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Purpose of Review We discuss the implications of the Research Domain Criteria (RDoC) initiative for neuroscience research on personality disorder (PD). To organize our review, we construct a preliminary conceptual mapping of PD symptom criteria onto RDoC constructs. We then highlight recent neuroscience research, often built around concepts that correspond to RDoC elements, and discuss the findings in reference to the constructs we consider most pertinent to PD. Recent Findings PD symptoms were strongly conceptually tied to RDoC constructs within the Social Processes domain, implicating brain systems involved in interpersonal rejection, facial emotion perception, and self-referential processes. Negative and Positive Valence Systems were conceptually associated with many PD symptoms, with particular relevance ascribed to the latter’s Reward Valuation construct, which could reflect a more widespread disruption of computational processes involved in estimating the probability and benefits of a future outcome. Within the Cognitive Systems domain, the Cognitive Control construct mainly related to PD symptoms associated with impulse control, suggesting a connection to neural circuits that underlie goal selection and behavioral control. Arousal and Regulatory Systems could only be conceptually mapped onto PD symptoms through the Arousal construct, with different symptoms reflecting either a higher or lower biological sensitivity to internal and external stimuli. Summary The RDoC framework has promise to advance neuroscience research on PD. The Social Processes domain is especially relevant to PD, although constructs falling within the other RDoC domains could also yield important insights into the neurobiology of PD and its connections with other forms of psychopathology. Identifying RDoC constructs (e.g., habit formation) that subserve more fundamental processes relevant to personality functioning warrants further investigation.
The NIMH Research Domain Criteria (RDoC) Initiative and Its
Implications for Research on Personality Disorder
Jacob W. Koudys
&Jenna M. Traynor
&Achala H. Rodrigo
&Dean Carcone
&Anthony C. Ruocco
Published online: 27 April 2019
#Springer Science+Business Media, LLC, part of Springer Nature 2019
Purpose of Review We discuss the implications of the Research Domain Criteria (RDoC) initiative for neuroscience research on
personality disorder (PD). To organize our review, we construct a preliminary conceptual mapping of PD symptom criteria onto
RDoC constructs. We then highlight recent neuroscience research, often built around concepts that correspond to RDoC ele-
ments, and discuss the findings in reference to the constructs we consider most pertinent to PD.
Recent Findings PD symptoms were strongly conceptually tied to RDoC constructs within the Social Processes domain, impli-
cating brain systems involved in interpersonal rejection, facial emotion perception, and self-referential processes. Negative and
Positive Valence Systems were conceptually associated with many PD symptoms, with particular relevance ascribed to the
latters Reward Valuation construct, which could reflect a more widespread disruption of computational processes involved in
estimating the probability and benefits of a future outcome. Within the Cognitive Systems domain, the Cognitive Control
construct mainly related to PD symptoms associated with impulse control, suggesting a connection to neural circuits that underlie
goal selection and behavioral control. Arousal and Regulatory Systems could only be conceptually mapped onto PD symptoms
through the Arousal construct, with different symptoms reflecting either a higher or lower biological sensitivity to internal and
external stimuli.
Summary The RDoC framework has promise to advance neuroscience research on PD. The Social Processes domain is espe-
cially relevant to PD, although constructs falling within the other RDoC domains could also yield important insights into the
neurobiology of PD and its connections with other forms of psychopathology. Identifying RDoC constructs (e.g., habit forma-
tion) that subserve more fundamental processes relevant to personality functioning warrants further investigation.
