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  1. Dependent personality disorder

    MedlinePlus

    Dependent personality disorder is a mental condition in which people depend too much on others to meet their emotional ... Causes of dependent personality disorder are unknown. The disorder usually ... It is one of the most common personality disorders and ...

  2. Dependent personality disorder

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/000941.htm Dependent personality disorder To use the sharing features on this page, please enable JavaScript. Dependent personality disorder is a mental condition in which people ...

  3. Dependent personality disorder: a critical review.

    PubMed

    Disney, Krystle L

    2013-12-01

    Dependent personality disorder (DPD) has evolved from an abstract idea rooted in a historic and psychoanalytic context to a codified diagnosis in the DSM-IV-TR. This comprehensive review paper chronicles the evolution of DPD through each version of the DSM. Major topics relevant to the disorder are also investigated, including gender and cultural considerations, stability and manifestations of DPD across different developmental stages, comorbidity issues, and others. The purpose of this review is to provide a broad yet comprehensive examination of the complex angles of maladaptive dependency and to identify essential next steps in furthering our knowledge of this disorder. The paper concludes with a discussion of shortcomings in the body of research relevant to DPD, along with specific suggestions for improvement in this field of study. PMID:24185092

  4. Matricide by person with bipolar disorder and dependent overcompliant personality.

    PubMed

    Livaditis, Miltos D; Esagian, Gkaro S; Kakoulidis, Christos P; Samakouri, Maria A; Tzavaras, Nikos A

    2005-05-01

    Matricide is an infrequent form of homicide. This paper is to present a case of matricide with typical characteristics of the act but interesting particularities as well. The perpetrator was a 43-year-old man, respected member of his community, with over compliant characteristics, eagerness in serving people and caring his parents, good social adaptation before and after the crime. He abandoned his family and work in order to better serve his old, disabled but over demanding mother who frequently insulted and humiliated him. Suddenly he came to a state of "mental confusion" and strangled her. After the crime, the perpetrator manifested the symptoms of a bipolar disorder and also received the diagnosis of dependant personality disorder. Years later, he presented again a crisis of escalating aggressive urge for which he was hospitalized. Many people and associations of his hometown actively demanded the minimal possible punishment for him. The case is discussed especially concerning: a) hypotheses about the aetiopathogeny of the act, b) the constant support provided to the perpetrator by his family and social environment. PMID:15932103

  5. Personality Disorders

    MedlinePlus

    ... this page You are here Home » Personality Disorder Personality Disorder What is “Personality?” Personality refers to a distinctive set of traits, ... family, friends, and co-workers. What is a Personality Disorder? Those who struggle with a personality disorder ...

  6. Dependent Personality Disorder: Comparing an Expert Generated and Empirically Derived Five-Factor Model Personality Disorder Count

    ERIC Educational Resources Information Center

    Miller, Joshua D.; Lynam, Donald R.

    2008-01-01

    Assessment of the "Diagnostic and Statistical Manual of Mental Disorders" (4th Ed.; "DSM-IV") personality disorders (PDs) using five-factor model (FFM) prototypes and counts has shown substantial promise, with a few exceptions. Miller, Reynolds, and Pilkonis suggested that the expert-generated FFM dependent prototype might be misspecified in…

  7. Personality disorders

    MedlinePlus

    Personality disorders are a group of mental conditions in which a person has a long-term pattern ... Causes of personality disorders are unknown. Genetic and environmental factors are thought to play a role. Mental health professionals categorize these ...

  8. Personality disorders

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/000939.htm Personality disorders To use the sharing features on this page, please enable JavaScript. Personality disorders are a group of mental conditions in ...

  9. Personality Disorders

    MedlinePlus

    Personality disorders are a group of mental illnesses. They involve long-term patterns of thoughts and behaviors ... serious problems with relationships and work. People with personality disorders have trouble dealing with everyday stresses and ...

  10. Personality Disorders

    MedlinePlus

    Personality disorders are a group of mental illnesses. They involve long-term patterns of thoughts and behaviors that ... serious problems with relationships and work. People with personality disorders have trouble dealing with everyday stresses and problems. ...

  11. Empathy and social problem solving in alcohol dependence, mood disorders and selected personality disorders.

    PubMed

    Thoma, Patrizia; Friedmann, Christine; Suchan, Boris

    2013-03-01

    Altered empathic responding in social interactions in concert with a reduced capacity to come up with effective solutions for interpersonal problems have been discussed as relevant factors contributing to the development and maintenance of psychiatric disorders. The aim of the current work was to review and evaluate 30 years of empirical evidence of impaired empathy and social problem solving skills in alcohol dependence, mood disorders and selected personality disorders (borderline, narcissistic, antisocial personality disorders/psychopathy), which have until now received considerably less attention than schizophrenia or autism in this realm. Overall, there is tentative evidence for dissociations of cognitive (e.g. borderline personality disorder) vs. emotional (e.g. depression, narcissism, psychopathy) empathy dysfunction in some of these disorders. However, inconsistencies in the definition of relevant concepts and their measurement, scarce neuroimaging data and rare consideration of comorbidities limit the interpretation of findings. Similarly, although impaired social problem solving appears to accompany all of these disorders, the concept has not been well integrated with empathy or other cognitive dysfunctions as yet. PMID:23396051

  12. Personality Disorders, Narcotics, and Stimulants; Relationship in Iranian Male Substance Dependents Population

    PubMed Central

    Noorbakhsh, Simasadat; Zeinodini, Zahra; Khanjani, Zeynab; Poorsharifi, Hamid; Rajezi Esfahani, Sepideh

    2015-01-01

    Background: Individuals with certain personality disorders, especially the antisocial and borderline personality disorders, are more prone to substance use disorders. Objectives: Regarding the importance of substance use disorders, this study aimed to explore the association between personality disorders and types of used drugs (narcotics and stimulants) in Iranian male substance users. Patients and Methods: The current study was a correlation study. We evaluated 285 male substance users and excluded 25 according to exclusion criteria. A total of 130 narcotic users and 130 stimulant users were recruited randomly in several phases from January 2013 to October 2013. All participants were referred to Substance Dependency Treatment Clinics in Tehran, Iran. Data collection process was accomplished by means of clinical interview based on DSM-V criteria for substance use disorders, Iranian version of addiction severity index (ASI), and Millon clinical multi-axial inventory-III (MCMI-III). Data were analyzed by SPSS 21 using Pearson correlation coefficient and regression, the. Results: There was a significant correlation between stimulant use and histrionic personality disorder (P < 0.001) and antisocial and narcissistic personality disorders (P < 0.05). In addition, correlation between avoidant, histrionic, and narcissistic personality disorders (P < 0.05) and depressed, antisocial, and borderline personality disorders (P < 0.001) with narcotics consumption were significant. In clusters, there was a significant correlation between cluster B personality disorders, and narcotic and stimulants consumption (P < 0.001). In addition, this association was explored between cluster C personality disorder and narcotics (P < 0.001). Conclusions: The results of this study in terms of personality disorders and types of used drugs were in accordance with the previous studies results. It is necessary to design appropriate treatment plans for medical treatment of those with personality

  13. Rethinking dependent personality disorder: comparing different human relatedness in cultural contexts.

    PubMed

    Chen, YuJu; Nettles, Margaret E; Chen, Shun-Wen

    2009-11-01

    We argue that the Diagnostic and Statistical Manual of Mental Disorders dependent personality disorder is a culturally related concept reflecting deeply rooted values, beliefs, and assumptions of American individualistic convictions about self and interpersonal relationship. This article integrates social psychology concepts into the exploration of psychopathology. Beginning with the construct of individualism and collectivism, we demonstrate the limitations of this commonly used framework. The indigenous Chinese concept of Confucianism and Chinese Relationalism is introduced to highlight that a well-differentiated self is not a universal premise of human beings, healthy existence. In East Asian Confucianism the manifestation of dependence and submission may be considered individuals' proper behavior and required for their social obligation, rather than a direct display of individuals' personality. Thus, the complexity of dependent personality disorder is beyond the neo-Kraepelinian approach assumed by the Diagnostic and Statistical Manual of Mental Disorders system. PMID:19996716

  14. Classification of personality disorder.

    PubMed

    Tyrer, P; Alexander, J

    1979-08-01

    An interview schedule was used to record the personality traits of 130 psychiatric patients, 65 with a primary clinical diagnosis of personality disorder and 65 with other diagnoses. The results were analysed by factor analysis and three types of cluster analysis. Factor analysis showed a similar structure of personality variables in both groups of patients, supporting the notion that personality disorders differ only in degree from the personalities of other psychiatric patients. Cluster analysis revealed five discrete categories; sociopathic, passive-dependent, anankastic, schizoid and a non-personality-disordered group. Of all the personality-disordered patients 63 per cent fell into the passive-dependent or sociopathic category. The results suggest that the current classification of personality disorder could be simplified. PMID:497619

  15. Antisocial personality disorder

    MedlinePlus

    Sociopathic personality; Sociopathy; Personality disorder - antisocial ... Cause of antisocial personality disorder is unknown. Genetic factors and environmental factors, such as child abuse, are believed to contribute to ...

  16. Does Comorbid Substance Use Disorder Exacerbate Borderline Personality Features?: A Comparison of Borderline Personality Disorder Individuals with vs. without Current Substance Dependence

    PubMed Central

    Lee, Han-Joo; Bagge, Courtney L.; Schumacher, Julie A.; Coffey, Scott F.

    2010-01-01

    There is compelling evidence that comorbid borderline personality disorder (BPD) negatively impact the clinical courses and outcomes of substance use disorders (SUD). Conversely, there is little evidence that concurrent SUD exacerbates the clinical characteristics of BPD. Thus, this study sought to examine whether the presence of current substance dependence among BPD patients would be associated with stronger BPD-relevant personality traits and behavioral characteristics. Female BPD patients without (BOR; n = 37) or with current substance dependence (BSUD; n = 19), and female non-BPD/SUD controls (CON; n = 48) were compared with respect to impulsivity, affective lability, affective intensity, externalizing behaviors, and self-harming/suicidal tendencies, taking into consideration their comorbid mood disorders, anxiety disorders, and antisocial personality disorder. Results indicated that both BOR and BSUD groups scored higher than CON in most of the measures, but BOR and BSUD failed to reveal significant group differences especially when the influence of comorbid psychopathology was removed. The overall pattern of findings remained identical even when comparing BPD patients with vs. without the diagnosis of lifetime substance dependence. Our results do not support the notion that BPD individuals with SUD display more severe BPD features than individuals with BPD alone. PMID:21116439

  17. Borderline personality disorder

    MedlinePlus

    Personality disorder - borderline ... Cause of borderline personality disorder (BPD) is unknown. Genetic, family, and social factors are thought to play roles. Risk factors for BPD include: Abandonment ...

  18. Personality disorder, emotional intelligence, and locus of control of patients with alcohol dependence

    PubMed Central

    Prakash, Om; Sharma, Neelu; Singh, Amool R.; Sengar, K. S.; Chaudhury, Suprakash; Ranjan, Jay Kumar

    2015-01-01

    Aim: To assess personality disorder (PD), emotional intelligence (EI), and locus of control of alcohol dependent (AD) patients and its comparison with normal controls. Materials and Methods: Based on purposive sampling technique, 33 AD patients were selected from the De-Addiction Ward of Ranchi Institute of Neuro-Psychiatry and Allied Sciences (RINPAS) and 33 matched normal subjects were selected from Ranchi and nearby places. Both the groups were matched on various sociodemographic parameters, that is, age, gender, and socioeconomic level. All participants were assessed with Millon Clinical Multiaxial Inventory-III, Mangal EI Inventory, and Locus of Control scale. Obtained responses were scored by using standard scoring procedures and subsequently statistically analyzed by using Chi-square test. Results: AD patients have more comorbid pathological personality traits and disorders in comparison to their normal counterparts. Depressive, narcissistic, and paranoid PDs were prominent among AD group; followed by schizotypal, antisocial, negativistic, dependent, schizoid, sadistic, masochistic, and borderline PD. In comparison to normal participants, AD patients were significantly deficient in almost all the areas of EI and their locus of control was externally oriented. Conclusion: Patients with AD have significantly higher PDs, low EI, and an external orientation on the locus of control. Identification and management of these comorbid conditions are likely to improve the management and outcome of AD. PMID:26257482

  19. Antisocial personality disorder

    MedlinePlus

    Sociopathic personality; Sociopathy; Personality disorder - antisocial ... Cause of antisocial personality disorder is unknown. Genetic factors and environmental factors, such as child abuse, are believed to contribute to the development ...

  20. Narcissistic personality disorder

    MedlinePlus

    Personality disorder - borderline; Narcissism ... A person with narcissistic personality disorder may: React to criticism with rage, shame, or humiliation Take advantage of other people to achieve his or her ...

  1. Narcissistic personality disorder

    MedlinePlus

    Personality disorder - borderline; Narcissism ... A person with narcissistic personality disorder may: React to criticism with rage, shame, or humiliation Take advantage of other people to achieve his or her own ...

  2. Randomized Trial of Dual-Focused versus Single-Focused Individual Therapy for Personality Disorders and Substance Dependence

    PubMed Central

    Ball, Samuel A.; Maccarelli, Lisa M.; LaPaglia, Donna M.; Ostrowski, Mark J.

    2011-01-01

    We conducted a randomized comparison of Dual Focus Schema Therapy with Individual Drug Counseling as enhancements to residential treatment for 105 substance dependent patients with versus without specific personality disorders. Both therapies were manual-guided and delivered for 6 months by experienced psychotherapists intensively trained and supervised with independent fidelity assessment. Using Cox Proportional Hazards, we found no psychotherapy differences in retention (days in treatment). Hierarchical Linear Modeling indicated that personality disordered participants started with higher psychiatric, interpersonal, and dysphoria symptoms, and both therapies reduced symptoms over 6 months. Contrary to predictions, Individual Drug Counseling resulted in more sustained reductions than Dual Focus Schema Therapy in several symptoms for several personality disorders. Our findings raised important questions about the added value of integrative or dual-focus therapies for co-occurring personality disorders and substance dependence relative to empirically supported therapies focused more specifically on addiction symptoms. PMID:21543951

  3. Personality disorder diagnosis

    PubMed Central

    WIDIGER, THOMAS A

    2003-01-01

    Every person has a characteristic manner of thinking, feeling, and relating to others. Some of these personality traits can be so dysfunctional as to warrant a diagnosis of personality disorder. The World Health Organization's International Classification of Diseases (ICD- 10) includes ten personality disorder diagnoses. Three issues of particular importance for the diagnosis of personality disorders are their differentiation from other mental disorders, from general personality functioning, and from each other. Each of these issues is discussed in turn, and it is suggested that personality disorders are more accurately and effectively diagnosed as maladaptive variants of common personality traits. PMID:16946918

  4. Paranoid personality disorder

    MedlinePlus

    ... have a full-blown psychotic disorder, such as schizophrenia . Causes Causes of paranoid personality disorder are unknown. ... common in families with psychotic disorders, such as schizophrenia and delusional disorder. This suggests genes may be ...

  5. Assessment of Rorschach dependency measures in female inpatients diagnosed with borderline personality disorder.

    PubMed

    Fowler, J Christopher; Brunnschweiler, Benjamin; Swales, Stephanie; Brock, Johanna

    2005-10-01

    The psychometric properties and predictive validity of the Dependency Index (DI; Hilsenroth & Bornstein, 2002) and the Rorschach Oral Dependency Scale (ROD; Masling, Rabie, & Blondheim, 1967) were examined to determine if these implicit measures of dependency predict observable attachment-seeking behavior in 66 female inpatients diagnosed with borderline personality disorder. Results indicate that both scales produce excellent reliability estimates. The DI and ROD yield adequate base rates, and the distributions of scores approximate normal distributions. The DI was predictive of nursing staff observation of positive attachment/treatment compliance (r = .28, p = .02) but not excessive isolation. By contrast, the ROD predicted positive attachment/treatment compliance (r = .38, p = .002) and excessive isolation (r = -.35, p = .004). Texture responses predicted excessive isolation (r = -.25, p = .05). Discriminant validity was supported when neither dependency measure predicted hostile interactions or self-destructive behaviors. Hierarchical regression analyses revealed that the ROD demonstrated incremental validity over the DI and select Comprehensive System (Exner, 1993) variables associated with dependency. PMID:16171415

  6. Avoidant personality disorder

    MedlinePlus

    ... Names Personality disorder - avoidant References American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Publishing. 2013. ...

  7. Borderline personality disorder

    MedlinePlus

    ... Names Personality disorder - borderline References American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Publishing. 2013. ...

  8. Histrionic personality disorder

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/001531.htm Histrionic personality disorder To use the sharing features on this page, please enable JavaScript. Histrionic personality disorder is a mental condition in which people ...

  9. Schizotypal personality disorder

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/001525.htm Schizotypal personality disorder To use the sharing features on this page, please enable JavaScript. Schizotypal personality disorder is a mental condition in which a ...

  10. Histrionic personality disorder

    MedlinePlus

    Histrionic personality disorder is a mental condition in which people act in a very emotional and dramatic way that ... Causes of histrionic personality disorder are unknown. Genes and ... may be responsible. It is diagnosed more often in women than ...

  11. Functional imaging of emotion reactivity in opiate-dependent borderline personality disorder.

    PubMed

    Smoski, Moria J; Salsman, Nicholas; Wang, Lihong; Smith, Veronica; Lynch, Thomas R; Dager, Stephen R; LaBar, Kevin S; Linehan, Marsha M

    2011-07-01

    Opiate dependence (OD) and borderline personality disorder (BPD), separately and together, are significant public health problems with poor treatment outcomes. BPD is associated with difficulties in emotion regulation, and brain-imaging studies in BPD individuals indicate differential activation in prefrontal cingulate cortices and their interactions with limbic regions. Likewise, a similar network is implicated in drug cue responsivity in substance abusers. The present, preliminary study used functional MRI to examine activation of this network in comorbid OD/BPD participants when engaged in an "oddball" task that required attention to a target in the context of emotionally negative distractors. Twelve male OD/BPD participants and 12 male healthy controls participated. All OD/BPD participants were taking the opiate replacement medication Suboxone, and a subset of participants was positive for substances of abuse on scan day. Relative to controls, OD/BPD participants demonstrated reduced activation to negative stimuli in the amygdala and anterior cingulate. Unlike previous studies that demonstrated hyperresponsivity in neural regions associated with affective processing in individuals with BPD versus healthy controls, comorbid OD/BPD participants were hyporesponsive to emotional cues. Future studies that also include BPD-only and OD-only groups are necessary to help clarify the individual and potentially synergistic effects of these two conditions. PMID:22448769

  12. Schizoid personality disorder

    MedlinePlus

    ... disorder is unknown. It may be related to schizophrenia and shares many of the same risk factors. Schizoid personality disorder is not as disabling as schizophrenia. It does not cause the disconnection from reality ( ...

  13. [Hysterical personality disorder].

    PubMed

    Darcourt, G

    1995-12-15

    The hysteric personality disorder is characterized by: 1. an intense need for affection; it is a child-like need, seeking protection and affection, making the patient subject to suggestibility and dependence, along with an erotic behaviour which is in reality associated to fear of sexuality; 2. an exaggerated and rapidly shifting expression of emotion leading to unstable, theatrical and histrionic expression of emotions giving an impression of shallowness and lack of authenticity; 3. a highly imaginative thinking pattern with flight of reality and tendency to dreaming, mythomania, memory reconstruction. PMID:8578149

  14. The Relationship of DSM-IV Personality Disorders to Nicotine Dependence-Results from a National Survey*

    PubMed Central

    Pulay, Attila J.; Stinson, Frederick S.; Ruan, W. June; Smith, Sharon M.; Pickering, Roger P.; Dawson, Deborah A; Grant, Bridget F.

    2010-01-01

    This study examined the prevalence of nicotine dependence (ND) and its associations with DSM-IV personality disorders (PDs) among current smokers (n=7,078), controlling for sociodemographic characteristics and comorbid Axis I and II disorders. Data were derived from a nationally representative sample of the U.S. population. Although all PDs were significantly associated with ND when sociodemographic factors were controlled, only schizotypal, borderline, narcissistic and obsessive-compulsive PDs were associated with ND after adding controls for Axis I and other Axis II disorders. These associations remained significant after controlling for degree of smoking exposure. The results suggest that both shared and PD-specific pathogenetic factors underlie these PD-ND associations. Implications are also discussed in terms of the relationship between personality features of schizotypal, borderline, narcissistic and obsessive-compulsive PDs and the self-medication hypothesis and the role of neurotransmission. PMID:20079976

  15. Attachment and Personality Disorders

    ERIC Educational Resources Information Center

    Sinha, Preeti; Sharan, Pratap

    2007-01-01

    Personality disorders (PDs) arise from core psychopathology of interpersonal relationships and understanding of self and others. The distorted representations of self and others, as well as unhealthy relationships that characterize persons with various PDs, indicate the possibility that persons with PDs have insecure attachment. Insecure…

  16. [The diagnostic and healing difficulty at "patient" with Klinefelter's syndrome, the disorders of the personality of the type borderline, the eating disorders and mixed dependence from the drugs].

    PubMed

    Mikołajczyk, Iwona; Wawrzyniak, Zbigniew

    2009-01-01

    It was described the case of 25-years-old person's dependent from medicines (reassuring, sleeping and analgesic)and alcohol from coexisting rare disorders happened in the detox squad. Establish that person, during the treatment metrical he is the man and possesses the characteristic genotype for the Klinefelter's syndrome, the features of the personality of type borderline and the eating disorders (bulimic side of annorexia). Her autobiography, psychical state (she underlined that he felt the woman despite the sex mentally by the whole time of the stay) her behavior are the interesting therapeutics problems. In the article was introduced the test explanation of mechanisms her psychical functioning, and the difficulty which appeared in the process of diagnosis and psychotherapy. The Klinefelter's syndrome was differentiated with transsexualism seldom in the aim of the more exact understanding of above mentioned difficulties. Medical and psychoterapeutic strategies were proposed for that person. PMID:19391512

  17. Avoidant personality disorder

    MedlinePlus

    American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Publishing. 2013. Blais MA, Smallwood P, Groves JE, Rivas-Vazquez RA. Personality and ...

  18. Schizotypal personality disorder

    MedlinePlus

    ... personality disorder (SPD) should not be confused with schizophrenia . People with SPD can have odd beliefs and behaviors, but unlike people with schizophrenia, they are not disconnected from reality and usually ...

  19. [Antisocial personality disorder].

    PubMed

    Repo-Tiihonen, Eila; Hallikainen, Tero

    2016-01-01

    Antisocial personality disorder (ASP), especially psychopathy as its extreme form, has provoked fear and excitement over thousands of years. Ruthless violence involved in the disorder has inspired scientists, too.The abundance of research results concerning epidemiology, physiology, neuroanatomy, heritability, and treatment interventions has made ASP one of the best documented disorders in psychiatry. Numerous interventions have been tested, but there is no current treatment algorithm. Biological and sociological parameters indicate the importance of early targeted interventions among the high risk children. Otherwise, as adults they cause the greatest harm. The use of medications or psychotherapy for adults needs careful consideration. PMID:26939485

  20. Psychotherapy of Personality Disorders

    PubMed Central

    Gabbard, Glen O.

    2000-01-01

    Although personality disorders are often regarded as “untreatable” by third-party payers, there is actually a growing empirical literature suggesting that Axis II conditions may be eminently treatable by psychotherapy. This literature is critically reviewed, the implications for length of treatment are discussed, and cost-effectiveness issues are examined. PMID:10608903

  1. Emotion Regulation and Substance Use Frequency in Women with Substance Dependence and Borderline Personality Disorder Receiving Dialectical Behavior Therapy

    PubMed Central

    Axelrod, Seth R.; Perepletchikova, Francheska; Holtzman, Kevin; Sinha, Rajita

    2011-01-01

    Background Dialectical Behavior Therapy (DBT) identifies emotion dysregulation as central to the dangerous impulsivity of borderline personality disorder (BPD) including substance use disorders, and DBT targets improved emotion regulation as a primary mechanism of change. However, improved emotion regulation with DBT and associations between such improvement and behavioral outcomes such as substance use has not been previously reported. Objective Thus, the goal of this study was to assess for improvement in emotion regulation and to examine the relationship between improvements in the emotion regulation and substance use problems following DBT treatment. Method Emotion regulation as assessed by the Difficulties in Emotion Regulation Scale, depressed mood as assessed by the Beck Depression Inventory, and their associations with substance use frequency were investigated in 27 women with substance dependence and BPD receiving 20 weeks of DBT in an academic community outpatient substance abuse treatment program. Results indicated improved emotion regulation, improved mood, and decreased substance use frequency. Further, emotion regulation improvement, but not improved mood, explained the variance of decreased substance use frequency. Conclusions This is the first study to demonstrate improved emotion regulation in BPD patients treated with DBT and to show that improved emotion regulation can account for increased behavioral control in BPD patients. Significance and Future Research Emotion regulation assessment is recommended for future studies to further clarify the etiology and maintenance of disorders associated with emotional dyregulation such as BPD and substance dependence, and to further explore emotion regulation as a potential mechanism of change for clinical interventions. PMID:21091162

  2. Understanding heterogeneity in borderline personality disorder: differences in affective reactivity explained by the traits of dependency and self-criticism.

    PubMed

    Kopala-Sibley, Daniel C; Zuroff, David C; Russell, Jennifer J; Moskowitz, D S; Paris, Joel

    2012-08-01

    This study examined whether the personality traits of self-criticism and dependency respectively moderated the effects of perceived inferiority and emotional insecurity on negative affect during interpersonal interactions in individuals with borderline personality disorder (BPD). A sample of 38 patients with BPD and matched community comparison participants completed event-contingent record forms after each significant interaction for a 20-day period. Multilevel models showed that, controlling for baseline levels of depressive symptoms and neuroticism, as well as lagged negative affect, event-level elevations in perceived inferiority and emotional insecurity were related to more negative affect in both groups. Event-level perceived inferiority was more strongly associated with negative affect in patients with BPD who reported higher levels of self-criticism, while event-level perceived emotional insecurity was more strongly associated with negative affect in patients with BPD who reported higher levels of dependency. No significant interactions emerged for the comparison group. These findings further our understanding of differences among patients with BPD and support the application of personality-vulnerability or diathesis-stress models in predicting negative affect in BPD. Results have implications for the design of therapies for patients with BPD. PMID:22686873

  3. Any Personality Disorder

    MedlinePlus

    ... Hyperactivity Disorder Among Children Autism Spectrum Disorder (ASD) Eating Disorders Among Adults - Anorexia Nervosa Eating Disorders Among Adults - Binge Eating Disorder Eating Disorders Among ...

  4. Antisocial Personality Disorder

    MedlinePlus

    ... Hyperactivity Disorder Among Children Autism Spectrum Disorder (ASD) Eating Disorders Among Adults - Anorexia Nervosa Eating Disorders Among Adults - Binge Eating Disorder Eating Disorders Among ...

  5. Borderline Personality Disorder

    MedlinePlus

    ... Hyperactivity Disorder Among Children Autism Spectrum Disorder (ASD) Eating Disorders Among Adults - Anorexia Nervosa Eating Disorders Among Adults - Binge Eating Disorder Eating Disorders Among ...

  6. Deliberate self-harm in substance-dependent patients and relationship with alexithymia and personality disorders: a case-control study.

    PubMed

    Verrocchio, M C; Conti, C; Fulcheri, M

    2010-01-01

    The aim of this study Is to evaluate differences in the prevalence of deliberate self-harm (DSH), alexithymia, and clinical personality patterns and syndromes between treatment-seeking substance-dependents and a comparison group, and to investigate the relationship of DSH with alexithymia, and personality disorders. One hundred and fifty-four subjects participated in the study (77 substance-dependent inpatients and 77 comparison group). DSM-IV diagnoses of substance dependence were made by the clinicians of the Addiction Services following assessment that included clinical observation. Participants were evaluated by the Deliberate Self Harm Inventory, Toronto Alexithymia Scale, and Millon Clinical Multiaxial Inventory. An Identifying Information Form was used to collect demographic information (e.g. age, educational history, marital status, and employment status). Only to the clinical sample information was added on: types of substance used, age at first substance use, age at regular substance use, and previous treatment attempts. Significant group differences were found for all measures (DSH, TAS-20, MCMI-III). Among substance-dependent patients there was a significant difference between groups with and without DSH in terms of previous treatment attempts, Hypomania and Borderline personality disorder. DSH were significantly correlated with difficulty in identifying feelings in all cases in both the comparison group and in the personality disorders group, and with difficulty describing feelings in the personality disorders group. Personality disorder and drug dependency were predictors for DSH. This study suggests that treatment of substance-dependents should involve screening for deliberate self-harm behavior, difficulty identifying and describing feelings, and personality disorders. Probably, when these problems are detected, specific psychological intervention should be integrated to usual treatment for substance-dependent patients. PMID:21122286

  7. The Stigma of Personality Disorders.

    PubMed

    Sheehan, Lindsay; Nieweglowski, Katherine; Corrigan, Patrick

    2016-01-01

    This article reviews the recent literature on the stigma of personality disorders, including an overview of general mental illness stigma and an examination of the personality-specific stigma. Overall, public knowledge of personality disorders is low, and people with personality disorders may be perceived as purposefully misbehaving rather than experiencing an illness. Health provider stigma seems particularly pernicious for those with borderline personality disorder. Most stigma research on personality disorders has been completed outside the USA, and few stigma-change interventions specific to personality disorder have been scientifically tested. Limited evidence suggests that health provider training can improve stigmatizing attitudes and that interventions combining positive messages of recovery potential with biological etiology will be most impactful to reduce stigma. Anti-stigma interventions designed specifically for health providers, family members, criminal justice personnel, and law enforcement seem particularly beneficial, given these sources of stigma. PMID:26780206

  8. Imagery Rescripting for Personality Disorders

    ERIC Educational Resources Information Center

    Arntz, Arnoud

    2011-01-01

    Imagery rescripting is a powerful technique that can be successfully applied in the treatment of personality disorders. For personality disorders, imagery rescripting is not used to address intrusive images but to change the implicational meaning of schemas and childhood experiences that underlie the patient's problems. Various mechanisms that may…

  9. Prescribing and borderline personality disorder

    PubMed Central

    Chanen, Andrew M; Thompson, Katherine N

    2016-01-01

    Summary Accurate diagnosis is fundamental to effective management of borderline personality disorder, but many patients remain undetected. The first-line management for borderline personality disorder is psychosocial treatment, not drugs. There are major prescribing hazards including polypharmacy, overdose and misuse. Drug treatment might be warranted for patients who have a co-occurring mental disorder such as major depression. If a drug is prescribed for borderline personality disorder, it should only be as an adjunct to psychosocial treatment. There should be clear and collaborative goals that are regularly reviewed with the patient. Use single drugs prescribed in limited quantities for a limited time. Stop drugs that are ineffective. PMID:27340322

  10. Borderline Personality Disorder

    PubMed Central

    Brüne, Martin

    2016-01-01

    The term ‘Borderline Personality Disorder’ (BPD) refers to a psychiatric syndrome that is characterized by emotion dysregulation, impulsivity, risk-taking behavior, irritability, feelings of emptiness, self-injury and fear of abandonment, as well as unstable interpersonal relationships. BPD is not only common in psychiatric populations but also more prevalent in the general community than previously thought, and thus represents an important public health issue. In contrast to most psychiatric disorders, some symptoms associated with BPD may improve over time, even without therapy, though impaired social functioning and interpersonal disturbances in close relationships often persist. Another counterintuitive and insufficiently resolved question is why depressive symptoms and risk-taking behaviors can occur simultaneously in the same individual. Moreover, there is an ongoing debate about the nosological position of BPD, which impacts on research regarding sex differences in clinical presentation and patterns of comorbidity. In this review, it is argued that many features of BPD may be conceptualized within an evolutionary framework, namely behavioral ecology. According to Life History Theory, BPD reflects a pathological extreme or distortion of a behavioral ‘strategy’ which unconsciously aims at immediate exploitation of resources, both interpersonal and material, based on predictions shaped by early developmental experiences. Such a view is consistent with standard medical conceptualizations of BPD, but goes beyond classic ‘deficit’-oriented models, which may have profound implications for therapeutic approaches. PMID:26929090

  11. Hyperactivity as a Personality Disorder.

    ERIC Educational Resources Information Center

    Waddell, Kathleen J.

    While hyperactivity in children has been alternately viewed as a form of minimal brain dysfunction, as a behavior disorder, or as an attention deficit disorder, recent findings on hyperactive adolescents and adults suggest that hyperactivity can be better understood as a personality disorder. Striking similarities appear when characteristics of…

  12. Borderline Personality Disorder: Psychotherapy

    MedlinePlus Videos and Cool Tools

    ... associated with one person to another person, such as the therapist. In that moment, the therapist talks ... other people. Therapy addresses intense shifts in emotions as patients learn to reflect and verbalize what they’ ...

  13. Prefrontal Gray Matter and Motivation for Treatment in Cocaine-Dependent Individuals with and without Personality Disorders

    PubMed Central

    Moreno-López, Laura; Albein-Urios, Natalia; Martinez-Gonzalez, José Miguel; Soriano-Mas, Carles; Verdejo-García, Antonio

    2014-01-01

    Addiction treatment is a long-term goal and therefore prefrontal–striatal regions regulating goal-directed behavior are to be associated with individual differences on treatment motivation. We aimed at examining the association between gray matter volumes in prefrontal cortices and striatum and readiness to change at treatment onset in cocaine users with and without personality disorders. Participants included 17 cocaine users without psychiatric comorbidities, 17 cocaine users with Cluster B disorders, and 12 cocaine users with Cluster C disorders. They completed the University of Rhode Island Change Assessment Scale, which measures four stages of treatment change (precontemplation, contemplation, action, and maintenance) and overall readiness to change, and were scanned in a 3 T MRI scanner. We defined three regions of interest (ROIs): the ventromedial prefrontal cortex (including medial orbitofrontal cortex and subgenual and rostral anterior cingulate cortex), the dorsomedial prefrontal cortex (i.e., superior medial frontal cortex), and the neostriatum (caudate and putamen). We found that readiness to change correlated with different aspects of ventromedial prefrontal gray matter as a function of diagnosis. In cocaine users with Cluster C comorbidities, readiness to change positively correlated with gyrus rectus gray matter, whereas in cocaine users without comorbidities it negatively correlated with rostral anterior cingulate cortex gray matter. Moreover, maintenance scores positively correlated with dorsomedial prefrontal gray matter in cocaine users with Cluster C comorbidities, but negatively correlated with this region in cocaine users with Cluster B and cocaine users without comorbidities. Maintenance scores also negatively correlated with dorsal striatum gray matter in cocaine users with Cluster C comorbidities. We conclude that the link between prefrontal–striatal gray matter and treatment motivation is modulated by co-existence of personality

  14. Personality Disorders in Persons with Gender Identity Disorder

    PubMed Central

    Duišin, Dragana; Batinić, Borjanka; Barišić, Jasmina; Djordjevic, Miroslav L.; Vujović, Svetlana; Bizic, Marta

    2014-01-01

    Background. Investigations in the field of gender identity disorder (GID) have been mostly related to psychiatric comorbidity and severe psychiatric disorders, but have focused less on personality and personality disorders (PDs). Aims. The aim of the study was to assess the presence of PDs in persons with GID as compared to cisgendered (a cisgender person is a person who is content to remain the gender they were assigned at birth) heterosexuals, as well as to biological sex. Methods. The study sample consisted of 30 persons with GID and 30 cisgendered heterosexuals from the general population. The assessment of PDs was conducted by application of the self-administered Structured Clinical Interview for DSM-IV Axis II PDs (SCID-II). Results. Persons with GID compared to cisgender heterosexuals have higher presence of PDs, particularly Paranoid PD, avoidant PDs, and comorbid PDs. In addition, MtF (transwomen are people assigned male at birth who identify as women) persons are characterized by a more severe psychopathological profile. Conclusions. Assessment of PDs in persons with GID is of great importance as it comprises a key part of personalized treatment plan tailoring, as well as a prognostic factor for sex-reassignment surgery (SRS) outcome. PMID:24959629

  15. [Comorbidity between cocaine addiction and personality disorders].

    PubMed

    Fernández-Montalvo, J; Lorea, I

    2007-01-01

    The aim of this paper was to review the current knowledge about the comorbidity between cocaine dependence and personality disorders. Results concerning a specific profile of cocaine patients are not conclusive. The prevalence rate of personality disorders in cocaine dependents is very heterogeneous (with a mean of 66% of cases), and a great variability is observed between all the studies carried out. There is a tendency for a higher proportion of cocaine dependents to be found within the cluster B category (mainly antisocial and borderline). Lastly, implications of this kind of study for future research and clinical practice are commented upon. PMID:17898818

  16. [Dis-social personality disorder].

    PubMed

    Habermeyer, E; Herpertz, S C

    2006-05-01

    Deviant behavior is gaining in clinical importance if it is founded on stable, characteristic, and enduring patterns of psychopathologically relevant personality traits which have their onset in childhood or adolescence. The classification of these traits shows variations, so that a distinction between the ICD-10 diagnosis of dis-social personality disorder, DSM-IV diagnosis of antisocial personality disorder, and the concept "psychopathy" is necessary. Our knowledge about the biological basis of antisocial behavior includes neurophysiologic, psychophysiologic, and genetic findings. Also relevant are results of neurotransmitter studies and structural resp. functional neuroimaging findings. Psychosocial risk factors include parental deficits, rejection, disregard, unstable relations, and abuse. Efficient psychotherapeutic treatment is cognitive-behavioral. Pharmacologic treatment is largely "off-label". The diagnosis of antisocial and dis-social personality disorders allows no conclusions on criminal responsibility. In addition to psychiatric diagnostics, considerations on the severity of the disorder and its effects on the ability to inhibit actions are necessary. PMID:16609871

  17. Obsessive-compulsive personality disorder

    MedlinePlus

    American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Publishing. 2013. Blais MA, Smallwood P, Groves JE, Rivas-Vazquez RA. Personality and ...

  18. Personality disorder in transcultural perspective.

    PubMed

    Morice, R

    1979-12-01

    Personality disorder constitutes one of the most controversial diagnostic categories within clinical psychiatry. Explosive and antisocial personality disorders in particular are central to this controversy. The difficulties for diagnosis encountered when clinician and patient belong to different socio-economic classes are seen to be magnified in the transcultural situation, when cultural and language variables are superimposed. The diagnosis of personality disorder among Australian Aborigines is reviewed, and the face validity of some prevalence rates is challenged. An examination of the terms for anger and aggression used by a Central Australian tribal Aboriginal group demonstrates that Aborigines differentiate them both quantitatively and qualitatively. This facility is seen as providing psychiatrists with a method for enhancing diagnosis of personality disorder in both clinical and epidemiological settings. PMID:295209

  19. Obsessive-compulsive personality disorder

    MedlinePlus

    ... They may not be able to express their anger directly. People with OCPD have feelings that they ... personality disorders. The social isolation and difficulty handling anger that are common with OCPD may lead to ...

  20. Schizoid personality disorder

    MedlinePlus

    ... handling relationships that focus on: Work Intellectual activities Expectations ... person from asking for help or support. Limiting expectations of emotional intimacy may help people with this ...

  1. Paranoid personality disorder

    MedlinePlus

    ... include: Concern that other people have hidden motives Expectation that they will be exploited (used) by others ... medicines can sometimes reduce paranoia and limit its impact on the person's daily functioning.

  2. Borderline Personality Disorder

    MedlinePlus

    ... person with BPD may experience intense episodes of anger, depression, and anxiety that may last from only ... closeness and love (idealization) to extreme dislike or anger (devaluation) Distorted and unstable self-image or sense ...

  3. Aggression in borderline personality disorder.

    PubMed

    Látalová, K; Prasko, J

    2010-09-01

    This review examined aggressive behavior in Borderline Personality Disorder (BPD) and its management in adults. Aggression against self or against others is a core component of BPD. Impulsiveness is a clinical hallmark (as well as a DSM-IV-TR diagnostic criterion) of BPD, and aggressive acts by BPD patients are largely of the impulsive type. BPD has high comorbidity rates with substance use disorders, Bipolar Disorder, and Antisocial Personality Disorder; these conditions further elevate the risk for violence. Treatment of BDP includes psychodynamic, cognitive behavioral, schema therapy, dialectic behavioral, group and pharmacological interventions. Recent studies indicate that many medications, particularly atypical antipsychotics and anticonvulsants, may reduce impulsivity, affective lability as well as irritability and aggressive behavior. But there is still a lack of large, double blind, placebo controlled studies in this area. PMID:20390357

  4. Dimensional models of personality disorder

    PubMed Central

    WIDIGER, THOMAS A

    2007-01-01

    There is little doubt that someday the classification of personality disorder will be dimensional. The failures of the categorical model are so many and are so well established that it is difficult to imagine that this model will ultimately survive. This paper provides a brief discussion of the major alternative proposals for a dimensional classification of personality disorder. It is possible that the authors of a future edition of a psychiatric diagnostic manual will simply choose one of these alternative proposals. However, the ideal solution might be to develop a common, integrative representation including the important contributions of each of the models. PMID:18235857

  5. Personality Disorders Classification and Symptoms in Cocaine and Opioid Addicts.

    ERIC Educational Resources Information Center

    Malow, Robert M.; And Others

    1989-01-01

    Examined extent to which personality disorders and associated symptom criteria were found among 117 cocaine- and opioid-dependent men in drug dependence treatment unit. Drug groups were distinguished by higher rates of antisocial and borderline symptomatology rather than by features associated with other personality disorders. Different…

  6. Borderline personality disorder in adolescence.

    PubMed

    Kaess, Michael; Brunner, Romuald; Chanen, Andrew

    2014-10-01

    Borderline personality disorder (BPD) is a common and severe mental disorder that is associated with severe functional impairment and a high suicide rate. BPD is usually associated with other psychiatric and personality disorders, high burden on families and carers, continuing resource utilization, and high treatment costs. BPD has been a controversial diagnosis in adolescents, but this is no longer justified. Recent evidence demonstrates that BPD is as reliable and valid among adolescents as it is in adults and that adolescents with BPD can benefit from early intervention. Consequently, adolescent BPD is now recognized in psychiatric classification systems and in national treatment guidelines. This review aims to inform practitioners in the field of adolescent health about the nature of BPD in adolescence and the benefits of early detection and intervention. BPD diagnosis and treatment should be considered part of routine practice in adolescent mental health to improve these individuals' well-being and long-term prognosis. PMID:25246626

  7. Task Dependent Prefrontal Dysfunction in Persons with Asperger's Disorder Investigated with Multi-Channel Near-Infrared Spectroscopy

    ERIC Educational Resources Information Center

    Iwanami, Akira; Okajima, Yuka; Ota, Haruhisa; Tani, Masayuki; Yamada, Takashi; Hashimoro, Ryuichiro; Kanai, Chieko; Watanabe, Hiromi; Yamasue, Hidenori; Kawakubo, Yuki; Kato, Nobumasa

    2011-01-01

    Dysfunction of the prefrontal cortex has been previously reported in individuals with Asperger's disorder. In the present study, we used multi-channel near-infrared spectroscopy (NIRS) to detect changes in the oxygenated hemoglobin concentration ([oxy-Hb]) during two verbal fluency tasks. The subjects were 20 individuals with Asperger's disorder…

  8. Comorbid personality disorders among patients with depression

    PubMed Central

    Wongpakaran, Nahathai; Wongpakaran, Tinakon; Boonyanaruthee, Vudhichai; Pinyopornpanish, Manee; Intaprasert, Suthi

    2015-01-01

    Purpose To investigate the personality disorders (PDs) diagnosed in patients with depressive disorders. Material and methods This study included a cross-sectional analysis, and was an extension of the Thai Study of Affective Disorder (THAISAD) project. Eighty-five outpatients with depressive disorders were interviewed using the Mini International Neuropsychiatric Inventory to assess for depression, in accordance with the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision and using the Thai version of the Structured Clinical Interview for PDs to assess for PD. Results Seventy-seven percent of the patients had at least one PD, 40% had one PD and 60% had two or more PDs (mixed cluster). The most common PDs found were borderline PD (20%) and obsessive–compulsive PD (10.6%), while the occurrence of avoidant PD was low when compared to the findings of previous, related studies. Among the mixed cluster, cluster A combined with cluster C was the common mix. Both dysthymic disorder and double depression were found to have a higher proportion of PDs than major depressive disorder (85.7% versus 76.1%). Dependent PD was found to be less common in this study than in previous studies, including those carried out in Asia. Conclusion The prevalence of PDs among those with depressive disorder varied, and only borderline PD seems to be consistently high within and across cultures. Mixed cluster plays a prominent role in depression, so more attention should be paid to patients in this category. PMID:25945052

  9. [General principles in psychotherapy of personality disorders].

    PubMed

    Bohus, Martin; Doering, Stephan; Schmitz, Bernt; Herpertz, Sabine C

    2009-01-01

    S2 guidelines for diagnostics and treatment of personality disorders have been developed under the umbrella of the AWMF Germany. Following the current trend to manualized axis I treatment programs, within the recent years specific treatment programs have also been developed for some personality disorders like borderline personality disorder, antisocial personality disorder and avoidant personality disorder. The superiority of these treatment programs compared to unspecific approaches is meanwhile proven on a robust empirical basis. The S2 guidelines task force extracted the principles of these manualized treatment programs to provide the framework for a general clinically oriented concept for the treatment of personality disorders. The intention was to develop a concept which gets beyond the school oriented therapeutic approaches in order to provide the platform for further developments of general and specific treatments for personality disorders. PMID:19350475

  10. Modernity and narcissistic personality disorder.

    PubMed

    Paris, Joel

    2014-04-01

    Narcissistic personality disorder (NPD) is a trait-based disorder that can be understood as a pathological amplification of narcissistic traits. While temperamental vulnerability and psychological adversity are risk factors for NPD, sociocultural factors are also important. This review hypothesizes that increases in narcissistic traits and cultural narcissism could be associated with changes in the prevalence of NPD. These shifts seem to be a relatively recent phenomenon, driven by social changes associated with modernity. While the main treatment for NPD remains psychotherapy, that form of treatment is itself a product of modernity and individualism. The hypothesis is presented that psychological treatment, unless modified to address the specific problems associated with NPD, could run the risk of supporting narcissism. PMID:22800179

  11. Phenomenology of Borderline Personality Disorder

    PubMed Central

    De Genna, Natacha M.; Feske, Ulrike

    2015-01-01

    Little is known about racial differences in borderline personality disorder (BPD) that may influence etiology, phenomenology, and treatment of women with BPD. A total of 83 women with BPD participated in this cross-sectional study: n = 41 white and n = 42 African-American women. Structured interviews were used to assess Axis I and II disorders, and a series of interviews and questionnaires captured internalizing and externalizing symptoms. The white women with BPD reported more severe internalizing symptoms, whereas the African-American women reported more severe externalizing symptoms. Except for the association between race and number of suicide attempts, the relationship between race and internalizing/externalizing symptoms was mediated by socioeconomic status. In conclusion, African-American women with BPD may present with more severe symptoms of lack of anger control and fewer suicidal behaviors than those of white women with BPD, raising the possibility that they are misdiagnosed and receive treatments that are not optimal for BPD. PMID:24284636

  12. What Is a Personality Disorder?

    PubMed

    Millon, Theodore

    2016-06-01

    The goal of this article is to describe, characterize, and differentiate personality disorders by connecting their conceptual features to their foundations in the natural sciences. What is proposed is akin to Freud's abandoned Project for a Scientific Psychology and Wilson's (1975) highly controversial Sociobiology. Both were worthy endeavors to advance our understanding of the styles and traits of human nature; this was to be done by exploring interconnections among the diverse disciplines of nature that evolved ostensibly unrelated bodies of research and manifestly dissimilar languages. PMID:27243919

  13. [Emotion activation in personality disorders].

    PubMed

    Zorn, Peter; Roder, Volker; Kramer, Ueli; Pomini, Valentino

    2007-01-01

    There are at least six psychotherapeutic treatments of personality disorders having received empirical and clinical validation in terms of their efficacy. These treatments are based on different theoretical models, namely the cognitive-behavioural, psychodynamic and interpersonal models. This article briefly presents these treatments, focusing on the process of therapeutic change. It is assumed that the process of emotional activation is one of the most interesting theoretical psychotherapy ingredient in treatments of these patients. The treatments are discussed regarding this hypothesis and its clinical implications. PMID:18253667

  14. Personality and substance dependence symptoms: modeling substance-specific traits.

    PubMed

    Grekin, Emily R; Sher, Kenneth J; Wood, Phillip K

    2006-12-01

    Personality traits related to neuroticism and disinhibition have been consistently associated with substance use disorders (SUDs). It is unclear, however, whether different personality traits predict distinct forms of substance dependence. Additionally, it is unclear whether personality traits continue to predict alcohol, drug, and tobacco dependence after controlling for comorbid antisociality and other SUDs. The current study addresses these questions by characterizing relations between personality traits and substance dependence symptoms in a longitudinal sample of 3,720 college students. Results revealed that antisociality and certain core personality traits predicted multiple types of substance pathology. In addition, several personality traits were differentially associated with alcohol, drug, and tobacco symptomatology. PMID:17176176

  15. Personality disorders in adopted versus non-adopted adults.

    PubMed

    Westermeyer, Joseph; Yoon, Gihyun; Amundson, Carla; Warwick, Marion; Kuskowski, Michael A

    2015-04-30

    The goal of this epidemiological study was to investigate lifetime history and odds ratios of personality disorders in adopted and non-adopted adults using a nationally representative sample. Data, drawn from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC), were compared in adopted (n=378) versus non-adopted (n=42,503) adults to estimate the odds of seven personality disorders using logistic regression analyses. The seven personality disorders were histrionic, antisocial, avoidant, paranoid, schizoid, obsessive-compulsive, and dependent personality disorder. Adoptees had a 1.81-fold increase in the odds of any personality disorder compared with non-adoptees. Adoptees had increased odds of histrionic, antisocial, avoidant, paranoid, schizoid, and obsessive-compulsive personality disorder compared with non-adoptees. Two risk factors associated with lifetime history of a personality disorder in adoptees compared to non-adoptees were (1) being in the age cohort 18-29 years (but no difference in the age 30-44 cohort), using the age 45 or older cohort as the reference and (2) having 12 years of education (but no difference in higher education groups), using the 0-11 years of education as the reference. These findings support the higher rates of personality disorders among adoptees compared to non-adoptees. PMID:25752207

  16. DSM-5 Personality Traits and DSM-IV Personality Disorders

    PubMed Central

    Hopwood, Christopher J.; Thomas, Katherine M.; Markon, Kristian E.; Wright, Aidan G.C.; Krueger, Robert F.

    2014-01-01

    Two issues pertinent to the DSM-5 proposal for personality pathology, the recovery of DSM-IV personality disorders (PDs) by proposed DSM-5 traits and the validity of the proposed DSM-5 hybrid model which incorporates both personality pathology symptoms and maladaptive traits, were evaluated in a large undergraduate sample (N = 808). Proposed DSM-5 traits as assessed with the Personality Inventory for DSM-5 explained a substantial proportion of variance in DSM-IV PDs as assessed with the Personality Diagnostic Questionnaire-4+, and trait indicators of the six proposed DSM-5 PDs were mostly specific to those disorders with some exceptions. Regression analyses support the DSM-5 hybrid model in that pathological traits and an indicator of general personality pathology severity provided incremental information about PDs. Findings are discussed in the context of broader issues around the proposed DSM-5 model of personality disorders. PMID:22250660

  17. Developmental aspects of borderline personality disorder.

    PubMed

    Reich, D B; Zanarini, M C

    2001-01-01

    This study examined whether patients with borderline personality disorder and controls with other personality disorders remember their childhoods differently with respect to separation difficulties, evocative memory, temperamental factors such as frustration tolerance and mood reactivity, and onset of symptoms. Two hundred and ninety patients with borderline personality disorder and 72 with other personality disorders were assessed using an instrument to rate memories of separation difficulties, temperamental problems, and onset of symptoms before age 18. Patients with borderline personality disorder remembered more difficulties with separation between ages 6 and 17 years, more mood reactivity and poorer frustration tolerance between ages 6 and 17, and the onset of more symptoms (most prominently sadness, depression, anxiety, and suicidality) before age 18 than did patients with other personality disorders. The groups did not differ in reports of evocative memory before age 18. These results indicate that many of the features of adult patients with borderline personality disorder may initially appear during childhood and adolescence and that these features may be used to differentiate borderline from other personality disorders. PMID:11600488

  18. Patterns of personality disorders in women with chronic eating disorders.

    PubMed

    Larsson, J O; Hellzén, M

    2004-09-01

    The aim of this study was to describe patterns of personality disorders (PDs) in women with chronic eating disorders (EDs). An index group of nineteen women who have had EDs for an average of 8.5 years was compared with a control group of same-aged women from the general population. At the time of the study the index group received treatment at a tertiary treatment center in Stockholm. The PDs were assessed using the DSM-IV part of the DSM-IV and ICD-10 Personality Questionnaire (DIP-Q). In the index group, eighteen of nineteen fulfilled the criteria for one or more PD. The number of PD diagnoses for each women ranged from zero (n = 1) to eight (n = 2) with a median of three. Among the controls, only one woman fulfilled the criteria for one or more PD. The most prevalent disorders in the index group were Borderline, Avoidant, and Obsessive-Compulsive. The index group had significantly higher DIP-Q dimensional scores than the controls in the Paranoid, Schizoid, Schizotypal, Borderline, Histrionic, Avoidant, and Dependent scales. Although the assessment of PD symptoms was limited to self-reports, the high prevalence of PD diagnoses and PD symptoms most probably reflects the severe psychiatric impairments in patients suffering from chronic ED. PMID:15656014

  19. Personality Disorders (and Their Relation to Syndromal Disorders).

    ERIC Educational Resources Information Center

    Beck, Aaron T.

    Personality disorders and their syndromal disorders may be considered in terms of their distal, phylogenetic origins, and their structures and functions. From an evolutionary standpoint, the syndromal disorders such as anxiety and depression may be viewed as preprogrammed reactions to a perceived threat or a perceived depletion of the individual's…

  20. Borderline personality disorder: study in adolescence.

    PubMed

    James, A; Berelowitz, M; Vereker, M

    1996-04-01

    The study of the presentation, symptomatology and family characteristics of an exclusively adolescent sample of patients with borderline personality disorder (BPD) was undertaken. Twenty-four cases of borderline personality disorder, 20 females, 4 males, identified using chart review and meeting the criteria of the Diagnostic Interview for Borderlines (DIB) and DSM III-R, were matched with psychiatric controls. Adolescents with borderline personality disorder were found to have high rates of affective symptomatology with Axis I diagnosis of major depressive disorder MDD (DSM-III-R), and high rates of interpersonal psychopathology, i.e., manipulation, devaluation, and a pervasive sense of boredom. The latter seem to be characteristic as for adults with borderline personality disorder. The families were particularly angry and volatile. PMID:9117533

  1. [Concepts of the borderline personality disorders].

    PubMed

    Ogłodek, Ewa; Araszkiewicz, Aleksander

    2011-08-01

    For many years, the borderline personality disorders have mainly been researched in terms of psychoanalytical theories, such as theories on relations with the object. Nowadays, there are three kinds of concepts that are distinguishable. The first ones are those which are group models, serving attempts to made characteristic sets of qualities, represented by individuals suffering from the borderline personality disorders, more precise. The remaining concepts are models of conflict and deficit, which explain complicated mechanisms of interactions of social, psychological and biological factors, and therefore, contribute to better understanding of the genesis of the symptoms of this disorder. Upon the basis of the attempts made so far in the field of describing the borderline personality disorders, one may indicate certain criteria, representative for the entire group of individuals with this diagnosis, regardless of the assumptions applicable to the genesis of the disorder and its symptoms, even though the population of the infirm suffering from the borderline personality disorders is not internally homogenous. The interest of psychologists, attempting to describe the borderline personality disorders, is focused upon certain sets of qualities, presented as the examples of descriptive models. Among the researchers, working on the issues of the borderline personality disorders in this manner, there are: Gunderson, Kernberg, Kohut, Winnicot, Guntrip, Fairbaim, Adler and Buie. PMID:21936354

  2. The therapeutic alliance in the treatment of personality disorders.

    PubMed

    Bender, Donna S

    2005-03-01

    care to avoid crossing inappropriate lines in a quest to build an alliance with patients with one of these disorders. Patients with Cluster C "anxious/fearful" personality disorders (avoidant, dependent, and obsessive-compulsive personality disorders) are emotionally inhibited and averse to interpersonal conflict. These patients frequently feel guilty and internalize blame for situations even when there is none, a tendency that may facilitate alliance building because the patients are willing to take some responsibility for their dilemma and may engage somewhat more readily with the therapist to sort it out, compared with patients with more severe Cluster A or B diagnoses. The author then reviews considerations relevant to treatment alliance that arise in the different treatment approaches that may be used with patients with personality disorders, including psychodynamic psychotherapy/psychoanalysis, cognitive-behavioral therapies, and psychopharmacology. The author also discusses issues, especially splitting, that arise in the alliance when patients with personality disorders are treated in inpatient psychiatric hospital settings. PMID:15803042

  3. Dreams and Nightmares in Personality Disorders.

    PubMed

    Schredl, Michael

    2016-02-01

    Although the relationship between dreaming and psychopathology has been studied quite extensively, research on dreaming in patients with personality disorders has been very scarce. In patients with borderline personality disorder, negatively toned dreams and heightened nightmare frequency have been found-characteristics not determined by co-morbid depression or posttraumatic stress disorder. The review includes suggestions for future studies as the existing results clearly indicate that this line of research is most interesting. Lastly, clinical recommendations especially regarding the treatment of the often found co-morbid nightmare disorder will be given. PMID:26781553

  4. A Personality Disorders: Schizotypal, Schizoid and Paranoid Personality Disorders in Childhood and Adolescence

    PubMed Central

    Esterberg, Michelle L.; Goulding, Sandra M.

