2023 - Faustino Et Al
2023 - Faustino Et Al
2023 - Faustino Et Al
https://doi.org/10.1007/s10942-022-00448-0
Abstract
Personality Belief Questionnaire is an instrument based on cognitive behavioral
theory, focused on core beliefs associated with personality disorders. This paper
reflects a preliminary psychometric study of the (European) Portuguese version of
the Personality Belief Questionnaire-Short Form (PBQ-SF-PT) in a non-clinical
sample. In a cross-sectional design 344 individuals (M age = 32.56, SD = 11.28)
were assessed with self-report instruments. Two studies were performed: one based
on an Exploratory Factor Analysis (EFA) and another based on theoretical PBQ-
SF subscales. Results showed to be similar. Factorial structure of PBQ-SF showed
seven factors combining different subscales in the same factor. Dependent, Avoidant
and Borderline items loaded in the same factor and Narcissistic, Histrionic and Anti-
social items loaded in the same factor. Convergent validity was studied with corre-
lations between PBQ-SF-PT subscales and early maladaptive schemas. The results
suggest that the Portuguese version of the questionnaire is acceptable and can be
used as a useful measure for the assessment of personality beliefs in the Portuguese
population. However, more research is required to explore psychometric features of
the PBQ-SF in clinical samples.
* Bruno Faustino
[email protected]
1
Faculdade de Psicologia da Universidade de Lisboa, Lisboa, Portugal
2
CICPSI - Centro de Investigação Em Ciência Psicológica, Lisboa, Portugal
3
HEI‑Lab, Lusófona University, Lisboa, Portugal
4
Instituto Universitário de Lisboa (ISCTE-IUL), CIS-ISCTE, Lisboa, Portugal
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B. Faustino et al.
Introduction
The cognitive theory of personality disorders states that core beliefs play a funda-
mental role in our emotions and behaviors (Beck et al., 2004; Butler et al., 2007).
Core beliefs, when dysfunctional, are responsible for sets of maladaptive thoughts
and behaviors, as well as disruptive affective states that promote suffering, distress
and psychological disorders (Beck & Freeman, 1990; Beck, et al., 2004). These core
beliefs can be described as fundamental cognitive schemas in the individual’s men-
tal architecture, which function as a network articulated around a recurring theme
with a representational character. These core beliefs form a cognitive pattern of the
individual’s mental processing, guiding and selecting the treatment of multimodal
information (cognitive, emotional/affective and behavioral). These are the sche-
mas that, through the attribution of meaning, trigger chain reactions, that can be
observed as behavior—which is the visible expression of personality traits, such
as beliefs or latent schemas (Beck et al., 2004). In this sense, Beck and Freeman
(1991), defended that each personality disorder contains a set of typical beliefs that
can be clinically evaluated, and be targeted in psychotherapeutic intervention.
With this in mind, Beck (Beck & Beck, 1991) developed the Personality Beliefs’
Questionnaire (PBQ) in order to assess the hypothetical central beliefs underlying
the personality disorders identified at the time.
The assessment of dysfunctional personality contents and patterns is a hallmark
in psychological assessment guiding not only the case conceptualization process, but
also the clinical decision-making (Faustino & Vasco, 2020a, 2020b, 2020c; Faustino
et al., 2021a). In this sense, the use of validated instruments to assess dysfunctional
core beliefs about the self and other, facilitates information gathering helping cli-
nicians to elaborate a specific personality profile based on the cognitive thematic
content of each individual. Therefore, the PBQ is an ideal instrument to assess dys-
functional personality beliefs that individuals use to interpret the world (Beck et al.,
2004). The PBQ contains 126 items, distributed by nine scales (14 items per scale).
Each item consists of an affirmation corresponding to a personality belief associated
with a typical cognitive profile. For example, for Narcissistic personality disorder
there are statements such as "As I am so superior, I have the right to special treat-
ment and privileges", or for Histrionic personality disorder there are statements such
as "I must be the center of attention". The answer format fits the question: “How
much do you believe in the statement?”. Respondents should rate each statement on
a Likert scale: 4—I totally believe, 3—I believe a lot; 2—I believe moderately; 1—I
believe little and 0—I don’t believe. Each scale corresponds to the beliefs associ-
ated with personality disorders related to Axis II of DSM IV (APA, 1994), namely:
Paranoid, Schizoid, Narcissistic, Histrionic, Obsessive–Compulsive, Anti-social,
Dependent, Avoidant and Passive-aggressive. A 10th scale referring to Borderline
personality disorder was added later, by combining beliefs of Avoidant, Depend-
ent, Paranoid and Passive-aggressive personality disorders (Butler et al., 2002).