Keywords Research domain criteria .Personality disorder .Negative valence systems .Positive valence systems .Cognitive
systems .Social processes
The National Institute of Mental Health proposed the
Research Domain Criteria (RDoC) in 2010 [1] as a new com-
mon framework for the development and integration of re-
search across multiple domains and levels of analysis. The
structure of the RDoC framework has been revised and up-
dated during its development and initial deployment, with the
most recent version published online on May 30, 2018 [2,
3••]. In the current framework, psychological constructs are
organized within five superordinate domains: Negative
Vale nce S y s t em s ,Positive Valence Systems,Cognitive
Systems,Social Processes,andArousal and Regulatory
Systems. Each domain is further divided into constructs and
subconstructs, each of which contains elements which may be
explored using seven different units of analysis: Molecules,
Paradigms. These constructs and units of analysis form the
rows and columns, respectively, of the RDoC Matrix. Prior to
May 2017, a Genes column was also represented as a unit of
analysis but was removed due to the present lack of robust
evidence of association between specific genes and
This article is part of the Topical Collection on Personality Disorders
*Anthony C. Ruocco
Department of Psychology, University of Toronto Scarborough,
Toronto M1C 1A4, Canada
Department of Psychological Clinical Science, University of
Toronto, Toronto, Canada
Current Psychiatry Reports (2019) 21: 37
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
... Despite its long history (beginning in 192 AD, when Galen linked the three maladaptive Hippocratic humors to personality types), psychiatric nosology has grappled with how best to classify personality disorders (PDs). Over the years, this challenge has been reflected in alternative approaches, such as subtypes within categories (e.g., Russ et al. 2008), prototypes (e.g., Westen et al. 2006), Research Domain Criteria (RDoC) (Koudys et al. 2019), transdiagnostic approaches (Livesley 2003), clinical staging (Chanen et al. 2016), and the Hierarchical Taxonomy of Psychopathology (HiTOP) (Kotov et al. 2017). Common among alternative approaches have been persistent criticisms of the International Classification of Diseases (ICD) and Diagnostic and Statistical Manual of Mental Disorders (DSM) categorical diagnostic systems and vocal calls to abolish such systems in favor of a dimensional classification system. ...
... Specifically, these theories (Blatt & Lerner 1983;Fonagy & Bateman 2009;Kernberg 1967Kernberg , 1984Livesley 2003;Masterson 1988) postulate that the defining features and core of personality pathology, and thus the general severity criterion common to all PDs, are defined as maladaptive self and interpersonal functioning, denoting an intrapsychic delay or impairment that interferes with an individual's capacity for understanding and managing the self in affectively charged attachment and/or interpersonal contexts, thereby prohibiting or delaying adequate adult role function. Further excitement over the introduction of LPF was generated because of its close alignment with the National Institute of Mental Health RDoC domain of Systems for Social Processes, which includes the processes of affiliation and attachment, social communication, perception and understanding of self, and perception and understanding of others, thereby opening up the possibility of neuroscientific advances in the conceptualization of personality pathology , Koudys et al. 2019). ...
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Level of Personality Functioning (LPF) represents the entry criterion (Criterion A) of the Alternative Model for Personality Disorders (AMPD) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). It is defined as a dimensional general severity criterion common to all personality disorders and conceptually independent of personality types or traits, and it represents maladaptive self (identity and self-direction) and interpersonal (empathy and intimacy) functioning. We review the history, measurement, and significance of LPF. We show that the inclusion of LPF in the AMPD is well justified if it is defined as a general adaptive failure of a subjective intrapsychic system needed to fulfill adult life tasks. If so defined, LPF distinguishes itself from maladaptive traits (Criterion B of the AMPD) and captures the contribution humans make as agentic authors to the interpretation and management of the self. While Criterion B maladaptive traits provide important descriptive nuance to manifestations of personality pathology, maladaptive LPF is conditional to the diagnosis of personality disorder. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 17 is May 7, 2021. Please see for revised estimates.
... Impulsivity is a core symptom of BPD that is stable across time and predicts BPD psychopathology over several years (Links, Heslegrave, & Reekum, 1999). The cognitive processes underlying impulsivity in BPD have not yet been fully identified, although deficits in so-called 'executive functions' that facilitate goal-directed behaviors are likely candidates (Koudys, Traynor, Rodrigo, Carcone, & Ruocco, 2019). Deficits in multiple related executive functions have been implicated in BPD, including in response inhibition, cognitive flexibility, decisionmaking, problem-solving, and planning (Paret, Jennen-Steinmetz, & Schmahl, 2017;Ruocco, 2005;Unoka & Richman, 2016). ...