    2010-01-01

    Cluster A personality disorders (PD), including schizotypal personality disorder (SPD), paranoid personality disorder (PPD), and schizoid PD, are marked by odd and eccentric behaviors, and are grouped together because of common patterns in symptomatology as well as shared genetic and environmental risk factors. The DSM-IV-TR describes personality disorders as representing stable and enduring patterns of maladaptive traits, and much of what is understood about Cluster A personality disorders in particular stems from research with adult populations. Less in known about these disorders in children and adolescents, and controversy remains regarding diagnosis of personality disorders in general in youth. The current paper reviews the available research on Cluster A personality disorders in childhood and adolescence; specifically, we discuss differentiating between the three disorders and distinguishing them from other syndromes, measuring Cluster A disorders in youth, and the nature and course of these disorders throughout childhood and adolescence. We also present recent longitudinal data from a sample of adolescents diagnosed with Cluster A personality disorders from our research laboratory, and suggest directions for future research in this important but understudied area. PMID:21116455

  5. Personality disorders in previously detained adolescent females: a prospective study.

    PubMed

    Krabbendam, Anne A; Colins, Olivier F; Doreleijers, Theo A H; van der Molen, Elsa; Beekman, Aartjan T F; Vermeiren, Robert R J M

    2015-01-01

    This longitudinal study investigated the predictive value of trauma and mental health problems for the development of antisocial personality disorder (ASPD) and borderline personality disorder (BPD) in previously detained women. The participants were 229 detained adolescent females who were assessed for traumatic experiences and mental health problems (mean age = 15.5 years). Three to 6 years later (M = 4.5; SD = 0.6), ASPD and BPD were diagnosed with a semistructured interview. Forty percent of the women had a personality disorder (i.e., ASPD 15.8%, BPD 9.2%, or both ASPD and BPD 15.2%). Posttraumatic stress, depressive symptoms, and dissociation during detention increased the risk for BPD in adulthood. Surprisingly, neither conduct problems nor substance dependence predicted ASPD; these findings require further study because they add to the controversy surrounding ASPD in females. The high prevalence rates of personality disorders indicate the need for intervention programs that target these unwanted outcomes. PMID:25420142

  6. Antisocial personality disorder in DSM-5: missteps and missed opportunities.

    PubMed

    Lynam, Donald R; Vachon, David D

    2012-10-01

    This paper evaluates the proposal for antisocial personality disorder (ASPD) in the Diagnostic and Statistical Manual of Mental Disorders-fifth edition (DSM-5). Some aspects of the proposal are appealing: personality disorders will be assessed using trait criteria, and these criteria are similar to trait descriptions of DSM-IV ASPD. Other aspects of the proposal are less appealing. First, the DSM-5 will depend on a newly constructed personality trait system rather than relying on a well validated, widely studied one. Second, the trait profile of ASPD is incomplete; although this profile reflects the traits included in DSM-IV, it maps poorly onto the full personality profile of ASPD. Third, the DSM Workgroup missed an opportunity to finally unify ASPD and psychopathy; history and research suggest that these disorders have diverged mistakenly. Fourth, the newly proposed criteria of impairments in self- and interpersonal functioning are of questionable derivation and utility. PMID:23106185

  7. Parents' personality clusters and eating disordered daughters' personality and psychopathology.

    PubMed

    Amianto, Federico; Ercole, Roberta; Marzola, Enrica; Abbate Daga, Giovanni; Fassino, Secondo

    2015-11-30

    The present study explores how parents' personality clusters relate to their eating disordered daughters' personality and psychopathology. Mothers and fathers were tested with the Temperament Character Inventory. Their daughters were assessed with the following: Temperament and Character Inventory, Eating Disorder Inventory-2, Symptom Checklist-90, Parental Bonding Instrument, Attachment Style Questionnaire, and Family Assessment Device. Daughters' personality traits and psychopathology scores were compared between clusters. Daughters' features were related to those of their parents. Explosive/adventurous mothers were found to relate to their daughters' borderline personality profile and more severe interoceptive awareness. Mothers' immaturity was correlated to their daughters' higher character immaturity, inadequacy, and depressive feelings. Fathers who were explosive/methodic correlated with their daughters' character immaturity, severe eating, and general psychopathology. Fathers' character immaturity only marginally related to their daughters' specific features. Both parents' temperament clusters and mothers' character clusters related to patients' personality and eating psychopathology. The cluster approach to personality-related dynamics of families with an individual affected by an eating disorder expands the knowledge on the relationship between parents' characteristics and daughters' illness, suggesting complex and unique relationships correlating parents' personality traits to their daughters' disorder. PMID:26315665

  8. Personality disorder: a new global perspective

    PubMed Central

    TYRER, PETER; MULDER, ROGER; CRAWFORD, MIKE; NEWTON-HOWES, GILES; SIMONSEN, ERIK; NDETEI, DAVID; KOLDOBSKY, NESTOR; FOSSATI, ANDREA; MBATIA, JOSEPH; BARRETT, BARBARA

    2010-01-01

    Personality disorder is now being accepted as an important condition in mainstream psychiatry across the world. Although it often remains unrecognized in ordinary practice, research studies have shown it is common, creates considerable morbidity, is associated with high costs to services and to society, and interferes, usually negatively, with progress in the treatment of other mental disorders. We now have evidence that personality disorder, as currently classified, affects around 6% of the world population, and the differences between countries show no consistent variation. We are also getting increasing evidence that some treatments, mainly psychological, are of value in this group of disorders. What is now needed is a new classification that is of greater value to clinicians, and the WPA Section on Personality Disorders is currently undertaking this task. PMID:20148162

  9. The neurobiology of personality disorders: implications for psychoanalysis.

    PubMed

    Siever, Larry J; Weinstein, Lissa N

    2009-04-01

    As advances in neuroscience have furthered our understanding of the role of brain circuitry, genetics, stress, and neuromodulators in the regulation of normal behavior and in the pathogenesis of psychopathology, an increasing appreciation of the role of neurobiology in individual differences in personality and their pathology in personality disorders has emerged. Individual differences in the regulation and organization of cognitive processes, affective reactivity, impulse/action patterns, and anxiety may in the extreme provide susceptibilities to personality disorders such as borderline and schizotypal personality disorder. A low threshold for impulsive aggression, as observed in borderline and antisocial personality disorders, may be related to excessive amygdala reactivity, reduced prefrontal inhibition, and diminished serotonergic facilitation of prefrontal controls. Affective instability may be mediated by excessive limbic reactivity in gabaminergic/glutamatergic/cholinergic circuits, resulting in an increased sensitivity or reactivity to environmental emotional stimuli as in borderline personality disorder and other cluster B personality disorders. Disturbances in cognitive organization and information processing may contribute to the detachment, desynchrony with the environment, and cognitive/perceptional distortions of cluster A or schizophrenia spectrum personality disorders. A low threshold for anxiety may contribute to the avoidant, dependent, and compulsive behaviors observed in cluster C personality disorders. These alterations in critical regulatory domains will influence how representations of self and others are internalized. Aspects of neurobiological functioning themselves become cognized through the medium of figurative language into an ongoing narrative of the self, one that can be transformed through the analytic process, allowing for the modulation of genetic/biological thresholds. PMID:19516057

  10. Personality disorders in a Swedish peacekeeping unit.

    PubMed

    Michel, Per-Olof; Lundin, Tom; Larsson, Gerry

    2005-01-01

    There is a lack of knowledge about the incidence of personality disorders and their consequences among peacekeepers. Moreover, most studies are follow-up studies in which, if at all, personality traits are screened for after the soldiers have left their service abroad. The aim of this paper was to study personality disorders in a longitudinal perspective. The method used was to screen the personnel in a Swedish mechanized battalion serving in Bosnia from March until October 1996 on four occasions: before deployment, immediately after deployment, 6 months after deployment and 1 year after deployment. Serving in the battalion were 724 individuals of whom 516 took part in the survey. The screening instrument used was the DSM-IV and ICD-10 Personality Questionnaire (DIP-Q). The result shows that the rate of personality disorders were on the same level, or a little bit lower, than in the general population. Moreover, personality disorders were related to impaired general mental health and to reported traumatic experiences. Personality disorders also seemed to contribute to poor mental health 1 year after returning home from a mission abroad. The implications of these results for the future selection of peacekeepers are discussed. PMID:16195111

  11. Construct Validity of Adolescent Antisocial Personality Disorder

    ERIC Educational Resources Information Center

    Taylor, Jeanette; Elkins, Irene J.; Legrand, Lisa; Peuschold, Dawn; Iacono, William G.

    2007-01-01

    This study examined the construct validity of antisocial personality disorder (ASPD) diagnosed in adolescence. Boys and girls were grouped by history of DSM-III-R conduct disorder (CD) and ASPD: Controls (n = 340) had neither diagnosis; CD Only (n = 77) had CD by age 17 but no ASPD through age 20; Adolescent ASPD (n = 64) had ASPD by age 17. The…

  12. Symptoms: Personal Snapshots of Anxiety Disorders

    MedlinePlus

    ... of these conditions: Panic Disorder: "For me, a panic attack is almost a violent experience. I feel disconnected from reality. I feel like I'm losing control in a very extreme way. My heart ... / Studying Anxiety Disorders / Symptoms: Personal snapshots of anxiety ...

  13. Antisocial personality disorder, alcohol, and aggression.

    PubMed

    Moeller, F G; Dougherty, D M

    2001-01-01

    Epidemiologic studies and laboratory research consistently link alcohol use with aggression. Not all people, however, exhibit increased aggression under the influence of alcohol. Recent research suggests that people with antisocial personality disorder (ASPD) may be more prone to alcohol-related aggression than people without ASPD. As a group, people with ASPD have higher rates of alcohol dependence and more alcohol-related problems than people without ASPD. Likewise, in laboratory studies, people with ASPD show greater increases in aggressive behavior after consuming alcohol than people without ASPD. The association between ASPD and alcohol-related aggression may result from biological factors, such as ASPD-related impairments in the functions of certain brain chemicals (e.g., serotonin) or in the activities of higher reasoning, or "executive," brain regions. Alternatively, the association between ASPD and alcohol-related aggression may stem from some as yet undetermined factor(s) that increase the risk for aggression in general. PMID:11496966

  14. The Concept of Personality Disorder in Childhood.

    ERIC Educational Resources Information Center

    Wolff, S.

    1984-01-01

    Advises child psychiatrists to use personality disorder diagnoses sparingly; to be aware of the constraints on adaptability of normal variations of temperament; and to positively diagnose those rare pathological impairments of personality brought about by minimal cerebral dysfunction, schizoid traits, and traits of excessive shyness. (RH)

  15. Borderline Personality Disorder and Posttraumatic Stress Disorder: Time for Integration?

    ERIC Educational Resources Information Center

    Hodges, Shannon

    2003-01-01

    An increasing prevalence of borderline personality disorder (BPD) and posttraumatic stress disorder (PTSD) diagnoses among women illustrates problems and limitations of the medical model system. Article explores overlapping relationship between BPD and PTSD and critiques how both are viewed within the mental health community. Previous research is…

  16. Personality Disorders, Coping Strategies, and Posttraumatic Stress Disorder in Women with Histories of Childhood Sexual Abuse

    ERIC Educational Resources Information Center

    Johnson, Dawn M.; Sheahan, Timothy C.; Chard, Kathleen M.

    2003-01-01

    Using a treatment-seeking sample of adult female survivors of childhood sexual abuse, the relationships between coping strategies, personality disorders (PD) and Posttraumatic Stress Disorder (PTSD) were explored. A variety of PDs were found to exist in this population, with avoidant, antisocial, dependent PDs having higher frequencies than…

  17. Early maladaptive schemas of personality disorder subtypes.

    PubMed

    Petrocelli, J V; Glaser, B A; Calhoun, G B; Campbell, L F

    2001-12-01

    This investigation attempted to examine the cognitive schemas of five distinct clusters that emerged from a cluster analysis of the personality disorder scales of the Millon Clinical Multiaxial Inventory-II (Millon, 1987). Specifically, the degree to which early maladaptive schemas, as measured by the Cognitive Schema Questionnaire-Short Form (Young, 1994), could correctly identify empirically derived patterns of personality disorders was examined. Between-cluster differences centered on five personality components and five schemas. Discriminant analyses revealed two significant functions composed of cognitive schemas, which correctly identified 61.2% of the entire sample in terms of cluster group membership. The total proportion of variance in the two significant functions associated with cluster group differences was 76.8%. Findings are discussed in relation to the domain theory of personality disorders posited by Millon and Davis (1996). PMID:11778396

  18. Controversies Surrounding Classification of Personality Disorder

    PubMed Central

    Tyrer, Peter

    2010-01-01

    Nowadays, it is apparent that personality disorder is a common condition. Some of the concepts of personality disorder that are currently in use are flawed and need to be revised. The aim of this article is to discuss the controversy created by the uncertainties in the current classification system and to suggest ways forward. In particular, the clinician needs to be aware of the importance of assessing personality abnormality in terms of a severity dimension, and of the ways in which such an abnormality can impact on treatments for other conditions. These changes in the notion of personality disorder are needed as, for the first time, a good evidence base is being established for potential treatments and these will be maximized if we have a classification fit for therapeutic purpose. PMID:20396426

  19. Sadistic personality disorder in sex offenders: relationship to antisocial personality disorder and sexual sadism.

    PubMed

    Berger, P; Berner, W; Bolterauer, J; Gutierrez, K; Berger, K

    1999-01-01

    To investigate the relationship of sadistic personality disorder (SPD), as defined in the appendix of DSM-III-R, to other personality disorders and to sexual sadism, 70 sex offenders (27 child molesters, 33 rapists, and 10 murderers) were assessed by the International Personality Disorder Examination. In 19 subjects (27.2%) from the total sample, SPD was diagnosed. The highest overlap appeared with borderline personality disorder (31.6%) and antisocial personality disorder (42.1%). However, in four cases SPD was the only personality disorder diagnosed. Factor analysis of the antisocial and sadistic criteria resulted in four major factors--one factor with high loadings on the sadistic criteria and the violent criteria of antisocial personality disorder, two factors with different forms of adult and juvenile aggression, and a fourth factor with high loadings on the antisocial criteria covering exploitative behavior. The results do not support SPD as a discrete disorder. Nevertheless, SPD may be seen as an important subdimension of antisocial personality disorder, distinct from more exploitative forms of antisocial behavior with less violence. Of those patients with SPD, 42.1% also had a DSM-III-R diagnosis of sexual sadism, which may be the most dangerous configuration. PMID:10372350

  20. [Impulse control disorders in borderline and antisocial personality disorder].

    PubMed

    Herpertz, S

    2007-01-18

    A borderline personality disorder is associated with highly impulsive acts that cannot be controlled by cognitive inhibition. In a psychopathic/antisocial personality disorder emotional inhibition of hostile acts is lacking. The patient has a high proclivity for risk-seeking, and is incapable of responding appropriately to punishment. In both disorders, the result is (auto)aggressive behavior. The family doctor must refer such patients to a specialist, when there is an acute danger of self-harm or when a grave functional limitation in the areas of work or interpersonal relationship has persisted over a long period of time. PMID:17619383

  1. 38 CFR 4.127 - Mental retardation and personality disorders.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... personality disorders. 4.127 Section 4.127 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS... and personality disorders. Mental retardation and personality disorders are not diseases or injuries... superimposed upon mental retardation or a personality disorder may be service-connected. (Authority: 38...

  2. 38 CFR 4.127 - Mental retardation and personality disorders.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... personality disorders. 4.127 Section 4.127 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS... and personality disorders. Mental retardation and personality disorders are not diseases or injuries... superimposed upon mental retardation or a personality disorder may be service-connected. (Authority: 38...

  3. 38 CFR 4.127 - Mental retardation and personality disorders.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... personality disorders. 4.127 Section 4.127 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS... and personality disorders. Mental retardation and personality disorders are not diseases or injuries... superimposed upon mental retardation or a personality disorder may be service-connected. (Authority: 38...

  4. 38 CFR 4.127 - Mental retardation and personality disorders.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... personality disorders. 4.127 Section 4.127 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS... and personality disorders. Mental retardation and personality disorders are not diseases or injuries... superimposed upon mental retardation or a personality disorder may be service-connected. (Authority: 38...

  5. 38 CFR 4.127 - Mental retardation and personality disorders.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... personality disorders. 4.127 Section 4.127 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS... and personality disorders. Mental retardation and personality disorders are not diseases or injuries... superimposed upon mental retardation or a personality disorder may be service-connected. (Authority: 38...

  6. Personal Relationships and Digestive Disorders

    MedlinePlus

    ... Help create more regularity in home life and time management. Avoiding disorganization, over-scheduling, or lack of planning will help the person with the condition feel more internally regulated and ... up at any time without warning. Understand that plans sometimes will need ...

  7. Defining the mechanisms of borderline personality disorder.

    PubMed

    Clarkin, John F; Posner, Michael

    2005-01-01

    Understanding the biological connections to mental processes was one of the original goals of psychoanalysis, and the development of cognitive and affective neuroscience and its methods might contribute to actualizing this goal. Personality disorders provide an opportunity to examine the complex mental structures of individuals experiencing extreme difficulties in interacting with their social environment. We provide initial information on a collaboration exploring an approach to one of the most serious personality disorders, borderline personality disorder, based upon the study of normal attention, individual differences in temperament, self definition and attachment organization, with the potential to illuminate the psychology and psychobiology of the disorder and to contribute to psychotherapeutic intervention. This developing model of borderline personality disorder can relate the symptoms to more enduring temperamental aspects of the patients. The goal is to understand the development of neural networks that underlie the abnormalities of adults, and eventually work out the interaction between temperament, genes, and experience that produce the disorder, and potentially inform intervention. PMID:15802943

  8. Borderline personality disorder: a disorder in search of advocacy.

    PubMed

    Zimmerman, Mark

    2015-01-01

    Compared with bipolar disorder, borderline personality disorder (BPD) is as frequent (if not more frequent), as impairing (if not more impairing), and as lethal (if not more lethal). Yet, BPD has received less than one-tenth the funding from the National Institutes of Health than has bipolar disorder. More than other reviewers of the literature on the interface between bipolar disorder and BPD, Paris and Black (Paris J and Black DW (2015) Borderline Personality Disorder and Bipolar Disorder: What is the Difference and Why Does it Matter? J Nerv Ment Dis 203:3-7) emphasize the clinical importance of correctly diagnosing BPD and not overdiagnosing bipolar disorder, with a focus on the clinical feature of affective instability and how the failure to recognize the distinction between sustained and transient mood perturbations can result in misdiagnosing patients with BPD as having bipolar disorder. The review by Paris and Black, then, is more of an advocacy for BPD than other reviews in this area have been. In the present article, the author will illustrate how the bipolar disorder research community has done a superior job of advocating for and "marketing" their disorder compared with researchers of BPD. Specifically, researchers of bipolar disorder have conducted multiple studies highlighting the problem with underdiagnosis, written commentaries about the problem with underdiagnosis, developed and promoted several screening scales to improve diagnostic recognition, published numerous studies of the operating characteristics of these screening measures, attempted to broaden the definition of bipolar disorder by advancing the concept of the bipolar spectrum, and repeatedly demonstrated the economic costs and public health significance of bipolar disorder. In contrast, researchers of BPD have almost completely ignored each of these issues and thus have been less successful in highlighting the public health significance of the disorder. PMID:25536098

  9. Personality disorders and treatment drop out in the homeless

    PubMed Central

    Salavera, Carlos; Tricás, José M; Lucha, Orosia

    2013-01-01

    The homeless drop out of treatment relatively frequently. Also, prevalence rates of personality disorders are much higher in the homeless group than in the general population. We hypothesize that when both variables coexist — homelessness and personality disorders — the possibility of treatment drop out grows. The aim of this study was to analyze the hypotheses, that is, to study how the existence of personality disorders affects the evolution of and permanence in treatment. One sample of homeless people in a therapeutic community (N = 89) was studied. The structured clinical interview for the diagnostic and statistical manual of mental disorders (DSM-IV-TR) was administered and participants were asked to complete the Millon Clinical Multiaxial Inventory-II (MCMI-II). Cluster B personality disorders (antisocial, borderline, and narcissistic) avoided permanence in the treatment process while cluster C disorders, as dependent, favored adhesion to the treatment and improved the prognosis. Knowledge of these personality characteristics should be used to advocate for better services to support homeless people and prevent their dropping out before completing treatment. PMID:23569378

  10. Historical roots of histrionic personality disorder.

    PubMed

    Novais, Filipa; Araújo, Andreia; Godinho, Paula

    2015-01-01

    Histrionic Personality Disorder is one of the most ambiguous diagnostic categories in psychiatry. Hysteria is a classical term that includes a wide variety of psychopathological states. Ancient Egyptians and Greeks blamed a displaced womb, for many women's afflictions. Several researchers from the 18th and 19th centuries studied this theme, namely, Charcot who defined hysteria as a "neurosis" with an organic basis and Sigmund Freud who redefined "neurosis" as a re-experience of past psychological trauma. Histrionic personality disorder (HPD) made its first official appearance in the Diagnostic and Statistical Manual of Mental Disorders II (DSM-II) and since the DSM-III, HPD is the only disorder that kept the term derived from the old concept of hysteria. The subject of hysteria has reflected positions about health, religion and relationships between the sexes in the last 4000 years, and the discussion is likely to continue. PMID:26441812

  11. Historical roots of histrionic personality disorder

    PubMed Central

    Novais, Filipa; Araújo, Andreia; Godinho, Paula

    2015-01-01

    Histrionic Personality Disorder is one of the most ambiguous diagnostic categories in psychiatry. Hysteria is a classical term that includes a wide variety of psychopathological states. Ancient Egyptians and Greeks blamed a displaced womb, for many women’s afflictions. Several researchers from the 18th and 19th centuries studied this theme, namely, Charcot who defined hysteria as a “neurosis” with an organic basis and Sigmund Freud who redefined “neurosis” as a re-experience of past psychological trauma. Histrionic personality disorder (HPD) made its first official appearance in the Diagnostic and Statistical Manual of Mental Disorders II (DSM-II) and since the DSM-III, HPD is the only disorder that kept the term derived from the old concept of hysteria. The subject of hysteria has reflected positions about health, religion and relationships between the sexes in the last 4000 years, and the discussion is likely to continue. PMID:26441812

  12. Executive functions in borderline personality disorder.

    PubMed

    Hagenhoff, Meike; Franzen, Nele; Koppe, Georgia; Baer, Nina; Scheibel, Niki; Sammer, Gebhard; Gallhofer, Bernd; Lis, Stefanie

    2013-11-30

    Different domains of executive function such as working memory and response inhibition were investigated together with elementary cognitive processes in borderline personality disorder (BPD). Patients with BPD (N=28) were compared to nonpatient controls (NP, N=28) on eight tasks (e.g. n-back, Go/NoGo, CPT-AX). In order to separate impairments in different cognitive domains and to assess the influence of more elementary cognitive processes on executive functioning, tasks were embedded in a reaction-time-decomposition approach. BPD patients solved tasks with accuracies comparable to those of nonpatients. The only exception was the n-back task, for which working memory is required: here, error rates were higher and increased more prominently in BPD patients depending on working memory load. In most tasks, movement times were shorter for BPD patients than for nonpatients, while the quality of task-solving was comparable. The faster processing in the BPD group was observable starting with the simplest task, i.e. a simple reaction-time task. These findings suggest that domains of executive functioning are differentially affected in BPD. In contrast to load-dependent deficits in working memory, response inhibition processes were unimpaired. Faster action-related processes could be observed in BPD patients in a variety of tasks; however, these did not influence executive functioning. PMID:23764434

  13. The Lifetime Course of Borderline Personality Disorder

    PubMed Central

    Biskin, Robert S

    2015-01-01

    Borderline personality disorder (BPD) has historically been seen as a lifelong, highly disabling disorder. Research during the past 2 decades has challenged this assumption. This paper reviews the course of BPD throughout life, including childhood, adolescence, and adulthood. BPD can be accurately identified in adolescence, and the course of the disorder, in adolescence and adulthood, is generally similar, with reductions in symptoms over time. Functional recovery is less consistent, and further research on factors or treatments that may improve the long-term functional outcome of patients with BPD is warranted. PMID:26175388

  14. Personality, Emotions, and the Emotional Disorders

    PubMed Central

    Watson, David; Naragon-Gainey, Kristin

    2015-01-01

    We examined symptom-level relations between the emotional disorders and general traits within the five-factor model of personality. Neuroticism correlated strongly with the general distress/negative affectivity symptoms (depressed mood, anxious mood, worry) that are central to these disorders; more moderately with symptoms of social phobia, affective lability, panic, posttraumatic stress disorder, lassitude, checking, and obsessive intrusions; and more modestly with agoraphobia, specific phobia, and other symptoms of depression and obsessive-compulsive disorder. Extraversion was negatively correlated with symptoms of social anxiety/social phobia and was positively related to scales assessing expansive positive mood and increased social engagement in bipolar disorder. Conscientiousness, agreeableness, and openness showed weaker associations and generally added little to the prediction of these symptoms. It is noteworthy, moreover, that our key findings replicated well across (a) self-rated versus (b) interview-based symptom measures. We conclude by discussing the diagnostic and assessment implications of these data. PMID:25815243

  15. An Integrative Dimensional Classification of Personality Disorder

    ERIC Educational Resources Information Center

    Widiger, Thomas A.; Livesley, W. John; Clark, Lee Anna

    2009-01-01

    Psychological assessment research concerns how to describe psychological dysfunction in ways that are both valid and useful. Recent advances in assessment research hold the promise of facilitating significant improvements in description and diagnosis. One such contribution is in the classification of personality disorder symptomatology. The…

  16. [Differential Diagnosis of ADHD from Personality Disorders].

    PubMed

    Ushijima, Sadanobu

    2015-01-01

    The author discussed some points regarding the process of differentially diagnosing ADHD from antisocial personality disorder with antisocial behaviors, such as the use of amphetamines, theft, and violence, and borderline personality disorder with eating disorder, self-harming, overdose, and domestic violence. Firstly, the characteristics of ADHD are a lack of interest in criminal activity, cunning, cruelty, or coming from a broken home, which are frequently observed in cases of conduct disorder. The second point concerns the main anxieties and conflicts of those with ADHD and borderline personality disorder. ADHD patients usually do not have anxieties regarding sensitiveness in interpersonal relationships, which borderline patients are likely to have. The characteristic anxieties of ADHD patients usually involve self-reproach, self-deprecation, and self-hatred derived from various kinds of mistake associated with ADHD symptoms, such as a short attention span, restlessness, and impulsiveness. Finally, the author points out that we also have to be aware of the various kinds of identity problem, even in the case of patients with typical symptoms of ADHD. PMID:26721071

  17. Early maladaptive schemas in personality disordered individuals.

    PubMed

    Jovev, Martina; Jackson, Henry J

    2004-10-01

    The present study aimed to examine the specificity of schema domains in three personality disorder (PD) groups, namely borderline (BPD), obsessive-compulsive (OCPD), and avoidant PD (AvPD), and to correctly identify the three PD groups on the basis of these schemas. The sample consisted of 48 clinical participants diagnosed with PDs and assigned to 1 of 3 groups on the basis of their Axis II diagnoses (BPD: n = 13; OCPD: n = 13; AvPD: n = 22). High scores on Dependence/Incompetence, Defectiveness/ Shame and Abandonment were found for the BPD group. Such pattern appears to be most consistent with Young's theory of BPD. Consistent with the theory and empirical findings of Beck et al. (1990, 2001), OCPD was associated with elevations on the Unrelenting Standards schema domain, but not on Emotional Inhibition, which was found to be elevated for AvPD. In conclusion, the present study suggests that there are different patterns of schema domains across different PDs and that the Schema Questionnaire (SQ) is potentially useful in differentiating between these PDs. PMID:15519957

  18. Dysphoria and aloneness in borderline personality disorder.

    PubMed

    Pazzagli, A; Monti, M R

    2000-01-01

    A close examination of dysphoria, anger and aloneness (three main characteristics of the borderline syndrome) provides a theoretical model of reference for the therapist. Dysphoria results from the cyclical emotional oscillation between hope for stability and disappointment in its inattainability; a dependent-anaclitic depression arises from the mixture of anger, aloneness and inner emptiness which is so characteristic of the borderline syndrome. The tendency to be immersed in the here-and-now, an intra-festum mentality, exacerbates the sense of isolation, causing more irritation, mute frustration and, consequently, anger. The effects and ramifications of anger, and the resultant precarious cohesion of the self, are explored in the borderline syndrome; they are especially illuminated by the application of Kernberg's pain-anger-hate-vengefulness cycle concept. Meanings of solitude, in its forms of aloneness and loneliness, are explored in their pertinence. Aloneness - the constant needy search for, but condemnation to never finding, objects to fill an inner sense of emptiness - is especially germane. Suggestions for assisting subjects with borderline personality disorder to overcome aloneness and the lack of historical progression are made. PMID:10867581

  19. The Natural History of Antisocial Personality Disorder

    PubMed Central

    Black, Donald W

    2015-01-01

    Antisocial personality disorder (ASPD) is characterized by a pattern of socially irresponsible, exploitative, and guiltless behaviour. ASPD is associated with co-occurring mental health and addictive disorders and medical comorbidity. Rates of natural and unnatural death (suicide, homicide, and accidents) are excessive. ASPD is a predictor of poor treatment response. ASPD begins early in life, usually by age 8 years. Diagnosed as conduct disorder in childhood, the diagnosis converts to ASPD at age 18 if antisocial behaviours have persisted. While chronic and lifelong for most people with ASPD, the disorder tends to improve with advancing age. Earlier onset is associated with a poorer prognosis. Other moderating factors include marriage, employment, early incarceration (or adjudication during childhood), and degree of socialization. PMID:26175389

  20. The Natural History of Antisocial Personality Disorder.

    PubMed

    Black, Donald W

    2015-07-01

    Antisocial personality disorder (ASPD) is characterized by a pattern of socially irresponsible, exploitative, and guiltless behaviour. ASPD is associated with co-occurring mental health and addictive disorders and medical comorbidity. Rates of natural and unnatural death (suicide, homicide, and accidents) are excessive. ASPD is a predictor of poor treatment response. ASPD begins early in life, usually by age 8 years. Diagnosed as conduct disorder in childhood, the diagnosis converts to ASPD at age 18 if antisocial behaviours have persisted. While chronic and lifelong for most people with ASPD, the disorder tends to improve with advancing age. Earlier onset is associated with a poorer prognosis. Other moderating factors include marriage, employment, early incarceration (or adjudication during childhood), and degree of socialization. PMID:26175389

  1. Pharmacological interventions for antisocial personality disorder

    PubMed Central

    Khalifa, Najat; Duggan, Conor; Stoffers, Jutta; Huband, Nick; Völlm, Birgit A; Ferriter, Michael; Lieb, Klaus

    2014-01-01

    data available were generally insufficient to allow any independent statistical analysis. The findings are limited to descriptive summaries based on analyses carried out and reported by the trial investigators. All the available data were derived from unreplicated single reports. Only three drugs (nortriptyline, bromocriptine, phenytoin) were effective compared to placebo in terms of improvement in at least one outcome. Nortriptyline was reported in one study as superior for men with alcohol dependency on mean number of drinking days and on alcohol dependence, but not for severity of alcohol misuse or on the patient’s or clinician’s rating of drinking. In the same study, both nortriptyline and bromocriptine were reported as superior to placebo on anxiety on one scale but not on another. In one study, phenytoin was reported as superior to placebo on the frequency and intensity of aggressive acts in male prisoners with impulsive (but not premeditated) aggression. In the remaining two studies, both amantadine and desipramine were not superior to placebo for adults with opioid and cocaine dependence, and desipramine was not superior to placebo for men with cocaine dependence. Authors’ conclusions The body of evidence summarised in this review is insufficient to allow any conclusion to be drawn about the use of pharmacological interventions in the treatment of antisocial personality disorder. PMID:20687091

  2. Toward a genetically-informed model of borderline personality disorder.

    PubMed

    Livesley, John

    2008-02-01

    This article describes a conceptual framework for describing borderline personality disorder (BPD) based on empirical studies of the phenotypic structure and genetic architecture of personality. The proposed phenotype has 2 components: (1) a description of core self and interpersonal pathology-the defining features of personality disorder-as these features are expressed in the disorder; and (2) a set of traits based on the anxious-dependent or emotional dysregulation factor of the four-factor model of PD. Four kinds of traits are described: emotional (anxiousness, emotional reactivity, emotional intensity, and pessimistic-anhedonia), interpersonal (submissiveness, insecure attachment, social apprehensiveness, and need for approval), cognitive (cognitive dysregulation), and self-harm (behaviors and ideas). Formulation of the phenotype was guided by the conceptualization of personality as a system of interrelated sub-systems. The psychopathology associated with BPD involves most components of the system. The trait structure of the disorder is assumed to reflect the genetic architecture of personality and individual traits are assumed to be based on adaptive mechanisms. It is suggested that borderline traits are organized around the trait of anxiousness and that an important feature of BPD is dysregulation of the threat management system leading to pervasive fearfulness and unstable emotions. The interpersonal traits are assumed to be heritable characteristics that evolved to deal with interpersonal threats that arose as a result of social living. The potential for unstable and conflicted interpersonal relationships that is inherent to the disorder is assumed to result from the interplay between the adaptive structure of personality and psychosocial adversity. The etiology of the disorder is discussed in terms of biological and environmental factors associated with each component of the phenotype. PMID:18312122

  3. The neuropsychology of antisocial personality disorder.

    PubMed

    Fitzgerald, Katherine L; Demakis, George J

    2007-03-01

    Antisocial Personality Disorder (APD) is a psychological disorder most commonly associated with the legal and criminal justice systems, as many persons arrested for the commission of illegal acts meet the diagnostic criteria for this disorder, such as deception, manipulation, disregard for the rights of others, and a lack of remorse for their behavior. Most researchers agree that this disorder stems from brain abnormalities, including the theories of frontal lobe dysfunction and differences in the autonomic nervous systems in individuals diagnosed with APD. The Integrated Emotional Systems (IES) model, a third model of APD, is itself not a brain abnormality, but provides an understanding of antisocial characteristics based on dysfunctions in select parts of the brain. Based on research using neuropsychological assessments and other techniques, several cognitive characteristics appear to exist among these individuals. Examples include cognitive inflexibility, attention deficits, and inappropriate processing of contextual cues in the environment, sometimes leading to poor behavioral choices. Further research is needed to help identify the cause of this disorder so that the most appropriate treatments can be made available to these individuals. PMID:17544650

  4. The frequency of personality disorders in patients with gender identity disorder

    PubMed Central

    Meybodi, Azadeh Mazaheri; Hajebi, Ahmad; Jolfaei, Atefeh Ghanbari

    2014-01-01

    Background: Co-morbid psychiatric disorders affect prognosis, psychosocial adjustment and post-surgery satisfaction in patients with gender identity disorder. In this paper, we assessed the frequency of personality disorders in Iranian GID patients. Methods: Seventy- three patients requesting sex reassignment surgery (SRS) were recruited for this crosssectional study. Of the participants, 57.5% were biologically male and 42.5% were biologically female. They were assessed through the Millon Clinical Multiaxial Inventory II (MCMI- II). Results: The frequency of personality disorders was 81.4%. The most frequent personality disorder was narcissistic personality disorder (57.1%) and the least was borderline personality disorder. The average number of diagnoses was 3.00 per patient. Conclusion: The findings of this study revealed that the prevalence of personality disorders was higher among the participants, and the most frequent personality disorder was narcissistic personality disorder (57.1%), and borderline personality disorder was less common among the studied patients. PMID:25664291

  5. [Construction of educational software about personality disorders].

    PubMed

    Botti, Nadja Cristiane Lappann; Carneiro, Ana Luíza Marques; Almeida, Camila Souza; Pereira, Cíntia Braga Silva

    2011-01-01

    The study describes the experience of building educational software in the area of mental health. The software was developed to enable the nursing student identify personality disorders. In this process, we applied the pedagogical framework of Vygotsky and the theoretical framework of the diagnostic criteria defined by DSM-IV. From these references were identified personality disorders characters in stories and / or children's movies. The software development bank was built with multimedia graphics data, sound and explanatory. The software developed like educational game like questions with increasing levels of difficulty. The software was developed with Microsoft Office PowerPoint 2007. It is believed in the validity of this strategy for teaching-learning to the area of mental health nursing. PMID:22664618

  6. Co-occurrence of dissociative identity disorder and borderline personality disorder.

    PubMed

    Ross, Colin A; Ferrell, Lynn; Schroeder, Elizabeth

    2014-01-01

    The literature indicates that, among individuals with borderline personality disorder, pathological dissociation correlates with a wide range of impairments and difficulties in psychological function. It also predicts a poorer response to dialectical behavior therapy for borderline personality disorder. We hypothesized that (a) dissociative identity disorder commonly co-occurs with borderline personality disorder and vice versa, and (b) individuals who meet criteria for both disorders have more comorbidity and trauma than individuals who meet criteria for only 1 disorder. We interviewed a sample of inpatients in a hospital trauma program using 3 measures of dissociation. The most symptomatic group was those participants who met criteria for both borderline personality disorder and dissociative identity disorder on the Dissociative Disorders Interview Schedule, followed by those who met criteria for dissociative identity disorder only, then those with borderline personality disorder only, and finally those with neither disorder. Greater attention should be paid to the relationship between borderline personality disorder and dissociative identity disorder. PMID:24377974

  7. Assessment Procedures for Narcissistic Personality Disorder

    PubMed Central

    Miller, Joshua D.; Campbell, W. Keith; Pilkonis, Paul A.; Morse, Jennifer Q.

    2010-01-01

    This study examined the degree of correspondence between two assessments for narcissistic personality disorder (NPD) in a mixed clinical and community sample—one using a self-report measure (Personality Diagnostic Questionnaire-4) and the other using clinical judgments derived from an assessment based on the longitudinal, expert, all data (LEAD) methodology. NPD scores demonstrated moderate convergence for the total scores but weak convergence for the individual criteria. The authors also examined the correlates created by each set of NPD scores using Cloninger's Temperament and Character Inventory (TCI). The NPD scores demonstrated areas of convergence (e.g., Cooperativeness, Self-directedness) and divergence (i.e., Harm Avoidance, Novelty Seeking) with these personality scores. These divergences may be due to the wording of certain items on the Personality Diagnostic Questionnaire-4 NPD scale, which may require rewriting if it is to provide an assessment that is more highly convergent with the Diagnostic and Statistical Manual of Mental Disorders NPD construct. PMID:18550845

  8. Personality and mood correlates of avoidant personality disorder.

    PubMed

    Meyer, Björn

    2002-04-01

    Avoidant personality disorder (APD) has been recognized as prevalent and clinically important; however, it is not clear how APD maps onto established personality and mood dimensions. In this cross-sectional survey study, 365 college students completed questionnaires assessing APD features and theoretically relevant personality and mood dimensions. Based on these self-report data, 6.6% may meet DSM-IV criteria for APD. Hierarchical regression analyses showed that APD features were associated with introversion, neuroticism, low self-esteem, and pessimistic expectancies. Additionally, APD features were linked with self-reports of elevated emotional responsiveness to threats and reduced emotional responsiveness to incentives (the behavioral inhibition system and behavioral activation system scales). After controlling for the effects of other personality, temperament, and cognitive measures, affective distress (i.e., anger, anxiety, and depression) was no longer related to APD. Results are consistent with APD models that emphasize the joint influences of emotional vulnerability and social-cognitive triggering and sustaining factors. PMID:12004493

  9. Depressive Personality Disorder: A Review of the Literature.

    ERIC Educational Resources Information Center

    Sale, Beverley A.

    The question of whether or not depressive personality disorder is a distinct disorder separate from mood disorders or other personality disorders has historically been debated by researchers and theorists and continues to be a topic of disagreement. Empirical studies reveal that only a modest relationship may exist between depressive personality…

  10. An exploration of links between early parenting experiences and personality disorder type and disordered personality functioning.

    PubMed

    Parker, G; Roy, K; Wilhelm, K; Mitchell, P; Austin, M P; Hadzi-Pavlovic, D

    1999-01-01

    Reports of early parenting were assessed using two measures, the Parental Bonding Index (PBI) and the Measure of Parenting Style (MOPS), in a sample of 265 patients with DSM-defined major depressive disorder. Psychiatrists then rated the extent to which sample members evidenced the personality "styles" underpinning 15 separate personality disorders, returning personality vignette scores. The extent of disordered functioning was also assessed across "parameters" and "domains" by psychiatrists, referrers, and family members, using a range of measures. Those with higher scores on vignettes measuring borderline, anxious, depressive, and self-defeating personality style rated parents as uncaring, overcontrolling, and abusive. When vignettes were consolidated into scores akin to the DSM clusters, the most consistent links between perceived dysfunctional parenting were with the Cluster C (anxious), and Cluster B (dramatic) styles and were nonsignificant for Cluster A (eccentric) style. Meeting criteria for an increasing number of personality disorder clusters was associated with increasing levels of adverse parenting. Multiple regression analyses indicated that disordered functioning (as assessed by the three independent rater groups) was most distinctly associated with paternal indifference and maternal overcontrol. PMID:10633316

  11. The Coraline Effect: The Misdiagnosis of Personality Disorders in College Students Who Grew up with a Personality Disordered Parent

    ERIC Educational Resources Information Center

    Donatone, Brooke

    2016-01-01

    College students may be misdiagnosed as personality disordered when in fact their problems are better explained by their upbringing. Growing up with a personality disordered parent may cause them to initially present with what appear to be personality disordered traits due to issues such as not learning adequate coping skills. Accurate diagnosis…

  12. [Borderline personality disorders: diagnosis and treatment].

    PubMed

    Allilaire, Jean-François

    2012-10-01

    Borderline personality disorders are complex clinical states with highly polymorphic symptoms and signs, leading to delays in their diagnosis and treatment. All international classifications emphasize certain clinical criteria such as unstable identity and interpersonal relationships, feelings of emptiness or boredom, and pathological impulsiveness. The prevalence is about 2%, with a female-male sex ratio of 2 or 3 to 1. Both adolescents and adults may be affected There is a high risk of suicide, addictive behaviors, eating disorders, and criminality. These individuals frequently have a history of trauma in early childhood, such as separation, loss, physical or sexual abuse, or affective privation. Subjective signs and symptoms are particularly important in the diagnostic and therapeutic evaluation, and this requires an empathic and subtle approach. Standardized and semi-structured interviews may help to identify comorbidities such as thymic disorders, anxiety, addiction, eating disorders, and, in some cases, psychotic symptoms. The psychiatric bio-psycho-social model takes into account multiple pathogenic factors, such as trauma during early development, temperamental instability and other emotional disorders, as well as psychosocial, neurobiological (5HT etc.) and genetic vulnerabilities. Treatment requires optimal integration of psychotherapeutic and pharmacotherapeutic approaches. Emergency intervention must be available in case of delirious or suicidal behavior The clinical course is often lengthy and complex, but outcome may be favorable, provided the principal risk--suicide--is correctly managed, PMID:23815019

  13. Where is the Personality in Personality Disorder Assessment? A Comparison Across Four Sets of Personality Disorder Scales

    ERIC Educational Resources Information Center

    Trobst, Krista K.; Ayearst, Lindsay E.; Salekin, Randall T.

    2004-01-01

    The present research examined the amount and kind of personality measured within four sets of personality disorder (PD) scales. Three samples of undergraduate students (Ns = 326, 537, and 617) completed at least one PD measure and a combined interpersonal circumplex model (ICM) and five-factor model (FFM) measure. The FFM dimensions were found to…

  14. Effectiveness of cognitive analytic therapy for personality disorders.

    PubMed

    Mulder, Roger; Chanen, Andrew M

    2013-02-01

    Personality disorders affect up to 50% of psychiatric out-patients. Most treatment studies have been performed in patients with borderline personality disorder. Structured psychosocial interventions for people with borderline personality disorders appear to have similar efficacy. There is some evidence that non-structured, non-specialised treatments offered by psychiatric general services might be ineffective and possibly harmful in patients with personality disorders. Cognitive analytic therapy is a time-limited, integrative psychotherapy, which appears to be effective for a range of personality disorders and superior to treatment as usual. Its practical nature and relatively short time limit may make it suitable for front-line clinical services. PMID:23377206

  15. Clinicians' emotional responses and Psychodynamic Diagnostic Manual adult personality disorders: A clinically relevant empirical investigation.

    PubMed

    Gazzillo, Francesco; Lingiardi, Vittorio; Del Corno, Franco; Genova, Federica; Bornstein, Robert F; Gordon, Robert M; McWilliams, Nancy

    2015-06-01

    The aim of this study is to explore the relationship between level of personality organization and type of personality disorder as assessed with the categories in the Psychodynamic Diagnostic Manual (PDM; PDM Task Force, 2006) and the emotional responses of treating clinicians. We asked 148 Italian clinicians to assess 1 of their adult patients in treatment for personality disorders with the Psychodiagnostic Chart (PDC; Gordon & Bornstein, 2012) and the Personality Diagnostic Prototype (PDP; Gazzillo, Lingiardi, & Del Corno, 2012) and to complete the Therapist Response Questionnaire (TRQ; Betan, Heim, Zittel-Conklin, & Westen, 2005). The patients' level of overall personality pathology was positively associated with helpless and overwhelmed responses in clinicians and negatively associated with positive emotional responses. A parental and disengaged response was associated with the depressive, anxious, and dependent personality disorders; an exclusively parental response with the phobic personality disorder; and a parental and criticized response with narcissistic disorder. Dissociative disorder evoked a helpless and parental response in the treating clinicians whereas somatizing disorder elicited a disengaged reaction. An overwhelmed and disengaged response was associated with sadistic and masochistic personality disorders, with the latter also associated with a parental and hostile/criticized reaction; an exclusively overwhelmed response with psychopathic patients; and a helpless response with paranoid patients. Finally, patients with histrionic personality disorder evoked an overwhelmed and sexualized response in their clinicians whereas there was no specific emotional reaction associated with the schizoid and the obsessive-compulsive disorders. Clinical implications of these findings were discussed. PMID:25868053

  16. Antisocial personality disorder with and without antecedent childhood conduct disorder: does it make a difference?

    PubMed

    Walters, Glenn D; Knight, Raymond A

    2010-04-01

    The purpose of this study was to test whether prior conduct disorder increased deviance in persons diagnosed with antisocial personality disorder. One hundred and three male inmates satisfying adult antisocial and conduct disorder criteria for antisocial personality disorder achieved significantly higher scores on self-report measures of criminal thinking and antisocial attitudes than 137 male inmates satisfying only the adult criteria for antisocial personality disorder and 87 male nonantisocial inmates. Inmates satisfying adult antisocial and conduct disorder criteria for antisocial personality disorder were also more likely to receive disciplinary infractions for misconduct than inmates in the other two conditions. The theoretical, diagnostic, and practical implications of these results are discussed. PMID:20420479

  17. Prevalence of Personality Disorders among Cocaine and Heroin Addicts.

    PubMed

    Craig, Robert J.

    2000-06-01

    Using the MCMI-III, we studied rates of personality disorders among 443 inpatient drug abusers (i.e., 160 opiate addicts and 283 cocaine addicts). For both samples the disorders of antisocial (60%), passive-aggressive (negativistic) (34%), and depressive personality disorders (32%) showed higher prevalence rates. Previous studies (N = 13) using different measures (e.g., SCID, SDIP, MCMI-I) reported similar findings in terms of overall prevalence of specific personality disorders, although actual rates varied by population. PMID:12466649

  18. Personality Pathology of Adults With Autism Spectrum Disorder Without Accompanying Intellectual Impairment in Comparison to Adults With Personality Disorders.

    PubMed

    Strunz, Sandra; Westphal, Linda; Ritter, Kathrin; Heuser, Isabella; Dziobek, Isabel; Roepke, Stefan

    2015-12-01

    Differentiating autism spectrum disorders (ASDs) without accompanying intellectual impairment from personality disorders is often challenging. Identifying personality traits and personality pathology specific to ASD might facilitate diagnostic procedure. We recruited a sample of 59 adults with ASD without accompanying intellectual impairment, 62 individuals with narcissistic personality disorder, 80 individuals with borderline personality disorder, and 106 nonclinical controls. Personality traits, measured with the neo-personality inventory-revised (NEO-PI-R), and personality pathology, measured with the dimensional assessment of personality pathology (DAPP-BQ), were assessed. Personality traits and personality pathology specific to ASD could be identified. ASD individuals scored significantly lower on the NEO-PI-R scales extraversion and openness to experience and significantly higher on the DAPP-BQ scales inhibitedness and compulsivity relative to all other groups. Diagnostic implications are discussed. PMID:25022250

  19. Relationship between Personality Disorder Functioning Styles and the Emotional States in Bipolar I and II Disorders

    PubMed Central

    Yao, Jiashu; Xu, You; Qin, Yanhua; Liu, Jing; Shen, Yuedi; Wang, Wei; Chen, Wei

    2015-01-01

    Background Bipolar disorder types I (BD I) and II (BD II) behave differently in clinical manifestations, normal personality traits, responses to pharmacotherapies, biochemical backgrounds and neuroimaging activations. How the varied emotional states of BD I and II are related to the comorbid personality disorders remains to be settled. Methods We therefore administered the Plutchick – van Praag Depression Inventory (PVP), the Mood Disorder Questionnaire (MDQ), the Hypomanic Checklist-32 (HCL-32), and the Parker Personality Measure (PERM) in 37 patients with BD I, 34 BD II, and in 76 healthy volunteers. Results Compared to the healthy volunteers, patients with BD I and II scored higher on some PERM styles, PVP, MDQ and HCL-32 scales. In BD I, the PERM Borderline style predicted the PVP scale; and Antisocial predicted HCL-32. In BD II, Borderline, Dependant, Paranoid (-) and Schizoid (-) predicted PVP; Borderline predicted MDQ; Passive-Aggressive and Schizoid (-) predicted HCL-32. In controls, Borderline and Narcissistic (-) predicted PVP; Borderline and Dependant (-) predicted MDQ. Conclusion Besides confirming the different predictability of the 11 functioning styles of personality disorder to BD I and II, we found that the prediction was more common in BD II, which might underlie its higher risk of suicide and poorer treatment outcome. PMID:25625553

  20. Mechanisms shaping the development of personality and personality disorders in children and adolescents.

    PubMed

    Lenkiewicz, Kamila; Srebnicki, Tomasz; Bryńska, Anita

    2016-01-01

    Until the end of the nineties last century personality disorders could not be diagnosed before the age of eighteen. Nevertheless, the results of studies published in the last decade have revealed that personality disorders can be observed in children and adolescents and that personality disorders diagnosed in adult patients had been present as early as in childhood. The knowledge of possible mechanisms shaping personality disorders in childhood is unsatisfactory and needs to be expanded. Developmental psychology explains the development of abnormal personality through inappropriate attachment patterns and abnormal transitions between developmental phases. Genetic and temperamental factors are also important in the aetiology of personality disorders as well as early maladaptive schemas resulting from personal experiences and interactions with others. The aim of this article is to review the current knowledge on the mechanisms shaping the development of personality and personality disorders in childhood and adolescence. PMID:27556119

  1. THE OFFENDER PERSONALITY DISORDER PATHWAY: RISKING REHABILITATION?

    PubMed

    McRae, Leon

    2015-01-01

    Following over a decade of treatment refusal by 'risky' offenders preventively detained in Dangerous and Severe Personality Disorder hospital and prison units, the coalition government now aims to improve treatment engagement in high secure prisons by clarifying pathways out of detention. This article asks whether the reconfiguration will end reliance upon preventive detention for public protection. Drawing on original empirical data collected by the author, it is argued that the government is unaware that offenders with 'severe personality disorder' appear to engage with treatment only if it increases their chances of achieving expedited parole. Hitherto, this incentive was provided by the Indeterminate Sentence for Public Protection; its replacement with determinate sentences under the Legal Aid, Sentencing and Punishment of Offenders Act 2012 will worsen treatment engagement, because they provide offenders with a prison release date. The troubling result may be increased reliance by the Secretary of State for Justice on his inherent jurisdiction under the Mental Health Act 1983 to transfer offenders due for prison release to secure psychiatric hospitals. To counter this limitation of risk-focused decision-making, it is proposed that judges be able to impose a new hybrid order combining a custodial term with a subsequent community mental health treatment requirement. PMID:26037377

  2. Interrelationship of Personality Disorders: Theoretical Formulations and Anecdotal Evidence.

    ERIC Educational Resources Information Center

    Vincent, Ken R.

    1987-01-01

    Attempts to define interrelationship of personality disorders. Discusses relationships between and among three major groupings of Diagnostic and Statistical Manual of Mental Disorders. Suggests that passive aggressive, avoidant, and borderline personality disorders serve as bridges between these groupings. Discusses placement within groupings with…

  3. Personality Profile of Women Affected with Borderline Personality Disorder

    PubMed Central

    Nasiri, Hamid; Abedi, Ahmad; Ebrahimi, Amrollah; Ameli, Sedigheh Sadr; Samouei, Rahele

    2013-01-01

    Introduction: The main objective of the present study is to review the psychological profile of female patients with borderline personality disorder in the women referring to the Centers of Counseling and Psychological Services at Isfahan city based on MMPI-2 test and comparing them with ordinary women. Method: The present study is of the type of cause-comparative and the selection of examinees was done in form of random sampling with 50 women with the BPD and 50 ordinary women and through confirmation of test recognition of MCMI-III and clinical interviews. In addition, 370 questions of MMPI-2 have also been implemented. Results: The results of this research showed a significant difference in validity of scales and the clinical scales of MMPI-2 test among women with BPD and regular women. The results of MANOVA test with the power of valuable test confirmed the existing differences. Conclusion: The obtained results shows that female patients with BPD has a specific and different psychological profile as compared with ordinary (regular) women and the obtained profile can be used in recognition and forecasting any disorder. PMID:23687463

  4. Genetic variation in personality traits explains genetic overlap between borderline personality features and substance use disorders

    PubMed Central

    Few, Lauren R.; Grant, Julia D; Trull, Timothy J.; Statham, Dixie J.; Martin, Nicholas G.; Lynskey, Michael T.; Agrawal, Arpana

    2014-01-01

    Aims To examine the genetic overlap between borderline personality features (BPF) and substance use disorders (SUDs) and the extent to which variation in personality traits contributes to this covariance. Design Genetic structural equation modelling was used to partition the variance in and covariance between personality traits, BPF, and SUDs into additive genetic, shared, and individual-specific environmental factors. Setting All participants were registered with the Australian Twin Registry. Participants A total of 3,127 Australian adult twins participated in the study. Measurements Diagnoses of DSM-IV alcohol and cannabis abuse/dependence (AAD; CAD), and nicotine dependence (ND) were derived via computer-assisted telephone interview. BPF and five-factor model personality traits were derived via self-report questionnaires. Findings Genetic factors were responsible for 49% (95%CI: 42%–55%) of the variance in BPF, 38–42% (95%CI range: 32%–49%) for personality traits and 47% (95%CI: 17%–77%), 54% (95%CI: 43%–64%), and 78% (67%–86%) for ND, AAD and CAD, respectively. Genetic and individual-specific environmental correlations between BPF and SUDs ranged from .33–.56 (95%CI range: .19–.74) and .19–.32 (95%CI range: .06–.43), respectively. Overall, there was substantial support for genetic influences that were specific to AAD, ND and CAD (31%–69%). Finally, genetic variation in personality traits was responsible for 11% (Extraversion for CAD) to 59% (Neuroticism for AAD) of the correlation between BPF and SUDs. Conclusions Both genetic and individual-specific environmental factors contribute to comorbidity between borderline personality features and substance use disorders. A substantial proportion of this comorbidity can be attributed to variation in normal personality traits, particularly Neuroticism. PMID:25041562

  5. Temperament, character, and personality disorder in bulimia nervosa.

    PubMed

    Bulik, C M; Sullivan, P F; Joyce, P R; Carter, F A

    1995-09-01

    In a sample of 76 women participating in a clinical treatment trial for bulimia nervosa, we examined the clinical differences between subjects with and without concurrent personality disorders and the ability of "self-directedness" (a character scale of Cloninger's Temperament and Character Inventory) to predict the presence of personality disorder. Sixty-three percent of the sample had at least one personality disorder diagnosis. Fifty-one percent of personality disorders were in cluster C, 41% were in cluster B, and 33% were in cluster A. The presence of personality disorder was associated with greater depressive symptoms, worse global functioning, laxative use, greater body dissatisfaction, higher harm avoidance, and lower self-directedness. As hypothesized, low self-directedness scores were associated with a markedly increased probability of a personality disorder. PMID:7561822

  6. Personality Pathology of Adults with Autism Spectrum Disorder without Accompanying Intellectual Impairment in Comparison to Adults with Personality Disorders

    ERIC Educational Resources Information Center

    Strunz, Sandra; Westphal, Linda; Ritter, Kathrin; Heuser, Isabella; Dziobek, Isabel; Roepke, Stefan

    2015-01-01

    Differentiating autism spectrum disorders (ASDs) without accompanying intellectual impairment from personality disorders is often challenging. Identifying personality traits and personality pathology specific to ASD might facilitate diagnostic procedure. We recruited a sample of 59 adults with ASD without accompanying intellectual impairment, 62…

  7. Rating of personality disorder features in popular movie characters

    PubMed Central

    Hesse, Morten; Schliewe, Sanna; Thomsen, Rasmus R

    2005-01-01

    Background Tools for training professionals in rating personality disorders are few. We present one such tool: rating of fictional persons. However, before ratings of fictional persons can be useful, we need to know whether raters get the same results, when rating fictional characters. Method Psychology students at the University of Copenhagen (N = 8) rated four different movie characters from four movies based on three systems: Global rating scales representing each of the 10 personality disorders in the DSM-IV, a criterion list of all criteria for all DSM-IV personality disorders in random order, and the Ten Item Personality Inventory for rating the five-factor model. Agreement was estimated based on intraclass-correlation. Results Agreement for rating scales for personality disorders ranged from 0.04 to 0.54. For personality disorder features based on DSM-IV criteria, agreement ranged from 0.24 to 0.89, and agreement for the five-factor model ranged from 0.05 to 0.88. The largest multivariate effect was observed for criteria count followed by the TIPI, followed by rating scales. Raters experienced personality disorder criteria as the easiest, and global personality disorder scales as the most difficult, but with significant variation between movies. Conclusion Psychology students with limited or no clinical experience can agree well on the personality traits of movie characters based on watching the movie. Rating movie characters may be a way to practice assessment of personality. PMID:16336663

  8. Recognizing borderline personality disorder in the family practice setting.

    PubMed

    Hubbard, J R; Saathoff, G B; Bernardo, M J; Barnett, B L

    1995-09-01

    The first step in the management of borderline personality disorder is making the correct diagnosis. A clinical example illustrates symptoms of a patient with borderline personality disorder in a family practice setting. Major characteristics of borderline personality disorder include severe mood instability, fear of abandonment, chronic boredom, self-injury, unstable interpersonal relationships, "splitting," identity instability and borderline rage. Early diagnosis may help prevent potential management problems and possible doctor-patient conflicts. PMID:7653428

  9. Caring for a Person with a Frontotemporal Disorder

    MedlinePlus

    ... Information for Patients, Families, and Caregivers Caring for a Person with a Frontotemporal Disorder In addition to managing the medical ... help with information about caregiver services and support. A stressful disorder Robert, 60, started humming and whistling ...

  10. Personal Identities and Disordered Eating Behaviors in Mexican American Women

    PubMed Central

    Stein, Karen Farchaus; Corte, Colleen; Ronis, David L.

    2011-01-01

    Eating disorder behaviors are prevalent in Latina populations. This study tested Schwartz’s (2006) theoretical view that a broad array of personal identities serves as an internal resource during acculturation and prevents internalization of dysfunctional weight related beliefs. Sixty-six Mexican American women completed measures of personal identities, fat self-definition, eating disorder symptoms and acculturation. Results show that few positive and many negative personal identities predict higher eating disorder scores and effects are mediated through the fat self-definition. Characteristics of personal identities may influence internalization of cultural values related to weight. Interventions focused on overall identity may prevent eating disorders in Latinas. PMID:20434070

  11. Personal identities and disordered eating behaviors in Mexican American women.

    PubMed

    Stein, Karen Farchaus; Corte, Colleen; Ronis, David L

    2010-08-01

    Eating disorder behaviors are prevalent in Latina populations. This study tested Schwartz's (2006) theoretical view that a broad array of personal identities serves as an internal resource during acculturation and prevents internalization of dysfunctional weight related beliefs. Sixty-six Mexican American women completed measures of personal identities, fat self-definition, eating disorder symptoms and acculturation. Results show that few positive and many negative personal identities predict higher eating disorder scores and effects are mediated through the fat self-definition. Characteristics of personal identities may influence internalization of cultural values related to weight. Interventions focused on overall identity may prevent eating disorders in Latinas. PMID:20434070

  12. An overview of Indian research in personality disorders

    PubMed Central

    Sharan, Pratap

    2010-01-01

    Personality disorders have significant, but often unrealized, public health importance. The present review summarizes the published work on personality disorders in the Indian population or by Indian researchers residing in the country. Researchers who have worked on assessment methodology in India have demonstrated that clinical diagnosis has a low reliability when compared with semi-structured interviews; and have attempted to increase the feasibility of the standardized use of International Personality Disorder Examination, a semi-structured interview developed by the World Health Organization (WHO). Studies on epidemiology demonstrate that none of the general population studies have employed standardized interviews, and hence, they grossly underestimate the prevalence of personality disorders in the community. The clinical epidemiology studies have employed questionnaires and interviews developed in the West, mostly without local adaptations, with discrepant results. However, these studies show that personality disorders are common in the clinical population and that rates vary across sub populations. While, there are a few reports attesting the theoretical importance of the role of culture in the formation and expression of personality disorders, empirical literature from India in this area is scanty. Similarly, there are few reports on the treatment of personality disorders, while, important areas such as service delivery, etiology, and validity of personality disorders, are unaddressed. The study of personality disorder in India is maturing, with researchers showing increased familiarity with the methodological nuances of this complex area of research. PMID:21836687

  13. Neurobehavioral study of borderline personality disorder.

    PubMed Central

    van Reekum, R; Conway, C A; Gansler, D; White, R; Bachman, D L

    1993-01-01

    The existence of an "organic" subgroup of borderline personality disorder (BPD) has been postulated. This report is of a case-controlled, chart-review study of BPD. The control sample consisted of patients with a variety of psychiatric diagnoses. The study found that 81% of the patients with BPD and 22% of the control patients had a history of brain injury, either developmental (44%), acquired (58%) or both. Furthermore, there was a positive correlation between the summed number of developmental and acquired brain injuries and the score on the retro-Diagnostic Interview for Borderline. A pilot neuropsychological study showed that seven of nine subjects with BPD had evidence of frontal system dysfunction. These results help to support the hypothesized existence of an organic BPD subgroup. PMID:8499428

  14. Psychopharmacologic treatment of borderline personality disorder.

    PubMed

    Ripoll, Luis H

    2013-06-01

    The best available evidence for psychopharmacologic treatment of borderline personality disorder (BPD) is outlined here. BPD is defined by disturbances in identity and interpersonal functioning, and patients report potential medication treatment targets such as impulsivity, aggression, transient psychotic and dissociative symptoms, and refractory affective instability Few randomized controlled trials of psychopharmacological treatments for BPD have been published recently, although multiple reviews have converged on the effectiveness of specific anticonvulsants, atypical antipsychotic agents, and omega-3 fatty acid supplementation. Stronger evidence exists for medication providing significant improvements in impulsive aggression than in affective or other interpersonal symptoms. Future research strategies will focus on the potential role of neuropeptide agents and medications with greater specificity for 2A serotonin receptors, as well as optimizing concomitant implementation of evidence-based psychotherapy and psychopharmacology, in order to improve BPD patients' overall functioning. PMID:24174895

  15. Psychopharmacologic treatment of borderline personality disorder

    PubMed Central

    Ripoll, Luis H.

    2013-01-01

    The best available evidence for psychopharmacologic treatment of borderline personality disorder (BPD) is outlined here. BPD is defined by disturbances in identity and interpersonal functioning, and patients report potential medication treatment targets such as impulsivity, aggression, transient psychotic and dissociative symptoms, and refractory affective instability Few randomized controlled trials of psychopharmacological treatments for BPD have been published recently, although multiple reviews have converged on the effectiveness of specific anticonvulsants, atypical antipsychotic agents, and omega-3 fatty acid supplementation. Stronger evidence exists for medication providing significant improvements in impulsive aggression than in affective or other interpersonal symptoms. Future research strategies will focus on the potential role of neuropeptide agents and medications with greater specificity for 2A serotonin receptors, as well as optimizing concomitant implementation of evidence-based psychotherapy and psychopharmacology, in order to improve BPD patients' overall functioning. PMID:24174895

  16. Schizotypal Personality Disorder: A Current Review

    PubMed Central

    Rosell, Daniel R.; Futterman, Shira E.; McMaster, Antonia; Siever, Larry J.

