Personality and Psychopathology

L33 PSYC 4541

Professor Thomas Oltmanns Semester: Spring, 2014Classroom: Cupples II: L007 Tuesday-Thursday; 11:30 am - 1:00 pm

OVERVIEW: This course is an advanced seminar in the study of personality traits and pathology and their impact in later life. It will cover a range of conceptual and methodological issues involved in scientific efforts to understand ways in which maladaptive personality traits disrupt people’s lives across the lifespan. Students will learn about the similarities and distinctions between normal and pathological personality traits as well as the role that personality may play with regard to the causes and treatment of other kinds of mental disorder.

A laboratory component of the class will focus on the specific methodological issues and skills that are associated with research on personality and health. One aspect of our research methods discussions will focus on the development of practical skills in conducting research interviews that are commonly used to elicit information about personality disorders.

One topic that will come up throughout the course is concerned with personality change (planned or unplanned). During the last two weeks of the course, we will consider briefly some psychological forms of treatment for borderline personality disorder. These discussions are designed to introduce students to these therapeutic approaches and their likely efficacy; it is not intended to provide training in the delivery of any professional services.

PREREQUISITES: Junior or senior standing and permission of the instructor. It is strongly recommended that students have previously completed courses in Abnormal Psychology and the Psychology of Personality.

COMPLETE CITI TRAINING: We will discuss information regarding participants in the SPAN Study. Therefore, it is important that everyone be familiar with principles regarding confidentiality of research data. Toward that end, every student in this class must complete the university’s CITI training course within the first three weeks of the semester.

GOALS: By the end of the course, you will develop an understanding of, or appreciation for, the following issues:

1. The description and identification of specific features of personality pathology viewed from the perspectives of both the official categorical model represented in the Diagnostic and Statistical Manual (DSM-5) and the alternative dimensional model that was proposed by the DSM-5 workgroup (currently located in the appendices of the diagnostic manual).

2. The advantages and limitations of different ways of collecting information about the presence of personality pathology (e.g., semi-structured diagnostic interviews and objective personality questionnaires such as the NEO-PI-R).

3. The impact of personality disorders on various real life outcomes, especially physical health but also other forms of mental disorder, such as depression, substance dependence, and eating disorders.

4. Psychosocial and biological mechanisms that may explain ways in which personality traits can have an impact on health. The latter include links between personality and stressful life events, health behaviors, and social relationships. The latter include functions of the neuroendocrine and autoimmune systems as well as chromosome stability.

5. Current thinking about developmental issues regarding changes in normal and abnormal personality features across the lifespan. This includes consideration of these constructs as they are related to normal aging.

6. A variety of fundamental research methods and concepts that influence the quality of evidence that is collected in efforts to study all of these issues, including methods used to recruit participants for research projects, psychometric issues to be considered when evaluating assessment tools, and alternatives to the use of questionnaires and interviews for eliciting information about personality characteristics.

7. Ways in which personality disorders can be treated using psychosocial forms of intervention such as dialectical behavior therapy and mentalization therapy.

CONFIDENTIALITY AND RESPECT FOR CLINICAL PROBLEMS: We all have our own eccentric personality characteristics, and at least 10 percent of adults qualify for a PD diagnosis. Respect and tolerance for individual differences are essential in this class, including the recognition that lots of people seek professional help for all kinds of reasons. In other words, this class is about us, not them.

THE SCIENTIFIC ATTITUDE: The application of science to questions regarding abnormal behavior carries with it the implicit assumption that these problems can be studied objectively. Clinical scientists adopt an attitude of open-minded skepticism, tempered by an appreciation for the research methods that are used to collect empirical data. We are going to discuss several controversial topics, including sexual behaviors, drug use, and crime. In order to get the most out of this class, you may have to set aside -- at least temporarily -- personal beliefs that you have already acquired about various forms of mental disorder.

OFFICE HOURS AND E-MAIL: I want you to discuss issues that are raised in class, and I want you to ask questions that occur to you when you are reading the articles, listening to lectures, or participating in class discussion. I have regular office hours and encourage you to use them for this purpose. If you can't make my regularly scheduled office hours, stop after class or give me a call, and we can arrange another time. I can also be reached easily on e-mail and will be happy to discuss issues in that forum.

