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  1. Dependent personality disorder

    MedlinePlus

    ... disapproval Becoming overly focused on fears of being abandoned Becoming very passive in relationships Feeling very upset ... a mental health professional if you or your child has symptoms of dependent personality disorder.

  2. Dependent personality disorder and physical abuse.

    PubMed

    Loas, Gwenolé; Cormier, Julie; Perez-Diaz, Fernando

    2011-01-30

    The aim of this study was to test the hypothesis that the likelihood of physical spousal abuse is increased in dependent personality disorder (DPD) compared to other personality disorders. The sample consisted of 305 subjects consecutively admitted to an outpatient department of legal medicine for physical abuse. Using the Structured Clinical Interview for Disorders, screen questionnaire (SCID-II-SQ), the subjects were divided into three groups: without personality disorders (WPD, N=108), with non-dependent personality disorders (NDPD, N=179) and with DPDs (DPD, N=18). First,, the three groups were compared to the rate of spouses among the perpetrators. The rate of spouses among the perpetrators was significantly different between the three groups: 44.4% of the perpetrators were the spouse for DPD subjects versus 11.2% for WPD and 20.1% for NDPD. Second, logistic regressions using the status of perpetrators (spouse or others) as dependent variable and socio-demographical variables as well as the rates of DPD, avoidant, obsessive-compulsive and borderline personality disorders as independent variables reported that these four disorders of personality were significant predictors. Moreover, the co-morbidities of DPD with avoidant, obsessive-compulsive or borderline personality disorders were higher than 50%. These results suggest first that DPD subjects are at high risk of physical abuse by their spouses and second that this relationship was found also for the two other cluster C personality disorders as well as for borderline personality disorder.

  3. [Gender differences in alcohol dependence: personality variables, psychopathological profile and personality disorders].

    PubMed

    Bravo de Medina, Ricardo; Echeburúa, Enrique; Aizpiri, Javier

    2008-05-01

    In this paper, gender differences in personality, psychopathology and personality disorders of alcohol-dependent patients are described. The sample consisted of 158 alcohol-dependent patients attending a psychiatric outpatient clinic (105 men and 55 women). All participants were assessed with various assessment tools related to personality (Impulsiveness Scale, Sensation Seeking Scale and STAI), psychopathology (SCL-90-R, BDI and Inadaptation Scale) and personality disorders (IPDE). There were no differences in personality variables, but the women had more anxiety and depressive symptoms and also more problems to adapt to everyday life than did the men. Personality disorders were not as prevalent as in the case of men, and the most frequent among women were obsessive-compulsive, dependent and histrionic personality disorders. Implications of this study for further research are commented on.

  4. 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 ...

  5. 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…

  6. 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

  7. 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.

  8. 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 ...

  9. [Personality variables, psychopathological alterations and personality disorders in alcohol-dependent patients according to Cloninger's typology of alcohol abuse].

    PubMed

    Echeburúa, Enrique; Bravo de Medina, Ricardo; Aizpiri, Javier

    2008-11-01

    In this paper, an evaluation of Cloninger's typology of alcohol abuse in personality, psychopathology and personality disorders is carried out. The sample consisted of 158 alcoholics in treatment (56 Type I alcohol-dependent patients and 102 Type II alcohol-dependent patients). All subjects were assessed with diverse assessment tools related to personality (Impulsiveness Scale, Sensation Seeking Scale and STAI), psychopathology (SCL-90-R, BDI and Inadaptation Scale) and personality disorders (IPDE). The main findings were that Type II alcohol-dependent patients were more impulsive and sensation-seeking and they displayed more hostility and emotional distress than Type I alcohol-dependent patients. Personality disorders were not so prevalent in the case of Type I alcohol-dependent patients. The most specific personality disorders for Type II alcohol-dependent patients were narcissistic and paranoid. The implications of this study for further research are commented on.

  10. 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

  11. Covariation of criteria sets for avoidant, schizoid, and dependent personality disorders.

    PubMed

    Trull, T J; Widiger, T A; Frances, A

    1987-06-01

    Avoidant personality disorder was a new addition to DSM-III. Reaction to its inclusion was mixed. Critics cited the lack of empirical data and the overlap with schizoid disorder. The authors consider the overlap and covariation among avoidant, schizoid, and dependent symptoms and diagnoses in a sample of 84 inpatients diagnosed by using a semistructured interview. Items for avoidant disorder covaried with criteria for dependent disorder but not with criteria for schizoid disorder. The authors point out the implications of these results for the revision of DSM-III (DSM-III-R).

  12. Reconceptualizing personality pathology in DSM-5: limitations in evidence for eliminating dependent personality disorder and other DSM-IV syndromes.

    PubMed

    Bornstein, Robert F

    2011-04-01

    The DSM-5 Personality and Personality Disorders Workgroup proposed that five DSM-IV personality disorders be eliminated as formal diagnostic categories (paranoid, schizoid, histrionic, narcissistic, and dependent), because these syndromes purportedly have low clinical utility and minimal evidence for validity. Scrutiny of studies cited in support of this proposal reveals difficulties in three areas: (1) Inadequate information regarding parameters of the literature search; (2) Mixed empirical support for proposed changes; and (3) Selective attention to certain disorders and not others. Review of validity and clinical utility data related to dependent personality disorder indicates that evidence regarding this syndrome does not differ from that of syndromes proposed for retention in DSM-5. Limitations in the research base cited by the workgroup illuminates gaps in the personality disorder literature, and may serve as a starting point for systematic research on personality pathology so that adequate empirical data are available to decide which syndromes to retain, revise, or remove in future versions of the diagnostic manual.

  13. 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

  14. Paranoid personality disorder

    MedlinePlus

    Personality disorder - paranoid ... Causes of paranoid personality disorder are unknown. The disorder appears to be more common in families with psychotic disorders, such as schizophrenia and delusional ...

  15. Distinguishing general and specific personality disorder features and implications for substance dependence comorbidity.

    PubMed

    Jahng, Seungmin; Trull, Timothy J; Wood, Phillip K; Tragesser, Sarah L; Tomko, Rachel; Grant, Julia D; Bucholz, Kathleen K; Sher, Kenneth J

    2011-08-01

    Clinical and population-based samples show high comorbidity between Substance Use Disorders (SUDs) and Axis II Personality Disorders (PDs). However, Axis II disorders are frequently comorbid with each other, and existing research has generally failed to distinguish the extent to which SUD/PD comorbidity is general or specific with respect to both specific types of PDs and specific types of SUDs. We sought to determine whether ostensibly specific comorbid substance dependence-Axis II diagnoses (e.g., alcohol use dependence and borderline personality disorder) are reflective of more pervasive or general personality pathology or whether the comorbidity is specific to individual PDs. Face-to-face interview data from Wave 1 and Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions were analyzed. Participants included 34,653 adults living in households in the United States. We used hierarchical factor models to statistically partition general and specific personality disorder dimensions while simultaneously testing for specific PD-substance dependence relations. Results indicated that substance dependence-Axis II comorbidity is characterized by general (pervasive) pathology and by Cluster B PD pathology over and above the relationship to the general PD factor. Further, these relations between PD factors and substance dependence diagnoses appeared to largely account for the comorbidity among substance dependence diagnoses in the younger but not older participants. Our findings suggest that a failure to consider the general PD factor, which we interpret as reflecting interpersonal dysfunction, can lead to potential mischaracterizations of the nature of certain PD and SUD comorbidities.