The instrument showed good internal consistency in several investigations, namely
in healthy and psychiatric patients, as well as good indexes of test–retest temporal
stability (r = 0.56 of the Avoidant scale = 0.93 of the Anti-social scale) referring to
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Preliminary Psychometric Properties of the Portuguese Version…
outpatient psychiatric patients (Bhar et al., 2012). The PBQ has also been shown
to be able to differentiate patients with different diagnoses of personality disorder
(Beck et al., 2001). Recently, Fournier, DeRubeis and Beck (2012) analyzed the
factor structure of the PBQ in 1121 participants, having found seven factors where
beliefs about Dependent and Avoidant personality disorders saturated in the same
factor. The same happened with Narcissistic and Anti-social personality disorders.
The factor related to the personality beliefs of Borderline disorder was also not evi-
dent in this analysis (Fournier et al., 2012).
Butler and colleagues (2007) referred to the need to develop a smaller and more
refined instrument for both clinical practice and research. In this sense, the devel-
opment of the Personality Beliefs Questionnaire—Short Form (PBQ—SF), was
advanced in two phases. First, nine experimental scales referring to personality
disorders were constructed, using the highest item-total correlations in a sample of
920 psychiatric patients, (M age = 36.4 SD = 11.1), 55% female (see Table 2). This
sample contained enough individuals with personality disorder to study the criterion
validity of five scales: Avoidant (n = 79), Dependent (n = 26), Obsessive–compul-
sive (n = 58), Narcissistic (n = 26) and Paranoid (n = 27) (Butler et al., 2007). Each
scale had only seven items, with the PBQ—SF having 65 items in total. In the sec-
ond phase, the PBQ—SF was applied to a sample of outpatient psychiatric patients
(n = 160, M age = 39.8, SD = 14.2 and 58% female). Internal consistency, construct
validity and test–retest stability were analyzed in this sample. The internal con-
sistency indexes were quite acceptable (Butler et al., 2007). The construct validity
was assessed by comparing the PBQ—SF scales with instruments that target other
clinical variables, namely: anxiety, depression, neuroticism, dysfunctional attitudes,
self—esteem and psychosocial functioning. For example, the PBQ—SF Avoid-
ant scale correlated negatively with a measure of self-esteem and positively with
measures of anxiety and depression. On the other hand, the PBQ—SF Narcissistic
scale correlated with the same variables but in an opposite way (Bhar et al., 2012).
Finally, test–retest stability obtained high values from 0.57 on the antisocial scale to
0.82 on the Obsessive–compulsive scale (Butler et al., 2007).
The construct of early maladaptive schemas is similar to the construct of core
beliefs. Early maladaptive schemas are described as the lifelong self-defeating pat-
terns of cognitions, emotions, memories and bodily sensations about the self and
others (Young et al., 2003). The authors defined eighteen early maladaptive sche-
mas organized into five domains, namely, disconnection and rejection, impaired
autonomy and performance, other-directedness, impaired limits, and overvigilance
and inhibition. Previous research supports the dysfunctional role of early maladap-
tive schemas in mental health (Faustino & Vasco, 2020a; Bishop et al., 2021; Nicol
et al., 2020) and emphasize the disconnection and rejection and impaired autonomy
domains has the most severe schema domains (Faustino & Vasco, 2020b; Renner
et al., 2012). One major difference between core beliefs and early maladaptive sche-
mas is that the first was defined to match specific beliefs of DSM criteria for person-
ality disorders, while the second was developed with a developmental perspective
(Young et al., 2003). However, despite these two different conceptual approaches
to the concept of schemas, they may share some commonalities (e.g., the cognitive
compound of both concepts), which is why that early maladaptive schemas may be
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B. Faustino et al.
used to explore convergent validity of the PBQ-SF. In other words, both constructs
encompass cognitive thematic representations regarding self (e,g., I am a failure),
others (e.g., Other will abuse me) and the world (e.g., The world is a dangerous
place). Therefore it is expected that personality beliefs correlate with five schema
domains. Specifically, it is expected that disconnection and rejection domain would
correlate with all PBQ-SF subscales along with impaired domain. Finally, the aim of
the present study is to conduct a preliminary psychometric study of the Personality
Beliefs Questionnaire-Short Form (PBQ-SF) in a non-clinical sample of the Portu-
guese population.
Method
Participants
The total sample consisted of 344 Portuguese participants, with mean age of approx-
imately 32 years (SD = 11.28), with the following academic qualifications, 9 (2.6%)
with 9º year of study or equivalent, 143 (41.6%) with 12º years of study, 103 (29.9%)
with master’s degree and 12 (23.5%) with PhD or post-doctoral degree. Of the 344
participants, 60 were male (17.4%) and 284 (82.6%) were female—see Table 1.
