Many organizations have adopted peer support to increase service alignment with recovery-oriented principles. Yet, few studies have scrutinized borderline personality disorder (BPD)-specific concepts of "recovery" and "recovery-oriented practice," nor evaluated the extent to which existing peer support services (PSS) align with these concepts. We addressed these knowledge gaps in four phases: (a) a literature review to understand BPD-specific concepts of "recovery" and "recovery-oriented practice," (b) a literature review and open web search to describe the implementation, feasibility, or effectiveness of PSS for people with BPD, (c) a landscaping survey of program administrators regarding their BPD-PSS programs, and (d) a critical review of the extent to which current peer support for BPD aligns with "recovery" and "recovery-oriented practice." We identified 40 published sources that defined "recovery" or "recovery-oriented practice" as it pertains to BPD, and narratively summarize these results, nine sources that described PSS for people with BPD, and received survey responses from seven BPD-PSS program administrators. Our critical review highlighted the distinctive but overlapping concepts of "clinical recovery" versus "personal recovery" and underscored the alignment of BPD-PSS with personal recovery goals, including increased self-knowledge and -acceptance, hope, engagement in meaningful social roles and relationships, and self-determination. While peer support is experienced positively by service users, peer supporters, and clinicians, challenges include setting boundaries, minimizing dual roles, and ensuring adequate training, supervision, and personal support to reduce burnout. Peer support appears to be a feasible avenue for meeting the personal recovery goals of people with BPD; however, formal program evaluations are needed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Psychopathic personality disorder (PPD) is a widely recognized disorder that has been associated with high levels of dysfunction across clinical, forensic, occupational, and social settings. The psychopathy construct displays robust connections to social and interpersonal dysfunction; however, research investigating these associations thus far largely relies on total or domain-level scores. This study aimed to employ a higher degree of abstraction to examine associations between psychopathy symptoms and various interpersonal outcomes at different levels of the psychopathy trait hierarchy. The Comprehensive Assessment of Psychopathic Personality (Cooke et al., 2012) was used, allowing for the highest level of nuance, with 33 individual symptom scales. A variety of different interpersonal outcome variables were collected using multiple methods. A university sample ( = 669) was used and informant reports ( = 337) were collected. Consistent with our hypotheses, correlation analyses indicated that there were distinct, and at times unique, associations between symptoms and interpersonal outcomes. Furthermore, regression models and dominance analyses showed taking a symptom-level approach can add incremental information over factor scores, particularly for self-reported outcomes. Future research should seek to replicate these findings across populations to elucidate any consistent patterns that could aid in the assessment and treatment of PPD. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Sexual minority men are more likely to be diagnosed with borderline personality disorder compared to their heterosexual counterparts. Minority stressors have been associated with criteria for borderline personality disorder (e.g., substance use, suicidality, impulsive behaviors, and interpersonal difficulties with rejection). However, to date, there are no known studies examining the association between traditional minority and intraminority stressors and borderline personality disorder symptomatology. The purpose of the study is to examine the association between traditional and intraminority stressors and borderline personality disorder symptomatology among sexual minority men. Data were collected from 312 sexual minority men ( = 24.00, = 4.04) via Qualtrics panels across the United States. A hierarchical linear regression was conducted with borderline personality disorder symptomatology as the outcome variable. Minority stressors (i.e., internalized homophobia, sexual orientation concealment, major discrimination, and day-to-day discrimination) were entered in Step 1, and intraminority stress was entered in Step 2. In Step 1, both major and day-to-day discrimination were significantly positively associated with borderline personality disorder symptomatology. In Step 2, intraminority stress was significantly positively associated with borderline personality disorder symptomatology, and day-to-day discrimination remained significant. These findings warrant clinicians to evaluate both minority and intraminority stressors, which may be an additional risk factor in the development and/or maintenance of borderline personality disorder symptomatology. