Penn State Penn State: College of the Liberal Arts


Table of Contents



Amanda N Moeller, Benjamin N Johnson, Kenneth N Levy, James M LeBreton

Source: Measuring and Modeling Persons and Situations 

In this chapter, we discuss the state of the science regarding the measurement of implicit personality (i.e., the elements of personality that are not accessible via conscious introspection). Optimal measurement of implicit personality necessitates a strong underlying psychological theory combined with indirect measurement that is resilient to dishonest responding; with such a foundation, researchers may evaluate the psychometric properties of their measures, including the independent predictive validity that indirect measures of implicit personality have over above direct measures of explicit personality. We review three prototypic classes of indirect measurement that lend themselves to assessing aspects of implicit personality: projective measures, response latency measures, and conditional reasoning measures. We discuss the history and theory behind each of these classes of measurement systems and introduce …

Frank Yeomans, John Clarkin, KN Levy

The American Psychiatric Association Publishing Textbook of Personality Disorders

Psychodynamic means “the mind in motion.” Psychodynamic psychotherapy refers to psychotherapies that stem from the psychoanalytic tradition and focus on the role of conflicting forces within the mind—competing desires, impulses, emotions, fears, and prohibitions—and their interface with external reality as sources of suffering and symptoms. The psychoanalytic tradition centers on the understanding of the mind elaborated initially by Freud (1923/1961) that emphasizes the role of unconscious aspects of mental functioning and the interaction of constitutional biological predispositions and environmental influences in psychological development. While psychodynamic therapies are primarily psychological treatments, in the course of the therapy, the therapist must continue to assess the impact of biological factors that affect the patient’s condition. As psychoanalysis evolved, its focus shifted from symptoms to character pathology (Gabbard 2005). More recently, with the emphasis on evidence-based treatments, models of psychodynamic therapy to treat specific types of personality disorder (PD) have been developed and researched (Bateman and Fonagy 2012; Clarkin et al. 2006; Yeomans et al. 2015). As the field continues to evolve, the dialogue between evidence-based models and clinical analytic practice is enriching both. As part of our discussion of the psychotherapy of personality disorders, we will also review the evolving conceptualization of those disorders.

Jacob A. Martin, Kenneth N. Levy

Chronic emptiness in borderline personality disorder (BPD) has received little empirical attention. We sought to examine basic properties of a single chronic emptiness item, including prevalence, reliability, validity, the relation of the emptiness item to other BPD criteria, and measures of personality. Undergrad- uates enrolled in psychology courses over 12 years’ time completed the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD) (N = 22,217). Subsets of participants completed the International Personality Disorder Examination—Screening Questionnaire (IPDE-SQ) (N = 2732), The Revised NEO Personality Inventory (Anxiety, Angry Hostility, Depression, Positive Emotions [reversed], and Impulsivity facets) (N = 10,506), and the Depression Anxiety Stress Scales (DASS) (N = 1110) as validity indicators; 10.0% of respondents endorsed emptiness. Reliability indices suggested moderate levels of reliability between two emptiness items (r(2730) = 0.61, p < 0.001). Among BPD criteria, emptiness and identity disturbance correlated most strongly (r(22,215) = 0.81, p < 0.001). MSI emptiness was more corre- lated with depression on the NEO (r(10,504) = 0.43, p < 0.001) and DASS (r(1108) = 0.51, p < 0.001) than other facets of negative affect. Emptiness was more correlated with greater borderline pathology than any other MSI-BPD item (Sample 1, rtet = 0.87; Sample 2, rtet = 0.86). This criterion warrants further study and attention, especially related to assessment of BPD.

Kenneth N Levy, William D Ellison

Journal: Training and Education in Professional Psychology 

Personality disorders (PDs) are relatively common, especially in clinical settings. A number of evidence-based treatments are now available, especially for borderline personality disorder (BPD). However, little is known about the relevant training available to doctoral students in clinical and counseling psychology. In the current study, data were extracted from 336 clinical and counseling PhD and PsyD programs from the Insider’s Guide to Graduate Programs in Clinical and Counseling Psychology (Sayette & Norcross, 2020), including the number of programs with faculty with specific interests in personality disorders and the number of programs with clinical opportunities related to personality disorders. We found that formal training in personality disorders is not widely available to most trainees in American Psychological Association (APA)-accredited doctoral training programs. Only 16% of programs have faculty …

