Table_1_Profiles of theory of mind impairments and personality in clinical and community samples: integrating the alternative DSM-5 model for personality disorders.pdf

IntroductionDeficits in theory of mind (ToM)—the ability to infer the mental states of others—have been linked to antagonistic traits in community samples. ToM deficits have also been identified in people with personality disorders (PD), although with conflicting evidence, partly due to the use of categorical diagnoses. The DSM-5 Alternative Model for Personality Disorders (AMPD) provides an opportunity for a more precise understanding of the interplay between ToM abilities and personality pathology. Therefore, the study aims to determine whether and how individuals with diverse ToM profiles differ regarding personality impairment (AMPD Criterion A) and pathological facets (AMPD Criterion B).MethodAdults with PD (n = 39) and from the community (n = 42) completed tests assessing ToM skills and self-reported questionnaires assessing AMPD Criteria A and B. Hierarchical agglomerative and TwoStep cluster analyses were consecutively computed using scores and subscores from ToM tests as clustering variables. Multivariate analyses of variance were subsequently performed to compare the clusters on both AMPD Criteria. Five clinically and conceptually meaningful clusters were found. The most notable differences across clusters were observed for Intimacy and Empathy dysfunctions (Criterion A), as well as for the Deceitfulness, Callousness, and Hostility facets from the Antagonism domain and the Restricted affectivity facet from the Detachment domain (Criterion B).DiscussionThe results support the association between antagonistic personality facets and ToM deficits. However, clusters showing impairments in ToM abilities did not necessarily exhibit high levels of personality dysfunction or pathological facets, emphasizing that both constructs are not isomorphic. Nevertheless, specific profiles can help refine existing interventions to make them more sensitive and specific to the nature of ToM dysfunctions while considering personality functioning and facets.

引言：心智理论（ToM）缺陷——即推断他人心理状态的能力——与社区样本中的对抗性特质有关联。心智理论缺陷在人格障碍（PD）患者中也得到了识别，尽管证据存在冲突，部分原因在于分类诊断的使用。DSM-5人格障碍替代模型（AMPD）为更精确地理解心智理论能力与人格病理之间的相互作用提供了机会。因此，本研究旨在确定具有不同心智理论特征的个人在人格损害（AMPD标准A）和病态特质（AMPD标准B）方面是否存在差异以及如何存在差异。方法：39名PD患者和42名社区成员完成了评估心智理论技能的测试以及评估AMPD标准A和B的自我报告问卷。使用心智理论测试的分数和子分数作为聚类变量，依次计算了层次聚类和两步聚类分析。随后，进行了多元方差分析，以比较AMPD两个标准上的聚类。发现了五个在临床和概念上具有意义的聚类。最显著的区别在于亲密关系和同理心功能障碍（标准A），以及来自对抗领域的欺骗、冷漠和敌意特质以及来自疏离领域的情感受限特质（标准B）。讨论：结果表明，对抗性人格特质与心智理论缺陷之间存在关联。然而，表现出心智理论能力损害的聚类并不一定表现出高水平的个性功能障碍或病态特质，这强调了这两个概念不是同构的。尽管如此，特定的特征有助于细化现有的干预措施，使其对心智理论功能障碍的本质更加敏感和具体，同时考虑个性功能和特质。