  16. Personality disorders

    MedlinePlus

    ... person has a long-term pattern of behaviors, emotions, and thoughts that is very different from his or her culture's expectations. These behaviors interfere with the person's ability to function in relationships, work, or other settings.

  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. 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 ...

  19. Personality traits and personality disorders.

    PubMed

    Deary, I J; Peter, A; Austin, E; Gibson, G

    1998-11-01

    The structure of personality disorder traits was examined in a sample of 400 undergraduates who completed the personality disorder questionnaire from the Structured Clinical Interview for DSM-III-R (SCID-II). The relations between personality disorder and normal personality traits indexed by the Eysenck Personality Questionnaire-Revised (EPQ-R) were examined. The three-cluster model of personality traits--as described in the DSM scheme--found equivocal support. Exploratory principal components analysis and confirmatory factor analysis found four broad factors of personality disorder that overlapped with normal personality traits: an asthenic factor related to neuroticism; an antisocial factor associated with psychoticism; an asocial factor linked to introversion-extraversion; and an anankastic (obsessive-compulsive) factor. There is growing agreement about the number and type of broad personality disorder dimensions; similar dimensions may be found in clinical and non-clinical samples, suggesting that those people with personality disorders differ quantitatively rather than qualitatively from others; and there is substantial overlap between normal and abnormal personality dimensions.

  20. 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.

  1. 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

  2. Schizotypal personality disorder

    MedlinePlus

    ... these beliefs so strongly that they have difficulty forming and keeping close relationships. People with SPD may also have depression. A second personality disorder, such as paranoid personality disorder , is also ...

  3. Personality disorders among alcohol-dependent patients manifesting or not manifesting cocaine abuse: a comparative pilot study.

    PubMed

    Echeburúa, Enrique; De Medina, Ricardo Bravo; Aizpiri, Javier

    2009-01-01

    This study assessed personality disorders (PDs) in 158 alcohol-dependent outpatients (62 manifesting cocaine abuse and 96 without cocaine abuse) with the International Personality Disorders Examination interview between 2003 and 2006. Thirty-nine alcohol-dependent/cocaine abusers (62.9% of this group) and 51 only alcohol-dependent patients (53.1% of this group) manifested at least one PD. There were no statistically significant differences between groups in the overall prevalence rate of PDs. The most prevalent PDs, among the alcohol-dependent/cocaine abusers, were antisocial (21%), narcissistic (14.5%), and borderline (11.3%) PDs. The most frequently diagnosed PDs among the only alcohol-dependent patients were obsessive-compulsive (20.8%), paranoid (10.4%), and dependent (9.4%) PDs. There were significant differences between the groups. The study limitations are discussed.

  4. 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

  5. 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 ( ...

  6. Dependency, impulsivity, and self-harm: traits hypothesized to underlie the association between cluster B personality and substance use disorders.

    PubMed

    Casillas, Alex; Clark, Lee Anna

    2002-10-01

    Cluster B personality disorders (PDs) (i.e., antisocial, borderline, histrionic, and narcissistic) typically show a high degree of comorbidity with substance use disorders (SUDs). Previous research suggests that the broad-based personality domains of Disinhibition and Negative Temperament/Neuroticism may be common factors to both types of disorders. Using a two-phase process (i.e., screening and follow-up), this study examined three lower-order personality traits (i.e., dependency, impulsivity, and self-harm) that fall within the Disinhibition and Neuroticism domains. The study evaluated the hypotheses that these traits (a) are related both to cluster B PDs and to SUDs; and (b) underlie the association between the two types of disorders. Results indicate that impulsivity and self-harm play a significant role in cluster B PDs and SUDs, as well as in their association with each other. However, dependency was not associated with either type of disorder. These results indicate that sets of individual traits can be of significant utility in understanding the comorbidity between PDs and SUDs.

  7. [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

  8. [Personality disorders in psychiatry].

    PubMed

    Denis, J F

    1990-04-01

    Psychiatric patients with personality disorders are among the most difficult because of the counter-transferential strain they put on clinicians and the paucity of specific treatment. The author develops the point that personality disorders are not diseases as implied in Axis I disorders, but social illness syndromes which depict systemic problems in which clinicians can be engulfed and entrapped. The difficult patient does not exist in isolation, a victim of his own drives and psyche, but rather is a specific socio-cultural actor living and emerging from a particular environmental context. Personality disorders are considered to be interpersonal patterns in which a person's debilitating behaviour elicits complementary behaviour that reinforces the original behaviour. Within a systems perspective, there is not a disordered personality so much as a disordering system of relationships. As with families and society, healers too become involved in the vicious cycle of personality disorders if they fail to see the manipulative interpersonal devices used by these patients. If clinicians accept too naively the lay person's simplistic belief that personality disorders are diseases to be treated by psychiatrists, they run the risk of fostering inappropriate passivity in patients in the face of life demands. Overindulgence and angry rejection are the two major pitfalls often seen in clinical practice. The approach proposed here may seem conterintuitive in laying stress on the need to actively resist the temptation to take over responsibility for a patient's life. There is a difference between a behaviour that a patient's illness (Axis I disorder) prevents him from controlling and an impulsive deliberate behaviour stemming from character pathology. It is a logical error to deal with personality disorders in the same manner and with the same conceptual terminology as for depressive and psychotic disorders. Principles of management are detailed and can be summarized as a kind

  9. 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…

  10. Schizoid personality disorder.

    PubMed

    Triebwasser, Joseph; Chemerinski, Eran; Roussos, Panos; Siever, Larry J

    2012-12-01

    Schizoid personality disorder (ScPD) is one of the "odd cluster" or "cluster A" personality disorders in DSM-IV. In the present article, the authors review information pertaining to the psychometric characteristics of ScPD as gleaned from a search of relevant publications as well as from databases of personality disorder study groups. Comparatively little evidence exists for the validity and reliability of ScPD as a separate, multifaceted personality disorder. Some authors, moreover, have contended that the group of patients termed "schizoid" actually fall into two distinct groups--an "affect constricted" group, who might better be subsumed within schizotypal personality disorder, and a "seclusive" group, who might better be subsumed within avoidant personality disorder. The research-based justification for retaining ScPD as an independent diagnosis is sufficiently sparse for it to seem reasonable to remove ScPD from the list of personality disorders in DSM-V, and instead to invite clinicians to code for schizoid traits using a dimensional model.

  11. Personality disorder cognitions in the eating disorders.

    PubMed

    Gabriel, Chloe; Waller, Glenn

    2014-02-01

    Patients with eating disorder have relatively high rates of comorbid personality disorder diagnoses, including both anxiety-based personality disorders (obsessive-compulsive and avoidant) and borderline personality disorder. However, there is preliminary evidence that the core cognitions underlying personality pathology in the eating disorders are those related specifically to anxiety. This article builds on that evidence, replicating and extending the findings with a large sample of patients with eating disorder (N = 374). There were no differences in personality disorder cognitions between eating disorder diagnoses. This study also examines the possibility that there are clusters of patients, differentiated by patterns of personality disorder cognition. Affect-related personality disorder cognitions were key to understanding the role of personality pathology in the eating disorders. It is suggested that those cognitions should be considered when planning psychological treatments.