    2014-01-01

    The study of schizotypal personality disorder (SPD) is important clinically, as it is understudied, challenging to treat, often under-recognized or misdiagnosed, and associated with significant functional impairment. SPD also represents an intermediate schizophrenia-spectrum phenotype, and therefore, can provide a better understanding of the genetics, pathogenesis, and treatment of related psychotic illnesses. In this review we discuss recent findings of SPD related to epidemiology and functional impairment; heritability and genetics; working memory and cognitive impairments; social-affective disturbances; and neurobiology. Additionally, we examine the challenges associated with treating patients with SPD, as well as clinical recommendations. Finally, we address future directions and areas in need of further exploration. PMID:24828284

  17. Distinct pattern of P3a event-related potential in borderline personality disorder.

    PubMed

    Meares, Russell; Melkonian, Dmitriy; Gordon, Evian; Williams, Leanne

    2005-02-28

    P3a and P3b event-related brain potentials to auditory stimuli were recorded for 17 unmedicated patients with borderline personality disorder, 17 matched healthy controls and 100 healthy control participants spanning five decades. Using high-resolution fragmentary decomposition for single-trial event-related potential analysis, distinctive disturbances in P3a in borderline personality disorder patients were found: abnormally enhanced amplitude, failure to habituate and a loss of temporal locking with P3b. Normative age dependencies from 100 controls suggest that natural age-related decline in P3a amplitude is reduced in borderline personality disorder patients and is likely to indicate failure of frontal maturation. On the basis of the theories of Hughlings Jackson, this conceptualization of borderline personality disorder is consistent with an aetiological model of borderline personality disorder. PMID:15706238

  18. Characteristics of effective day treatment programming for persons with borderline personality disorder.

    PubMed

    Miller, B C

    1995-06-01

    Day treatment, or partial hospitalization, may have unique advantages for the treatment of patients with borderline personality disorder. Such treatment may offer patients the optimal level of intensiveness and containment, resulting in less regressive dependency and acting-out behavior. To be successful in treatment of patients with borderline personality disorder, a day treatment program should facilitate the patient's need to experience and express affect safely, optimize the program's ability to provide less restrictiveness than inpatient treatment but more sustained and intensive support than outpatient treatment, and use verbal and nonverbal approaches to help patients maintain primary responsibility for their well-being. A length of stay of three weeks allows patients to regain baseline functioning and resume long-term outpatient care. Treatment goals should be clear and resolvable in three weeks. PMID:7641004

  19. Borderline Personality Disorder: Why 'fast and furious'?

    PubMed

    Brüne, Martin

    2016-01-01

    The term 'Borderline Personality Disorder' (BPD) refers to a psychiatric syndrome that is characterized by emotion dysregulation, impulsivity, risk-taking behavior, irritability, feelings of emptiness, self-injury and fear of abandonment, as well as unstable interpersonal relationships. BPD is not only common in psychiatric populations but also more prevalent in the general community than previously thought, and thus represents an important public health issue. In contrast to most psychiatric disorders, some symptoms associated with BPD may improve over time, even without therapy, though impaired social functioning and interpersonal disturbances in close relationships often persist. Another counterintuitive and insufficiently resolved question is why depressive symptoms and risk-taking behaviors can occur simultaneously in the same individual. Moreover, there is an ongoing debate about the nosological position of BPD, which impacts on research regarding sex differences in clinical presentation and patterns of comorbidity.In this review, it is argued that many features of BPD may be conceptualized within an evolutionary framework, namely behavioral ecology. According to Life History Theory, BPD reflects a pathological extreme or distortion of a behavioral 'strategy' which unconsciously aims at immediate exploitation of resources, both interpersonal and material, based on predictions shaped by early developmental experiences. Such a view is consistent with standard medical conceptualizations of BPD, but goes beyond classic 'deficit'-oriented models, which may have profound implications for therapeutic approaches. PMID:26929090

  20. Chronic complex dissociative disorders and borderline personality disorder: disorders of emotion dysregulation?

    PubMed

    Brand, Bethany L; Lanius, Ruth A

    2014-01-01

    Emotion dysregulation is a core feature of chronic complex dissociative disorders (DD), as it is for borderline personality disorder (BPD). Chronic complex DD include dissociative identity disorder (DID) and the most common form of dissociative disorder not otherwise specified (DDNOS, type 1), now known as Other Specified Dissociative Disorders (OSDD, type 1). BPD is a common comorbid disorder with DD, although preliminary research indicates the disorders have some distinguishing features as well as considerable overlap. This article focuses on the epidemiology, clinical presentation, psychological profile, treatment, and neurobiology of chronic complex DD with emphasis placed on the role of emotion dysregulation in each of these areas. Trauma experts conceptualize borderline symptoms as often being trauma based, as are chronic complex DD. We review the preliminary research that compares DD to BPD in the hopes that this will stimulate additional comparative research. PMID:26401297

  1. A synopsis of the WPA Educational Program on Personality Disorders

    PubMed Central

    SIMONSEN, ERIK; RONNINGSTAM, ELSA; MILLON, THEODORE

    2008-01-01

    This article describes the headlines of the Educational Program on Personality Disorders produced by the WPA Section on Personality Disorders and the International Society on the Study of Personality Disorders. Lifelong personality traits serve as a substrate and a context for understanding more florid and distinct forms of psychopathology. Personality disorders affect at least 10% of the population, and the direct and indirect social costs associated with crime, substance abuse, increased need for medical care, family disruption, delayed recovery from clinical syndromes and medical diseases is substantial. Numerous theories, models and methods have been proposed to describe and to understand personality and its disorders: descriptive, statistical, psychoanalytic, evolutionary, neurobiologic. Classification has either taken a prototypical or a polythetic approach, but in recent years dimensional formats for classifying personalities have gained more interest. Personality pathology has a complex and variable character of interwoven developmental bio-psycho-social influences. A number of reliable instruments for assessment of personality and its disorders have emerged during the last three decades and a wide range of tailored psychotherapeutic techniques are now available. Personality disorders are treatable and remission is more likely than treatment resistance. Education is needed for all health professionals in psychiatric services. The full WPA program is available to be downloaded for free from WPA’s website www.wpanet.org PMID:18560515

  2. Integrating a developmental perspective in dimensional models of personality disorders.

    PubMed

    De Clercq, Barbara; De Fruyt, Filip; Widiger, Thomas A

    2009-03-01

    There is growing evidence that manifestations of personality pathology are traceable in early years of life. Nevertheless, the existing diagnostic nomenclature contains little recognition of childhood antecedents of adult personality disorders (PD). The current paper suggests that these childhood antecedents are more readily recognized to the extent that the personality disorders are themselves understood as configurations of extreme Five-Factor Model personality traits. From this dimensional perspective, we propose the Dimensional Personality Symptom Itempool (DIPSI), an age-specific model for describing child and adolescent trait pathology. We suggest that the DIPSI represents a comprehensive conceptualization of childhood PD antecedents and may contribute to the understanding of the developmental course of personality disorders. Issues and concerns to further elaborate this life-span perspective on personality disorders are discussed. PMID:19167138

  3. Personality Disorder Symptoms Are Differentially Related to Divorce Frequency

    PubMed Central

    Disney, Krystle L.; Weinstein, Yana; Oltmanns, Thomas F.

    2013-01-01

    Divorce is associated with a multitude of outcomes related to health and well-being. Data from a representative community sample (N = 1,241) of St. Louis residents (ages 55–64) were used to examine associations between personality pathology and divorce in late midlife. Symptoms of the 10 DSM–IV personality disorders were assessed with the Structured Interview for DSM–IV Personality and the Multisource Assessment of Personality Pathology (both self and informant versions). Multiple regression analyses showed Paranoid and Histrionic personality disorder symptoms to be consistently and positively associated with number of divorces across all three sources of personality assessment. Conversely, Avoidant personality disorder symptoms were negatively associated with number of divorces. The present paper provides new information about the relationship between divorce and personality pathology at a developmental stage that is understudied in both domains. PMID:23244459

  4. Personality disorder symptoms are differentially related to divorce frequency.

    PubMed

    Disney, Krystle L; Weinstein, Yana; Oltmanns, Thomas F

    2012-12-01

    Divorce is associated with a multitude of outcomes related to health and well-being. Data from a representative community sample (N = 1,241) of St. Louis residents (ages 55-64) were used to examine associations between personality pathology and divorce in late midlife. Symptoms of the 10 DSM-IV personality disorders were assessed with the Structured Interview for DSM-IV Personality and the Multisource Assessment of Personality Pathology (both self and informant versions). Multiple regression analyses showed Paranoid and Histrionic personality disorder symptoms to be consistently and positively associated with number of divorces across all three sources of personality assessment. Conversely, Avoidant personality disorder symptoms were negatively associated with number of divorces. The present paper provides new information about the relationship between divorce and personality pathology at a developmental stage that is understudied in both domains. PMID:23244459

  5. Personality functioning in patients with avoidant personality disorder and social phobia.

    PubMed

    Eikenaes, Ingeborg; Hummelen, Benjamin; Abrahamsen, Gun; Andrea, Helene; Wilberg, Theresa

    2013-12-01

    Avoidant personality disorder (APD) and social phobia (SP) are closely related, such that they are suggested to represent different severity levels of one social anxiety disorder. This cross-sectional study aimed to compare patients with APD to patients with SP, with particular focus on personality dysfunction. Ninety-one adult patients were examined by diagnostic interviews and self-report measures, including the Index of Self-Esteem and the Severity Indices of Personality Problems. Patients were categorized in three groups; SP without APD (n = 20), APD without SP (n = 15), and APD with SP (n = 56). Compared to patients with SP without APD, patients with APD reported more symptom disorders, psychosocial problems, criteria of personality disorders, and personality dysfunction regarding self-esteem, identity and relational problems. These results indicate that APD involves more severe and broader areas of personality dysfunction than SP, supporting the conceptualization of APD as a personality disorder as proposed for DSM-5. PMID:23786266

  6. The influence of comorbid personality disorders on recovery from depression

    PubMed Central

    Wongpakaran, Tinakon; Wongpakaran, Nahathai; Boonyanaruthee, Vudhichai; Pinyopornpanish, Manee; Intaprasert, Suthi

    2015-01-01

    Purpose The impact of personality disorders on the treatment of and recovery from depression is still a controversial topic. The aim of this paper is to provide more information on what has led to this disagreement. Materials and methods Clinician-rated Hamilton Depression Rating Scale (HAMD) scores were assessed among 82 depressed outpatients who were receiving a routine treatment combination of antidepressant medication and psychosocial intervention. The participants were followed up over five visits at 3-month intervals: at the baseline, at 3, 6, 9 and 12 months. Personality disorders were assessed after the last visit in accordance with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. These repeated measures were used to explore the impact of personality disorders on HAMD scores by using a linear mixed model. Results Among the four personality clusters that were used (A, B, C, and mixed), only those in cluster B and in the mixed cluster were found to take significantly longer than those without personality disorders, for reduction in HAMD scores over the course of treatment. Conclusion In this study, the impact of personality disorders on treatment outcomes varied with the way that the personality disorder variables were described and used as independent predictors. This is because the outcomes were influenced by the impact weight of each personality disorder, even within the same cluster. PMID:25834447

  7. Assessment and Treatment of Personality Disorders: A Behavioral Perspective

    ERIC Educational Resources Information Center

    Nelson-Gray, Rosemery O.; Lootens, Christopher M.; Mitchell, John T.; Robertson, Christopher D.; Hundt, Natalie E.; Kimbrel, Nathan A.

    2009-01-01

    Personality disorders are complex and highly challenging to treatment providers; yet, for clients with these problems, there exist very few treatment options that have been supported by research. Given the lack of empirically-supported therapies for personality disorders, it can be difficult to make treatment decisions for this population. The…

  8. School Climate and Continuity of Adolescent Personality Disorder Symptoms

    ERIC Educational Resources Information Center

    Kasen, Stephanie; Cohen, Patricia; Chen, Henian; Johnson, Jeffrey G.; Crawford, Thomas N.

    2009-01-01

    Background: Schools are key social contexts for shaping development and behavior in youths; yet, little is known of their influence on adolescent personality disturbance. Method: A community-based sample of 592 adolescents was assessed for family and school experiences, Axis I psychiatric disorders, and Axis II personality disorder (PD) symptoms,…

  9. Treating Obesity: Clinical Implications of Comorbid Borderline Personality Disorder.

    ERIC Educational Resources Information Center

    Sansone, Randy A.; Wiederman, Michael W.; Sansone, Lori A.

    1999-01-01

    Reviews possible links between obesity and borderline-personality disorder and discusses treatment approaches for those individuals demonstrating such comorbidity. Approaches include modification of current techniques for obesity treatment and incorporation of psychodynamic counseling specific to borderline-personality disorder. (Author/GCP)

  10. Comorbidity of Personality Disorders and Depression: Implications for Treatment.

    ERIC Educational Resources Information Center

    Shea, M. Tracie; And Others

    1992-01-01

    Reviews studies of impact of comorbidity of personality disorders and depression on response to various forms of treatment. Notes that findings support belief that personality disorders are associated with poorer response to treatment for depression. Also notes that limited data available suggest that depression may be positive prognostic…

  11. Predictors of comorbid personality disorders in patients with panic disorder with agoraphobia.

    PubMed

    Latas, M; Starcevic, V; Trajkovic, G; Bogojevic, G

    2000-01-01

    The aim of this study was to ascertain predictors of comorbid personality disorders in patients with panic disorder with agoraphobia (PDAG). Sixty consecutive outpatients with PDAG were administered the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II) for the purpose of diagnosing personality disorders. Logistic regressions were used to identify predictors of any comorbid personality disorder, any DSM-IV cluster A, cluster B, and cluster C personality disorder. Independent variables in these regressions were gender, age, duration of panic disorder (PD), severity of PDAG, and scores on self-report instruments that assess the patient's perception of their parents, childhood separation anxiety, and traumatic experiences. High levels of parental protection on the Parental Bonding Instrument (PBI), indicating a perception of the parents as overprotective and controlling, emerged as the only statistically significant predictor of any comorbid personality disorder. This finding was attributed to the association between parental overprotection and cluster B personality disorders, particularly borderline personality disorder. The duration of PD was a significant predictor of any cluster B and any cluster C personality disorder, suggesting that some of the cluster B and cluster C personality disorders may be a consequence of the long-lasting PDAG. Any cluster B personality disorder was also associated with younger age. In conclusion, despite a generally nonspecific nature of the relationship between parental overprotection in childhood and adult psychopathology, the findings of this study suggest some specificity for the association between parental overprotection in childhood and personality disturbance in PDAG patients, particularly cluster B personality disorders. PMID:10646616

  12. A developing world perspective on homicide and personality disorder.

    PubMed

    Mela, Mansfield; Audu, Moses; Tesfaye, Markos; Gurmu, Samson

    2014-07-01

    High rates of psychotic disorder among special populations of homicide offenders, females, youth and the mentally disordered, have received much investigation. Personality disorder, especially antisocial personality disorder, augments the relative risk ratio of violence, especially in combination with substance use disorder. Few studies of these correlates of violence and especially homicide have been reported in low- and medium-income countries (LMIC). Using the structured clinical interview for DSM diagnosis (SCID), personality disorders were identified in a cross sectional study involving 546 homicide offenders in Jimma prison, Ethiopia. Predictors of personality disorder were determined using multivariate analysis of various demographic and clinical variables, for example, age, psychiatric history and substance use. Out of the 316 offenders who completed the SCID, only 16% fulfilled DSM IV criteria for personality disorder. The rationale for killing, self-defence, anger and revenge (52% of offenders), planning involved in offending (50%) and reasonably high level of relationship functioning (57% married) were different from most data from the high-income countries. Diagnostically relevant cultural factors in LMIC, not in play in high-income countries, may explain the differences in personality disorders similar to other mental disorders and the underlying mediators of homicide. PMID:24166685

  13. Borderline personality disorder, stigma, and treatment implications.

    PubMed

    Aviram, Ron B; Brodsky, Beth S; Stanley, Barbara

    2006-01-01

    Borderline personality disorder (BPD) is often viewed in negative terms by mental health practitioners and the public. The disorder may have a stigma associated with it that goes beyond those associated with other mental illnesses. The stigma associated with BPD may affect how practitioners tolerate the actions, thoughts, and emotional reactions of these individuals. It may also lead to minimizing symptoms and overlooking strengths. In society, people tend to distance themselves from stigmatized populations, and there is evidence that some clinicians may emotionally distance themselves from individuals with BPD. This distancing may be especially problematic in treating patients with BPD; in addition to being unusually sensitive to rejection and abandonment, they may react negatively (e.g., by harming themselves or withdrawing from treatment) if they perceive such distancing and rejection. Clinicians' reactivity may be self-protective in response to actual behavior associated with the pathology. As a consequence, however, the very behaviors that make it difficult to work with these individuals contribute to the stigma of BPD. In a dialectical relationship, that stigma can influence the clinician's reactivity, thereby exacerbating those same negative behaviors. The result is a self-fulfilling prophecy and a cycle of stigmatization to which both patient and therapist contribute. The extent to which therapist distancing is influenced by stigma is an important question that highlights the possibility that the stigma associated with BPD can have an independent contribution to poor outcome with this population. A final issue concerns the available means for identifying and limiting the impact of stigmatization on the treatment of individuals with BPD. PMID:16990170

  14. Prosodic Abnormalities in Schizotypal Personality Disorder

    PubMed Central

    Dickey, Chandlee C.; Vu, Mai-Anh T; Voglmaier, Martina M.; Niznikiewicz, Margaret A.; McCarley, Robert W.; Panych, Lawrence P.

    2012-01-01

    Objective Patients with schizophrenia speak with blunted vocal affect but little is known regarding the prosody of persons with schizotypal personality disorder (SPD). This work examined expressive prosody in SPD, its relationship to brain structure, and outlined a framework for measuring elements of prosody in clinical populations. Methods Twenty-eight antipsychotic-naïve SPD subjects were matched with 27 healthy comparison (HC) subjects. Subjects read aloud short sentences and responded to probes to record both predetermined and self-generated speech samples. Samples were analyzed acoustically (pause proportion, duration, attack, and pitch variability) and subjectively by raters (amount of pauses, degree of emotion portrayed, and how much they wanted to hear more from the subjects) on paragraph, sentence, word, word-fragment, and syllable levels. Alexithymia and ability to self-monitor behavior was compared between groups. The pars opercularis was manually traced on structural MRI data. Results SPD subjects' speech had significantly more pauses, was slower, had less pitch variability, and expressed less emotion than HC subjects. Pitch variability correlated with socio-economic status achievement. There was no difference between groups in left or right pars opercularis volumes. A statistically significant correlation suggested smaller left pars opercularis volumes in SPD subjects correlated with more pauses and less emotion. SPD subjects reported more alexithymia and difficulty self-monitoring their behavior compared with controls. In SPD subjects the high alexithymia correlated with raters not wanting to hear more from them and SPD subjects' inability to modulate their social behavior correlated with their having fewer friends. Thus, the SPD subjects exhibited insight. Conclusions SPD subjects displayed significant prosodic deficits that were measurable in speech samples as brief as a word-fragment. The determinants of these deficits are not known although may

  15. [Hysteria I. Histrionic personality disorder. A psychotherapeutic challenge].

    PubMed

    Sulz, S

    2010-07-01

    What is left of Freud's hysteria in modern diagnostics is the histrionic personality. Psychological and somatic functional disorders, such as dissociative and somatoform disorders are freed from the label of being hysterical, but even the histrionic personality disorder does not enjoy professional agreement as far as diagnostics and therapy are concerned. This disorder is characterized by dramatization, suggestibility, superficial changing affects, impressionist cognitive style, preoccupation with outward appearance, seductive behavior and the wish to take centre stage, a compensatory attitude resulting from important childhood relationships. A comorbidity with narcissistic and antisocial personality exists and also with ADHS. PMID:20585747

  16. Social workers' ratings of comorbid personality disorders in substance abusers.

    PubMed

    Hesse, Morten

    2005-07-01

    Clinical diagnoses of personality disorders have been discredited in the literature. However, the artificial dichotomization of dimensions, along with the constraint of having to select only one or a few diagnoses, may have limited the ability of clinical judgment to converge with other clinician's judgments, or with relevant external criteria. Assessment with a dimensional approach to personality disorders may provide improved agreement. In this study, substance abusers were rated by two different staff members involved in their treatment. Inter-rater agreement was moderately high for paranoid, schizotypal, antisocial, and borderline personality disorder, and high-moderate discriminant validity was found for all personality disorders except schizoid and obsessive-compulsive personality disorder. PMID:15925133

  17. The Relationship Between Childhood Abuse and Adult Personality Disorder Symptoms

    PubMed Central

    Grover, Kelly E.; Carpenter, Linda L.; Price, Lawrence H.; Gagne, Gerard G.; Mello, Andrea F.; Mello, Marcelo F.; Tyrka, Audrey R.

    2015-01-01

    This study assessed personality disorder symptomatology in a community sample of healthy adults without diagnosable DSM-IV-TR Axis I psychiatric disorders who reported a history of childhood abuse. Twenty-eight subjects with a history of moderate to severe physical, sexual, and/or emotional abuse according to the Childhood Trauma Questionnaire were compared to 33 subjects without an abuse history on symptoms of personality disorders. Subjects in the Abuse group were more likely to report subclinical symptoms of paranoid, narcissistic, borderline, antisocial, obsessive compulsive, passive-aggressive, and depressive personality disorders. These findings link reports of childhood abuse with symptoms of personality disorders in the absence of Axis I psychiatric disorders in a community sample of healthy adults. PMID:17685839

  18. Emotions and memory in borderline personality disorder.

    PubMed

    Winter, Dorina; Elzinga, Bernet; Schmahl, Christian

    2014-01-01

    Memory processes such as encoding, storage, and retrieval of information are influenced by emotional content. Because patients with borderline personality disorder (BPD) are particularly susceptible to emotional information, it is relevant to understand whether such memory processes are altered in this patient group. This systematic literature review collects current evidence on this issue. Research suggests that emotional information interferes more strongly with information processing and learning in BPD patients than in healthy controls. In general, BPD patients do not seem to differ from healthy control subjects in their ability to memorize emotional information, but they tend to have specific difficulties forgetting negative information. Also, BPD patients seem to recall autobiographical, particularly negative events with stronger arousal than healthy controls, while BPD patients also show specific temporo-prefrontal alterations in neural correlates. No substantial evidence was found that the current affective state influences learning and memory in BPD patients any differently than in healthy control subjects. In general, a depressive mood seems to both deteriorate and negatively bias information processing and memories, while there is evidence that dissociative symptoms impair learning and memory independently of stimulus valence. This review discusses methodological challenges of studies on memory and emotions in BPD and makes suggestions for future research and clinical implications. PMID:24355827

  19. [Neurocognitive functioning in borderline personality disorder].

    PubMed

    Poletti, Michele

    2009-01-01

    Neurocognitive dysfunctions in subjects with a diagnosis of borderline personality disorder (BPD) have been often reported in several recent studies, reviewed in this paper. Most marked impairments are reported for executive functions, autobiographical memory and social cognition processes. These impairments may be considered as neurocognitive correlates of some clinical symptoms of BPD: the dysexecutive impairment, particularly of those processes based on the orbitofrontal cortex, is the correlate of the increased impulsivity; the interference of negative emotions on encoding and retrieval of autobiographical memories is the correlate of the frequent dissociative symptoms; difficulties in social cognition processes (for example in emotion recognition) are the correlate of the instable interpersonal relationships. Early cognitive impairments are also detected in children and adolescents with borderline clinical symptoms, suggesting that neurocognitive functioning: (1) might be considered an indirect index of the neurobiological impact of the childhood trauma that usually BPD subjects report; (2) might be a moderator in the development of BPD. Reviewed studies suggest the utility of a neuropsychological evaluation in all those subjects, children, adolescents and adults, that present borderline clinical symptoms. PMID:20218216

  20. Electroencephalographic abnormalities in antisocial personality disorder.

    PubMed

    Calzada-Reyes, Ana; Alvarez-Amador, Alfredo; Galán-García, Lídice; Valdés-Sosa, Mitchell

    2012-01-01

    The presence of brain dysfunction in violent offenders has been frequently examined with inconsistent results. The aim of the study was to assess the EEG of 84 violent offenders by visual inspection and frequency-domain quantitative analysis in 84 violent prisoners. Low-resolution electromagnetic tomography (LORETA) was also employed for theta band of the EEG spectra. Antisocial personality disorder (ASPD) was present in 50 of the offenders and it was absent in the remaining 34. The prevalence of EEG abnormalities, by visual inspection, was similar for both the ASPD group (82%) and non-ASPD group (79%). The brain topography of these anomalies also did not differ between groups, in contrast to results of the EEG quantitative analysis (QEEG) and LORETA that showed remarkable regional differences between both groups. QEEG analysis showed a pattern of excess of theta-delta activities and decrease of alpha band on the right fronto-temporal and left temporo-parietal regions in the ASPD group. LORETA signified an increase of theta activity (5.08 Hz) in ASPD group relative to non-ASPD group within left temporal and parietal regions. Findings indicate that QEEG analysis and techniques of source localization may reveal differences in brain electrical activity among offenders with ASPD, which was not obvious to visual inspection. PMID:22152445

  1. Social cognition in borderline personality disorder

    PubMed Central

    Roepke, Stefan; Vater, Aline; Preißler, Sandra; Heekeren, Hauke R.; Dziobek, Isabel

    2013-01-01

    Many typical symptoms of borderline personality disorder (BPD) occur within interpersonal contexts, suggesting that BPD is characterized by aberrant social cognition. While research consistently shows that BPD patients have biases in mental state attribution (e.g., evaluate others as malevolent), the research focusing on accuracy in inferring mental states (i.e., cognitive empathy) is less consistent. For complex and ecologically valid tasks in particular, emerging evidence suggests that individuals with BPD have impairments in the attribution of emotions, thoughts, and intentions of others (e.g., Preißler et al., 2010). A history of childhood trauma and co-morbid PTSD seem to be strong additional predictors for cognitive empathy deficits. Together with reduced emotional empathy and aberrant sending of social signals (e.g., expression of mixed and hard-to-read emotions), the deficits in mental state attribution might contribute to behavioral problems in BPD. Given the importance of social cognition on the part of both the sender and the recipient in maintaining interpersonal relationships and therapeutic alliance, these impairments deserve more attention. PMID:23335877

  2. A Metastructural Model of Mental Disorders and Pathological Personality Traits

    PubMed Central

    Wright, Aidan G.C.; Simms, Leonard J.

    2015-01-01

    Background Psychiatric comorbidity is extensive in both psychiatric settings and the general population. Such comorbidity challenges whether DSM-based mental disorders serve to effectively carve nature at its joints. In response, a substantial literature has emerged showing that a small number of broad dimensions—internalizing, externalizing, and psychoticism—can account for much of the observed covariation among common mental disorders. However, the location of personality disorders within this emerging metastructure has only recently been studied, and no studies have yet examined where pathological personality traits fit within such a broad metastructural framework. Methods We conducted joint structural analyses of common mental disorders, personality disorders, and pathological personality traits in a sample of 628 current or recent psychiatric outpatients. Results Bridging across the psychopathology and personality trait literatures, the results provide evidence for a robust five-factor metastructure of psychopathology, including broad domains of symptoms and features related to internalizing, disinhibition, psychoticism, antagonism, and detachment. Conclusions These results reveal evidence for a psychopathology metastructure that (a) parsimoniously accounts for much of the observed covariation among common mental disorders, personality disorders, and related personality traits, and (b) provides an empirical basis for the organization and classification of mental disorder. PMID:25903065

  3. Personality dimensions as common and broadband-specific features for internalizing and externalizing disorders.

    PubMed

    Hink, Laura K; Rhee, Soo H; Corley, Robin P; Cosgrove, Victoria E; Hewitt, John K; Schulz-Heik, Robert J; Lahey, Benjamin B; Waldman, Irwin D

    2013-08-01

    Several researchers have suggested that the nature of the covariation between internalizing and externalizing disorders may be understood better by examining the associations between temperament or personality and these disorders. The present study examined neuroticism as a potential common feature underlying both internalizing and externalizing disorders and novelty seeking as a potential broad-band specific feature influencing externalizing disorders alone. Participants were 12- to 18-year-old twin pairs (635 monozygotic twin pairs and 691 dizygotic twin pairs; 48 % male and 52 % female) recruited from the Colorado Center for Antisocial Drug Dependence. Genetic and nonshared environmental influences shared in common with neuroticism influenced the covariation among distinct internalizing disorders, the covariation among distinct externalizing disorders, and the covariation between internalizing and externalizing disorders. Genetic influences shared in common with novelty seeking influenced the covariation among externalizing disorders and the covariation between major depressive disorder and externalizing disorders, but not the covariation among internalizing disorders or between anxiety disorders and externalizing disorders. Also, after accounting for genetic and environmental influences shared in common with neuroticism and novelty seeking, there were no significant common genetic or environmental influences among the disorders examined, suggesting that the covariance among the disorders is sufficiently explained by neuroticism and novelty seeking. We conclude that neuroticism is a heritable common feature of both internalizing disorders and externalizing disorders, and that novelty seeking is a heritable broad-band specific factor that distinguishes anxiety disorders from externalizing disorders. PMID:23474797

  4. Substance abusers' personality disorders and staff members' emotional reactions

    PubMed Central

    Thylstrup, Birgitte; Hesse, Morten

    2008-01-01

    Background Previous research has indicated that aggressive behaviour and DSM-IV cluster B personality disorders (PD) may be associated with professionals' emotional reactions to clients, and that cluster C PD may be associated with positive emotional reactions. Methods Staff members recruited from workshops completed a self-report inventory of emotional reactions to patients, the Feeling Word Checklist-58, and substance abusers completed a self-report of DSM-IV personality disorder, the DSM-IV and ICD-10 Personality Disorder Questionnaire. Correlational analysis and multiple regression analysis was used to assess the associations between personality disorders and emotional reations. Results Cluster B disorder features were associated with feeling distance to patients, and cluster C disorder features were associated with feeling helpful towards patients. Cluster A disorders had no significant impact on emotional reactions. Conclusion The findings confirm clinical experiences that personality disorder features in patients with substance abuse have an impact on staff members reactions to them. These reactions should be considered in supervision of staff, and in treatment models for patients with co-morbid personality disorders and substance abuse. PMID:18402658

  5. Personality Profile of Parents of Children with Attention Deficit Hyperactivity Disorder

    PubMed Central

    Dadashzadeh, Hossein; Amiri, Shahrokh; Atapour, Ahmad; Abdi, Salman; Asadian, Mahan

    2014-01-01

    Objectives. The present study was carried out aiming to identify the personality profile of parents of children with Attention Deficit Hyperactivity Disorder (ADHD). Methods. This study is of a descriptive, analytic, cross-sectional type in which parents of 6–12-year-old children with ADHD who were referred to the Bozorgmehr Psychiatric Clinic, affiliated with Tabriz University of Medical Sciences, were enrolled. ADHD was diagnosed according to the criteria of DSM-IV-TR and a quasi-structured diagnostic interview (K-SADS-PL). The personality profile of the parents was assessed with the Millon Clinical Multiaxial Inventory-III (MCMI-III). Results. According to the findings of this study, the most common personality problems based on the assessment scales in the MCMI-III belonged to the clinical patterns of depressive personality in 43 persons (25.3%), histrionic personality in 34 persons (20%), and compulsive personality in 29 persons (17.1%). According to discriminant analysis, four scales of somatoform, sadistic, dependence, and though disorder were direct and antisocial scale was reverse significant predictors of membership in the women group. Conclusion. According to the findings of this pilot study, personality disorders are prevalent in parents of ADHD children and mothers suffer from personality disorders more than fathers. PMID:25525613

  6. Child maltreatment and trajectories of personality and behavioral functioning: Implications for the development of personality disorder

    PubMed Central

    Kim, Jungmeen; Cicchetti, Dante; Rogosch, Fred A.; Manly, Jody Todd

    2009-01-01

    This study investigated the longitudinal impact of maltreatment parameters on personality processes and maladjustment and prospective relationships between personality trajectory classes and subsequent maladjustment outcomes. The sample involved maltreated (n = 249) and nonmaltreated (n = 200) children followed longitudinally between ages 6 – 10. Growth mixture modeling indicated multifinality in personality development depending on the risk status (i.e., maltreated vs. nonmaltreated). Two trajectory classes of ego resiliency were identified for maltreated children; those who showed a declining trajectory exhibited greater maladjustment. In contrast, three trajectory classes of ego control were identified for nonmaltreated children; the subgroups showing increases in ego under-control or dramatic changes from high ego under-control to high ego over-control exhibited poor adjustment. Experiencing multiple maltreatment subtypes and physical/sexual abuse were related to higher levels of ego under-control and externalizing symptomatology, whereas early onset of maltreatment was associated with the low and decreasing trajectory of ego resiliency and higher levels of internalizing symptomatology. The findings suggest that ego resiliency and ego control – personality processes related to self-regulation – may be important factors in identifying distinct pathways to later personality disorders as well as pathways to resilient functioning. PMID:19583889

  7. Reasons for Change in Borderline Personality Disorder (and Other Axis II Disorders)

    PubMed Central

    Zanarini, Mary C.

    2008-01-01

    Borderline personality disorder (BPD) is a slow moving disorder. Most patients with BPD improve over time. The reasons for this change are unclear. Both therapy as usual and the reparations that adult life offers can facilitate these changes. PMID:18638649

  8. Comorbid bipolar disorder and borderline personality disorder and substance use disorder.

    PubMed

    Hidalgo-Mazzei, Diego; Walsh, Emily; Rosenstein, Lia; Zimmerman, Mark

    2015-01-01

    Bipolar disorder (BD) and borderline personality disorder (BPD) are disabling and life-threatening conditions. Both disorders share relevant comorbidities, particularly the risk of having a lifetime substance use disorder (SUD). We tested the hypothesis that patients with both BD type I (BDI) or II (BDII) and BPD would have a higher rate of SUD than would patients with either disorder alone. A total of 3651 psychiatric patients were evaluated with semistructured diagnostic interviews for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, axis I and II disorders. A total of 63 patients were diagnosed with both BD and BPD, and these patients were significantly more likely to have a SUD compared with BDII patients without BPD (76% vs. 50%, χ = 9.69, p < 0.01). There were no differences when comparing the comorbid group with BPD patients without BD (76% vs. 71%, χ = 0.519, p = 0.4). The present study shows the importance of taking both BPD and BD into consideration insofar as the co-occurrence of the disorders increased the risk of having a SUD especially when compared with BDII alone. PMID:25494335

  9. Personality traits and psychiatric comorbidities in alcohol dependence.

    PubMed

    Donadon, M F; Osório, F L

    2016-01-01

    Non-adaptive personality traits may constitute risk factors for development of psychiatric disorders such as depression and anxiety. We aim to evaluate associations and the predictive value of personality traits among alcohol-dependent individuals, with or without psychiatric comorbidities. The convenience sample comprised two groups of males over 18 years of age: one with subjects who had an alcohol dependence diagnosis (AG, n=110), and a control group without abuse and/or alcohol dependence diagnosis (CG, n=110). The groups were assessed by means of the Structured Clinical Interview DSM-IV (SCID-IV). AG participants were recruited among outpatients from the university hospital, whereas CG participants were recruited from a primary healthcare program. Data collection was done individually with self-assessment instruments. Parametric statistics were performed, and a significance level of P=0.05 was adopted. A positive correlation was observed between openness and the length of time that alcohol has been consumed, as were significant and negative correlations between conscientiousness and both the length of time alcohol has been consumed and the number of doses. For alcoholics, extraversion emerged as a protective factor against depression development (P=0.008) and tobacco abuse (P=0.007), whereas openness worked as a protective factor against anxiety (P=0.02). The findings point to specific deficits presented by alcoholics in relation to personality traits with or without psychiatric comorbidities and to the understanding that therapeutic approaches should favor procedures and/or preventive measures that allow more refined awareness about the disorder. PMID:26628399

  10. Personality traits and psychiatric comorbidities in alcohol dependence

    PubMed Central

    Donadon, M.F.; Osório, F.L.

    2015-01-01

    Non-adaptive personality traits may constitute risk factors for development of psychiatric disorders such as depression and anxiety. We aim to evaluate associations and the predictive value of personality traits among alcohol-dependent individuals, with or without psychiatric comorbidities. The convenience sample comprised two groups of males over 18 years of age: one with subjects who had an alcohol dependence diagnosis (AG, n=110), and a control group without abuse and/or alcohol dependence diagnosis (CG, n=110). The groups were assessed by means of the Structured Clinical Interview DSM-IV (SCID-IV). AG participants were recruited among outpatients from the university hospital, whereas CG participants were recruited from a primary healthcare program. Data collection was done individually with self-assessment instruments. Parametric statistics were performed, and a significance level of P=0.05 was adopted. A positive correlation was observed between openness and the length of time that alcohol has been consumed, as were significant and negative correlations between conscientiousness and both the length of time alcohol has been consumed and the number of doses. For alcoholics, extraversion emerged as a protective factor against depression development (P=0.008) and tobacco abuse (P=0.007), whereas openness worked as a protective factor against anxiety (P=0.02). The findings point to specific deficits presented by alcoholics in relation to personality traits with or without psychiatric comorbidities and to the understanding that therapeutic approaches should favor procedures and/or preventive measures that allow more refined awareness about the disorder. PMID:26628399

  11. A Systematic Review of Personality Disorders and Health Outcomes

    PubMed Central

    Dixon-Gordon, Katherine L.; Whalen, Diana J.; Layden, Brianne K.; Chapman, Alexander L.

    2015-01-01

    Personality disorders have been associated with a wide swath of adverse health outcomes and correspondingly high costs to healthcare systems. To date, however, there has not been a systematic review of the literature on health conditions among individuals with personality disorders. The primary aim of this article is to review research documenting the associations between personality disorders and health conditions. A systematic review of the literature revealed 78 unique empirical English-language peer-reviewed articles examining the association of personality disorders and health outcomes over the past 15 years. Specifically, we reviewed research examining the association of personality disorders with sleep disturbance, obesity, pain conditions, and other chronic health conditions. In addition, we evaluated research on candidate mechanisms underlying health problems in personality disorders and potential treatments for such disorders. Results underscore numerous deleterious health outcomes associated with PD features and PD diagnoses, and suggest potential biological and behavioural factors that may account for these relations. Guidelines for future research in this area are discussed. PMID:26456998

  12. Salivary lysozyme in smoking alcohol dependent persons.

    PubMed

    Waszkiewicz, Napoleon; Zalewska-Szajda, Beata; Zalewska, Anna; Waszkiewicz, Magdalena; Szajda, Slawomir Dariusz; Repka, Bernadeta; Szulc, Agata; Kepka, Alina; Minarowska, Alina; Ladny, Jerzy Robert; Zwierz, Krzysztof

    2012-01-01

    The purpose of this study was to evaluate the effect of chronic alcohol intoxication and smoking on the concentration and output of salivary lysozyme. Thirty seven men participated in the study, including 17 male smoking alcohol-dependent patients after chronic alcohol intoxication (AS), and 20 control non-smoking male social drinkers (CNS) with no history of alcohol abuse or smoking. The level of lysozyme was assessed by the radial immunodiffusion method. Significantly lower lysozyme output in the AS group compared to the CNS group was found. Moreover, gingival index was significantly higher in AS than in the CNS group. It appeared that the reduced salivary lysozyme output was more likely the result of ethanol action than smoking. In conclusion, persons addicted to alcohol and nicotine have a poorer periodontal status than non-smoking social drinkers, which may partially be due to the diminished protective effects of lysozyme present in the saliva. PMID:23264227

  13. Tridimensional Personality Questionnaire data on alcoholic violent offenders: specific connections to severe impulsive cluster B personality disorders and violent criminality

    PubMed Central

    Tikkanen, Roope; Holi, Matti; Lindberg, Nina; Virkkunen, Matti

    2007-01-01

    Background The validity of traditional categorical personality disorder diagnoses is currently re-evaluated from a continuous perspective, and the evolving DSM-V classification may describe personality disorders dimensionally. The utility of dimensional personality assessment, however, is unclear in violent offenders with severe personality pathology. Methods The temperament structure of 114 alcoholic violent offenders with antisocial personality disorder (ASPD) was compared to 84 offenders without ASPD, and 170 healthy controls. Inclusion occurred during a court-ordered mental examination preceded by homicide, assault, battery, rape or arson. Participants underwent assessment of temperament with the Tridimensional Personality Questionnaire (TPQ) and were diagnosed with DSM-III-R criteria. Results The typical temperament profile in violent offender having ASPD comprised high novelty seeking, high harm avoidance, and low reward dependence. A 21% minority scored low in trait harm avoidance. Results, including the polarized harm avoidance dimension, are in accordance with Cloninger's hypothesis of dimensional description of ASPD. The low harm avoidance offenders committed less impulsive violence than high harm avoidance offenders. High harm avoidance was associated with comorbid antisocial personality disorder and borderline personality disorder. Conclusion Results indicate that the DSM based ASPD diagnosis in alcoholic violent offenders associates with impulsiveness and high novelty seeking but comprises two different types of ASPD associated with distinct second-order traits that possibly explain differences in type of violent criminality. Low harm avoidance offenders have many traits in common with high scorers on the Hare Psychopathy Checklist-Revised (PCL-R). Results link high harm avoidance with broad personality pathology and argue for the usefulness of self-report questionnaires in clinical praxis. PMID:17662159

  14. New criteria for personality disorders in DSM-V.

    PubMed

    Esbec, E; Echeburúa, E

    2011-01-01

    Diagnosing disorders in the current edition of the DSMIV involves two aspects. The first is the concept of a personality disorder, which currently is defined as a pervasive, stable and presents at least from adolescence pattern of "inner experience and behavior" that is deviant from a person's cultural norms. The second aspect involves defining what type of personality disorder is present among a list of ten, with a catch-all "not otherwise specified category". There are many problems with the existing system: the different personality types are poorly defined and the diagnostic criteria overlap heavily. The proposed revision on the DSM-V website appears quite complicated and has three major facets: a new definition for personality disorder, focused on "adaptive failure" involving "impaired sense of self-identity" or "failure to develop effective interpersonal functioning"; five personality types (Antisocial/Psychopathic, Avoidant, Borderline, Obsessive-Compulsive, and Schizotypal); and a series of six personality "trait domains", each of them with a subset of facets. This new proposed system for personality disorder diagnosis may be controversial. Finally challenges for the next future are discussed. PMID:21274817

  15. On the relationship of the five-factor personality model to personality disorders: four reservations.

    PubMed

    Coolidge, F L; Becker, L A; DiRito, D C; Durham, R L; Kinlaw, M M; Philbrick, P B

    1994-08-01

    McCrae and Costa since 1986 have proferred a five-factor personality model as a lingua franca among different psychometric test users, and they suggest that their operationalization of the five-factor model, the NEO Personality Inventory, may also be useful in the clinical assessment of the abnormal personality. The present study examined the inventory and its relationship to the 11 personality disorders of Axis II of DSM-III-R in a sample of 180 adults. Correlational multivariate analyses appear to indicate a limited usefulness of the five-factor model in the understanding of personality disorders, and four major objections are offered. Further research with clinical samples, other models of personality, and other measures of personality disorders are encouraged. PMID:7984716

  16. DSM-5 section III personality traits and section II personality disorders in a Flemish community sample.

    PubMed

    Bastiaens, Tim; Smits, Dirk; De Hert, Marc; Vanwalleghem, Dominique; Claes, Laurence

    2016-04-30

    The Personality Inventory for DSM-5 (PID-5; Krueger et al., 2012) is a dimensional self-report questionnaire designed to measure personality pathology according to the criterion B of the DSM-5 Section III personality model. In the current issue of DSM, this dimensional Section III personality model co-exists with the Section II categorical personality model derived from DSM-IV-TR. Therefore, investigation of the inter-relatedness of both models across populations and languages is warranted. In this study, we first examined the factor structure and reliability of the PID-5 in a Flemish community sample (N=509) by means of exploratory structural equation modeling and alpha coefficients. Next, we investigated the predictive ability of section III personality traits in relation to section II personality disorders through correlations and stepwise regression analyses. Results revealed a five factor solution for the PID-5, with adequate reliability of the facet scales. The variance in Section II personality disorders could be predicted by their theoretically comprising Section III personality traits, but additional Section III personality traits augmented this prediction. Based on current results, we discuss the Section II personality disorder conceptualization and the Section III personality disorder operationalization. PMID:27086247

  17. Is season of birth related to disordered eating and personality in women with eating disorders?

    PubMed Central

    Shuman, Nicole K.; Krug, Isabel; Maxwell, Millie; Pinheiro, Andrea Poyastro; Brewerton, Timothy; Thornton, Laura M.; Berrettini, Wade H.; Brandt, Harry; Crawford, Steven; Crow, Scott; Fichter, Manfred M.; Halmi, Katherine A.; Johnson, Craig; Kaplan, Allan S.; Keel, Pamela; LaVia, Maria; Mitchell, James; Rotondo, Alessandro; Strober, Michael; Woodside, D. Blake; Kaye, Walter H.; Bulik, Cynthia M.

    2015-01-01

    We assessed the relation between season of birth and eating disorder symptoms and personality characteristics in a sample of 880 women with eating disorders and 580 controls from two Price Foundation Studies. Eating disorder symptoms were assessed using Structured Interview of Anorexic and Bulimic Disorders and the Structured Clinical Interview for DSM-IV. Personality traits were assessed using the Temperament and Character Inventory and the Frost Multidimensional Perfectionism Scale. Date of birth was obtained from a sociodemographic questionnaire. No significant differences were observed 1) in season of birth across eating disorder subtypes and controls; nor 2) for any clinical or personality variables and season of birth. We found no evidence of season of birth variation in eating disorders symptoms or personality traits. Contributing to previous conflicting findings, the present results do not support a season of birth hypothesis for eating disorders. PMID:21150253

  18. Comorbidity of Personality Disorders and Adult Attention Deficit Hyperactivity Disorder (ADHD)--Review of Recent Findings.

    PubMed

    Matthies, Swantje; Philipsen, Alexandra

    2016-04-01

    Children suffering from attention deficit hyperactivity disorder (ADHD) may remit until adulthood. But, more than 60-80% have persisting ADHD symptoms. ADHD as an early manifesting neurodevelopmental disorder is considered a major risk factor for the development of comorbid psychiatric disorders in later life. Particularly, personality disorders are oftentimes observed in adult patients suffering from ADHD. If ADHD and personality disorders share common etiological mechanisms and/or if ADHD as a severely impairing condition influences psychological functioning and learning and leads to unfavorable learning histories is unclear. The development of inflexible and dysfunctional beliefs on the basis of real and perceived impairments or otherness due to the core symptoms of ADHD is intuitively plausible. Such beliefs are a known cause for the development of personality disorders. But, why some personality disorders are more frequently found in ADHD patients as for example antisocial and borderline personality disorder remains subject of debate. Because of the high prevalence of ADHD and the high impact of personality disorders on daily functioning, it is important to take them into account when treating patients with ADHD. Research on the developmental trajectories leading to personality disorders in adult ADHD patients might open the door for targeted interventions to prevent impairing comorbid clinical pictures. PMID:26893231

  19. CONTINUITY OF AXES I AND II: TOWARD A UNIFIED MODEL OF PERSONALITY, PERSONALITY DISORDERS, AND CLINICAL DISORDERS

    PubMed Central

    Krueger, Robert F.

    2008-01-01

    In the current standard psychiatric nomenclature, the DSM–IV–TR (APA, 2000), mental disorders are divided into two groups: Clinical Disorders (CDs) and Personality Disorders (PDs), and CD and PD diagnoses are recorded on two separate axes (Axes I and II, respectively). This article considers evidence regarding putative bases for distinguishing between CDs and PDs, and finds that these constructs are more similar than distinct. Links between the domains may be better understood by focusing on how personality connects CDs and PDs. This perspective underlines the need to work toward a more unified model of personality, PDs, and CDs in research and in future editions of the DSM. PMID:16175735

  20. Pharmacological interventions for borderline personality disorder

    PubMed Central

    Stoffers, Jutta; Völlm, Birgit A; Rücker, Gerta; Timmer, Antje; Huband, Nick; Lieb, Klaus

    2014-01-01

    Background Drugs are widely used in borderline personality disorder (BPD) treatment, chosen because of properties known from other psychiatric disorders (“off-label use”), mostly targeting affective or impulsive symptom clusters. Objectives To assess the effects of drug treatment in BPD patients. Search methods We searched bibliographic databases according to the Cochrane Developmental, Psychosocial and Learning Problems Group strategy up to September 2009, reference lists of articles, and contacted researchers in the field. Selection criteria Randomised studies comparing drug versus placebo, or drug versus drug(s) in BPD patients. Outcomes included total BPD severity, distinct BPD symptom facets according to DSM-IV criteria, associated psychopathology not specific to BPD, attrition and adverse effects. Data collection and analysis Two authors selected trials, assessed quality and extracted data, independently. Main results Twenty-eight trials involving a total of 1742 trial participants were included. First-generation antipsychotics (flupenthixol decanoate, haloperidol, thiothixene); second-generation antipsychotics (aripirazole, olanzapine, ziprasidone), mood stabilisers (carbamazepine, valproate semisodium, lamotrigine, topiramate), antidepressants (amitriptyline, fluoxetine, fluvoxamine, phenelzine sulfate, mianserin), and dietary supplementation (omega-3 fatty acid) were tested. First-generation antipsychotics were subject to older trials, whereas recent studies focussed on second-generation antipsychotics and mood stabilisers. Data were sparse for individual comparisons, indicating marginal effects for first-generation antipsychotics and antidepressants. The findings were suggestive in supporting the use of second-generation antipsychotics, mood stabilisers, and omega-3 fatty acids, but require replication, since most effect estimates were based on single studies. The long-term use of these drugs has not been assessed. Adverse event data were scarce

  1. [Personality disorders self-inflicted woundings in detention].

    PubMed

    Anselmi, Nino; Mirigliani, Alessia

    2010-01-01

    Personality disorders, especially borderline and antisocial, are pre-eminent in a penitentiary. Under detention, among 100 patients valuated, 75% have a personality disorder; the 55% of these is diagnosed with borderline personality, while the 20% have a diagnosis of antisocial personality. Borderline disorder is often unnoticed instead of antisocial that is emphasized by self-inflicted wounding and behavioural disorders. The most frequent self-damaging behaviours are, first of all, slashes, then ingestion of foreign bodies and finally burnings and using sharp objects. Environment associated with narrowness, overcrowding, low drugs effects, heighten self-inflicted wounding. Psychiatrists, psychologists and prison guards must consider this manipulative, recriminating, self-therapeutic behavioural way aimed just by obtaining benefits. PMID:20380243

  2. Advances in psychotherapy of personality disorders: a research update.

    PubMed

    McMain, Shelley; Pos, Alberta E

    2007-02-01

    This article reviews psychotherapy studies published between 2003 and 2006 directed at psychotherapy for personality disorders (PDs). Over the past 3 years, there has been a substantial increase in these studies compared with previous decades. Psychodynamic therapy, cognitive-behavioral therapy, and variants of these approaches have been evaluated and shown to have positive results. Borderline personality disorder continues to garner the most attention and has been shown to respond favorably to several types of therapeutic interventions on a range of outcomes. Avoidant personality disorder and obsessive-compulsive personality disorder also respond positively to psychotherapy. Although growing attention to the treatment of PDs is encouraging, further research is indicated. A summary of recent empirical findings and their implications for clinical practice are discussed. PMID:17257514

  3. Borderline Personality Disorder and Development: Counseling University Students.

    ERIC Educational Resources Information Center

    Tryon, Georgiana Shick; And Others

    1988-01-01

    Discusses problems and methodology of diagnosis and counseling of college students with borderline personality disorder. Recommends that providing these students with structure through consistent limit setting can produce positive changes in their behavior. (Author/ABL)

  4. Sex Bias in Classifying Borderline and Narcissistic Personality Disorder.

    PubMed

    Braamhorst, Wouter; Lobbestael, Jill; Emons, Wilco H M; Arntz, Arnoud; Witteman, Cilia L M; Bekker, Marrie H J

    2015-10-01

    This study investigated sex bias in the classification of borderline and narcissistic personality disorders. A sample of psychologists in training for a post-master degree (N = 180) read brief case histories (male or female version) and made DSM classification. To differentiate sex bias due to sex stereotyping or to base rate variation, we used different case histories, respectively: (1) non-ambiguous case histories with enough criteria of either borderline or narcissistic personality disorder to meet the threshold for classification, and (2) an ambiguous case with subthreshold features of both borderline and narcissistic personality disorder. Results showed significant differences due to sex of the patient in the ambiguous condition. Thus, when the diagnosis is not straightforward, as in the case of mixed subthreshold features, sex bias is present and is influenced by base-rate variation. These findings emphasize the need for caution in classifying personality disorders, especially borderline or narcissistic traits. PMID:26421970

  5. Personality and Substance Abuse Disorders: A Review of the Recent Literature on Their Comorbidity and Implications for Diagnosis and Treatment.

    ERIC Educational Resources Information Center

    Sherman, Gregory A.

    The major questions when considering substance abuse/dependence and personality are how these two constructs are related and how they interact. A review of the prevalence literature since 1986 documenting the co-occurrence of substance abuse disorders and personality disorders is presented in this study. Sampled are substance abuse and personality…

  6. The Construct Validity of Passive-Aggressive Personality Disorder

    PubMed Central

    Hopwood, Christopher J.; Morey, Leslie C.; Markowitz, John C.; Pinto, Anthony; Skodol, Andrew E.; Gunderson, John G.; Zanarini, Mary C.; Shea, M. Tracie; Yen, Shirley; McGlashan, Thomas H.; Ansell, Emily B.; Grilo, Carlos M.; Sanislow, Charles A.

    2010-01-01

    Although Passive Aggressive personality disorder (PAPD) plays an important role in many theories of personality pathology, it was consigned to the appendix of the fourth edition of the DSM. The scientific basis of this decision has been questioned, but several controversies persist regarding PAPD, including its structure, content validity, overlap with other PDs, and relations to validating variables such as personality traits, childhood experiences, and clinically relevant correlates. This study examined these facets of PAPD’s construct validity in a large clinical sample. Results suggest that the construct is unidimensional, internally consistent, and reasonably stable. Furthermore, PAPD appears systematically related to borderline and narcissistic personality disorders, sets of personality traits, and childhood experiences consistent with several theoretical formulations, dysfunction, substance abuse disorders, and history of hospitalizations. Overall, results support the construct validity of PAPD. PMID:19821648

  7. Personality Disorder Symptoms and Marital Functioning

    ERIC Educational Resources Information Center

    South, Susan C.; Turkheimer, Eric; Oltmanns, Thomas F.

    2008-01-01

    Pathological personality is strongly linked with interpersonal impairment, yet no study to date has examined the relationship between concurrent personality pathology and dysfunction in marriage--a relationship that most people find central to their lives. In a cross-sectional study of a community sample of married couples (N = 82), the authors…

  8. The plight of personality disorders in the DSM-5.

    PubMed

    Limandri, Barbara J

    2012-09-01

    This article provides a brief history of the development of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association, and how it relates to the proposed fifth edition to be published in 2013. Of particular emphasis is Axis II and how this axis is likely to be restructured. The reconceptualization of the nosology for personality disorders has been controversial since the publication of the DSM-III-R (Wilson, 1993). In both the clinical and academic communities, ongoing debate about diagnostic classification of personality disorders has been common. One recurrent theme among the deliberations on diagnosis and personality disorder focuses on the question of whether distinct (categorical) diagnoses exist or whether diagnoses are dimensionally related to each other in some empirically determined way. The proposed changes for Axis II in the DSM-5 are likely to bridge the gap between these two arguments by revamping the overall criteria and discarding the three currently used diagnostic clusters. The resulting nosology proposes six personality disorders with common factors in Criteria A and Criteria B. However, a major concern and a continuing problem not likely to be resolved in this edition is the symptom resemblance of borderline personality disorder and bipolar disorder. This article suggests some ways the revised DSM might affect mental health nursing practice. PMID:22957953

  9. Autonomic Impairment in Borderline Personality Disorder: A Laboratory Investigation

    ERIC Educational Resources Information Center

    Weinberg, Anna; Klonsky, E. David; Hajcak, Greg

    2009-01-01

    Recent research suggests that emotional dysfunction in psychiatric disorders can be reflected in autonomic abnormalities. The present study examines sympathetic and parasympathetic autonomic nervous system activity in individuals with Borderline Personality Disorder (BPD) before, during, and following a social stressor task. Data were obtained…

  10. Personality Disorder among Male Prisoner in Erbil/ Iraq

    ERIC Educational Resources Information Center

    Aziz, Saman SH.; Ali, Sirwan K.

    2015-01-01

    Background and objectives: Personality disorders are enduring, persistent and pervasive disorders of inner experience and behavior that cause distress or significant impairment in social functioning. They have strong relationship to offending and violence; our aim in the study was to determine the prevalence rate of each specific types of…

  11. The Emotional Lexicon of Individuals Diagnosed with Antisocial Personality Disorder

    ERIC Educational Resources Information Center

    Gawda, Barbara

    2013-01-01

    This study investigated the specific emotional lexicons in narratives created by persons diagnosed with antisocial personality disorder (ASPD) to test the hypothesis that individuals with ASPD exhibit deficiencies in emotional language. Study participants consisted of 60 prison inmates with ASPD, 40 prison inmates without ASPD, and 60 men without…

  12. [Personality disorders and psychiatric comorbidity in obsessive-compulsive disorder and anorexia nervosa].

    PubMed

    Müller, B; Wewetzer, C; Jans, T; Holtkamp, K; Herpertz, S C; Warnke, A; Remschmidt, H; Herpertz-Dahlmann, B

    2001-08-01

    The aim of this prospective longitudinal study was to examine the course of adolescent anorexia nervosa and obsessive-compulsive disorder (OCD) (fulfilling DSM-III-R criteria) to compare psychiatric comorbidity and personality disorders of both groups. Because anorexia nervosa patients are mainly female, we compared them only with female OCD patients. Ten years after discharge the whole sample (32 female patients; 100%) of a group of 39 (32 female; 7 male) anorexia nervosa patients could be reexamined personally. 25 (61%) female patients of a group of 116 patients (41 female; 75 male) with obsessive-compulsive disorder were also reexamined. The anorexia nervosa patients were interviewed using the Structured Interview for Anorexia and Bulimia nervosa (SIAB [39]) to assess eating disorder symptomatology. To examine comorbid psychiatric disorders we used the Composite International Diagnostic Interview, WHO [44] and SCID-II [45] for personality disorders. One fourth of the patients with anorexia nervosa (AN) and 20% of the patients with obsessive-compulsive disorder had a personality disorder according to DSM-III-R. Most of them were "Cluster C"-personality disorders (AN: 28%; OCD: 20%). In the group of the female OCD patients 8% schizoid, 4% schizotype and 12% paranoid personality disorders were observed. The most prevalent psychiatric disorders were anxiety (AN: 28%; OCD: 20%) and affective disorders (AN: 16%; OCD: 16%). Our results support the view that in the course of anorexia nervosa and in obsessive-compulsive disorder there is a high prevalence of psychiatric comorbidity and "Cluster C"-personality disorders according to DSM-III-R. These results might confirm a model of a high vulnerability of the serotonergic neurotransmitter system in patients with anorexia nervosa or OCD. PMID:11584688

  13. Can Personality Disorder Experts Recognize DSM-IV Personality Disorders from Five-Factor Model Descriptions of Patient Cases?

    PubMed Central

    Rottman, Benjamin M.; Kim, Nancy S.; Ahn, Woo-kyoung; Sanislow, Charles A.

