neglected the importance of operationalizing interpersonal problems according to their latent structure by using divergent representations of the construct: (a) computing scores for severity, agency, and communion (“dimensional approach”),...

Background: There is a need for valid self-report measures of core health-related quality of life (HRQoL) domains. Objective: To derive brief, reliable and valid health profile measures from the Patient Reported Outcomes Measurement Information System® (PROMIS®) item banks. Methods: Literature review, investigator consensus process, item respo...

Two dimensional, hierarchical classification models of personality pathology have emerged as alternatives to traditional categorical systems: multi-tiered models with increasing numbers of factors and models that distinguish between a general factor of severity and specific factors reflecting style. Using a large sample (N=840) with a range of psyc...

Few studies have examined behaviors in romantic relationships associated with borderline personality disorder (BPD). We assessed critical variables from marital research: the emotional bank account (positive-to-negative behaviors) and the four horsemen of the apocalypse (criticism, defensiveness, contempt, and stonewalling). Couples (N = 130, or 26...

Interpersonal dysfunction is a core feature of personality disorders, often affecting close relationships. Nevertheless, relatively little is known about the moment-to-moment interactional processes that contribute to discord. Here, we investigated the role of physiological attunement during a conflict discussion in romantic couples oversampled for...

We report on the development and psychometric properties of an instrument for the assessment of knowledge of effective parenting skills specific to conduct problems using an item response theory (IRT) framework. The initial item pool (36 items) for the Knowledge of Effective Parenting Test (KEPT) was administered online to a national sample (N = 1,...

Personality disorders (PDs) are commonly associated with romantic relationship disturbance. However, research has seldom evaluated who people with high PD severity partner with, and what explains the link between PD severity and romantic relationship disturbance. First, we examined the degree to which people match with partners with similar levels...

The association between depression and neuroticism is complex; however, because of the difficulty in assessing neuroticism during mood episodes, the mechanisms underlying this relationship remain poorly understood. In this study, we sought to decompose neuroticism into finer grained elements that were uncorrelated with psychiatric symptoms and exam...

To encourage screening for personality disorders (PDs), we developed (in previous work) self-report scales for PDs using the Inventory of Interpersonal Problems (IIP). The combined score from three of the scales-inter-personal sensitivity, interpersonal ambivalence, and aggression-requiring 15 items (IIP-15) did the best job of distinguishing betwe...

Two dimensional, hierarchical classification models of personality pathology have emerged as alternatives to traditional categorical systems: multi-tiered models with increasing numbers of factors and models that distinguish between severity and style. To evaluate the validity of these proposed theoretical structures, we compared factor analytic mo...

Background: Borderline Personality Disorder (BPD) is associated with sensitivity to signals of interpersonal threats and misplaced trust in others. The amygdala, an integral part of the threat evaluation and response network, responds to both fear- and trust-related stimuli in non-clinical samples, and is more sensitive to emotional stimuli in BPD...

Objective: Psychopathology research is transitioning from relying on discrete diagnoses to domains of transdiagnostic processes. Although this resolves many problems, this research is largely based on nomothetic principles and reflects between-person differences assessed at one point in time. However, transdiagnostic domains of individual differenc...

The lack of sensitive measures suitable for use across the range of functioning in autism spectrum disorder (ASD) is a barrier to treatment development and monitoring. The Emotion Dysregulation Inventory (EDI) is a caregiver-report questionnaire designed to capture emotional distress and problems with emotion regulation in both minimally verbal and...

Objectives The PROMIS-Preference (PROPr) score is a recently developed summary score for the Patient-Reported Outcomes Measurement Information System (PROMIS). PROPr is a preference-based scoring system for seven PROMIS domains created using multiplicative multi-attribute utility theory. It serves as a generic, societal, preference-based summary sc...

Purpose: Health status descriptive systems based on item response theory (IRT), such as the Patient-Reported Outcomes Measurement Information System (PROMIS®), have item banks to measure domains of health. We developed a method to present such banks for health-state valuation. Methods: We evaluated four different presentation approaches: a singl...

We investigated the latent structure of narcissistic personality disorder by comparing dimensional, hybrid, and categorical latent variable models, using confirmatory factor analysis (CFA), nonparametric and semiparametric factor analysis, and latent class analysis, respectively. We first explored these models in a clinical sample and then preregis...

Background: Health-related quality of life (HRQL) preference-based scores are used to assess the health of populations and patients and for cost-effectiveness analyses. The National Institutes of Health Patient-Reported Outcomes Measurement Information System (PROMIS®) consists of patient-reported outcome measures developed using item response the...