  12. Multiple personality disorder.

    PubMed

    Piper, A

    1994-05-01

    Five aspects of the diagnosis and treatment of multiple personality disorder (MPD) were examined. The following five conclusions were made: the contemporary diagnostic criteria are vague and overinclusive; the recent alleged increase in prevalence of the disorder is almost certainly artefactual; legal proceedings involving MPD patients raise disturbing questions about personal responsibility; there is little literature support for the theory that MPD results from childhood trauma; and many of the techniques used to diagnose and treat the condition reinforce its symptoms. A careful revision of diagnostic criteria for the disorder is recommended.

  13. Schizotypal personality disorder.

    PubMed

    Chemerinski, Eran; Triebwasser, Joseph; Roussos, Panos; Siever, Larry J

    2013-10-01

    Early phenomenological descriptions of schizophrenia have acknowledged the existence of milder schizophrenia spectrum disorders characterized by the presence of attenuated symptoms typically present in chronic schizophrenia. The investigation of the schizophrenia spectrum disorders offers an opportunity to elucidate the pathophysiological mechanisms giving rise to schizophrenia. Differences and similarities between subjects with schizotypal personality disorder (SPD), the prototypical schizophrenia personality disorder, and chronic schizophrenia have been investigated with genetic, neurochemical, imaging, and pharmacological techniques. Patients with SPD and the more severely ill patients with chronic schizophrenia share cognitive, social, and attentional deficits hypothesized to result from common neurodevelopmentally based cortical temporal and prefrontal pathology. However, these deficits are milder in SPD patients due to their capacity to recruit other related brain regions to compensate for dysfunctional areas. Individuals with SPD are also less vulnerable to psychosis due to the presence of protective factors mitigating subcortical DA hyperactivity. Given the documented close relationship to other schizophrenic disorders, SPD will be included in the psychosis section of DSM-5 as a schizophrenia spectrum disorder as well as in the personality disorder section.

  14. Paranoid personality disorder.

    PubMed

    Triebwasser, Joseph; Chemerinski, Eran; Roussos, Panos; Siever, Larry J

    2013-12-01

    Paranoid personality disorder (PPD) is currently included in DSM-IV's "odd cluster" or "cluster A." In the present article, the authors review available information pertaining to the psychometric properties of PPD, as derived from the relevant literature and from databases of personality disorder study groups. There is comparatively little published evidence for the reliability and validity of PPD, and researchers by and large have tended not to study the disorder, either because of investigators' difficulty recruiting individuals with PPD into research studies, or (as seems more likely) because the trait-paranoia from which many psychiatric patients suffer has seemed better explained by other DSM-IV disorders on Axis I and/or Axis II than by PPD. Given the scant empirical evidence on PPD, it seems reasonable to remove it as an independent diagnosis from the next edition of DSM, and instead to encourage clinicians to code trait-paranoia using a dimensional approach.

  15. [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.

  16. [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

  17. 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

  18. Borderline Personality Disorder: Psychotherapy

    MedlinePlus

    ... to Ask About BPD Programs There are different types of therapy for borderline personality disorder (BPD). Therapy may be given one-on-one and through support groups, enabling people with BPD to interact with others. The most effective type of therapy appears to be dialectical behavior therapy ( ...

  19. 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 ...

  20. 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 ...

  1. 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 ...

  2. [Borderline personality disorder].

    PubMed

    Machizawa, S

    1994-05-01

    Although Borderline Personality Disorder (BPD) overlaps considerably with Major Depression, recent studies of biology, genetics and childhood trauma have demonstrated that there are substantial differences between the two disorders. It is suggested that their apparent relationship is rather nonspecific. In this paper, the author emphasizes that the core symptom of BPD is impulsiveness, which causes depressive symptoms and/or is induced by depressive episodes, forming a vicious cycle. Furthermore, in BPD patients, depressive symptoms are modified by impulsiveness, masochism, vanity, despair, and difficulties in interpersonal relationships. The author concludes that BPD is not a homogeneous but heterogeneous syndrome, classified into subtypes: depressive type, impulsive type, and identity diffusion type. Treatment needs to be considered according to these types.

  3. 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.

  4. 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

  5. [Personality disorders in smokers: a review].

    PubMed

    Fernández del Río, Elena; Becoña Iglesias, Elisardo

    2010-01-01

    The association between psychopathology and nicotine dependence in smokers has been a relevant topic in recent years. Nevertheless, little is known about personality disorders in smokers. The aim of this article is to review research published nationally and internationally which analyzes the relation between tobacco use and personality disorders. Our review permits us to affirm that research on the presence of Axis II disorders in smokers is rather scarce. Of 12 studies analyzed, it can be concluded that the prevalence of personality disorders in smokers is highly variable (between 9% and 45%), and that, in the majority of the studies, smoking is associated first with the presence of cluster C disorders (dependent, avoidant and obsessive-compulsive), and second, with cluster B disorders (histrionic, narcissistic, borderline and antisocial). Finally, we note the various limitations of previous studies and stress the need to better understand these disorders, given their relevance to the treatment of smokers.

  6. 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…

  7. 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

  8. 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

  9. [Effect of developmental disorders on personality and personality disorders].

    PubMed

    Honda, Hideo

    2013-01-01

    Developmental disorders (DD) are now so common that it is even more necessary to investigate the relationship between DD and personality disorders (PD). Despite the lack of studies, DD and PD have much in common. For research on personality and its disorders, direct, real-time observation by researchers themselves on the "black box" of temperament and its interaction with the environment is needed. For research on DD, especially in those with mild DD symptoms, how developmental characteristics and their interaction with the environment affect the personality in adulthood should be investigated.

  10. Personality disorders: review and clinical application in daily practice.

    PubMed

    Angstman, Kurt B; Rasmussen, Norman H

    2011-12-01

    Personality disorders have been documented in approximately 9 percent of the general U.S. population. Psychotherapy, pharmacotherapy, and brief interventions designed for use by family physicians can improve the health of patients with these disorders. Personality disorders are classified into clusters A, B, and C. Cluster A includes schizoid, schizotypal, and paranoid personality disorders. Cluster B includes borderline, histrionic, antisocial, and narcissistic personality disorders. Cluster C disorders are more prevalent and include avoidant, dependent, and obsessive-compulsive personality disorders. Many patients with personality disorders can be treated by family physicians. Patients with borderline personality disorder may benefit from the use of omega-3 fatty acids, second-generation antipsychotics, and mood stabilizers. Patients with antisocial personality disorder may benefit from the use of mood stabilizers, antipsychotics, and antidepressants. Other therapeutic interventions include motivational interviewing and solution-based problem solving.

  11. 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

  12. [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.

  13. [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

  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. [Personality in patients with panic disorder].

    PubMed

    Sanz-Carrillo, C; García-Campayo, J J; Sánchez Blanque, A

    1993-01-01

    Fourty-five patients diagnosed ad Panic Disorder and forty-five control patients are studied. Personality traits are assessed by Cattel's 16 PF. Test and several subscales derived from MMPI (dependence, repression, hypersensibility, etc.). Anxiety is measured by Zung's Anxiety Scale. Panic disorder patients show higher "dependence", "inferiority", "hypersensibility", low "ego strength", "parmia", "shrewdness", "self-sentiment integration" and high "ergic tension". In addition, male patients show significative differences in "affectothymia", "self-sufficiency", "self-sentiment integration" and "invia". PMID:8172011

  16. 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 ...

  17. [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.