    2012-01-01

    Background Dimensional models of personality are under consideration for integration into the next Diagnostic and Statistical Manual of Mental Disorders (DSM-V), but the clinical utility of such models is unclear. Objective To test the ability of clinical researchers who specialize in personality disorders to diagnose personality disorders using dimensional assessments, and to compare these researchers’ ratings of clinical utility for a dimensional system versus for the DSM-IV. Method A sample of 73 researchers who had each published at least three (Median=15) articles on personality disorders participated between December 2008 and January 2009. The Five-Factor Model (FFM), one of the most-studied dimensional models to date, was compared to the DSM-IV. Participants provided diagnoses for case profiles in DSM-IV and FFM formats, and then rated the DSM-IV and FFM on six aspects of clinical utility. Results Overall, participants had difficulty identifying correct diagnoses from FFM profiles, and the same held true for a subset reporting equal familiarity with the DSM-IV and FFM. Participants rated the FFM as less clinically useful than the DSM for making prognoses, devising treatment plans, and communicating with professionals, but more useful for communicating with patients. Conclusions The results suggest that personality disorder expertise and familiarity with the FFM are insufficient to correctly diagnose personality disorders using FFM profiles. Because of ambiguity inherent in FFM profile descriptors, it may be that this insufficiency is unlikely to be attenuated with increased clinical familiarity with the FFM. PMID:21208595

  14. Structure of the DSM-IV personality disorders as revealed in clinician ratings.

    PubMed

    Blais, Mark A; Malone, Johanna C

    2013-05-01

    The revisions proposed for the DSM-5 would greatly alter how personality pathology is conceptualized, assessed, and diagnosed. One aspect of the proposed changes, elimination of four current personality disorders, has raised considerable controversy. The present study attempts to inform this debate by exploring clinicians' views of the structure of Personality Disorders using the current diagnostic system, the DSM-IV. An exploratory factor analysis was conducted on the DSM-IV Personality Disorder criteria using clinician ratings for 280 patients. The factor analysis revealed eight clear and meaningful factors. The eight factors contained all six personality disorders proposed for retention in DSM-5 but also contained clear representations of two disorders (Paranoid and Schizoid) identified for removal from the system. These conditions appear to have clinical utility and their removal may have unintended negative consequences in clinical practice. Dependent and Avoidant criteria also merged to form a new construct with interesting clinical implications. These findings provide new insights into the complex typologies clinicians employ when applying the DSM-IV system to personality disordered patients. Lastly we argue that successful refinement of clinically significant constructs, like diagnostic systems, requires a balanced appraisal of evidence for clinical utility as well as external and internal validity. PMID:23219361

  15. Milestones in the history of personality disorders

    PubMed Central

    Crocq, Marc-Antoine

    2013-01-01

    This paper analyzes the major historical milestones in the study of normal and abnormal personality, from antiquity up until the 20th century. Special attention is paid to the interaction between dimensional and typological approaches, which was a major issue during the preparation of DSM-5. Theories of personality started with the humoral theory of Greek medicine. Pinel, and later Esquirol and Prichard, are credited with the first descriptions of abnormal personalities in textbooks of psychiatry. Between the late 19th and early 20th centuries, elaborate systems of normal and abnormal personality, associating to some degree types and dimensions, were devised by a succession of European psychologists, such as Ribot, Heymans, and Lazursky. Emil Kraepelin and Kurt Schneider proposed classifications of abnormal personality types. In parallel, psychoanalysts stressed the role of early life experiences. Towards the mid-20th century, statistical methods were applied to the scientific validation of personality dimensions with pioneers such as Cattell, anticipating the five-factor model. PMID:24174889

  16. Coercion, competence, and consent in offenders with personality disorder

    PubMed Central

    Zlodre, J; Yiend, J; Burns, T

    2016-01-01

    Competence to consent to treatment has not previously been examined in a personality disorder cohort without comorbid mental disorder. We examined competence and coercion in 174 individuals diagnosed with severe personality disorder using two validated tools (the MacArthur Competence Assessment Tool for Treatment and the MacArthur Coercion Assessment Scale – Short Form). Competence was not categorically impaired, but there were variations within the sample on dimensional competence measures. Further, there were significant negative correlations between experienced coercion and competence. Higher coercion scores were associated with two components of competence: lower understanding and reasoning. Patients who consented to treatment had higher scores on competence measures and experienced less coercion. These findings suggest that therapeutic approaches that decrease experienced coercion and increase competence may increase the engagement of individuals diagnosed with severe personality disorders in treatment. PMID:27284235

  17. Emotional hyper-reactivity in borderline personality disorder.

    PubMed

    Sansone, Randy A; Sansone, Lori A

    2010-09-01

    According to clinical experience, the Diagnostic and Statistical Manual of Mental Disorders, and authorities in the field, patients with borderline personality disorder tend to be hyper-reactive to environmental stimuli. In addition to the preceding clinical impressions and experiences, the majority of empirical studies in this area have concluded that patients with borderline personality disorder are indeed hyper-responsive to experimental environmental stimuli, whether the stimuli are negative, positive, or even neutral or ambiguous. While two empirical studies did not find hyper-responsiveness, both were undertaken in inpatients with borderline personality disorder, and the potential for emotional blunting from psychotropic medications may have been a potential confound. These findings have several clinical implications in both mental health and primary care settings. PMID:20941347

  18. A further validation of the Minnesota Borderline Personality Disorder Scale.

    PubMed

    Rojas, Elizabeth C; Cummings, Jenna R; Bornovalova, Marina A; Hopwood, Christopher J; Racine, Sarah E; Keel, Pamela K; Sisk, Cheryl L; Neale, Michael; Boker, Steven; Burt, S Alexandra; Klump, Kelly L

    2014-04-01

    Previous research indicates that borderline personality disorder (BPD) is well conceptualized as a dimensional construct that can be represented using normal personality traits. A previous study successfully developed and validated a BPD measure embedded within a normal trait measure, the Minnesota Borderline Personality Disorder Scale (MBPD). The current study performed a further validation of the MBPD by examining its convergent validity, external correlates, and heritability in a sample of 429 female twins. The MBPD correlated strongly with the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II) screener for BPD and moderately with external correlates. Moreover, the MBPD and SCID-II screener exhibited very similar patterns of external correlations. Additionally, results indicated that the genetic and environmental influences on MBPD overlap with the genetic and environmental influences on the SCID-II screener, which suggests that these scales are measuring the same construct. These data provide further evidence for the construct validity of the MBPD. PMID:24364505

  19. Pearls for Working with People Who Have Personality Disorder Diagnoses.

    PubMed

    Combs, Gene; Oshman, Lauren

    2016-06-01

    Personality disorders are a group of diagnostic categories applicable when people show personality traits that are so extreme they cause clear difficulties in their lives and relationships. More widespread agreement is found on sorting by three broad categories (odd/eccentric, dramatic/emotional/erratic, and anxious/fearful) than by more specific subtypes. Primary care physicians need to recognize when extreme personality traits are causing difficulties in their relationships with patients and to have a way to approach these difficulties when they arise. This article reviews current thinking on the diagnosis and treatment of personality disorders, focusing especially on dramatic/emotional/erratic disorders, which are those most often problematic in clinical settings. PMID:27262006

  20. [Instability of personality characteristics and personality disorders during the lifespan: effects for assessment in older adults].

    PubMed

    Tummers, J H A; Derksen, J L L; van Alphen, S P J

    2010-04-01

    The instability of personality characteristics and personality disorders during the lifespan is the topic of this literature search. It concerns the effects of this instability for personality assessment in older adults. Five longitudinal studies, based on the Big Five model of Costa & McCrae, support the hypothesis that personality characteristics change during the lifespan. Neuroticism, extraversion and openness decrease with age. In contrast, altruism and conscientiousness increase with age. One longitudinal and three cross-sectional studies of personality pathology indicate age-specific changes in the expression of (mal) adaptive personality characteristics. Besides that, nearly one third of the DSM criteria for Axis II personality disorders are insufficiently applicable to older people, based on a large cross sectional study. Therefore the temporal instability of personality characteristics and the limited validity of the Axis II criteria complicate personality assessment in older adults. Improvements could be found in major standardization studies of personality questionnaires in elderly patients in mental health care and nursing home care. Significant changes in the DSM, such as the development of an age specific and multidimensional approach to personality disorders is also recommended. PMID:20443285

  1. Elevated expectancies among persons diagnosed with bipolar disorder

    PubMed Central

    Johnson, Sheri L.; Eisner, Lori R.; Carver, Charles S.

    2010-01-01

    Objective Students at risk for bipolar disorder endorse highly ambitious goals. This study examined expectations for the future among people with actual bipolar disorder, versus people with no history of mood disorder and persons with history of unipolar depression. Methods One hundred and three students were assessed for Axis I disorders and completed a measure of expected life outcomes. Results History of mania, but not history of depression, related to higher expectations of achieving popular fame and wealth. Conclusions People with history of mania anticipate great success in domains involving public recognition. PMID:19254445

  2. Personality Disorders in Later Life: Questions about the Measurement, Course, and Impact of Disorders

    PubMed Central

    Oltmanns, Thomas F.; Balsis, Steve

    2011-01-01

    Lifespan perspectives have played a crucial role in shaping our understanding of many forms of psychopathology. Unfortunately, little attention has been given to personality disorders in middle adulthood and later life. Several issues are responsible for this deficiency, including difficulty applying the diagnostic criteria for personality disorders to older people and challenges in identifying appropriate samples of older participants. The goal of this review is to explore the benefits of considering older adults in the study of personality disorders. Later life offers a unique opportunity for investigators to consider links between personality pathology and consequential outcomes in people’s lives. Many domains are relevant, including health, longevity, social adjustment, marital relationships, and the experience of major life events. We review each domain and consider ways in which the study of middle-aged and older adults challenges researchers to evaluate how personality disorders in general are defined and measured. PMID:21219195

  3. Axis I diagnostic comorbidity and borderline personality disorder.

    PubMed

    Zimmerman, M; Mattia, J I

    1999-01-01

    Borderline personality disorder (PD) has been the most studied PD. Research has examined the relationship between borderline PD and most axis I diagnostic classes such as eating disorders, mood disorders, and substance use disorders. However, there is little information regarding the relationship of borderline PD and overall comorbidity with all classes of axis I disorders assessed simultaneously. In the present study, 409 patients were evaluated with semistructured diagnostic interviews for axis I and axis II disorders. Patients with a diagnosis of borderline PD versus those who did not receive the diagnosis were assigned significantly more current axis I diagnoses (3.4 v 2.0). Borderline PD patients were twice as likely to receive a diagnosis of three or more current axis I disorders (69.5% v 31.1%) and nearly four times as likely to have a diagnosis of four or more disorders 147.5% v 13.7%). In comparison to nonborderline PD patients, borderline PD patients more frequently received a diagnosis of current major depressive disorder (MDD), bipolar I and II disorder, panic disorder with agoraphobia, social and specific phobia, posttraumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), eating disorder NOS, and any somatoform disorder. Similar results were observed for lifetime diagnoses. Overall, borderline PD patients were more likely to have multiple axis I disorders than nonborderline PD patients, and the differences between the two groups were present across mood, anxiety, substance use, eating, and somatoform disorder categories. These findings highlight the importance of performing thorough evaluations of axis I pathology in patients with borderline PD in order not to overlook syndromes that are potentially treatment-responsive. PMID:10428182

  4. Attachment and social cognition in borderline personality disorder: Specificity in relation to antisocial and avoidant personality disorders.

    PubMed

    Beeney, Joseph E; Stepp, Stephanie D; Hallquist, Michael N; Scott, Lori N; Wright, Aidan G C; Ellison, William D; Nolf, Kimberly A; Pilkonis, Paul A

    2015-07-01

    Theory and research point to the role of attachment difficulties in borderline personality disorder (BPD). Attachment insecurity is believed to lead to chronic problems in social relationships, attributable, in part, to impairments in social cognition, which comprise maladaptive mental representations of self, others, and self in relation to others. However, few studies have attempted to identify social-cognitive mechanisms that link attachment insecurity to BPD and to assess whether such mechanisms are specific to the disorder. For the present study, empirically derived indices of mentalization, self-other boundaries, and identity diffusion were tested as mediators between attachment style and personality disorder symptoms. In a cross-sectional structural equation model, mentalization and self-other boundaries mediated the relationship between attachment anxiety and BPD. Mentalization partially mediated the relationship between attachment anxiety and antisocial personality disorder (PD) symptoms, and self-other boundaries mediated the relationship between attachment anxiety. PMID:25705979

  5. Positive affective and cognitive states in borderline personality disorder.

    PubMed

    Reed, Lawrence Ian; Zanarini, Mary C

    2011-12-01

    The aim of the current study was to compliment previous studies identifying negative states present in borderline personality disorder (BPD) by investigating the presence of positive affective and cognitive states. Ninety-six patients with criteria-defined borderline personality disorder and 24 axis II comparison participants completed the Positive Affect Scale, a 50-item self-report measure designed to assess positive states thought to be characteristic of and discriminating for BPD. Seventeen positive states (4 affective, 10 cognitive, and 3 mixed) were found to be significantly more common among axis II comparison participants than borderline patients. Twelve of these states were common to both borderline patients and axis II comparison participants. Furthermore, four positive states, when co-occurring together, were particularly strongly associated with borderline personality disorder (three negatively and one positively): (a) Fond of myself, (b) That things around me are real, (c) That I've forgiven others, and (d) Assertive. Finally, the overall mean score on the PAS significantly distinguished patients with borderline personality disorder from axis II comparison participants. Taken together, these results suggest that borderline patients are far less likely to report experiencing positive states of an affective, cognitive, and mixed nature than axis II comparison participants. They also suggest that being assertive is a positive state particularly discriminating for borderline personality disorder. PMID:22217230

  6. An approach to the psychobiology of personality disorders.

    PubMed

    Posner, Michael I; Rothbart, Mary K; Vizueta, Nathalie; Thomas, Kathleen M; Levy, Kenneth N; Fossella, John; Silbersweig, David; Stern, Emily; Clarkin, John; Kernberg, Otto

    2003-01-01

    Human variability in temperament allows a unique natural experiment where reactivity, self-regulation, and experience combine in complex ways to produce an individual personality. Personality disorders may result from changes in the way past memories filter new information in situations of emotional involvement with others. According to this view, disorders are specific to their initiating circumstances rather than a general difficulty that might extend to classes of information processing remote from triggers for the disorder. A different view suggests a more general deficit in attentional control mechanisms that might extend to a wide range of situations far from those related to the core abnormality. This paper outlines methods for examining these views and presents data from the study of borderline personality disorder, arguing in favor of high negative emotionality being combined with a deficit in an executive attentional control network. Because this attentional network has already been well described in terms of anatomy, the cognitive operations involved, development, chemical modulators, and effects of lesions and candidate genes, these findings may have implications for understanding the disorder and its treatment. We consider these implications in terms of a general approach to the study of personality development and its disorders. PMID:14984139

  7. Borderline Personality Disorder and Personality Traits: A Comparison of SCID-II BPD and NEO-PI.

    ERIC Educational Resources Information Center

    Clarkin, John F.; And Others

    1993-01-01

    Hospitalized female patients with borderline personality disorder were assessed for Axis II disorders by the Structured Clinical Inventory for the Diagnostic and Statistical Manual of Mental Disorders (SCID-II) and for personality traits with the NEO Personality Inventory. The relationship of results to social adjustment and the utility of…

  8. Problematic boundaries in the diagnosis of bipolar disorder: the interface with borderline personality disorder.

    PubMed

    Zimmerman, Mark; Morgan, Theresa A

    2013-12-01

    It is clinically important to recognize both bipolar disorder and borderline personality disorder (BPD) in patients seeking treatment for depression, and it is important to distinguish between the two. The most studied question on the relationship between BPD and bipolar disorder is their diagnostic concordance. Across studies approximately 10 % of patients with BPD had bipolar I disorder and another 10 % had bipolar II disorder. Likewise, approximately 20 % of bipolar II patients were diagnosed with BPD, though only 10 % of bipolar I patients were diagnosed with BPD. While the comorbidity rates are substantial, each disorder is, nonetheless, diagnosed in the absence of the other in the vast majority of cases (80-90 %). In studies examining personality disorders broadly, other personality disorders were more commonly diagnosed in bipolar patients than was BPD. Likewise, the converse is also true: other axis I disorders such as major depression, substance abuse, and post-traumatic stress disorder are more commonly diagnosed in patients with BPD than is bipolar disorder. Studies comparing patients with BPD and bipolar disorder find significant differences on a range of variables. These findings challenge the notion that BPD is part of the bipolar spectrum. While a substantial literature has documented problems with the under-recognition and under-diagnosis of bipolar disorder, more recent studies have found evidence of bipolar disorder over-diagnosis and that BPD is a significant contributor to over-diagnosis. Re-conceptualizing the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, diagnostic criteria for bipolar disorder as a type of test, rather than the final word on diagnosis, shifts the diagnostician from thinking solely whether a patient does or does not have a disorder to considering the risks of false-positive and false-negative diagnoses, and the ease by which each type of diagnostic error can be corrected by longitudinal observation

  9. The relation between attachment, personality, internalizing, and externalizing dimensions in adolescents with borderline personality disorder.

    PubMed

    Ramos, Vera; Canta, Guilherme; de Castro, Filipa; Leal, Isabel

    2016-01-01

    The relation between attachment and personality features is an important field to explore in adolescent borderline personality disorder (BPD), and previous research has shown that personality features may be conceptualized within latent internalizing and externalizing dimensions. This cross-sectional study used a structural equation model to examine the association between the BPD participants' perception of attachment and personality features, mediated by the underlying internalizing/externalizing personality dimensions. Data were analyzed for 60 adolescents, ages 15 to 18 years, diagnosed with BPD who completed attachment and personality self-report measures. The authors' results showed a good fit of the model, suggesting a significant association between attachment and the internalizing/externalizing dimensions, which simultaneously congregate and influence personality traits. The perception of attachment anxiety was positively related to the internalizing dimension and at the same time negatively related to the externalizing dimension. However, the perception of attachment avoidance was not related to internalizing or externalizing personality dimensions. PMID:27583810

  10. Avoidant personality disorder is a separable schizophrenia-spectrum personality disorder even when controlling for the presence of paranoid and schizotypal personality disorders The UCLA family study.

    PubMed

    Fogelson, D L; Nuechterlein, K H; Asarnow, R A; Payne, D L; Subotnik, K L; Jacobson, K C; Neale, M C; Kendler, K S

    2007-03-01

    It is unresolved whether avoidant personality disorder (APD) is an independent schizophrenia (Sz)-spectrum personality disorder (PD). Some studies find APD and social anxiety symptoms (Sxs) to be separable dimensions of psychopathology in relatives (Rels) of schizophrenics while other studies find avoidant Sxs to be correlated with schizotypal and paranoid Sxs. Rates of APD among first-degree Rels of Sz probands, attention-deficit/hyperactivity disorder (ADHD) probands, and community control (CC) probands were examined. Further analyses examined rates when controlling for the presence of schizotypal (SPD) and paranoid (PPD) personality disorders, differences in APD Sxs between relative groups, and whether APD in Rels of Szs reflects a near miss for another Sz-spectrum PD. Three hundred sixty-two first-degree Rels of Sz probands, 201 relatives of ADHD probands, and 245 Rels of CC probands were interviewed for the presence of DSM-III-R Axis I and II disorders. Diagnoses, integrating family history, interview information, and medical records, were determined. APD occurred more frequently in Rels of Sz probands compared to CC probands (p<0.001) and also when controlling for SPD and PPD (p<0.005). Two Sxs of APD were most characteristic of the Rels of Sz probands: "avoids social or occupational activities..." and "exaggerates the potential difficulties..." 65% of the Rels of Sz probands who had diagnoses of APD were more than one criterion short of a DSM-III-R diagnosis of either SPD or PPD. This indicates that APD is a separate Sz-spectrum disorder, and not merely a sub-clinical form of SPD or PPD. PMID:17306508

  11. Avoidant Personality Disorder is a Separable Schizophrenia Spectrum Personality Disorder even when Controlling for the Presence of Paranoid and Schizotypal Personality Disorders

    PubMed Central

    Fogelson, D. L.; Nuechterlein, K. H.; Asarnow, R. A.; Payne, D. L.; Subotnik, K. L.; Jacobson, K. C.; Neale, M. C.; Kendler, K. S.

    2007-01-01

    It is unresolved whether avoidant personality disorder (APD) is an independent schizophrenia (Sz)-spectrum personality disorder (PD). Some studies find APD and social anxiety symptoms (Sxs) to be a separable dimension of psychopathology in relatives (Rels) of schizophrenics while other studies find avoidant Sxs to be correlated with schizotypal and paranoid Sxs. Rates of APD among first degree Rels of Sz probands, attention-deficit/hyperactivity disorder (ADHD) probands, and community control (CC) probands were examined. Further analyses examined rates when controlling for the presence of schizotypal (SPD) and paranoid (PPD) personality disorders, differences in APD Sxs between relative groups, and whether APD in Rels of Szs reflects a near miss for another Sz-spectrum PD. 362 first degree Rels of Sz probands, 201 relatives of ADHD probands, and 245 Rels of CC probands were interviewed for the presence of DSM-III-R Axis I and II disorders. Diagnoses, integrating family history, interview information, and medical records, were determined. APD occurred more frequently in Rels of Sz probands compared to CC probands (p<.001) and also when controlling for SPD and PPD (p<.005). Two Sxs of APD were most characteristic of the Rels of Sz probands: “avoids social or occupational activities…” and “exaggerates the potential difficulties…” 65% of the Rels of Sz probands who had diagnoses of APD were more than one criterion short of a DSM-III-R diagnosis of either SPD or PPD. This indicates that APD is a separate Sz-spectrum disorder, and not merely a sub-clinical form of SPD or PPD. PMID:17306508

  12. PERSONALITY DISORDER RESEARCH AGENDA FOR THE DSM–V

    PubMed Central

    Widiger, Thomas A.; Simonsen, Erik; Krueger, Robert; Livesley, W. John; Verheul, Roel

    2008-01-01

    The American Psychiatric Association is sponsoring a series of international conferences to set a research agenda for the development of the next edition of the diagnostic manual. The first conference in this series, “Dimensional Models of Personality Disorder: Etiology, Pathology, Phenomenology, & Treatment,” was devoted to reviewing the existing research and setting a future research agenda that would be most effective in leading the field toward a dimensional classification of personality disorder. The purpose of this article, authored by the Steering Committee of this conference, was to provide a summary of the conference papers and their recommendations for research. Covered herein are the reviews and recommendations concerning alternative dimensional models of personality disorder, behavioral genetics and gene mapping, neurobiological mechanisms, childhood antecedents, cross–cultural issues, Axes I and II continuity, coverage and cutoff points for diagnosis, and clinical utility. PMID:16175740

  13. Parental qualities as perceived by borderline personality disorders.

    PubMed

    Goldberg, R L; Mann, L S; Wise, T N; Segall, E A

    1985-01-01

    This study explores the contribution of parental qualities to the borderline personality disorder. The Parental Bonding Inventory is used to compare four parental qualities (caring mother, caring father, overprotective father, and overprotective mother) across three groups (borderline personality disorders, assorted psychiatric controls and normal controls). The major finding was that the borderline patients perceived their parents to be significantly less caring and more overprotective than both the psychiatric control or nonclinical control groups. This study was verified previous reports that patients diagnosed with an affective illness (in either the borderline group or psychiatric control group) reported no significant differences on the inventory. Pinpointing parental characteristics which antecede mental disorders may be an important first step in devising primary preventive interventions for adult disorders. PMID:4077030

  14. Preliminary study of relationships between hypnotic susceptibility and personality disorder functioning styles in healthy volunteers and personality disorder patients

    PubMed Central

    2011-01-01

    Background Hypnotic susceptibility is one of the stable characteristics of individuals, but not closely related to the personality traits such as those measured by the five-factor model in the general population. Whether it is related to the personality disorder functioning styles remains unanswered. Methods In 77 patients with personality disorders and 154 healthy volunteers, we administered the Stanford Hypnotic Susceptibility Scale: Form C (SHSSC) and the Parker Personality Measure (PERM) tests. Results Patients with personality disorders showed higher passing rates on SHSSC Dream and Posthypnotic Amnesia items. No significant correlation was found in healthy volunteers. In the patients however, SHSSC Taste hallucination (β = 0.26) and Anosmia to Ammonia (β = -0.23) were significantly correlated with the PERM Borderline style; SHSSC Posthypnotic Amnesia was correlated with the PERM Schizoid style (β = 0.25) but negatively the PERM Narcissistic style (β = -0.23). Conclusions Our results provide limited evidence that could help to understand the abnormal cognitions in personality disorders, such as their hallucination and memory distortions. PMID:21801440

  15. The treatment of personality-disordered offenders in Germany.

    PubMed

    Trestman, Robert L; Eucker, Sabine; Müller-Isberner, Rüdiger

    2007-01-01

    Offenders with mental illness challenge forensic systems throughout the world. Those with personality disorders present additional challenges. In this article, the authors describe relevant German legislation and the consequent forensic treatment of personality-disordered offenders in the German psychiatric and correctional systems, with a focus on the German state of Hessen. The development of laws and regulations are addressed, as are the parallels and distinctions between forensic hospitals and correctional settings. Current treatment approaches and programs are described. Research initiatives and future directions for the system, and comparisons with the system in the United States conclude the article. PMID:17592169

  16. Treatment issues for personality disorders in epilepsy.

    PubMed

    Trimble, Michael

    2013-03-01

    This article supports a view that certain personality disturbances in epilepsy should be viewed as associated with the cerebral abnormalities that also lead to seizures. Herein I discuss two main variants: that related to temporal lobe epilepsy and that associated with juvenile myoclonic epilepsy. In view of its controversial nature, I also comment on the link between aggression and epilepsy. Recommendations for treatment include psychological and social therapies with further advice about the use of antiepileptic drugs (AEDs) and psychotropic medications in these conditions. PMID:23458465

  17. Diagnosis of antisocial personality disorder and criminal responsibility.

    PubMed

    Spaans, Marleen; Barendregt, Marko; Haan, Bernadette; Nijman, Henk; de Beurs, Edwin

    2011-01-01

    The present study empirically investigates whether personality disorders and psychopathic traits in criminal suspects are reasons for diminished criminal responsibility or enforced treatment in high security hospitals. Recently, the tenability of the claim that individuals with personality disorders and psychopathy can be held fully responsible for crimes has been questioned on theoretical bases. According to some interpretations, these disorders are due to cognitive, biological and developmental deficits that diminish the individual's accountability. The current article presents two studies among suspects of serious crimes under forensic evaluation in a Dutch forensic psychiatric observation clinic. The first study examined how experts weigh personality disorders in their conclusions as far as the degree of criminal responsibility and the need for enforced forensic psychiatric treatment are concerned (n=843). The second study investigated associations between PCL-R scores and experts' responsibility and treatment advisements (n=108). The results suggest that in Dutch forensic practice, the presence of a personality disorder decreased responsibility and led to an advice for enforced forensic treatment. Experts also take characteristics of psychopathy concerning impulsivity and (ir)responsibility into consideration when judging criminal accountability. Furthermore, they deem affective deficiencies sufficiently important to indicate suspects' threat to society or dangerousness and warrant a need for forensic treatment. PMID:21903271

  18. Personality disorders and violence: what is the link?

    PubMed

    Howard, Richard

    2015-01-01

    Despite a well-documented association between personality disorders (PDs) and violence, the relationship between them is complicated by the high comorbidity of mental disorders, the heterogeneity of violence (particularly in regard to its motivation), and differing views regarding the way PDs are conceptualised and measured. In particular, it remains unclear whether there is a causal relationship between PDs and violence, and what the psychological mechanisms might be that mediate such a relationship. Here, a perspective on PD and violence is offered that views the relationship between them through the lenses of the Five Factor Model of personality and a quadripartite typology of violence. Evidence is reviewed suggesting that emotion dysregulation/impulsiveness, psychopathy, and delusional ideation conjointly contribute to the increased risk of violence shown by people with PD, and do so by contributing to a broad severity dimension of personality dysfunction. This view is consistent with the abandonment of personality disorder categories in the forthcoming eleventh edition of the International Classification of Diseases (ICD-11), where severity of personality disorder is defined in terms of the degree of harm to self and others. PMID:26401314

  19. Personality disorder in DSM-5: an oral history.

    PubMed

    Zachar, P; Krueger, R F; Kendler, K S

    2016-01-01

    As the revision process leading to DSM-5 began, the domain of personality disorder embodied the highest aspirations for major change. After an initial prototype-based proposal failed to gain acceptance, the Personality and Personality Disorders Work Group (P&PDWG) developed a hybrid model containing categorical and dimensional components. A clash of perspectives both within the P&PDWG and between the P&PDWG and DSM-5 oversight committees led to the rejection of this proposal from the main body of DSM-5. Major issues included conflicting ways of conceptualizing validation, differences of opinion from personality disorder experts outside the P&PDWG, divergent concepts of the magnitude of evidence needed to support substantial changes, and the disagreements about clinical utility of the hybrid model. Despite these setbacks, the 'Alternative DSM-5 Model of Personality Disorder' is presented in Section III of the DSM-5. Further research should clarify its performance relative to the DSM-IV criteria reprinted in the main DSM-5 text. PMID:26482368

  20. Attention-deficit/hyperactivity disorder: a personal perspective.

    PubMed

    Ginsberg, Michael L

    2008-08-01

    Children with ADHD can achieve academic and personal success in adulthood. In this article the author shares personal perspectives on his own struggles with ADHD as a child and shares insights, tips, and anecdotes from his own life. These insights, when viewed in light of the scientific literature regarding ADHD, offer new directions for research into the management of the disorder in children and adolescents. PMID:18822837

  1. Five-factor model personality traits in opioid dependence

    PubMed Central

    Kornør, Hege; Nordvik, Hilmar

    2007-01-01

    Background Personality traits may form a part of the aetiology of opioid dependence. For instance, opioid dependence may result from self-medication in emotionally unstable individuals, or from experimenting with drugs in sensation seekers. The five factor model (FFM) has obtained a central position in contemporary personality trait theory. The five factors are: Neuroticism, Extraversion, Openness to Experience, Agreeableness and Conscientiousness. Few studies have examined whether there is a distinct personality pattern associated with opioid dependence. Methods We compared FFM personality traits in 65 opioid dependent persons (mean age 27 years, 34% females) in outpatient counselling after a minimum of 5 weeks in buprenorphine replacement therapy, with those in a non-clinical, age- and sex-matched sample selected from a national database. Personality traits were assessed by a Norwegian version of the Revised NEO Personality Inventory (NEO PI-R), a 240-item self-report questionnaire. Cohen's d effect sizes were calculated for the differences in personality trait scores. Results The opioid-dependent sample scored higher on Neuroticism, lower on Extraversion and lower on Conscientiousness (d = -1.7, 1.2 and 1.7, respectively) than the controls. Effects sizes were small for the difference between the groups in Openness to experience scores and Agreeableness scores. Conclusion We found differences of medium and large effect sizes between the opioid dependent group and the matched comparison group, suggesting that the personality traits of people with opioid dependence are in fact different from those of non-clinical peers. PMID:17683593

  2. Cladistic association analysis of Y chromosome effects on alcohol dependence and related personality traits

    PubMed Central

    Kittles, Rick A.; Long, Jeffrey C.; Bergen, Andrew W.; Eggert, Monica; Virkkunen, Matti; Linnoila, Markku; Goldman, David

    1999-01-01

    Association between Y chromosome haplotype variation and alcohol dependence and related personality traits was investigated in a large sample of psychiatrically diagnosed Finnish males. Haplotypes were constructed for 359 individuals using alleles at eight loci (seven microsatellite loci and a nucleotide substitution in the DYZ3 alphoid satellite locus). A cladogram linking the 102 observed haplotype configurations was constructed by using parsimony with a single-step mutation model. Then, a series of contingency tables nested according to the cladogram hierarchy were used to test for association between Y haplotype and alcohol dependence. Finally, using only alcohol-dependent subjects, we tested for association between Y haplotype and personality variables postulated to define subtypes of alcoholism—antisocial personality disorder, novelty seeking, harm avoidance, and reward dependence. Significant association with alcohol dependence was observed at three Y haplotype clades, with significance levels of P = 0.002, P = 0.020, and P = 0.010. Within alcohol-dependent subjects, no relationship was revealed between Y haplotype and antisocial personality disorder, novelty seeking, harm avoidance, or reward dependence. These results demonstrate, by using a fully objective association design, that differences among Y chromosomes contribute to variation in vulnerability to alcohol dependence. However, they do not demonstrate an association between Y haplotype and the personality variables thought to underlie the subtypes of alcoholism. PMID:10097188

  3. Cladistic association analysis of Y chromosome effects on alcohol dependence and related personality traits.

    PubMed

    Kittles, R A; Long, J C; Bergen, A W; Eggert, M; Virkkunen, M; Linnoila, M; Goldman, D

    1999-03-30

    Association between Y chromosome haplotype variation and alcohol dependence and related personality traits was investigated in a large sample of psychiatrically diagnosed Finnish males. Haplotypes were constructed for 359 individuals using alleles at eight loci (seven microsatellite loci and a nucleotide substitution in the DYZ3 alphoid satellite locus). A cladogram linking the 102 observed haplotype configurations was constructed by using parsimony with a single-step mutation model. Then, a series of contingency tables nested according to the cladogram hierarchy were used to test for association between Y haplotype and alcohol dependence. Finally, using only alcohol-dependent subjects, we tested for association between Y haplotype and personality variables postulated to define subtypes of alcoholism-antisocial personality disorder, novelty seeking, harm avoidance, and reward dependence. Significant association with alcohol dependence was observed at three Y haplotype clades, with significance levels of P = 0.002, P = 0.020, and P = 0.010. Within alcohol-dependent subjects, no relationship was revealed between Y haplotype and antisocial personality disorder, novelty seeking, harm avoidance, or reward dependence. These results demonstrate, by using a fully objective association design, that differences among Y chromosomes contribute to variation in vulnerability to alcohol dependence. However, they do not demonstrate an association between Y haplotype and the personality variables thought to underlie the subtypes of alcoholism. PMID:10097188

  4. Neurocognitive deficits in borderline personality disorder: implications for treatment.

    PubMed

    Judd, Patricia A

    2012-03-01

    The cognitive dimension of Borderline Personality Disorder has received relatively little attention in the clinical literature and is poorly understood. This article illustrates how a range of cognitive problems including attention deficit disorder and learning disabilities may contribute to the cognitive disturbances identified in the disorder including dissociation, paranoia, all or nothing thinking, overvalued ideas, and denial and splitting. A review of relevant research supporting the presence of cognitive deficits is summarized along with a developmental pathway for the expression of the cognitive dimension. Clinical examples are provided. Recommendations for inclusion of assessment and treatment strategies that address cognitive deficits within a psychodynamically based psychotherapy are discussed. PMID:23006031

  5. Do people with borderline personality disorder complicated by antisocial personality disorder benefit from the STEPPS treatment program?

    PubMed

    Black, Donald W; Simsek-Duran, Fatma; Blum, Nancee; McCormick, Brett; Allen, Jeff

    2016-08-01

    Systems Training for Emotional Predictability and Problem Solving (STEPPS) is a group treatment for persons with borderline personality disorder (BPD). We describe results from two data sets on outcome in persons who participated in STEPPS with BPD alone or BPD plus antisocial personality disorder (ASPD). In Study 1, we examined the effect of comorbid ASPD on outcome in 65 persons with BPD who participated in a randomized controlled trial at an academic medical centre. In Study 2, we examined the effect of comorbid ASPD on outcome in 64 offenders with BPD who participated in STEPPS in correctional settings. All subjects were assessed for the presence of BPD and ASPD. In Study 1, subjects with ASPD experienced greater improvement in BPD symptoms, impulsiveness and global symptoms. In Study 2, offenders with ASPD experienced greater improvement in positive and negative behaviours and positive affectivity. We conclude that persons with BPD plus ASPD benefit from STEPPS in community and correctional settings. The findings suggest that persons with BPD plus ASPD show greater improvement in some domains than persons with BPD only. People with ASPD should not be automatically excluded from participation in the program. Copyright © 2015 John Wiley & Sons, Ltd. PMID:26671625

  6. Aggression, Impulsivity, and Psychopathic Traits in Combined Antisocial Personality Disorder and Substance Use Disorder

    PubMed Central

    Alcorn, Joseph L.; Gowin, Joshua L.; Green, Charles E.; Swann, Alan C.; Moeller, F. Gerard; Lane, Scott D.

    2015-01-01

    Aggression, impulsivity, and psychopathic traits are prominent in both antisocial personality disorder (ASPD) and substance use disorders (SUD), but have rarely been examined collectively. The authors' results show that all three variables were elevated in adults with comorbid ASPD/SUD, relative to SUD-only and control subjects. PMID:24026715

  7. Modified Therapeutic Community Treatment for Offenders with MICA Disorders: Antisocial Personality Disorder and Treatment Outcomes

    ERIC Educational Resources Information Center

    McKendrick, Karen; Sullivan, Christopher; Banks, Steven; Sacks, Stanley

    2006-01-01

    Treatment outcomes 1 year after release from prison were compared for two subgroups of male inmates with co-occurring serious mental illness and chemical abuse (MICA) disorders, those with a diagnosis for Antisocial Personality Disorder (APD), and those without a diagnosis of APD. The foundation study had randomly assigned inmates to either…

  8. CAPs-IDD: Characteristics of Assessment Instruments for Psychiatric Disorders in Persons with Intellectual Developmental Disorders

    ERIC Educational Resources Information Center

    Zeilinger, E. L.; Nader, I. W.; Brehmer-Rinderer, B.; Koller, I.; Weber, G.

    2013-01-01

    Background: Assessment of psychiatric disorders in persons with an intellectual developmental disorder (IDD) can be performed with a variety of greatly differing instruments. This makes the choice of an instrument best suited for the intended purpose challenging. In this study, we developed a comprehensive set of characteristics for the evaluation…

  9. Childhood Sexual Abuse and Borderline Personality Disorder in the Eating Disorders.

    ERIC Educational Resources Information Center

    Waller, Glenn

    1994-01-01

    Examination of 115 women with eating disorders revealed a secondary diagnosis of borderline personality disorder associated with a history of childhood sexual abuse. A model involving background features, precipitants, and immediate and long-term psychological consequences is suggested to explain the link to childhood abuse, and implications for…

  10. Discourse Cohesion in the Verbal Interactions of Individuals Diagnosed with Autistic Disorder or Schizotypal Personality Disorder.

    ERIC Educational Resources Information Center

    Baltaxe, Christiane A. M.; And Others

    1995-01-01

    This study compared high functioning adolescents and young adults with autism (n=8) or schizotypal personality disorder (n=9) in use of social language referencing. Both groups had similar rates, types, and patterns of cohesive reference errors, though subjects with schizotypal disorder used cohesive ties of reference more often and more correctly…

  11. Personal Space Regulation in Childhood Autism Spectrum Disorders

    PubMed Central

    Gessaroli, Erica; Santelli, Erica; di Pellegrino, Giuseppe; Frassinetti, Francesca

    2013-01-01

    People appropriately adjust the distance between themselves and others during social interaction, and they may feel discomfort and move away when another person intrudes on their personal space. In the present study, we investigated personal space in children with persistent difficulties in the domain of social behavior, such as children with autism spectrum disorders (ASD), and in children with typical development (TD). The stop-distance paradigm was used to derive estimates of interpersonal distance, before and after a brief interaction with an unfamiliar adult confederate. The results showed that ASD children felt comfortable at a greater distance compared to TD children. Moreover, personal space shrunk after interaction with the confederate in TD children, but it failed to do so in ASD children. These findings reveal that autism deeply affects the regulation of personal space, influencing both its size and flexibility. PMID:24086410

  12. The Relationship between Attachment Status and Personality Disorders.

    ERIC Educational Resources Information Center

    Hopper, Melissa T.

    This research paper provides information that would be useful to practicing counselors and counselors in training. It reviews the relevant research pertaining to the relationship between attachment status and personality disorders. It also critiques methodological issues, including major assessment instruments and frequently used research designs.…

  13. Transactional processes in the development of adult personality disorder symptoms.

    PubMed

    Carlson, Elizabeth A; Ruiz, Sarah K

    2016-08-01

    The development of adult personality disorder symptoms, including transactional processes of relationship representational and behavioral experience from infancy to early adolescence, was examined using longitudinal data from a risk sample (N = 162). Significant preliminary correlations were found between early caregiving experience and adult personality disorder symptoms and between representational and behavioral indices across time and adult symptomatology. Significant correlations were also found among diverse representational assessments (e.g., interview, drawing, and projective narrative) and between concurrent representational and observational measures of relationship functioning. Path models were analyzed to investigate the combined relations of caregiving experience in infancy; relationship representation and experience in early childhood, middle childhood, and early adolescence; and personality disorder symptoms in adulthood. The hypothesized model representing interactive contributions of representational and behavioral experience represented the data significantly better than competing models representing noninteractive contributions. Representational and behavioral indicators mediated the link between early caregiving quality and personality disorder symptoms. The findings extend previous studies of normative development and support an organizational developmental view that early relationship experiences contribute to socioemotional maladaptation as well as adaptation through the progressive transaction of mutually informing expectations and experience. PMID:27427797

  14. Multidimensional Model of Trauma and Correlated Antisocial Personality Disorder

    ERIC Educational Resources Information Center

    Martens, Willem H. J.

    2005-01-01

    Many studies have revealed an important relationship between psychosocial trauma and antisocial personality disorder. A multidimensional model is presented which describes the psychopathological route from trauma to antisocial development. A case report is also included that can illustrate the etiological process from trauma to severe antisocial…

  15. Further Comments toward a Dimensional Classification of Personality Disorder

    ERIC Educational Resources Information Center

    Widiger, Thomas A.; Trull, Timothy J.

    2008-01-01

    Responds to the comments by H. N. Garb (2007) and A. M. Ruscio (2007) on the current authors' original article "Plate tectonics in the classification of personality disorder: Shifting to a dimensional model" (2007). Unable to respond to all of Garb's and Ruscio's concerns given space limitations, the current authors attempt to respond to key…

  16. Antisocial personality disorder, sexual sadism, malignant narcissism, and serial murder.

    PubMed

    Geberth, V J; Turco, R N

    1997-01-01

    This paper examines the research on serial murder and its relationship to antisocial personality disorder and sexual sadism. The concept of malignant narcissism is also discussed. Case studies of serial killers are examined regarding the nature of sexual violation and crime scene behavior. PMID:8988574

  17. A More Unified View of the Multiple Personality Disorder.

    ERIC Educational Resources Information Center

    Kelley, Ronald L.; Kodman, Frank

    1987-01-01

    Offers perspective of Multiple Personality Disorder (MPD) phenomenon based on current clinical experience. Asserts that the Jmind is polypsychic with multitude of psychological systems and processes existing in conjunction with one another, that MPD individuals have fragmented or dissociated ego states due to stress on unity of sense of self, and…

  18. Borderline Personality Disorder: Too Complex for Cognitive Therapy?

    ERIC Educational Resources Information Center

    Pretzer, James L.

    Historically, the literature on psychotherapy with borderline personality disorder has been based on object-relations theory or psychoanalytical approaches, rather than cognitive and behavioral approaches. In clinical assessment, the term borderline has been used to refer to patients with both neurotic and psychotic symptoms, a particular type of…

  19. Borderline Personality Disorder: A Dysregulation of the Endogenous Opioid System?

    ERIC Educational Resources Information Center

    Bandelow, Borwin; Schmahl, Christian; Falkai, Peter; Wedekind, Dirk

    2010-01-01

    The neurobiology of borderline personality disorder (BPD) remains unclear. Dysfunctions of several neurobiological systems, including serotoninergic, dopaminergic, and other neurotransmitter systems, have been discussed. Here we present a theory that alterations in the sensitivity of opioid receptors or the availability of endogenous opioids…

  20. A Chart Review of Schizotypal Personality Disorders in Children.

    ERIC Educational Resources Information Center

    Nagy, Joan; Szatmari, Peter

    1986-01-01

    The literature on the diagnostic validity of schizotypal personality disorders (SPD) in childhood is reviewed, and the results of a chart review of 20 SPD children meeting Diagnostic and Statistical Manual III criteria are presented suggesting that SPD in childhood exists and warrants study. (Author/CB)

  1. Development and Validation of the Minnesota Borderline Personality Disorder Scale

    ERIC Educational Resources Information Center

    Bornovalova, Marina A.; Hicks, Brian M.; Patrick, Christopher J.; Iacono, William G.; McGue, Matt

    2011-01-01

    Although large epidemiological data sets can inform research on the etiology and development of borderline personality disorder (BPD), they rarely include BPD measures. In some cases, however, proxy measures can be constructed using instruments already in these data sets. In this study, the authors developed and validated a self-report measure of…

  2. Borderline Personality Traits and Disorder: Predicting Prospective Patient Functioning

    ERIC Educational Resources Information Center

    Hopwood, Christopher J.; Zanarini, Mary C.

    2010-01-01

    Objective: Decisions about the composition of personality assessment in the "Diagnostic and Statistical Manual of Mental Disorders" (5th ed.; DSM-V) will be heavily influenced by the clinical utility of candidate constructs. In this study, we addressed 1 aspect of clinical utility by testing the incremental validity of 5-factor model (FFM)…

  3. Personality Disorders and Clinical Syndromes in ADHD Prisoners

    ERIC Educational Resources Information Center

    Gudjonsson, Gisli H.; Wells, June; Young, Susan

    2012-01-01

    Objective: The main objective of this article is to investigate the type of personality disorders and clinical syndromes (CSs) that were best related to ADHD symptoms among prisoners. Method: The authors screened for childhood and adult ADHD symptoms and administered the Millon Clinical Multiaxial Inventory-III (MCMI-III) to 196 serving prisoners.…

  4. Is Anakin Skywalker suffering from borderline personality disorder?

    PubMed

    Bui, Eric; Rodgers, Rachel; Chabrol, Henri; Birmes, Philippe; Schmitt, Laurent

    2011-01-30

    Anakin Skywalker, one of the main characters in the "Star Wars" films, meets the criteria for borderline personality disorder (BPD). This finding is interesting for it may partly explain the commercial success of these movies among adolescents and be useful in educating the general public and medical students about BPD symptoms. PMID:20537718

  5. Outdoor Adventure & Eating Disorders: A Personal Perspective to Research.

    ERIC Educational Resources Information Center

    Richards, Kaye

    1999-01-01

    A female outdoor educator who had recovered from anorexia nervosa reflects on the boundaries between her personal and professional identity as she anticipates taking on a research role in adventure-therapy programs. Gender issues in outdoor education are discussed in relation to women's body image and eating disorders. (SV)

  6. Interpersonal Precipitants and Suicide Attempts in Borderline Personality Disorder

    ERIC Educational Resources Information Center

    Brodsky, Beth S.; Groves, Shelly A.; Oquendo, Maria A.; Mann, J. John; Stanley, Barbara

    2006-01-01

    Borderline personality disorder (BPD) is often characterized by multiple low lethality suicide attempts triggered by seemingly minor incidents, and less commonly by high lethality attempts that are attributed to impulsiveness or comorbid major depression. The relationships among life events, impulsiveness, and type of suicidal behavior has hardly…

  7. Empirical evaluation of the MCMI-III personality disorder scales.

    PubMed

    Rossi, Gina; Hauben, Claudia; Van den Brande, Iris; Sloore, Hedwig

    2003-04-01

    The MCMI-III personality disorder scales were empirically validated with a sample of 870 clinical patients and inmates. Prevalence rates of personality disorders were in general lower on the MCMI-III than clinical ratings, but trait prevalence was generally higher; thus a base rate of 75 on the MCMI-III could be a guideline in the screening of trait prevalence. However, the sensitivity of some MCMI-III scales was very low. Moreover, the correlations of most personality disorder scales of the MCMI-III were significant and positive with corresponding measures on clinical ratings and MMPI-2 personality disorder scales, but these were, in general, not significantly higher than some other correlations. As a consequence the discriminant validity seems to be questionable. The MCMI-III alone cannot be used as a diagnostic inventory, but the test could be useful as a screening device as a part of a multimethod approach that allows aggregation over measures in making diagnostic decisions. PMID:12785653

  8. Dream Content Analysis in Persons with an Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Daoust, Anne-Marie; Lusignan, Felix-Antoine; Braun, Claude M. J.; Mottron, Laurent; Godbout, Roger

    2008-01-01

    Dream questionnaires were completed by 28 young adults with autism spectrum disorder (ASD) participants. Seventy-nine typically developed individual served as the control group. In a subset of 17 persons with ASD and 11 controls matched for verbal IQ, dream narratives were obtained following REM sleep awakenings in a sleep laboratory.…

  9. Personality profiles in young adults with disordered eating behavior.

    PubMed

    Raynal, Patrick; Melioli, Tiffany; Chabrol, Henri

    2016-08-01

    Personality traits are closely related to eating disorders (ED) and might be involved in their development and maintenance. Nevertheless little is known regarding the association between personality traits and disordered eating in subclinical populations. College students answered questionnaires assessing disordered eating behaviors (DEB) and the following personality disorder (PD) traits: schizotypal, autistic, obsessional, borderline and cyclothymic. Participants with DEB (n=101, 87% women) displayed significantly higher scores for several variables including schizotypy, cyclothymic, borderline and obsessional traits compared to other participants (n=378). Cluster analysis in the DEB subsample led to the identification of three groups: 1) a cluster with a high level of traits (HT); 2) a cluster scoring high on schizotypal, borderline and cyclothymic traits (SBC); 3) a cluster with a low level of traits (LT). Symptoms of depression, suicidal ideations, trait anger and obsessive-compulsive symptoms were higher in the HT and the SBC clusters compared to the LT cluster. Given that two thirds of participants suffering from DEB appeared to display a morbid personality profile, it appears of prime importance to take into account PD traits of individuals with DEB. PMID:27289047

  10. Are alexithymia and schizoid personality disorder synonymous diagnoses?

    PubMed

    Coolidge, Frederick L; Estey, Alisa J; Segal, Daniel L; Marle, Peter D

    2013-02-01

    Relationships among alexithymia, personality disorders, and higher-order psychopathological and interpersonal dimensions were examined in 199 college students and a close relative of each. Alexithymia, the difficulty to express and identify emotions, was measured by the Observer Alexithymia Scale (OAS; [Haviland, M. G., Warren, W. L., & Riggs, M. L. (2000). An observer scale to measure alexithymia. Psychosomatics, 41, 385-392]), which was completed by each student's relative. Each student completed three self-report measures: the Coolidge Axis II Inventory (CATI; [Coolidge, F. L. (2000). Coolidge Axis II Inventory: Manual. Colorado Springs, CO: Author.), the Five Dimensional Personality Test (5DPT; [van Kampen, D. (2009). Personality and psychopathology: A theory-based revision of Eysenck's PEN model. Clinical Practice and Epidemiology in Mental Health, 5, 9-21]), and the Horney-Coolidge Tridimensional Inventory (HCTI; [Coolidge, F. L. (1998). Horney-Coolidge Tridimensional Inventory: Manual. Colorado Springs, CO: Author]). Results indicated that higher levels of alexithymia are associated with personality disorders and their traits, such as schizoid, avoidant, and paranoid. With regard to the issue of the similarity and difference between alexithymia and schizoid personality disorder, there was sufficient evidence across all of the measures to suggest that they are not synonymous entities. Finally, alexithymic traits were associated with concurrent depressive traits even in a non-clinical sample. PMID:23021894

  11. Informed consent for research in Borderline Personality Disorder

    PubMed Central

    Dew, Rachel E

    2007-01-01

    Background Previous research on informed consent for research in psychiatric patients has centered on disorders that affect comprehension and appreciation of risks. Little has been written about consent to research in those subjects with Borderline Personality Disorder, a prevalent and disabling condition. Discussion Despite apparently intact cognition and comprehension of risks, a borderline subject may deliberately choose self-harm in order to fulfill abnormal psychological needs, or due to suicidality. Alternatively, such a subject may refuse enrollment due to transference or the desire to harm him or herself. Such phenomena could be precipitated or prevented by the interpersonal dynamics of the informed consent encounter. Summary Caution should be exercised in obtaining informed consent for research from subjects with Borderline Personality Disorder. A literature review and recommendations for future research are discussed. PMID:17493277

  12. Altered state and trait disgust in borderline personality disorder.

    PubMed

    Schienle, Anne; Haas-Krammer, Alexandra; Schöggl, Helmut; Kapfhammer, Hans-Peter; Ille, Rottraut

    2013-02-01

    Clinical experience suggests that the emotion disgust plays an important role in borderline personality disorder (BPD). We investigated 30 female patients with BPD and 30 healthy women who answered different measures of trait disgust, specifically disgust proneness, disgust sensitivity, and self-disgust. Moreover, all participants rated affective facial expressions as well as affective scenes according to perceived or elicited basic emotions. The patients with BPD reported elevated trait disgust, especially for the area of self-disgust. They also rated facial expressions of disgust as more intense than did the healthy women but only when the person who displayed this emotion was male. This sex-specific disgust bias was independent of depression and experienced sexual/physical abuse in the clinical group. Altogether, the patients with BPD showed a broad spectrum of altered disgust processes, which was positively correlated with disorder severity. Consequently, the assessment of disgust reactivity should be introduced as a diagnostic tool for this disorder. PMID:23364118

  13. Interpretation bias in Cluster-C and borderline personality disorders.

    PubMed

    Arntz, Arnoud; Weertman, Anoek; Salet, Sjoerd

    2011-08-01

    Cognitive therapy (CT) assumes that personality disorders (PDs) are characterized by interpretational biases that maintain the disorder. Changing interpretations is therefore a major aim of CT of PDs. This study tested whether Borderline PD (BPD), Avoidant and Dependent PD (AV/DEPD), and Obsessive-Compulsive PD (OCPD) are characterized by specific interpretations. Among the 122 participants there were 55 PD patients (17 BPD, 30 AV/DEPD, 29 OCPD diagnoses), 26 axis-1 patients, and 41 nonpatients. Participants put themselves into 10 scripts of negative events and noted feelings, thoughts and behaviors that came to mind. Next, they chose between hypothesized BPD-specific, AV/DEPD-specific, and OCPD-specific interpretations of each event (forced choice). Lastly, participants rated belief in each interpretation. Regression analyses revealed that forced choices and belief ratings supported the CT-model of BPD and AV/DEP: interpretations were specific. The alleged OCPD-beliefs were however not specifically related to OCPD, with relatively high popularity in axis-1 patients and nonpatients. The open responses were classified by judges blind for diagnoses, with the following results. BPD was characterized by low levels of solution-focused and healthy-flexible/accepting responses, and higher levels of criticizing others and malevolent interpretations of others. AV/DEPD was characterized by lower levels of solution-focused responses, and higher levels of self-criticism, negative emotions, guilt and fear of judgment, as well as lower levels of other-criticism. OCPD only showed trends for lower healthy responses, and higher compulsiveness and worry. It is concluded that the assumptions of CT are supported for BPD and AV/DEPD, but not - at least not on the explicit interpretational level - for OCPD. CT of OCPD might need a slightly different approach. PMID:21621746

  14. A Further Validation of the Minnesota Borderline Personality Disorder Scale

    PubMed Central

    Rojas, Elizabeth, E.; Cummings, Jenna, R.; Bornovalova, Marina A.; Hopwood, Christopher J.; Racine, Sarah E.; Keel, Pamela K.; Sisk, Cheryl, L.; Neale, Michael; Boker, Steven; Burt, Alexandra S.; Klump, Kelly L.

    2014-01-01

    Previous research indicates that Borderline Personality Disorder (BPD) is well conceptualized as a dimensional construct that can be represented using normal personality traits. A previous study successfully developed and validated a BPD measure embedded within a normal trait measure, the Minnesota Borderline Personality Disorder Scale (MBPD). The current study performed a further validation of the MBPD by examining its convergent validity, external correlates, and heritability in a sample of 429 female twins. The MBPD correlated strongly with the SCID-II screener for BPD and moderately with external correlates. Moreover, the MBPD and SCID-II screener exhibited very similar patterns of external correlations. Additionally, results indicated that the genetic and environmental influences on MBPD overlap with the genetic and environmental influences on the SCID-II screener, which suggests that these scales are measuring the same construct. This data provide further evidence for the construct validity of the MBPD. PMID:24364505

  15. Daily Interpersonal and Affective Dynamics in Personality Disorder

    PubMed Central

    Wright, Aidan G.C.; Hopwood, Christopher J.; Simms, Leonard J.

    2015-01-01

    In this naturalistic study we adopt the lens of interpersonal theory to examine between-and within-person differences in dynamic processes of daily affect and interpersonal behaviors among individuals (N = 101) previously diagnosed with personality disorders who completed daily diaries over the course of 100 days. Dispositional ratings of interpersonal problems and measures of daily stress were used as predictors of daily shifts in interpersonal behavior and affect in multilevel models. Results indicate that ~40%–50% of the variance in interpersonal behavior and affect is due to daily fluctuations, which are modestly related to dispositional measures of interpersonal problems but strongly related to daily stress. The findings support conceptions of personality disorders as a dynamic form of psychopathology involving the individuals interacting with and regulating in response to the contextual features of their environment. PMID:26200849

  16. Eating disorder detection through personality traits and self-concept.

    PubMed

    Sánchez Guarnido, A J; Herruzo Cabrera, F J; Pino Osuna, M J

    2012-12-01

    The current scientific evidence suggests that certain dimensions of the personality and self-concept act as risk factors of eating disorder (ED). However, there is little investigation that explores the different elements involved in both groups of variables together and in an exhaustive way. Our aim is to be able to discriminate between individuals diagnosed with ED and controls free of symptoms according to these personality traits and selfconcept. To accomplish our objective, the Inventory of Eating Disorders 2 (EDI-2), Inventory of Personality NEO Revised (NEO-PI-R) and Self-Concept Form-5 (AF-5) were administered to a sample composed of 69 cases of ED and 89 controls, and an analysis of logistic regression was carried out. The pattern obtained could correctly classify 96.2% of the people diagnosed with ED and, consistent with the previous research, it should work in the same way to detect people at risk of developing ED in the future. PMID:23221394

  17. [Personality disorders--different outlooks and attempts at their integration].

    PubMed

    Grabski, Bartosz; Gierowski, Józef Krzysztof

    2012-01-01

    The paper presents different approaches to personality disorders. The authors critically discuss the contemporary categorical psychiatrie (medical) classification and also present psychological approaches with the special attention put to personality trait theories and stemming from them the Five Factor Model (FFM). Due to the coming time of the publication of a new revision of the American classification DSM- 5 the detailed description of the proposals for the new system has been presented. The authors included the most updated version which has just recently been published on the DSM-5 APA web site on 11h June 2011. The proposed changes go forward to the voices of critique of present solutions, and create a hybrid system which will incorporate some elements of the dimensional approach to personality disorders. PMID:23394022

  18. The DSM-5 Levels of Personality Functioning and Severity of Iranian Patients With Antisocial and Borderline Personality Disorders

    PubMed Central

    Amini, Mehdi; Pourshahbaz, Abbas; Mohammadkhani, Parvaneh; Khodaie Ardakani, Mohammad Reza; Lotfi, Mozhgan

    2015-01-01

    Background: Fundamental problems with Personality Disorders (PD) diagnostic system in the previous version of DSM, led to the revision of DSM. Therefore, a multidimensional system has been proposed for diagnosis of personality disorder features in DSM-5. In the dimensional approach of DSM-5, personality disorders diagnosis is based on levels of personality functioning (Criteria A) and personality trait domains (Criteria B). Objectives: The purpose of this study was firstly, to examine the DSM-5 levels of personality functioning in antisocial and borderline personality disorders, and second, to explore which levels of personality functioning in patients with antisocial and borderline personality disorders can better predicted severity than others. Patients and Methods: This study had a cross sectional design. The participants consisted of 252 individuals with antisocial (n = 122) and borderline personality disorders (n = 130). They were recruited from Tehran prisoners, and clinical psychology and psychiatry centers of Razi and Taleghani Hospitals, Tehran, Iran. The sample was selected based on judgmental sampling. The SCID-II-PQ, SCID-II and DSM-5 levels of personality functioning were used to diagnose and assess personality disorders. The data were analyzed by correlation and multiple regression analysis. All statistical analyses were performed using the SPSS 16 software. Results: Firstly, it was found that DSM-5 levels of personality functioning have a strong correlation with antisocial and borderline personality symptoms, specially intimacy and self-directedness (P < 0.001). Secondly, the findings showed that identity, intimacy and self-directedness significantly predicted antisocial personality disorder severity (P < 0.0001). The results showed that intimacy and empathy were good predictors of borderline personality disorder severity, as well (P < 0.0001). Conclusions: Overall, our findings showed that levels of personality functioning are a significant

  19. Aberrant functional brain connectome in people with antisocial personality disorder.

    PubMed

    Tang, Yan; Long, Jun; Wang, Wei; Liao, Jian; Xie, Hua; Zhao, Guihu; Zhang, Hao

    2016-01-01

    Antisocial personality disorder (ASPD) is characterised by a disregard for social obligations and callous unconcern for the feelings of others. Studies have demonstrated that ASPD is associated with abnormalities in brain regions and aberrant functional connectivity. In this paper, topological organisation was examined in resting-state fMRI data obtained from 32 ASPD patients and 32 non-ASPD controls. The frequency-dependent functional networks were constructed using wavelet-based correlations over 90 brain regions. The topology of the functional networks of ASPD subjects was analysed via graph theoretical analysis. Furthermore, the abnormal functional connectivity was determined with a network-based statistic (NBS) approach. Our results revealed that, compared with the controls, the ASPD patients exhibited altered topological configuration of the functional connectome in the frequency interval of 0.016-0.031 Hz, as indicated by the increased clustering coefficient and decreased betweenness centrality in the medial superior frontal gyrus, precentral gyrus, Rolandic operculum, superior parietal gyrus, angular gyrus, and middle temporal pole. In addition, the ASPD patients showed increased functional connectivity mainly located in the default-mode network. The present study reveals an aberrant topological organisation of the functional brain network in individuals with ASPD. Our findings provide novel insight into the neuropathological mechanisms of ASPD. PMID:27257047

  20. Aberrant functional brain connectome in people with antisocial personality disorder

    PubMed Central

    Tang, Yan; Long, Jun; Wang, Wei; Liao, Jian; Xie, Hua; Zhao, Guihu; Zhang, Hao

    2016-01-01

    Antisocial personality disorder (ASPD) is characterised by a disregard for social obligations and callous unconcern for the feelings of others. Studies have demonstrated that ASPD is associated with abnormalities in brain regions and aberrant functional connectivity. In this paper, topological organisation was examined in resting-state fMRI data obtained from 32 ASPD patients and 32 non-ASPD controls. The frequency-dependent functional networks were constructed using wavelet-based correlations over 90 brain regions. The topology of the functional networks of ASPD subjects was analysed via graph theoretical analysis. Furthermore, the abnormal functional connectivity was determined with a network-based statistic (NBS) approach. Our results revealed that, compared with the controls, the ASPD patients exhibited altered topological configuration of the functional connectome in the frequency interval of 0.016–0.031 Hz, as indicated by the increased clustering coefficient and decreased betweenness centrality in the medial superior frontal gyrus, precentral gyrus, Rolandic operculum, superior parietal gyrus, angular gyrus, and middle temporal pole. In addition, the ASPD patients showed increased functional connectivity mainly located in the default-mode network. The present study reveals an aberrant topological organisation of the functional brain network in individuals with ASPD. Our findings provide novel insight into the neuropathological mechanisms of ASPD. PMID:27257047

  1. Enhanced emotion-induced amnesia in borderline personality disorder

    PubMed Central

    HURLEMANN, RENÉ; HAWELLEK, BARBARA; MAIER, WOLFGANG; DOLAN, RAYMOND J.