... Similarly, the results of the present investigation speak to the potential utility of incorporating dimensional assessments of pathological personality trait domains into neurobiological research on PD, as we determined that an impulsiveness dimension was significantly associated with activation in prefrontal brain regions. Relationships between pathological personality traits and potential neuroimaging-based biomarkers should be explored in future research, as this work could illuminate the neurobiology of traits contained in proposed dimensional conceptualizations of PD according to the National Institute of Mental Health's Research Domain Criteria initiative (Koudys et al., 2019). ...
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Background Impulsivity is a central symptom of borderline personality disorder (BPD) and its neural basis may be instantiated in a frontoparietal network involved in response inhibition. However, research has yet to determine whether neural activation differences in BPD associated with response inhibition are attributed to attentional saliency, which is subserved by a partially overlapping network of brain regions. Methods Patients with BPD ( n = 45) and 29 healthy controls (HCs; n = 29) underwent functional magnetic resonance imaging while completing a novel go/no-go task with infrequent odd-ball trials to control for attentional saliency. Contrasts reflecting a combination of response inhibition and attentional saliency (no-go > go), saliency processing alone (oddball > go), and response inhibition controlling for attentional saliency (no-go > oddball) were compared between BPD and HC. Results Compared to HC, BPD showed less activation in the combined no-go > go contrast in the right posterior inferior and middle-frontal gyri, and less activation for oddball > go in left-hemispheric inferior frontal junction, frontal pole, superior parietal lobe, and supramarginal gyri. Crucially, BPD and HC showed no activation differences for the no-go > oddball contrast. In BPD, higher vlPFC activation for no-go > go was correlated with greater self-rated BPD symptoms, whereas lower vlPFC activation for oddball > go was associated with greater self-rated attentional impulsivity. Conclusions Patients with BPD show frontoparietal disruptions related to the combination of response inhibition and attentional saliency or saliency alone, but no specific response inhibition neural activation difference when attentional saliency is controlled. The findings suggest a neural dysfunction in BPD underlying attention to salient or infrequent stimuli, which is supported by a negative correlation with self-rated impulsiveness.
... Additionally, we expected that probands with BPD, relatives, and controls, might differ in their extent of activation in the right middle and superior frontal gyri, as well as the left middle and inferior frontal gyri, given meta-analytic and other neuroimaging findings pertaining to the GNG task (Swick et al., 2011;Rodrigo et al., 2014). Finally, we predicted that higher impulsive traits would be related to lower PFC activation during response inhibition regardless of comorbid diagnosis, consistent with a trans-diagnostic neuroscience approach to defining the neurocircuitry of personality psychopathology, such as the Research Domain Criteria (RDoC) initiative (Koudys et al., 2019). Therefore, this study takes an important step toward understanding how the familial risk for BPD is reflected in the neurophysiology of response inhibition and provides a basis for research on related biomarkers for the diagnosis and associated impulsive traits. ...
... Similarly, while we did not assess every psychiatric diagnosis characterized by impulsivity (e.g., gambling disorder, attention-deficit/hyperactivity disorder). Our strategy to deal with questions of specificity and diagnostic comorbidity was to link the biomarkers to impulsive traits in a trans-diagnostic manner (i.e., regardless of psychiatric diagnosis), consistent with neuroscience-oriented research approaches, such as RDoC (Koudys et al., 2019). Third, several exclusions were applied to reduce the likelihood that the obtained results are influenced to confounding factors (e.g., current substance use disorder, neurologic illness). ...