Instruments
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Preliminary Psychometric Properties of the Portuguese Version…
Age
M 32.56
SD 11.28
Minimum 18
Maximum 67
Sex
Male 60 (17.4%)
Female 284 (82.6%)
Scholarship
9º year or equivalent 9 (2.6%)
12º year 143(41.6%)
Master degree 103 (29.9%)
PhD 12 (23.5%)
Psychotherapy
Yes 74 (21.5%)
No 270 (78.5%)
Undefined 9 (4%)
Early Maladaptive Schemas were assessed by the YSQ-S3 (Young, 2005, trans-
lated and adapted for Portuguese Population by Rijo, 2017). The YSQ-S3 is a self-
report measure with 90 items aimed to assess 18 maladaptive schemas, divided in
five domains: disconnection and rejection, impaired autonomy and performance,
other-directedness, impaired limits, and overvigilance and inhibition. It has a
response format in 6-point Likert scale ranging from 1 (does not describe me at
all), to 6 (describe me totally). The scale also has a general index. Rijo (2017),
described satisfactory psychometric properties in the validation study of the YSQ-
S3 for the Portuguese population (N = 1226). An adequate model fit with 18 factors
(χ2 = 2430.234; p = 0.000) with adequate values of Cronbach’s alphas which ranged
from weak in impaired self-control schema (α = 0.65) to strong in failure schema
(α = 0.86). Moreover, all schemas correlated positively with Beck Depression Inven-
tory (BDI, Beck, 1976) (p < 0.001), which may be viewed as evidence of convergent
validity (Rijo, 2017). In the present study the general index was used which showed
an excellent internal consistency (α = 0.97). Internal consistency of the subscales
ranged from good in impaired limits composite subscale (α = 0.82) to very good
(α = 0.95) in disconnection and rejection composite subscale.
Brief Symptoms Inventory (BSI, Derogatis, 1993, adapted for the Portuguese popu-
lation by Canavarro, 1999). It is a 53-item self-report, constituting a reduced version
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of the SCL-90, in which participants rate the extent to which they have been dis-
turbed in the past week by several symptoms on a scale from 0 (not at all) to 4
(extremely). The BSI has nine subscales designed to assess individual symptom
groups (e.g., somatization, depression, anxiety). The Portuguese version (Canavarro,
1999) showed good psychometric properties—alphas ranging from 0.70 to 0.80. In
a sample of non-clinical participants, the GSI average was 0.48 (SD = 1.430) and
test retest reliability of 0.79. In a clinical sample, the author obtained an average of
1.43 (SD = 0.943). A value ≥ to 1.7 may point to an emotion disturbance (Canavarro,
1999). In the present study, the total score (α = 0.97) showed high internal consist-
ency and all the subscales showed from acceptable to good internal consistency:
(1) Somatization (α = 0.84); (2) Obsessive–compulsive (α = 0.85); (3) Interpersonal
Sensivity (α = 0.83); (4) Depression (α = 0.92); (5) Anxiety (α = 0.87); (6) Hostility
(α = 0.85); (7) Phobic Anxiety (α = 0.81); (8) Paranoid Ideation (α = 0.83); (9) Psy-
choticism (α = 0.72).
Individuals were recruited from the general population through online social media
(e.g., Facebook, LinkedIn), through a post that presented a link that led to the ques-
tionnaire. To participate, individuals had to click on the link which re-directed them
to the online Qualtrics platform with the informed consent. After providing their
consent to participate, individuals had to complete the instruments described previ-
ously. This research was approved by the ethics committee Faculty of Psychology of
the University of Lisbon. Factor structure of the Portuguese version of the PBQ—
Short Form was explored through an exploratory factor analysis (EFA). Pearson cor-
relations were used to explore convergent validity and associations with symptoma-
tology. All statistical analysis were performed with the IBM SPSS Statistics version
25.
Results
Several steps were taken to carry out the validation process, which was aligned with
Beaton et al. (2000) guidelines to cross-cultural adaptation of self-report measures.
First, an authorization was required from Beck Institute, which was given. Second,
the PBQ—Short Version was translated into Portuguese by a bilingual speaker (Por-
tuguese– English) then the back-translation was performed by another bilingual
speaker. Third, the original English version and the English retroversion were com-
pared by the authors. Some minor vocabulary adjustments had to be made in the
translated version to maintain semantic coherence with the original version. Four, a
pre-test of the approved translated version was performed by presented the PBQ—
Short Form to 20 individuals, which were unfamiliar with this questionnaire. The
aim of the pre-test was to confirm if it was clear and easy to understand, concerning
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Preliminary Psychometric Properties of the Portuguese Version…
the vocabulary, sentence structure and comprehensiveness of the items. The com-
prehensiveness, item structure and clarity of the sentences were asked individually
to each participant of the pre-test. Five, after this initial process the PBQ—Short
Form was ready to be tested in the general population.