    2009-01-01

    Background Current biological concepts of borderline personality disorder (BPD) emphasize the interference of emotional hyperarousal and cognitive functions. A prototypical example is episodic memory. Pre-clinical investigations of emotion–episodic memory interactions have shown specific retrograde and anterograde episodic memory changes in response to emotional stimuli. These changes are amygdala dependent and vary as a function of emotional arousal and valence. Method To determine whether there is amygdala hyper-responsiveness to emotional stimuli as the underlying pathological substrate of cognitive dysfunction in BPD, 16 unmedicated female patients with BPD were tested on the behavioural indices of emotion-induced amnesia and hypermnesia established in 16 healthy controls. Results BPD patients displayed enhanced retrograde and anterograde amnesia in response to presentation of negative stimuli, while positive stimuli elicited no episodic memory-modulating effects. Conclusion These findings suggest that an amygdala hyper-responsiveness to negative stimuli may serve as a crucial aetiological contributor to emotion-induced cognitive dysfunction in BPD. PMID:17224096

  2. Recovery, as Experienced by Women with Borderline Personality Disorder.

    PubMed

    Larivière, Nadine; Couture, Élise; Blackburn, Catherine; Carbonneau, Manon; Lacombe, Christophe; Schinck, Shella-Ann; David, Pierre; St-Cyr-Tribble, Denise

    2015-12-01

    Studies examining recovery through the service users' perspectives have mainly included persons with schizophrenia or bipolar disorder. Giving voice to those with borderline personality disorder (BPD) would enrich our understanding of recovery, as their specific experiences may bring new dimensions, obstacles and facilitators. The objective of this study was to qualitatively capture the experience of recovery in women with BPD. Participants were women between 18 and 65 years old who had a diagnosis of BPD and completed at least 2 years in a program for persons with BPD. During the first meeting, they produced a picture collage, followed by an interview on their experience of recovery. The second meeting was a phone interview to discuss new thoughts. In addition, their medical records were reviewed. A thematic analysis of the interviews was conducted and organized with the Person-Environment-Occupation model. Although recovery was not the best term to name their experience, they all talked about a process towards stability and wellbeing (n = 12). Dimensions of recovery included, for example, letting go of the past (person), being involved in meaningful activities (occupation) and having healthy relationships (environment). Facilitators included social support and participation in a specialized therapy program. The main obstacle was unstable family relationships. The findings from this study showed similar dimensions to previous recovery studies, new perspectives on certain dimensions, as well as new ones. They also reinforced the importance to incorporate intervention outcomes that target the person with BPD, their social environment and meaningful occupations. PMID:25736797

  3. Personality disorder models and their coverage of interpersonal problems.

    PubMed

    Williams, Trevor F; Simms, Leonard J

    2016-01-01

    Interpersonal dysfunction is a defining feature of personality disorders (PDs) and can serve as a criterion for comparing PD models. In this study, the interpersonal coverage of 4 competing PD models was examined using a sample of 628 current or recent psychiatric patients who completed the NEO Personality Inventory-3 First Half (NEO-PI-3FH; McCrae & Costa, 2007), Personality Inventory for the DSM-5 (PID-5; Krueger et al., 2012), Computerized Adaptive Test of Personality Disorder-Static Form (CAT-PD-SF; Simms et al., 2011), and Structured Clinical Interview for DSM-IV Personality Questionnaire (SCID-II PQ; First, Spitzer, Gibbon, & Williams, 1995). Participants also completed the Inventory of Interpersonal Problems-Short Circumplex (IIP-SC; Soldz, Budman, Demby, & Merry, 1995) to assess interpersonal dysfunction. Analyses compared the severity and style of interpersonal problems that characterize PD models. Previous research with DSM-5 Section II and III models was generally replicated. Extraversion and Agreeableness facets related to the most well defined interpersonal problems across normal-range and pathological traits. Pathological trait models provided more coverage of dominance problems, whereas normal-range traits covered nonassertiveness better. These results suggest that more work may be needed to reconcile descriptions of personality pathology at the level of specific constructs. PMID:26168406

  4. Recent Life Events Preceding Suicide Attempts in a Personality Disorder Sample: Findings from the Collaborative Longitudinal Personality Disorders Study

    ERIC Educational Resources Information Center

    Yen, Shirley; Pagano, Maria E.; Shea, Tracie M.; Grilo, Carlos M.; Gunderson, John G.; Skodol, Andrew E.; McGlashan, Thomas H.; Sanislow, Charles A.; Bender, Donna S.

    2005-01-01

    Few studies have examined the relationship between life events, suicide attempts, and personality disorders (PDs), in spite of the strong associations between PDs and suicidal behavior, and the poor coping strategies often exhibited by these individuals. The authors examined whether participants with PDs who attempted suicide during the first 3…

  5. Ethnicity in Trauma and Psychiatric Disorders: Findings from the Collaborative Longitudinal Study of Personality Disorders

    PubMed Central

    Pérez Benítez, Carlos I.; Yen, Shirley; Shea, M. Tracie; Edelen, Maria O.; Markowitz, John C.; McGlashan, Thomas H.; Ansell, Emily B.; Grilo, Carlos M.; Skodol, Andrew E.; Gunderson, John G.; Morey, Leslie C.

    2013-01-01

    The study’s aims are to explore ethnic differences in rates of adverse childhood experiences and lifetime traumatic events and in rates of psychiatric disorders for patients exposed to similar traumas. Rates of these events and rates of major depressive disorder, posttraumatic stress, substance use, and borderline personality disorders were compared among 506 non-Hispanic Whites (N-HW), 108 Latina(o)s, and 94 African Americans (AA) participating in the Collaborative Longitudinal Personality Disorder Study. We found that Whites reported higher rates of neglect than African Americans and Latina(o)s, higher rates of verbal/emotional abuse than African Americans, and higher rates of accidents and injuries/feared serious injury than Latina(o)s. African Americans had higher rates of seeing someone injured/killed than Whites. No significant interaction was observed between adverse events and ethnicity for mental disorders. PMID:20455250

  6. Attention deficit hyperactivity disorder, reading disability, and personality disorders in a prison population.

    PubMed

    Rasmussen, K; Almvik, R; Levander, S

    2001-01-01

    Attention Deficit Hyperactivity Disorder (ADHD) has long been recognized in children, and for many the disorder persists into adulthood. There is a growing concern that the adults with ADHD who have the least favorable outcome, are among those who end up in prison. The aim of this study was to assess childhood ADHD and its persistence into adulthood among a representative sample of Norwegian prison inmates, as well as personality disorders and reading difficulties, which in previous studies have been linked to ADHD. The results indicate that persistent ADHD is very common among prison inmates. Personality disorders and reading difficulties are also common. Psychiatric comorbidity complicates the diagnosis of ADHD in adults. A greater awareness about ADHD in adults certainly is warranted, especially within the prison system because of the risk of misdiagnosing psychiatric disorders and also the risk of missing a condition possibly amenable to treatment. PMID:11471785

  7. Sex- and Subtype-Related Differences of Personality Disorders (Axis II) and Personality Traits in Persistent ADHD.

    PubMed

    Jacob, Christian P; Gross-Lesch, Silke; Reichert, Susanne; Geissler, Julia; Jans, Thomas; Kittel-Schneider, Sarah; Nguyen, Trang T; Romanos, Marcel; Reif, Andreas; Dempfle, Astrid; Lesch, Klaus-Peter

    2014-02-01

    Objective: Despite growing awareness of adult ADHD and its comorbidity with personality disorders (PDs), little is known about sex- and subtype-related differences. Method: In all, 910 patients (452 females, 458 males) affected with persistent adult ADHD were assessed for comorbid PDs with the Structured Clinical Interview of DSM-IV and for personality traits with the revised NEO personality inventory, and the Tridimensional Personality Questionnaire. Results: The most prevalent PDs were narcissistic PD in males and histrionic PD in females. Affected females showed higher Neuroticism, Openness to Experience, and Agreeableness scores as well as Harm Avoidance and Reward Dependence scores. Narcissistic PD and antisocial PD have the highest prevalence in the H-type, while Borderline PD is more frequent in the C-type. Conclusion: Sex- and subtype-related differences in Axis II disorder comorbidity as well as impairment-modifying personality traits have to be taken into account in epidemiological studies of persistent ADHD. (J. of Att. Dis. XXXX; XX(X) XX-XX). PMID:24510476

  8. [Stalemates and opportunities in the treatment of borderline personality disorder].

    PubMed

    Bouchard, Sébastien

    2010-01-01

    Borderline personality disorder is a serious mental health problem for which one of its main characteristics is significant difficulties in relationships with others. These relational problems have the unfortunate consequence of fostering negative attitudes among mental health professionals and contributing to the stigmatization of people suffering from this disorder. In this article, the author emphasizes the importance of taking into account the parameter of the therapeutic frame within which the feeling of facing a stalemate in the treatment of borderline personality disorder patients occurs. Six general strategies are presented that enable the therapist to limit or hinder the risk of stalemate in treatment. This article then presents the commonalities between treatments teams that tend to feel comfortable and efficacious in their management of borderline personality disorder patients. Finally, a case history is used to illustrate how some stalemates can in fact be seen as opportunities for growth for both the patient and the therapist. In order to avoid the vicious circle of negative interactions with patients already hypersensitive to inconsistencies and rejection, the author concludes by insisting on the necessity that more mental health professional have access to training programs and workshops specifically addressing how to better manage and treat people with BPD. PMID:21761087

  9. Neurological soft signs in homicidal men with antisocial personality disorder.

    PubMed

    Lindberg, Nina; Tani, Pekka; Stenberg, Jan-Henry; Appelberg, Björn; Porkka-Heiskanen, Tarja; Virkkunen, Matti

    2004-11-01

    Neurological soft signs (NSS) are characterized by abnormalities in motor, sensory, and integrative functions. NSS have been regarded as a result of neurodevelopmental dysfunction, and as evidence of a central nervous system defect, resulting in considerable sociopsychological dysfunction. During the last decade there has been growing evidence of brain dysfunction in severe aggressive behavior. As a symptom, aggression overlaps a number of psychiatric disorders, but it is commonly associated with antisocial personality disorder. The aim of the present study was to examine NSS in an adult criminal population using the scale by Rossi et al. [29]. Subjects comprised 14 homicidal men with antisocial personality disorder recruited from a forensic psychiatric examination. Ten age- and gender-matched healthy volunteers as well as eight patients with schizophrenia, but no history of physical aggression, served as controls. The NSS scores of antisocial offenders were significantly increased compared with those of the healthy controls, whereas no significant differences were observed between the scores of offenders and those of patients with schizophrenia. It can be speculated that NSS indicate a nonspecific vulnerability factor in several psychiatric syndromes, which are further influenced by a variety of genetic and environmental components. One of these syndromes may be antisocial personality disorder with severe aggression. PMID:15504651

  10. Therapeutic interaction with an older personality disordered patient.

    PubMed

    Josephs, Lawrence; Sanders, Avihay; Gorman, Bernard S

    2014-06-01

    This study reflects an assessment of the relationship between change in defensive functioning and change in the therapeutic interaction during an eight-year treatment episode of an older personality disordered woman. The patient, Ms. Q, possessed schizoid, avoidant, and depressive personality disorders as well as major depression as assessed by the Millon Clinical Multiaxial Inventory-III (MCMI-III). At the end of the treatment episode, Ms. Q still possessed an avoidant personality disorder and significant depressive personality traits but no longer possessed clinically significant schizoid traits or major depression. Ms. Q made significant positive change in her adaptive defensive functioning as assessed by the Defense Mechanism Rating Scale (DMRS). Through time-series analysis it was discovered that positive change in adaptive defenses was predicted by increases in a specific type of therapeutic interaction as assessed by the Psychotherapy Q Sort (PQS). In this therapeutic interaction the therapist in a didactic and advice-giving manner highlighted the patient's role in a problem in a clear and coherent way that could be perceived as tactless. Time-series analysis revealed a reciprocal relationship in which positive changes in adaptive defenses predicted further increases in that particular quality of therapeutic interaction. PMID:24828587

  11. Personality and Psychiatric Disorders in Women Affected by Polycystic Ovary Syndrome

    PubMed Central

    Scaruffi, Elisabetta; Gambineri, Alessandra; Cattaneo, Stefania; Turra, Jenni; Vettor, Roberto; Mioni, Roberto

    2014-01-01

    Background: Polycystic ovary syndrome (PCOS) is the most prevalent endocrine disorder among fertile women. Studies show reduced quality of life, anxiety, depression, body dissatisfaction, eating disorder, and sexual dysfunction, but the etiology of these disturbs remains still debated. The aim of our study is to verify whether this hyperandrogenic syndrome characterizes a strong psycho(patho)logical personality. Method: Sixty PCOS subjects (mean age 25.8 ± 4.7 years) were evaluated by anthropometric, metabolic, hormonal, clinical, and psychological parameters. After the certainty of the diagnosis of PCOS, the Rorschach test, according to Exner’s comprehensive system (CS) and the Millon Clinical Multiaxial Inventory-III (MCMI-III) were administered to each patient. The control group, on which the comparison was carried out, was composed by 40 healthy and aged compared women who were exclusively administered the Rorschach test according to CS. Results: MCMI-III evidenced axis II DSM-IV personality disorders [4.1% schizoid, depressive, sadistic, negativistic (passive–aggressive), and masochistic, 6.1% avoiding, 12.2% dependent, 20.4% histrionic, 16.3% narcissistic, 2.0% obsessive–compulsive], and axis I DSM-IV psychiatric disorders: 10.2% anxiety, 2.0% somatoform disorder and bipolar disorder, 16.3% major depressive disorder. Finally, we found 44.9% delusional disorder and 4.1% thought disorder. Rorschach test’s results show 53.1% reduced coping abilities and social skills, 55.1% depression, 30.6% perceptual distortion and cognitive slippage, 24.5% constantly alert and worry, 8.1% at risk for suicide, and finally about 50% of our patients had chronic stress. Conclusion: PCOS women have relevant personality and psychiatric disorders, when compared with normal subjects. PMID:25429283

  12. Eating disorder therapists' personal eating disorder history and professional ethics: an interpretive description.

    PubMed

    Williams, Meris; Haverkamp, Beth E

    2015-01-01

    This qualitative study sought to explore and understand eating disorder (ED) therapists' perceptions of whether and how their personal ED histories had professional ethical relevance. Analysis of multiple interviews with 11 therapist-participants indicated that they perceived their personal ED histories as having substantial ethical relevance in their day-to-day practice with ED clients. The major categories of ethics experiences that emerged were: boundaries, therapist wellness, helpfulness of personal ED history, and openness regarding therapists' personal ED histories. The findings have practical utility for the education, training, and continuing education of ED-historied practitioners. PMID:25719397

  13. The Expected Personality Characteristics of Alcohol-Dependent Individuals.

    ERIC Educational Resources Information Center

    Malouff, John M.; Schutte, Nicola S.

    2002-01-01

    Uses the Big Five personality factors as a framework for examining the expected personality characteristics of individuals who are alcohol-dependent. Results help explain prior findings about the social handicap of problem drinking with regard to making friends, dating, marriage, and working. Findings have potential use in alcohol-problem…

  14. Underlying personality differences between alcohol/substance-use disorder patients with and without an affective disorder.

    PubMed

    Janowsky, D S; Hong, L; Morter, S; Howe, L

    1999-01-01

    The Myers-Briggs Type Indicator (MBTI), a popular personality test, was used to profile the personalities of in-patient alcoholics/substance-use disorder patients who had, and those who did not have, a concurrent affective disorder diagnosis. The MBTI divides individuals into eight categories: Extroverts and Introverts, Sensors and Intuitives, Thinkers and Feelers, and Judgers and Perceivers. Alcohol/substance-use disorder patients with no affective disorder differed from a normative population only in being significantly more often Sensing and significantly less often Intuitive single-factor types. The Extroverted/Sensing/ Feeling/Judging four-factor type was also significantly over-represented in this group, compared to a normative population. In contrast, mood-disordered alcohol/substance-use disorder patients were significantly more often Introverted, Sensing, Feeling, and Perceiving and significantly less often Extroverted, Intuitive, Thinking, and Judging single-factor types. They were also significantly more often Introverted/Sensing/ Feeling/Perceiving and Introverted/Intuitive/Feeling/Perceiving four-factor types. 'Pure' alcohol/ substance-use disorder patients differed from alcohol/substance-use disorder patients with a mood disorder in that they were significantly more often Extroverted and Thinking and significantly less often Introverted and Feeling single-factor types; and significantly less often were an Introverted/Sensing/ Feeling/Perceiving four-factor type. The above results may have psychogenetic, diagnostic, and psychotherapeutic implications. PMID:10414613

  15. CLARIFYING THE CONVERGENCE BETWEEN OBSESSIVE COMPULSIVE PERSONALITY DISORDER CRITERIA AND OBSESSIVE COMPULSIVE DISORDER

    PubMed Central

    Eisen, Jane L.; Coles, Meredith E.; Shea, M. Tracie; Pagano, Maria E.; Stout, Robert L.; Yen, Shirley; Grilo, Carlos M.; Rasmussen, Steven A.

    2008-01-01

    In this study we examined the convergence between obsessive-compulsive personality disorder (OCPD) criteria and obsessive-compulsive disorder (OCD). Baseline assessments of 629 participants of the Collaborative Longitudinal Personality Disorders Study were used to examine the associations between OCPD criteria and diagnoses of OCD. Three of the eight OCPD criteria—hoarding, perfectionism, and preoccupation with details—were significantly more frequent in subjects with OCD (n = 89) than in subjects without OCD (n = 540). Logistic regressions were used to predict the probability of each OCPD criterion as a function of Axis I diagnoses (OCD, additional anxiety disorders, and major depressive disorder). Associations between OCD and these three OCPD criteria remained significant in the logistic regressions, showing unique associations with OCD and odds ratios ranging from 2.71 to 2.99. In addition, other anxiety disorders and major depressive disorder showed few associations with specific OCPD criteria. This study suggests variability in the strength of the relationships between specific OCPD criteria and OCD. The findings also support a unique relationship between OCPD symptoms and OCD, compared to other anxiety disorders or major depression. Future efforts to explore the link between Axis I and Axis II disorders may be enriched by conducting analyses at the symptom level. PMID:16776557

  16. Comorbid antisocial and borderline personality disorders: mentalization-based treatment.

    PubMed

    Bateman, Anthony; Fonagy, Peter

    2008-02-01

    Mentalization is the process by which we implicitly and explicitly interpret the actions of ourselves and others as meaningful based on intentional mental states (e.g., desires, needs, feelings, beliefs, and reasons). This process is disrupted in individuals with comorbid antisocial (ASPD) and borderline personality disorder (BPD), who tend to misinterpret others' motives. Antisocial characteristics stabilize mentalizing by rigidifying relationships within prementalistic ways of functioning. However, loss of flexibility makes the person vulnerable to sudden collapse when the schematic representation is challenged. This exposes feelings of humiliation, which can only be avoided by violence and control of the other person. The common path to violence is via a momentary inhibition of the capacity for mentalization. In this article, the authors outline their current understanding of mentalizing and its relation to antisocial characteristics and violence. This is illustrated by a clinical account of mentalization-based treatment adapted for antisocial personality disorder. Treatment combines group and individual therapy. The focus is on helping patients maintain mentalizing about their own mental states when their personal integrity is challenged. A patient with ASPD does not have mental pain associated with another's state of mind; thus, to generate conflict in ASPD by thinking about the victim will typically be ineffective in inducing behavior change. PMID:18186112

  17. [Comorbid antisocial and borderline personality disorders: mentalization-based treatment].

    PubMed

    Bateman, Anthony; Fonagy, Peter

    2010-01-01

    Mentalization is the process by which we implicitly and explicitly interpret the actions of ourselves and others as meaningful based on intentional mental states (e.g., desires, needs, feelings, beliefs, and reasons). This process is disrupted in individuals with comorbid antisocial (ASPD) and borderline personality disorder (BPD), who tend to misinterpret others' motives. Antisocial characteristics stabilize mentalizing by rigidifying relationships within prementalistic ways of functioning. However, loss of flexibility makes the person vulnerable to sudden collapse when the schematic representation is challenged. This exposes feelings of humiliation, which can only be avoided by violence and control of the other person. The common path to violence is via a momentary inhibition of the capacity for mentalization. In this article, the authors outline their current understanding of mentalizing and its relation to antisocial characteristics and violence. This is illustrated by a clinical account of mentalization-based treatment adapted for antisocial personality disorder. Treatment combines group and individual therapy. The focus is on helping patients maintain mentalizing about their own mental states when their personal integrity is challenged. A patient with ASPD does not have mental pain associated with another's state of mind; thus, to generate conflict in ASPD by thinking about the victim will typically be ineffective in inducing behavior change. PMID:20795523

  18. Personality Trait Differences in Boys and Girls with Clinical or Sub-Clinical Diagnoses of Conduct Disorder versus Antisocial Personality Disorder

    ERIC Educational Resources Information Center

    Taylor, Jeanette; Iacono, William G.

    2007-01-01

    This study tested differences in personality traits measured by the Multidimensional Personality Questionnaire (MPQ) in a community sample of adolescents with definite or probable conduct disorder (CD) diagnoses that did not progress to a diagnosis of antisocial personality disorder (ASPD) by early adulthood (n=43), those with definite or probable…

  19. Are inmates’ subjective sleep problems associated with borderline personality, psychopathy, and antisocial personality independent of depression and substance dependence?

    PubMed Central

    Harty, Laura; Duckworth, Rebecca; Thompson, Aaron; Stuewig, Jeffrey; Tangney, June P.

    2009-01-01

    Previous research investigating the relationship between Borderline Personality Disorder (BPD) and sleep problems, independent of depression, has been conducted on small atypical samples with mixed results. This study extends the literature by utilizing a much larger sample and by statistically controlling for depression and substance dependence. Subjective reports of sleep problems were obtained from 513 jail inmates (70% male) incarcerated on felony charges. Symptoms of BPD were significantly associated with sleep problems even when controlling for depression. Thus, sleep problems associated with BPD cannot be attributed simply to co-morbid symptoms of depression and substance dependence was ruled out as proximal causes for this relationship. Symptoms of depression, but not Antisocial Personality features, were related to sleep problems independent of substance dependence. Treatment of individuals with BPD may be more effective if sleep problems are explicitly addressed in the treatment plan. PMID:20198127

  20. A Follow-up Study of Early Onset Psychosis: Comparison between Outcome Diagnoses of Schizophrenia, Mood Disorders, and Personality Disorders.

    ERIC Educational Resources Information Center

    McClellan, Jon M.; And Others

    1993-01-01

    This study of 95 youths previously diagnosed with psychotic disorders found that at follow-up, 24 had a diagnosis of schizophrenia, 9 with psychotic mood disorders, 5 with personality disorders, and 1 with schizo-affective disorder. The study confirmed findings regarding early onset schizophrenia and psychotic mood disorders and emphasized the…

  1. The DSM-III personality disorders. Perspectives from psychology.

    PubMed

    Widiger, T A; Frances, A

    1985-06-01

    Although psychiatry and psychology have shared an interest in the classification of personality throughout the history of both professions, the efforts of each have largely been independent, with little collaboration or communication. We attempt to bridge this gap by describing a number of research programs in psychology that have implications for the psychiatric diagnosis of personality disorders. We discuss in particular the prototypal model of categorization, the use of behavioral indicators, the identification of prototypic acts, the aggregation of behavior across time and situations, the dimensional model of classification, and the interpersonal circumplex. PMID:3890799

  2. Personality disorders at the interface of psychiatry and the law: legal use and clinical classification

    PubMed Central

    Johnson, Sally C.; Elbogen, Eric B.

    2013-01-01

    Personality disorders have a complex relationship with the law that in many ways reflects their complexity within the clinical and research communities. This paper addresses expert testimony about personality disorders, outlines how personality disorders are assessed in forensic cases, and describes how personality disorders are viewed in different legal contexts. Reasons are identified why personality disorders are not generally accepted as significant mental illness within the legal system, including high incidence of personality dysfunction in criminal populations, frequent comorbidity of personality disorders making it difficult to determine direct causation, and difficulty determining where on a continuum personality traits should be defined as illness (or not). In summary, the legal system, to a significant degree, mirrors the clinical conception of personality disorders as not severe mental diseases or defects, not likely to change, and most often, under volitional control. PMID:24174894

  3. Personality disorders in heart failure patients requiring psychiatric management: comorbidity detections from a routine depression and anxiety screening protocol.

    PubMed

    Tully, Phillip J; Selkow, Terina

    2014-12-30

    Several international guidelines recommend routine depression screening in cardiac disease populations. No previous study has determined the prevalence and comorbidities of personality disorders in patients presenting for psychiatric treatment after these screening initiatives. In the first stage 404 heart failure (HF) patients were routinely screened and 73 underwent structured interview when either of the following criteria were met: (a) Patient Health Questionnaire ≥10; (b) Generalized Anxiety Disorder Questionnaire ≥7); (c) Response to one item panic-screener. Or (d) Suicidality. Patients with personality disorders were compared to the positive-screen patients on psychiatric comorbidities. The most common personality disorders were avoidant (8.2%), borderline (6.8%) and obsessive compulsive (4.1%), other personality disorders were prevalent in less than <3% of patients. Personality disorder patients had significantly greater risk of major depression (risk ratio (RR) 1.2; 95% confidence interval (CI) 1.2-13.3), generalized anxiety disorder (RR 3.2; 95% CI 1.0-10.0), social phobia (RR 3.8; 95% CI 1.3-11.5) and alcohol abuse/dependence (RR 3.2; 95% 1.0-9.5). The findings that HF patients with personality disorders presented with complex psychiatric comorbidity suggest that pathways facilitating the integration of psychiatric services into cardiology settings are warranted when routine depression screening is in place. PMID:25238983

  4. Schemas and Borderline Personality Disorder symptoms in incarcerated women.

    PubMed

    Specht, Matt W; Chapman, Alex; Cellucci, Tony

    2009-06-01

    There is increasing interest regarding the role of maladaptive cognition in Borderline Personality Disorder (BPD). The current study examined the relationship between early maladaptive schema (EMS) domains and BPD symptoms as well as whether schema domains account for the relationship between childhood maltreatment and BPD severity. Incarcerated women (N=105) were assessed for BPD symptoms via semi-structured diagnostic interview. Disconnection/Rejection and Impaired Limits were associated with BPD pathology although these domains shared variance with depression and antisocial personality disorder pathology, respectively. In addition, the relationship between childhood abuse and BPD severity was non-significant after controlling for schema domains. Related findings and the implications for cognitive treatment of BPD are discussed. PMID:19159865

  5. Sexual sadism and sadistic personality disorder in sexual homicide.

    PubMed

    Hill, Andreas; Habermann, Niels; Berner, Wolfgang; Briken, Peer

    2006-12-01

    Controversies exist about the diagnostic validity of sexual sadism and its relation to sadistic personality disorder in sex offenders. The aim of this study was to investigate which diagnostic, developmental, and criminal characteristics differentiate sexual sadistic from non-sadistic sexual homicide perpetrators. Psychiatric court reports on 166 men who had committed a sexual homicide were evaluated regarding psychiatric, sexual and criminal history. Sixty-one offenders (36.7%) with sexual sadism (SeSd) were compared with 105 (63.3%) offenders without this diagnosis (NSeSd). Besides the sexual sadistic symptoms, there were seven factors that discriminated best between the two groups (sexual masochism, sadistic personality disorder, isolation in childhood, multiple sexual homicide, previous rape, previous tendencies for similar behavior, and long duration of the homicidal act). Sexual sadism is connected with circumscribed other characteristics and has to be considered in risk assessment and treatment of sex offenders. PMID:17192143

  6. [Sociocultural aspects of the genesis of personality disorders].

    PubMed

    Pérez Urdániz, A; Santos García, J M; Molina Ramos, R; Rubio Larrosa, V; Carrasco Perera, J L; Mosqueira Terrón, I; Romero, E F

    2001-01-01

    The prevalence of personality disorders seems to be increasing in the last decades. Many sociologists and historians believe that since the end of World War II, we have seen important changes, social, cultural and economic, which could indicate that we are entering a new age. The Postmodern Age, after nearly 500 years of Modern Age. Postmodernits is characterized by an increase of the speed in all realms of life, permanent changes, materialism, dominance of capitalism as economic model, changes of roles, etc. We speculate about the posibility that the characteristics of postmodern society may be contributing to the increase of prevalence of personality disorders in general and some of them in particular. PMID:11333519

  7. Promoting Good Psychiatric Management for Patients With Borderline Personality Disorder.

    PubMed

    Links, Paul S; Ross, James; Gunderson, John G

    2015-08-01

    General psychiatric management for patients with borderline personality disorder was devised to be an outpatient intervention that could be readily learned and easily delivered by independent community mental health professionals. To disseminate the approach, Drs. Gunderson and Links developed the Handbook of Good Psychiatric Management for Borderline Personality Disorder (Gunderson & Links, ) that presented the basics of the approach, videos to illustrate the appropriate clinical skills, and case examples to practice adherence to the approach. Unfortunately, the inclusion of "psychiatric" in the treatment's name may discourage psychologists and other mental health professionals from using this therapy. In this article, we review the basic principles and approaches related to general psychiatric management. With a case example, we illustrate how psychologists can use all the general psychiatric management principles for their patients with BPD, except medications and, as a result, provide and deliver this approach effectively. PMID:26197971

  8. [Repetitive thermal self-manipulation in borderline personality disorder].

    PubMed

    von Wild, T; Namdar, T; Stollwerck, P L; Mailänder, P; Siemers, F

    2011-10-01

    Self-mutilations are one of the major characteristics of patients with borderline personality disorder (BPD). Thermal injuries of BPD should be treated by a plastic surgeon who is faced to a challenge in the plastic-reconstructive strategy because of the most complex psychiatric disease. This means the need of a multidisciplinary strategy. Based on 3 case reports such conflict between best plastic reconstructive treatment of the burns wound and the psychiatric limit with the appropriate therapy options are presented. PMID:21863546

  9. Metacognitive interpersonal therapy in a case of obsessive-compulsive and avoidant personality disorders.

    PubMed

    Fiore, Donatella; Dimaggio, Giancarlo; Nicoló, Giuseppe; Semerari, Antonio; Carcione, Antonino

    2008-02-01

    Metacognitive interpersonal therapy (MIT) for personality disorders is aimed at both improving metacognition--the ability to understand mental statesand modulating problematic interpersonal representations while building new and adaptive ones. Attention to the therapeutic relationship is basic in MIT. Clinicians recognize any dysfunctional relationships with patients and work to achieve attunement to make the latter aware of their problematic interpersonal patterns. The authors illustrate here the case of a man suffering from obsessive-compulsive and avoidant personality disorders with dependent traits. He underwent combined individual and group therapies to (a) modulate his perfectionism, (b) prevent shifts towards avoiding responsibilities to protect himself from feared negative judgments, and (c) help him acknowledge suppressed desires. We show how treatment focused on the various dysfunctional personality aspects. PMID:18186113

  10. Quantitative electroencephalographic measures in homicidal men with antisocial personality disorder.

    PubMed

    Lindberg, Nina; Tani, Pekka; Virkkunen, Matti; Porkka-Heiskanen, Tarja; Appelberg, Björn; Naukkarinen, Hannu; Salmi, Tapani

    2005-07-15

    Many symptoms of antisocial personality disorder have been proposed to be related to decreased daytime vigilance. To explore this hypothesis, quantitative analyses were conducted of the electroencephalographic (EEG) activity of drug-free and detoxified homicidal male offenders with antisocial personality disorder as the primary diagnosis. Subjects comprised 16 men recruited from a forensic psychiatric examination in a special ward of a university psychiatric hospital. Fifteen healthy age- and gender-matched controls with no criminal record or history of physical violence consisted of hospital staff and students. An overall reduction of alpha power was observed in the waking EEG of offenders. A bilateral increase in occipital delta and theta power was also found in these individuals. This study provides further support to the growing evidence of brain dysfunction in severe aggressive behavior. Homicidal offenders with antisocial personality disorder seem to have difficulties in maintaining normal daytime arousal. Decreased vigilance, together with social and psychological variables, may explain their aberrant behavior in everyday life. New studies are, however, needed to specify the vigilance problems of this patient group. PMID:16026854

  11. Extreme Cognitions in Bipolar Spectrum Disorders: Associations with Personality Disorder Characteristics and Risk for Episode Recurrence

    PubMed Central

    Stange, Jonathan P.; Adams, Ashleigh Molz; O'Garro-Moore, Jared K.; Weiss, Rachel B.; Ong, Mian-Li; Walshaw, Patricia D.; Abramson, Lyn Y.; Alloy, Lauren B.

    2014-01-01

    Bipolar spectrum disorders (BSDs) are often characterized by cognitive inflexibility and affective extremities, including “extreme” or polarized thoughts and beliefs, which have been shown to predict a more severe course of illness. However, little research has evaluated factors that may be associated with extreme cognitions, such as personality disorders, which are often characterized by extreme, inflexible beliefs and also are associated with poor illness course in BSDs. The present study evaluated associations between BSDs, personality disorder characteristics, and extreme cognitions (polarized responses made on measures of attributional style and dysfunctional attitudes), as well as links between extreme cognitions and the occurrence of mood episodes, among euthymic young adults with BSDs (n = 83) and demographically-matched healthy controls (n = 89) followed prospectively for three years. The relationship between personality disorder characteristics and negative and positive extreme cognitions was stronger among BSD participants than among healthy controls, even after statistically accounting for general cognitive styles. Furthermore, extreme negative cognitions predicted the prospective onset of major depressive and hypomanic episodes. These results suggest that extreme cognitive styles are most common in individuals with BSDs and personality disorder characteristics, and they provide further evidence that extreme negative cognitions may confer risk for mood dysregulation. PMID:25645172

  12. The Bright and Dark Side Correlates of Creativity: Demographic, Ability, Personality Traits and Personality Disorders Associated with Divergent Thinking

    ERIC Educational Resources Information Center

    Furnham, Adrian

    2015-01-01

    This research examined the personality trait and personality disorder correlates of creative potential, as assessed by a divergent thinking (DT) test. Over 4,000 adult managers attending an assessment center completed a battery of tests including a "bright side," normal personality trait measures (NEO Personality Inventory-Revised, or…

  13. The relationship between the Five-Factor Model and latent DSM-IV personality disorder dimensions

    PubMed Central

    Nestadt, Gerald; Costa, Paul T.; Hsu, Fang-Chi; Samuels, Jack; Bienvenu, O. Joseph; Eaton, William W.

    2007-01-01

    This study compared the latent structure of the DSM-IV personality disorders to the Five-Factor Model (FFM) of general personality dimensions. The subjects in the study were 742 community-residing individuals who participated in the Hopkins Epidemiology of Personality Disorder Study. DSM-IV personality disorder traits were assessed by psychologists using the International Personality Disorder Examination, and personality disorder dimensions were derived previously using dichotomous factor analysis. The NEO-PI(R), a measure of the FFM, was administered to all subjects. The relationship between the two sets of personality-related constructs was examined using a construct validity framework and also using Pearson’s correlation coefficients, multiple linear regression models, and spline regression models. The five personality disorder factors each exhibited small to moderate correlations with several NEO dimensions; together, the NEO domain and facet scores “explained” a fifth to a third of the variance in personality disorder dimensions. Examples of non-linear relationships between the personality dimensions were identified. There is a modest correspondence between the personality disorder dimensions and FFM traits, and the traits of FFM only partially explain the variance of the personality disorders. Dimensional measures of general personality may be a suitable alternative to the DSM-IV. Whether additional maladaptive traits would better define the domain of personality disorders remains an important objective for future research. PMID:18063048

  14. Obsessive-compulsive disorders and anxiety disorders: A comparison of personality and emotionality patterns.

    PubMed

    Pelissolo, Antoine; Moukheiber, Albert; Mallet, Luc

    2015-10-30

    Even though obsessive-compulsive disorders (OCD) and anxiety disorders (AD) have been separated in the taxonomy adopted by the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, many issues remain concerning the physiopathological similarities and differences between those categories. Our objective was therefore to explore and compare their personality and emotional features, with the assumption that the distinction of two independent spectrums should imply the existence of two partially distinct temperamental profiles. We used the Temperament and Character Inventory (TCI-R) and the Positive and Negative Emotionality (PNE) scale to compare two groups of patients with OCD (n=227) or AD (n=827). The latter group included patients with social anxiety disorder, panic disorder, agoraphobia, and generalized anxiety disorder. Most temperament, character and emotionality measures showed no significant differences between both groups. In the personality measures results, only the self-directedness score (TCI-R) was significantly lower in OCD patients but this difference was not significant when the comparison was adjusted for the depressive scale score and age. Only lower PNE positive affects scores were obtained in OCD patients in the adjusted comparisons. These findings suggest that OCD and AD are not really distinguishable from the point of view of associated personality traits. PMID:26292619

  15. Personality Disorders, Impulsiveness, and Novelty Seeking in Persons with DSM-IV Pathological Gambling and Their First-Degree Relatives.

    PubMed

    Black, Donald W; Coryell, William H; Crowe, Raymond R; Shaw, Martha; McCormick, Brett; Allen, Jeff

    2015-12-01

    This study investigates the presence of personality disorders, impulsiveness, and novelty seeking in probands with DSM-IV pathological gambling (PG), controls, and their respective first-degree relatives using a blind family study methodology. Ninety-three probands with DSM-IV PG, 91 controls, and their 395 first-degree relatives were evaluated for the presence of personality disorder with the Structured Interview for DSM-IV Personality. Impulsiveness was assessed with the Barratt Impulsiveness Scale (BIS). Novelty seeking was evaluated using questions from Cloninger's Temperament and Character Inventory. Results were analyzed using logistic regression by the method of generalized estimating equations to account for within family correlations. PG probands had a significantly higher prevalence of personality disorders than controls (41 vs. 7 %, OR = 9.0, P < 0.001), along with higher levels of impulsiveness and novelty seeking. PG probands with a personality disorder had more severe gambling symptoms; earlier age at PG onset; more suicide attempts; greater psychiatric comorbidity; and a greater family history of psychiatric illness than PG probands without a personality disorder. PG relatives had a significantly higher prevalence of personality disorder than relatives of controls (24 vs. 9%, OR = 3.2, P < 0.001) and higher levels of impulsiveness. Risk for PG in relatives is associated with the presence of personality disorder and increases along with rising BIS Non-Planning and Total scale scores. Personality disorders, impulsiveness, and novelty seeking are common in people with PG and their first-degree relatives. The presence of a personality disorder appears to be a marker of PG severity and earlier age of onset. Risk for PG in relatives is associated with the presence of personality disorder and trait impulsiveness. These findings suggest that personality disorder and impulsiveness may contribute to a familial diathesis for PG. PMID:25424057

  16. [Comorbid Personality Disorders and Parenting Stress in Mothers with Postpartum Depression].

    PubMed

    Ramsauer, Brigitte

    2016-01-01

    The original peer-reviewed paper presents the results of the analysis of the effects of psychiatric comorbidities of maternal postpartum depression, anxiety disorder and personality disorder (PD) on parenting stress. In the aforementioned analysis, mothers without PD (depression/ anxiety only) were compared to mothers with Borderline PD and mothers with other PD. Depending on the maternal PD, different sources of parenting stress have been revealed as specific to the mothers’ experience of parenting stress, suggesting differential indications for psychosocial interventions to ease the burden of stress on the mother-infant system. PMID:27027218

  17. Frontal Dysfunctions of Impulse Control – A Systematic Review in Borderline Personality Disorder and Attention-Deficit/Hyperactivity Disorder

    PubMed Central

    Sebastian, Alexandra; Jung, Patrick; Krause-Utz, Annegret; Lieb, Klaus; Schmahl, Christian; Tüscher, Oliver

    2014-01-01

    Disorders such as borderline personality disorder (BPD) or attention-deficit/hyperactivity disorder (ADHD) are characterized by impulsive behaviors. Impulsivity as used in clinical terms is very broadly defined and entails different categories including personality traits as well as different cognitive functions such as emotion regulation or interference resolution and impulse control. Impulse control as an executive function, however, is neither cognitively nor neurobehaviorally a unitary function. Recent findings from behavioral and cognitive neuroscience studies suggest related but dissociable components of impulse control along functional domains like selective attention, response selection, motivational control, and behavioral inhibition. In addition, behavioral and neural dissociations are seen for proactive vs. reactive inhibitory motor control. The prefrontal cortex with its sub-regions is the central structure in executing these impulse control functions. Based on these concepts of impulse control, neurobehavioral findings of studies in BPD and ADHD were reviewed and systematically compared. Overall, patients with BPD exhibited prefrontal dysfunctions across impulse control components rather in orbitofrontal, dorsomedial, and dorsolateral prefrontal regions, whereas patients with ADHD displayed disturbed activity mainly in ventrolateral and medial prefrontal regions. Prefrontal dysfunctions, however, varied depending on the impulse control component and from disorder to disorder. This suggests a dissociation of impulse control related frontal dysfunctions in BPD and ADHD, although only few studies are hitherto available to assess frontal dysfunctions along different impulse control components in direct comparison of these disorders. Yet, these findings might serve as a hypothesis for the future systematic assessment of impulse control components to understand differences and commonalities of prefrontal cortex dysfunction in impulsive disorders. PMID

  18. Stability and fluctuation of personality disorder features in daily life.

    PubMed

    Wright, Aidan G C; Simms, Leonard J

    2016-07-01

    Very little is known about the daily stability and fluctuation of personality pathology. To address this gap in knowledge, we investigated the naturalistic manifestation of personality pathology over the course of 100 days. A group of individuals (N = 101) diagnosed with any personality disorder (PD) completed a daily diary study over 100 consecutive days (Mdn = 94 days, range = 33-101 days). Participants completed daily ratings of 30 manifestations of personality pathology. Patterns of stability and variability over the course of the study were then examined. Results indicated that individual PD manifestations and domains of PD manifestations were variable across days and differed widely in their frequency. Additionally, individual averages and level of variability in PD domains were highly stable across months, individual averages of PD domains were predicted by baseline dispositional ratings of PD traits with a high degree of specificity, and daily variability PD domains was associated with elevated levels of PD traits. This pattern of findings suggests that dynamic processes of symptom exacerbation and diminution that are stable in mean level and variability in expression over time characterizes personality pathology. Further, dispositional ratings are significant predictors of average daily expression of PD features. (PsycINFO Database Record PMID:27196437

  19. The 'Self' and Borderline Personality Disorder: Conceptual and Clinical Considerations.

    PubMed

    Kerr, Ian B; Finlayson-Short, Laura; McCutcheon, Louise K; Beard, Hilary; Chanen, Andrew M

    2015-01-01

    Some concept of self has been used by many, although not all, researchers and clinicians as an 'organising construct' for borderline personality disorder (BPD). There is considerable variation in this usage and how clearly researchers have defined the self. Given this diversity, and that 'self' is often used interchangeably with parallel concepts (e.g., psyche, brain-mind, 'person') or with features of self (e.g., self-awareness, identity), unqualified use of the term is problematic. This is further complicated by the heterogeneity and 'comorbidity' of BPD and the limitations of syndromally based psychiatric nosology. Still, BPD remains in current classification systems and can be reliably diagnosed. A considerable body of research on self and BPD has accrued, including a recent profusion and confluence of neuroscientific and sociopsychological findings. These have generated supporting evidence for a supra-ordinate, functionally constituted entity of the self ranging over multiple, interacting levels from an unconscious, 'core' self, through to a reflective, phenotypic, 'idiographic' and relational self constituted by interpersonal and sociocultural experience. Important insights have been generated regarding emotional and social-cognitive dysregulation, disorder of self-awareness, relationality, identity, and coherence and continuity of the self. Many of these are shared by various trauma-related, dissociative disorders. A construct of the self could be useful as an explanatory principle in BPD, which could be construed as a 'self-state' (and relational) disorder, as opposed to a less severe disorder of aspects of the self (e.g., mood or memory). We offer a tentative description of 'Self' in this context, noting that any such construct will require a clear definition and to be evaluable. PMID:26346462

  20. Sibling Experiences: Living with Young Persons with Autism Spectrum Disorders.

    PubMed

    Ward, Beth; Tanner, Brianna Smith; Mandleco, Barbara; Dyches, Tina T; Freeborn, Donna

    2016-01-01

    Like other young people, those with autism spectrum disorder (ASD) have an impact on siblings in both positive and negative ways. Research indicates positive attributes include maturity and responsibility; positive self-concept; less quarrelling and competition; admiration for the person with ASD; and satisfactory sibling relationships. Negative attributes include fear of frightening or violent behavior, decreased sibling intimacy, and social and emotional difficulties. However, most research relies on information from parents/teachers, rather than from siblings. Therefore, this qualitative descriptive study explored experiences of 11 brothers and 11 sisters living with a young person with ASD through audiorecorded semi-structured interviews. Analysis revealed the overall theme was contradiction. Participants recognized difficulties (decreased parental attention, extra responsibility, bothersome behaviors, communication difficulties) and positive aspects (became empathetic, loved and appreciated the child, realized the experience was life-changing) of living with a young person with ASD. Younger siblings frequently reflected on childhood experiences, wished they could play together, and mentioned what the young person could do. Adolescent siblings learned life lessons from the experience, talked about life changes when ASD was diagnosed, and seemed introspective and protective toward the young person with ASD. Male siblings often wished they played more often while growing up with the young person, and frequently mentioned the child/adolescent's aggressive behaviors; female siblings focused on relationship and communication difficulties of the young person ASD. Interventions to help siblings provide positive behavioral support, engage in developmentally appropriate play, and communicate reciprocally are warranted. Nurses can help parents understand siblings' perceptions and can encourage parents to support siblings. PMID:27254975

  1. Construct Validity of the Adolescent Borderline Personality Disorder: A Review

    PubMed Central

    Bondurant, Helen; Greenfield, Brian; Tse, Sze Man

    2004-01-01

    Introduction Although the term borderline personality disorder (BPD) is used to describe adolescents in clinical settings, there is confusion as to what it comprises. To further elucidate that diagnosis, this article reviews its construct validity. Method Relevant publications appearing in PsychInfo (1872 to present) were reviewed for the purposes of this article. Results Thirty-six of the approximately sixty-five publications selected for consideration were included in this review. Conclusion The construct validity of adolescent BPD is supported by internal consistency (comparable to that of adults), group differences (ie this diagnosis segregates BPD from non-BPD adolescents), convergent validity (ie multiple measures of this disorder measure the same pathology) and concurrent validity, whereby these youth manifest functional impairment and distress. By contrast, the adolescent BPD criteria manifest less construct validity than the adult diagnosis in that its criteria did not uniformly predict the overall diagnosis, and showed more criterion overlap with other personality disorders and a broader pattern of axis II comorbidity. Further diminishing its construct validity, factor analysis suggested that adolescent BPD was not a single entity, and its low predictive validity was demonstrated by little diagnostic stability through adolescence into adulthood. PMID:19030500

  2. Personality Disorders and the Persistence of Substance Use Disorders: A Reanalysis of Published NESARC Findings

    PubMed Central

    Vergés, Alvaro; Jackson, Kristina M.; Bucholz, Kathleen K.; Trull, Timothy J.; Lane, Sean P.; Sher, Kenneth J.

    2014-01-01

    The purpose of this study was to examine whether published findings regarding the association of personality disorders (PDs) with the persistence of substance use disorders (SUDs) are attributable to an artifact due to time of assessment of the PD. Two previous studies analyzed data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and found that Antisocial PD, Schizotypal PD, and Borderline PD are unique predictors of SUDs. However, a design limitation in NESARC (assessment of PDs at different waves) can potentially compromise these findings. To assess the influence of time of assessment of PDs and to identify associations that might be robust to time of assessment, we compared the association of PDs with two estimates of SUD persistence that were based on different populations at risk: 1) among those who were diagnosed with SUD at baseline, the proportion who continued to meet full criteria at follow-up (“prediction”), and 2) among those who were diagnosed with SUD at follow-up, the proportion who met full criteria at baseline (“postdiction”). Differences between prediction and postdiction revealed a robust pattern of higher odds ratios for postdiction among PDs assessed at baseline, and lower odds ratios for postdiction among PDs assessed at follow-up. All published significant associations between PDs and persistence of SUDs became non-significant in the postdiction analyses, with the exception of Obsessive-Compulsive PD predicting Nicotine Dependence persistence. The present results raise serious doubts about the validity of published findings on PDs and SUD persistence from the NESARC. Design limitations in NESARC preclude a direct comparison among PDs measured at different waves. PMID:25314264

  3. [A team approach in unemployed persons with psychosomatic disorders].

    PubMed

    Majski-Cesarec, S

    1996-03-01

    A survey was conducted among persons with the health disorders considered to be aggravating factors in finding employment, who were on the list of the unemployed registered with a regional employment bureau. In 1994/1995 forty persons were selected and examined by a vocational guidance team. The team included a psychologist, a pedagogue, an occupational health specialist, a legal advisor and the employment bureau officer. The criteria were based on the health disorders that are contraindicative for an occupation, on the length of unemployment, time of onset of disease or disability, social status, satisfactory residual work capacity for another occupation, job opportunity and on the person's motivation for work, retraining, earning additional qualifications or for schooling. Results demonstrate that investing in vocational guidance is justified if negative selection as well as a futile loss of time, money and effort spent on schooling are to be avoided. The programme of retraining, additional training and finding an occupation in accordance with one's residual work capacity continues to be applicable only in the case of a newly diagnosed disease, newly inflicted injury or wound as well as a useful and humane method in the work of employment bureaus and vocational guidance teams. PMID:8768448

  4. Nicotine dependence and psychosis in Bipolar disorder and Schizoaffective disorder, Bipolar type.

    PubMed

    Estrada, Elena; Hartz, Sarah M; Tran, Jeffrey; Hilty, Donald M; Sklar, Pamela; Smoller, Jordan W; Pato, Michele T; Pato, Carlos N

    2016-06-01

    Patients with Bipolar disorder smoke more than the general population. Smoking negatively impacts mortality and clinical course in Bipolar disorder patients. Prior studies have shown contradictory results regarding the impact of psychosis on smoking behavior in Bipolar disorder. We analyzed a large sample of Bipolar disorder and Schizoaffective disorder, Bipolar Type patients and predicted those with a history of psychosis would be more likely to be nicotine dependent. Data from subjects and controls were collected from the Genomic Psychiatry Cohort (GPC). Subjects were diagnosed with Bipolar disorder without psychosis (N = 610), Bipolar disorder with psychosis (N = 1544). Participants were classified with or without nicotine dependence. Diagnostic groups were compared to controls (N = 10065) using logistic regression. Among smokers (N = 6157), those with Bipolar disorder had an increased risk of nicotine dependence (OR = 2.5; P < 0.0001). Patients with Bipolar disorder with psychosis were more likely to be dependent than Bipolar disorder patients without psychosis (OR = 1.3; P = 0.03). Schizoaffective disorder, Bipolar Type patients had more risk of nicotine dependence when compared to Bipolar disorder patients with or without psychosis (OR = 1.2; P = 0.02). Bipolar disorder patients experiencing more severity of psychosis have more risk of nicotine dependence. © 2015 Wiley Periodicals, Inc. PMID:26467098

  5. Do changes on MCMI-II personality disorder scales in short-term psychotherapy reflect trait or state changes?

    PubMed

    Jensen, Hans Henrik; Mortensen, Erik Lykke; Lotz, Martin

    2008-01-01

    The Millon Clinical Multiaxial Inventory (MCMI) has become an important and commonly used instrument to assess personality functioning. Several studies report significant changes on MCMI personality disorder scales after psychological treatment. The aim of the study was to investigate whether pre-post-treatment changes in 39-session psychodynamic group psychotherapy as measured with the MCMI reflect real personality change or primarily reflect symptomatic state changes. Pre-post-treatment design included 236 psychotherapy outpatients. Personality changes were measured on the MCMI-II and symptomatic state changes on the Symptom Check List 90-R (SCL-90-R). The MCMI Schizoid, Avoidant, Self-defeating, and severe personality disorder scales revealed substantial changes, which could be predicted from changes on SCL-90-R global symptomatology (GSI) and on the SCL-90-R Depression scale. The MCMI Dependent personality score was the only MCMI personality scale showing significant change when the SCL-90-R Depression change score was included as a covariate. Splitting patients into those with and without personality disorders did not change the results. Observed changes on MCMI-II personality disorder scales in short-term psychotherapy reflect change in symptomatic state. The MCMI-II Base Rate cut-off points probably include too many patients, justifying the introduction of new scoring procedures in the MCMI-III. PMID:18389425

  6. Personality Disorders in DSM-5: A Commentary on the Perceived Process and Outcome of the Proposal of the Personality and Personality Disorders Work Group.

    PubMed

    Silk, Kenneth R

    2016-01-01

    There has been much discussion and controversy concerning the process undertaken and the decisions made with respect to the Personality and Personality Disorders Work Group (PPDWG) proposal for DSM-5, as well as the rejection of the work group's final proposal, by the American Psychiatric Association Board of Trustees. This commentary suggests that the way the PPDWG members were selected and the perceived secrecy associated with the PPDWG's deliberations almost assured that, despite the hard work and good intentions of the group members, the proposal would raise controversy and could ultimately fail. This commentary provides a personal perspective on some of the issues, assumptions, and preconceptions that arose between members of different theoretical and conceptual camps within the field of personality disorders. It concludes with suggestions as to how we might avoid these mistakes in the future and also how we might take advantage of the PPDWG's substantive work as we make future attempts to improve diagnosis in the area of personality disorders. PMID:27603745

  7. Cerebellar-Dependent Eyeblink Conditioning Deficits in Schizophrenia Spectrum Disorders

    PubMed Central

    Forsyth, Jennifer K.; Bolbecker, Amanda R.; Mehta, Crystal S.; Klaunig, Mallory J.; Steinmetz, Joseph E.; O'Donnell, Brian F.; Hetrick, William P.

    2012-01-01

    Accumulating evidence suggests that abnormalities in neural circuitry and timing associated with the cerebellum may play a role in the pathophysiology of schizophrenia. Schizotypal personality disorder (SPD) may be genetically linked to schizophrenia, but individuals with SPD are freer from potential research confounds and may therefore offer insight into psychophysiological correlates of schizophrenia. The present study employed a delay eyeblink conditioning (EBC) procedure to examine cerebellar-dependent learning in schizophrenia, SPD, and healthy control subjects (n = 18 per group) who were matched for age and gender. The conditioned stimulus was a 400-ms tone that coterminated with a 50 ms unconditioned stimulus air puff. Cognitive performance on the Picture Completion, Digit Symbol Coding, Similarities, and Digit Span subscales of the Wechsler Adult Intelligence Scale—Third Edition was also investigated. The schizophrenia and SPD groups demonstrated robust EBC impairment relative to the control subjects; they had significantly fewer conditioned responses (CRs), as well as smaller CR amplitudes. Schizophrenia subjects showed cognitive impairment across subscales compared with SPD and control subjects; SPD subjects showed intermediate performance to schizophrenia and control subjects and performed significantly worse than controls on Picture Completion. Impaired EBC was significantly related to decreased processing speed in schizophrenia spectrum subjects. These findings support the role of altered cortico-cerebellar-thalamic-cortical circuitry in the pathophysiology of schizophrenia spectrum disorders. PMID:21148238

  8. Patient-reported outcomes in borderline personality disorder

    PubMed Central

    Hasler, Gregor; Hopwood, Christopher J.; Jacob, Gitta A.; Brändle, Laura S.; Schulte-Vels, Thomas

    2014-01-01

    Patient-reported outcome (PRO) refers to measures that emphasize the subjective view of patients about their health-related conditions and behaviors. Typically, PROs include self-report questionnaires and clinical interviews. Defining PROs for borderline personality disorder (BPD) is particularly challenging given the disorder's high symptomatic heterogeneity, high comorbidity with other psychiatric conditions, highly fluctuating symptoms, weak correlations between symptoms and functional outcomes, and lack of valid and reliable experimental measures to complement self-report data. Here, we provide an overview of currently used BPD outcome measures and discuss them from clinical, psychometric, experimental, and patient perspectives. In addition, we review the most promising leads to improve BPD PROs, including the DSM-5 Section III, the Recovery Approach, Ecological Momentary Assessments, and novel experimental measures of social functioning that are associated with functional and social outcomes. PMID:25152662

  9. Antisocial personality disorder: diagnostic, ethical and treatment issues.

    PubMed

    Kaylor, L

    1999-01-01

    Antisocial personality disorder (ASPD) is a complex disorder that creates a diagnostic, ethical, and treatment dilemma for mental health professionals. Psychosocial, biological, and cultural influences play a role in the development of ASPD. People with ASPD often had harsh early childhoods that impaired their ability to trust in adulthood. Research supports intriguing biological links, but it remains unclear if biological differences are the cause or the effect of ASPD. Individualism, patriarchy, and widespread media violence create the cultural context for the development of ASPD. ASPD is difficult to clinically diagnose and treat, and there is controversy concerning whether ASPD is a psychiatric or a legal-ethical problem. However, the management of ASPD often falls to mental health services. This article addresses treatment and primary prevention of ASPD in a way that is relevant to mental health practice. PMID:10633643

  10. Adult attachment in the clinical management of borderline personality disorder.

    PubMed

    Fossati, Andrea

    2012-05-01

    Borderline personality disorder (BPD) is a common psychiatric disorder associated with severe functional impairment, high rates of suicide and comorbid psychiatric illness, intensive use of treatment, and high costs to society. The etiology and pathogenesis of BPD are still uncertain, although an interaction between biological and psychosocial factors has been proposed to explain how the condition develops. Attachment disturbances represent one of the developmental risk factors that have been most consistently found to be associated with BPD, with a number of studies reporting a significant strong association between insecure attachment and BPD, notwithstanding the variety of measures and attachment types employed in these studies. In this article, the author first reviews clinical descriptions and research findings concerning the association between attachment disturbances and BPD and then discusses how attachment theory may help clinicians who work with patients with BPD better understand the psychopathology of the illness and plan treatment. PMID:22617081

  11. [Borderline personality disorder: the patients and their relatives].

    PubMed

    Apfelbaum, Sergio; Gagliesi, Pablo

    This present paper reviews the current theories about the borderline personality disorder and their relations with their families and significant others. The biosocial theory states that the relationship between emotional vulnerability and the interactions with family relations seems to explain the problems with DLP clients. This disorder is defined then as an interaction disease. Relatives and significant others usually have symptoms, beliefs, and emotions produced by this interaction. A list of general strategies for the assistance of these clients and their families is introduced: The transformation of the complaint into a problem, the psycho education, the reduction of expressed emotions, the acceptance and the training in different abilities. At the end, the experience with psycho education approach workshops is commented, as well as the use of a psycho educational manual. PMID:15597126

  12. A Comparison of Passive Aggressive and Negativistic Personality Disorders

    PubMed Central

    Hopwood, Christopher J.; Wright, Aidan G.C.

    2012-01-01

    Passive aggressive personality disorder (PAPD) has historically played an important role in clinical theorizing and was diagnosable prior to the DSM-IV, in which the construct was relabeled ‘negativistic’, expanded to include negative affective symptoms, and appendicized. In this study we tested the hypothesis that the expansion of PAPD to include content related to negative moods and non-specific personality pathology compromised its discriminant validity. In an undergraduate sample (N = 1215), a self-report measure of PAPD was only moderately related to NEGPD and showed less diagnostic overlap with other PDs than NEGPD. Furthermore, a conjoint factor analysis yielded a strong first factor (moodiness) which appeared less specific to passive aggressive behavior than three other factors (irresponsibility, inadequacy and contempt). We conclude that future research on this potentially important clinical construct should focus on core passive aggressive features and abandon the negativistic content that has been added to it in successive editions of the DSM. PMID:22329420

  13. The Rejection-Rage Contingency in Borderline Personality Disorder

    PubMed Central

    Berenson, Kathy R.; Downey, Geraldine; Rafaeli, Eshkol; Coifman, Karin; Leventhal, Nina

    2011-01-01

    Though longstanding clinical observation reflected in the DSM-IV suggests that the rage characteristic of borderline personality disorder (BPD) often appears in response to perceived rejection, the role of perceived rejection in triggering rage in BPD has never been empirically tested. Extending basic personality research on rejection sensitivity to a clinical sample, a priming-pronunciation experiment and a 21-day experience-sampling diary examined the contingent relationship between perceived rejection and rage in participants diagnosed with BPD compared to healthy controls. Despite the differences in these two assessment methods, the indices of rejection-contingent rage that they produced were both elevated in the BPD group, and were strongly interrelated. They provide corroborating evidence that reactions to perceived rejection significantly explain the rage seen in BPD. PMID:21500875

  14. The emotional lexicon of individuals diagnosed with antisocial personality disorder.

    PubMed

    Gawda, Barbara

    2013-12-01

    This study investigated the specific emotional lexicons in narratives created by persons diagnosed with antisocial personality disorder (ASPD) to test the hypothesis that individuals with ASPD exhibit deficiencies in emotional language. Study participants consisted of 60 prison inmates with ASPD, 40 prison inmates without ASPD, and 60 men without antisocial tendencies who described situations involving love, hate and anxiety depicted by photographs. The lexical choices made in the narratives were analyzed, and a comparison of the three groups revealed differences between the emotional narratives of inmates with ASPD, inmates without ASPD, and the control group. Although the narratives of the individuals with ASPD included more words describing emotions and higher levels of emotional intensity, the valence of these words was inappropriate. The linguistic characteristics of these narratives were associated with high levels of psychopathy and low emotional reactivity. PMID:23337952

  15. Comorbid psychiatric disorders in substance dependence patients: A control study

    PubMed Central

    Shantna, K.; Chaudhury, S.; Verma, A. N.; Singh, A. R.

    2009-01-01

    Background: The purpose of this study was to investigate the comorbidity of mental disorders among a random sample of substance dependence patients from a psychiatric inpatients department and the general population. Materials and Methods: Comprehensive data was collected from inpatients with substance abuse/dependence and comorbidity of mental disorders at the Ranchi Institute of Neuropsychiatry and Allied Sciences (RINPAS) and from normal controls from the general population during the period January 2007 to May 2007. Results: The results show that the most prevalent comorbid disorders in substance dependence patients and substance abusers were depressive disorders. Conclusions: The majority of substance dependence patients suffered from comorbid mental disorders. Comorbidity needs to be taken into account when analyzing the relationship between substance dependence and depression and in planning treatment strategies for comorbid conditions. PMID:21180482

  16. DOES HAVING A DYSFUNCTIONAL PERSONALITY HURT YOUR CAREER? AXIS II PERSONALITY DISORDERS AND LABOR MARKET OUTCOMES

    PubMed Central

    ETTNER, SUSAN L.; MACLEAN, JOHANNA CATHERINE; FRENCH, MICHAEL T.