We examined event-contingent recording of daily interpersonal interactions in a diagnostically diverse sample of 101 psychiatric outpatients who were involved in a romantic relationship. We tested whether the unique effect of borderline personality disorder (BPD) symptoms on affective responses (i.e., hostility, sadness, guilt, fear, and positive a...

FULL PREPRINT LINK: https://psyarxiv.com/tv7r9/ We investigated the latent structure of narcissistic personality disorder (NPD) by comparing dimensional, hybrid, and categorical latent variable models, using confirmatory factor analysis (CFA), non-parametric (NP-FA) and semi-parametric factor analysis (SP-FA), and latent class analysis, respective...

Lay summary: This paper describes a new measure of poor emotional control called the Emotion Dysregulation Inventory (EDI). Caregivers of 1,755 youth with ASD completed candidate items, and advanced statistical techniques were applied to identify the best final items. The EDI is unique because it captures common emotional problems in ASD and is ap...

Study Objectives To develop and evaluate the measurement properties of child-report and parent-proxy versions of the PROMIS ® Pediatric Sleep Disturbance and Sleep-Related Impairment item banks. Methods A national sample of 1,104 children (8-17 years-old) and 1,477 parents of children 5-17 years-old was recruited from an internet panel to evaluate...

Calls have increased to place interpersonal and self-disturbance as defining features of personality disorders (PDs). Findings from a methodologically diverse set of studies suggest that a common factor undergirds all PDs. The nature of this core of PDs, however, is not clear. In the current study, interviews were completed for DSM-IV PD diagnosis...

We examined event-contingent recording (ECR) of daily interpersonal interactions in a diagnostically diverse sample of 101 psychiatric outpatients who were involved in a romantic relationship. We tested whether the unique effect of borderline personality disorder (BPD) symptoms on affective responses (i.e., hostility, sadness, guilt, fear, positive...

PurposeNational initiatives, such as the UK Improving Access to Psychological Therapies program (IAPT), demonstrate the feasibility of conducting empirical mental health assessments on a large scale, and similar initiatives exist in other countries. However, there is a lack of international consensus on which outcome domains are most salient to mon...

Purpose: We sought to select a parsimonious subset of domains from the patient-reported outcomes measurement information system (PROMIS(®)) that could be used for preference-based valuation. Domain selection criteria included face validity, comprehensiveness, and structural independence. Methods: First, 9 health outcomes measurement experts sele...

Narcissism has significant interpersonal costs, yet little research has examined behavioral and affective patterns characteristic of narcissism in naturalistic settings. Here we studied the effect of narcissistic features on the dynamic processes of interpersonal behavior and affect in daily life. We used interpersonal theory to generate transactio...

Objective There is a need to monitor patients receiving prescription opioids to detect possible signs of abuse. To address this need, we developed and calibrated an item bank for severity of abuse of prescription pain medication as part of the Patient-Reported Outcomes Measurement Information System (PROMIS®). Methods Comprehensive literature sear...

We examined the relationship between psychopathology and interpersonal problems in a sample of 825 clinical and community participants. Sixteen psychiatric diagnoses and five transdiagnostic dimensions were examined in relation to self-reported interpersonal problems. The structural summary method was used with the Inventory of Interpersonal Proble...

This manuscript has been accepted for publication at the Journal of Abnormal Psychology (http://www.apa.org/pubs/journals/abn). The American Psychological Association retains the copyright. It been copyedited and is not the final version of record. Additionally, Supplementary Materials and Mplus output files for the models that make up this study a...

Introduction There is no standard pediatric self-report measure of sleep health. Furthermore, existing measures have not been informed by stakeholders or developed using rigorous measurement science. The Patient Reported Outcomes Measurement Information System (PROMIS®) has produced over 100 person-centered measures that evaluate physical, mental,...

Theoretical and empirical work suggests that aggression in those with borderline personality disorder (BPD) occurs primarily in the context of emotional reactivity, especially anger and shame, in response to perceived rejection. Using intensive repeated measures, we examined a within-person process model in which perceived rejection predicts increa...

We examined the relationship between psychopathology and interpersonal problems in a sample of 825 clinical and community participants. Sixteen psychiatric diagnoses and five transdiagnostic dimensions were examined in relation to self-reported interpersonal problems. The structural summary method was used with the Inventory of Interpersonal Proble...

Examining differences in social integration, social support, and relationship characteristics in social networks may be critical for understanding the character and costs of the social difficulties experienced of borderline personality disorder (BPD). We conducted an ego-based (self-reported, individual) social network analysis of 142 participants...

Purpose: The field of patient-centered outcomes research (PCOR) continues to develop. Patient-reported outcomes and, in particular the Patient-Reported Outcomes Measurement Information System (PROMIS) contribute complementary data to clinician-derived outcomes traditionally used in health decision-making. However, there has been little work to und...