Stability and Fluctuation of Personality Disorder Features in Daily Life

Abstract

Very little is known about the daily stability and fluctuation of personality pathology. To address this gap in knowledge, we investigated the naturalistic manifestation of personality pathology over the course of 100 days. A group of individuals (N=101) diagnosed with any personality disorder (PD) completed a daily diary study over 100 consecutive days (Mdn = 94 days, Range = 33-101 days). Participants completed daily ratings of 30 manifestations of personality pathology. Patterns of stability and variability over the course of the study were then examined. Results indicated that individual PD manifestations and domains of PD manifestations were variable across days and differed widely in their frequency. Additionally, individual averages and level of variability in PD domains were highly stable across months, individual averages of PD domains were predicted by baseline dispositional ratings of PD traits with a high degree of specificity, and daily variability PD domains was associated with elevated levels of PD traits. This pattern of findings suggests that dynamic processes of symptom exacerbation and diminution that are stable in mean level and variability in expression over time characterizes personality pathology. Further, dispositional ratings are significant predictors of average daily expression of PD features.

Lack of group-to-individual generalizability is a threat to human subjects research

“…Sample 3. Participants from sample 3 were taken from an ecological momentary assessment study of individuals with clinically diagnosed personality disorders (23,24). Participants (n = 101) completed ratings of psychosocial and interpersonal experiences once per day for 100 d. Complete details regarding recruitment, diagnosis, and study procedures can be found in the studies by Wright et al (23) and Wright and Simms (24).…”

Uncovering general, shared, and unique temporal patterns in ambulatory assessment data

“…Daily expression of PD was measured using 30 items created for this project. Details related to full item set and scale development can be found in Wright and Simms (2016) MANOVA. We conducted a one-way multivariate analysis of variance (MANOVA) to evaluate if the average level of symptoms across the days used in the present study differed across the subgroups obtained from S-GIMME.…”

“…Referred to variously as experience sampling, ecological momentary assessment, or ambulatory assessment (Shiffman, Stone, & Hufford, 2008;Trull & Ebner-Primer, 2013), these approaches generally use intensive longitudinal data collection designs to sample behavior on a time-scale closer to the dynamic processes they intend to measure. Research in psychopathology increasingly relies on these methods to understand the nuanced and complex dynamic processes of mental illness (e.g., Ebner-Priemer et al, 2007;Hamaker & Wichers, 2017;Muehlenkamp et al, 2009;Myin-Germeys, van Os, Schwartz, Stone, & Delespaul, 2001;Pe et al, 2015;Sadikaj et al, 2013;Shiffman et al, 2002;Silk, Steinberg, & Morris, 2003;Smyth et al, 2007;Trull et al, 2008;Wright & Simms, 2016; see also Myin-Germeys et al, 2009 andEbner-Priemer, 2013 for reviews). This work has almost exclusively relied on the aforementioned diagnostic classification schemes by placing individuals in predefined groups and conducting analysis under the assumption of within-group homogeneity.…”

Ratings of affective and interpersonal tendencies differ for grandiose and vulnerable narcissism: A replication and extension of Gore and Widiger (2016)

“…Careful design of these studies will allow for the identification of how threats to the ego of narcissistic individuals relate to cognitive, emotional, and behavioral outcomes. There is an emergent literature that suggests relative stability of narcissism and related traits (e.g., self‐esteem, grandiosity; Wright & Simms, ), although it may differ by narcissism dimension (Guekes et al, ), but a more granular understanding of how traits function differently by situation is lacking. We believe that the frequency, intensity, and duration of different affective and interpersonal responses to threat are a key component of understanding the overlap between narcissistic grandiosity and vulnerability.…”

“…Although the empirical profiles associated with these narcissism dimensions are largely dissimilar, this is at odds with many theoretical perspectives that emphasize the joint role of grandiosity and emotional/ego‐based vulnerability in narcissism, as well as clinical reports that suggest narcissistic clients “virtually always” display traits of both grandiosity and vulnerability (Pincus, Cain, & Wright, , p. 440) that oscillate over the course of treatment. However, very little research has attempted to address the question of whether narcissistic grandiosity and vulnerability fluctuate within individuals across time, although some research exists that demonstrates grandiosity is relatively stable over time (Giacomin & Jordan, ; Lavner, Lamkin, Miller, Campbell, & Karney, ; Wright & Simms, ).…”