    2011-01-01

    Despite recent interest in how psychiatric disorders affect work outcomes, little is known about the role of personality disorders (PDs), which are poorly understood yet prevalent (15%) and impairing. We used nationally representative data for 12,457 men and 16,061 women to examine associations of PDs with any employment, full-time employment, chronic unemployment, being fired or laid off, and having trouble with a boss or co-worker. Antisocial, paranoid, and obsessive-compulsive PDs demonstrated the broadest patterns of associations with adverse outcomes. Findings suggest that PDs may have implications for the productivity of co-workers as well as that of the disordered employees themselves. PMID:22053112

  17. Dysfunctional affect regulation in borderline personality disorder and in somatoform disorder

    PubMed Central

    van Dijke, Annemiek

    2012-01-01

    Background Although affect dysregulation is considered a core component of borderline personality disorder (BPD) and somatoform disorders (SoD), remarkably little research has focused on the prevalence and nature of affect dysregulation in these disorders. Also, despite apparent similarities, little is known about how dysfunctional under- and overregulation of affect and positive and negative somatoform and psychoform dissociative experiences inter-relate. Prior studies suggest a clear relationship between early childhood psychological trauma and affect dysregulation, especially when the caretaker is emotionally, sexually, or physically abusing the child, but how these relate to under- and overregulation while differentiating for developmental epochs is not clear. Although an elevated risk of childhood trauma exposure or complex posttraumatic stress disorder (CPTSD) symptoms has been reported in BPD and SoD, trauma histories, dysfunctional affect regulation, dissociation, PTSD, and CPTSD were never assessed in unison in BPD and/or SoD. Method BPD and/or SoD diagnoses were confirmed or ruled out in 472 psychiatric inpatients using clinical interviews. Dysfunctional under- and overregulation of affect and somatoform and psychoform dissociation, childhood trauma-by-primary-caretaker (TPC), PTSD, and CPTSD were all measured using self reports. Results No disorder-specific form of dysfunctional affect regulation was found. Although both BPD and SoD can involve affect dysregulation and dissociation, there is a wide range of intensity of dysfunctional regulation phenomena in patients with these diagnoses. Evidence was found for the existence of three qualitatively different forms of experiencing states: inhibitory experiencing states (overregulation of affect and negative psychoform dissociation) most commonly found in SoD, excitatory experiencing states (underregulation of affect and positive psychoform dissociation) most commonly found in BPD, and combination of

  18. Clinicians' Judgments of the Clinical Utility of Personality Disorder Trait Descriptions.

    PubMed

    Crego, Cristina; Sleep, Chelsea E; Widiger, Thomas A

    2016-01-01

    Proposed for the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) was a five-domain, 25-dimensional trait model that would have constituted a significant part of the diagnostic criteria for each personality disorder. A primary concern with respect to the proposal was that clinicians might find such an approach to be unacceptable. This study provides results from three independent data collections that compared clinicians' clinical utility ratings for each iteration of the DSM-5 dimensional trait assignments, along with an alternative list of traits derived from the Five Factor Form (FFF). The clinicians considered the final trait assignments that were posted for the avoidant, narcissistic, obsessive-compulsive, and schizoid personality disorders to be significantly less acceptable than the original assignments. They also considered the FFF trait assignments to be preferable to the DSM-5 final postings with respect to the avoidant, narcissistic, obsessive-compulsive, dependent, and histrionic personality disorders. The implications of these results for future editions of the diagnostic manual are discussed. PMID:26588083

  19. Examining the DSM-5 alternative personality disorder model operationalization of antisocial personality disorder and psychopathy in a male correctional sample.

    PubMed

    Wygant, Dustin B; Sellbom, Martin; Sleep, Chelsea E; Wall, Tina D; Applegate, Kathryn C; Krueger, Robert F; Patrick, Christopher J

    2016-07-01

    For decades, it has been known that the Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnosis of Antisocial Personality Disorder (ASPD) is a nonadequate operationalization of psychopathy (Crego & Widiger, 2015). The DSM-5 alternative model of personality disorders provides an opportunity to rectify some of these long held concerns. The current study compared the Section III alternative model's trait-based conception of ASPD with the categorical model from the main diagnostic codes section of DSM-5 in terms of associations with differing models of psychopathy. We also evaluated the validity of the trait-based conception more broadly in relation to measures of antisocial tendencies as well as psychopathy. Participants were 200 male inmates who were administered a battery of self-report and interview-based researcher rating measures of relevant constructs. Analyses showed that Section III ASPD outperformed Section II ASPD in predicting scores on Hare's (2003) Psychopathy Checklist-Revised (PCL-R; r = .88 vs. .59). Additionally, aggregate scores for Section III ASPD performed well in capturing variance in differing ASPD and psychopathy measures. Finally, we found that the Section III ASPD impairment criteria added incrementally to the Section III ASPD traits in predicting PCL-R psychopathy and SCID-II ASPD. (PsycINFO Database Record PMID:26914324

  20. Determinants of Psychosocial Difficulties Experienced by Persons with Brain Disorders: Towards a ‘Horizontal Epidemiology’ Approach

    PubMed Central

    Sabariego, Carla; Coenen, Michaela; Ballert, Carolina; Cabello, Maria; Leonardi, Matilde; Anczewska, Marta; Pitkänen, Tuuli; Raggi, Alberto; Mellor, Blanca; Covelli, Venusia; Świtaj, Piotr; Levola, Jonna; Schiavolin, Silvia; Chrostek, Anna; Bickenbach, Jerome; Chatterji, Somnath; Cieza, Alarcos

    2015-01-01

    Background Persons with brain disorders experience significant psychosocial difficulties (PSD) in daily life, e.g. problems with managing daily routine or emotional lability, and the level of the PSD depends on social, physical and political environments, and psychologic-personal determinants. Our objective is to determine a brief set of environmental and psychologic-personal factors that are shared determinants of PSD among persons with different brain disorders. Methods Cross-sectional study, convenience sample of persons with either dementia, stroke, multiple sclerosis, epilepsy, migraine, depression, schizophrenia, substance dependence or Parkinson’s disease. Random forest regression and classical linear regression were used in the analyses. Results 722 subjects were interviewed in four European countries. The brief set of determinants encompasses presence of comorbidities, health status appraisal, stressful life events, personality changes, adaptation, self-esteem, self-worth, built environment, weather, and health problems in the family. Conclusions The identified brief set of common determinants of PSD can be used to support the implementation of cross-cutting interventions, social actions and policy tools to lower PSD experienced by persons with brain disorders. This set complements a recently proposed reliable and valid direct metric of PSD for brain disorders called PARADISE24. PMID:26675663

  1. Personality Disorder in Adult Attention-Deficit/Hyperactivity Disorder: Attrition and Change During Long-term Treatment.

    PubMed

    Gift, Thomas E; Reimherr, Frederick W; Marchant, Barrie K; Steans, Tammy A; Wender, Paul H

    2016-05-01

    Personality disorders (PDs) are commonly found in adults with attention-deficit/hyperactivity disorder (ADHD) and are associated with increased ADHD symptoms and psychosocial impairment. To assess the impact of PDs or personality traits on retention rates in ADHD trials and whether treating ADHD affects the expression of PD, data were analyzed from 2 methylphenidate trials. Assessment of PDs and personality traits included using the Wisconsin Personality Disorders Inventory IV and the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Personality Disorders. Attention-deficit/hyperactivity disorder symptoms were evaluated using the Wender-Reimherr Adult Attention Deficit Disorder Scale. Major findings were that subjects with cluster A, cluster B, passive-aggressive, or more than 1 PD showed more attrition. Subjects dropping out also had more schizoid and narcissistic traits. Attention-deficit/hyperactivity disorder symptoms (p < 0.001) and all personality traits (range, p = 0.03 to p = 0.001) improved, but there was almost no correlation between changes on these 2 measures. Conversely, of 11 Wisconsin Personality Disorders Inventory IV items that improved most, 8 resembled ADHD or oppositional defiant disorder symptoms. PMID:27082828

  2. A behavioral treatment for opioid-dependent patients with antisocial personality.

    PubMed

    Neufeld, Karin J; Kidorf, Michael S; Kolodner, Kenneth; King, Van L; Clark, Michael; Brooner, Robert K

    2008-01-01

    Antisocial personality disorder (APD) is associated with increased problem severity in treatment-seeking opioid-dependent patients. Treatment studies have reported mixed results but generally show that patients with APD make progress that is often comparable to drug-dependent patients without the personality disorder. Much of this work is based on secondary analyses of studies evaluating responses to a variety of drug abuse treatment interventions. This study reports on a randomized prospective trial evaluating a behavioral approach for managing opioid-dependent patients with APD. Subjects (N = 100) met Diagnostic and Statistical Manual of Mental Disorders criteria for opioid dependence and APD using a structured clinical interview and were randomly assigned to either an experimental condition (n = 51), which used a highly structured contingency management intervention, or a control condition (n = 49), which reflected standard methadone treatment. Subjects in the experimental group had significantly better counseling attendance and some indication of lower psychosocial impairment compared to the control group. The experimental intervention increased attendance in subjects with low and high levels of psychopathy and with and without other psychiatric comorbidity. These findings support the development of interventions more tailored to drug-dependent patients with APD. PMID:17574801

  3. Association between Reactive Attachment Disorder/Disinhibited Social Engagement Disorder and Emerging Personality Disorder: A Feasibility Study

    PubMed Central

    Mwimba, Gracia; Pritchett, Rachel; Davidson, Claire

    2016-01-01

    A systematic review of reactive attachment disorder (RAD)/disinhibited social engagement disorder (DSED) in adolescence highlighted that young people with the disorder had indiscriminate friendliness with difficulties in establishing and maintaining stable relationships. Most reported experiences of rejection. We were struck by similarities between the above and features of emergence of personality disorders (EPD). This feasibility study aimed to determine best ways of recruiting and retaining vulnerable young people and the proportion of participants with RAD/DSED who might have emerging borderline personality disorder (EBPD). Participants were referred to the study by their treating clinicians from local mental health teams. Results showed strong association between RAD/DSED and EBPD. Participant characteristics showed high levels of out of home placements, early termination of school careers, suicide attempts, quasipsychotic symptoms, and multiagency involvements. They experienced the project as an opportunity to talk about relationships and reported that they would like more of this in usual clinical contacts. They all agreed to be contacted for future studies. Previous studies have shown that early detection and treatment of emergent personality traits can alter trajectory. Future research will continue to explore these trajectories, explore detection of vulnerability factors, and evaluate interventions. PMID:27366788

  4. Association between Reactive Attachment Disorder/Disinhibited Social Engagement Disorder and Emerging Personality Disorder: A Feasibility Study.

    PubMed

    Mirza, Khadija; Mwimba, Gracia; Pritchett, Rachel; Davidson, Claire

    2016-01-01

    A systematic review of reactive attachment disorder (RAD)/disinhibited social engagement disorder (DSED) in adolescence highlighted that young people with the disorder had indiscriminate friendliness with difficulties in establishing and maintaining stable relationships. Most reported experiences of rejection. We were struck by similarities between the above and features of emergence of personality disorders (EPD). This feasibility study aimed to determine best ways of recruiting and retaining vulnerable young people and the proportion of participants with RAD/DSED who might have emerging borderline personality disorder (EBPD). Participants were referred to the study by their treating clinicians from local mental health teams. Results showed strong association between RAD/DSED and EBPD. Participant characteristics showed high levels of out of home placements, early termination of school careers, suicide attempts, quasipsychotic symptoms, and multiagency involvements. They experienced the project as an opportunity to talk about relationships and reported that they would like more of this in usual clinical contacts. They all agreed to be contacted for future studies. Previous studies have shown that early detection and treatment of emergent personality traits can alter trajectory. Future research will continue to explore these trajectories, explore detection of vulnerability factors, and evaluate interventions. PMID:27366788

  5. Genetic and Neuroimaging Features of Personality Disorders: State of the Art.

    PubMed

    Ma, Guorong; Fan, Hongying; Shen, Chanchan; Wang, Wei

    2016-06-01

    Personality disorders often act as a common denominator for many psychiatric problems, and studies on personality disorders contribute to the etiopathology, diagnosis, and treatment of many mental disorders. In recent years, increasing evidence from various studies has shown distinctive features of personality disorders, and that from genetic and neuroimaging studies has been especially valuable. Genetic studies primarily target the genes encoding neurotransmitters and enzymes in the serotoninergic and dopaminergic systems, and neuroimaging studies mainly focus on the frontal and temporal lobes as well as the limbic-paralimbic system in patients with personality disorders. Although some studies have suffered due to unclear diagnoses of personality disorders and some have included few patients for a given personality disorder, great opportunities remain for investigators to launch new ideas and technologies in the field. PMID:27037690

  6. Co-occurrence of avoidant personality disorder and child sexual abuse predicts poor outcome in long-standing eating disorder.

    PubMed

    Vrabel, Karianne R; Hoffart, Asle; Rø, Oyvind; Martinsen, Egil W; Rosenvinge, Jan H

    2010-08-01

    Few consistent predictive factors for eating disorder have been identified across studies. In the current 5-year prospective study, the objective was to examine whether (a) personality disorder and child sexual abuse predict the course of severity of eating disorder symptoms after inpatient treatment and (b) how the predictors interact. A total of 74 patients with long-standing eating disorder and mean age of 30 years were assessed at the beginning and end of inpatient therapy and at 1-, 2-, and 5-year follow-up. A mixed model was used to examine the predictors. Avoidant personality disorder and child sexual abuse interacted in predicting high levels of eating disorder over a long-term course. These results suggest that eating disorder, avoidant personality disorder, and sequelae after child sexual abuse are potential targets for treatment that need further investigation. PMID:20677852

  7. [Skills Training for Patients with Borderline Personality Disorder].

    PubMed

    Armbrust, Michael; Ehrig, Christian

    2016-07-01

    The emotionally instable personality disorder, mostly called borderline disorder, shows central abnormalities in impulse control as well as instability of mood and identity. It is composed of behaviour problems in creating relationships and in self-management, first of all by high psychophysiological tension. The prevalence of this disorder is 10 % in outpatients and 20 % in inpatients and has therefore high relevance for the medical-psychotherapeutic care system. The treatment is deemed to be complex and interminable. Regarding all evaluated techniques of treatment the best examined is the Dialectical Behavioral Therapy (DBT). This specific therapy, developed in the eighties by Marsha M. Linehan, can be used for inpatient and outpatient treatment and combines single and group sessions. It is essential in mental health care of this disorder, but not available everywhere. Essential part of DBT is the skill training, a specific technique for the acquirement and for exercising skills for mindfulness, modulation of tension, regulation of emotions, structuring of social competence and developing self value. The central goal of DBT is to ensure the survival of the patients, to reduce self- and external aggressive behaviour and to provide inpatient crisis interventions. For sustained crisis management skills for reality acceptance are best fitting. But before, fast available sensory and active body-related skills should be used. Radical acceptance is the most important, since most effective, skill. The skills training, although in use for only twenty years, is permanently expanding in practice and is meanwhile also used for other disorders such as, for example, PTSD or ADHD. Since 2010, there also exists an elaborated DBT-version for adolescents. For medical care politics and health-economic reasons a supply with skills training for in- and outpatients all over the country is desirable. PMID:27388871

  8. Anger, preoccupied attachment, and domain disorganization in borderline personality disorder

    PubMed Central

    Morse, Jennifer Q.; Hill, Jonathan; Pilkonis, Paul A.; Yaggi, Kirsten; Broyden, Nichaela; Stepp, Stephanie; Reed, Lawrence Ian; Feske, Ulrike

    2010-01-01

    Emotional dysregulation and attachment insecurity have been reported in borderline personality disorder (BPD). Domain disorganization, evidenced in poor regulation of emotions and behaviors in relation to the demands of different social domains, may be a distinguishing feature of BPD. Understanding the interplay between these factors may be critical for identifying interacting processes in BPD and potential subtypes of BPD. Therefore, we examined the joint and interactive effects of anger, preoccupied attachment, and domain disorganization on BPD traits in clinical sample of 128 psychiatric patients. The results suggest that these factors contribute to BPD both independently and in interaction, even when controlling for other personality disorder traits and Axis I symptoms. In regression analyses, the interaction between anger and domain disorganization predicted BPD traits. In recursive partitioning analyses, two possible paths to BPD were identified: high anger combined with high domain disorganization and low anger combined with preoccupied attachment. These results may suggest possible subtypes of BPD or possible mechanisms by which BPD traits are established and maintained. PMID:19538080

  9. Reduced Personal Space in Individuals with Autism Spectrum Disorder.

    PubMed

    Asada, Kosuke; Tojo, Yoshikuni; Osanai, Hiroo; Saito, Atsuko; Hasegawa, Toshikazu; Kumagaya, Shinichiro

    2016-01-01

    Maintaining an appropriate distance from others is important for establishing effective communication and good interpersonal relations. Autism spectrum disorder (ASD) is a developmental disorder associated with social difficulties, and it is thus worth examining whether individuals with ASD maintain typical or atypical degrees of social distance. Any atypicality of social distancing may impact daily social interactions. We measured the preferred distances when individuals with ASD and typically developing (TD) individuals approached other people (a male experimenter) and objects (a coat rack with clothes) or when other people approached them. Individuals with ASD showed reduced interpersonal distances compared to TD individuals. The same tendency was found when participants judged their preferred distance from objects. In addition, when being approached by other people, both individuals with ASD and TD individuals maintained larger interpersonal distances when there was eye contact, compared to no eye contact. These results suggest that individuals with ASD have a relatively small personal space, and that this atypicality exists not only for persons but also for objects. PMID:26814479

  10. Improvement in Borderline Personality Disorder in Relationship to Age

    PubMed Central

    Shea, M. Tracie; Edelen, Maria Orlando; Pinto, Anthony; Yen, Shirley; Gunderson, John G.; Skodol, Andrew E.; Markowitz, John; Sanislow, Charles A.; Grilo, Carlos M.; Ansell, Emily; Daversa, Maria T.; Zanarini, Mary C.; McGlashan, Thomas H.; Morey, Leslie C.

    2008-01-01

    Objective It is commonly believed that some features of borderline personality disorder improve as individuals reach their late 30s and 40s. The current study examined age-related change in borderline criteria and functional impairment, testing the hypothesis that older age would be associated with relatively more improvement than younger age. Method 216 male and female participants with borderline personality disorder were followed prospectively with yearly assessments over 6 years. Results Participants showed similar rates of improvement in borderline features regardless of age. A significant age by study year interaction showed functioning in older subjects to reverse direction and begin to decline in the latter part of the follow-up, in contrast to younger subjects who maintained or continued improvement over the six years. Despite the decline, functioning for the older subjects was comparable to or slightly better at year 6 than at year 1. Conclusion Improvement in borderline features is not specific to the late 30s and 40s. There may be a reversal of improvement in functioning in some borderline patients in this older age range. PMID:18851719

  11. Psychophysiological ambulatory assessment of affective dysregulation in borderline personality disorder.

    PubMed

    Ebner-Priemer, Ulrich W; Welch, Stacy S; Grossman, Paul; Reisch, Thomas; Linehan, Marsha M; Bohus, Martin

    2007-04-15

    Many experts now believe that pervasive problems in affect regulation constitute the central area of dysfunction in borderline personality disorder (BPD). However, data is sparse and inconclusive. We hypothesized that patients with BPD, in contrast to healthy gender and nationality-matched controls, show a higher frequency and intensity of self-reported emotions, altered physiological indices of emotions, more complex emotions and greater problems in identifying specific emotions. We took a 24-hour psychophysiological ambulatory monitoring approach to investigate affect regulation during everyday life in 50 patients with BPD and in 50 healthy controls. To provide a typical and unmanipulated sample, we included only patients who were currently in treatment and did not alter their medication schedule. BPD patients reported more negative emotions, fewer positive emotions, and a greater intensity of negative emotions. A subgroup of non-medicated BPD patients manifested higher values of additional heart rate. Additional heart rate is that part of a heart rate increase that does not directly result from metabolic activity, and is used as an indicator of emotional reactivity. Borderline participants were more likely to report the concurrent presence of more than one emotion, and those patients who just started treatment in particular had greater problems in identifying specific emotions. Our findings during naturalistic ambulatory assessment support emotional dysregulation in BPD as defined by the biosocial theory of [Linehan, M.M., 1993. Cognitive-Behavioral Treatment of Borderline Personality Disorder. The Guildford Press, New York.] and suggest the potential utility for evaluating treatment outcome. PMID:17321599

  12. Circular structure of the MCMI-III personality disorder scales.

    PubMed

    Strack, S; Choca, J P; Gurtman, M B

    2001-06-01

    Millon's (1987) circular model of personality disorders was examined in a large sample of psychiatric patients (N = 2,366) who completed the Millon Clinical Multiaxial Inventory-III (MCMI-III; Millon, 1997) as part of routine assessment after presentation for treatment. Principal components analyses were conducted to identify the first two dimensions in MCMI-III base rate scores, weighted and unweighted raw scores, and nonoverlapping scale scores. Similar analyses were made on these scores when acquiescence was partialled out. Circular plots of the scales were examined against Millon's hypothesized arrangement and the model was tested using confirmatory factor analysis. Results replicated those of Strack, Lorr, and Campbell (1990) with the MCMI-II. Millon's horizontal Impassive-Expressive dimension was recovered in both regular and residual scores but the vertical axis appeared to represent an Impulsivity-Compulsivity dimension rather than the Autonomous-Enmeshed continuum envisioned by Millon. Although scale order followed Millon's predictions for the most part, a number of departures from theoretical expectations were noted and none of the score sets yielded a good fit to the hypothetical structure. Millon's model appears to have promise as a circumplex that can encompass all of the personality disorders but changes are needed to rectify discrepancies between the theory and empirical findings. PMID:11406998

  13. A Comparison of Obsessive-Compulsive Personality Disorder Scales

    PubMed Central

    Samuel, Douglas B.; Widiger, Thomas A.

    2010-01-01

    The current study utilized a large undergraduate sample (n = 536), oversampled for DSM-IV-TR obsessive-compulsive personality disorder (OCPD) pathology, to compare eight self-report measures of OCPD. No prior study has compared more than three measures and the results indicated that the scales had only moderate convergent validity. We also went beyond the existing literature to compare these scales to two external reference points: Their relationships with a well established measure of the five-factor model of personality (FFM) and clinicians' ratings of their coverage of the DSM-IV-TR criterion set. When the FFM was used as a point of comparison the results suggested important differences among the measures with respect to their divergent representation of conscientiousness, neuroticism, and agreeableness. Additionally, an analysis of the construct coverage indicated that the measures also varied in terms of their representation of particular diagnostic criteria. For example, while some scales contained items distributed across the diagnostic criteria, others were concentrated more heavily on particular features of the DSM-IV-TR disorder. PMID:20408023

  14. Reduced Personal Space in Individuals with Autism Spectrum Disorder

    PubMed Central

    Asada, Kosuke; Tojo, Yoshikuni; Osanai, Hiroo; Saito, Atsuko; Hasegawa, Toshikazu; Kumagaya, Shinichiro

    2016-01-01

    Maintaining an appropriate distance from others is important for establishing effective communication and good interpersonal relations. Autism spectrum disorder (ASD) is a developmental disorder associated with social difficulties, and it is thus worth examining whether individuals with ASD maintain typical or atypical degrees of social distance. Any atypicality of social distancing may impact daily social interactions. We measured the preferred distances when individuals with ASD and typically developing (TD) individuals approached other people (a male experimenter) and objects (a coat rack with clothes) or when other people approached them. Individuals with ASD showed reduced interpersonal distances compared to TD individuals. The same tendency was found when participants judged their preferred distance from objects. In addition, when being approached by other people, both individuals with ASD and TD individuals maintained larger interpersonal distances when there was eye contact, compared to no eye contact. These results suggest that individuals with ASD have a relatively small personal space, and that this atypicality exists not only for persons but also for objects. PMID:26814479

  15. Personality factors and eating disorders: self-uncertainty.

    PubMed

    von Lojewski, Astrid; Abraham, Suzanne

    2014-01-01

    The International Personality Disorder Examination interview (IPDE) was used to examine common features of personality amongst eating disorder (ED) patients. Female inpatients (N=155), aged 18 to 45, BMI<30 kg/m(2), were interviewed. Items present in ≥ 25% of patients were analysed by factor analysis. Five factors emerged - 'interpersonal anxiety', 'instability', 'self-uncertainty', 'obsessionality' and 'perfectionism' accounting for 62% of the variance. Patients with BMI, <18.5 kg/m(2) had significantly greater 'interpersonal anxiety' factor scores. Patients who purged had higher 'interpersonal anxiety', 'instability', and 'perfectionism' factor scores. Differences between ED diagnostic groups were accounted for by body weight and purging. Increasing age was weakly associated with improvement in 'self-uncertainty' and 'instability' scores. This study separates obsessionality and perfectionism, possibly reflecting ED patients' 'need for control', and introduces a new factor 'self-uncertainty' which reflects their poor self-concept. The contribution of this factor structure to development and duration of illness should be studied. PMID:24411761

  16. Individual Characteristics, Familial Experience, and Psychopathology in Children of Mothers with Borderline Personality Disorder

    ERIC Educational Resources Information Center

    Barnow, Sven; Spitzer, Carsten; Grabe, Hans J.; Kessler, Christoph; Freyberger, Harald J.

    2006-01-01

    Objective: The aim of this study was to examine individual characteristics, familial experience, and psychopathology of children of mothers with borderline personality disorder (BPD). Method: Children of mothers with BPD were compared to children of mothers (1) with depressive disorders, (2) with cluster C personality disorders, and (3) without…

  17. Relationships between Psychosocial Development and Personality Disorder Symptomatology in Late Adolescents.

    ERIC Educational Resources Information Center

    Johnson, Jeffrey G.

    1993-01-01

    Studied the extent to which psychosocial development thorough the first 5 stages of E. H. Erikson's theory of personality development is associated with personality disorder symptoms, using 106 undergraduates. Negative resolutions of stages one through five may predict the presence of personality disorder symptomatology during late adolescence.…

  18. Examining the Relationship between Childhood Sexual Abuse and Borderline Personality Disorder: Does Social Support Matter?

    ERIC Educational Resources Information Center

    Elzy, Meredith B.

    2011-01-01

    The relationship between childhood sexual abuse and borderline personality disorder is a prominent issue in the etiological research on borderline personality disorder. This study further explored the relationship between childhood sexual abuse and the development of borderline personality features while evaluating the moderating role of a primary…

  19. Using First-Person Accounts To Teach Students about Psychological Disorders.

    ERIC Educational Resources Information Center

    Banyard, Victoria L.

    2000-01-01

    Describes instructional use of brief first-person accounts of mental disorders. Explores the benefits of using first-person, autobiographical accounts as required reading in a course on abnormal psychology. Finds that first-person accounts were more helpful in increasing student appreciation of the experience of having a disorder and empathy for…

  20. 32 CFR 147.11 - Guideline I-Emotional, mental, and personality disorders.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 1 2013-07-01 2013-07-01 false Guideline I-Emotional, mental, and personality... CLASSIFIED INFORMATION Adjudication § 147.11 Guideline I—Emotional, mental, and personality disorders. (a) The concern: Emotional, mental, and personality disorders can cause a significant deficit in...

  1. 32 CFR 147.11 - Guideline I-Emotional, mental, and personality disorders.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 1 2010-07-01 2010-07-01 false Guideline I-Emotional, mental, and personality... CLASSIFIED INFORMATION Adjudication § 147.11 Guideline I—Emotional, mental, and personality disorders. (a) The concern: Emotional, mental, and personality disorders can cause a significant deficit in...

  2. 32 CFR 147.11 - Guideline I-Emotional, mental, and personality disorders.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 1 2012-07-01 2012-07-01 false Guideline I-Emotional, mental, and personality... CLASSIFIED INFORMATION Adjudication § 147.11 Guideline I—Emotional, mental, and personality disorders. (a) The concern: Emotional, mental, and personality disorders can cause a significant deficit in...

  3. 32 CFR 147.11 - Guideline I-Emotional, mental, and personality disorders.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 1 2014-07-01 2014-07-01 false Guideline I-Emotional, mental, and personality... CLASSIFIED INFORMATION Adjudication § 147.11 Guideline I—Emotional, mental, and personality disorders. (a) The concern: Emotional, mental, and personality disorders can cause a significant deficit in...

  4. 32 CFR 147.11 - Guideline I-Emotional, mental, and personality disorders.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 1 2011-07-01 2011-07-01 false Guideline I-Emotional, mental, and personality... CLASSIFIED INFORMATION Adjudication § 147.11 Guideline I—Emotional, mental, and personality disorders. (a) The concern: Emotional, mental, and personality disorders can cause a significant deficit in...

  5. Exploration of microstructural abnormalities in borderline personality disorder

    NASA Astrophysics Data System (ADS)

    Fritzsche, Klaus H.; Brunner, Romuald; Henze, Romy; Meinzer, Hans-Peter; Stieltjes, Bram

    2012-03-01

    As with other mental disorders, the causes of borderline personality disorder (BPD) are complex and not fully understood. In this study we aimed to determine whether adults with BPD exhibit microstructural abnormalities using diffusion tensor imaging (DTI). 56 female right-handed individuals (age range, 14-18 years), 19 with a DSM-IV diagnosis of BPD, 18 patients with a DSM-IV defined current psychiatric disorder and 19 healthy control subjects were included. Groups were matched for age and IQ. DTI Images were analyzed using Tract-Based Spatial Statistics (TBSS). The analysis revealed significanty reduced fractional anisotropy (FA) values in the group of BPD patients compared to the normal controls. Similar FA reductions could not be found comparing BPD patients to clinical controls. Several clusters of increased radial (DR), axial (DA), and mean (MD) diffusivity were consistently identified when comparing the BPD patients to clinical as well as to healthy controls. None of the measures showed significant differences between the clinical and healthy controls. Diverse possible factors have been suggested to play a role in the disease, including environmental factors, neurobiological factors, or brain abnormalities. The presented results may play an important role in this ongoing debate.

  6. Brain structure and function in borderline personality disorder.

    PubMed

    O'Neill, Aisling; Frodl, Thomas

    2012-10-01

    The spotlight on borderline personality disorder (BPD) has been growing in recent years, with the number of papers discussing potential causes and triggers of the disorder rapidly on the increase. Also on the increase, though still lacking sufficient numbers to produce well-supported hypotheses, are studies employing neuroimaging techniques as investigative tools in BPD. In this review, we investigate the current state and findings of neuroimaging studies in BPD, focusing in particular, on the studies examining structural, functional, and neurometabolic abnormalities in the disorder. Some suspected trends in the data are highlighted, including reductions in the hippocampi and amygdalae of BPD patients compared to healthy controls, exaggerated amygdala activity in BPD patients when confronted with emotion-related stimulus, and negative correlations between increases in left amygdalar creatine and reductions in amygdalar volume, reductions in absolute N-acetylaspartate concentration in the dorsolateral prefrontal cortex of BPD patients, and increases in glutamate concentration in the anterior cingulate cortices of BPD patients. We also discuss the limitations of some of the current studies including hindrances due to sample effects and techniques used and the potential of future neuroimaging research in BPD. PMID:22252376

  7. The relationship between attachment styles and Cluster B personality disorders in prisoners and forensic inpatients.

    PubMed

    Timmerman, Irma G H; Emmelkamp, Paul M G

    2006-01-01

    The relationship between attachment styles and Cluster B personality disorders were examined among prisoners, forensic inpatients and controls from the general population. Forensic inpatients and prisoners reported significantly less frequently the secure attachment style (Relationship Questionnaire) and significantly more the fearful attachment style compared to the normal controls. Both forensic groups could not be distinguished from each other. Further, prisoners, forensic inpatients and controls could not be differentiated on the basis of the dismissing nor the preoccupied attachment style. With respect to personality pathology, almost all relationships between Cluster C pathology, on the one hand, and attachment styles, on the other, were significant. Cluster A pathology was clearly related to the secure and fearful attachment style. With respect to cluster B pathology, the results were more specific but also less clear. The results were strongly dependent on the way the personality pathology variables were treated, as either categorical or dimensional. None of the cluster B personality pathology variables were associated with the fearful attachment style and histrionic personality pathology was negatively associated with the dismissing attachment style. Antisocial personality features were associated with a dismissing attachment style. Borderline personality pathology, when treated as a categorical variable, was significantly related to the preoccupied attachment style. These results show that (1) cluster A and cluster C pathology are more strongly associated with attachment than cluster B, (2) treating personality data as either dimensional or categorical is of major importance to the conclusions that can be drawn, (3) it is important to control for the influence of co-morbid personality pathology when examining the relationship between (Cluster B) personality pathology and attachment. PMID:16289754

  8. Perceived reasons for substance misuse among persons with a psychiatric disorder.

    PubMed

    Laudet, Alexandra B; Magura, Stephen; Vogel, Howard S; Knight, Edward L

    2004-07-01

    The etiology of substance use among persons with severe mental illness remains unclear. This study investigates stated reasons for substance use among persons in recovery from co-occurring disorders of serious mental illness and substance abuse and dependence. The desire to fit in with peers played a key role in the initiation of substance use; boredom, loneliness, temptations to use, and stress were cited most as relapse triggers. The authors discuss the need for dually diagnosed persons to develop sobriety-supporting peer networks to help them learn adaptive strategies to deal with the stress of recovery; further, treatment programs should instill hope for recovery and provide opportunities for meaningful activities and relationships. PMID:15291712

  9. Age of onset of mood disorders and complexity of personality traits.

    PubMed

    Ostacoli, L; Zuffranieri, M; Cavallo, M; Zennaro, A; Rainero, I; Pinessi, L; Pacchiana Parravicini, M V; Ladisa, E; Furlan, P M; Picci, R L

    2013-01-01

    Objective. The aim of the present study is to evaluate the link between the age of onset of mood disorders and the complexity of the personality traits. Methods. 209 patients with major depressive or manic/hypomanic episodes were assessed using the Structured Clinical Interview for DSM Axis I diagnoses and the Millon Clinical Multiaxial Inventory-III (MCMI-III). Results. 17.2% of the patients had no elevated MCMI-III scores, 45.9% had one peak, and 36.9% had a complex personality disorder with two or more elevated scores. Mood disorders onset of 29 years or less was the variable most related to the complexity of personality disorders as indicated from a recursive partitioning analysis. Conclusions. The relationship between mood disorders and personality traits differ in reference to age of onset of the mood disorder. In younger patients, maladaptive personality traits can evolve both in a mood disorder onset and in a complex personality disorder, while the later development of a severe mood disorder can increase the personality symptomatology. Our results suggest a threshold of mood disorder onset higher compared to previous studies. Maladaptive personality traits should be assessed not only during adolescence but also in young adults to identify and treat potential severe mood disorders. PMID:23738216

  10. Age of Onset of Mood Disorders and Complexity of Personality Traits

    PubMed Central

    Ostacoli, L.; Zuffranieri, M.; Cavallo, M.; Zennaro, A.; Rainero, I.; Pinessi, L.; Pacchiana Parravicini, M. V.; Ladisa, E.; Furlan, P. M.; Picci, R. L.

    2013-01-01

    Objective. The aim of the present study is to evaluate the link between the age of onset of mood disorders and the complexity of the personality traits. Methods. 209 patients with major depressive or manic/hypomanic episodes were assessed using the Structured Clinical Interview for DSM Axis I diagnoses and the Millon Clinical Multiaxial Inventory-III (MCMI-III). Results. 17.2% of the patients had no elevated MCMI-III scores, 45.9% had one peak, and 36.9% had a complex personality disorder with two or more elevated scores. Mood disorders onset of 29 years or less was the variable most related to the complexity of personality disorders as indicated from a recursive partitioning analysis. Conclusions. The relationship between mood disorders and personality traits differ in reference to age of onset of the mood disorder. In younger patients, maladaptive personality traits can evolve both in a mood disorder onset and in a complex personality disorder, while the later development of a severe mood disorder can increase the personality symptomatology. Our results suggest a threshold of mood disorder onset higher compared to previous studies. Maladaptive personality traits should be assessed not only during adolescence but also in young adults to identify and treat potential severe mood disorders. PMID:23738216

  11. The efficacy of various modalities of psychotherapy for personality disorders: a systematic review of the evidence and clinical recommendations.

    PubMed

    Verheul, Roel; Herbrink, Marjolein

    2007-02-01

    The aim of this paper is to review the level of empirical evidence for four different formats and settings that are available for psychotherapy delivery, i.e., group psychotherapy, out-patient individual psychotherapy, day hospital psychotherapy, and in-patient psychotherapy. The focus is on studies which include a wide range of DSM-IV-TR Axis II personality disorders. The results show that various psychotherapeutic treatments have proven to be efficacious with respect to reducing symptomatology and personality pathology, and improving social functioning in patients with Cluster A, B, C, or not-otherwise-specified personality disorders. This is especially true for cognitive-behaviorally or psychodynamically oriented out-patient individual psychotherapies. However, some evidence indicates that this also applies to (1) long-term, psychodynamically oriented group psychotherapy, (2) short-term, psychodynamically oriented psychotherapy in a day hospital setting, and (3) various duration variants of psychodynamically oriented, in-patient psychotherapy programmes. The available evidence mostly applies to borderline, dependent, avoidant and not-otherwise-specified personality disorder, and perhaps also paranoid, obsessive-compulsive, and schizotypal personality disorder. It is unknown whether these conclusions also apply to schizoid, antisocial, narcissistic, and histrionic personality disorder. PMID:17365156

  12. Personality disturbances in drug-dependent women: relationship to childhood abuse.

    PubMed

    Haller, Deborah L; Miles, Donna R

    2004-05-01

    This study examined associations between childhood abuse and personality disturbances in 228 drug-dependent women. Thirty-six percent denied abuse, 50% reported emotional, 42% physical, and 42% sexual abuse. Million Clinical Multiarial Inventory (MCMI-III) scores > 74 provided evidence of personality disturbance and scores on Minnesota Multiphasic Personality Inventory-2 (MMPI-2) scales measuring somatic complaints, depression, anxiety and postraumatic stress disorder (PTSD) served as covariates. Emotional and physical abuse survivors were at increased risk for borderline, masochistic, and avoidant disturbances and decreased risk for narcissistic disturbances. Emotional abuse survivors were also less likely to be sadistic whereas physical abuse survivors were more likely to be paranoid. Sexual abuse survivors were twice as likely be antisocial; however, no association was found with borderline personality. Finally, an increased prevalence of severe personality disturbances was observed among those experiencing multiple types of abuse. Childhood trauma predisposes drug-dependent women to develop troublesome personality characteristics that are independent of drug addiction and other psychological problems associated with childhood trauma. PMID:15230076

  13. Corpus callosum abnormalities in women with borderline personality disorder and comorbid attention-deficit hyperactivity disorder

    PubMed Central

    Rüsch, Nicolas; Luders, Eileen; Lieb, Klaus; Zahn, Roland; Ebert, Dieter; Thompson, Paul M.; Toga, Arthur W.; van Elst, Ludger Tebartz

    2007-01-01

    Objective Decreased brain volumes in prefrontal, limbic and parietal areas have been found in women with borderline personality disorder (BPD). Recent models suggest impaired structural and functional connectivity in this condition. To investigate this, we studied the thickness of the corpus callosum, the largest connecting fibre bundle in the human brain. Methods We acquired magnetic resonance imaging scans from 20 healthy women and 20 women with BPD and comorbid attention-deficit hyperactivity disorder. A novel computational mesh-based method was applied to measure callosal thickness at high spatial resolution. Results Women with BPD had a thinner isthmus of the corpus callosum, compared with healthy women. In the patient group, a history of childhood sexual abuse was associated with a thinner posterior body of the corpus callosum. Conclusion Interhemispheric structural connectivity involving parietal and temporal areas may be impaired in women with BPD and comorbid attention-deficit hyperactivity disorder. PMID:18043765

  14. Familial aggregation of candidate phenotypes for borderline personality disorder.

    PubMed

    Ruocco, Anthony C; Hudson, James I; Zanarini, Mary C; Gunderson, John G

    2015-01-01

    Borderline personality disorder (BPD) and its core Diagnostic and Statistical Manual of Mental Disorders (DSM) factor-analytically derived phenotypes aggregate in families. To potentially inform future conceptualizations of BPD, this study examined the familial aggregation and co-aggregation with BPD of 3 additional candidate phenotypes for BPD psychopathology: anxiousness, aggressiveness, and cognitive dysregulation. Participants included 347 probands (126 with BPD, 128 without BPD, and 93 with major depressive disorder) and 814 parents and siblings of probands. All participants completed diagnostic assessments and scales assessing the candidate phenotypes. The familial aggregation of phenotypes (correlation of level of phenotype between family members), the familial co-aggregation of phenotypes with BPD (correlation of phenotype with BPD between family members), and the within-individual correlation of phenotypes with BPD were assessed. All 3 candidate phenotypes showed high levels of familial aggregation (rs = .14 - .53, ps < .001), the magnitudes of which were comparable with DSM-based core sectors of psychopathology. Anxiousness and cognitive dysregulation showed strong within-individual associations with BPD (rs = .55 and .46, respectively; ps < .001) and substantial familial co-aggregation with BPD (rs = .12 and .13, respectively; ps ≤ .002). In contrast, aggressiveness showed a weak within-individual association with BPD (r = .11, p = .12) and little familial co-aggregation with BPD (r = .05, p = .21). These findings suggest that anxiousness and cognitive dysregulation are promising phenotypes for BPD psychopathology that move beyond factor-analytically based conceptualizations. In contrast, aggressiveness was only weakly related to BPD, suggesting that this phenotype may not represent an essential feature of this disorder. PMID:25046574

  15. Gender differences in the frequency of personality disorders in depressed outpatients.

    PubMed

    Carter, J D; Joyce, P R; Mulder, R T; Sullivan, P F; Luty, S E

    1999-01-01

    We examined gender differences in the frequency of DSM-III-R personality disorder diagnoses and symptomatology in a sample of 225 depressed outpatients. This research partially replicates and extends one of the first studies in this area by Golomb et al. (1995). Males were significantly more likely than females to meet diagnoses for schizotypal, paranoid, narcissistic, antisocial, obsessive compulsive, and borderline personality disorder. Compared to females, males were also significantly more likely to have schizoid, schizotypal, narcissistic, antisocial, and obsessive-compulsive personality disorder symptomatology. Females did not predominate in any personality disorder symptomatology or diagnoses. A possible explanation for these findings is discussed. The results of this study challenge traditional assumptions about gender differences in the frequency of personality disorders, and confirm the need for future studies to investigate the relation between gender and personality disorders in specific Axis I samples. PMID:10228928

  16. Convergent validity of the MCMI-III personality disorder scales and the MMPI-2 scales.

    PubMed

    Rossi, Gina; Van den Brande, Iris; Tobac, An; Sloore, Hedwig; Hauben, Claudia

    2003-08-01

    The MCMI-III personality disorder scales (Millon, 1994) were empirically validated in a sample of prisoners, psychiatric inpatients, and outpatients (N = 477). The scale intercorrelations were congruent with those obtained by Millon, Davis, and Millon (1997). We conclude that our Flemish/Dutch version shows no significant differences with the original version of the MCMI-III as far as intercorrelations are concerned. Convergent validity of the MCMI-III personality disorder scales was evaluated by the correlational data between the MCMI-III personality disorder scales and the MMPI-2 clinical (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) and personality disorder (Somwaru & Ben-Porath, 1995) scales. Improved convergence was obtained compared with previous versions of the MCMI-I. Only the compulsive MCMI-III personality disorder scale remains problematic. The scale even showed negative correlations with some of the related clinical scales and with the corresponding personality disorder scales of the MMPI-2. PMID:14521181

  17. Methodological considerations for treatment trials for persons with borderline personality disorder

    PubMed Central

    Zanarini, Mary C.; Stanley, Barbara; Black, Donald W.; Markowitz, John C.; Goodman, Marianne; Pilkonis, Paul; Lynch, Thomas R.; Levy, Kenneth; Fonagy, Peter; Bohus, Martin; Farrell, Joan; Sanislow, Charles

    2014-01-01

    Background The National Institute of Mental Health convened an international group of experts to examine the conduct of treatment trials for persons with borderline personality disorder (BPD). The rapid growth of treatment research had led to the recognition that investigators face unique methodological issues with these challenging patients. Methods Conference members reviewed critical aspects of psychotherapy and pharmacotherapy trial design for patients with BPD. Results This article summarizes discussions held on March 17-18, 2005. Conclusion This paper addresses the most pressing issues in sample selection and trial design pertaining to BPD; issues that have bedeviled both investigators submitting applications and reviewers trying to assess the merit of these grants. By disseminating this work, conference members hope to make this process more consistent and productive for all concerned. PMID:20445834

  18. Some suggestions for the DSM-5 schizotypal personality disorder construct.

    PubMed

    Hummelen, Benjamin; Pedersen, Geir; Karterud, Sigmund

    2012-05-01

    This study relates to the schizotypal personality disorder (SPD) proposal of the upcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by investigating the construct validity of SPD as defined by DSM-IV in a large sample of patients from the Norwegian Network of Personality-Focused Treatment Programs (N = 2619), assessed by structured diagnostic interviews and the Longitudinal, Expert All Data standard. We investigated factor structure and psychometric properties of the SPD criteria, as well as co-occurrence patterns between SPD and other PDs. Thirty-six patients were diagnosed with SPD and 513 patients (21%) endorsed at least 2 schizotypal criteria. We found that 2 factors were specific for SPD, a cognitive-perceptual factor (ideas of reference, magical thinking, and unusual perceptual experiences) and an oddness factor (odd thinking and speech, constricted affect, and odd appearance or behavior). The criteria belonging to these factors had appropriate psychometric properties. The criteria of the cognitive-perceptual factor were more strongly associated with borderline personality disorder (PD) than with the other PDs. We did not find support for a consistent factor that reflected interpersonal problems. The criteria that used to be part of this factor (suspiciousness, lack of friends or confidants, and excessive social anxiety) performed poorly as specific SPD criteria. SPD was more strongly associated with antisocial PD and paranoid PD than with the other PDs. We suggest that ideas of reference should be included explicitly under the schizotypal facet of cognitive dysregulation in DSM-5, with less emphasis on the social phobic aspects of this feature. Furthermore, there should be more emphasis on the cognitive aspects of suspiciousness in SPD, and it should be considered to split up the affectivity criterion into constricted affect and inappropriate affect, with the latter type of affect being the expression of problems with

  19. Management of borderline personality disorder: a review of psychotherapeutic approaches

    PubMed Central

    STONE, MICHAEL H.

    2006-01-01

    There are currently three major psychotherapeutic approaches to the management of borderline personality disorder (BPD): the psychodynamic, the cognitive-behavioral, and the supportive. There are special varieties within each: e.g., transference-focused psychotherapy (psychodynamic) or dialectic behavioral therapy (cognitive-behavioral). Though differing in basic conceptions and in methodology, all approaches aim at the amelioration of both the symptom-aspects that dominate the clinical picture at the outset, and the personality difficulties that remain apparent after the symptoms have been alleviated. The term "management" implies a focus on the more serious aspects of the borderline picture. These can be pictured hierarchically as to their level of seriousness, and there is universal agreement about the nature of this hierarchy. Therapists must pay attention first to suicidal and self-mutilative behaviors. Next, one deals with any threats to interrupt therapy prematurely. Third in order of seriousness: non-suicidal symptoms such as (mild to moderate) depression, substance abuse, panic and other anxiety manifestations, or dissociation. Psychopharmacological treatment will often be used adjunctively to help control any target symptoms, which usually fall into such categories as cognitive-perceptual, affect dysregulation, or impulsive/ behavioral dyscontrol. Therapists must then be alert to any signs of withholding, dishonesty, or antisocial tendencies, since these have an adverse effect on prognosis. When all these disruptive influences are (to the extent possible) dealt with, therapists will next take up milder symptoms such as social anxiety or lability of mood. Throughout this initial process, the personality-disorder attributes of BPD will become more apparent, and will usually emerge with greater clarity, once the serious symptoms have been dealt with. The management issues will gradually be supplanted with the overlapping and enduring personality issues

  20. Management of borderline personality disorder: a review of psychotherapeutic approaches.

    PubMed

    Stone, Michael H

    2006-02-01

    There are currently three major psychotherapeutic approaches to the management of borderline personality disorder (BPD): the psychodynamic, the cognitive-behavioral, and the supportive. There are special varieties within each: e.g., transference-focused psychotherapy (psychodynamic) or dialectic behavioral therapy (cognitive-behavioral). Though differing in basic conceptions and in methodology, all approaches aim at the amelioration of both the symptom-aspects that dominate the clinical picture at the outset, and the personality difficulties that remain apparent after the symptoms have been alleviated. The term "management" implies a focus on the more serious aspects of the borderline picture. These can be pictured hierarchically as to their level of seriousness, and there is universal agreement about the nature of this hierarchy. Therapists must pay attention first to suicidal and self-mutilative behaviors. Next, one deals with any threats to interrupt therapy prematurely. Third in order of seriousness: non-suicidal symptoms such as (mild to moderate) depression, substance abuse, panic and other anxiety manifestations, or dissociation. Psychopharmacological treatment will often be used adjunctively to help control any target symptoms, which usually fall into such categories as cognitive-perceptual, affect dysregulation, or impulsive/ behavioral dyscontrol. Therapists must then be alert to any signs of withholding, dishonesty, or antisocial tendencies, since these have an adverse effect on prognosis. When all these disruptive influences are (to the extent possible) dealt with, therapists will next take up milder symptoms such as social anxiety or lability of mood. Throughout this initial process, the personality-disorder attributes of BPD will become more apparent, and will usually emerge with greater clarity, once the serious symptoms have been dealt with. The management issues will gradually be supplanted with the overlapping and enduring personality issues

  1. Long-Term Course of Borderline Personality Disorder.

    PubMed

    Stone, Michael H

    2016-01-01

    Information concerning the longitudinal course of Borderline Personality Disorder (BPD) derives mainly from (a) long-term (10 to 25 year) retrospective follow-up studies, primarily those conducted during the 1980s/1990s, (b) brief (1 to 3 year) follow-up studies of recent randomized controlled trials (RCTs) of several different treatment approaches, and (c) prospective follow-up studies. The patients contacted in the retrospective studies had been treated mostly by psychoanalytically informed approaches or supportive. Though there was a significant suicide rate of 3 to 9%, about two-thirds of the BPD patients eventually achieved a global assessment score in the 60s or beyond. BPD represents a heterogeneous group of patients, whose outcome is a function of many variables, including personality traits (paranoid and narcissistic conducing to less favorable outcomes), cultural differences, socio-economic level, intelligence level, gender, and age of onset. The RCT studies focused on amelioration of the symptom components of BPD, especially tendencies to self-injury and suicide. The currently favored treatment methods showed in a large percentage of patients, a lessening of these self-destructive behaviors after a year or two of treatment. The time spans were too brief to allow assessment of improvement in key life areas (attainment of self-sufficiency in work, widening of the circle of friends, and success in forming satisfactory intimate partnerships). The prospective studies are based on reassessments at regular intervals of BPD patients and a control group with other personality disorders. Over the past 16 years the BPD patients, compared with controls, were slower to achieve remission, and more apt to show cognitive peculiarities initially-though they showed appreciable improvement over time. The "recovered" BPD patients, compared with the non-recovered patients, showed twice the likelihood of achieving a successful intimate relationship. At 16 years the Mc

  2. Symptoms: Personal snapshots of anxiety disorders | NIH MedlinePlus the Magazine

    MedlinePlus

    ... of this page please turn Javascript on. Feature: Phobias and Anxiety Disorders Symptoms: Personal snapshots of anxiety ... And it was scary.” Social Anxiety Disorder (Social Phobia): "In any social situation, I felt fear. I ...

  3. THE ROLE OF METAPERCEPTION IN PERSONALITY DISORDERS: DO PEOPLE WITH PERSONALITY PROBLEMS KNOW HOW OTHERS EXPERIENCE THEIR PERSONALITY?

    PubMed Central

    Carlson, Erika N.; Oltmanns, Thomas F.

    2016-01-01

    Do people with personality problems have insight into how others experience them? In a large community sample of adults (N = 641), the authors examined whether people with personality disorder (PD) symptoms were aware of how a close acquaintance (i.e., a romantic partner, family member, or friend) perceived them by measuring participants’ metaperceptions and self-perceptions as well as their acquaintance’s impression of them on Five-Factor Model traits. Compared to people with fewer PD symptoms, people with more PD symptoms tended to be less accurate and tended to overestimate the negativity of the impressions they made on their acquaintance, especially for the traits of extraversion, agreeableness, and conscientiousness. Interestingly, these individuals did not necessarily assume that their acquaintance perceived them as they perceived themselves; instead, poor insight was likely due to their inability to detect or utilize information other than their self-perceptions. Implications for the conceptualization, measurement, and treatment of PDs are discussed. PMID:26200846

  4. The Role of Metaperception in Personality Disorders: Do People with Personality Problems Know How Others Experience Their Personality?

    PubMed

    Carlson, Erika N; Oltmanns, Thomas F

    2015-08-01

    Do people with personality problems have insight into how others experience them? In a large community sample of adults (N = 641), the authors examined whether people with personality disorder (PD) symptoms were aware of how a close acquaintance (i.e., a romantic partner, family member, or friend) perceived them by measuring participants' metaperceptions and self-perceptions as well as their acquaintance's impression of them on Five-Factor Model traits. Compared to people with fewer PD symptoms, people with more PD symptoms tended to be less accurate and tended to overestimate the negativity of the impressions they made on their acquaintance, especially for the traits of extraversion, agreeableness, and conscientiousness. Interestingly, these individuals did not necessarily assume that their acquaintance perceived them as they perceived themselves; instead, poor insight was likely due to their inability to detect or utilize information other than their self-perceptions. Implications for the conceptualization, measurement, and treatment of PDs are discussed. PMID:26200846

  5. Predicting Future Antisocial Personality Disorder in Males from a Clinical Assessment in Childhood

    ERIC Educational Resources Information Center

    Lahey, Benjamin B.; Loeber, Rolf; Burke, Jeffrey D.; Applegate, Brooks

    2005-01-01

    It is essential to identify childhood predictors of adult antisocial personality disorder (APD) to target early prevention. It has variously been hypothesized that APD is predicted by childhood conduct disorder (CD), attention-deficit/hyperactivity disorder (ADHD), or both disorders. To test these competing hypotheses, the authors used data from a…

  6. Relationships between thought suppression and symptoms of borderline personality disorder.

    PubMed

    Sauer, Shannon E; Baer, Ruth A

    2009-02-01

    The current study examined relationships among childhood emotional vulnerability, an invalidating childhood environment, thought suppression, and symptoms of borderline personality disorder (BPD). Emotional vulnerability and an invalidating childhood environment are described by Linehan (1993) as important biosocial precursors to the development of BPD. Using a student sample selected to have a wide range of BPD symptoms, we examined whether thought suppression mediates the relationship between these biosocial precursors and symptoms of BPD. Results supported the hypothesis that thought suppression fully mediates the relationship between invalidating environment and BPD symptoms. Mixed support was found for the hypothesis that thought suppression mediates the relationship between emotional vulnerability and BPD symptoms. We also examined whether fear of emotions mediates the relationship between the biosocial precursors and thought suppression. Results supported this hypothesis, and also suggested that fear of emotion contributes independently to mediating the relationship between biosocial precursors and BPD symptoms. PMID:19267661

  7. Use of Clozapine for Borderline Personality Disorder: A Case Report

    PubMed Central

    Amamou, Badii; Salah, Walid Bel Hadj; Mhalla, Ahmed; Benzarti, Nejla; Elloumi, Hend; Zaafrane, Ferid; Gaha, Lotfi

    2016-01-01

    Patients with borderline personality disorder (BPD) show significant impairment in functioning, particularly in the interpersonal and social domains. Prior reports suggest that clozapine may be effective in the management of BPD. We present the case of a patient with BPD who experienced persistent suicidal ideation and was treated with clozapine at a state psychiatric hospital. After treatment failure with other psychotropic medications, clozapine medication was initiated; not only did suicidal ideation cease, but social and professional functioning also greatly improved to the point of no longer requiring intensive levels of observation or restrictive procedures. Clozapine appears to be efficacious in the management of suicide attempts and self-injurious behavior. Moreover, it appears to be promising as a therapeutic measure for ameliorating the global functioning of patients with severe BPD. Larger, randomized, blinded, and controlled prospective studies are needed to confirm these findings and to determine optimal dosage. PMID:27121437

  8. The role of mindfulness in borderline personality disorder features.

    PubMed

    Wupperman, Peggilee; Neumann, Craig S; Whitman, Jeannie B; Axelrod, Seth R

    2009-10-01

    This study investigated whether deficits in mindfulness (attention, awareness, and acceptance of the present moment) underlie variability in borderline personality disorder (BPD) features and related impairments in interpersonal functioning, impulsivity, and emotion regulation. A path analytic approach was used to examine the relationships of trait mindfulness with BPD features, interpersonal effectiveness, impulsive and passive emotion-regulation, and neuroticism in a psychiatric sample of adults (N = 70). As hypothesized, mindfulness was associated inversely with BPD features and core areas of dysfunction, and these associations continued when controlling for neuroticism. Furthermore, mindfulness deficits continued to predict BPD features even when interpersonal effectiveness, passive and impulsive emotion-regulation, and neuroticism were controlled. These findings suggest that mindfulness may be a unique predictor for the expression of BPD pathology. An emphasis on mindfulness may thus be crucial in enhancing the formulation and treatment of BPD. PMID:19829206

  9. Associations between Antisocial Personality Disorder and Sex on Discounting Rates

    PubMed Central

    Andrade, Leonardo F.; Riven, Levi; Petry, Nancy M.

    2014-01-01

    Numerous studies show that individuals with substance use and gambling problems discount delayed and probabilistic outcomes at different rates than controls. Few studies, however, investigated the association of discounting with antisocial personality disorders (ASPD), and none evaluated whether sex impacts these relationships. Because females with ASPD exhibit different patterns of antisocial behavior than their male counterparts, they may also differ in their decision-making tendencies. This study examined the effects of ASPD and sex on discounting in pathological gamblers. Results revealed effects of ASPD, and an interaction between ASPD and sex, on probability discounting rates. None of these variables, however, were related to delay discounting. Females with ASPD highly preferred probabilistic outcomes, suggesting that female gamblers with ASPD are particularly impulsive when it comes to probabilistic rewards. Greater understanding of sex differences in ASPD might help guide the selection of more effective sex-specific prevention and treatment programs. PMID:25364042

  10. Suicidal risk and management in borderline personality disorder.

    PubMed

    Goodman, Marianne; Roiff, Tracey; Oakes, Allison H; Paris, Joel

    2012-02-01

    This paper reviews recent advances in our understanding of suicidality in borderline personality disorder (BPD), with a focus on suicide risk assessment, guidelines for treatment, and medicolegal concerns. Relevant material on distinctions between suicide completers and suicide attempters, contributions of published American Psychiatric Association Guidelines, the controversial role of hospitalization, and management strategies regarding litigation is addressed. Despite accumulating data on suicidality in BPD, the current state of knowledge offers only partial clues to help identify the BPD patients most at risk of death by suicide, and offers a limited armamentarium of treatment targeted to suicide prevention, creating discomfort in clinicians and fears regarding litigation in the event of a successful suicide. Promising new interventions include less resource-intensive psychotherapies as well as brief crisis intervention. PMID:22113831

  11. The neurobiology of empathy in borderline personality disorder.

    PubMed

    Ripoll, Luis H; Snyder, Rebekah; Steele, Howard; Siever, Larry J

    2013-03-01

    We present a neurobiological model of empathic dysfunction in borderline personality disorder (BPD) to guide future empirical research. Empathy is a necessary component of interpersonal functioning, involving two distinct, parallel neural networks. One form of empathic processing relies on shared representations (SR) of others' mental states, while the other is associated with explicit mental state attribution (MSA). SR processing is visceral and automatic, contributing to attunement, but also emotional contagion. MSA processing contributes to deliberate, perspectival forms of empathic understanding. Empathic dysfunction in BPD may involve hyper-reactivity of SR networks and impairment of MSA networks. Nevertheless, this empathic dysfunction is subtle, but contributes to interpersonal difficulties. Interaction between genetic factors and traumatic attachment stressors may contribute to development of BPD, with painful attachment insecurity and disorganization affecting SR and MSA network functioning. Future avenues for BPD research will include developmental assessment of attachment and neurobiological functioning under varying conditions. PMID:23389774

  12. Reactivity to sensations in borderline personality disorder: a preliminary study.

    PubMed

    Rosenthal, M Zachary; Ahn, Roianne; Geiger, Paul J

    2011-10-01

    Individuals with borderline personality disorder (BPD) are widely considered to have problems with emotional reactivity. However, the specific kinds of stimuli that are associated with heightened emotional reactivity in BPD have not been well characterized. Thus, it is unclear whether the emotional dysfunction in BPD occurs in response to any emotionally evocative stimuli, or to specific classes of stimuli. In this study, we used subjective measures (self-report and interview-based) to compare reactivity to sensations (auditory, gustatory, olfactory, tactile, visual) between participants with BPD (n = 30) and healthy controls (n = 50). Controlling for trait negative emotional reactivity, individuals with BPD reported being significantly more reactive across sensory stimuli. However, the difference between controls and BPD was significantly greater for reactivity to auditory stimuli compared to other sensory stimuli. Findings from this study provide preliminary data suggesting individuals with BPD may be characterized by heightened self-reported reactivity to aversive sounds. PMID:22023306

  13. Use of Clozapine for Borderline Personality Disorder: A Case Report.

    PubMed

    Amamou, Badii; Salah, Walid Bel Hadj; Mhalla, Ahmed; Benzarti, Nejla; Elloumi, Hend; Zaafrane, Ferid; Gaha, Lotfi

    2016-05-31

    Patients with borderline personality disorder (BPD) show significant impairment in functioning, particularly in the interpersonal and social domains. Prior reports suggest that clozapine may be effective in the management of BPD. We present the case of a patient with BPD who experienced persistent suicidal ideation and was treated with clozapine at a state psychiatric hospital. After treatment failure with other psychotropic medications, clozapine medication was initiated; not only did suicidal ideation cease, but social and professional functioning also greatly improved to the point of no longer requiring intensive levels of observation or restrictive procedures. Clozapine appears to be efficacious in the management of suicide attempts and self-injurious behavior. Moreover, it appears to be promising as a therapeutic measure for ameliorating the global functioning of patients with severe BPD. Larger, randomized, blinded, and controlled prospective studies are needed to confirm these findings and to determine optimal dosage. PMID:27121437

  14. Five-factor model personality domains in the prediction of Axis II personality disorders: an exploratory study in late adulthood women non-clinical sample.