KN Levy, William D Ellison

Publisher: American Psychological Association 

Personality disorders are relatively common, especially in clinical settings. A number of evidence-based treatments are now available, especially for borderline personality disorder. However, little is known about the relevant training available to doctoral students in clinical and counseling psychology. in the current study, data were extracted from 336 clinical and counseling Ph. D. and Psy. D. programs from the Insider’s Guide to Graduate Programs in Clinical and Counseling Psychology>(Norcross & Sayette, 2020), including the number of programs with faculty with specific interests in personality disorders and the number of programs with clinical opportunities related to personality disorders. We found that formal training in personality disorders is not widely available to most trainees in APA-accredited doctoral training programs. Only 16% of programs have faculty with interests in personality disorders, all of them clinical psychology programs. Ph. D. programs were more likely to have PD-interested faculty than Psy. D. programs, and, within clinical Ph. D. programs, PCSAS-accredited programs were more likely to have PD-interested faculty than programs without PCSAS accreditation. Similarly, only 15% of programs (all clinical psychology programs) offer practicum opportunities in psychotherapy for personality disorders. Our findings indicate that doctoral level psychology programs are not sufficiently preparing their students with personality disorder training, which serves as a substantial disservice to both trainees and the public.

Marc J Diener, William H Gottdiener, John R Keefe, Kenneth N Levy, Nick Midgley

Journal: The Lancet Psychiatry 

conclude that “fluoxetine (alone or in combination with CBT [cognitive behavioural therapy]) seems to be the best choice for the acute treatment of moderate-to-severe depressive disorder in children and adolescents.” However, the meta-analysis has several statistical and methodological flaws that belie this and other conclusions.
First, the authors’ own data indicate that the conclusions about the superiority of fluoxetine are unjustifiable. Almost none of the comparisons between fluoxetine or fluoxetine plus CBT and other treatments are significant. Furthermore, the confidence intervals of most interventions versus pill placebo overlap with that of fluoxetine and fluoxetine plus CBT, indicating that none should be considered superior to any other.

Thomas M Crow, Kenneth N Levy, Bekh Bradley, Negar Fani, Abigail Powers

Journal: Child Abuse & Neglect

Most people will experience a traumatic event in their lifetime, but only a subset (<10%) will develop posttraumatic stress disorder (PTSD). Objective To facilitate prevention and intervention of PTSD, it is important to understand how risk and resilience factors interact with one another to explain individual differences in risk for PTSD, especially in underprivileged groups, who often experience greater burden of trauma and PTSD. Method The current study utilized multiple and moderated regression to examine the relation between childhood maltreatment and adulthood PTSD risk in the context of various attachment patterns and emotion dysregulation in a sample (n = 856) of mostly low-income, African American participants. Results Moderation analysis indicated that the strongest association between self-reported childhood maltreatment and PTSD symptoms was manifest in participants reporting the highest …

Troy G Steiner, Kenneth N Levy, Joseph C Brandenburg, Reginald B Adams Jr

Journal: Personality and Individual Differences

To date, prominent theories still disagree on whether the pathological grandiosity that underlies narcissism stems from a defensive, compensatory process in response to insecurity or from years of unjustified overvaluation during formative stages of development. Across two studies, we introduce a novel method to test these theories by examining visual representations of self. In Study 1, we measured Self-Concept Clarity and the distortion of (n = 96) participants’ self-images (generated using the reverse correlation technique) relative to their actual appearances. In Study 2, we then compared attractiveness ratings of the actual photographs of participants with their self-images generated in Study 1, through judgments made by independent raters (n = 45). Our work revealed that a) lower Self-Concept Clarity predicts self-image distortion, b) the narcissistic desire to conceal flaws mediates this association, and c) self …


Benjamin N Johnson, Kenneth N Levy

Personality Disorders: Theory, Research, and Treatment, Volume 11, Issue 2, p.141

Borderline personality disorder (BPD) is serious, prevalent, and symptomatically heterogeneous. Identifying distinct phenotypes of BPD features promises useful diagnostic and treatment implications. Although a series of subtyping studies exist, only two have examined BPD symptom configurations while taking into account BPD severity. We used factor mixture modeling to identify discrete subtypes of BPD features, simultaneously considering symptom severity, in the largest nonclinical young adult sample to date. Undergraduates (N= 20,010; 63.86% women; M age= 18.75, SD= 1.73) completed the McLean Screening Instrument for BPD, which was condensed to measure the 9 Diagnostic and Statistical Manual of Mental Disorders BPD criteria dichotomously. We used a model comparison approach to determine the optimal latent factor and class structure of BPD symptoms and validated classes via BPD-relevant …

Benjamin N Johnson, Tracy L Clouthier, Lia K Rosenstein, Kenneth N Levy

The terms pampering and spoiling have roots within early psychoanalytic literature, and over time they have become a part of the vernacular. This entry will focus on pampering/spoiling as described in psychoanalytic literature and address the following: the mechanics of pampering/spoiling, why it might happen, and the possible risks for development.