Understanding of the biological factors that run in families affected with borderline personality disorder (BPD) is limited. The authors investigated the familial aggregation of neurophysiological biomarkers of response inhibition in the first-degree biological relatives of probands with BPD and associations with psychiatric diagnosis and impulsive traits. In the present study, psychiatric diagnoses and impulsive traits were measured in BPD probands (n = 86), psychiatrically affected and non-affected relatives (n = 60) and controls (n = 83). While undergoing neuroimaging using functional near-infrared spectroscopy, prefrontal cortex (PFC) activation was measured during a go/no-go response inhibition task and compared between probands, relatives and controls. Additionally, non-psychiatrically affected relatives and controls were contrasted to examine the potential impact of familial risk for BPD on response inhibition-related PFC activation in the absence of confounding psychiatric morbidity. Probands showed bilateral decreases in PFC activation during response inhibition compared to relatives and controls. Conversely, both affected and non-affected relatives displayed higher activation than controls and probands in left lateral/medial and right medial PFC, although non-affected relatives showed a lesser extent of activation than affected relatives. Probands and controls reporting greater impulsive traits displayed deactivation across the PFC during response inhibition, whereas relatives showed increased activation. In this first family study of neuroimaging biomarkers in BPD, we showed that the familial risk for BPD is reflected in activation of the PFC during response inhibition, with lifetime psychiatric diagnosis and higher impulsive traits in relatives associated with larger increases in PFC activity. Higher PFC activity during response inhibition including among non-affected relatives could reflect a neurophysiological compensatory mechanism.
... Er zijn ook aanwijzingen dat cognitieve problemen in de kindertijd, en dan met name problemen in het executief functioneren, de aanwezigheid van allerlei psychische stoornissen, waaronder dwangstoornissen, gedragsstoornissen en schizofrenie spectrum stoornissen, op latere leeftijd voorspellen (Caspi et al., 2014). Mogelijk zijn deze tekorten in cognitief functioneren een uiting van neuro-anatomische afwijkingen die tegelijkertijd ook de kwetsbaarheid voor psychische stoornissen vergroten (Caspi & Moffit, 2018;Koudys et al., 2019). ...
Comorbiditeit roept de vraag op of er niet één algemene kwetsbaarheid bestaat voor alle psychische stoornissen. Deze onderliggende kwetsbaarheid voor psychische stoornissen wordt wel de algemene psychopathologie-factor genoemd, kortweg p-factor 1. In deze bijdrage schetsen we de (her)ontdekking van deze p-factor, enkele hypothesen over de aard, de link met biologische aspecten en het mogelijke nut voor de klinische praktijk. 1 Hoewel wij hier de algemene psychopathologiefactor gelijk stellen aan de p-factor is het belangrijk onderscheid te maken tussen het theoretisch construct en de statistische uitkomstmaat. De algemene psychopathologie factor is te beschouwen als een theoretisch construct dat de samenhang tussen psychische stoornissen verklaart (cf. Constantinou & Fonagy, 2020) en de p-factor als de statistische weergave van de covariantie tussen symptomen in een bepaalde steekproef. Het lastige is dat andere onderzoekers (i.c. Watts et al., 2020) precies de omgekeerde betekenis geven aan de p-factor (als het theoretische construct) en de algemene factor psychopathologie (als statistische uitkomstmaat). Hoe dan ook, het is van belang onderscheid te maken, zoals intelligentie ook wordt onderscheiden van een iq-score. In deze bijdrage zullen we, omwille van de leesbaarheid, dit onderscheid niet steeds expliciet maken.
... Self-interpersonal impairment across PD diagnoses may contribute to a significant degree of shared variance in FC in these four networks, a hypothesis that has yet to be explored in a PD sample using a cross-cutting measure of personality impairment. In fact, there is a clear paucity of research that explores the dimensional neurobiology of PD, as fMRI has almost exclusively been used to characterize the neural underpinnings of specific PD diagnoses, despite the potential of dimensional, neuroscience-based research to illuminate the neurobiology of PD (Koudys, Traynor, Rodrigo, Carcone, & Ruocco, 2019). ...