    PubMed

    Henriques-Calado, Joana; Duarte-Silva, Maria Eugénia; Junqueira, Diana; Sacoto, Carlota; Keong, Ana Marta

    2014-05-01

    Relationships between Axis II personality disorders (DSM-IV) and the five-factor model were explored in a non-clinical sample of late adulthood women. The sample consists of 90 women (M = 72.29 years of age, standard deviation = 7.10), who were administered with two measures, the NEO-FFI and the Personality Diagnostic Questionnaire-4+. Some personality disorders scales such as paranoid, schizotypal, borderline and dependent demonstrate a differentiated pattern of five-factor model domain predictors. Low agreeableness predicted schizoid, narcissistic and antisocial; histrionic, obsessive-compulsive and negativistic were predicted by high neuroticism and low agreeableness; high neuroticism and low extraversion, in turn, predicted dependent and depressive scales. Also, two clusters of personality disorders are identified, one associated with low agreeableness and another with low agreeableness and high neuroticism. This study suggest that some traits become maladaptive personality traits, and correspond more closely to psychopathology, when they become opposite to what would be expected in line with studies in normal late adulthood development. PMID:24700735

  15. Positive Childhood Experiences: Resilience and Recovery From Personality Disorder in Early Adulthood

    PubMed Central

    Skodol, Andrew E.; Bender, Donna S.; Pagano, Maria E.; Shea, M. Tracie; Yen, Shirley; Sanislow, Charles A.; Grilo, Carlos M.; Daversa, Maria T.; Stout, Robert L.; Zanarini, Mary C.; McGlashan, Thomas H.; Gunderson, John G.

    2009-01-01

    Objective Recent follow-along studies of personality disorders have shown significant improvement in psychopathology over time. The purpose of this study was to prospectively investigate the association between positive childhood experiences related to resiliency and remission from personality disorder. Method Five hundred twenty patients with DSM-IV–based semistructured interview diagnoses of schizotypal, borderline, avoidant, or obsessive-compulsive personality disorders were evaluated 6 times over 4 years between September 1996 and June 2002. Positive childhood experiences, including achievements, positive interpersonal relationships with others, and caretaker competencies, were measured using the Childhood Experiences Questionnaire-Revised. The effects of positive childhood experiences on clinically significant remission from personality disorder were determined using survival and proportional hazard regression analyses. Results Positive achievement experiences and positive interpersonal relationships during childhood or adolescence were significantly associated with remission from avoidant and schizotypal personality disorders. The greater the number of positive experiences and the broader the developmental period they spanned, the better the prognosis of these personality disorders. Conclusions The prognosis of certain personality disorders is better in patients whose developmental histories include positive experiences. Early treatment designed to foster personal strengths and competencies and to develop inter-personal skills might benefit young patients diagnosed with personality disorders. PMID:17685749

  16. Personality adjustment and social support of parents who care for children with pervasive developmental disorders.

    PubMed

    Weiss, S J

    1991-02-01

    The goal of this study was to examine the degree of personality adjustment and perceived social support of parents who care for children with pervasive developmental disorders. Data were collected with the California Q-Set (a personality measure) and the Norbeck Social Support Questionnaire. Personality adjustment of the parents was found to be significantly less than optimal, with a high degree of anxiety, minimal ego resilience, and use of defensive coping processes. Siblings of the child with the disorder and mothers of the parents were those most frequently identified as providing support to the caregiver, although friends, special education teachers, and daycare staff were the individuals whose support was most significantly related to greater amounts of perceived affection and affirmation, tangible aid, and concrete caregiving assistance. In fact, the more the caregivers depended upon their families for support, the less well adjusted were the caregivers on the personality measure. The implications of the findings for caregivers and their families are discussed. PMID:2039277

  17. Comparing the Temporal Stability of Self-Report and Interview Assessed Personality Disorder

    PubMed Central

    Samuel, Douglas B.; Hopwood, Christopher J.; Ansell, Emily B.; Morey, Leslie C.; Sanislow, Charles A.; Markowitz, John C.; Yen, Shirley; Shea, M. Tracie; Skodol, Andrew E.; Grilo, Carlos M.

    2015-01-01

    Findings from several large-scale, longitudinal studies over the last decade have challenged the long held assumption that personality disorders (PDs) are stable and enduring. However, the findings, including those from the Collaborative Longitudinal Personality Disorders Study (CLPS; Gunderson et al., 2000), rely primarily upon results from semistructured interviews. As a result, less is known about the stability of PD scores from self-report questionnaires, which differ from interviews in important ways (e.g., source of the ratings, item development, and instrument length) that might increase temporal stability. The current study directly compared the stability of the DSM-IV PD constructs assessed via the Schedule for Nonadaptive and Adaptive Personality (SNAP – 2; Clark, Simms, Wu, & Casillas, in press) with those from the Diagnostic Interview for DSM-IV Personality Disorders (DIPD-IV; Zanarini, Frankenburg, Sickel & Yong, 1996) over two years in a sample of 529 CLPS participants. Specifically, we compared dimensional and categorical representations from both measures in terms of rank-order and mean-level stability. Results indicated that the dimensional scores from the self-report questionnaire had significantly greater rank order (mean r = .69 versus .59) and mean-level (mean d = .21 versus .30) stability. In contrast, categorical diagnoses from the two measures evinced comparable rank-order (mean kappa = .38 versus .37) and mean-level stability (median prevalence rate decrease of 3.5% versus 5.6%). These findings suggest the stability of PD constructs depends at least partially on the method of assessment and are discussed in the context of previous research and future conceptualizations of personality pathology. PMID:21443287

  18. Personality disorders in offspring of mothers with mood disorders: results from a longitudinal family study.

    PubMed

    Cullen, Kathryn R; Eberly, Lynn E; Heller, Monika D; Schlesinger, Amanda; Gold, Phillip W; Martinez, Pedro E; Klimes-Dougan, Bonnie

    2014-08-30

    Offspring of mothers with mood disorders are known to be at risk for a range of adverse outcomes, but the prevalence of personality disorders (PDs) in this group is unknown. The goal of this study was to assess risk of PD diagnoses and symptoms in offspring of mothers with and without mood disorders, and to explore contributing factors to this risk. This longitudinal study assessed PDs and symptoms of PDs in offspring of mothers with bipolar disorder (O-BD), major depression (O-MDD), and no psychiatric diagnosis (O-WELL) in mid-adolescence and in early adulthood. O-BD were more likely to develop a Cluster B PD than O-MDD or O-WELL in adolescence, and more likely to develop a Cluster B PD then O-WELL in early adulthood. Dimensional analyses revealed that O-BD had elevated symptoms in PDs across all PD clusters at mid-adolescence and young adulthood. O-MDD showed elevated symptoms of antisocial PD at both time points, and of obsessive-compulsive PD at young adulthood. Offspring of mothers with mood disorders, especially O-BD, are at increased risk for PD diagnoses and symptoms in mid-adolescence and early adulthood. Contributing factors to risk of PD symptoms in at-risk offspring are discussed. PMID:24844978

  19. Personality disorders in offspring of mothers with mood disorders: Results from a longitudinal family study

    PubMed Central

    Cullen, Kathryn R.; Eberly, Lynn E.; Heller, Monika D.; Schlesinger, Amanda; Gold, Phillip W.; Martinez, Pedro E.; Klimes-Dougan, Bonnie

    2015-01-01

    Offspring of mothers with mood disorders are known to be at risk for a range of adverse outcomes, but the prevalence of personality disorders (PDs) in this group is unknown. The goal of this study was to assess risk of PD diagnoses and symptoms in offspring of mothers with and without mood disorders, and to explore contributing factors to this risk. This longitudinal study assessed PDs and symptoms of PDs in offspring of mothers with bipolar disorder (O-BD), major depression (O-MDD), and no psychiatric diagnosis (O-WELL) in mid-adolescence and in early adulthood. O-BD were more likely to develop a Cluster B PD than O-MDD or O-WELL in adolescence, and more likely to develop a Cluster B PD then O-WELL in early adulthood. Dimensional analyses revealed that O-BD had elevated symptoms in PDs across all PD clusters at mid-adolescence and young adulthood. O-MDD showed elevated symptoms of antisocial PD at both time points, and of obsessive-compulsive PD at young adulthood. Offspring of mothers with mood disorders, especially O-BD, are at increased risk for PD diagnoses and symptoms in mid-adolescence and early adulthood. Contributing factors to risk of PD symptoms in at-risk offspring are discussed. PMID:24844978

  20. The Impact of NEO PI-R Gender-Norms on the Assessment of Personality Disorder Profiles

    PubMed Central

    Samuel, Douglas B.; Ansell, Emily B.; Hopwood, Christopher J.; Morey, Leslie C.; Markowitz, John C.; Skodol, Andrew E.; Grilo, Carlos M.

    2010-01-01

    Many personality assessment inventories provide gender-specific norms to allow comparison of an individual’s standing relative to others of the same gender. In some cases, this means that an identical raw score produces standardized scores that differ notably depending on whether the respondent is male or female. Thus, an important question is whether unisex-normed scores or gender-normed scores more validly assess personality. We examined the gender-normed and unisex-normed scores from the NEO Personality Inventory – Revised (NEO PI-R; Costa & McCrae, 1992) in a large clinical sample, using two measures of personality disorder as validating criteria. Gender-normed scores did not obtain significantly higher correlations. In fact, for two personality disorders, antisocial and narcissistic, gender-normed scores yielded significantly lower correlations, suggesting that personality disorder pathology relates most closely to one’s absolute level of a personality trait rather than one’s standing relative to others of the same gender. We discuss ramifications of this finding for personality research and clinical assessment. PMID:20822266

  1. Personality traits as predictors of occupational performance and life satisfaction among mentally disordered offenders.

    PubMed

    Lindstedt, Helena; Söderlund, Anne; Stålenheim, Gunilla; Sjödén, Per-Olow

    2005-01-01

    The study investigated to what extent personality traits, e.g. socialization, proneness for anxiety, aggression and hostility were associated with and predictive of self-reported and observed occupational performance and perceived life satisfaction among male mentally disordered offenders (MDOs). Also, subjects with psychopathic-related personality traits were compared with subjects without such traits regarding demographic data and dependent variables. The MDOs were included from the Swedish National Board of Forensic Medicine. A total of 55 subjects were visited at their hospital ward for data collection with the Karolinska Scales of Personality (KSP), Capability to Perform Daily Occupation (CPDO), Allen Cognitive Level Screen (ACLS) and the Manchester Quality of Life Scale (MANSA). Seven KSP scales and two KSP factors correlated significantly with the dependent variables. Regression analyses revealed that the KSP Socialization scale, the KSP Anxiety-proneness and Psychopathy factors were the most important predictors. Subjects with psychopathy differed from remaining groups by having more conduct disorders before 15 years, being more often brought up in outcasted families and less subjected to measures of pupil welfare activities. The life history was concluded to be important influencing occupational performance and life satisfaction. Subjects with high anxiety proneness should be given attention in treatment planning. PMID:16757464

  2. Sexual dysfunction, mood, anxiety, and personality disorders in female patients with fibromyalgia

    PubMed Central

    Kayhan, Fatih; Küçük, Adem; Satan, Yılmaz; İlgün, Erdem; Arslan, Şevket; İlik, Faik

    2016-01-01

    Background We aimed to investigate the current prevalence of sexual dysfunction (SD), mood, anxiety, and personality disorders in female patients with fibromyalgia (FM). Methods This case–control study involved 96 patients with FM and 94 healthy women. The SD diagnosis was based on a psychiatric interview in accordance with the Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria. Mood and anxiety disorders were diagnosed using the Structured Clinical Interview. Personality disorders were diagnosed according to the Structured Clinical Interview for DSM, Revised Third Edition Personality Disorders. Results Fifty of the 96 patients (52.1%) suffered from SD. The most common SD was lack of sexual desire (n=36, 37.5%) and arousal disorder (n=10, 10.4%). Of the 96 patients, 45 (46.9%) had a mood or anxiety disorder and 13 (13.5%) had a personality disorder. The most common mood, anxiety, and personality disorders were major depression (26%), generalized anxiety disorder (8.3%), and histrionic personality disorder (10.4%). Conclusion SD, mood, and anxiety disorders are frequently observed in female patients with FM. Pain plays a greater role in the development of SD in female patients with FM. PMID:26937190

  3. Alternative Speech Communication System for Persons with Severe Speech Disorders

    NASA Astrophysics Data System (ADS)

    Selouani, Sid-Ahmed; Sidi Yakoub, Mohammed; O'Shaughnessy, Douglas

    2009-12-01

    Assistive speech-enabled systems are proposed to help both French and English speaking persons with various speech disorders. The proposed assistive systems use automatic speech recognition (ASR) and speech synthesis in order to enhance the quality of communication. These systems aim at improving the intelligibility of pathologic speech making it as natural as possible and close to the original voice of the speaker. The resynthesized utterances use new basic units, a new concatenating algorithm and a grafting technique to correct the poorly pronounced phonemes. The ASR responses are uttered by the new speech synthesis system in order to convey an intelligible message to listeners. Experiments involving four American speakers with severe dysarthria and two Acadian French speakers with sound substitution disorders (SSDs) are carried out to demonstrate the efficiency of the proposed methods. An improvement of the Perceptual Evaluation of the Speech Quality (PESQ) value of 5% and more than 20% is achieved by the speech synthesis systems that deal with SSD and dysarthria, respectively.

  4. Aggression in borderline personality disorder: A multidimensional model.

    PubMed

    Mancke, Falk; Herpertz, Sabine C; Bertsch, Katja

    2015-07-01

    This article proposes a multidimensional model of aggression in borderline personality disorder (BPD) from the perspective of the biobehavioral dimensions of affective dysregulation, impulsivity, threat hypersensitivity, and empathic functioning. It summarizes data from studies that investigated these biobehavioral dimensions using self-reports, behavioral tasks, neuroimaging, neurochemistry as well as psychophysiology, and identifies the following alterations: (a) affective dysregulation associated with prefrontal-limbic imbalance, enhanced heart rate reactivity, skin conductance, and startle response; (b) impulsivity also associated with prefrontal-limbic imbalance, central serotonergic dysfunction, more electroencephalographic slow wave activity, and reduced P300 amplitude in a 2-tone discrimination task; (c) threat hypersensitivity associated with enhanced perception of anger in ambiguous facial expressions, greater speed and number of reflexive eye movements to angry eyes (shown to be compensated by exogenous oxytocin), enhanced P100 amplitude in response to blends of happy versus angry facial expressions, and prefrontal-limbic imbalance; (d) reduced cognitive empathy associated with reduced activity in the superior temporal sulcus/gyrus and preliminary findings of lower oxytocinergic and higher vasopressinergic activity; and (e) reduced self-other differentiation associated with greater emotional simulation and hyperactivation of the somatosensory cortex. These biobehavioral dimensions can be nicely linked to conceptual terms of the alternative Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) model of BPD, and thus to a multidimensional rather than a traditional categorical approach. PMID:26191822

  5. Volume of hippocampal substructures in borderline personality disorder.

    PubMed

    Kreisel, Stefan Henner; Labudda, Kirsten; Kurlandchikov, Oleg; Beblo, Thomas; Mertens, Markus; Thomas, Christine; Rullkötter, Nina; Wingenfeld, Katja; Mensebach, Christoph; Woermann, Friedrich G; Driessen, Martin

    2015-03-30

    Borderline personality disorder (BPD) may be associated with smaller hippocampi in comparison to hippocampal size in controls. However, specific pathology in hippocampal substructures (i.e., head, body and tail) has not been sufficiently investigated. To address hippocampal structure in greater detail, we studied 39 psychiatric inpatients and outpatients with a DSM-IV diagnosis of BPD and 39 healthy controls. The hippocampus and its substructures were segmented manually on magnetic resonance imaging scans. The volumes of hippocampal substructures (and total hippocampal volume) did not differ between BPD patients and controls. Exploratory analysis suggests that patients with a lifetime history of posttraumatic stress disorder (PTSD) may have a significantly smaller hippocampus - affecting both the hippocampal head and body - in comparison to BPD patients without comorbid PTSD (difference in total hippocampal volume: -10.5%, 95%CI -2.6 to -18.5, significant). Also, patients fulfilling seven or more DSM-IV BPD criteria showed a hippocampal volume reduction, limited to the hippocampal head (difference in volume of the hippocampal head: -16.5%, 95%CI -6.1 to -26.8, significant). Disease heterogeneity in respect to, for example, symptom severity and psychiatric comorbidities may limit direct comparability between studies; the results presented here may reflect hippocampal volumes in patients who are "less" affected or they may simply be a chance finding. However, there is also the possibility that global effects of BPD on the hippocampus may have previously been overestimated. PMID:25624067

  6. Empathy in Narcissistic Personality Disorder: From Clinical and Empirical Perspectives

    PubMed Central

    Baskin-Sommers, Arielle; Krusemark, Elizabeth; Ronningstam, Elsa

    2015-01-01

    Narcissistic personality disorder (NPD) is associated with an assortment of characteristics that undermine interpersonal functioning. A lack of empathy is often cited as the primary distinguishing feature of NPD. However, clinical presentations of NPD suggest that empathy is not simply deficient in these individuals, but dysfunctional and subject to a diverse set of motivational and situational factors. Consistent with this presentation, research illustrates that empathy is multidimensional, involving 2 distinct emotional and cognitive processes associated with a capacity to respectively understand and respond to others’ mental and affective states. The goal of this practice review is to bridge the gap between our psychobiological understanding of empathy and its clinical manifestations in NPD. We present 3 case studies highlighting the variability in empathic functioning in people with NPD. Additionally, we summarize the literature on empathy and NPD, which largely associates this disorder with deficient emotional empathy, and dysfunctional rather than deficient cognitive empathy. Because this research is limited, we also present empathy-based findings for related syndromes (borderline and psychopathy). Given the complexity of narcissism and empathy, we propose that multiple relationships can exist between these constructs. Ultimately, by recognizing the multifaceted relationship between empathy and narcissism, and moving away from an all or nothing belief that those with NPD simply lack empathy, therapists may better understand narcissistic patients’ behavior and motivational structure. PMID:24512457

  7. Empathy in narcissistic personality disorder: from clinical and empirical perspectives.

    PubMed

    Baskin-Sommers, Arielle; Krusemark, Elizabeth; Ronningstam, Elsa

    2014-07-01

    Narcissistic personality disorder (NPD) is associated with an assortment of characteristics that undermine interpersonal functioning. A lack of empathy is often cited as the primary distinguishing feature of NPD. However, clinical presentations of NPD suggest that empathy is not simply deficient in these individuals, but dysfunctional and subject to a diverse set of motivational and situational factors. Consistent with this presentation, research illustrates that empathy is multidimensional, involving 2 distinct emotional and cognitive processes associated with a capacity to respectively understand and respond to others' mental and affective states. The goal of this practice review is to bridge the gap between our psychobiological understanding of empathy and its clinical manifestations in NPD. We present 3 case studies highlighting the variability in empathic functioning in people with NPD. Additionally, we summarize the literature on empathy and NPD, which largely associates this disorder with deficient emotional empathy, and dysfunctional rather than deficient cognitive empathy. Because this research is limited, we also present empathy-based findings for related syndromes (borderline and psychopathy). Given the complexity of narcissism and empathy, we propose that multiple relationships can exist between these constructs. Ultimately, by recognizing the multifaceted relationship between empathy and narcissism, and moving away from an all or nothing belief that those with NPD simply lack empathy, therapists may better understand narcissistic patients' behavior and motivational structure. PMID:24512457

  8. [Electroconvulsive therapy for major depression in borderline personality disorder].

    PubMed

    Gescher, D M; Malevani, J

    2012-03-01

    Depressive disorder is a serious and frequent complication in borderline personality disorder (BPD), however, its severity tends to be neglected particularly if symptoms are short-lived or inconsistent as is common in patients with BPD. Yet the high frequency in these patients requires especially rapid and effective therapy to reduce the risks of vital endangerment, chronification and psychosocial impairment. Efficient crisis intervention is essential for continuity of the disease-specific multimodal therapy enabling lasting remission and social and vocational rehabilitation in BPD. In particular with regard to the high incidence of poor or failed pharmacological responses in patients with BPD, electroconvulsive therapy (ECT) is of significant relevance among antidepressant treatment options. Despite the wide consensus on its efficacy, there are only few selected trials on ECT for major depression (MD) in BPD. This review summarises the published original studies on this issue, and critically scrutinises indication, benefits and risks of ECT for MD in BPD. It contributes to a focused, discriminating view on ECT and thus enables an optimised patient-oriented, efficient indication for MD in BPD. PMID:21678232

  9. Borderline personality disorder: a dysregulation of the endogenous opioid system?

    PubMed

    Bandelow, Borwin; Schmahl, Christian; Falkai, Peter; Wedekind, Dirk

    2010-04-01

    The neurobiology of borderline personality disorder (BPD) remains unclear. Dysfunctions of several neurobiological systems, including serotoninergic, dopaminergic, and other neurotransmitter systems, have been discussed. Here we present a theory that alterations in the sensitivity of opioid receptors or the availability of endogenous opioids constitute part of the underlying pathophysiology of BPD. The alarming symptoms and self-destructive behaviors of the affected patients may be explained by uncontrollable and unconscious attempts to stimulate their endogenous opioid system (EOS) and the dopaminergic reward system, regardless of the possible harmful consequences. Neurobiological findings that support this hypothesis are reviewed: Frantic efforts to avoid abandonment, frequent and risky sexual contacts, and attention-seeking behavior may be explained by attempts to make use of the rewarding effects of human attachment mediated by the EOS. Anhedonia and feelings of emptiness may be an expression of reduced activity of the EOS. Patients with BPD tend to abuse substances that target mu-opioid receptors. Self-injury, food restriction, aggressive behavior, and sensation seeking may be interpreted as desperate attempts to artificially set the body to survival mode in order to mobilize the last reserves of the EOS. BPD-associated symptoms, such as substance abuse, anorexia, self-injury, depersonalization, and sexual overstimulation, can be treated successfully with opioid receptor antagonists. An understanding of the neurobiology of BPD may help in developing new treatments for patients with this severe disorder. PMID:20438240

  10. Sleep disturbances and circadian CLOCK genes in borderline personality disorder.

    PubMed

    Fleischer, Monika; Schäfer, Michael; Coogan, Andrew; Häßler, Frank; Thome, Johannes

    2012-10-01

    Borderline personality disorder (BPD) is characterised by a deep-reaching pattern of affective instability, incoherent identity, self-injury, suicide attempts, and disturbed interpersonal relations and lifestyle. The daily activities of BPD patients are often chaotic and disorganized, with patients often staying up late while sleeping during the day. These behavioural patterns suggest that altered circadian rhythms may be associated with BPD. Furthermore, BPD patients frequently report suffering from sleep disturbances. In this review, we overview the evidence that circadian rhythms and sleep are disturbed in BPD, and we explore the possibility that personality traits that are pertinent for BPD may be associated with circadian typology, and perhaps to circadian genotypes. With regards to sleep architecture, we review the evidence that BPD patients display altered non-REM and REM sleep. A possible cue to a deeper understanding of this temporal dysregulation might be an analysis of the circadian clock at the molecular and cellular level, as well as behavioural studies using actigraphy and we suggest avenues for further exploration of these factors. PMID:22806005

  11. Violations of personal space by individuals with autism spectrum disorder.

    PubMed

    Kennedy, Daniel P; Adolphs, Ralph

    2014-01-01

    The ability to maintain an appropriate physical distance (i.e., interpersonal distance) from others is a critical aspect of social interaction and contributes importantly to real-life social functioning. In Study 1, using parent-report data that had been acquired on a large number of individuals (ages 4-18 years) for the Autism Genetic Resource Exchange and the Simons Simplex Collection, we found that those with Autism Spectrum Disorder (ASD; n = 766) more often violated the space of others compared to their unaffected siblings (n = 766). This abnormality held equally across ASD diagnostic categories, and correlated with clinical measures of communication and social functioning. In Study 2, laboratory experiments in a sample of high-functioning adults with ASD demonstrated an altered relationship between interpersonal distance and personal space, and documented a complete absence of personal space in 3 individuals with ASD. Furthermore, anecdotal self-report from several participants confirmed that violations of social distancing conventions continue to occur in real-world interactions through adulthood. We suggest that atypical social distancing behavior offers a practical and sensitive measure of social dysfunction in ASD, and one whose psychological and neurological substrates should be further investigated. PMID:25100326

  12. Violations of Personal Space by Individuals with Autism Spectrum Disorder

    PubMed Central

    Kennedy, Daniel P.; Adolphs, Ralph

    2014-01-01

    The ability to maintain an appropriate physical distance (i.e., interpersonal distance) from others is a critical aspect of social interaction and contributes importantly to real-life social functioning. In Study 1, using parent-report data that had been acquired on a large number of individuals (ages 4–18 years) for the Autism Genetic Resource Exchange and the Simons Simplex Collection, we found that those with Autism Spectrum Disorder (ASD; n = 766) more often violated the space of others compared to their unaffected siblings (n = 766). This abnormality held equally across ASD diagnostic categories, and correlated with clinical measures of communication and social functioning. In Study 2, laboratory experiments in a sample of high-functioning adults with ASD demonstrated an altered relationship between interpersonal distance and personal space, and documented a complete absence of personal space in 3 individuals with ASD. Furthermore, anecdotal self-report from several participants confirmed that violations of social distancing conventions continue to occur in real-world interactions through adulthood. We suggest that atypical social distancing behavior offers a practical and sensitive measure of social dysfunction in ASD, and one whose psychological and neurological substrates should be further investigated. PMID:25100326

  13. A dependencies mapping method for personal health monitoring.

    PubMed

    Rogerson, Simon; Wilford, Sara; Fairweather, Ben

    2013-01-01

    This chapter discusses the research undertaken in developing a comprehensive dependencies map for Personal Health Monitoring (PHM). Included is a discussion of the underlying research approach adopted and how this was operationalized. A new dependencies mapping method has been developed and this is described in detail. Illustrations of the derived tools are given using the PHM analysis undertaken. A summary of the analysis outcomes and the resulting recommendations are discussed. The chapter concludes with some suggestions of ways in which this type of data set can be used in practice to deliver fit-for-purpose PHM systems. PMID:23920459

  14. Prevalence of premorbid personality disorder and its clinical correlates in patients with delusional disorder.

    PubMed

    de Portugal, Enrique; Díaz-Caneja, Covadonga M; González-Molinier, Manuel; de Castro, María Jesús; del Amo, Victoria; Arango, Celso; Cervilla, Jorge A

    2013-12-30

    The aim of this study was to investigate the presence of premorbid Personality Disorder (PD) and its relationship with clinical correlates in patients with Delusional Disorder (DD). Eighty-six outpatients with DD whose diagnoses were confirmed using the Structured Clinical Interview for DSM-IV Axis I (SCID-I) Disorders (psychosis module) were evaluated for premorbid PD utilizing the Standardized Assessment of Personality (SAP). Psychopathology was assessed using Module B of SCID-I and the Positive and Negative Syndrome Scale (PANSS); psychosocial functioning was evaluated with the Global Assessment of Functioning scale. Premorbid intelligence was assessed using the Wechsler Adult Intelligence Scale-Third Edition, vocabulary subtest. A sociodemographic-clinical questionnaire was completed. Sixty-four percent of the patients had at least one premorbid PD, the most common being paranoid PD (38.4%), followed by schizoid PD (12.8%). The presence of at least one premorbid PD was significantly associated with higher scores for psychopathology, in particular, on the affective dimension of DD symptoms. However, the presence of premorbid PD was not associated with psychosocial functioning. Each of the premorbid PD was associated with different psychopathological profiles. Premorbid PD is a relevant phenomenon in DD, given its high prevalence and comorbidity, its influence on clinical correlates and its potential ability to predict specific sub-syndromes. PMID:23993136

  15. The Application of an Etiological Model of Personality Disorders to Problem Gambling.

    PubMed

    Brown, Meredith; Allen, J Sabura; Dowling, Nicki A

    2015-12-01

    Problem gambling is a significant mental health problem that creates a multitude of intrapersonal, interpersonal, and social difficulties. Recent empirical evidence suggests that personality disorders, and in particular borderline personality disorder (BPD), are commonly co-morbid with problem gambling. Despite this finding there has been very little research examining overlapping factors between these two disorders. The aim of this review is to summarise the literature exploring the relationship between problem gambling and personality disorders. The co-morbidity of personality disorders, particularly BPD, is reviewed and the characteristics of problem gamblers with co-morbid personality disorders are explored. An etiological model from the more advanced BPD literature-the biosocial developmental model of BPD-is used to review the similarities between problem gambling and BPD across four domains: early parent-child interactions, emotion regulation, co-morbid psychopathology and negative outcomes. It was concluded that personality disorders, in particular BPD are commonly co-morbid among problem gamblers and the presence of a personality disorder complicates the clinical picture. Furthermore BPD and problem gambling share similarities across the biosocial developmental model of BPD. Therefore clinicians working with problem gamblers should incorporate routine screening for personality disorders and pay careful attention to the therapeutic alliance, client motivations and therapeutic boundaries. Furthermore adjustments to therapy structure, goals and outcomes may be required. Directions for future research include further research into the applicability of the biosocial developmental model of BPD to problem gambling. PMID:25373399

  16. Longitudinal associations between social anxiety disorder and avoidant personality disorder: A twin study.

    PubMed

    Torvik, Fartein Ask; Welander-Vatn, Audun; Ystrom, Eivind; Knudsen, Gun Peggy; Czajkowski, Nikolai; Kendler, Kenneth S; Reichborn-Kjennerud, Ted

    2016-01-01

    Social anxiety disorder (SAD) and avoidant personality disorder (AvPD) are frequently co-occurring psychiatric disorders with symptomatology related to fear of social situations. It is uncertain to what degree the 2 disorders reflect the same genetic and environmental risk factors. The current study addresses the stability and co-occurrence of SAD and AvPD, the factor structure of the diagnostic criteria, and genetic and environmental factors underlying the disorders at 2 time points. SAD and AvPD were assessed in 1,761 young adult female twins at baseline and 1,471 of these approximately 10 years later. Biometric models were fitted to dimensional representations of SAD and AvPD. SAD and AvPD were moderately and approximately equally stable from young to middle adulthood, with increasing co-occurrence driven by environmental factors. At the first wave, approximately 1 in 3 individuals with AvPD had SAD, increasing to 1 in 2 at follow-up. The diagnostic criteria for SAD and AvPD had a two-factor structure with low cross-loadings. The relationship between SAD and AvPD was best accounted for by a model with separate, although highly correlated (r = .76), and highly heritable (.66 and .71) risk factors for each disorder. Their genetic and environmental components correlated .84 and .59, respectively. The finding of partially distinct risk factors indicates qualitative differences in the etiology of SAD and AvPD. Genetic factors represented the strongest time-invariant influences, whereas environmental factors were most important at the specific points in time. PMID:26569037

  17. The Influence of Posttraumatic Stress Disorder on Treatment Outcomes of Patients With Borderline Personality Disorder.

    PubMed

    Boritz, Tali; Barnhart, Ryan; McMain, Shelley F

    2016-06-01

    The aim of this study was to determine the influence of posttraumatic stress disorder (PTSD) on treatment outcomes in patients with borderline personality disorder (BPD). Participants were 180 individuals diagnosed with BPD enrolled in a randomized controlled trial that compared the clinical and cost effectiveness of dialectical behavior therapy (DBT) and general psychiatric management (GPM). Multilevel linear models and generalized linear models were used to compare clinical outcomes of BPD patients with and without PTSD. BPD patients with comorbid PTSD reported significantly higher levels of global psychological distress at baseline and end of treatment compared to their non-PTSD counterparts. Both groups evidenced comparable rates of change on suicide attempts and non-suicidal self-injury (NSSI), global psychological distress, and BPD symptoms over the course of treatment and post-treatment follow-up. DBT and GPM were effective for BPD patients with and without PTSD across a broad range of outcomes. PMID:26305394

  18. Capacity to Delay Reward Differentiates Obsessive Compulsive Disorder and Obsessive Compulsive Personality Disorder

    PubMed Central

    Pinto, Anthony; Steinglass, Joanna E.; Greene, Ashley L.; Weber, Elke U.; Simpson, H. Blair

    2013-01-01

    Background Although the relationship between obsessive compulsive disorder (OCD) and obsessive compulsive personality disorder (OCPD) has long been debated, clinical samples of OCD (without OCPD) and OCPD (without OCD) have never been systematically compared. We studied whether individuals with OCD, OCPD, or both conditions differ on symptomatology, functioning, and a measure of self-control: the capacity to delay reward. Methods 25 OCD, 25 OCPD, 25 comorbid OCD+OCPD, and 25 healthy controls (HC) completed clinical assessments and a validated intertemporal choice task that measures capacity to forego small immediate rewards for larger delayed rewards. Results OCD and OCPD subjects both showed impairment in psychosocial functioning and quality of life, as well as compulsive behavior, but only subjects with OCD reported obsessions. Individuals with OCPD, with or without comorbid OCD, discounted the value of delayed monetary rewards significantly less than OCD and HC. This excessive capacity to delay reward discriminates OCPD from OCD, and is associated with perfectionism and rigidity. Conclusions OCD and OCPD are both impairing disorders marked by compulsive behaviors, but they can be differentiated by the presence of obsessions in OCD and by excessive capacity to delay reward in OCPD. That individuals with OCPD show less temporal discounting (suggestive of excessive self-control) whereas prior studies have shown that individuals with substance use disorders show greater discounting (suggestive of impulsivity) supports the premise that this component of self-control lies on a continuum in which both extremes (impulsivity and overcontrol) contribute to psychopathology. PMID:24199665

  19. Comorbidity of Borderline Personality Disorder and Lifetime Substance Use Disorders in a Nationally Representative Sample.

    PubMed

    Carpenter, Ryan W; Wood, Phillip K; Trull, Timothy J

    2016-06-01

    Borderline personality disorder (BPD) is comorbid with substance use disorders (SUDs). However, most epidemiological work on BPD and SUDs has collapsed nonalcohol substances into a drug use disorder indicator, potentially obscuring patterns of association between BPD and individal SUDs. Using a nationally representative sample (National Epidemiologic Survey on Alcohol and Related Conditions; N = 34,481), the authors examined the association between lifetime BPD and nine lifetime SUDs. First, the authors examined the bivariate association of BPD and each SUD. BPD was associated with all nine SUDs. Second, they added relevant covariates (demographic variables, additional psychopathology) to each model. Seven SUDs remained significant. Finally, to account for shared variance across SUDs, the authors conducted a multivariate logistic regression with the nine SUDs and covariates as predictors. Alcohol, cocaine, and opiate use disorder were the only significant SUD predictors, indicating a unique association between BPD and these three SUDs. Future research should explore factors involved in the association of BPD with these specific SUDs. PMID:25893556

  20. The Validity of a Personality Disorder Diagnosis for People with an Intellectual Disability

    ERIC Educational Resources Information Center

    Moreland, Jessica; Hendy, Steve; Brown, Freddy

    2008-01-01

    Background: It has long been appreciated that people with intellectual disabilities experience mental health problems. Studies into the prevalence of personality disorder in the population of people with an intellectual disability indicate significant variations, which have no clear explanation. Method: Work on personality disorder and personality…

  1. Development of Borderline Personality Disorder in Adolescence and Young Adulthood: Introduction to the Special Section

    ERIC Educational Resources Information Center

    Stepp, Stephanie D.

    2012-01-01

    Recognizable symptoms and features of borderline personality disorder (BPD) appear during adolescence. However, there has been resistance to diagnose or research this disorder prior to adulthood because of clinical lore that BPD is a long-standing illness and that personality traits are not stable until adulthood. This has resulted in little…

  2. Use of Dialectical Behavior Therapy in Borderline Personality Disorder: A View from Residency

    ERIC Educational Resources Information Center

    Sharma, Binali; Dunlop, Boadie W.; Ninan, Philip T.; Bradley, Rebekah

    2007-01-01

    Objective: The authors describe the use of dialectical behavior therapy (DBT) in treating borderline personality disorder during psychiatry residency, and assess the status of DBT education within psychiatry residencies in the United States. Method: The authors present a patient with borderline personality disorder treated by a resident using DBT,…

  3. Initial Development of a Measure of Emotional Dysregulation for Individuals with Cluster B Personality Disorders

    ERIC Educational Resources Information Center

    Newhill, Christina E.; Mulvey, Edward P.; Pilkonis, Paul A.

    2004-01-01

    Individuals with DSM-IV Cluster B personality disorders are at particular risk of violence toward self or others. Emotional dysregulation is likely to be a factor in such incidents and is a central issue addressed in therapies with personality-disordered individuals. This article reports findings from a study that developed an original 18-item…

  4. [Functional Neuroimaging Pilot Study of Borderline Personality Disorder in Adolescents].

    PubMed

    LeBoeuf, Amélie; Guilé, Jean-Marc; Labelle, Réal; Luck, David

    2016-01-01

    Borderline personality disorder (BPD) is being increasingly recognized by clinicians working with adolescents, and the reliability and validity of the diagnosis have been established in the adolescent population. Adolescence is known to be a period of high risk for BPD development as most patients identify the onset of their symptoms to be in the adolescent period. As with other mental health disorders, personality disorder, are thought to result from the interaction between biological and environmental factors. Functional neuroimaging studies are reporting an increasing amount of data on abnormal neuronal functions in BPD adult patients. However, no functional neuroimaging studies have been conducted in adolescents with BPD.Objectives This pilot project aims to evaluate the feasibility of a functional magnetic resonance imaging (fMRI) study coupled with clinical and psychological measures in adolescent girls with a diagnosis of BPD. It also aims to identify neuronal regions of interest (ROI) for the study of BPD in adolescent girls.Method Six female adolescents meeting DSM-IV criteria for BPD and 6 female adolescents without psychiatric disorder were recruited. Both groups were evaluated for BPD symptoms, depressive symptoms, impulsivity, affective lability, and other potential psychiatric comorbidities. We used fMRI to compare patterns of regional brain activation between these two groups as they viewed 20 positive, 20 negative and 20 neutral emotion-inducing pictures, which were presented in random order.Results Participants were recruited over a period of 22 months. The protocol was well tolerated by participants. Mean age of the BPD group and control group was 15.8 ± 0.9 years-old and 15.5 ± 1.2 years-old respectively. Psychiatric comorbidity and use of medication was common among participants in the BPD group. This group showed higher impulsivity and affective lability scores. For the fMRI task, BPD patients demonstrated greater differences in activation

  5. Genome-wide association study of antisocial personality disorder.

    PubMed

    Rautiainen, M-R; Paunio, T; Repo-Tiihonen, E; Virkkunen, M; Ollila, H M; Sulkava, S; Jolanki, O; Palotie, A; Tiihonen, J

    2016-01-01

    The pathophysiology of antisocial personality disorder (ASPD) remains unclear. Although the most consistent biological finding is reduced grey matter volume in the frontal cortex, about 50% of the total liability to developing ASPD has been attributed to genetic factors. The contributing genes remain largely unknown. Therefore, we sought to study the genetic background of ASPD. We conducted a genome-wide association study (GWAS) and a replication analysis of Finnish criminal offenders fulfilling DSM-IV criteria for ASPD (N=370, N=5850 for controls, GWAS; N=173, N=3766 for controls and replication sample). The GWAS resulted in suggestive associations of two clusters of single-nucleotide polymorphisms at 6p21.2 and at 6p21.32 at the human leukocyte antigen (HLA) region. Imputation of HLA alleles revealed an independent association with DRB1*01:01 (odds ratio (OR)=2.19 (1.53-3.14), P=1.9 × 10(-5)). Two polymorphisms at 6p21.2 LINC00951-LRFN2 gene region were replicated in a separate data set, and rs4714329 reached genome-wide significance (OR=1.59 (1.37-1.85), P=1.6 × 10(-9)) in the meta-analysis. The risk allele also associated with antisocial features in the general population conditioned for severe problems in childhood family (β=0.68, P=0.012). Functional analysis in brain tissue in open access GTEx and Braineac databases revealed eQTL associations of rs4714329 with LINC00951 and LRFN2 in cerebellum. In humans, LINC00951 and LRFN2 are both expressed in the brain, especially in the frontal cortex, which is intriguing considering the role of the frontal cortex in behavior and the neuroanatomical findings of reduced gray matter volume in ASPD. To our knowledge, this is the first study showing genome-wide significant and replicable findings on genetic variants associated with any personality disorder. PMID:27598967

  6. The Influence of Personality Traits on Emotion Expression in Bulimic Spectrum Disorders: A Pilot Study.

    PubMed

    Giner-Bartolomé, Cristina; Steward, Trevor; Wolz, Ines; Jiménez-Murcia, Susana; Granero, Roser; Tárrega, Salomé; Fernández-Formoso, José Antonio; Soriano-Mas, Carles; Menchón, José M; Fernández-Aranda, Fernando

    2016-07-01

    Facial expressions are critical in forming social bonds and in signalling one's emotional state to others. In eating disorder patients, impairments in facial emotion recognition have been associated with eating psychopathology severity. Little research however has been carried out on how bulimic spectrum disorder (BSD) patients spontaneously express emotions. Our aim was to investigate emotion expression in BSD patients and to explore the influence of personality traits. Our study comprised 28 BSD women and 15 healthy controls. Facial expressions were recorded while participants played a serious video game. Expressions of anger and joy were used as outcome measures. Overall, BSD participants displayed less facial expressiveness than controls. Among BSD women, expressions of joy were positively associated with reward dependence, novelty seeking and self-directedness, whereas expressions of anger were associated with lower self-directedness. Our findings suggest that specific personality traits are associated with altered emotion facial expression in patients with BSD. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association. PMID:27028106

  7. BORDERLINE PERSONALITY DISORDER IN THE MEDICAL SETTING: Suggestive Behaviors, Syndromes, and Diagnoses

    PubMed Central

    Sansone, Lori A.

    2015-01-01

    Borderline personality disorder is a personality dysfunction that is characterized by disinhibition and impulsivity, which oftentimes manifest as self-regulation difficulties. Patients with this disorder have always been present in medical settings, but have been described as “difficult patients” rather than patients with borderline personality disorder. According to empirical findings, a number of behaviors and medical syndromes/diagnoses are suggestive of borderline personality disorder. Suggestive behaviors in the medical setting may include aggressive or disruptive behaviors, the intentional sabotage of medical care, and excessive healthcare utilization. Suggestive medical syndromes and diagnoses in the medical setting may include alcohol and substance misuse (including the abuse of prescription medications), multiple somatic complaints, chronic pain, obesity, sexual impulsivity, and hair pulling. While not all-inclusive or diagnostic, these behaviors and syndromes/diagnoses may invite further clinical evaluation of the patient for borderline personality disorder. PMID:26351624

  8. BORDERLINE PERSONALITY DISORDER IN THE MEDICAL SETTING: Suggestive Behaviors, Syndromes, and Diagnoses.

    PubMed

    Sansone, Randy A; Sansone, Lori A

    2015-01-01

    Borderline personality disorder is a personality dysfunction that is characterized by disinhibition and impulsivity, which oftentimes manifest as self-regulation difficulties. Patients with this disorder have always been present in medical settings, but have been described as "difficult patients" rather than patients with borderline personality disorder. According to empirical findings, a number of behaviors and medical syndromes/diagnoses are suggestive of borderline personality disorder. Suggestive behaviors in the medical setting may include aggressive or disruptive behaviors, the intentional sabotage of medical care, and excessive healthcare utilization. Suggestive medical syndromes and diagnoses in the medical setting may include alcohol and substance misuse (including the abuse of prescription medications), multiple somatic complaints, chronic pain, obesity, sexual impulsivity, and hair pulling. While not all-inclusive or diagnostic, these behaviors and syndromes/diagnoses may invite further clinical evaluation of the patient for borderline personality disorder. PMID:26351624

  9. Preferred Psychological Internet Resources for Addressing Anxiety Disorders, Parenting Problems, Eating Disorders, and Chemical Dependency.

    ERIC Educational Resources Information Center

    Morse, Laura; Doran, Matt; Simonin, Danielle; Smith, Allyson; Maloney, Colleen; Wright, Cara; Underwood, Michelle; Hoppel, Andrea; O'Donnell, Shannon; Chambliss, Catherine

    Although the Internet offers information about psychological problems and support resources for behavioral health problems, the quality of this information varies widely. So as to offer guidance in this area, preferred sites pertaining to anxiety disorders, parenting problems, eating disorders, and chemical dependency were analyzed. A total of 365…

  10. Trajectories of Attention Deficit Hyperactivity Disorder and Oppositional Defiant Disorder Symptoms as Precursors of Borderline Personality Disorder Symptoms in Adolescent Girls

    ERIC Educational Resources Information Center

    Stepp, Stephanie D.; Burke, Jeffrey D.; Hipwell, Alison E.; Loeber, Rolf

    2012-01-01

    Little empirical evidence exists regarding the developmental links between childhood psychopathology and borderline personality disorder (BPD) in adolescence. The current study addresses this gap by examining symptoms of attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) as potential precursors. ADHD and BPD…

  11. The relationship between personality disorders and Axis I psychopathology: deconstructing comorbidity.

    PubMed

    Links, Paul S; Eynan, Rahel

    2013-01-01

    The purpose of this review is (a) to study and systematically review the recent literature examining the co-occurrence and relationships between Axis I psychiatric disorders and Axis II personality disorders, specifically the six originally proposed for the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5, and (b) to consider the clinical utility of the current Axis I and Axis II approach in the DSM-IV-TR and apply findings to state a position on the issue of collapsing together Axis I and Axis II. Community surveys or prospective cohort studies were reviewed as a priority. Our review indicates that the associations between clinical disorders and personality disorders clearly varied within each disorder and across the six personality disorders. Our understanding has advanced, particularly related to the clinical utility of comorbidity, and there may be sufficient evidence to support moving borderline personality disorder to Axis I. However, it seems premature to conclude that comorbidity is best conceptualized by having all disorders in a single category or by deleting disorders so that comorbidity is reduced. Our review suggests some priorities for future research into comorbidity, such as including personality disorders in future multivariate comorbidity models. PMID:23157449

  12. Personality disorder symptomatology is associated with anomalies in striatal and prefrontal morphology.

    PubMed

    Payer, Doris E; Park, Min Tae M; Kish, Stephen J; Kolla, Nathan J; Lerch, Jason P; Boileau, Isabelle; Chakravarty, M M

    2015-01-01

    Personality disorder symptomatology (PD-Sx) can result in personal distress and impaired interpersonal functioning, even in the absence of a clinical diagnosis, and is frequently comorbid with psychiatric disorders such as substance use, mood, and anxiety disorders; however, they often remain untreated, and are not taken into account in clinical studies. To investigate brain morphological correlates of PD-Sx, we measured subcortical volume and shape, and cortical thickness/surface area, based on structural magnetic resonance images. We investigated 37 subjects who reported PD-Sx exceeding DSM-IV Axis-II screening thresholds, and 35 age, sex, and smoking status-matched control subjects. Subjects reporting PD-Sx were then grouped into symptom-based clusters: N = 20 into Cluster B (reporting Antisocial, Borderline, Histrionic, or Narcissistic PD-Sx) and N = 28 into Cluster C (reporting Obsessive-Compulsive, Avoidant, or Dependent PD-Sx); N = 11 subjects reported PD-Sx from both clusters, and none reported Cluster A (Paranoid, Schizoid, or Schizotypal) PD-Sx. Compared to control, Cluster C PD-Sx was associated with greater striatal surface area localized to the caudate tail, smaller ventral striatum volumes, and greater cortical thickness in right prefrontal cortex. Both Cluster B and C PD-Sx groups also showed trends toward greater posterior caudate volumes and orbitofrontal surface area anomalies, but these findings did not survive correction for multiple comparisons. The results point to morphological abnormalities that could contribute to Cluster C PD-Sx. In addition, the observations parallel those in substance use disorders, pointing to the importance of considering PD-Sx when interpreting findings in often-comorbid psychiatric disorders. PMID:26379535

  13. Personality disorder symptomatology is associated with anomalies in striatal and prefrontal morphology

    PubMed Central

    Payer, Doris E.; Park, Min Tae M.; Kish, Stephen J.; Kolla, Nathan J.; Lerch, Jason P.; Boileau, Isabelle; Chakravarty, M. M.

    2015-01-01

    Personality disorder symptomatology (PD-Sx) can result in personal distress and impaired interpersonal functioning, even in the absence of a clinical diagnosis, and is frequently comorbid with psychiatric disorders such as substance use, mood, and anxiety disorders; however, they often remain untreated, and are not taken into account in clinical studies. To investigate brain morphological correlates of PD-Sx, we measured subcortical volume and shape, and cortical thickness/surface area, based on structural magnetic resonance images. We investigated 37 subjects who reported PD-Sx exceeding DSM-IV Axis-II screening thresholds, and 35 age, sex, and smoking status-matched control subjects. Subjects reporting PD-Sx were then grouped into symptom-based clusters: N = 20 into Cluster B (reporting Antisocial, Borderline, Histrionic, or Narcissistic PD-Sx) and N = 28 into Cluster C (reporting Obsessive–Compulsive, Avoidant, or Dependent PD-Sx); N = 11 subjects reported PD-Sx from both clusters, and none reported Cluster A (Paranoid, Schizoid, or Schizotypal) PD-Sx. Compared to control, Cluster C PD-Sx was associated with greater striatal surface area localized to the caudate tail, smaller ventral striatum volumes, and greater cortical thickness in right prefrontal cortex. Both Cluster B and C PD-Sx groups also showed trends toward greater posterior caudate volumes and orbitofrontal surface area anomalies, but these findings did not survive correction for multiple comparisons. The results point to morphological abnormalities that could contribute to Cluster C PD-Sx. In addition, the observations parallel those in substance use disorders, pointing to the importance of considering PD-Sx when interpreting findings in often-comorbid psychiatric disorders. PMID:26379535

  14. Traumatic exposure and posttraumatic stress disorder in borderline, schizotypal, avoidant, and obsessive-compulsive personality disorders: findings from the collaborative longitudinal personality disorders study.

    PubMed

    Yen, Shirley; Shea, M Tracie; Battle, Cynthia L; Johnson, Dawn M; Zlotnick, Caron; Dolan-Sewell, Regina; Skodol, Andrew E; Grilo, Carlos M; Gunderson, John G; Sanislow, Charles A; Zanarini, Mary C; Bender, Donna S; Rettew, Jennifer Bame; McGlashan, Thomas H

    2002-08-01

    The association between trauma and personality disorders (PDs), while receiving much attention and debate, has not been comprehensively examined for multiple types of trauma and PDs. The authors examined data from a multisite study of four PD groups: schizotypal, borderline (BPD), avoidant, and obsessive-compulsive, and a major depression comparison group. Rates of traumatic exposure to specific types of trauma, age of first trauma onset, and rates of posttraumatic stress disorder are compared. Results indicate that BPD participants reported the highest rate of traumatic exposure (particularly to sexual traumas, including childhood sexual abuse), the highest rate of posttraumatic stress disorder, and youngest age of first traumatic event. Those with the more severe PDs (schizotypal, BPD) reported more types of traumatic exposure and higher rates of being physically attacked (childhood and adult) when compared to other groups. These results suggest a specific relationship between BPD and sexual trauma (childhood and adult) that does not exist among other PDs. In addition, they support an association between severity of PD and severity of traumatic exposure, as indicated by earlier trauma onset, trauma of an assaultive and personal nature, and more types of traumatic events. PMID:12193835

  15. Awareness and Treatment of Alcohol Dependence in Japan: Results from Internet-Based Surveys in Persons, Family, Physicians and Society

    PubMed Central

    Taguchi, Yurie; Takei, Yoshiyuki; Sasai, Ryoko; Murteira, Susana

    2014-01-01

    Aims: To understand current awareness of, and views on, treatment of alcohol dependence in Japan. Methods: (a) Nationwide internet-based survey of 520 individuals, consisting of 52 diagnosed alcohol-dependent (AD) persons, 154 potentially alcohol-dependent (ADP) persons, 104 family members and 106 friends/colleagues of AD persons, and 104 general individuals, derived from a consumer panel where the response rate was 64.3%. We enquired into awareness about the treatment of alcohol dependence and patient pathways through the healthcare network. (b) Nationwide internet-based survey of physicians (response rate 10.1% (2395/23,695) to ask 200 physicians about their management of alcohol use disorders). Results: We deduced that 10% of alcohol-dependent Japanese persons had ever been diagnosed with alcohol dependence, with only 3% ever treated. Regarding putative treatment goals, 20–25% of the AD and ADP persons would prefer to attempt to abstain, while 60–75% preferred ‘reduced drinking.’ A half of the responding physicians considered abstinence as the primary treatment goal in alcohol dependence, while 76% considered reduced drinking as an acceptable goal. Conclusion: AD and ADP persons in Japan have low ‘disease awareness’ defined as ‘understanding of signs, symptoms and consequences of alcohol use disorders,’ which is in line with the overseas situation. The Japanese drinking culture and stigma toward alcohol dependence may contribute to such low disease awareness and current challenging treatment environment. While abstinence remains the preferred treatment goal among physicians, reduced drinking seems to be an acceptable alternative treatment goal to many persons and physicians in Japan. PMID:24893604

  16. Pharmacologic management of borderline personality disorder: a case study.

    PubMed

    Links, Paul S; Cook, Michele; Quastel, Adam

    2005-01-01

    General principles of the "outcome-focused" model of psychopharmacologic management of patients with BPD are illustrated using the case of Ms. A, a patient with borderline personality disorder (BPD) experiencing impulsivity such as suicidal behavior, chronic insomnia and concurrent substance abuse. The model includes (1) measurement of specific behavioral outcomes related to functioning; (2) assessment of the role of substance use/abuse in patients with BPD; (3) consideration of interventions to clarify and strengthen the boundaries of the therapeutic relationship-including short lengths of time between prescription refills, medication contracts outlining consequences if substances are obtained outside of the relationship, and urine testing to ascertain compliance; (4) an understanding of the psychodynamic meanings attributed to medication while positive and negative medication effects are monitored with treatment response or transference issues, and; (5) use of the N-of-1 approach to test the new medication vs previous medications using patient specific outcomes that are anticipated to change with the pharmacologic management. PMID:16459755

  17. Borderline personality disorder: a comparison between children and adults.

    PubMed

    Sharp, Carla; Romero, Catherine

    2007-01-01

    Recently, more empirical studies have been devoted to the investigation of borderline personality disorder (BPD) in children and adolescents. Against this background, the purpose of the current review is to compare research findings on diagnostic-related phenomena in child and adolescent samples with those in adult samples to establish the utility of the BPD construct in childhood and adolescence. A search of relevant publications reported in Pubmed and PsycInfo from 1940 (the first clinical descriptions of BPD in childhood) to 2006 was carried out. A total of 58 studies were included. The review of the adult literature was not exhaustive but relied on excellent existing and comprehensive reviews of the adult literature carried out in the past 5 years. Although significant differences seem to exist between juveniles and adults in diagnostic-related phenomena associated with BPD, these can be explained by the principle of heterotypic continuity in development. Moreover, enough overlap between juvenile and adult BPD has been observed to warrant further empirical investigation into the construct of juvenile BPD. Specific areas for future research in juvenile BPD suggested by this review include studies of comorbidity, measure development, and the use of neurobiological measures such as functional neuroimaging. PMID:17666001

  18. Borderline Personality Disorder as a Female Phenotypic Expression of Psychopathy?

    PubMed Central

    Sprague, Jenessa; Javdani, Shabnam; Sadeh, Naomi; Newman, Joseph P.; Verona, Edelyn

    2011-01-01

    Evidence suggests that the combination of the interpersonal-affective (F1) and impulsive-antisocial (F2) features of psychopathy may be associated with borderline personality disorder (BPD), specifically among women (e.g., Coid, 1993; Hicks, Vaidyana-than, & Patrick, 2010). However, empirical research explicitly examining gendered relationships between BPD and psychopathy factors is lacking. To further inform this area of research, we investigated the hypothesis that the interplay between the two psychopathy factors is associated with BPD among women across two studies. Study 1 consisted of a college sample of 318 adults (51% women), and Study 2 consisted of a large sample of 488 female prisoners. The interpersonal-affective (F1) and impulsiveantisocial psychopathy (F2) scores, measured with self-report and clinician-rated indices, respectively, were entered as explanatory variables in regression analyses to investigate their unique contributions to BPD traits. Across two independent samples, results indicated that the interaction of high F1 and F2 psychopathy scores was associated with BPD in women. This association was found to be specific to women in Study 1. These results suggest that BPD and psychopathy, at least as they are measured by current instruments, overlap in women and, accordingly, may reflect gender-differentiated phenotypic expressions of similar dispositional vulnerabilities. PMID:22452756

  19. White Matter Abnormalities in Schizophrenia and Schizotypal Personality Disorder

    PubMed Central

    Lener, Marc S.; Wong, Edmund; Tang, Cheuk Y.; Byne, William; Goldstein, Kim E.; Blair, Nicholas J.; Haznedar, M. Mehmet; New, Antonia S.; Chemerinski, Eran; Chu, King-Wai; Rimsky, Liza S.; Siever, Larry J.; Koenigsberg, Harold W.; Hazlett, Erin A.

    2015-01-01

    Prior diffusion tensor imaging (DTI) studies examining schizotypal personality disorder (SPD) and schizophrenia, separately have shown that compared with healthy controls (HCs), patients show frontotemporal white matter (WM) abnormalities. This is the first DTI study to directly compare WM tract coherence with tractography and fractional anisotropy (FA) across the schizophrenia spectrum in a large sample of demographically matched HCs (n = 55), medication-naive SPD patients (n = 49), and unmedicated/never-medicated schizophrenia patients (n = 22) to determine whether (a) frontal-striatal-temporal WM tract abnormalities in schizophrenia are similar to, or distinct from those observed in SPD; and (b) WM tract abnormalities are associated with clinical symptom severity indicating a common underlying pathology across the spectrum. Compared with both the HC and SPD groups, schizophrenia patients showed WM abnormalities, as indexed by lower FA in the temporal lobe (inferior longitudinal fasciculus) and cingulum regions. SPD patients showed lower FA in the corpus callosum genu compared with the HC group, but this regional abnormality was more widespread in schizophrenia patients. Across the schizophrenia spectrum, greater WM disruptions were associated with greater symptom severity. Overall, frontal-striatal-temporal WM dysconnectivity is attenuated in SPD compared with schizophrenia patients and may mitigate the emergence of psychosis. PMID:24962608

  20. Satanism, ritual abuse, and multiple personality disorder: a sociohistorical perspective.

    PubMed

    Mulhern, S

    1994-10-01

    During the past decade in North America, a growing number of mental health professionals have reported that between 25% and 50% of their patients in treatment for multiple personality disorder (MPD) have recovered early childhood traumatic memories of ritual torture, incestuous rape, sexual debauchery, sacrificial murder, infanticide, and cannibalism perpetrated by members of clandestine satanic cults. Although hundreds of local and federal police investigations have failed to corroborate patients' therapeutically constructed accounts, because the satanic etiology of MPD is logically coherent with the neodissociative, traumatic theory of psychopathology, conspiracy theory has emerged as the nucleus of a consistent pattern of contemporary clinical interpretation. Resolutely logical and thoroughly operational, ultrascientific psychodemonology remains paradoxically oblivious to its own irrational premises. When the hermetic logic of conspiracy theory is stripped away by historical and socio/psychological analysis, however, the hypothetical perpetrators of satanic ritual abuse simply disappear, leaving in their wake the very real human suffering of all those who have been caught up in the social delusion. PMID:7960286

  1. Defining the neurocircuitry of borderline personality disorder: functional neuroimaging approaches.

    PubMed

    Brendel, Gary R; Stern, Emily; Silbersweig, David A

    2005-01-01

    Functional neuroimaging recently has been used to localize brain dysfunction in borderline personality disorder (BPD). Initial studies have examined baseline activity or emotional reactivity, and our group has investigated what we consider to be a crucial interaction between negative emotion and behavioral (dys)control. This research is beginning to identify abnormal frontolimbic circuitry likely underlying core clinical features of this condition. We review the evidence for dysfunction in specific frontolimbic regions, leading to a mechanistic model of symptom formation in BPD. In addition, we offer an integration of these neuroimaging findings with developmental perspectives on the emergence of borderline psychopathology, focusing on the ways in which early psychosocial experience may interact with developing brain systems. We also consider possible mechanisms of psychotherapeutic change at the neural systems level in BPD. Finally, we propose that future neuroimaging studies of BPD should integrate multiple levels of observation (structural, functional, neurochemical, genetic, and clinical) in a model-driven fashion to further understand the dynamic relationship between biological and psychological factors in the development and treatment of this difficult condition. PMID:16613437

  2. Facial expression of emotions in borderline personality disorder and depression.

    PubMed

    Renneberg, Babette; Heyn, Katrin; Gebhard, Rita; Bachmann, Silke

    2005-09-01

    Borderline personality disorder (BPD) is characterized by marked problems in interpersonal relationships and emotion regulation. The assumption of emotional hyper-reactivity in BPD is tested regarding the facial expression of emotions, an aspect highly relevant for communication processes and a central feature of emotion regulation. Facial expressions of emotions are examined in a group of 30 female inpatients with BPD, 27 women with major depression and 30 non-patient female controls. Participants were videotaped while watching two short movie sequences, inducing either positive or negative emotions. Frequency of emotional facial expressions and intensity of happiness expressions were examined, using the Emotional Facial Action Coding System (EMFACS-7, Friesen & Ekman, EMFACS-7: Emotional Facial Action Coding System, Version 7. Unpublished manual, 1984). Group differences were analyzed for the negative and the positive mood-induction procedure separately. Results indicate that BPD patients reacted similar to depressed patients with reduced facial expressiveness to both films. The highest emotional facial activity to both films and most intense happiness expressions were displayed by the non-clinical control group. Current findings contradict the assumption of a general hyper-reactivity to emotional stimuli in patients with BPD. PMID:15950175

  3. Maternal Borderline Personality Disorder Symptoms and Parenting of Adolescent Daughters

    PubMed Central

    Zalewski, Maureen; Stepp, Stephanie D.; Scott, Lori N.; Whalen, Diana J.; Beeney, Joseph F.; Hipwell, Alison E.