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Preliminary Psychometric Properties of the Portuguese Version…
SF45_DEPENDENT .759
SF65_BORDERLINE .746
SF44_DEPENDENT .702
SF56_DEPENDENT .696
SF18_DEPENDENT .665
SF31_AVOIDANT .655
SF63_DEPENDENT .615
SF62_DEPENDENT .558
SF5_AVOIDANT .557
SF43_AVOIDANT .530
SF15_DEPENDENT .443
SF2_AVOIDANT .442
SF39_AVOIDANT .442 .409
SF27_NARCISS .796
SF58_NARCISS .734
SF26_NARCISS .710
SF38_ANTISOC .692
SF46_NARCISS .650
SF8_HISTRIONIC .604
SF16_NARCISS .597
SF59_ANTISOC .567
SF60_NARCISS .489
SF25_SCHIZOID
SF10_NARCISS
SF61_ANTISOC
SF13_PARANOID .759
SF14_PARANOID .698
SF48_PARANOID .678
SF3_PARANOID .654
SF49_PARANOID .641
SF17_PARANOID .429 .587
SF64_BORDERLI .539
SF24_PARANOID .405 .509
SF32_ANTISOC
SF4_PASS_AGRES
SF40_OBS_COMP .774
SF11_OBS_COMP .694
SF30_OBS_COMP .641
SF6_OBS_COMP .640
SF57_OBS_COMP .415 .540
SF19_OBS_COMP .470
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Table 2 (continued)
1 2 3 4 5 6 7 8 9 10
SF9_OBS_COMP
SF29_SCHIZOID .735
SF50_SCHIZOID .645
SF12_SCHIZOID .602
SF36_SCHIZOID .534
SF28_SCHIZOID .490
SF53_SCHIZOID .410
SF47_PASS_AGRES .671
SF41_PASS_AGRES .553
SF51_PASS_AGRES .511
SF21_PASS_AGRES .465
SF7_PASS_AGRES .402
SF_34_HISTRIONIC .598
SF22_HISTRIONIC .406 .575
SF37_HISTRIONIC .400 .531
SF55_HISTRIONIC .450
SF52_HISTRIONIC .580
SF54_HISTRIONIC .504
SF1_AVOIDANT .458
SF35_ANTISOC .533
SF23_ANTISOC .423 .503
SF42_ANTISOC .422
SF33_AVOIDANT .546
SF20_PASS_AGRES
23, 38, 59 (antisocial). F2 remained with six items and was designed the narcissism
subscale. In F3 only item 64 (borderline) was removed, and this factor remained
with seven items being named the paranoid subscale. F4 remained the same with
six items, being defined as the obsessive–compulsive subscale. F5 remained the
same with six items, being defined as the schizoid subscale. F6 remained the same
with five items, being defined as the passive-aggressive subscale. F7 and F8 were
clustered to match the histrionic subscale, having six items (item 1—avoidant, was
removed). F9 had three items representing the antisocial subscale. In this sense the
items 23, 38 and 59 (which represents antisocial beliefs), were added to this sub-
scale, remaining with six items. Items 2, 5, 31, 43 and 39 were included in F10
along with item 33, which was defined as the avoidance subscale. This subscale
remained with 6 items. Finally, the borderline subscale was elaborated based on
Butler et al. (2002) criteria, with items 31, 44, 45, 56, 49, 64 and 65. This was the
only composite scale.
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Preliminary Psychometric Properties of the Portuguese Version…
Internal Consistency Cronbach alpha for total scale was considered good. And
for the PSQ-SF subscales the internal consistency was as follows: F1, Dependent
(α = 0.87); F2, Narcissistic (α = 0.85); F3, Paranoid (α = 0.92); F4, Obsessive–com-
pulsive (α = 0.85), F5, Schizoid (α = 0.76), F6, Passive-aggressive (α = 0.81); F7,
Histrionic (α = 0.81), F8 – Borderline (α = 0.86), F9, Antisocial (α = 0.67) and F10,
Avoidant (α = 0.83). The total scale showed an excellent (α = 0.96) Cronbach alpha.
– see Table 7.
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Table 3 Scale-level descriptive statistics and Cronbach’s Alpha for PBQ-SF (N = 344)
α Mean SD Skewness Kurtosis
Discussion
The present study aimed to conduct a preliminary psychometric study of the Euro-
pean-Portuguese version of the Personality Beliefs Questionnaire-Short Form (PBQ-
SF; Butler et al., 2007) in a non-clinical sample. These are the first steps to fully val-
idate the PBQ-SF-PT, which is regarded as a long-standing need in the assessment
of dysfunctional beliefs in the Portuguese population.
Two studies were conducted: one based on the original subscales of the PBQ-SF
developed by Butler and associates (2007), and another based on the exploratory
factor analysis (EFA). Despite being two studies, results were very similar. There-
fore, discussion will be integrated and some considerations are described.
EFA revealed a factor structure different from the theoretical assumptions (Butler
et al., 2007). EFA revealed a factor structure composed by ten factors where some
items from different subscales clustered in different expected factors. For example,
items from dependent, avoidant and borderline subscales clustered together, as well
as items from narcissistic, histrionic and antisocial subscales, which is similar to the
study from Fournier, & associates (2012). The authors found a seven factor structure
where items loaded on a single factor, as well as items from narcissistic and antiso-
cial subscales. Another aspect is that items from borderline and paranoid subscales
loaded mostly on a single factor. These findings suggest an overlap between beliefs
individuals tend to hold that are not exclusively to one personality disorders which
is in line with dimensional approaches to personality pathology (Faustino & Vasco,
2020a). The sample under study is not a clinical sample, which means that indi-
viduals may have higher levels of psychological flexibility encompassing less rigid
beliefs and core schemas (Faustino et al., 2021b; Faustino, 2022).