  18. Endophenotypes in the personality disorders

    PubMed Central

    Siever, Larry J.

    2005-01-01

    The identification of endophenotypes in the personality disorders may provide a basis for the identification of underlying genotypes that influence the traits and dimensions of the personality disorders, as well as susceptibility to major psychiatric illnesses. Clinical dimensions of personality disorders that lend themselves to the study of corresponding endophenotypes include affective instability impulsiwity aggression, emotional information processing, cognitive disorganization, social deficits, and psychosis. For example, the propensity to aggression can be evaluated by psychometric measures, interview, laboratory paradigms, neurochemical imaging, and pharmacological studies. These suggest that aggression is a measurable trait that may be related to reduced serotonergic activity. Hyperresponsiveness of amygdala and other limbic structures may be related to affective instability, while structural and functional brain alterations underlie the cognitive disorganization in psychoticlike symptoms of schizotypal personality disorder. Thus, an endophenotypic approach not only provides clues to underlying candidate genes contributing to these behavioral dimensions, but may also point the way to a better understanding of pathophysiological mechanisms. PMID:16262209

  19. 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 ...

  20. Employment in Borderline Personality Disorder

    PubMed Central

    Sansone, Lori A.

    2012-01-01

    A number of studies in the literature have explored employment outcomes in patients with borderline personality disorder. However, after imposing our exclusion criteria, we located only 11 viable studies, published between the years 1983 and 2010. Individual studies examined employment outcomes in 8 to 249 individuals, but eight studies consisted of 33 participants or less. At baseline, participants were recruited from various locales, including hospital settings (7 studies), outpatient settings (2 studies), day treatment (1 study), and a college campus (1 study). The follow-up periods in these studies ranged from 1 to 27 years. Three studies compared participants with borderline personality disorder to a cohort of individuals with other types of psychopathology whereas only two studies used a normative comparison group. Given a host of potential limitations, findings cautiously suggest that nearly half of individuals with borderline personality disorder remain unemployed at follow-up, and of these, only a portion are self-supporting; 20 to 45 percent subsist on disability. However, several studies found modest employment gains among some individuals with borderline personality disorder, and one study developed a work/school acclimatization program, which meaningfully improved employment outcomes. This general area warrants further research to clarify the explicit employment outcomes of patients with borderline personality disorder. PMID:23074700

  1. [Personality disorders: old and new problems].

    PubMed

    Smulevich, A B; Shostakovich, B V

    2001-01-01

    Correlations were found between the structure of personality disorders (PD) (neurotic--borderline personality organization) and the regularities of PD dynamics. Taking into consideration the regularities of interaction of psychopathologic manifestations with positive symptomatology, three types of PD dynamics were psychopathologically identified, which show information on polar (compensation--decompensation) processes: 1) that in form of personality development; 2) that in form of PD-associated quasipsychoses; associated with DP; 3) that in form of transformation of characterological disorders into psychopathologic ones. The first two types of dynamics, which appear as as actualization of pathocharacterological formations in the pattern of mental disorders, reflect decompensation processes. In neurotic personality (emotionally labile, anxious, dependent, sensitive schizoids, etc) there is a deep (in terms of personality development) reorganization of characterological abnormalies. In borderline personality (paranoid, expansive schizoids, anancasts, borderline, etc.), aggravation and chronic pattern of mental disorders occurs with dynamics of PD-associated quasipsychoses. The third type of dynamics is not accompanied by aggravation of pathocharacterological manifestations and reflects compensation process. Separation of the isolated symptom complexes, PD derivatives (steady-state catathymically charged pathocharacterological formations are symptom-forming) is possible in any type of personality organization, but more frequently is observed at complex forms with a high proportion of facultative complexes and accentuations.

  2. Pharmacotherapeutical treatment of personality disorders.

    PubMed

    Hesselink, J M

    1995-09-01

    Since some years it has become evident that objective disturbances can be found in patients suffering from personality disorders. Research findings from earlier date already demonstrated low levels of 5-hydroxyindoleacetic acid in the cerebrospinal fluid, especially in patients with personality disorders, under exclusion of depressive features. Furthermore, data have been collected on the correlation between a hyposerotonergic state and disturbances in aggression and impulse control in a variety of syndromes such as automutilation, bulimia nervosa, suicide attempts and various states of drug abuse. However, psychopharmacological research in personality disorders is rare and to date mainly patients with borderline and schizotypical personality disorders have been studied. It is quite remarkable for this area to find more review articles than original contributions based on the results of clinical trials. A great variety of recommendations for pharmacotherapy in these patients exists in literature, among which treatment with carbamazepine, lithium, low-dose neuroleptics, tricyclic antidepressants and serotonin uptake inhibitors. In this article we will analyze the research methodology and the results of clinical trials forming the base for pharmacotherapeutic treatment recommendations. Only the results of well-controlled studies will be reviewed.

  3. Disinhibition and borderline personality disorder.

    PubMed

    Nigg, Joel T; Silk, Kenneth R; Stavro, Gillian; Miller, Torri

    2005-01-01

    We review different conceptions of inhibitory control that may be relevant to the regulatory problems featured in borderline personality disorder (BPD). These conceptions have often been framed with regard to personality traits of inhibitory control, but can also be related to cognitive measures of response suppression as well as affect regulation. Reactive behavioral inhibition is relatively unstudied in relation to BPD. A substantial amount of literature links executive function problems with BPD, but that literature has not isolated executive response inhibition nor been controlled for other personality disorder symptoms of antisociality, attention-deficit/hyperactivity disorder (ADHD), or depression, anxiety, or posttraumatic symptoms. We therefore conducted a study of this question looking at BPD symptoms in an adult sample with a small number of BPD subjects and other disorders. Results indicated that symptoms of BPD were correlated with response inhibition (measured by stop signal reaction time) even after controlling for the overlap of stop inhibition with ADHD, antisociality, and other Axis II disorder symptoms. We conclude by hypothesizing discrete developmental routes to BPD, based on different mechanism breakdowns, which would be amenable to empirical investigation at the cognitive or trait level of analysis. PMID:16613434

  4. 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…

  5. Personality disorders and body weight.

    PubMed

    Maclean, Johanna Catherine; Xu, Haiyong; French, Michael T; Ettner, Susan L

    2014-01-01

    We examine the impact of Axis II personality disorders (PDs) on body weight. PDs are psychiatric conditions that develop early in life from a mixture of genetics and environment, are persistent, and lead to substantial dysfunction for the affected individual. The defining characteristics of PDs conceptually link them with body weight, but the direction of the relationship likely varies across PD type. To investigate these links, we analyze data from Wave II of the National Epidemiological Survey of Alcohol and Related Conditions. We measure body weight with the body mass index (BMI) and a dichotomous indicator for obesity (BMI≥30). We find that women with PDs have significantly higher BMI and are more likely to be obese than otherwise similar women. We find few statistically significant or economically meaningful effects for men. Paranoid, schizotypal, and avoidant PDs demonstrate the strongest adverse impacts on women's body weight while dependent PD may be protective against elevated body weight among men. Findings from unconditional quantile regressions demonstrate a positive gradient between PDs and BMI in that the effects are greater for higher BMI respondents.

