Mental disorders with body-centered symptoms, such as somatic, eating, and body dysmorphic disorders, present difficulties in psychotherapy because psychological suffering is manifested in the body rather than expressed verbally. The present study illustrates a single case multi-method investigation sensitive to detecting characteristic change manifestations in the treatment of these disorders. We investigated a treatment of a patient with body dysmorphic disorder. Computerized linguistic measures were applied to 86 sessions to assess changes in symbolic processing; out of the 86 sessions, 40 were analyzed to calculate the proportion of speech focused on bodily symptoms versus on relationships. Changes in personality were assessed using the SWAP-200 on nine sessions from different treatment stages. Measures of linguistic style, speech content, and personality showed marked changes over the treatment. The patient manifested schizoid and schizotypal personality traits that decreased over time, along with an increase in personality high-functioning dimension. The patient\'s ability to translate his emotional experience into words steadily increased, switching the primary focus of narratives from bodily symptoms to relationships. A multimethod assessment of the treatment of body dysmorphic disorder shows that improvement in personality functioning is accompanied by a shift from a focus on bodily experiences to a focus on relationships.

OBJECTIVE: Nonverbal Learning Disability (NLD) is a controversial diagnosis which continues to lack an agreed upon diagnostic taxonomy despite its long existence and overlap with other disorders. NLD is considered a dysfunction of the right hemisphere with neuropsychological, academic, and social-emotional/adaptation deficits along with poor motor coordination. This case study reviews an adolescent diagnosed with NLD and Mosaic Turner Syndrome (MTS) and discusses challenges encountered to emphasize importance of an early diagnostic accuracy and the effect of developmental conditions.
METHODS: A 17-year-old female presented for neuropsychological evaluation for a mental health diagnosis and possible academic accommodations. Chief complaints included lifelong functionally interfering difficulties with attention, organization, and emotional and social functioning. Medical history was significant for MTS.
RESULTS: The patient\'s VCI was in the high-average range (VCI = 114), while her PSI was in the low-average range (PSI = 81). She demonstrated high-average to average visual-spatial, construction abilities, and language skills, while performance ranged low-average for perceptual-motor processing and processing speed. Performance on delayed visual-graphic figures was significantly weaker compared to her superior performance on verbal memory for meaningful information. Finally, her delayed visual-graphic was significantly impaired compared to her general performance visual-spatial and construction abilities.
CONCLUSIONS: The constellation of symptoms reported by the patient, combined with the results of neuropsychological assessment, was highly congruent with prototypical nonverbal learning disability, except for difficulties in mathematical skills. This case demonstrates the importance of proper diagnosis during childhood, the role of neuropsychological evaluation in specific learning disability (SLD) assessment, and lasting effects of a developmental condition on adult functioning.

Traditionally, narcissistic characteristics are considered relatively stable, although clinical accounts and recent research show that additional narcissistic states are variable and fluctuate in actuality. Narcissism research tends to focus on cross-sectional, group-based, trait approaches. Momentary ecological assessments allow one to discover individuals\' true colors by observing narcissistic experiences while they unfold in real-time and real-world settings. Within momentary ecological assessments, inspecting single cases enables insight into individual dynamics and presentations. Consequently, this research collected grandiose and vulnerable narcissistic trait and state data 10 times a day for 6 days. Based on the highest trait scores, two individual cases are presented per category: predominantly grandiose narcissistic, predominantly vulnerable narcissistic, and combined narcissistic. Overall, the descriptions provide evidence for the dynamics within and between grandiose and vulnerable narcissistic states. Further, broad patterns for each narcissistic dimension were uncovered, in which the grandiose subdimension experienced mainly grandiosity, and the vulnerable and combined subdimensions experienced both grandiosity and vulnerability. Out of the three, the combined subdimension experienced the highest instability and levels of daily vulnerability. However, each individual case showed unique fluctuation patterns that highlight the importance of personalized, real-life assessments in research and clinical care.