Another aspect was that the schizoid factor emerge similarly to theoretical pre-
dictions (Butler et al., 2007). In the study from Fournier and associates (2012), this
factor did not emerged, which means that maybe this subscale needs to be revised
in order to achieve standardization across different populations. Despite the EFA
results, in study two, subscales were computed based on the standard procedure
from Butler et al., (2007). This is a preliminary study of the PBQ-SF in the Portu-
guese population and therefore more research is required to explore if the factorial
structure is replicated. In this sense, the original structure of the PBQ-SF-PT was
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Table 4 Pearson correlations between PBQ-SF subscales and YSQ-S3 schema domains (N = 283)
YSQ-S3 Disconnection and Impaired Impaired Limits Other’s domain Overvigilance
Rejection Autonomy and Inhibition
*p =.05; ** p = .01;
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Table 5 Pearson correlations between PBQ-SF subscales and BSI-53 subscales (N = 283)
GSI Somatization Obsessive– Inter- Depression Anxiety Hostility Phobic Anxiety Paranoid Ideation Psicoticism
Compul- personal
sive Sensivity
PBQ-SF .29** .34** .33** .26** .40** .31** .35** .36** .37** .35**
Dependent, Avoidant and Border- .37** .38** .34** .30** .46** .33** .40** .42** .42** .31**
line
Narcissistic, Histrionic and Anti- .04 .14* .05 .05 .20** .04 .10 .06 .13* .11
social
Paranoid and Borderline .29** .32** .31** .24** .38** .27** .28** .34** .35** .31**
Obsessive–compulsive .24** .24** .23** .23** .31** .24** .26** .32** .30** .22**
Schizoid .20** .25** .31** .18** .14* .20** .29** .26** .22** .27**
Passive-aggressive .21** .41** .30** .24** .39** .34** .39** .34** .37** .36**
Histrionic .21** .26** .15** .16** .31** .19** .18** .21** .25** .22**
*p =.05; ** p = .01;
B. Faustino et al.
Preliminary Psychometric Properties of the Portuguese Version…
Table 6 Hierarchical regression analysis with PBQ-SF subscales as predictors of symptomatology and
early maladaptive schemas (N = 283)
R2 B SE B β t p VIF
Symptomatology (BSI-53)
Dependent, Avoidant and Borderline .139 .550 .073 .452 7.523 .000 1.390
Narcissistic, Histrionic and Antisocial .168 .305 .086 .212 3.551 .000 1.370
Schizoid .189 .186 .065 .148 2.840 .005 1.049
Early Maladaptive Schemas (YSQ-S3)
Passive-aggressive .203 .635 .092 .397 6.935 .000 1.264
Obsessive–compulsive .214 .186 .091 .117 2.046 .042 1.264
Table 7 Scale-level descriptive statistics and Cronbach’s Alpha for PBQ-SF (N = 344)
Number of items α Mean SD Skewness Kurtosis
Dependent 15, 18, 44, 45, 56, 62, 63 .87 3.99 0.89 − 1.17 1.25
Narcissistic 16, 26, 27, 46, 58, 60 .85 4.44 0.73 − 2.33 7.23
Paranoid 3, 13, 14, 17, 24, 48, 49 .92 3.72 0.97 − 0.63 − 0.15
Obsessive–compulsive 6, 11, 19, 30, 40, 57 .85 3.27 0.92 − 0.20 − 0.82
Schizoid 12, 28, 29, 36, 50, 53 .76 2.94 0.82 0.01 − 0.40
Passive-aggressive 7, 21, 41, 47, 51 .81 3.67 0.91 − 0.55 − 0.36
Histrionic 22, 34, 37, 52, 54, 55 .81 4.50 0.93 − 1.05 1.26
Borderline (added) 64, 65 .55 4.00 1.00 − 1.11 0.87
Antisocial 23, 35, 42, 23, 38, 59 .75 3.41 0.62 − 1.26 1.90
Avoidant 2, 5, 31, 33, 39, 43 .83 3.73 0.87 − 0.88 0.57
kept and the 10 sub-scales were computed matching the DSM-IV criteria for person-
ality disorders.
Convergent validity was explored by testing correlations between PBQ-SF sub-
scales and early maladaptive schematic domains. Early maladaptive schemas are
clusters of memories, cognitions, emotions and bodily sensations developed in early
infancy or adolescent in regard to the frustration of core psychological needs (Faus-
tino & Vasco, 2020c; Young et al., 2003). These schemas contain self and other gen-
eralized beliefs about the world thematically related, with some theoretical overlap-
ping with the original cognitive theory of personality disorders (Beck & Freeman,
1990). Almost all PBQ-SF subscales were correlated with theoretical schematic
domains, which strengthens this theoretical assumption. However, in the original
PBQ-SF subscales, the narcissistic subscale did not correlate with impaired limits
domain, which is theoretically related with psychological entitlement, a trait associ-
ated with narcissist personality disorder.
