Kennedy M. Balzen

Despite evidence for the onset of personality disorder (PD) during adolescence, few studies have examined the internal structure of the alternative model for PDs in youth. Network analysis offers a valuable alternative to factor analytic approaches by modeling the unique associations among observed indicators, allowing for identification of central features within the network of personality pathology. This preregistered, cross-sectional study used network analysis to examine links between maladaptive personality trait domains and level of personality functioning (LPF) in adolescents to identify structurally central features of adolescent PD symptomatology. A sample of 1,441 adolescents (n = 1,174 community; n = 267 clinical) completed measures of LPF (Criterion A) and maladaptive traits (Criterion B). Network analyses were conducted separately in each sample, followed by a formal network comparison test. Both networks were densely connected and demonstrated high accuracy and stability. Centrality analyses indicated that LPF domains and subdomains yielded the highest strength centrality. Network structure and global connectivity were largely invariant across the clinical and community samples. Small differences in network structure were observed between boys and girls, and between early and late adolescents, though only at the LPF subdomain level. Findings underscore the central structural role of self and interpersonal functioning (i.e., LPF) within adolescent personality pathology networks, supporting its relevance as a potential organizing framework for understanding maladaptive personality traits. The similarity in network structure across community and clinical samples further reinforces the dimensional nature of PD in adolescents. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Introduction: Recent advances in psychiatric nosology replace categorical personality disorder diagnoses with dimensional frameworks characterized by level of personality functioning (LPF) and maladaptive traits. Increased emphasis on the assessment of self‐functioning with LPF has led scholars to advocate for the inclusion of narrative identity into these models. The current study aimed to examine the utility of narrative identity for the assessment of LPF, and as an aid alongside LPF in predicting a relevant clinical outcome—functional impairment. Methods: Life story narratives, alongside measures of LPF and functional impairment, were collected from 141 emerging adults (M _age = 20.70, SD = 2.08) drawn from a mixed college and clinical sample with borderline personality disorder. Results: Maladaptive LPF was significantly associated with greater narrative deterioration and lower levels of agency, communion, and growth at the bivariate level. Regression analyzes revealed that narrative agency significantly predicted more adaptive self‐reported LPF, whereas narrative deterioration predicted more maladaptive interview‐rated LPF. Best subsets regression revealed that narrative deterioration, alongside self‐reported and interview‐rated LPF, explained the most variance in functional impairment with minimal model bias. Conclusion: Results highlight the utility of narrative identity for the assessment of LPF and as an aid to LPF in predicting functional impairment.

This study evaluated the Personality Inventory for DSM-5 Brief Form (PID-5-BF) as a screening tool for personality disorder (PD) in adolescents. Data from clinical (n = 127) and community (n = 139) samples of adolescents aged 12 to 17 were analyzed. Exploratory structural equation modeling supported the five-factor structure, with good to excellent internal consistency. Nomological validity was demonstrated through correlations with other measures of personality and psychopathology. All PID-5-BF domains, except antagonism, differed significantly between adolescents with borderline PD (BPD), non-BPD inpatients, and community controls. However, only negative affectivity showed significantly higher mean scores among inpatient youths with BPD compared to those without BPD. Receiver operating characteristic curve analyses indicated that only negative affectivity among the PID-5-BF domains demonstrated diagnostic accuracy in the lower moderate range for identifying BPD, whereas the total score and other domains showed limited performance. In comparison, a measure of identity diffusion demonstrated stronger discriminative ability. Overall, these findings suggest that the PID-5-BF might be a useful tool for identifying pathological personality trait-related risk factors associated with general psychopathology. However, its utility might be more limited in accurately detecting BPD specifically within adolescent populations.

Self-injurious behavior (SIB) is conceptualized as the deliberate, direct harm to oneself, and encompasses nonsuicidal self-injury (NSSI, or deliberate self-harm), suicidal behavior, and suicide (G...

Identity formation is central to adolescent development. Challenges in establishing a stable sense of self is associated with maladaptive identity function, which has been recognized as a core feature of personality pathology. The narrative identity framework offers a unique lens to garner salient information about one's sense of self. The Awareness of Narrative Identity Questionnaire (ANIQ) is a self-report measure of narrative identity validated in adults but is yet to be validated in adolescents. The current study aimed to conduct the first psychometric evaluation of the ANIQ in a sample of 205 youth aged 10-14 years (M = 12.1 ± 1.06 years; 50.7% female; 73.7% Hispanic) recruited from a public charter school. Results confirmed the four-factor structure of the ANIQ and showed high internal consistency. Convergent validity was supported through negative associations between the ANIQ and borderline personality features and identity diffusion. Incremental validity of the ANIQ over identity diffusion in predicting borderline personality features was also examined, but not supported. Overall, results support the ANIQ as a promising instrument for the assessment of narrative identity in youth. However, some improvements to the ANIQ might be necessary in order to use it as a clinical tool in identifying youth with personality pathology.

There have been proposals to expand definitions for categorical disorders and dimensionally conceptualized syndromes (e.g., psychopathy) to include negative mood lability and dysregulation (NMD). Factor analytic results are often presented in support of these proposals, and we provide factor analytic demonstrations across clinically oriented samples showing that NMD indicators load strongly onto factors with a range of psychopathology. This is unsurprising from a transdiagnostic perspective but shows that factor analysis could potentially be used to justify expanding definitions for specific constructs even though NMD indicators show strong, nonspecific loadings on psychopathology factors ranging widely in nature. Expanding construct definitions and assessment approaches to emphasize NMD also may negatively impact discriminant validity. We agree that targeting NMD is essential for comprehensive assessment, but our demonstrative analyses highlight a need for using factor analysis and other statistical methods in a careful, theoretically driven manner when evaluating psychopathology structure and developing measures.

Introduction: The rate of adolescent suicide attempt has increased drastically over the past 10 years. However, little is known regarding what predicts a more versus less lethal attempt, which is of critical interest to clinicians managing this at‐risk population. We sought to extend the study of lethality in adolescents by exploring its relationship with two recognized risk‐factors for suicide attempt: fearlessness about death (FAD) and suicide planning.Methods: Participants (N = 254) were administered measures of FAD and depressive symptoms upon entering intensive outpatient treatment for adolescents exhibiting suicidal thoughts and behaviors. Attempts made between treatment entry and 6 months following discharge (n = 47) were scored on a 4‐point ordinal scale of lethality. The resulting continuum ranged from no attempt to attempts of low to moderate levels of lethality.Results: FAD and suicide planning distinguished between levels of lethality of future attempt at the bivariate and multivariate level. FAD's predictive relationship with lethality while controlling for age, sex, depression, and prior attempt diminished when suicide planning was covaried.Conclusion: FAD and suicide planning significantly predicted more versus less lethal future attempts in our sample of adolescents in a clinical setting. Our findings suggest that FAD influences the lethality of a future attempt by promoting planning for suicide. More studies are needed to assess whether the brief FAD scale might be a valuable adjunct in the clinical management of youth with suicidal thoughts and behaviors.