Good Psychiatric Management (GPM) is a generalist clinical management approach for borderline personality disorder that incorporates common ingredients of good standard care for any psychiatric diagnosis with what works from prevailing specialist psychotherapies. Similar to all validated therapies for BPD, it relies on a specified formulation of the disorder\' symptoms as arising from interpersonal hypersensitivity, to dynamically describe typical patterns of daily self- and interpersonal issues that drive the instability that defines the general personality dysfunction characteristic of the disorder. Recent adaptations of GPM have been proposed for narcissistic personality disorder and obsessive-compulsive personality disorder, with development of similar dynamic models for both (intrapsychic coherence model and model of overcontrol). New dimensional models of personality disorder diagnosis have been developed to address limitations of categorical approach, but the incorporation of these models into usage in the delivery of clinical services (where categorical approach remains the most used) is limited. This paper describes an adaptation of GPM to two cases of personality disorder that illustrate the usefulness of GPM models for dynamic representation of complex daily fluctuations in internal psychic coherence and interpersonal functioning. Specialist psychotherapies will never meet the demands of public health needs to treat personality dysfunction, and incorporation of new dimensional models of diagnosis are needed for treatments that can provide a minimal standard of care for providers and patients.

Depressive disorders in adolescence are among the most challenging clinical syndromes to diagnostically identify and treat in psychotherapy. The Psychodynamic Diagnostic Manual, Second Edition (PDM-2) proposes an integration between nomothetic knowledge and an idiographic understanding of adolescent patients suffering from depression to promote a person-centered approach. This single-case study was aimed at describing and discussing the clinical value of an accurate diagnostic assessment within the PDM-2 framework.
Albert, a 16-year-old adolescent with a DSM-5 diagnosis of major depressive disorder, was assessed using instruments from various perspectives: the Structured Clinical Interview for DSM-5; the Psychodynamic Chart-Adolescent of the PDM-2, and other clinician-report instruments; and the Shedler-Westen Assessment Procedure for Adolescents and Defense Mechanisms Rating Scale Q-sort, coded by external observers.
Albert\'s assessment revealed impairments in various mental capacities, especially in regulating self-esteem. He presented a borderline personality organization at a high level and an emerging narcissistic personality syndrome.
The case discussion showed the importance of providing clinically meaningful assessments to plan for effective treatments in youth populations. Especially, it is necessary to understand the adolescent\'s unique characteristics in terms of mental and personality functioning and consider the developmental trajectories and adaptation processes that characterize this specific developmental period.

A proposed feature of personality pathology involves disturbances in identity, of which a lack of insight is one such manifestation. From recommendations in the literature, one potential approach to assess and quantify such impairment and link it to personality pathology, would be to obtain self-reports and informant reports and subsequently index the degree personality pathology severity exacerbates self-other discrepancies. The current study examines the degree to which self-reports and informant reports of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), Section III trait scores are discrepant (i.e., mean-level discrepancies and correlational accuracy), as well as whether general personality pathology severity moderates these characteristics. Target participants (N = 208) in an elevated-risk community sample completed the Personality Inventory for DSM-5 (PID-5), and knowledgeable informants rated targets using the informant version of the PID-5. General personality pathology severity was assessed via an aggregate of five-factor model personality disorder prototype scores derived from self-report, informant-report, and interview ratings. Mean-level discrepancies and correlational accuracy (and their moderation by general personality pathology) for PID-5 domains, facets, and personality disorder scores were subsequently examined. Results suggested that targets tended to mostly rate themselves only slightly lower than informants across all PID-5 scores (median dz = .21), and correlational accuracy across all PID-5 scores was moderate (median r = .34). Importantly, however, mean-level discrepancies increased as general personality pathology severity scores increased. Implications and future directions for the multimethod assessment of dimensional personality pathology are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Self-report questionnaires are the most commonly used personality assessment despite longstanding concerns that self-report responses may be distorted by self-protecting motives and response biases. In a large-scale meta-analysis ( N = 33,033; k = 152 samples), we compared the means of self- and informant reports of the same target\'s Big Five personality traits to examine the discrepancies in two rating sources and whether people see themselves more positively than they are seen by others. Inconsistent with a general self-enhancement effect, results showed that self-report means generally did not differ from informant-report means (average δ = -.038). Moderate mean differences were found only when we compared self-reports with stranger reports, suggesting that people are critical of unacquainted targets. We discuss implications of these findings for personality assessment and other fields in which self-enhancement motives are relevant.