GRADING PROCEDURE: Your grade will be based on a two exams (one midterm and a final) a group classroom presentation, and your class participation.

Each exam will contain 50 multiple-choice questions covering only the material from the preceding section of the course. The final exam will contain 100 multiple-choice questions covering the last section of the course as well as lecture material and chapters in the primary textbook that were covered earlier in the course. Everyone must take the final exam. Material from case studies that were assigned prior to the third exam will not be covered on the final.

Your grade will be determined by your two highest scores on the first three exams added together with one half of your score on the final exam.

USING THE SIDP WEBSITE TO LEARN INTERVIEW SKILLS: The SPAN lab maintains an instructional website that is designed to help research assistants learn to use the SIDP semi-structured diagnostic interview. The URL is: wuspan.cybermill.com.

I will give you access so that you can use it.

PRESENTATION ASSIGNMENT: Case presentations will be given 45 minutes of class time to describe one person who is participating in the SPAN Study. You may write one, five-page paper, in lieu of one of the first three multiple-choice exams. This assignment will be worth a possible 50 points. The paper is due on Tuesday, April 17th at class time. Students choosing this alternative are expected to examine recent professional journals, identify one article that they find particularly interesting, and write a summary/critique of this article (be sure to follow specific directions provided elsewhere on this course homepage -- see section on "Assignments."

The class will be divided into teams of 3 people; you will be assigned to one of those teams. Your team will be provided with data from one of the participants in the SPAN Study.

Describe the person’s personality from the contrasting points of view of the FFM and the DSM.Also, whenever possible, please comment on several related issues that we have discussed in class, including:

1. Motivations (especially getting along and getting ahead) as viewed from the evolutionary point of view described by Buss.

2. Behavioral footprints, or “if, then” statements as described by Mischel (i.e., please consider the importance of situations that might provoke problems).

3. Self-knowledge (the extent to which the person is aware of, or able to discuss, potential problems).

4. Developmental changes

Tell us what surprised you about the tests (consistencies and inconsistencies)

EXAMINATION SCHEDULE: The final exam will be on Monday, May 5th, from 1:00 - 3:00 pm. The time cannot be changed. Please consider conflicts and exam congestion before it's too late.

PASS/FAIL: If you are taking the course on the Credit/No Credit option, you must receive at least a "C-" to receive credit for the course. This option must be elected during the Add period.

ACADEMIC HONESTY: Students are expected to work independently on the written assignment and on exams, which must be taken in the classroom (unless special permission is obtained prior to the day of an exam). Please note prior comments about the use of old exams (which is forbidden).

ATTENDANCE: Lectures, discussions, and readings will be used in a complementary fashion to facilitate students' progress toward the goals listed above. Some information will be presented in lecture that is not covered in the assigned readings. Students are expected to attend class on a regular basis, and they will be held responsible for any material covered in discussions or lectures.

COURSE SCHEDULE:

Date: Topic:

January 14 Personality traits: the Five Factor ModelJanuary 16 Life narratives and CAPS as alternative models of personality

January 21 Personality disorder types in DSM-5January 23 Dimensional system for personality pathology (DSM-5)

January 28 Self-knowledge and the limitations of self-report measuresJanuary 30 Research Methods: Sampling and prevalence for PD symptoms

February 04 Normal aging: Emotion regulation and social relationshipsFebruary 06 Research Methods: Psychometric evaluation of interviews and questionnaires

February 11 Continuity and change in personality traitsFebruary 13 Research Methods: Longitudinal designs (and burnout in PDs)

February 18 Successful adaptation (flourishing, well-being, “shift and persist”)February 20 Research Methods: Interviewing skills and assessment of psychopathology

February 25 Personality pathology across the lifespanFebruary 27 Research Methods: Semi-structured diagnostic interviews

March 04 MIDTERM EXAM --------------------------------------------------------------------------------March 06 Research Methods: Semi-structured diagnostic interviews

March 11 SPRING BREAKMarch 13 SPRING BREAK

March 18 Personality and health (read Sarah Hampson)March 20 Research Methods: measuring stress followed by presentation of Case 1