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Table 8 Pearson correlations between PBQ-SF subscales and YSQ-S3 schema domains (N = 283)
YSQ-S3 Disconnection Impaired Impaired Other’s Overvigilance
and Rejection Auton- Limits domain and Inhibition
omy
*.05; **.01
The original version and the EFA version of the PBQ-SF-PT both were correlated
with symptomatology, which is in line with previous empirical findings (Butler et al.,
2007; Fournier et al., 2012; Ryan et al., 2015). According to cognitive theory of per-
sonality disorders, inflexible, long-standing and generalized beliefs embed deeply
in core schemas about the self, others, world and future lie at the core of personal-
ity disorders (Beck & Freeman, 1990; Young et al., 2003). These results emphasize
associations between dysfunctional beliefs and several symptomatic domains, such
as depression, anxiety and hostility. Also, Butler, and colleagues (2007), stated that
the PBQ-SF may also be associated with symptomatology because it may reflect a
general distress factor, which is consistent with elevation in personality pathological
profile (higher number of dysfunctional beliefs). The narcissistic subscale only cor-
related with somatization, depression and paranoid ideation. Also, the lack of asso-
ciations between impaired limits and narcissism, suggests than a content analysis
should be made to explore if the PBQ-SF is more associated with grandiose narcis-
sism and/or vulnerable narcissism. Grandiose narcissism is characterized by a ten-
dency to overestimate one’s capabilities, high self–esteem and interpersonal domi-
nance, while vulnerable narcissism, is characterized by a tendency to be insecure,
hypersensitive and focused on criticism (Wink, 1991). Controversies in the assess-
ment of narcissism are well documented in literature. Specifically, Miller and col-
leagues (2017) suggested that grandiose narcissism seems to captures the prototype
manifestation of narcissism with higher levels of antagonism (e.g., grandiosity, self-
ishness and callousness) and agentic extraversion (i.e., assertiveness, high and atten-
tion seeking/exhibitionism). Vulnerable narcissism seems to capture higher levels
of antagonistic traits (e.g., distrust, selfishness deceitfulness and callousness) and a
tendency to experience negative affect (i.e., anxiety, depression, self-consciousness,
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Preliminary Psychometric Properties of the Portuguese Version…
and vulnerability). These two dimensions may have different etiological factors
(e.g., lack of discipline/overvaluation vs pervasive emotional neglect/lower self-
steem) that confound the assessment of narcissism because they rely on different
motivational tendencies (Miller et al., 2017). Taken together these results suggest
that the narcissistic subscale of PBQ-SF seems to measure the vulnerable narcissism
beliefs rather than grandiose narcissism beliefs. Finally, borderline, schizoid, narcis-
sistic and passive-aggressive subscales were the best predictors of symptomology.
Thus, borderline personality disorder tends to be regarded as one of the most perva-
sive personality disorder and in this study, may help to support this claim because it
was the stronger predictor of symptomatology.
Despite the similar correlational patterns of the subscales, it is possible to deline-
ate some differences. Each PBQ-SF-PT subscale suggests differential associations
in terms of intensity with schemas and symptoms. Some examples can be given.
The dependent, paranoid, passive-aggressive, borderline and avoidance subscales
correlated with greater intensity in the disconnection and rejection schema domain
than the other subscales, suggesting that individuals with schemas in this domain
may manifest dependency, borderline and avoidance beliefs. Another example,
regarding the correlational pattern with symptoms may be given. The dependent,
paranoid, passive-aggressive, borderline and avoidance subscales correlated strongly
with depression and anxiety than the narcissistic, schizoid and antisocial. This pat-
tern suggests that individuals with beliefs associated dependency and avoidance may
experience stronger symptoms of sadness, depression and anxiety that individuals
with narcissistic, schizoid and antisocial beliefs. Taken together these results seem
to point out that each subscale of the PBQ-SF-PT may reflect different cognitive
profiles in terms of schema development, core beliefs and symptomatology.
According to these results, both versions of the PBQ-SF-PT seem to be psycho-
metrically reliable and potentially useful in clinical practice. The EFA-derived ver-
sion of the PBQ-SF-PT seems to capture the dimensional nature of the personality
functioning which is aligned with dimensional approach to personality disorders.