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Background: Recently proposed alternative dimensional models of personality disorder (PD) place the severity of impairments in self and interpersonal functioning at the core of personality pathology. However, associations of these impairments with disturbances in social, cognitive, and affective brain networks remain uninvestigated. Methods: The present study examined patterns of resting-state functional connectivity (rsFC) in a sample of 74 age- and sex-matched participants (45 inpatients with PD and 29 healthy controls). At a minimum, PD patients carried a diagnosis of borderline PD, although the majority of the sample had one or more additional PDs. rsFC patterns in the following networks were compared between groups and in association with dimensional personality impairments: default mode network (DMN)/core mentalization, frontolimbic, salience, and central executive. Further, the extent to which variation in rsFC was explained by levels of personality impairment as compared to typology-specific borderline PD symptom severity was explored. Results: Relative to controls, the PD group showed disruptions in rsFC within the DMN/core mentalization and frontolimbic networks. Among PD patients, greater severity of dimensional self-interpersonal impairment was associated with stronger intralimbic rsFC. In contrast, severity of borderline PD-specific typology was not associated with any rsFC patterns. Conclusions: Disruptions in core mentalization and affective networks are present in PD. Higher intralimbic functional connectivity may underlie self-interpersonal personality impairment in PD regardless of diagnostic typology-specific PD symptoms, providing initial neurobiological evidence supporting alternative dimensional conceptualizations of personality pathology.
... Further to this, larger neurocognitive studies with suitable control or clinical groups would help to disentangle the specific profile of deficits common to comorbid personality disorder and SUD. This future work may help to establish transdiagnostic components that may inform future advances in assessment, treatment targets, clinical practice, and research (Koudys et al., 2019;Ruggero et al., 2019). Studies aiming to improve treatment outcomes in both SUD (Verdejo-Garcia et al., 2019) and personality disorder are increasingly focused on elucidating neuroscientific mechanisms that can guide the development of novel treatments (e.g., Herpertz et al., 2020;Pascual et al., 2015;Vita et al., 2018) and these may specifically be adapted to account for the common co-occurrence of SUD and BPD, adding to a small number of treatment studies (Pennay et al., 2011). ...
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At least one in four patients with substance use disorder (SUD) meet criteria for personality disorder and overlapping neurocognitive deficits may reflect shared neurobiological mechanisms. We studied neurocognition in females attending residential SUD treatment by comparing SUD with (n = 20) or without (n = 30) comorbid personality disorder. Neuropsychological testing included working memory, inhibition, shifting, verbal fluency, design fluency, psychomotor speed, immediate and delayed verbal memory, processing speed, premorbid functioning, cognitive screening, and self-reported executive function. As expected, whole-sample deficits included working memory (d = –.91), self-reported executive function (d = –.87), processing speed (d = –.40), delayed verbal memory recall (d = –.39), premorbid functioning (d = –.51), and cognitive screening performance (d = –.61). Importantly, the comorbid personality disorder group showed greater self-reported executive dysfunction (d = –.67) and poorer shifting performance (d = –.65). However, they also evidenced better working memory (d = .84), immediate (d = .95) and delayed (d = .83) verbal memory, premorbid functioning (d = .90), and cognitive screening performance (d = .77). Overall executive dysfunction deficits were concordant with those observed in previous SUD studies. Surprisingly, comorbid personality disorder was associated with a pattern indicating poorer subjective (self-report) but better objective performance on a number of tasks, apart from shifting deficits that may relate to emotion dysregulation. Subjective emotional dysfunction may influence the cognitive deficits observed in the personality disorder group.
The need for research on modifiable risk factors in anxiety has been highlighted in previous reviews synthesizing literature on the etiology and maintenance of anxiety. The Research Domain Criteria (RDoC) provides a useful framework to lead this body of work. A scoping review was conducted to examine the extent and nature of research evidence on each RDoC domain as they have been investigated in anxiety via relevant correlates, with the end goal of informing future research priorities. The coverage of this review was limited to search terms bound within non-disorder-specific anxious pathology. The adopted selection criteria resulted in 170 cases (across 94 studies) where RDoC-relevant correlates of anxiety were studied. Results highlight disparate research focus across domains (limited research on processes within the Positive Valence Systems, Systems for Social Processes, and Arousal/Regulatory Systems), inconsistent findings within domains (Cognitive Systems), and a lack of research on cross-domain interactions.