  6. Theodore Millon's Contributions to Conceptualizing Personality Disorders.

    PubMed

    Pincus, Aaron L; Krueger, Robert F

    2015-01-01

    We review Theodore Millon's contributions to conceptualizing personality disorders in contemporary clinical science and practice. Millon worked tirelessly across professional domains and theoretical orientations, developing a rich integrative theory of personality and its pathology, directly and indirectly impacting the evolving iterations of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III through DSM-5), and advocating for the personality disorders through his contributions to cofounding the International Society for the Study of Personality Disorders and the Journal of Personality Disorders. We conclude with a closer look at Millon's final major contributions to conceptualizing personality disorders as well as the strengths and limitations of his approach.

  7. Personality disorders and dimensions in pathological gambling.

    PubMed

    Odlaug, Brian L; Schreiber, Liana R N; Grant, Jon E

    2012-06-01

    Comorbid DSM-IV Axis II personality disorders appear to be common in pathological gambling (PG) and may contribute to the chronic problems often associated with the disorder. This study sought to examine the relationship between PG, personality disorders, and impulsivity in a sample of pathological gamblers. Personality assessments included the SCID-II, Eysenck Impulsiveness Questionnaire, Tridimensional Personality Questionnaire, and Barratt Impulsiveness Scale. A total of 77 individuals with DSM-IV PG were included in this study, of which 35 (45.5%) met criteria for at least one personality disorder. Specific aspects of impulsivity were associated with certain personality disorders in PG when grouped by cluster, yet the presence of a personality disorder was not positively correlated with gambling severity. It remains unclear how the presence of a personality disorder and aspects of impulsivity may affect treatment outcome. Further exploration of these disorders and dimensions of personality may encourage a more inclusively global treatment approach.

  8. [Personality disorders in the DSM-5].

    PubMed

    Kuritárné Szabó, Ildikó

    2012-01-01

    Significant changes are proposed in the personality disorders section of the 5th. edition of the DSM. The article summarizes the historical background of the personality disorder classification, including personality-types theory, trait-theory, and clinical concepts based upon psychiatric and psychoanalytical traditions. After briefly summarizing concerns on current approach to diagnosing personality disorders in DSM-IV, we summarise the most important features of the newly developed personality disorders classification, including concepts have been modified during long years of investigation. The new system will have modified less than was originally intended, and will be a hybrid model of dimensional categorical approach to diagnosing personality disorders. The ten personality disorder types are reduced to six, and they will have new criteria based on maladaptive trait dimensions. The trait structure model was derived from existing personality and personality disorder trait models, and includes five broad higher-order trait domains, which are negative affectivity, detachment, antagonism, disinhibition, and psychoticism. A new set of general criteria are developed for defining personality disorder. Self and interpersonal functioning represent the core impairment in personality functioning central to personality disorder, and the presence of maladaptive personality traits is also required. Severity continuum of personality pathology can be rated on the Levels of Personality Functioning Scale.

  9. [Personality disorders in the DSM-5].

    PubMed

    Kuritárné Szabó, Ildikó

    2012-01-01

    Significant changes are proposed in the personality disorders section of the 5th. edition of the DSM. The article summarizes the historical background of the personality disorder classification, including personality-types theory, trait-theory, and clinical concepts based upon psychiatric and psychoanalytical traditions. After briefly summarizing concerns on current approach to diagnosing personality disorders in DSM-IV, we summarise the most important features of the newly developed personality disorders classification, including concepts have been modified during long years of investigation. The new system will have modified less than was originally intended, and will be a hybrid model of dimensional categorical approach to diagnosing personality disorders. The ten personality disorder types are reduced to six, and they will have new criteria based on maladaptive trait dimensions. The trait structure model was derived from existing personality and personality disorder trait models, and includes five broad higher-order trait domains, which are negative affectivity, detachment, antagonism, disinhibition, and psychoticism. A new set of general criteria are developed for defining personality disorder. Self and interpersonal functioning represent the core impairment in personality functioning central to personality disorder, and the presence of maladaptive personality traits is also required. Severity continuum of personality pathology can be rated on the Levels of Personality Functioning Scale. PMID:23180732

  10. 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…

  11. 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

  12. Patient With Borderline Personality Disorder

    PubMed Central

    Griffiths, Dorothy E.

    1989-01-01

    Every family practice includes people who are difficult to manage. Persons with a borderline personality disorder can be the most difficult of all. They will trust no one, and consequently few, if any, others will be able to tolerate their profoundly difficult interpersonal communication style. These patients will present to their family physician more and more often with a variety of somatic and emotional symptoms. They will demand, either verbally or silently, that these symptoms be relieved immediately. This increasing demand for immediate response may eventually cause the physician to reject the patient. An understanding of this condition and how it develops in infancy may enable the physician to help the patient. A family physician who can set appropriate limits to the patient's demands may slowly convince the patient that he can trust and not be hurt. PMID:21248944

  13. Psychopathy/antisocial personality disorder conundrum.

    PubMed

    Ogloff, James R P

    2006-01-01

    Psychopathy has traditionally been characterised as a disorder primarily of personality (particularly affective deficits) and, to a lesser extent, behaviour. Although often used interchangeably, the diagnostic constructs of psychopathy, antisocial personality disorder, and dissocial personality disorder are distinct. In this article, the relevant historical and contemporary literature concerning psychopathy is briefly reviewed. The diagnostic criteria for psychopathy, antisocial personality disorder, and dissocial personality disorder are compared. Consideration is given to the assessment, prevalence, and implications of psychopathy for violence risk and treatment efficacy. The DSM-IV-TR criteria for antisocial personality disorder, in particular, are largely behaviourally based. The ICD criteria for dissocial personality disorder, while paying more attention to affective deficits, also do not represent the broad personality and behavioural components of psychopathy. Since 1980, a great deal of research on these disorders has been conducted, using the Hare Psychopathy Checklist, Revised (PCL-R). The PCL-R assesses both personality (interpersonal and affective) and behavioural (lifestyle and antisocial) deficits. As such, the research and clinical implications of psychopathy, as operationalised by the PCL-R, cannot be readily extrapolated to the diagnoses of antisocial personality disorder and dissocial personality disorder. As currently construed, the diagnosis of antisocial personality disorder grossly over-identifies people, particularly those with offence histories, as meeting the criteria for the diagnosis. For example, research shows that between 50% and 80% of prisoners meet the criteria for a diagnosis of antisocial personality disorder, yet only approximately 15% of prisoners would be expected to be psychopathic, as assessed by the PCL-R. As such, the characteristics and research findings drawn from the psychopathy research may not be relevant for those

  14. Diagnosing personality disorders in psychiatric inpatients.

    PubMed

    Jackson, H J; Whiteside, H L; Bates, G W; Bell, R; Rudd, R P; Edwards, J

    1991-03-01

    This study investigated assumptions made by DSM-III and DSM-III-R regarding Axis I-Axis II associations and sex differences for the 11 personality disorders (PD). A total of 112 patients formed 4 Axis I diagnostic groups: recent-onset schizophrenia (n = 35); recent-onset mania (n = 26); unipolar affective disorder (n = 30); and a mixed diagnostic group (n = 21). The prevalence of PD was determined using the Structured Interview for DSM-III Personality Disorders (SIDP). Schizophrenia was associated with antisocial PD and schizotypal PD; manic disorder was associated with histrionic PD; and unipolar affective disorder was associated with borderline, dependent and avoidant PD. Some of these results were consistent with DSM-III/DSM-III-R postulates. However, there was little support for the DSM-III/DSM-III-R statements on sex differences in the prevalence of PD, except for antisocial PD. The implications of the results for DSM-III/DSM-III-R assumptions are discussed.