Thus, a careful inspection of the clustered items reveals that factor one and factor
two gathered items that resembles the cluster C (anxious and fearful) and cluster
B (dramatic, emotional, erratic) domain of the personality disorder criteria (DSM-
5, 2013). In this sense, maybe in non-clinical populations personality beliefs asso-
ciated with narcissism, histrionic and antisocial personality disorders may tend to
cluster together, instead of cluster separately. Thus, this EFA-derived version of the
PBQ-SF-PT seems to be aligned with the dimensionally oriented DSM-5 alterna-
tive model of personality disorders (AMPD), where personality pathology is defined
from indices of personality functioning (criterion A in the AMPD) and maladaptive
personality traits (criterion B in the AMPD). Thus, this also raises the question if
the PBQ-SF-PT, which is based on dysfunctional beliefs, may be useful in assessing
personality disorders from a dimensional perspective. This issue should be answered
in the future. Moreover, theoretically-derived PBQ-SF-PT seems to reflect a tradi-
tional categorical perspective on personality disorders by dividing each disorder
from the others. In this sense, clinicians can choose the version he/she intends to use
depending on the purpose of the assessment and the population. Probably, the EFA
version can be used to characterize the profile of personality traits in the non-clinical
13
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Table 9 Pearson correlations between PBQ-SF subscales and BSI-53 subscales (N = 283)
GSI Somatization Obsessive– Inter- Depression Anxiety Hostility Phobic Anxiety Paranoid Ideation Psicoticism
Compulsive personal
Sensivity
PBQ-SF .49** .38** .33** .27** .43** .32** .37** .39** .40** .34**
Dependent .44** .31** .30** .26** .41** .29** .34** .37** .36** .26**
Narcissistic .12* .15** .04 .02 .20** .03 .10 .06 .12* .09
Paranoid .43** .31** .29** .24** .37** .26** .26** .33** .35** .30**
Obsessive–compulsive .35** .23** .23** .22** .30** .23** .26** .32** .29** .22**
Schizoid .29** .25** .31** .17** .14* .20** .29** .26** .21** .26**
Passive-aggressive .41** .41** .29** .24** .39** .34** .39** .33** .37** .36**
Histrionic 31** .20** .14* .14** .28** .20** .18** .23** .24** .22**
Borderline (cs) .38** 40** .38** .27** .49** .34** .41** .44** .41** .30**
Antisocial .22** .13* .11* .13* .20** .12* .11* .08 .17** .17**
Avoidant .48** .40** .35** .31** .44** .33** .39** .39** .43** .33**
Table 10 Hierarchical regression analysis with PBQ-SF subscales as predictors of symptomatology and
early maladaptive schemas, which are dependent variables (N = 283)
R2 B SE B β t p VIF
Symptomatology (BSI-53)
Borderline (cs) .26 .41 05 .479 8.07 .000 1.78
Schizoid .29 .12 .04 .133 2.74 .006 1.19
Narcissistic .31 − .22 .05 − .217 − 4.09 .000 1.41
Passive-aggressive .33 .14 .05 .167 2.70 .007 1.93
Early Maladaptive Schemas (YSQ-S3)
Passive-aggressive .20 .55 .10 .34 5.31 .000 1.65
Borderline (cs) .21 .67 .19 .41 3.39 .001 5.79
Dependent .23 − .48 .18 − .29 − 2.66 .008 4.81
population, while the theoretical version can be used to diagnose pathological per-
sonality traits compatible with the categorical view of personality disorder in clini-
cal populations. Nevertheless, more research is required to explore if both versions
of PBQ-SF-PT have similar psychometric qualities with non-clinical and clinical
populations.
To our knowledge there are not many studies of the PBQ EFA with non-clinical
samples. Usually, a confirmatory analysis is conducted. However, the factorial struc-
ture of PBQ-SF in non-clinical and clinical samples seems to vary. For the sake of
the present study only studies with EFA in non-clinical samples will be described.
EFA showed a similar result with the study of Trull and colleagues (1993). In a non-
clinical sample of college undergraduates, authors explored an EFA of nine PBQ
subscales finding a two factor solution. Factor 1 marked by the Antisocial and Nar-
cissistic subscales was labeled interpersonal dominance and Factor 2 marked by the
Avoidant and Dependent subscales was labeled anxious attachment. Another study
in a non-clinical Brazilian sample, revealed a 9 factors with mixed pool of items that
were hard to interpret. As an example, factor 1 was composed of items from Para-
noid, Antisocial and Borderline subscales and was labeled “The other is bad”. Fac-
tor 2 was composed with items from Dependent and Borderline subscales and was
labeled “I am fragile and unable” (Leite et al., 2012). Nevertheless, Factor 3 (I am
superior), with items from narcissism and histrionic subscales and factor 4 (I can-
not fail), with items of obsessive–compulsive subscale were similar with the present
study. Thus, narcissism and histrionic beliefs tend to cluster together as they reflect
an internal tendency to be the center of attention and admiration from others.
Results from the divergent/discriminant validity of the EFA-derived version of
the PBQ-SF-PT seems to suggest that all subscales have similar associations with
symptomatology and early maladaptive schemas. Only the narcissistic, histrionic
and antisocial factor of the EFA-derived version and the narcissistic and antisocial