Background The research domain criteria (RDoC) domain of negative valence systems can be used to subsume long established and recently developed research approaches, which build upon theoretical knowledge and clinical practice of various psychiatric disorders.Objective This article outlines how the five constructs within the RDoC domain of negative valence systems can contribute to integrating empirical studies into a coherent and differentiated biopsychosocial model.Material and methodsThis is a qualitative review article that summarizes empirical results and discusses new developments on the basis of exemplary studies and selected reviews.Results and discussionThe RDoC domain of negative valence systems differentiates in three constructs the time horizon, in which persons need to adequately react to (1) acute, (2) potential, and (3) sustained threats elicited by negative stimuli or situations. These three constructs can be outlined relatively well with specific experimental paradigms and neuronal circuits. Two further constructs focus on the negative consequences of (4) losses and (5) frustrative non-rewards. The former seems to be currently relatively diffusely defined whereas the latter is clearly circumscribed by its relation to specific forms of aggression. Behavioral, physiological, and neuronal reactions to acute and potential threats can be well compared between humans and animals and can be specified with the help of mathematical models. These models can contribute to a better understanding of how healthy and diseased persons process negative stimuli or situations.
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Traditional categorical approaches to classifying personality disorders are limited in important ways, leading to a shift in the field to dimensional approaches to conceptualizing personality pathology. Different areas of psychology – personality, developmental, and psychopathology – can be leveraged to understand personality pathology by examining its structure, development, and underlying mechanisms. However, an integrative model that encompasses these distinct lines of inquiry has not yet been proposed. In order to address this gap, we review the latest evidence for dimensional classification of personality disorders based on structural models of maladaptive personality traits, provide an overview of developmental theories of pathological personality, and summarize the Research Domain Criteria (RDoC) initiative, which seeks to understand underlying mechanisms of psychopathology. We conclude by proposing an integrative model of personality pathology development that aims to elucidate the developmental pathways of personality pathology and its underlying mechanisms.
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The Research Domain Criteria (RDoC) and the Hierarchical Taxonomy of Psychopathology (HiTOP) represent major dimensional frameworks proposing two alternative approaches to accelerate progress in the way psychopathology is studied, classified, and treated. RDoC is a research framework rooted in neuroscience aiming to further the understanding of transdiagnostic biobehavioral systems underlying psychopathology and ultimately inform future classifications. HiTOP is a dimensional classification system, derived from the observed covariation among symptoms of psychopathology and maladaptive traits, which seeks to provide more informative research and treatment targets (i.e., dimensional constructs and clinical assessments) than traditional diagnostic categories. This article argues that the complementary strengths of RDoC and HiTOP can be leveraged in order to achieve their respective goals. RDoC's biobehavioral framework may help elucidate the underpinnings of the clinical dimensions included in HiTOP, whereas HiTOP may provide psychometrically robust clinical targets for RDoC-informed research. We present a comprehensive mapping between dimensions included in RDoC (constructs and subconstructs) and HiTOP (spectra and subfactors) based on narrative review of the empirical literature. The resulting RDoC-HiTOP interface sheds light on the biobehavioral correlates of clinical dimensions and provides a broad set of dimensional clinical targets for etiological and neuroscientific research. We conclude with future directions and practical recommendations for using this interface to advance clinical neuroscience and psychiatric nosology. Ultimately, we envision that this RDoC-HiTOP interface has the potential to inform the development of a unified, dimensional, and biobehaviorally-grounded psychiatric nosology.