  15. [Psychotherapy of personality disorders in adolescence].

    PubMed

    Baader, Aline; Schmeck, Klaus; Resch, Franz; Kaess, Michael

    2014-01-01

    By the current state of knowledge adolescent personality disorders should be taken seriously due to their high prevalence and severe symptomatology. Personality disorders are characterized by a stable pattern of deviation concerning cognition, affectivity, impulse control, and interpersonal relationships and have negative repercussions in psychosocial functioning and subsequent development. There is emerging evidence that personality disorder diagnosis is reliable and valid during adolescence. It is essential to detect youth with personality pathology in order to refer them to specific psychotherapeutic interventions and consequently avoid further chronification and life-long functional impairment. This selective review will give an overview over personality disorders in adolescents as well as according psychotherapeutic interventions.

  16. DSM-5 personality traits and DSM-IV personality disorders.

    PubMed

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

    2012-05-01

    Two issues pertinent to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; 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 6 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.

  17. The comorbidity of multiple personality disorder and DSM-III-R axis II disorders.

    PubMed

    Fink, D

    1991-09-01

    , borderline, antisocial) and Cluster C personality disorders (avoidant, compulsive, dependent, passive-aggressive) are believed to be primarily developmental disturbances. Comorbidity of these personality disorders with MPD involves consideration of the interaction of many developmental processes with the psychological impact of severe childhood trauma. Many MPD patients present with an apparent mixed personality profile consisting of an array of avoidant, compulsive, borderline, narcissistic, dependent, and passive-aggressive features. Although this article explores comorbidity of MPD with each of the personality disorders defined in DSM-III-R individually, it seems likely that a number of posttraumatic personality organizations can be defined that commonly coexist with MPD.(ABSTRACT TRUNCATED AT 400 WORDS)

  18. 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.

  19. Personality traits, personality disorders, and migraine: a review.

    PubMed

    Davis, Rachel E; Smitherman, Todd A; Baskin, Steven M

    2013-05-01

    The personality trait of neuroticism has been associated with migraine, although research is needed to clarify potential moderators of this relationship and the extent to which neuroticism reflects a stable disposition or instead is a function of general somatic distress or situational influences. With the possible exception of harm avoidance, research has not consistently identified any other personality trait unique among migraineurs. Personality disorders have been researched less extensively, but existing data suggests that borderline personality disorder, in particular, is associated with increased negative impact of migraine, risk for medication overuse, and poor response to treatment that is likely of greater clinical importance than any personality trait per se.

  20. Personality disorders: conceptual issues and responsibility.

    PubMed

    Sass, H; Herpertz, S; Houben, I

    1994-01-01

    The historical roots of the concepts of abnormal personality, social deviance, delinquency and penal responsibility are described, demonstrating that former concepts of psychopathic personality often included negative social evaluations. Modern classification systems such as DSM-III-R and ICD-10 prefer a behavior-oriented definition of personality disorders, which increases reliability but may lead to a reductionistic and purely criteriological assessment of personality. A checklist for the assessment of personality disorders (AMPS) according to ICD-10 and DSM-III-R is presented, including four subaffective forms derived from the typology of personality disorders described by Kurt Schneider and Kretschmer. To justify statements of diminished legal responsibility or irresponsibility under the German Penal Code, a differentiation between psychopathological phenomena in personality disorders and pure social deviance is needed. The three notions of psychopathy, sociopathy and dissocial behavior are suggested to guide necessary decisions concerning prognosis and therapy chances.

  1. Commentary: personality disorders and criminal law.

    PubMed

    Slovenko, Ralph

    2009-01-01

    The history of the personality-disorder diagnosis in law and psychiatry-in particular, the antisocial personality disorder-is recounted along with the arguments of renowned forensic psychiatrists as well as public opinion. Jurisdictions around the world are divided on the impact of the diagnosis on criminal responsibility or on sentencing.

  2. Gender weighting of DSM-III-R personality disorder criteria.

    PubMed

    Sprock, J; Blashfield, R K; Smith, B

    1990-05-01

    This study explored the gender weighting of the diagnostic criteria for personality disorders. Gender weighting was defined in terms of how 33 female and 17 male nonclinicians ranked the diagnostic criteria along a male-female dimension. Although the a priori expectation was that antisocial would be the prototypically masculine personality disorder and histrionic the feminine, the subjects ranked criteria from the sadistic category as the most masculine and those from the dependent category as the most feminine. These results and the subjects' gender weighting of criteria for borderline, obsessive-compulsive, and self-defeating personality disorders are analyzed in detail.

  3. [Dispute over the multiple personality disorder: theoretical or practical dilemma?].

    PubMed

    Stankiewicz, Sylwia; Golczyńska, Maria

    2006-01-01

    Dissociative identity disorder (DID) could also be referred to as multiple personality disorder (MPD). Due to rare occurrence and difficulty in its' identification it is infrequently diagnosed in Poland. The indicated disorder has been portrayed by the authors throughout the historical context, referring to initial 18th century's references concerning dissociation. A typical dissociatively disordered person has been characterized along with his individual personality categories such as: original personality, altered personality, host and personality fragment. Moreover various diagnosis criterions of DID have been introduced. DID has also been differentiated with other disorders: PTSD (post-traumatic stress disorder) and BPD (borderline personality disorder). A hypothesis has been set up, stating that DID is directly correlated with the trauma experienced during childhood, while PTSD is linked with traumatic lived-through events in the later period of ones' life. The most contemporary and frequently used research tools for DID have been indicated: dissociative experience scale (DES) and somatoform dissociation questionnaire (SDQ-20). Based upon the known literature, the authors have presented treatment methods such as hypnotherapy and recorded therapy sessions. It is the view of the authors that the switching in dissociative identity disorder is of adaptive character (it occurrs depending upon adaptive needs).

  4. What dimensions underlie cluster B personality disorders?

    PubMed

    Looper, K J; Paris, J

    2000-01-01

    This report presents a conceptual model of the relationships between personality dimensions and the four personality disorders listed in the B cluster on axis II. The hypothesis will be developed that while impulsivity is the common dimension underlying all four disorders, differences between the categories reflect the severity of impulsive traits, interactions with other personality dimensions, the effects of gender, and the influence of culture. Clinical and research implications of the model are then described.

  5. Personality disorders as an expression of the dimensional polarity in personality development in late adulthood women.

    PubMed

    Henriques-Calado, Joana; Duarte-Silva, Maria Eugénia; Campos, Rui C; Junqueira, Diana; Sacoto, Carlota; Keong, Ana Marta

    2014-01-01

    Relationships between Axis II personality disorders and Sidney Blatt constructs of dependency and self-criticism were explored in a late adulthood women sample. The sample consisted of 102 women (M = 72.07 years of age, SD = 7.04) who were administered two measures, the Personality Diagnostic Questionnaire-4+ and the Depressive Experiences Questionnaire. The histrionic, dependent, and obsessive-compulsive personality disorder scales are shown to be significant predictors of dependency, and the narcissistic, borderline, and avoidant scales are significant predictors of self-criticism. The application of a dimensional interpersonal approach to psychopathology is discussed.