March 25 Social mechanisms linking personality and healthMarch 27 Research Methods: effect sizes followed by presentation of Case 2

April 01 Biological mechanisms linking personality and healthApril 03 Research Methods: Item Response Theory followed by presentation of Case 3

April 08 Racial health disparities April 10 Research Methods: thin slice assessment followed by presentation of Case 4

April 15 Treatment of personality disorders; General issuesApril 17 Research Methods: lab challenge tasks followed by presentation of Case 5

April 22 Treatment of personality disorders: Dialectical Behavior Therapy and MentalizationApril 24 presentation of Case 6 followed by Course Summary and Integration

Readings:

Personality traits: FFM

Rubenzer, S.J., & Faschingbauer, T.R. (2004). Personality, character, and leadership in the White House: Psychologists assess the presidents. Washington, D.C.: Brassey's. Read Chapters 1 and 2.

Life narratives and the CAPS model of personality

McAdams, D. P., & McLean, K. C. (2013). Narrative identity. Current Directions In Psychological Science, 22, 233-238.

Fleeson, W. (2004). Moving personality beyond the person-situation debate: The challenge and the opportunity of within-person variability. Current Directions In Psychological Science, 13, 83-87.

Mischel, W., Shoda, Y., & Mendoza-Denton, R. (2002). Situation-behavior profiles as a locus of consistency in personality. Current Directions In Psychological Science, 11(2), 50-54.

Personality disorder types in DSM-5

Skodol, A.E. (2005). Manifestations, clinical diagnosis, and comorbidity. In J.M. Oldham, A.E. Skodol, and D.S. Bender (Eds), Textbook of personality disorders. Washington, D.C.: American Psychiatric Publishing. Pp. 57-88.

Dimensional system for personality pathology (DSM-5)

Krueger, R. F. (2013). Personality disorders are the vanguard of the post-DSM-5.0 era. Personality Disorders: Theory, Research, and Treatment, 4, 355-362.

Widiger, T. A. (2013). A postmortem and future look at the personality disorders in DSM-5. Personality Disorders: Theory, Research, and Treatment, 4, 382-387.

Self-knowledge and the limitations of self-report measures

Wilson, T.D. (2002). Strangers to ourselves: Discovering the adaptive unconscious. Cambridge, MA: Harvard University Press. Read chapters 2, 3, 4, and 8.

Vazire, S., & Carlson, E. N. (2011). Others sometimes know us better than we know ourselves. Current Directions In Psychological Science, 20, 104-108

Oltmanns, T.F., & Turkheimer, E. (2009). Person perception and personality pathology. Current Directions in Psychological Science. 18, 32-36.

Research Methods: Sampling and prevalence for PD symptoms

Samuels, J. (2011). Personality disorders: Epidemiology and public health issues. International Review Of Psychiatry, 23, 223-233.Oltmanns, T.F., Rodrigues, M.M., Weinstein, Y., & Gleason, M.E.J. (in press). Prevalence of

personality disorders at midlife in a community sample: Disorders and symptoms reflected in interview, self, and informant reports. Journal of Psychopathology and Behavioral Assessment.

Normal aging: Emotion regulation and social relationships

Carstensen, L.L (2009). A long bright future: An action plan for a lifetime of happiness, health, and financial security. New York: Broadway Books.

Research Methods: Psychometric evaluation of interviews and questionnaires

Funder, D. C. (2012). Accurate personality judgment. Current Directions In Psychological Science, 21, 177-182.

Meyer, G. J., Finn, S. E., Eyde, L. D., Kay, G. G., Moreland, K. L., Dies, R. R., & ... Reed, G. M. (2001). Psychological testing and psychological assessment: A review of evidence and issues. American Psychologist, 56(2), 128-165.

Continuity and change in personality traits

Kandler, C. (2012). Nature and nurture in personality development: The case of neuroticism and extraversion. Current Directions In Psychological Science, 21(5), 290-296.

Rothbart, M. K. (2007). Temperament, development, and personality. Current Directions In Psychological Science, 16(4), 207-212.