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Purpose of review: This review article aims at giving an update on studies investigating correlates of aggression in personality disorders during the last 5 years. Recent findings: Most data refer to borderline personality disorder (BPD) and antisocial personality disorder (ASPD). In BPD, emotion dysregulation, hypersensitivity to interpersonal rejection/threat, increased rumination, increased negative urgency, aggression-related knowledge structures, and invalidation were either corroborated or emerged as psychological correlates of aggression, while reduced ambiguity sensitivity, hyposensitivity to interpersonal threat, and reduced mindfulness were associated with aggression in ASPD. Neurobiologically, alterations of the monoaminooxidase-A-, the oxytocinergic-, and the prefrontal-limbic-system as well as increases of the thyroid hormone T3, γ-aminobutyric acid and several inflammatory markers were associated with increased aggression across various personality disorders. Our understanding of correlates of aggression in personality disorders has increased over the last 5 years. More efforts in improving the conceptualization of personality disorders and aggression are needed to develop innovative treatments for those affected.
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Background: Amotivation is a prevalent symptom in schizophrenia (SZ) and depression (MDD), and is linked to poor functional outcomes in affected individuals. Conceptualizations of motivation have outlined a multi-faceted construct comprised of reward responsiveness, reward expectancy, reward valuation, effort valuation, and action selection/preference-based decision making. To date, findings from studies utilizing variable-centered approaches to examining isolated facets of motivation in SZ and MDD have been inconsistent. Thus, the present study adopted a person-centered approach, and comprehensively examined the reward system in a non-clinical sample in an attempt to explore potential subtypes of motivation impairments, while minimizing the effects of illness-related confounds. Methods: Ninety-six healthy undergraduate students were evaluated for amotivation, schizotypal traits, depressive symptoms, and cognition, and administered objective computerized tasks to measure the different facets of motivation. Cluster analysis was performed to explore subgroups of individuals based on similar motivation task performance. Additionally, correlational analyses were conducted in order to examine inter-relationships between motivation facets, and relations between clinical measures and facets of motivation. Results: Cluster analysis identified two subgroups of individuals with differential motivation performance profiles. Correlational analyses revealed that reward responsiveness was associated with amotivation, depressive symptoms, and negative schizotypy. Further, significant inter-correlations were found between reward responsiveness and reward expectancy, as well as between reward valuation and effort valuation. Conclusions: Our results mark important steps forward in understanding motivation in a non-clinical sample, and guide future dimensional and comprehensive analyses of the multi-faceted reward system. It remains to be seen whether these patterns of results will be similar in clinical populations such as SZ and MDD.
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Background: Although difficulties in emotion regulation (ER) are considered a core feature of borderline personality disorder (BPD), the specific strategies that individuals with BPD most commonly use, their diagnostic specificity, and their associations with harmful behaviors have not been firmly established. Sampling and methods: Individuals with BPD (n = 30), mixed anxiety and/or depressive disorders (MAD; n = 30), and healthy controls (HC; n = 32) completed questionnaires assessing both cognitive ER strategies (e.g., cognitive reappraisal) and potentially harmful behaviors that individuals might use to regulate their emotions (e.g., self-injury). Results: BPD subjects endorsed more maladaptive cognitive ER strategies and fewer adaptive strategies compared to HC. Compared to MAD subjects, BPD individuals endorsed more maladaptive cognitive ER strategies, but only when those with subthreshold symptoms in the MAD group were excluded. BPD also endorsed engaging in potentially harmful behaviors more often than both HC and MAD. Discriminant analysis revealed that MAD endorsed lower rates of problem-solving and cognitive reappraisal compared to both HC and BPD. Higher maladaptive and lower adaptive ER strategies were associated with higher rates of potentially harmful behaviors, although the specific strategies differed for MAD versus BPD. Conclusions: BPD and MAD endorse cognitive ER strategies with a comparable frequency, although BPD subjects engage in potentially harmful behaviors more often. Subthreshold BPD symptoms may also affect rates of ER strategy use in individuals with other mental disorders.