Kenneth N Levy

Cambridge University Press

Comments on the original chapter by P. Fonagy et al.(see record 2020-10989-069) regarding contemporary psychodynamic treatments (PDTs) for personality disorders. In this commentary, the author highlights some of the points that he think could have had more emphasis in stressing the unique contributions and utility of a psychodynamic approach. Psychodynamic approaches to personality disorders, although diverse, all share certain basic tenets. Arguably there may be additional tenets for consideration, but the author focuses on the following:(1) that early childhood relationships with caregivers play an important role in shaping how we experience and view subsequent relationships (this is the idea of transference);(2) that some mental processes, such as motives, desires, and memories, are not readily available to awareness or conscious introspection (the idea of the unconscious);(3) people are sometimes …

Kenneth N Levy, Joanna Pantelides

The Wiley Encyclopedia of Personality and Individual Differences: Clinical, Applied, and Cross‐Cultural Research. p.89-95

Borderline personality disorder (BPD) is a highly prevalent, chronic, and debilitating disorder characterized by instability in one’s sense of self, others, and mood. This instability is expressed as emotional lability, impulsivity, interpersonal dysfunction, angry outbursts, suicidality, and non‐suicidal self‐injury. One in 10 patients with BPD will end up dying from suicide. Those suffering from BPD are more likely to commit suicide than those with depression, PTSD, eating disorders, and unmediated bipolar disorder. BPD has historically been thought to be difficult to treat. However, several integrative treatments – deriving from both the cognitive‐behavioral and psychodynamic traditions – that have shown efficacy in randomized controlled trials and are now available to clinicians and their patients.

Sindes Dawood, Michael N Hallquist, Aaron L Pincus, Nilam Ram, Michelle G Newman, Stephen J Wilson, Kenneth N Levy

Journal of Psychopathology and Behavioral Assessment. Volume 42, Issue 1, P. 13-24

Experience sampling methods are widely used in clinical psychology to study affective dynamics in psychopathology. The present study examined whether affect ratings (valence and arousal) differed as a function of assessment schedule (signal- versus event-contingent) in a clinical sample and considered various approaches to modeling these ratings. A total of 40 community mental health center outpatients completed ratings of their affective experiences over a 21-day period using both signal-contingent schedules (random prompts) and event-contingent schedules (ratings following social interactions). We tested whether assessment schedules impacted 1) the central tendency (mean) and variability (standard deviation) of valence or arousal considered individually, 2) the joint variability in valence and arousal via the entropy metric, and 3) the between-person differences in configuration of valence-arousal …

Susanne Hörz, Diana Diamond, John F Clarkin, Kenneth N Levy, Michael Rentrop, Melitta Fischer Kern, Nicole M Cain, Stephan Doering

RET: Revista de Toxicomanías. Issue 84, p. 44-52

Este estudio examina la psicopatología y las características clínicas de pacientes con trastorno límite de la personalidad (TLP) y trastorno de personalidad narcisista comórbido (TPN) de dos ensayos controlados aleatorizados internacionales. De una muestra combinada de 188 pacientes con TLP, 25 también cumplían los criterios para un diagnóstico comórbido de TPN de acuerdo con el DSM-IV. Los pacientes con TLP y TPN comórbido, en comparación con los pacientes con TLP sin TPN comórbido, mostraron significativamente más criterios de TLP (M= 7, 44 vs. M= 6, 55, p

William D Ellison, Kenneth N Levy, Michelle G Newman, Aaron L Pincus, Stephen J Wilson, Peter Molenaar

Personality Disorders: Theory, Research, and Treatment, Volume 11, Issue 2, p.131

Borderline personality disorder (BPD) involves instability in self-concept, emotions, and behavior. However, the dynamic, longitudinal relations among BPD symptoms and between these symptoms and other problematic emotional experiences are poorly understood. It is also unclear whether these dynamics are the same across persons (including across diagnostic boundaries), specific to individuals with BPD, or idiographic. The current study uses ecological momentary assessment and group iterative multiple model estimation, a novel, data-driven approach to identifying dynamic patterns in time-series data at group, subgroup, and individual levels, to investigate the dynamic connections among select features of BPD (anger, impulsivity, and identity disturbance) and anxiety-related experiences. Forty-two psychiatric outpatients diagnosed with BPD (n= 27) or with an anxiety disorder, but not BPD (n= 15), rated …

Yogev Kivity, Kenneth N Levy, Stéphane Kolly, Ueli Kramer

Journal of Personality Disorders. Volume 34, Issue 1, p 1-21.