Roberts, B. W., & Mroczek, D. (2008). Personality trait change in adulthood. Current Directions In Psychological Science, 17, 31-35.

Research Methods: Longitudinal designs (and burnout in PDs)

Ferrer, E., & McArdle, J. J. (2010). Longitudinal modeling of developmental changes in psychological research. Current Directions In Psychological Science, 19, 149-154.

Successful adaptation (flourishing, well-being)

Keyes, C.L.M. (2007). Promoting and protecting mental health as flourishing. American Psychologist.

Lucas, R. E. (2007). Adaptation and the set-point model of subjective well-being: Does happiness change after major life events?. Current Directions In Psychological Science, 16(2), 75-79.

Research Methods: Interviewing skills and assessment of psychopathology

Shea, S.C. (1995). Psychiatric interviewing: The art of understanding. Philadelphia, PA: Saunders.  Read Chapter 7, "Personality disorders: Reflections of the social history."

Personality pathology across the lifespan

Paris, J. (2003). Personality disorders over time: Precursors, course, and outcome.  Washington, D.C.: American Psychiatric Press.

Clark, L. (2009). Stability and change in personality disorder. Current Directions In Psychological Science, 18(, 27-31.

Oltmanns, T.F., & Balsis, S. (2011). Personality pathology in later life: Questions about the measurement, course, and impact of disorders. Annual Review of Clinical Psychology, 7, 321-349.

Research Methods: Semi-structured diagnostic interviews

Widiger, T. A., & Samuel, D. B. (2009). Evidence-based assessment of personality disorders. Personality Disorders: Theory, Research, and Treatment, S(1), 3-17.

Personality and health

Cohen, S., & Pressman, S.D. (2006). Positive affect and health. Current Directions in Psychological Science, 15, 122-125.

Smith, T. W., Gallo, L. C., Shivpuri, S., & Brewer, A. L. (2012). Personality and health: Current issues and emerging perspectives. In A. Baum, T. A. Revenson, J. Singer (Eds.), Handbook of health psychology (2nd ed.) (pp. 375-404). New York, NY US: Psychology Press.

Research Methods: measuring stress

Monroe, S. M., & Reid, M. W. (2009). Life stress and major depression. Current Directions In Psychological Science, 18, 68-72.

Social mechanisms linking personality and health

Hampson, S. E. (2012). Personality processes: Mechanisms by which personality traits 'get outside the skin.'. Annual Review of Psychology, 63, 315-339.

Uchino, B. N., Vaughn, A. A., & Matwin, S. (2008). Social psychological processes linking personality to physical health: A multilevel analysis with emphasis on hostility and optimism. In F. Rhodewalt (Ed.), Personality and social behavior (pp. 251-283). New York, NY US: Psychology Press.

Research Methods: effect sizes

Ozer, D. J. (2007). Evaluating effect size in personality research. In R. W. Robins, R. Fraley, R. F. Krueger (Eds.), Handbook of research methods in personality psychology (pp. 495-501). New York, NY US: Guilford Press.

Cortina, J. M., & Landis, R. S. (2009). When small effect sizes tell a big story, and when large effect sizes don't. In C. E. Lance, R. J. Vandenberg (Eds.) , Statistical and methodological

myths and urban legends: Doctrine, verity and fable in the organizational and social sciences (pp. 287-308). New York, NY US: Routledge/Taylor & Francis Group.

Biological mechanisms linking personality and health

Miller, G. E., Chen, E., & Parker, K. J. (2011). Psychological stress in childhood and susceptibility to the chronic diseases of aging: Moving toward a model of behavioral and biological mechanisms. Psychological Bulletin, 137(6), 959-997.

Research Methods: Item Response Theory

Warne, R. T., McKyer, E. J., & Smith, M. L. (2012). An introduction to item response theory for health behavior researchers. American Journal of Health Behavior, 36(1), 31-43.

Reise, S. P., Ainsworth, A. T., & Haviland, M. G. (2005). Item Response Theory: Fundamentals, Applications, and Promise in Psychological Research. Current Directions In Psychological Science, 14(2), 95-101.