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Identity disturbance is increasingly considered to drive personality disorder (PD) onset. Previous research has investigated how identity relates to PD using either self-report scales or narratives to assess identity. Few studies have investigated how both operationalizations relate to one another and to models of PD. More so, no study has investigated whether a narrative identity assessment offers additional explanatory power in understanding PD, beyond what is captured by a self-rated identity assessment, or vice versa. We aimed to address these gaps by administering a rating scale measuring (mal)adaptive identity alongside a prompt to write a narrative about a turning point event to 331 individuals aged 18-30 (72.2% female, = 22.56). Using this multimethod approach, we investigated (a) associations of narrative identity dimensions (agency, communion, exploratory processing) with self-rated identity, self- and interpersonal dysfunction, and symptoms of borderline and antisocial PD, and (b) whether these narrative identity dimensions could explain unique variance in self- and interpersonal dysfunction, and borderline and antisocial PD symptoms, above and beyond self-rated identity, and vice versa. Results revealed significant associations among narrative identity, self-rated identity, and models of PD. Furthermore, communion demonstrated incremental value in explaining PD features, beyond what was accounted for by self-rated identity. However, narrative identity did not offer additional explanatory power in understanding self- and interpersonal dysfunction, beyond self-rated identity. Self-rated identity showed incremental value in explaining all PD models, beyond narrative identity. These results emphasize the importance of employing different methodologies for assessing identity in elucidating how identity disturbance manifests in personality pathology. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

There is a robust, yet poorly understood relationship between nonheterosexual orientation and borderline personality disorder (BPD), with lesbian, gay, and bisexual individuals evidencing greater BPD symptoms compared to heterosexual individuals. Recent evidence suggests possible psychometric bias in BPD diagnostic criteria leading to greater endorsement among sexual minority individuals, which hinders researchers' ability to make valid group comparisons. The present study utilized an epidemiological sample of 35,995 men and women to evaluate the extent of differential item functioning (DIF) among BPD criteria across sexual orientation groups using a multiple indicators multiple causes approach. All criteria except affective instability and emptiness indicated DIF for at least one sexual minority focal group, although both demonstrated DIF in sensitivity analyses. DIF was most consistently indicated for suicidality, efforts to avoid abandonment, and impulsivity. Contrary to predictions, DIF was mostly nonuniform with greater item discrimination for sexual minority groups compared to their heterosexual counterparts. Finally, all estimated effect sizes were small, suggesting that DIF was not practically meaningful and unlikely to impact the validity of group comparisons for BPD criteria across heterosexual and nonheterosexual men and women. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Most socially and/or ethically aversive traits from clinical and broad personality research overlap to a large degree. For the latter, however, the association with interpersonal personality dysfunction (IPD) is understudied. Moreover, it is also unclear to what extent the associations of aversive traits with IPD are due to their shared versus unique aspects. We investigate these questions based on a theoretical framework that comprehensively describes the shared variance of all aversive traits. To this end, we concurrently measured 20 aversive traits from clinical and broad personality research together with their common core. Results from five studies (four of them preregistered, total = 4,847) revealed that all aversive traits are associated with IPD and that most do so (only) due to their common core. Only three traits offered additional aspects beyond the common core relevant for IPD. The results inform debates about whether to include more traits in the Alternative Model for Personality Disorders. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Borderline personality disorder (BPD) is a complex and severe psychiatric condition characterized by emotional, self-image, behavior, and relational instability. While adult BPD heterogeneity has been extensively studied, the phenomenological borderline personality features (BPFs) in adolescence remain uninvestigated. This study aimed to explore the potentially dynamic causal relationships between BPFs in adolescence and identify the subtypes through cross-lagged panel network (CLPN) analysis. Two independent Chinese adolescent samples were followed over 18 months (₁ = 1,056, = 15.37, SD1 = 1.86) and 6 months (₂ = 723, = 16.84, ₂ = 0.48) to track BPFs. CLPN modeling was employed to investigate the stability, potential causal relations, and subtypes of adolescent BPFs. The results revealed a relatively stable overall adolescent BPF network structure with some subtle changes over time. Impulsivity emerged as the BPF with the highest out-expected influence, indicating its predictive role for other BPFs. A strong reciprocal causal relationship was observed between impulsivity and affective instability. Based on the CLPN estimation, two distinct BPFs subgroups were spontaneously clustered: externalized-dysregulation subtype (impulsivity, affective instability, and self-harm/suicide) and introjective-disturbance subtype (identity disturbance, chronic emptiness, and stress-related dissociation). The present study tentatively explores a potential typology for adolescent BPF based on these two clusters, which possibly have different pathological mechanisms, and moreover offer insights into the essential construct and clinical intervention of adolescent BPD. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Borderline personality disorder (BPD) is characterized by unstable self-image, conflictual interpersonal relationships, emotional dysregulation, and marked impulsivity. One form of impulsivity commonly seen in BPD is binge eating; however, little is known about this maladaptive behavior in the context of BPD. In the eating disorder (ED) literature, multiple theories suggest binge eating occurs as a result of heightened levels of negative affect. Given that BPD and EDs share emotional dysregulation and impulsivity as maintaining mechanisms of each respective disorder, these theories of binge eating may provide a model for binge eating in BPD. Existing literature suggests feelings of emotional emptiness may precede binge episodes in those with EDs. The current study sought to explore feelings of emptiness as antecedents to binge eating behaviors in those with BPD traits. Using ecological momentary assessment, binge episodes, affect, and feelings of emptiness were tracked throughout the day for 14 days in undergraduate students with BPD traits ( = 55). The current study found momentary feelings of emptiness at the time of the binge eating episode significantly predicted increased odds of a binge episode occurring. Additionally, momentary feelings of emptiness, as well as other negative affects, increase following a binge episode. Results suggest treatment of binge eating within BPD should include elements of acceptance of negative affects including emptiness, such as in dialectical behavior therapy distress tolerance skills training. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Borderline personality disorder (BPD) is commonly comorbid with chronic pain and associated with pain symptoms and interference. BPD features are associated with negative affect, which is associated with pain catastrophizing and/or pain anxiety, and finally pain severity or interference. We extended models of the BPD-pain associations in a chronic pain sample ( = 202), highlighting the role of negative affect (depression and anxiety) and pain catastrophizing, and exploring the potential benefit of emotional suppression/distraction as a component of these associations. BPD symptoms were positively associated with pain severity, mediated by negative affect and pain catastrophizing, supporting a cognitive-affective pathway linking BPD to pain experiencing. There was only minor evidence for the benefit of incorporating emotional suppression/distraction into research or treatment on the BPD-pain association. We provide clinical implications based on targeting affective symptoms and catastrophizing among individuals with co-occurring chronic pain and BPD. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Increasing interest surrounds the relation between Level of Personality Functioning (LPF), as defined by Criterion A of the Alternative Model for Personality Disorders, and the Hierarchical Taxonomy of Psychopathology (HiTOP) model. However, the integration of LPF within HiTOP remains unclear. Using bivariate correlation and linear regression analyses, this study assessed the associations between LPF and HiTOP spectra (externalizing antisocial, externalizing drug use, internalizing, antagonism, detachment, and psychoticism). A sample of 1,183 participants (46.2% female, = 31.3 ± 14.8 years) from the Italian community completed various self-report measures to capture impairments in personality functioning, and several psychopathology symptoms. Bivariate correlations and regression analyses showed that the LPF facets were consistently associated with all HiTOP domains, even though the LPF measures used in this study appeared more reflective of internalizing symptoms than externalizing ones. The identity facet of LPF was uniquely associated with all outcome criteria, whereas no unique associations were evident for self-direction. Empathy facet had the highest association with antagonism while intimacy presented the highest relation with detachment. Overall, the evidence presented in this study partially supports the construct validity of Criterion A, highlighting its relevance across a wide range of psychopathological symptoms and its potential utility in clinical assessment beyond formal personality disorder diagnoses. Thus, this study may contribute to the understanding of LPF's role in the dimensional model of psychopathology and underscores the importance of considering personality functioning in the assessment and treatment of mental disorders. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