subscales of the theoretically-derived version of the PBQ-SF-PT showed a differ-
ent correlational pattern from the other subscales. With low-medium correlations
13
B. Faustino et al.
with schemas and symptoms, these subscales seem to capture beliefs associated
with an externalizing motivational tendency. Individuals with beliefs associated
with Narcissistic, Histrionic and Antisocial Personality disorders tend to be exter-
nally focused and oriented towards the others, because the others are the means to
achieve the gratification of their emotional needs (e.g., admiration, praise, attention
and/or exploitation). Because they have an external locus of control, they may lack
the required insight skills to acknowledge symptoms and/or vulnerable side of the
self. This may explain the correlational pattern of the factor. This factor behaves
differently than the other factors, however, this is consistent with cognitive theory
of personality disorders (Beck & Freeman, 1990; Young et al., 2003). Moreover,
all other subscales seem to have a similar correlational pattern with symptomatol-
ogy and early maladaptive schemas which suggests a modest preliminary divergent/
discriminant validity. It was expected that all PBQ-SF-PT subscales were positively
correlated with these two constructs because, previous empirical data suggested
that dysfunctional personality beliefs tend to be associated with psychopathological
symptoms (Bhar et al., 2012). Therefore, these subscales seems to measure cogni-
tive themes associated with other cognitive-affective structures (schemas) and symp-
toms that are clinically significant.
Both versions of the PBQ-SF-PT seem to support previous assumptions where
dysfunctional beliefs are associated and predict psychopathological symptomatol-
ogy. In this sense, addressing maladaptive beliefs in case conceptualization may
enhance clinical decision making, especially when it comes to address cognitive
structures underlying a widespread cluster of symptoms. Another aspect concerns
the notion that in non-clinical samples individuals may have several personality
beliefs that are not exclusive to a specific personality disorder profile. This may
be due to higher levels of psychological flexibility (Faustino et al., 2021b). Clini-
cians may adopt an open mind when it comes to the assessment of a cognitive per-
sonality profile in patients who are in distress but do not belong to a specific diag-
nostic domain. The results of this study suggest that individuals may hold several
beliefs that may not fit specific diagnostic criteria. However, they are significant
when it comes to subjective emotional suffering which is signaled through psycho-
pathological symptoms. In this sense, it would be interesting to explore how per-
sonality beliefs may relate with emotional schemas, which are also associated with
symptomatology (Faustino et al., 2020; Faustino & Vasco, 2021). Finally, the asso-
ciations between personality beliefs and early maladaptive schemas suggest close
relationship between beliefs and schemas. Conceptually, a clear distinction is still
lacking. But clinically, it can be stated that personality beliefs are embedded in the
dysfunctional schematic structure which was developed through the repetition of the
frustration of core emotional needs in the childhood and adolescent (Young et al.,
2003). In this sense, individuals who developed early maladaptive schemas may
also develop several dysfunctional beliefs about the self and others which can be
assessed through the PBQ-SF-PT. Also, previous findings suggested that early mala-
daptive schemas are not attached directly with Axis II personality disorder (Beck
et al., 2001). They seem to have a dimensional intrinsic feature proving to be a trans-
diagnostic construct which is supported by previous empirical findings (Faustino,
2022). Also, schema development may be viewed as a dialectical set of processes
13
Preliminary Psychometric Properties of the Portuguese Version…
where individuals elaborate on past and current emotional experiences and construct
both adaptive and maladaptive views of the self and other than lie on a continuum
(Faustino, 2022). This may also help to explain why the EFA-derived version of the
PBQ-SF-PT may be associated with a dimensional, rather than categorical perspec-
tive of the personality functioning.
Despite some interesting results some limitations may be described. This study was
conducted in a non-clinical sample, which limits the extrapolation to clinical indi-
viduals. Thus, the PBQ-SF may be better suited to assess personality disorder in
clinical samples. Thus, the identification of dysfunctional beliefs may be difficult
because individuals with deeply entrenched dysfunctional may see them as natural
and consistent with the way they see themselves and the world. The sample under
study had more women than men participants which may introduce some biases
in the results. Not having a similar sample distribution of participants sociodemo-
graphic characteristics may lead to over or under representation of responses which
may confound psychometric data. Therefore, these results may be interpreted with
caution. This study was conducted on-line, which may have some limitations regard-
ing the attention and commitment that individuals have when responding to ques-
tionnaires. A confirmatory factor analysis (CFA) was not performed, because an
empirically factor structure of PBQ-SF in the Portuguese Population was missing.
Previous findings suggested that factorial structure of PBQ-SF may differ from the
proposed theory (Butler et al., 2007). In this sense, it is required to first conduct
and EFA and then a CFA to test if the same factorial structure is confirmed in the
Portuguese population. This study is currently in development. Thus, in the future
PBQ-SF psychometrics should be studied in clinical samples to explore if the facto-
rial structure remains stable. Rash analysis is also a procedure that would be applied
to this instrument (Faustino et al., 2019). The PBQ-SF-PT should be tested with the
Brief Core Schemas Scale (BCSS, Fowler et al., 2006) to deepen convergent valid-
ity. Test–retest reliability should be performed in the future to explore the stabil-
ity of the PBQ-SF-PT in non-clinical and clinical samples. Also, content analysis
should be considered to augment scale refinement in order to explore if some items
may be rewritten to better match the Portuguese lexicon.
Funding None.
Declarations
13
B. Faustino et al.
Ethical Approval This study was approved by Ethics committee of the Faculty of Psychology of the Uni-
versity of Lisbon.
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