    2014-01-01

    Maternal borderline personality disorder (BPD) symptoms are associated with poorer parenting. However, most studies conducted are with young children. In the current study, the authors examined associations between maternal BPD symptoms and parenting in an urban community sample of 15- to 17-year-old girls (n = 1,598) and their biological mothers. Additionally, the authors tested the impact of adolescent temperament on these associations. Mothers reported on their own psychopathology and their daughters' temperament. Adolescent girls reported on mothers' parenting methods in terms of psychological and behavioral control. Results demonstrated that maternal BPD symptoms were associated with aspects of psychological and behavioral control, even after controlling for maternal depression and alcohol use severity. After examining specific BPD components that may account for these associations, the authors found that affective/behavioral dysregulation, but not interpersonal dysregulation or identity disturbance, uniquely accounted for parenting. Adolescent temperament did not moderate these associations. BPD symptoms, particularly affective/behavioral dysregulation, are important targets when conducting parenting interventions. PMID:24689767

  4. A Fairbairnian structural analysis of the narcissistic personality disorder.

    PubMed

    Celani, David P

    2014-06-01

    Fairbairn's structural theory is based on the developing child's need to dissociate actual events between himself or herself and his or her objects that are excessively rejecting in order to contine an uninterrupted, pristine attachment to them. This eventuates in three selves in relation to three objects: One pair is conscious (the central ego which relates to the ideal object), while the other two pairs (the antilibidinal ego, which relates to the rejecting object, and the libidinal ego, which relates to the exciting object) are mostly held in the unconscious. Fairbairn saw the fluid relationship between the two split-off pairs of unconscious part selves and the conscious central ego as the primary dynamic of the human personality. The author proposes a specific variation in Fairbairn's structural theory to account for the development of narcissism. Specifically, this disorder is viewed as the result of a developmental history in which the child finds himself or herself in an exceedingly hostile interpersonal environment that precludes the child from using an idealized version either of his or her parental objects as the "exciting object." The child therefore substitutes a grandiose view of himself or herself as the exciting object. This defense deflects external influences and replaces relationships with external objects with a closed internal world that is comprised of an admiring part-self basking in reflected love from its relationship with an exciting part-object. PMID:24866161

  5. Working around a contested diagnosis: borderline personality disorder in adolescence.

    PubMed

    Koehne, Kristy; Hamilton, Bridget; Sands, Natisha; Humphreys, Cathy

    2013-01-01

    This discourse analytic study sits at the intersection of everyday communications with young people in mental health settings and the enduring sociological critique of diagnoses in psychiatry. The diagnosis of borderline personality disorder (BPD) is both contested and stigmatized, in mental health and general health settings. Its legitimacy is further contested within the specialist adolescent mental health setting. In this setting, clinicians face a quandary regarding the application of adult diagnostic criteria to an adolescent population, aged less than 18 years. This article presents an analysis of interviews undertaken with Child and Adolescent Mental Health Services (CAMHS) clinicians in two publicly funded Australian services, about their use of the BPD diagnosis. In contrast with notions of primacy of diagnosis or of transparency in communications, doctors, nurses and allied health clinicians resisted and subverted a diagnosis of BPD in their work with adolescents. We delineate specific social and discursive strategies that clinicians displayed and reflected on, including: team rules which discouraged diagnostic disclosure; the lexical strategy of hedging when using the diagnosis; the prohibition and utility of informal 'borderline talk' among clinicians; and reframing the diagnosis with young people. For clinicians, these strategies legitimated their scepticism and enabled them to work with diagnostic uncertainty, in a population identified as vulnerable. For adolescent identities, these strategies served to forestall a BPD trajectory, allowing room for troubled adolescents to move and grow. These findings illuminate how the contest surrounding this diagnosis in principle is expressed in everyday clinical practice. PMID:22674745

  6. Borderline Personality Disorder in the Emergency Department: Good Psychiatric Management.

    PubMed

    Hong, Victor

    2016-01-01

    Patients with borderline personality disorder (BPD) are high utilizers of psychiatric emergency services and present unique challenges in that setting. Frequently advised to visit an emergency department (ED) if safety is in question, their experiences once there often do not have beneficial effects. Issues specific to patients with BPD in the ED include volatile interactions with staff, repeat visits, concerns about safety (and liability), and disposition. Emergency department staff attitudes toward these patients are frequently negative when compared to patients with other diagnoses, and can detrimentally affect outcomes and perpetuate stigma regarding BPD. These attitudes are often due to lack of education and training about how to understand, approach, and treat the patient with BPD. The limited literature regarding the treatment of BPD in the ED offers few guidelines. This article presents an approach based on Good Psychiatric Management that can reduce negative reactions by ED staff and make ED visits more effective and less harmful. Relevant principles include psychoeducation, the reinforcement of the connection between symptoms and interpersonal stressors, and employment of an active, authentic therapeutic stance. Training ED staff in these principles could lead to attitudinal changes, reduced stigma, and potentially improved outcomes. PMID:27603743

  7. Social Cognition in a Clinical Sample of Personality Disorder Patients.

    PubMed

    Ruiz-Tagle, Amparo; Costanzo, Elsa; De Achával, Delfina; Guinjoan, Salvador

    2015-01-01

    Social cognition was assessed in a clinical sample of personality disorder (PD) stable patients receiving ambulatory treatment (N = 17) and healthy matched controls (N = 17) using tests of recognition of emotions in faces and eyes, in a test of social faux pas and in theory of mind (ToM) stories. Results indicated that when compared with healthy controls, individuals with PD showed a clear tendency to obtain lower scoring in tasks assessing recognition of emotion in faces (T = -2.602, p = 0.014), eyes (T = -3.593, p = 0.001), ToM stories (T = -4.706, p = 0.000), and Faux pas (T = -2.227, p = 0.035). In the present pilot study, PD individuals with a normal cognitive efficiency showed an impaired performance at social cognition assessment including emotion recognition and ToM. PMID:26074824

  8. Social Cognition in a Clinical Sample of Personality Disorder Patients

    PubMed Central

    Ruiz-Tagle, Amparo; Costanzo, Elsa; De Achával, Delfina; Guinjoan, Salvador

    2015-01-01

    Social cognition was assessed in a clinical sample of personality disorder (PD) stable patients receiving ambulatory treatment (N = 17) and healthy matched controls (N = 17) using tests of recognition of emotions in faces and eyes, in a test of social faux pas and in theory of mind (ToM) stories. Results indicated that when compared with healthy controls, individuals with PD showed a clear tendency to obtain lower scoring in tasks assessing recognition of emotion in faces (T = −2.602, p = 0.014), eyes (T = −3.593, p = 0.001), ToM stories (T = −4.706, p = 0.000), and Faux pas (T = −2.227, p = 0.035). In the present pilot study, PD individuals with a normal cognitive efficiency showed an impaired performance at social cognition assessment including emotion recognition and ToM. PMID:26074824

  9. Personal relatedness and attachment in infants of mothers with borderline personality disorder.

    PubMed

    Hobson, R Peter; Patrick, Matthew; Crandell, Lisa; García-Pérez, Rosa; Lee, Anthony

    2005-01-01

    The principal aim of this study was to assess personal relatedness and attachment patterns in 12-month-old infants of mothers with borderline personality disorder (BPD). We also evaluated maternal intrusive insensitivity toward the infants in semistructured play. We videotaped 10 mother-infant dyads with borderline mothers and 22 dyads where the mothers were free from psychopathology, in three different settings: a modification of Winnicott's Set Situation in which infants faced an initially unresponsive ("still-face") stranger, who subsequently tried to engage the infant in a game of give and take; the Strange Situation of Ainsworth and Wittig; and a situation in which mothers were requested to teach their infants to play with miniature figures and a toy train. In relation to a set of a priori predictions, the results revealed significant group differences as follows: (a) compared with control infants, toward the stranger the infants of mothers with BPD showed lower levels of "availability for positive engagement," lower ratings of "behavior organization and mood state," and a lower proportion of interpersonally directed looks that were positive; (b) in the Strange Situation, a higher proportion (8 out of 10) of infants of borderline mothers were categorized as Disorganized; and (c) in play, mothers with BPD were rated as more "intrusively insensitive" toward their infants. The results are discussed in relation to hypotheses concerning the interpersonal relations of women with BPD, and possible implications for their infants' development. PMID:16761548

  10. Neighborhood Disorder and the Sense of Personal Control: Which Factors Moderate the Association?

    ERIC Educational Resources Information Center

    Kim, Joongbaeck; Conley, Meghan E.

    2011-01-01

    This study examines whether and how select individual characteristics moderate the relationship between neighborhood disorder and a sense of personal control. Our findings show that neighborhood disorder is associated with a decreased sense of control. However, regression analyses including interaction terms of neighborhood disorder and some…

  11. Adolescent Disruptive Behavior and Borderline Personality Disorder Symptoms in Young Adult Men

    ERIC Educational Resources Information Center

    Burke, Jeffrey D.; Stepp, Stephanie D.

    2012-01-01

    Very few studies have prospective information, especially regarding males, on the prediction of Borderline Personality Disorder (BPD) in adulthood from psychiatric disorders in childhood. Certain childhood disorders, however, have notably similar features in common with BPD. In particular, the affective dysfunction, hostility and interpersonal…

  12. Depressive Personality Disorder: A Comparison of Three Self-Report Measures

    ERIC Educational Resources Information Center

    Miller, Joshua D.; Tant, Adam; Bagby, R. Michael

    2010-01-01

    Depressive personality disorder (DPD) was included in the appendix of the "Diagnostic and Statistical Manual of Mental Disorders", Fourth Edition ("DSM-IV") for further study. Questions abound regarding this disorder in terms of its distinctiveness from extant diagnostic constructs and clinical significance.This study examines the interrelations…

  13. Social Experience-Dependent Myelination: An Implication for Psychiatric Disorders

    PubMed Central

    Toritsuka, Michihiro; Kishimoto, Toshifumi

    2015-01-01

    Myelination is one of the strategies to promote the conduction velocity of axons in order to adjust to evolving environment in vertebrates. It has been shown that myelin formation depends on genetic programing and experience, including multiple factors, intracellular and extracellular molecules, and neuronal activities. Recently, accumulating studies have shown that myelination in the central nervous system changes more dynamically in response to neuronal activities and experience than expected. Among experiences, social experience-dependent myelination draws attention as one of the critical pathobiologies of psychiatric disorders. In this review, we summarize the mechanisms of neuronal activity-dependent and social experience-dependent myelination and discuss the contribution of social experience-dependent myelination to the pathology of psychiatric disorders. PMID:26078885

  14. Two-Year Prospective Naturalistic Study of Remission from Major Depressive Disorder as a Function of Personality Disorder Comorbidity

    ERIC Educational Resources Information Center

    Grilo, Carlos M.; Sanislow, Charles A.; Shea, Tracie M.; Skodol, Andrew E.; Stout, Robert L.; Gunderson, John G.; Yen, Shirley; Bender, Donna S.; Pagano, Maria E.; Morey, Leslie C.; McGlashan, Thomas H.

    2005-01-01

    In this study, the authors examined prospectively the 24-month natural course of remission from major depressive disorder (MDD) as a function of personality disorder (PD) comorbidity. In 302 participants (196 women, 106 men), psychiatric and PDs were assessed at baseline with diagnostic interviews, and the course of MDD was assessed with the…

  15. Personality Subtypes in Adolescents with Eating Disorders: Validation of a Classification Approach

    ERIC Educational Resources Information Center

    Thompson-Brenner, Heather; Eddy, Kamryn T.; Satir, Dana A.; Boisseau, Christina L.; Westen, Drew

    2008-01-01

    Background: Research has identified three personality subtypes in adults with eating disorders (EDs): a high-functioning, an undercontrolled, and an overcontrolled group. The current study investigated whether similar personality prototypes exist in adolescents with EDs, and whether these personality prototypes show relationships to external…

  16. Dimensional personality traits and the prediction of DSM-IV personality disorder symptom counts in a nonclinical sample.

    PubMed

    Bagby, R Michael; Marshall, Margarita B; Georgiades, Stelios

    2005-02-01

    The third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III; APA, 1980) set forth a categorical system of personality psychopathology that is composed of discrete personality disorders (PDs), each with a distinct set of diagnostic criteria. Although this system is widely accepted and highly influential, alternative dimensional approaches to capturing personality psychopathology have been proposed. Three dimensional models of personality have garnered particular attention-the Five-Factor Model (FFM; Costa & McCrae, 1992), the Seven-Factor Psychobiological Model of Temperament and Character (Seven-Factor Model; Cloninger, Svrakic, & Przybeck, 1993); and the 18-factor model of personality pathology (18-factor model; Livesley, 1986). Although the personality traits from each of these models has been examined in relation to the ten personality disorders in the DSM-IV, no study has examined the comparative and incremental validity of these models in predicting PD symptoms for these ten disorders. Using self-report instruments that measure these models and the ten DSM-IV PDs, correlation and linear regression analyses indicate that traits from all three models had statistically significant associations with PD symptom counts. Hierarchical regressions revealed that the 18-factor model had incremental predictive validity over the FFM and Seven-Fac-tor Model in predicting symptom counts for all ten DSM-IV PDs. The FFM had incremental predictive validity over the Seven-Factor Model model for all ten disorders and the Seven-Factor was able to add incremental predictive validity over the 18-factor model for five of the ten PDs and for eight of the ten disorders relative to the FFM. PMID:15899720

  17. Video Game Addiction in Gambling Disorder: Clinical, Psychopathological, and Personality Correlates

    PubMed Central

    Jiménez-Murcia, Susana; Fernández-Aranda, Fernando; Granero, Roser; Chóliz, Mariano; La Verde, Melania; Aguglia, Eugenio; Signorelli, Maria S.; Sá, Gustavo M.; Aymamí, Neus; Gómez-Peña, Mónica; del Pino-Gutiérrez, Amparo; Moragas, Laura; Fagundo, Ana B.; Sauchelli, Sarah; Fernández-Formoso, José A.; Menchón, José M.

    2014-01-01

    Objective. We studied the prevalences of video game use (VGU) and addiction (VGA) in gambling disorder (GD) patients and compared them with subjects with non-video game use (non-VGU) in relation to their gambling behavior, psychopathology, and personality characteristics. Method. A sample of 193 GD patients (121 non-VGU, 43 VGU, and 29 VGA) consecutively admitted to our pathological gambling unit participated in the study. Assessment. Measures included the video game dependency test (VDT), symptom checklist-90-revised, and the temperament and character inventory-revised, as well as a number of other GD indices. Results. In GD, the observed prevalence of VG (use or addiction) was 37.3% (95% CI :30.7% ÷ 44.3),VGU 22.3% (95% CI :17.0% ÷ 28.7), and VGA 15% (95% CI :10.7% ÷ 20.7). Orthogonal polynomial contrast into logistic regression showed positive linear trends for VG level and GD severity and other measures of general psychopathology. After structural equation modeling, higher VG total scores were associated with younger age, general psychopathology, and specific personality traits, but not with GD severity. Patients' sex and age were involved in the mediational pathways between personality traits and VG impairment. Conclusions. GD patients with VG are younger and present more dysfunctional personality traits, and more general psychopathology. The presence of VG did not affect the severity of GD. PMID:25126551

  18. Arrest types and co-occurring disorders in persons with schizophrenia or related psychoses.

    PubMed

    McCabe, Patrick J; Christopher, Paul P; Druhn, Nicholas; Roy-Bujnowski, Kristen M; Grudzinskas, Albert J; Fisher, William H

    2012-07-01

    This study examined the patterns of criminal arrest and co-occurring psychiatric disorders among individuals with schizophrenia or related psychosis that were receiving public mental health services and had an arrest history. Within a 10-year period, 65% of subjects were arrested for crimes against public order, 50% for serious violent crimes, and 45% for property crimes. The presence of any co-occurring disorder increased the risk of arrest for all offense categories. For nearly all offense types, antisocial personality disorder and substance use disorders conferred the greatest increase in risk for arrest. Among anxiety disorders, post-traumatic stress disorder was associated with a greater risk of arrest for serious violent crimes but not other offense types. Criminal risk assessments and clinical management in this population should focus on co-occurring antisocial personality disorder and substance use disorders in addition to other clinical and non-clinical factors. PMID:22270830

  19. Mental health, personality, and parental rearing styles of adolescents with Internet addiction disorder.

    PubMed

    Xiuqin, Huang; Huimin, Zhang; Mengchen, Li; Jinan, Wang; Ying, Zhang; Ran, Tao

    2010-08-01

    The objectives of this study were to compare the personality profiles of adolescent males with and without Internet addiction disorder (IAD), and to determine if IAD is associated with specific parental rearing behaviors. A total of 304 subjects (204 IAD positive and 100 IAD negative controls) completed three instruments: Symptom Checklist-90-revision (SCL-90-R), Eysenck Personality Questionnaire Revised (EPQ-R), and Egna Minnen av Barndoms Uppfostran--'My Memories of Upbringing' (EMBU). SCL-90-R profiles of adolescents with IAD revealed comparatively higher mean scores for all of the nine domains, and significantly higher scores for obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, and paranoid ideation; the mean global symptom index of adolescents with IAD was also significantly higher by approximately 10%. EPQ profiles of adolescents with IAD showed that Internet-dependent individuals tended to exhibit a significantly lower degree of extraversion and a significantly higher degree of psychoticism when compared with the control group. EMBU profiles revealed that adolescents with IAD generally rated both maternal and paternal rearing practices as lacking in emotional warmth, being over-involved, rejecting, and punitive (mothers only). The results of this study confirm that IAD often occurs concurrently with mental symptoms and personality traits such as introversion and psychoticism. Adolescents with IAD consistently rated parental rearing behaviors as being over-intrusive, punitive, and lacking in responsiveness. These findings suggest that the influences of parenting style and family function are important factors in the development of Internet dependency. PMID:20712498

  20. Stepped care: an alternative to routine extended treatment for patients with borderline personality disorder.

    PubMed

    Paris, Joel

    2013-10-01

    This review examined evidence supporting stepped care for borderline personality disorder as an alternative to routine extended treatment. Empirical studies have shown that patients with borderline personality disorder have a heterogeneous course, but symptomatic improvement can sometimes be relatively rapid. Currently, there is no evidence that any long-term treatment is superior to briefer interventions for borderline personality disorder. Long-term therapy may not be necessary for all patients, and its routine use leads to access problems. A stepped-care model, similar to models applied to other severe mental disorders, might provide a better use of resources. Stepped care can be used to limit the use of expensive programs and reduce waiting lists. Not all patients with borderline personality disorder can be treated briefly, but a stepped-care model allows those with less severe symptoms to be managed with fewer resources, freeing up more time and personnel for the treatment of those who need treatment the most. PMID:23945913

  1. Regional Cortical Thinning in Subjects With Violent Antisocial Personality Disorder or Schizophrenia

    PubMed Central

    Narayan, Veena M.; Narr, Katherine L.; Kumari, Veena; Woods, Roger P.; Thompson, Paul M.; Toga, Arthur W.; Sharma, Tonmoy

    2011-01-01

    Violent behavior is associated with antisocial personality disorder and to a lesser extent with schizophrenia. Neuroimaging studies have suggested that several biological systems are disturbed in schizophrenia, and structural changes in frontal and temporal lobe regions are reported in both antisocial personality disorder and schizophrenia. The neural substrates that underlie violent behavior specifically and their structural analogs, however, remain poorly understood. Nor is it known whether a common biological basis exists for aggressive, impulsive, and violent behavior across these clinical populations. To explore the correlates of violence with brain structure in antisocial personality disorder and schizophrenia, the authors used magnetic resonance imaging data to investigate for the first time, to the authors’ knowledge, regional differences in cortical thickness in violent and nonviolent individuals with schizophrenia and/or antisocial personality disorder and in healthy comparison subjects. Subject groups included right-handed men closely matched for demographic variables (total number of subjects=56). Violence was associated with cortical thinning in the medial inferior frontal and lateral sensory motor cortex, particularly in the right hemisphere, and surrounding association areas (Brodmann’s areas 10, 11, 12, and 32). Only violent subjects with antisocial personality disorder exhibited cortical thinning in inferior mesial frontal cortices. The biological underpinnings of violent behavior may therefore vary between these two violent subject groups in which the medial frontal cortex is compromised in antisocial personality disorder exclusively, but laminar abnormalities in sensorimotor cortices may relate to violent behavior in both antisocial personality disorder and schizophrenia. PMID:17728428

  2. A longitudinal study of the 10-year course of interpersonal features in borderline personality disorder.

    PubMed

    Choi-Kain, Lois W; Zanarini, Mary C; Frankenburg, Frances R; Fitzmaurice, Garrett M; Reich, D Bradford

    2010-06-01

    The literature on borderline personality disorder (BPD) describes interpersonal disturbances as a core sector of psychopathology. The longitudinal course of these features remains poorly understood. Our aim is to describe the course of interpersonal features of BPD in a more detailed way than has been done previously. Twenty interpersonal aspects of borderline psychopathology were assessed using two reliable semi-structured diagnostic interviews at baseline and at five successive two-year follow-up waves in the ongoing McLean Study for Adult Development. Behaviorally-oriented features, such as recurrent breakups, sadism, demandingness, entitlement, regression in treatment, and boundary violations, remitted quickly and were rare at the end of follow-up. The interpersonal features slowest to remit were affective responses to being alone, active caretaking, discomfort with care, and dependency. The behavioral interpersonal features of BPD remit rapidly, while core affectively-oriented features related to intolerance of aloneness and conflicts over dependency are more persistent. PMID:20545500

  3. Police officers' views of their encounters with people with personality disorder.

    PubMed

    Martin, T; Thomas, S

    2015-03-01

    In Australia, people experiencing personality disorder have featured little in policing studies and policy or mental health policy and legislation, and in the absence of specific guidance their behaviours represent an ongoing challenge for police. This paper presents police officers' accounts from a qualitative research project that explored police encounters with people experiencing mental illness. The officers singled out people with personality disorder and expressed frustration, anger, powerlessness and resignation with their referrals of this group to health services. Officers reported that emergency departments were reluctant to assess people with personality disorder and when they did assess them stated that the person did not meet criteria for admission to mental health services, or if admitted, they were quickly discharged. People with personality disorder were reported to take up considerable police resources. When police were told by mental health professionals that there was nothing they could do about people experiencing personality disorder, then the question from police was what was to be done with them. While pockets of collaborative practice exist between police and mental health services, much change is required to demonstrate that the needs of the person with personality disorder are being met. PMID:23834347

  4. Confidence in facial emotion recognition in borderline personality disorder.

    PubMed

    Thome, Janine; Liebke, Lisa; Bungert, Melanie; Schmahl, Christian; Domes, Gregor; Bohus, Martin; Lis, Stefanie

    2016-04-01

    Dysfunctions of social-cognitive processes such as the recognition of emotions have been discussed to contribute to the severe impairments of interpersonal functioning in borderline personality disorder (BPD). By investigating how patients with BPD experience the intensity of different emotions in a facial expression and how confident they are in their own judgments, the current study aimed at identifying subtle alterations of emotion processing in BPD. Female patients with BPD (N = 36) and 36 healthy controls were presented with faces that displayed low-intense anger and happiness or ambiguous expressions of anger and happiness blends. Subjects were asked to rate (a) the intensity of anger and happiness in each facial expression and (b) their confidence in their judgments. Patients with BPD rated the intensity of happiness in happy faces lower than did controls, but did not differ in regard to the assessment of angry or ambiguous facial stimuli or the rating of anger. They reported lower confidence in their judgments, which was particularly pronounced for the assessment of happy facial expressions. The reduced rating of happiness was linked to higher state anger, whereas the reduced confidence in the assessment of happy faces was related to stronger feelings of loneliness and the expectation of social rejection. Our findings suggest alterations in the processing of positive social stimuli that affect both the experience of the emotional intensity and the confidence subjects experience during their assessment. The link to loneliness and social rejection sensitivity points to the necessity to target these alterations in psychotherapeutical interventions. (PsycINFO Database Record PMID:26389624

  5. Emotional lability and affective synchrony in borderline personality disorder.

    PubMed

    Schoenleber, Michelle; Berghoff, Christopher R; Tull, Matthew T; DiLillo, David; Messman-Moore, Terri; Gratz, Kim L

    2016-07-01

    Extant research on emotional lability in borderline personality disorder (BPD) has focused almost exclusively on lability of individual emotions or emotion types, with limited research considering how different types of emotions shift together over time. Thus, this study examined the temporal dynamics of emotion in BPD at the level of both individual emotions (i.e., self-conscious emotions [SCE], anger, and anxiety) and mixed emotions (i.e., synchrony between emotions). One hundred forty-four women from the community completed a diagnostic interview and laboratory study involving 5 emotion induction tasks (each of which was preceded and followed by a 5-min resting period or neutral task). State ratings of SCE, anger, and anxiety were provided at 14 time points (before and after each laboratory task and resting period). Hierarchical linear modeling results indicate that women with BPD reported greater mean levels of SCE and Anxiety (but not Anger), and greater lability of Anxiety. Women with BPD also exhibited greater variability in lability of all 3 emotions (suggestive of within-group differences in the relevance of lability to BPD). Results also revealed synchrony (i.e., positive relations) between each possible pair of emotions, regardless of BPD status. Follow-up regression analyses suggest the importance of accounting for lability when examining the role of synchrony in BPD, as the relation of SCE-Anger synchrony to BPD symptom severity was moderated by Anger and SCE lability. Specifically, synchronous changes in SCE and Anger were associated with greater BPD symptom severity when large shifts in SCE were paired with minor shifts in Anger. (PsycINFO Database Record PMID:27362623

  6. Chemical Dependency and Eating Disorders: Are They Really so Different?

    ERIC Educational Resources Information Center

    Cooper, Stewart E.

    1989-01-01

    Develops biopsychosocial perspective to help counselors integrate assessment, treatment, evaluation, and research with chemical dependency and eating disorders addictions. Claims that, although different in content and symptoms, the underlying similarities between these clinical syndromes are clearly seen through this paradigm. (Author)

  7. Personality Features and Expressed Concerns of Adolescents with Eating Disorders.

    ERIC Educational Resources Information Center

    Pryor, Tamara; Wiederman, Michael W.

    1998-01-01

    Investigates differences between adolescent females diagnosed with either anorexia nervosa (n=26) or bulimia nervosa (n=30) using the Millon Adolescent Personality Inventory. About half of the participants displayed an inhibited personality style. Anorexics scored higher on the Respectful personality scale. Expressed concerns over self-concept,…

  8. Mediation of early maladaptive schemas between perceptions of parental rearing style and personality disorder symptoms.

    PubMed

    Thimm, Jens C

    2010-03-01

    In schema therapy (ST), early maladaptive schemas (EMS) are proposed to be the defining core of personality disorders. Adverse relational experiences in childhood are assumed to be the main cause for the development of EMS. The present study explored the links between perceived parental rearing behaviours, EMS, and personality disorder symptoms in a clinical sample (N=108). Results from mediation analyses suggest that EMS mediate the relationships between recalled parenting rearing behaviours and personality disorder symptoms. Findings give support to the theoretical model ST is based on. PMID:19896642

  9. Prevalence and treatment of personality disorders in Dutch forensic mental health services.

    PubMed

    de Ruiter, Corine; Trestman, Robert L

    2007-01-01

    Offenders with serious personality disorders challenge forensic systems throughout the world. In this article, the authors describe the legal system that shapes the forensic treatment of personality-disordered offenders in the Dutch psychiatric and correctional systems. The evolution of laws and regulations are addressed, as is the bifurcation of treatment between forensic hospitals and correctional settings. Prevalence data of personality disorders in the Dutch systems are presented, and comparisons between the Dutch and American systems are delineated. Current treatment modalities are described. Research initiatives and future directions for the system are presented. PMID:17389350

  10. Relationships between childhood maltreatment, parenting style, and borderline personality disorder criteria.

    PubMed

    Hernandez, Ana; Arntz, Arnoud; Gaviria, Ana M; Labad, Antonio; Gutiérrez-Zotes, José Alfonso

    2012-10-01

    This study examines the relationship of different types of childhood maltreatment and the perceived parenting style with borderline personality disorder (BPD) criteria. Kendall's Tau partial correlations were performed controlling for the effect of simultaneous adverse experiences and Axis I and II symptoms in a sample of 109 female patients (32 BPD, 43 other personality disorder, and 34 non-personality disorder). BPD criteria were associated with higher scores on emotional and sexual abuse, whereas parenting style did not show a specific association with BPD. Findings of the present study help clarify the effects of overlapping environmental factors that are associated with BPD. PMID:23013341

  11. Birth order and memories of traumatic and family experiences in Greek patients with borderline personality disorder versus patients with other personality disorders.

    PubMed

    Karamanolaki, Hara; Spyropoulou, Areti C; Iliadou, Aggeliki; Vousoura, Eleni; Vondikaki, Stamatia; Pantazis, Nikos; Vaslamatzis, Grigoris

    2016-01-01

    The purpose of this study was to assess the possible effect of recalled traumatic experiences, perceived parental rearing styles, and family parameters on the occurrence of borderline personality disorder (BPD) versus other personality disorders (other-PDs). A total of 88 adult outpatients with personality disorders completed the Traumatic Antecedents Questionnaire and the Egna Minnen av Barndoms Uppfostran, which measures perceptions regarding parental rearing. Results indicated that incidence of traumatic childhood experiences was higher among those in the BPD group compared to those in the other-PD group. Firstborns were less likely to carry a diagnosis of BPD over other-PDs. Also, significantly more BPD compared to other-PD patients reported being the father's favorite child over siblings. Results suggest that traumatic experiences, birth order, and family interactions in the presence of siblings seem to differentially affect the formation of borderline diagnosis compared to other-PDs. Limitations and clinical implications of the study are discussed in detail. PMID:27583811

  12. Personality pathology and alcohol dependence at midlife in a community sample.

    PubMed

    Agrawal, Arpana; Narayanan, Gitanjali; Oltmanns, Thomas F

    2013-01-01

    The present study examined the association between personality pathology (PP) and alcohol dependence (AD; both lifetime and in the past 12 months) among middle-aged to older adults incorporating three sources of assessment, specifically, diagnostic interviews as well as self- and informant reports. We collected data from a representative sample of community participants (N = 1,630; ages 54-65 years) and their informants (N = 1,462). Measures employed were the substance use disorder sections of the Mini-International Neuropsychiatric Interview Schedule for Mental Disorders, the Structured Interview for DSM-IV Personality (American Psychiatric Association, 2000, Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text rev.; DSM-IV-TR SIDP) and the NEO-Personality Inventory-Revised (Costa, P. T., & McCrae, R. R., Revised NEO-Personality Inventory (NEO-PI-R) and NEO Five-Factor Inventory (NEO-FFI) manual, 1992, Odessa, FL, Psychological Assessment Resources; self-report and informant versions). To complement the diagnostic interview for personality disorders (PDs), we utilized a PD-count technique derived from the five-factor model (FFM), which provided an index of PP liability. Factors representing lifetime and past-12 month AD were regressed on each of the 10 PP factors constructed from the SIDP interview, as well as self-report and informant FFM-count scores. Lifetime diagnosis of AD was positively associated with higher scores on several PP measures, including paranoid, schizotypal, antisocial, borderline, histrionic, and narcissistic PP. There was an inverse relation between lifetime AD and the factor score for obsessive-compulsive PP. With regard to AD in the past 12 months, antisocial, borderline, histrionic, and narcissistic PP factors were significantly associated with increased risk for AD, whereas the obsessive-compulsive and schizoid PP factors were associated with decreased risk for AD. The present data indicate that features of antisocial and

  13. Comorbid Personality Disorders in Obsessive-Compulsive Disorder and Its Symptom Dimensions.

    PubMed

    Bulli, Francesco; Melli, Gabriele; Cavalletti, Veronica; Stopani, Eleonora; Carraresi, Claudia

    2016-06-01

    The current paper was aimed at: (1) investigating the comorbidity between obsessive-compulsive disorder (OCD) and personality disorders (PDs) using an OCD sample and clinician-administered structured interviews; (2) exploring the associations of different cluster comorbid PDs with the specific symptom dimensions of OCD; (3) analyzing the variables which could play a significant role in the probability of having at least one comorbid PD, controlling for confounding variables. The SCID-II and Y-BOCS, together with a series of self-report measures of OCD, depression and anxiety symptoms were administered to a clinical sample of 159 patients with a primary diagnosis of OCD. 20.8 % of the participants suffered from at least one comorbid PD; the most common was obsessive-compulsive PD (9.4 %), followed by narcissistic PD (6.3 %). In OCD patients with comorbid cluster C PDs, the percentage of responsibility for harm, injury, or bad luck symptoms was significantly greater than other OCD symptom dimensions (p < .005). Logistic regression found some evidence supporting the association between severity of OCD symptoms and comorbid PDs. PDs are prevalent among Italian people with OCD and should be routinely assessed, as comorbidity may affect help-seeking behaviour and response to treatment. PMID:26442944

  14. Sleep-Wake Patterns of Adolescents with Borderline Personality Disorder and Bipolar Disorder.

    PubMed

    Huỳnh, Christophe; Guilé, Jean-Marc; Breton, Jean-Jacques; Godbout, Roger

    2016-04-01

    Sleep-wake patterns are rarely examined in adolescents with borderline personality disorder (BPD) or bipolar disorder (BD). Within a developmental perspective, this study explores the sleep-wake cycle of adolescents aged 12-17 years with BPD or BD and healthy controls (HC) during periods with and without entrainment by school/work schedules. Eighteen euthymic BPD, six euthymic BD, and 20 HC adolescents wore wrist actigraphy during nine consecutive days to assess sleep-wake patterns. During school/work days, BPD adolescents spent more time awake when they were in bed compared to HC and BD adolescents (p = 0.039). On schedule-free days, BPD and BD youths spent more time in bed compared to HC adolescents (p = 0.015). BPD adolescents woke up over 1 h later compared to HC (p = 0.003). Total sleep time was more variable between nights in BPD adolescents compared to the HC group (p = 0.031). Future research should explore if sleep-wake pattern disruptions are a cause or a consequence of BPD symptomatology in adolescents. Addressing sleep-wake pattern during clinical assessment and treatment of BPD adolescents may potentially reduce their symptoms; this therapeutic effect still needs to be evaluated. PMID:26003420

  15. Treatment for comorbid borderline personality disorder and alcohol use disorders: A review of the evidence and future recommendations

    PubMed Central

    Gianoli, Mayumi O.; Jane, J. Serrita; O’Brien, Erin; Ralevski, Elizabeth

    2013-01-01

    There is a high degree of comorbidity between borderline personality disorder (BPD) and alcohol use disorders (AUDs) including alcohol abuse (AA) and dependence (AD). There is some evidence that this pattern of comorbidity may be associated with poorer prognosis. Although there are many different psychotherapeutic and pharmacological treatments for BPD and AUDs when they occur alone, there are very few treatment options when they occur together. The objective of this paper was to review the existing treatment options—both psychotherapeutic and pharmacological—for patients with dual diagnoses of BPD and AUDs and to explore alternative treatment options that warrant further study. There have been a number of studies that have examined the efficacy of specific psychotherapies targeting drinking among patients with comorbid BPD; however, their efficacy in reducing BPD symptoms is unknown. There are also three psychotherapies that were specifically developed for patients with BPD and SUDs, but only one of these (Dynamic Deconstructive Psychotherapy) has been tested among patients with dual diagnoses of BPD and AUDs. Research on pharmacotherapy for dual diagnoses of BPD and AUD is scarce, and no study has yet explored medication options that can concurrently manage symptoms of BPD and decrease alcohol consumption. Interestingly, there is growing evidence that anticonvulsants and second generation antipsychotics, the recent medications of choice for the management of anger in BPD, may also reduce alcohol craving and consumption. Although premature, these findings are encouraging especially for this population of patients for whom treatment options are very limited. PMID:22686496

  16. A psychometric study of the prevalence of DSM-IV personality disorders among office-based methadone maintenance patients.

    PubMed

    Teplin, David; O'Connell, Tara; Daiter, Jeff; Varenbut, Michael

    2004-08-01

    Using the DSM-IV criteria for personality disorders, prevalence rates for these disorders were evaluated among methadone maintenance patients, with a psychometric test--the Millon Clinical Multiaxial Inventory (MCMI-III). We found that 77% of patients met the study criteria for at least one personality disorder. Of those who had a personality disorder, 20% had two personality disorders, 14% had three personality disorders, and 6% had four personality disorders. Rates of specific personality disorders are reported. Consistencies and divergence from existing research literature are noted. It is suggested that future research compare psychometrically based self-report questionnaires to a structured clinical interview format, within the same clinical population. PMID:15540490

  17. Personality, Attentional Biases towards Emotional Faces and Symptoms of Mental Disorders in an Adolescent Sample

    PubMed Central

    O’Leary-Barrett, Maeve; Pihl, Robert O.; Artiges, Eric; Banaschewski, Tobias; Bokde, Arun L. W.; Büchel, Christian; Flor, Herta; Frouin, Vincent; Garavan, Hugh; Heinz, Andreas; Ittermann, Bernd; Mann, Karl; Paillère-Martinot, Marie-Laure; Nees, Frauke; Paus, Tomas; Pausova, Zdenka; Poustka, Luise; Rietschel, Marcella; Robbins, Trevor W.; Smolka, Michael N.; Ströhle, Andreas; Schumann, Gunter; Conrod, Patricia J.

    2015-01-01

    Objective To investigate the role of personality factors and attentional biases towards emotional faces, in establishing concurrent and prospective risk for mental disorder diagnosis in adolescence. Method Data were obtained as part of the IMAGEN study, conducted across 8 European sites, with a community sample of 2257 adolescents. At 14 years, participants completed an emotional variant of the dot-probe task, as well two personality measures, namely the Substance Use Risk Profile Scale and the revised NEO Personality Inventory. At 14 and 16 years, participants and their parents were interviewed to determine symptoms of mental disorders. Results Personality traits were general and specific risk indicators for mental disorders at 14 years. Increased specificity was obtained when investigating the likelihood of mental disorders over a 2-year period, with the Substance Use Risk Profile Scale showing incremental validity over the NEO Personality Inventory. Attentional biases to emotional faces did not characterise or predict mental disorders examined in the current sample. Discussion Personality traits can indicate concurrent and prospective risk for mental disorders in a community youth sample, and identify at-risk youth beyond the impact of baseline symptoms. This study does not support the hypothesis that attentional biases mediate the relationship between personality and psychopathology in a community sample. Task and sample characteristics that contribute to differing results among studies are discussed. PMID:26046352

  18. Three-Pronged Assessment and Diagnosis of Personality Disorder and its Consequences: Personality Functioning, Pathological Traits, and Psychosocial Disability

    PubMed Central

    Clark, Lee Anna; Ro, Eunyoe

    2014-01-01

    The alternative dimensional model of personality disorder (PD) in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5; American Psychiatric Association, 2013), Section III, has two main criteria: Impairment in personality functioning and one or more pathological personality traits. The former is defined as disturbances in self functioning (viz., identity, self-direction), and/or interpersonal functioning (viz., empathy, intimacy). Distinguishing personality functioning and traits is important conceptually, because simply having extreme traits is not necessarily pathological. However, adding personality functioning to PD diagnosis represents an empirical challenge, because the constructs overlap conceptually. Further, there is debate regarding whether diagnosis of mental disorder requires either distress or disability, concepts that also overlap with maladaptive-range personality traits and personality dysfunction. We investigated interrelations among these constructs using multiple self-report measures of each domain in a mixed community-patient sample (N = 402). We examined the structures of functioning (psychosocial disability and personality), and personality traits, first independently, then jointly. The disability/functioning measures yielded the three dimensions we have found previously (Ro & Clark, 2013). Trait measures had a hierarchical structure which, at the five-factor level, reflected neuroticism/negative affectivity (N/NA), (low) sociability, disinhibition, (dis)agreeableness, and rigid goal engagement. When all measures were co-factored, a hierarchical structure again emerged which, at the five-factor level, included (1) internalizing (N/NA and self-pathology vs. quality-of-life/satisfaction), (2) externalizing (social/interpersonal dysfunction, low sociability, and disagreeableness), (3) disinhibition, (4) poor basic functioning, and (5) rigid goal engagement. Results are discussed in terms of developing an integrated PD

  19. Perinatal risk factors in offenders with severe personality disorder: a population-based investigation

    PubMed Central

    Fazel, Seena; Bakiyeva, Liliya; Cnattingius, Sven; Grann, Martin; Hultman, Christina M.; Lichtenstein, Paul; Geddes, John R.

    2013-01-01

    Although perinatal factors are associated with the development of several psychiatric disorders, it is unknown whether these factors are linked with personality disorder. Cases of personality disorder were drawn from a national registry of all forensic psychiatric evaluations (n=150). Two control groups were used: 1. A sample of forensic evaluations without any psychiatric disorder (n=97) allowing for a nested case-control investigation; 2: A population-based sample matched by age and gender with no history of psychiatric hospitalization (n=1498). Prematurity (<37 weeks of completed gestation) was significantly associated with a diagnosis of personality disorder, both in the nested and the population-based case-control comparisons with adjusted odds ratios (OR) for this risk factors ranging from 2 to 4. Asphyxia (adjusted OR=2.4, 95% CI: 1.4-4.1) and complicated delivery (adjusted OR=1.5, 1.0-2.1) were associated with personality disorder in the population-based study, and the former remained significant in multivariate models. Overall, perinatal complications were found to be associated with a later diagnosis of personality disorder in this selected sample. As with other psychiatric disorders where such associations have been demonstrated, changes during the perinatal period may lead to abnormal brain development and function. PMID:23013342

  20. The impact of thought disorder on therapeutic alliance and personal recovery in schizophrenia and schizoaffective disorder: An exploratory study.

    PubMed

    Cavelti, Marialuisa; Homan, Philipp; Vauth, Roland

    2016-05-30

    Thought and language disorders are a main feature of schizophrenia. The aim of the study is to explore the impact of thought disorder on therapeutic alliance and personal recovery because of its interference with verbal communication. Thought disorder, positive and negative symptoms (Positive and Negative Syndrome Scale), functioning (Modified Global Assessment of Functioning scale), insight (Scale to Assess Unawareness of Mental Disorder), attachment insecurity (Psychosis Attachment Measure), therapeutic alliance (Scale to Assess the Therapeutic Relationship), and personal recovery (Recovery Assessment Scale, Integration Sealing-Over Scale) were assessed in 133 outpatients with schizophrenia or schizoaffective disorder at baseline and twelve months later. The data were analyzed by hierarchical multiple linear regression. Higher levels of thought disorder were significantly associated with lower clinicians' ratings, but not with patients' ratings of therapeutic alliance. In addition, lower clinicians' ratings of therapeutic alliance were significantly linked to a more sealing over and less integrative recovery style. In fact, the lower therapeutic alliance ratings mediated the association between thought disorder and a sealing over recovery style. The results highlight the importance of considering thought disorder in treatment of schizophrenia and schizoaffective disorder which may interfere with therapeutic alliance and treatment efforts towards recovery. PMID:27137967

  1. Iowa Gambling Task scores predict future drug use in bipolar disorder outpatients with stimulant dependence.

    PubMed

    Nejtek, Vicki A; Kaiser, Kathryn A; Zhang, Bin; Djokovic, Marija

    2013-12-30

    Poor decision-making is associated with poor recovery in persons with bipolar disorder and drug relapse in persons with stimulant dependence. Cognitive predictors of stimulant use in those with comorbid bipolar and stimulant dependence are surprisingly absent. Our goal was to determine if a single baseline assessment of decision-making (Iowa Gambling Task, IGT) would predict future drug use in bipolar disorder outpatients with comorbid stimulant dependence. Ninety-four men and women of multiple race/ethnic origins consented to participate in a 20-week study. Data analyses were performed on 63 comorbid bipolar outpatients completing at least four study weeks and 28 cocaine dependent volunteers without a mood disorder who participated as cocaine controls. There were no significant differences in IGT scores between comorbid patients and cocaine controls. In the comorbid group, IGT scores significantly predicted future drug use during the study. Age, sex, race, years of mental illness, or mood state did not significantly influence IGT scores. This is the first longitudinal study to show that IGT scores obtained at a single baseline assessment predicts future objective drug use in comorbid bipolar disorder outpatients with cocaine or methamphetamine dependence. Evaluating decision-making with the IGT may provide clinicians with valuable insight about the trajectory of their patients' risk for future drug use. These data suggest a need to augment existing treatment with cognitive restructuring to prevent slips and relapses in comorbid bipolar patients. The lack of a bipolar control group and a modest sample size may limit data interpretations. PMID:24012163

  2. [From "psychopathy" to "personality disorder"--conceptual history of a problematic field within psychiatry].

    PubMed

    Hoff, Paul; Camenisch, Paul

    2015-11-11

    The issue of personality disorders addresses fundamental questions of psychiatry: Is there a clear boundary between normal behaviour and the state of mental illness? Which criteria are defining this boundary? Is a personality disorder really a mental illness or «just» a special variation of an individual lifestyle? This paper reviews the development of the terms psychopathy/personality disorder from the early 19th century to the present-day diagnostic manuals ICD-10 and DSM-5. This debate spreads out–as it does with regard to any other mental disorder–between psychopathological, neurobiological and social sciences approaches. It is of high practical relevance to realize that nowadays effective therapeutic options for patients with personality disorders are available. Therefore, the therapeutic nihilism of earlier times is no longer justified. PMID:26558933

  3. Emotional hyper-reactivity in borderline personality disorder is related to trauma and interpersonal themes.

    PubMed

    Sauer, Christina; Arens, Elisabeth A; Stopsack, Malte; Spitzer, Carsten; Barnow, Sven

    2014-12-15

    Heightened emotional reactivity is one of the core features of borderline personality disorder (BPD). However, recent findings could not provide evidence for a general emotional hyper-reactivity in BPD. The present study examines the emotional responding to self-relevant pictures in dependency of the thematic category (e.g., trauma, interpersonal interaction) in patients with BPD. Therefore, women with BPD (n=31), women with major depression disorder (n=29) and female healthy controls (n=33) rated pictures allocated to thematically different categories (violence, sexual abuse, interaction, non-suicidal self-injury, and suicide) regarding self-relevance, arousal, valence and the urge of non-suicidal self-injury. Compared to both control groups, patients with BPD reported higher self-relevance regarding all categories, but significantly higher emotional ratings only for pictures showing sexual abuse and interpersonal themes. In addition, patients with BPD and comorbid posttraumatic stress disorder showed higher emotional reactivity in violence pictures. Our data provide clear evidence that patients with BPD show a specific emotional hyper-reactivity with respect to schema-related triggers like trauma and interpersonal situations. Future studies are needed to investigate physiological responses to these self-relevant themes in patients with BPD. PMID:25066960

  4. The impact of DSM-5's alternative model for personality disorders on criminal defendants.

    PubMed

    Filone, Sarah; Strohmaier, Heidi; Murphy, Megan; DeMatteo, David

    2014-01-01

    The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) workgroup on personality disorders initially proposed several revisions to diagnostic criteria and disorder labels, some of which could have had a direct impact on the perception and sentencing of criminal defendants. The recent publication of the DSM-5 included these revisions in an appendix for future research, indicating that the revised criteria require additional research before implementation. This study examined how the proposed changes, if implemented, might affect jury members' sentencing recommendations and perceptions of the defendant. Participants read vignettes in which diagnostic label (antisocial personality disorder vs. dyssocial personality disorder vs. psychopathy) and crime type (white collar vs. violent crime) were manipulated. Results suggest that participants perceived white collar offenders more negatively than violent offenders, and were generally more influenced by crime type than diagnosis. The diagnostic label was most influential on recidivism ratings and participants' perceptions of violent offenders. PMID:24352768

  5. Pathological gambling and personality disorders: an exploratory study with the IPDE.

    PubMed

    Fernández-Montalvo, Javier; Echeburúa, Enrique

    2004-10-01

    This article describes the most frequent personality disorders related to pathological gambling. Participants included 50 pathological gamblers assessed with the IPDE, and 50 normative subjects from the general population with the same demographic features (age, sex, and socioeconomic level). Thirty-two percent of the clinical sample (vs. the 8% of the normative sample) showed at least one personality disorder. The most prevalent disorders were Borderline (16%), followed by Antisocial, Paranoid, Narcissistic, and Non-specified (8% each). Gamblers with personality disorders presented an average of 1.5 disorders and they reported higher gambling severity and more severe symptoms of anxiety, depression and alcohol abuse. The implications of this study for clinical practice and research are discussed. PMID:15519959

  6. Short-term group schema therapy for mixed personality disorders: a pilot study

    PubMed Central

    Skewes, Sally A.; Samson, Rachel A.; Simpson, Susan G.; van Vreeswijk, Michiel

    2015-01-01

    Schema Therapy has shown promising results for personality disorders but there is a limited evidence base for group schema therapy (ST-g) with mixed personality disorders. The aim of this study was to explore the feasibility, acceptability, and preliminary effectiveness of ST-g in a sample of eight participants with mixed personality disorders (with a predominant diagnosis of avoidant personality disorder) and high levels of comorbidity. Treatment was comprised of 20 sessions which included cognitive, behavioral, and experiential techniques. Specific schema-based strategies were chosen for a diagnostically mixed group of personality disorder clients. Six participants attended until end of treatment and two dropped-out before mid-treatment. All outcome measures showed changes with large effect sizes in avoidant personality disorder symptom severity, depression and anxiety levels between pre-therapy and follow-up. Four participants achieved a loss of personality disorder diagnosis at the end of therapy. By follow-up, five participants had achieved a loss of diagnosis, suggesting that participants derived ongoing benefits from the group even after treatment ended. Six participants no longer met criteria for depression at the end of treatment and this was maintained for all participants at 6-month follow-up. At follow-up, the majority of participants showed clinically significant change on the Global Symptom Index (GSI). For the Schema Mode Inventory (SMI) maladaptive modes, the majority of participants showed improvement at follow-up. At follow-up, 40% of participants showed clinically significant change on the SMI adaptive modes. Qualitative feedback indicates that the group helps to normalize participants' psychological experiences and difficulties and promotes self-expression and self-disclosure, while reducing inhibition. Preliminary results suggest that short-term ST-g may benefit those with mixed personality disorders, but generalizability is limited by the

  7. Adjectival descriptions of personality disorders: a convergent validity study of the MCMI-III.

    PubMed

    Craig, R J; Olson, R E

    2001-10-01

    The responses to a 469-item list of adjectives (consensually validated by national experts as representing key descriptors for each personality disorder) from 202 male substance abusers in outpatient treatment were correlated with their responses to the MCMI-III, a frequently used test for the assessment of personality disorders. Results suggested good convergent validity for the interpersonal descriptive domain for the MCMI-III scales. The Histrionic scale had extremely high convergent validity. PMID:11693858

  8. The Convergent and Concurrent Validity of Trait-Based Prototype Assessment of Personality Disorder Categories in Homeless Persons

    ERIC Educational Resources Information Center

    Samuel, Douglas B.; Connolly, Adrian J.; Ball, Samuel A.

    2012-01-01

    The "DSM-5" proposal indicates that personality disorders (PDs) be defined as collections of maladaptive traits but does not provide a specific diagnostic method. However, researchers have previously suggested that PD constructs can be assessed by comparing individuals' trait profiles with those prototypic of PDs and evidence from the five-factor…

  9. The Fregoli delusion: a disorder of person identification and tracking.

    PubMed

    Langdon, Robyn; Connaughton, Emily; Coltheart, Max

    2014-10-01

    Fregoli delusion is the mistaken belief that some person currently present in the deluded person's environment (typically a stranger) is a familiar person in disguise. The stranger is believed to be psychologically identical to this known person (who is not present) even though the deluded person perceives the physical appearance of the stranger as being different from the known person's typical appearance. To gain a deeper understanding of this contradictory error in the normal system for tracking and identifying known persons, we conducted a detailed survey of all the Fregoli cases reported in the literature since the seminal Courbon and Fail (1927) paper. Our preliminary reading of these cases revealed a notable lack of definitional clarity. So, we first formulated a classification scheme of different person misidentification delusions so as to identify those cases that qualified as instances of Fregoli according to the above characterization: the mistaken belief that a known person is present in the environment in a different guise to his or her typical appearance. We identified 38 clear cases of this type and set out to answer a series of questions motivated by current hypotheses about the origin of the Fregoli delusion. We asked whether the patients misidentified particular strangers, made reference to the misidentified known persons using wigs or plastic surgery (or other techniques to disguise their appearance), misidentified many different strangers or only one, showed other symptoms (in particular, other misidentification delusions), and made inferences about the motives of the known persons in disguise. We conclude by discussing the implications of our findings for current hypotheses concerning the origin of the Fregoli delusion. PMID:25219764

  10. Recovery from chronic factitious disorder (Munchausen's syndrome): a personal account.

    PubMed

    Bass, Christopher; Taylor, Michael

    2013-01-01

    This case report provides an account by a patient (with permission) of chronic factitious disorder and the factors that led to recovery. Such accounts are extremely rare in the literature. This account also throws into sharp focus current controversies in the classification of factitious disorders. PMID:24343927

  11. Increased Opioid Dependence in a Mouse Model of Panic Disorder

    PubMed Central

    Gallego, Xavier; Murtra, Patricia; Zamalloa, Teresa; Canals, Josep Maria; Pineda, Joseba; Amador-Arjona, Alejandro; Maldonado, Rafael; Dierssen, Mara

    2009-01-01

    Panic disorder is a highly prevalent neuropsychiatric disorder that shows co-occurrence with substance abuse. Here, we demonstrate that TrkC, the high-affinity receptor for neurotrophin-3, is a key molecule involved in panic disorder and opiate dependence, using a transgenic mouse model (TgNTRK3). Constitutive TrkC overexpression in TgNTRK3 mice dramatically alters spontaneous firing rates of locus coeruleus (LC) neurons and the response of the noradrenergic system to chronic opiate exposure, possibly related to the altered regulation of neurotrophic peptides observed. Notably, TgNTRK3 LC neurons showed an increased firing rate in saline-treated conditions and profound abnormalities in their response to met5-enkephalin. Behaviorally, chronic morphine administration induced a significantly increased withdrawal syndrome in TgNTRK3 mice. In conclusion, we show here that the NT-3/TrkC system is an important regulator of neuronal firing in LC and could contribute to the adaptations of the noradrenergic system in response to chronic opiate exposure. Moreover, our results indicate that TrkC is involved in the molecular and cellular changes in noradrenergic neurons underlying both panic attacks and opiate dependence and support a functional endogenous opioid deficit in panic disorder patients. PMID:20204153

  12. A functional MRI study of deception among offenders with antisocial personality disorders.

    PubMed

    Jiang, W; Liu, H; Liao, J; Ma, X; Rong, P; Tang, Y; Wang, W

    2013-08-01

    Deceit is a core feature of antisocial personality disorder (ASPD), and the study of deception in ASPD has important implications for identifying the underlying mechanism of ASPD. A great deal of functional neuroimaging literature has described the neural correlates of deception in healthy volunteers, but there have been few imaging studies examining people with ASPD. The neural correlates of lie-telling in ASPD, and which specific brain activities are related to the capacity to lie, are unclear. In this study, 32 offenders who satisfied the Personality Diagnostic Questionaire-4 and PDI-IV (Personality Disorder Interview) criteria for ASPD were divided into three groups based on their capacity for deception, which was evaluated based on the deceitfulness criterion of the PDI-IV ASPD. All offenders underwent functional magnetic resonance imaging (fMRI) while responding to questions in a truthful, inverse, or deceitful manner. We primarily created contrasts in the brain activities between truth-telling and lie-telling, and then computed the Pearson's correlation coefficients between activities contrasts of individual, i.e. BOLD (blood-oxygen-level-dependent) strength during deception minus that during truth-telling, and the capacity for deception. Our results indicated that the bilateral dorsolateral prefrontal cortex extending to the middle frontal gyrus, the left inferior parietal lobule, and the bilateral anterior cingulate gyrus/medial superior frontal gyrus were associated with deception among people with ASPD. As the capacity for deception increased, the contrasted brain activities of the above regions decreased. This study found that truthful and untruthful communications of ASPD subjects can be differentiated in terms of brain BOLD activities, and more importantly, this study is the first to use fMRI to discover that BOLD activities during deception are correlated with the capacity to lie. The latter finding might challenge the diagnostic accuracy of lie

  13. The role of identity in the DSM-5 classification of personality disorders

    PubMed Central

    2013-01-01

    In the revised Diagnostic and Statistical Manual DSM-5 the definition of personality disorder diagnoses has not been changed from that in the DSM-IV-TR. However, an alternative model for diagnosing personality disorders where the construct “identity” has been integrated as a central diagnostic criterion for personality disorders has been placed in section III of the manual. The alternative model’s hybrid nature leads to the simultaneous use of diagnoses and the newly developed “Level of Personality Functioning-Scale” (a dimensional tool to define the severity of the disorder). Pathological personality traits are assessed in five broad domains which are divided into 25 trait facets. With this dimensional approach, the new classification system gives, both clinicians and researchers, the opportunity to describe the patient in much more detail than previously possible. The relevance of identity problems in assessing and understanding personality pathology is illustrated using the new classification system applied in two case examples of adolescents with a severe personality disorder. PMID:23902698

  14. Epidemiology, Comorbidity, and Behavioral Genetics of Antisocial Personality Disorder and Psychopathy

    PubMed Central

    Werner, Kimberly B.; Few, Lauren R.; Bucholz, Kathleen K.

    2015-01-01

    Psychopathy is theorized as a disorder of personality and affective deficits while antisocial personality disorder (ASPD) diagnosis is primarily behaviorally based. While ASPD and psychopathy are similar and are highly comorbid with each other, they are not synonymous. ASPD has been well studied in community samples with estimates of its lifetime prevalence ranging from 1-4% of the general population.4,5 In contrast, psychopathy is almost exclusively investigated within criminal populations so that its prevalence in the general population has been inferred by psychopathic traits rather than disorder (1%). Differences in etiology and comorbidity with each other and other psychiatric disorders of these two disorders are also evident. The current article will briefly review the epidemiology, etiology, and comorbidity of ASPD and psychopathy, focusing predominately on research completed in community and clinical populations. This paper aims to highlight ASPD and psychopathy as related, but distinct disorders. PMID:26594067

  15. Workplace Accommodations for Persons with Musculoskeletal Disorders. Implementing the Americans with Disabilities Act Series.

    ERIC Educational Resources Information Center

    Morosky, Frank N.

    This brief paper summarizes requirements of the Americans with Disabilities Act (ADA) of 1990 related to workplace accommodations for persons with musculo-skeletal disorders. The following topics are addressed: (1) the relevance of the ADA to people with musculo-skeletal disorders; (2) employment provisions of the ADA to protect individuals with…

  16. Correspondence between Self-Report and Interview-Based Assessments of Antisocial Personality Disorder

    ERIC Educational Resources Information Center

    Guy, Laura S.; Poythress, Norman G.; Douglas, Kevin S.; Skeem, Jennifer L.; Edens, John F.

    2008-01-01

    Antisocial personality disorder (ASPD) is associated with suicide, violence, and risk-taking behavior and can slow response to first-line treatment for Axis I disorders. ASPD may be assessed infrequently because few efficient diagnostic tools are available. This study evaluated 2 promising self-report measures for assessing ASPD--the ASPD scale of…

  17. The Epidemiology of Alcohol, Drug, and Mental Disorders among Homeless Persons.

    ERIC Educational Resources Information Center

    Fischer, Pamela J.; Breakey, William R.

    1991-01-01

    Describes research on the prevalence of alcohol, drug, and mental (ADM) disorders and the characteristics of homeless substance abusers and persons with mental illnesses. Reviews methodological problems. Finds prevalence rates of ADM disorders, extreme poverty, isolation from support network, and contact with correctional agencies higher in…

  18. Borderline personality disorder in adolescents: the He-who-must-not-be-named of psychiatry

    PubMed Central

    Larrivée, Marie-Pier

    2013-01-01

    This article reviews the possibility and pertinence of diagnosing borderline personality disorder in adolescents. The etiology and clinical manifestations of this disorder in adolescents are discussed, and its management is addressed in terms of psychotherapy, pharmacology, hospitalization issues, and family involvement considerations. PMID:24174891

  19. Validation of Measures of Biosocial Precursors to Borderline Personality Disorder: Childhood Emotional Vulnerability and Environmental Invalidation

    ERIC Educational Resources Information Center

    Sauer, Shannon E.; Baer, Ruth A.

    2010-01-01

    Linehan's biosocial theory suggests that borderline personality disorder (BPD) results from a transaction of two childhood precursors: emotional vulnerability and an invalidating environment. Until recently, few empirical studies have explored relationships between these theoretical precursors and symptoms of the disorder. Psychometrically sound…

  20. The New Alternative DSM-5 Model for Personality Disorders: Issues and Controversies

    ERIC Educational Resources Information Center

    Porter, Jeffrey S.; Risler, Edwin

    2014-01-01

    Purpose: Assess the new alternative "Diagnostic and Statistical Manual of Mental Disorders", fifth edition (DSM-5) model for personality disorders (PDs) as it is seen by its creators and critics. Method: Follow the DSM revision process by monitoring the American Psychiatric Association website and the publication of pertinent journal…