Diagnoses of personality disorders (PD) must rely on judgments of observers-either clinicians or acquaintances-because personality disorders are primarily defined in terms of maladaptive interpersonal behavior. Little is known, however, about how closely acquaintances\' judgments of PD traits relate to self-reports of theoretically relevant Big Five traits or directly observed behavioral outcomes in interpersonal situations. The present study examines associations between judgments of the 10 PD traits provided by close acquaintances, self-reports of PD-relevant Big Five personality traits, and observed interpersonal behaviors across three different three-person laboratory interactions (i.e., unstructured chat, cooperative task, competitive game).
The sample consisted of 256 undergraduate students (130 females; Mage  = 19.83, SD = 1.25). Four unacquainted observers independently rated participants\' behaviors from video recordings.
In line with previous work, informant reports of PD traits demonstrate strong convergent validity with relevant self-reported Big Five traits (as identified by Lynam & Widiger, 2001). Directly observed behavior is meaningfully associated with acquaintances\' judgments and self-reports of PD-relevant traits, and the associations between these judgments and behavior are strongest for traits associated with histrionic and schizoid PD. Vector correlations between behavioral profiles associated with informant and self-reports show that both assessments have similar behavioral correlates. Associations between PD trait ratings and behavior appeared to differ as a function of gender, with males showing more and stronger correlations.
Informants\' ratings of PD traits are impressively accurate, converging both with self-reports of relevant traits and directly observed interpersonal behavior. Therefore, a comprehensive understanding of PDs and associated traits can be augmented by information from multiple acquaintances who have the opportunity to observe how an individual interacts with others on a daily basis across diverse contexts.

OBJECTIVE: The World Health Organization\'s estimations indicate that about 50% of patients in well-developed countries may not adhere to long-term therapies. In the field of psychiatry, drop-outs from psychiatric treatment are particularly important. Personality disorders are a significant part of this sphere. The aim of this research was to empirically verify the hypothesis regarding the relation between comorbid personality disorders and drop-outs from treatment among patients of psychiatric wards.
METHODS: This study was a prospective cohort study. 110 patients, hospitalized in 3 different psychiatric wards, were included. Personality disorders were assessed with the Structured Clinical Interview For DSM-IV Personality Disorders (SCID-II). The research was financed by the Polish National Science Center (DEC-2011/01/N/NZ5/05364).
RESULTS: The response rate was 89.1%. 72.56% of patients suffered from personality disorders (SCID-II) (among them the most prevalent were: personality disorder - not otherwise specified - 40.7% and borderline personality disorder - 12.38%; 22.95% of patients dropped out from treatment). However, occurrence of personality disorders was not relevant for those drop-outs. On the other hand, relationships at the level of certain criteria of borderline personality disorders and passive-aggressive personality have been revealed. These relationships became stronger when considered from the perspective of differences in the organization of treatment at individual wards.
CONCLUSIONS: Some personality disorders may play an important role in drop-outs from psychiatric treatment. Presented results require further research.

Parent-Child Interaction Therapy (PCIT) is an evidence-based intervention designed for families of 2- to 6-year-old children with disruptive behavior disorders. This article illustrates the application of PCIT in a 10-year-old boy with attention deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD). Both parents and the patient attended PCIT sessions. The course of therapy included minor changes to the PCIT protocol. After 13 PCIT sessions, the patient displayed disruptive behaviors within normal limits, and 12 months later he no longer met diagnostic criteria for ODD. Results remained stable at a 17-month follow-up assessment. This case study suggests that the use of PCIT in families of children with ODD markedly older than the recommended age range might be a promising approach for improving family functioning and reducing behavior problems. Further research with larger samples of older children with ODD is needed to replicate and elaborate the findings of this case study.