This study examined several forms of repetitive negative thinking in relation to measures of Cluster B disorders to identify unique and co-occurring cognitive mechanisms contributing to these symptom presentations. MTurk participants ( = 725; 53% men; 76% White) completed categorical and dimensional trait-based measures of Cluster B disorders alongside six measures of rumination and worry. Oversampling strategies were used during participant recruitment to obtain a sample with clinically relevant personality features. Path analyses examined each form of repetitive negative thinking in relation to Cluster B measures while controlling for shared variance between each construct. Anger rumination demonstrated notable relations across all four Cluster B personality disorders. Similarly, sadness rumination was positively associated with all four Cluster B personality disorders. Self-critical rumination and depressive rumination were uniquely associated with borderline symptoms. Worry demonstrated negative associations with measures of narcissistic, histrionic, and antisocial/psychopathy symptoms. Findings expand previous research by highlighting probable transdiagnostic and distinguishing cognitive process contributing to the presentation of Cluster B personality pathology. However, partialling the influence of overlapping constructs presents notable challenges in identifying and interpreting unique relations between various forms of repetitive negative thinking and Cluster B symptoms. Future research investigating these relations within outpatient and inpatient samples may provide avenues for the development of effective cognitive-based interventions for treating these symptoms. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Disinhibition is a personality trait with broad health implications and has been included in several prominent models of maladaptive personality traits and psychopathology, such as the fifth edition, Alternative Model of Personality Disorders and the Hierarchical Taxonomy of Psychopathology. Cross-sectional global self-report and clinical interview research suggests that disinhibition is tightly linked with interpersonal problems, particularly antagonistic problems. However, very little work has examined how individual differences in disinhibition manifest in interpersonal functioning in social situations in daily life. We examined how trait disinhibition and its lower level facets (e.g., irresponsibility, impulsivity, distractibility) relate to ecological momentary assessments of interpersonal interactions in daily life across three samples (total person = 1,068, total observation = 38,212). Results showed a consistent and positive association between trait disinhibition and negative affect in daily life (both in general and specifically during social interactions), above and beyond the effect of trait antagonism. We also found a negative association between trait disinhibition and warmth during social interactions, though this effect was fully accounted for by trait antagonism. We did not find consistent associations between trait disinhibition and positive affect or dominance in daily life. These findings have implications for the manifestation of disinhibition in daily life and the relation between externalizing and internalizing psychopathology. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

In 2022, published a 10-year retrospective on the fifth edition (DSM-5), Section III, Alternative Model for PDs (AMPD; American Psychiatric Association, 2013). The articles of the 10-year retrospective provided evidence in support of the validity, reliability, and clinical utility of the AMPD. Specifically, it provided evidence in support of the unidimensional factor structure of the LPF and the five-dimensional structure of the pathological trait domains. In addition, evidence in support of the construct validity of the LPF in its association with psychiatric severity, functional outcomes, traditional PDs, cognitive, emotional, and contextual correlates, and other indices of maladaptive self- and interpersonal functioning was provided. Despite this evidence, a significant gap has since been identified related to how the American Psychiatric Association (APA) decides to accept proposed revisions to diagnostic criteria. The goal of the current special issue is to address this gap. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Youth with personality pathology are at a greater risk of developing broader psychopathology and experiencing poorer life outcomes in general. Therefore, detecting personality problems, specifically features of borderline personality disorder (BPD), provides opportunities for early intervention. In this study, we investigated the incremental value of Criteria A and B of the alternative model for personality disorders (AMPD) compared to a BPD symptom count based on the , fifth edition Section II personality disorder model in broader psychopathology (i.e., internalizing and externalizing symptoms) and age-adequate psychosocial functioning (i.e., attainment of developmental milestones). In a clinical sample of 246 young people ( = 19.22, = 2.76, 81.7% female), separate path analyses showed that a BPD symptom count, Criterion A, and Criterion B were all relatively strongly related to the outcome measures. In a combined path model, the AMPD and especially Criterion B explained additional variance in internalizing and externalizing pathology and age-adequate psychosocial functioning. The current results underscore the value of the AMPD for the early detection of negative psychopathological and psychosocial outcomes commonly associated with BPD. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Our cross-sectional study provides a head-to-head comparison of Section II and Section III of , fifth edition (DSM-5) diagnostic models of personality disorders (PDs) in identifying significant personality correlates of psychiatric hospitalization (PH). PH is an indicator of a breakdown in one's existing ability to manage mental crisis. The sample was recruited from psychiatric clinical services () as well as universities and the local community (). We used the Structured Clinical Interview for PD (SCID-5-PD) for Section II diagnosis, the Self and Interpersonal Functioning Scale (SIFS) for Criterion A and the Personality Inventory for (PID-5) for Criterion B. Separate logistic regressions analyses showed high discriminative utility for all diagnostic models: the number of Section II diagnosis, level of personality functioning, and five maladaptive traits (AUC between .89 and .97). Binomial logistic regression with a forward stepwise procedure showed that Section II number of diagnoses revealed incremental utility over Criteria A and B in distinguishing between individuals experiencing a mental health crisis requiring PH and those not requiring immediate intervention. We conclude that each diagnostic model, when considered individually, exhibits a high degree of discriminatory performance. However, employing all these models concurrently for identifying personality correlates of PH proves impractical. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

In this study, we compare the incremental predictive capacities of the , Section II personality disorders (SII-PDs) with Section III trait domains of the Alternative Model of Personality Disorders (AMPD) in a psychiatric outpatient sample ( = 185). To this end, a series of hierarchical regression analyses was conducted in which the 10 SII-PDs and the five AMPD trait domains served as the predictor variables and five areas of clinical dysfunction as the criterion variables. Two models for each criterion were tested. In Model A, the 10 PDs were entered as a block, followed by the block entry of trait domains; in Model B, the block entry of these predictors was reversed. As the AMPD was designed to address the shortcomings of the SII-PDs, it was hypothesized that the AMPD trait domains would show greater predictive capacity vis-à-vis the latter by (a) explaining more overall variance for each criterion variables when entered first into the model versus when SII-PDs was entered first and (b) explaining more incremental variance than SII-PDs when block was entered second. These hypotheses were partially supported. Overall, the AMPD trait domains predicted more variance than SII-PDs and demonstrated better model fit and more predictive power for three of the criterion variables. Similarly, the AMPD domains predicted a significant but modest incremental increase in variance over that of the SII-PDs for three of the criterion variables. We conclude that more work needs to be done to improve the AMPD, particularly in the assessment of externalizing psychopathology as it relates to clinical dysfunction. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Borderline personality disorder (BPD) is defined by the presence of at least five of nine symptoms in Section II of the , fifth edition. In the fifth edition, Section III Alternative Model of Personality Disorders (AMPD), BPD is defined by deficits in self and/or interpersonal functioning (Criterion A), elevated negative affectivity, and elevated antagonism and/or disinhibition (Criterion B). However, it is unclear if these definitions describe the same people and if the AMPD criteria explain unique variability in treatment outcomes in this population. In a treatment-seeking sample of adult participants diagnosed with BPD according to Section II criteria ( = 65, = 27.60, 70.8% female, 76.9% White), we found a majority (66.2%) would have also received the diagnosis based on AMPD criteria. Those meeting AMPD criteria reported more severe Section II BPD symptoms than those who did not, s < .02, s > 0.60, and the presence or severity of Section II fears of abandonment and inappropriate anger uniquely predicted AMPD BPD diagnoses, s < .03, s ≥ 2.31. Changes in AMPD dimensions explained 34% of the variability in change in work/social adjustment ( = .13) and quality of life ( = .22), respectively, over and above changes in Section II symptoms during a novel cognitive-behavioral treatment for BPD. These results suggest that AMPD criteria capture a more severe subset of BPD than Section II criteria and may be important predictors of treatment outcomes. We discuss the potential trade-offs of this shift in diagnosis. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Stigmatizing views surrounding mental illness are widespread. Personality disorders (PDs) are among the most stigmatized mental illnesses, as individuals with PDs are often described using pejorative terms, which might impact clinicians' a priori expectations and increase the likelihood of stigmatization, discrimination, or early termination from treatment. The degree to which the terms used in any diagnostic classification systems are stigmatizing has never been examined. The current study aims to explore the level of stigma perceived in diagnostic terms used and to compare which systems of classification (the , fifth edition [] Section II, Alternative Model of Personality Disorder, and Hierarchical Taxonomy of Psychopathology [HiTOP]) are reported as less stigmatizing. The current study consisted of three samples. Individuals with lived experience of personality pathology ( = 218) completed an online survey examining the level of stigma perceived in diagnostic terms; mental health care providers ( = 75) and undergraduate psychology students ( = 732) also completed online surveys examining their perceptions of stigma within diagnostic terms. We examined differences in perceived stigma between the three classification systems across the three samples. Among mental health care providers, the HiTOP was rated as the least stigmatizing while categorical labels were rated as the most stigmatizing. There were no significant differences found among individuals with lived experience or undergraduate students. Understanding the degree to which the terms used to describe personality pathology contributes to reducing stigma has potentially important repercussions for research and clinical practice. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Traditional personality disorders (PDs; e.g., ] Section II PDs), as well as dimensional traits (e.g., alternative model for PD [AMPD]), offer unique advantages in personality pathology assessment. However, very little is known about how these systems compare in predicting observable behavior. This study compares self-report ratings of PD symptoms (i.e., Structured Clinical Interview for PD) with self-reports of AMPD traits (i.e., Personality Inventory for -) in predicting clinical outcomes, 1 year later, via three different methods: (a) naturalistically observed psychosocial functioning (i.e., electronically activated recorder [EAR]), (b) informant-reported interpersonal functioning (i.e., Inventory of Interpersonal Problems-32), and (c) self-reported suicidality (SI), depression, anxiety, and substance use symptoms (i.e., Psychiatric Diagnostic Screening Questionnaire). Data were analyzed from 72 individuals in current or recent psychiatric treatment meeting diagnosis for at least one PD. Results showed that Section II PD and AMPD ratings yielded meaningful and comparable predictions of naturalistically observed EAR variables and informant-rated interpersonal functioning. The AMPD appeared to offer slight advantages in the prediction of EAR-observed negative affect, hostile words, and informant-rated interpersonal functioning, with clearer advantages at the facet level. Overall, these results provide tentative evidence that both Section II PD and AMPD systems show meaningful links with clinical outcomes measured via multiple methods 1 year later, but with clearer advantages for the AMPD at the facet level. Moreover, results show that the EAR is a viable method for capturing naturalistically observed clinically meaningful, in vivo behavior of individuals exhibiting maladaptive personality patterns. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The objective of this preregistered study was to gather evidence on training and clinical experiences offered by clinical psychology doctoral programs on the treatment of antagonism-a construct from the personality and psychopathology literature that captures individual differences in aggressiveness, callousness, grandiosity, domineering, and manipulativeness. We surveyed current graduate students ( = 376) in APA-accredited clinical psychology doctoral programs ( = 28.4; 83.2% female; 65.2% White) about their experiences in training and treatment of antagonistic patients (ANT-patients) as well as experiences with patients with predominant negative affect (NA; e.g., anxious and depressed). Students reported significantly less training to treat antagonism compared to NA (|| = 0.43-2.88), as well as lower rates of direct clinical experience, generally poorer treatment experiences, and stronger countertransference reactions (|| = 0.53-1.40). These discrepancies were especially large for adult-focused students compared to child/adolescent-focused students. In fact, adult-focused students reported a mean competency rating of = 1.71, between the scalar points (1) and (2). Overall, these results indicate a lack of training and competence to treat antagonism among current graduate students, especially adult-focused students. We believe the crux of this issue is a field-wide lack of robust empirical work on antagonism treatments (for adults). Moving forward, we implore researchers and funding agencies to help address this substantial gap, which is both an ethical and practical imperative. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Although clinical psychologists have long speculated that antagonistic individuals may lack insight into their moral deficits, some evidence has shown that more (vs. less) antagonistic people view moral traits as somewhat desirable and rate themselves as lower on moral characteristics (suggestive of some insight). But, we suggest that antagonistic people's struggles with insight can be detected as part of a basic social-cognitive bias that entails believing the self is better-than-average on socially desirable characteristics (i.e., the "better-than-average effect" [BTAE]). Specifically, although antagonistic people may rate themselves lower on moral characteristics than less antagonistic people, they may still believe that their relative standing on moral characteristics compares favorably to others. Participants ( = 515) completed indicators of the Dark Tetrad (D4) constructs (narcissism, Machiavellianism, psychopathy, and sadism) and rated themselves in relation to others on moral and immoral character traits. Overall, participants exhibited very large BTAEs (i.e., rated the self as "better-than-average" on moral character traits); only psychopathy and sadism consistently related negatively to BTAEs, but people with elevations in each D4 construct (or any D4 facet) still exhibited large-to-very-large BTAEs. Such antagonistic participants viewed themselves as possessing substantially greater amounts of moral than immoral character traits but viewed average others as possessing an equal mix of these traits. (PsycInfo Database Record (c) 2024 APA, all rights reserved).