The authors examined whether alliance dynamics are affected by tailoring the therapeutic relationship to the individual patient in brief psychotherapy of borderline personality disorder. Sixty patients were randomized to 10-session Good Psychiatric Management (GPM-BV) or GPM combined with Motive-Oriented Therapeutic Relationship techniques (MOTR+GPM-BV). Patient- and therapist-rated alliance was assessed weekly. Self-reported symptomatic distress was assessed pre-, mid-, and posttreatment. In MOTR+GPM-BV, stronger therapist-rated alliance predicted lower symptomatic distress in the same timepoint, but not in a lag, whereas symptomatic distress predicted therapist-rated alliance in a lag. Therapist-rated alliance was lower than patient-rated alliance in GPM-BV but not in MOTR+GPM-BV. In MOTR+GPM-BV, higher agreement on strong alliance tended to predict lower symptomatic distress. Patient …


Benjamin N. Johnson & Kenneth N. Levy

Personality Disorders: Theory, Research, and Treatment, 1-10

Kenneth N. Levy

Contemporary Psychodynamic Treatments, 440-443

Kenneth N. Levy, Jessica K. Hlay, Benjamin N. Johnson, & Courtney P. Witmer

Evolutionary Psychological Science, 5, 426-439

Kenneth N. Levy, John R. Keefe, & Johannes C. Ehrenthal

Contemporary Psychodynamic Psychotherapy, 89-106

Kenneth N. Levy, Yogev Kivity, & Frank E. Yeomans

Case Formulation for Personality Disorders, 19-40

Levy, K. N., Kivity, Y., & Yeomans, F. E.

Kramer, U (Ed.), Case Formulation for Personality Disorder: Tailoring in Psychotherapy to the Individual Client, Chapter 2


Ehrenthal, J. C., Levy, K. N., Scott, L. N., & Granger, D.

Journal of Personality Disorders, 32, 93-114.

Kenneth N. Levy, Yogev Kivity, Benjamin N. Johnson, & Caroline V. Gooch

Journal of Clinical Psychology, 74, 1996-2013

Lazar, S. G., Bendat, M., Gabbard, G., Levy, K., Mcwilliams, N., Plakun, E. M., Shedler, J., & Yeomans, F. E.

Journal of Psychiatric Practice, 24, 179-193.

Lazar, S. G., Bendat, M., Gabbard, G., Levy, K., Mcwilliams, N., Plakun, E. M., Shedler, J., Yeomans, F. E.
Levy, K & Johnson, B. N.

Canadian Psychology, 1-48.

Levy, K. N., Kelly, K. M., & Ray, W. J.

Case studies in abnormal psychology. Sage.

Levy, K. N., Kivity, Y., Johnson, B. N., & Gooch, C. V.

Journal of Clinical Psychology.

Levy, K. N., McMain, S, Bateman, A., & Clouthier, T

Psychiatric Clinic of North America, 41, 711-728.

Scala, J. W., Levy, K. N., Johnson, B. N., Kivity, Y., Ellison, W.  D.,Pincus, A. L., Newman, M. G., & Wilson, S. J.

The role of negative affect and self-concept clarity in predicting self-injurious urges using ecological momentary assessment. Journal of Personality Disorders, 32, 36-57.


Hörz-Sagstetter, S., Diamond, D., Clarkin, J. F., Levy, K. N., Rentrop, M., Fischer- Kern, M., . . . & Doering, S.
Levy, K. N., Draijer, N., & Yeomans, F. E.

Transference-Focused Psychotherapy. In A. Wenzel (Ed.), The SAGE Encyclopedia of Abnormal and Clinical Psychology.

Wasserman, R.H., Levy, K.N., Beeney, J.E., Molenaar, P.C.M.,& Clarkin, J.F

The alliance-outcome correlation in a randomized controlled trial of three treatments for borderline personality disorder


Beeney, J. E., Hallquist, M. N., Ellison, W. D., & Levy, K. N.

Personality Disorders: Theory, Research, and Treatment, 7(1), 28.

Kramer, U., & Levy, K. N.

Journal of Psychotherapy Integration, 26, 338-346

Lenzenweger, M. F., Clarkin, J. F., & Kernberg, O. F.

Psychoanalytic Association Winter Meeting: The Relation of Reflective Function to Neurocognitive Functioning in Patients with Borderline Personality Disorder

Mallinckrodt, B., Anderson, M. Z., Choi, G., Levy, K. N., Petrowski, K., Sauer, E. M., ... & Wiseman, H.

Psychotherapy Research, 1-15.

Perez, D. L., Vago, D. R., Pan, H., Root, J., Fuchs, B. H., Leung, L., Epstein, J., Cain, N. M., Clarkin, J. F., Lenzenweger, M. F., Kernberg, O. F., Levy, K. N., Silbersweig, D. A., Stern, E.

Psychiatry and clinical neurosciences, 70, 51-61.

Pincus, A. L., Dowgwillo, E. A., Levy, K. N., Wilson, S. J., & Newman, M. G.

Personality disorder and interpersonal functioning in daily life. International Journal of Psychology, 51, 892.