  6. 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…

  7. 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

  8. Personality disorders and 'restoration to sanity'.

    PubMed

    Osran, H C; Weinberger, L E

    1994-01-01

    Historically, the use of the insanity defense has been limited although not exclusively to those with a psychotic mental disorder at the time of the crime. Occasionally, an insanity acquittee may primarily suffer from a personality disorder at the time of commitment to the psychiatric hospital. Such examples can include someone with a personality disorder who malingers psychosis and legal insanity or who at the time of the crime may have been suffering from a drug-induced or brief reactive psychosis. One such case will be presented as well as dilemmas created for the clinician and forensic evaluator. In addition, pertinent medical and psychological literature and legal case precedents will be discussed. Finally, a proposed guideline for the treatment and evaluation of the personality-disordered insanity acquittee will be offered, focusing specifically on the aspects of the personality disorder that contribute to the individual's dangerousness.

  9. [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.

  10. 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.

  11. A personality disorder of excessive power strivings.

    PubMed

    Charny, I W

    1997-01-01

    None of the existing formal diagnostic categories in psychiatry today addresses adequately the issues of excessive power-seeking, corruption and destructiveness. Excessive power strivings both poison the personality of the individual who is obsessed in his spirit and mind with power and do unacceptable harm to other peoples' lives. The present proposal of a diagnostic category of a Personality Disorder of Excessive Power Strivings is intended to fit into current diagnostic schema of DSM as well as into an earlier proposal (1) to examine in all psychopathology not only the burdens and damage people do and impose on their own selves and their own functioning, but also the harm they do to other peoples' lives and functioning. The diagnosis is to be used when the individual displays prolonged and severe manifestations of the following listed criteria: The basic feature which is always present in this personality disorder is: 1. Intense and extensive power strivings. In addition, at least three other of the following characteristics should be present; 2. Lack of empathy for people, and indifference to the suffering of others; 3. "Street smart" alertness and remarkable cunning committed to seizing and expanding power; 4. Ruthlessness in cultivation of power; 5. Scapegoating and projection of blame on to targeted individuals or a group, an insistent need to identify certain others as lowly, worthless and intended victims; 6. Corruption by power and addiction to power; 7. Demands of other people to be dependent on one's powerful personality, or that they become one's obedient followers; 8. Emphasis on symbolisms of pure vs. impure, holy vs. infidel, chosen vs. condemned; 9. A basic disrespect for the lives of others evidenced in callous or indifferent exposure of others to undue risks; 10. An absence of conscience in contexts of self-interest and opportunity; 11. A homicide/suicide orientation.

  12. 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.

  13. 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

  14. 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.

  15. 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

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

    PubMed

    Esterberg, Michelle L; Goulding, Sandra M; Walker, Elaine F

    2010-12-01

    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.

  17. Assessment of DSM-5 Personality Disorder.

    PubMed

    Widiger, Thomas A

    2015-01-01

    The purpose of this article is to present an approach to defining, identifying, and assessing personality disorders, including the links between these definitions and personality assessment, with a particular reference to the proposed revisions to the personality disorders section of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM-5]; American Psychiatric Association, 2013 ). The article discusses measures of maladaptive variants of the Five-factor model (FFM) that are coordinated with both the traditional personality disorder syndromes as well as the DSM-5 dimensional trait model. Discussed as well is the assessment of the more psychodynamically oriented deficits in sense of self and interpersonal relatedness that are also included within the hybrid model proposed for DSM-5.

  18. The relationship between borderline personality disorder and bipolar disorder.

    PubMed

    Zimmerman, Mark; Morgan, Theresa A

    2013-06-01

    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. Research considering whether BPD should be considered part of a bipolar spectrum reaches differing conclusions. We reviewed the most studied question on the relationship between BPD and bipolar disorder: 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 nontheless diagnosed in the absence of the other in the vast majority of cases (80% to 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 also more commonly diagnosed in patients with BPD than is bipolar disorder. These findings challenge the notion that BPD is part of the bipolar spectrum.

  19. 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.

  20. [Differential diagnosis of dissociative identity disorder (multiple personality disorder)].

    PubMed

    Stübner, S; Völkl, G; Soyka, M

    1998-05-01

    Recently the concept of dissociative identity disorder (formerly known as multiple personality disorder) has attracted increasing public and scientific interest. However, it is rarely diagnosed in the clinical setting. the reported case of a 47-year-old woman with a history of child abuse demonstrates the problems of differential diagnosis. A number of psychopathologic symptoms pointed to a multiple personality disorder, but in the follow-up psychotic symptoms such as delusions, possible hallucinations and bizarre behavior clearly emerged. The differential diagnosis of dissociative identity disorder includes paranoid schizophrenia, as in the case described, borderline personality disorder, hysteria, simulation and the false memory syndrome. Finally, social and cultural factors have to be considered.

  1. 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

  2. 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…

  3. 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)

  4. 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…

  5. [Depression and personality disorders: mutual influences].

    PubMed

    Rimlinger, B

    2010-12-01

    The first disposition described as having an influence on mood date back to ancient Greece. The current modeling of personality disorders is organized essentially in a category-specific logic (DSMIV, CIM-10) and dimensional logic ("big five", Eysenck model, Cloninger model, etc.). The heterogeneity of these evaluation tools affects the readability of the studies concerning the effects of comorbidity on depressive disorders. The frequency of the coexistence of personality disorders/depression (≥50%) which is associated with the severity of the depressive episodes, with pejorative evolutionary prognosis and resistance in treatments, appears to justify a reorganization of classifications in the future DSM-V.

  6. [Legal approach of antisocial personality disorders].

    PubMed

    Stingo, Néstor Ricardo

    2011-01-01

    We mention the different terms used over time to describe those behavioral disorders where prevailing selfishness, brutality, insensitivity, irresponsibility, manipulation and lack of empathy. It takes into account the biological, psychological and environmental theories. It refers to the importance of mirror neurons and its value in relation to the understanding of feelings. The criteria for the diagnosis, stressing the differences between psychopathic personalitya and antisocial personality disorder. Some sentences from different courts with various criteria are transcribed, for the apportionment or insanity of cases whose diagnosis is the psychopathic personality. Culminating with the legal approach of this type of personalities, from a civil and criminal perspective.

  7. [Legal approach of antisocial personality disorders].

    PubMed

    Stingo, Néstor Ricardo

    2011-01-01

    We mention the different terms used over time to describe those behavioral disorders where prevailing selfishness, brutality, insensitivity, irresponsibility, manipulation and lack of empathy. It takes into account the biological, psychological and environmental theories. It refers to the importance of mirror neurons and its value in relation to the understanding of feelings. The criteria for the diagnosis, stressing the differences between psychopathic personalitya and antisocial personality disorder. Some sentences from different courts with various criteria are transcribed, for the apportionment or insanity of cases whose diagnosis is the psychopathic personality. Culminating with the legal approach of this type of personalities, from a civil and criminal perspective. PMID:22091452

  8. Accurately Diagnosing and Treating Borderline Personality Disorder

    PubMed Central

    Gentile, Julie P.; Correll, Terry L.

    2010-01-01

    The high prevalence of comorbid bipolar and borderline personality disorders and some diagnostic criteria similar to both conditions present both diagnostic and therapeutic challenges. This article delineates certain symptoms which, by careful history taking, may be attributed more closely to one of these two disorders. Making the correct primary diagnosis along with comorbid psychiatric conditions and choosing the appropriate type of psychotherapy and pharmacotherapy are critical steps to a patient's recovery. In this article, we will use a case example to illustrate some of the challenges the psychiatrist may face in diagnosing and treating borderline personality disorder. In addition, we will explore treatment strategies, including various types of therapy modalities and medication classes, which may prove effective in stabilizing or reducing a broad range of symptomotology associated with borderline personality disorder. PMID:20508805

  9. 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

  10. 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

  11. 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).