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Purpose of Review Advancements in taxometric and dimensional approaches to personality psychopathology have pushed for refinements to the borderline personality disorder (BPD) phenotype, but proposed revisions to the diagnosis in major nosological systems hinge in part on evidence to support their validity. We review recent phenotypic and cognitive research on BPD and consider ways that changes to the phenotype may be validated using cognitive measures. Recent Findings Phenotypic research on BPD has identified core symptom dimensions underlying the DSM diagnosis, which also aggregate in families. While a unidimensional model of the disorder has been found in some studies, latent subgroups within the diagnosis have also been uncovered. Cognitive findings reveal deficits primarily in executive functions relevant to self-regulation but also in episodic memory and attentional abilities. Summary Cognitive functioning should be considered as a potential validator of proposed changes or refinements to the BPD phenotype, including categorical and dimensional conceptualizations.
The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Workbook was developed to help people who are struggling with intense emotions like anxiety, sadness, anger, and guilt. A person may have an emotional disorder when his or her emotions are so overwhelming that they get in the way of moving forward in life. Although emotions affect our lives in different ways, there are three features that often occur across emotional disorders. These are (a) frequent, strong emotions; (b) negative reactions to emotions; and (c) avoidance of emotions. The goal of this workbook is to change the way that people with emotional disorders respond to their emotions when they occur. This treatment program is applicable to all anxiety and unipolar depressive disorders and potentially other disorders with strong emotional components. The strategies included in this treatment are largely based on common principles found in existing empirically supported psychological treatments.
Objective: Borderline personality disorder (BPD) is a prevalent, complex, and serious mental disorder involving multiple symptoms and maladaptive behaviour. The underlying psychobiological mechanisms involved are not yet fully understood, but increasing evidence indicates that changes in hypothalamic-pituitary-adrenal stress axis (HPA) activity may contribute to BPD. Whilst various studies have demonstrated elevated levels of cortisol (the end-product of the HPA axis) in BPD sufferers, others have presented opposite findings. Inconsistent findings may be attributable to comorbidities, collection and measurement methods, gender, and sample size. Considering these discrepancies, the aim of this systematic review and meta-analysis was to assess available studies in the scientific literature examining basal/ baseline cortisol levels in patients diagnosed with borderline personality disorder compared to non-psychiatric controls. Methods: A systematic literature review was conducted with descriptions of primary studies in addition to a meta-analysis of studies with a control group. Meta-analysis was performed using Comprehensive Meta-analysis software (CMA version 2). The effect size (Hedges' g) was calculated with random-effect model. Results: A systematic literature search identified 16 studies that met the eligibility criteria from a total of 1076 unique records initially examined. Twelve studies (N = 546; 278 borderline personality disorder and 268 non-psychiatric controls) fulfilled the inclusion criteria for meta-analysis. The standardised mean difference (Hedges' g) of basal cortisol level between BPD and control groups was -0.32 (pooled data from 12 studies; 95% confidence interval -0.56 to -0.06, p = 0.01), indicating significantly lower mean cortisol level for the BPD group. Conclusion: Cortisol as a biomarker of the HPA axis is an important and helpful measure in the study of stress disorders such as BPD. However, considerations of potential confounding factors must be considered.
Anxiety disorders are among the most prevalent psychiatric disorders in youth; however, progress in treatment for childhood anxiety has stalled over the past decade. The National Institute of Mental Health (NIMH) Research Domain Criteria (RDoC) project represents a shift toward a dimensional and interdisciplinary approach to psychiatric disorders; this shift can reframe developmental psychopathology for childhood anxiety and facilitate novel advances in its classification and treatment. Here we highlight constructs in the Systems for Social Processes and the Negative Valence System domains of RDoC, as they relate to childhood anxiety disorders. Childhood anxiety relates to both RDoC domains. In terms of social processes, through natural reliance on parents to reduce children's fear, attachment represents one particular social process, which plays a central role in anxiety among youth. In terms of negative valence, considerable research links threat conditioning to pediatric anxiety. Finally, fronto-amygdala circuitry relates to all three entities, as it has been shown to underly both attachment processes and threat learning, while it also has been consistently implicated in anxiety disorders across development. Through integrative and translational approaches, RDoC provides unique opportunities and simultaneous challenges for advancing the understanding and treatment of childhood anxiety disorders.