Amarnani, R. (2009). Two theories, one theta: A gentle introduction to item response theory as an alternative to classical test theory. The International Journal Of Educational And Psychological Assessment, 3104-109.

Racial health disparities

Chen, E. (2012). Protective factors for health among low-socioeconomic-status individuals. Current Directions In Psychological Science, 21(3), 189-193.

Chen, E., & Miller, G. E. (2012). “Shift-and-persist” strategies: Why low socioeconomic status isn’t always bad for health. Perspectives On Psychological Science, 7(2), 135-158.

Evans, G. W., Chen, E., Miller, G., & Seeman, T. (2012). How poverty gets under the skin: A life course perspective. In V. Maholmes, R. B. King (Eds.), The Oxford handbook of poverty and child development (pp. 13-36). New York, NY US: Oxford University Press.

Govia, I. O., Jackson, J. S., & Sellers, S. L. (2011). Social inequalities. In K. L. Fingerman, C. A. Berg, J. Smith, T. C. Antonucci (Eds.) , Handbook of life-span development (pp. 727-744). New York, NY US: Springer Publishing Co.

Jackson, J. S., Knight, K. M., & Rafferty, J. A. (2010). Race and unhealthy behaviors: Chronic stress, the HPA axis, and physical and mental health disparities over the life course. American Journal Of Public Health, 100(5), 933-939

Research Methods: thin slice assessment

Ambady, N. (2010). The perils of pondering: Intuition and thin slice judgments. Psychological Inquiry, 21, 271-278.

Leising, D., Krause, S., Köhler, D., Hinsen, K., & Clifton, A. (2011). Assessing interpersonal functioning: Views from within and without. Journal of Research In Personality, 45, 631-641

Freeman, J. B., & Ambady, N. (2011). A dynamic interactive theory of person construal. Psychological Review, 118, 247-279.

Treatment of personality disorders; General issues

Choi-Kain, L. W., & Gunderson, J. G. (2008). Mentalization: Ontogeny, assessment, and application in the treatment of borderline personality disorder. American Journal of Psychiatry, 165, 1127-1135.

Linehan, M. M., & Dexter-Mazza, E. T. (2008). Dialectical behavior therapy for borderline personality disorder. In D. H. Barlow (Ed.) , Clinical handbook of psychological disorders: A step-by-step treatment manual (4th ed.) (pp. 365-420).

Research Methods: lab challenge tasks

Bornstein, R. F. (2003). Behaviorally referenced experimentation and symptom validation: A paradigm for 21st-century personality disorder research. Journal of Personality Disorders, 17, 1-18.

Treatment of personality disorders: Dialectical Behavior Therapy and Mentalization

Bliss, S., & McCardle, M. (2013). An exploration of common elements in dialectical behavior therapy, mentalization based treatment and transference focused psychotherapy in the treatment of borderline personality disorder. Clinical Social Work Journal,

Diamond, D., Yeomans, F. E., Stern, B., Levy, K. N., Hörz, S., Doering, S., & ... Clarkin, J. F. (2013). Transference focused psychotherapy for patients with comorbid narcissistic and borderline personality disorder. Psychoanalytic Inquiry, 33, 527-551.

Levy, K. N., Clarkin, J. F., Yeomans, F. E., Scott, L. N., Wasserman, R. H., & Kernberg, O. F. (2006). The mechanisms of change in the treatment of borderline personality disorder with transference focused psychotherapy. Journal Of Clinical Psychology, 62(4), 481-501.

Kernberg, O. F., Yeomans, F. E., Clarkin, J. F., & Levy, K. N. (2008). Transference focused psychotherapy: Overview and update. The International Journal Of Psychoanalysis, 89, 601-620.

Bateman, A. W., & Fonagy, P. (2012). Mentalization-based treatment of borderline personality disorder. In T. A. Widiger (Ed.) , The Oxford handbook of personality disorders (pp. 767-784). New York, NY US: Oxford University Press.

Bateman, A., & Fonagy, P. (2009). Randomized controlled trial of outpatient mentalization-based treatment versus structured clinical management for borderline personality disorder. The American Journal Of Psychiatry, 166(12), 1355-1364.