  12. 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.

  13. Schizotypal personality disorder and the insanity defense.

    PubMed

    Felthous, A R

    1986-07-01

    What constitutes a "mental disorder" for purposes of the insanity defense? Does mental disorder denote any diagnosable condition listed in the third edition of the Diagnostic and Statistical Manual of Mental Disorders? Is a mental disorder a disturbance wherein the functional criteria of the appropriate insanity law appear to be met? Or does insanity law define mental disorder apart from functional criteria of insanity? The answer to the last question is that some insanity laws attempt to define or qualify mental disorder, but many do not. Unclarities in the law leave room for unnecessary disagreements between expert witnesses even before the functional criteria for insanity are to be addressed. The potential for confusion is compounded when the defendant's disturbance is ambiguous, amphibious, or both. Schizotypal personality disorder is offered as an example of such a disturbance, and inferences are discussed.

  14. 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 ...

  15. 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...

  16. 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...

  17. 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...

  18. 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...

  19. 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...

  20. Long-term outcome in personality disorders.

    PubMed

    Stone, M H

    1993-03-01

    Personality disorders meeting DSM or ICD criteria represent the severe end of the broad spectrum of personality configurations involving maladaptive traits. The literature regarding long-term outcome of personality disorders is sparse. Most attention is devoted to formerly institutionalised patients with borderline, antisocial, or schizotypal disorders. Borderline patients at 10-25-year follow-up have a wide range of outcomes, from clinical recovery (50-60%) to suicide (3-9%). Certain factors (e.g. artistic talent) conduce to higher recovery rates, others (e.g. parental cruelty) to lower rates. Schizoid and schizotypal patients tend to remain isolated, and to lead marginal lives. The long-term outcome in antisocial persons is bleak if psychopathic traits are prominent. Personality traits and their corresponding disorders are egosyntonic, harden into habit, and are both slow to change and hard to modify. There is no one treatment of choice. Psychoanalysis and related methods work best within the anxious/inhibited group; cognitive/behavioural techniques are well suited to the disorders requiring limit setting and the amelioration of maladaptive habits. PMID:8453424

  1. Association of personality disorders with Type A and Type B alcoholics.

    PubMed

    Bottlender, Miriam; Preuss, Ulrich W; Soyka, Michael

    2006-02-01

    Personality disorders frequently occur as comorbid disorder in alcohol-dependent subjects. Antisocial personality was described as an important characteristic in Cloninger's Type 2 and Babor's Type B subjects. The impact of other personality disorders on these alcoholism typologies, their pathogenesis and prognosis is, however, still unclear. The present study investigated the prevalence of personality disorders in 237 (194 males) detoxified alcohol-dependent patients after subtyping this sample according to Babor's Type A/B following the criteria suggested by Schuckit et al. (1995). Personality disorders were assessed with the SCID-II (DSM-IV). In all, 160 patients (68 %) could be classified as Type A, and 77 (32 %) as Type B. Type B subjects were younger, had an earlier onset,more alcohol intake and a more severe course of alcohol dependence. Type B patients had significantly more often any cluster A and B personality disorder, and significantly specifically more often a borderline, antisocial and avoidant personality disorder. There were no statistical differences concerning the other personality disorders. In summary, the Type A/B dichotomy using the criteria of Schuckit et al. (1995) was replicated successfully. Differences concerning cluster B personality disorder prevalence of Type B subjects demonstrated that these subjects are significantly more often affected from borderline and antisocial personality disorder. The impact of other personality disorders does not play a substantial role in subtyping alcoholics.

  2. 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.

  3. The Zuckerman-Kuhlman Personality Questionnaire predicts functioning styles of personality disorder: a trial in healthy subjects and personality-disorder patients.

    PubMed

    Huang, Jingyi; He, Wei; Chen, Wanzhen; Yu, Wenjun; Chen, Wei; Shen, Mowei; Wang, Wei

    2011-04-30

    Normal personality traits, as measured by the Zuckerman-Kuhlman Personality Questionnaire (ZKPQ), predicted some personality disorders in a sample of healthy volunteers. Whether these predictions could be more pronounced in patients with personality disorders remains unknown. We administered the ZKPQ and the Parker Personality Measure (PERM), which describes the functioning styles of personality disorder, in 134 patients with a range of personality disorders and in 268 age-, gender- and education level-matched healthy volunteers. Cluster A patients scored lowest on Sociability, cluster B highest on Impulsive Sensation Seeking and Aggression-Hostility, cluster C1 (Avoidant and Dependent types) highest on Neuroticism-Anxiety, and cluster C2 (Obsessive-Compulsive type) highest on Activity. Most of the predictors were consistent across both the healthy and patient groups. The variances that accounted for predicting most PERM styles by the ZKPQ traits in the patient group were higher than those in the healthy group. Our results showed that the ZKPQ traits could specifically predict the PERM styles in both healthy subjects and personality-disorder patients. This result was more pronounced in the latter group. The most powerful predictions were obtained for Antisocial, Dependent, Borderline and Avoidant styles, and the weakest for the Schizotypal and Schizoid styles in the patient group.

  4. 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

  5. Personality disorder types proposed for DSM-5.

    PubMed

    Skodol, Andrew E; Bender, Donna S; Morey, Leslie C; Clark, Lee Anna; Oldham, John M; Alarcon, Renato D; Krueger, Robert F; Verheul, Roel; Bell, Carl C; Siever, Larry J

    2011-04-01

    The Personality and Personality Disorders Work Group has proposed five specific personality disorder (PD) types for DSM-5, to be rated on a dimension of fit: antisocial/psychopathic, avoidant, borderline, obsessive-compulsive, and schizotypal. Each type is identified by core impairments in personality functioning, pathological personality traits, and common symptomatic behaviors. The other DSM-IV-TR PDs and the large residual category of personality disorder not otherwise specified (PDNOS) will be represented solely by the core impairments combined with specification by individuals' unique sets of personality traits. This proposal has three main features: (1) a reduction in the number of specified types from 10 to 5; (2) description of the types in a narrative format that combines typical deficits in self and interpersonal functioning and particular configurations of traits and behaviors; and (3) a dimensional rating of the degree to which a patient matches each type. An explanation of these modifications in approach to diagnosing PD types and their justifications--including excessive co-morbidity among DSM-IV-TR PDs, limited validity for some existing types, lack of specificity in the definition of PD, instability of current PD criteria sets, and arbitrary diagnostic thresholds--are the subjects of this review.

  6. 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

  7. 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

  8. Neurobiological correlates of borderline personality disorder.

    PubMed

    Schmahl, Christian G; McGlashan, Thomas H; Bremner, J Douglas

    2002-01-01

    Although patients with borderline personality disorder (BPD) are commonly seen in psychiatric practice, there has been far less biological research in BPD than in other psychiatric disorders. This article reviews the neurobiological research that has been performed to date in BPD and integrates the biological, psychological, and clinical findings in this disorder. BPD is best thought of in terms of dimensions rather than as a specific disorder. Each dimension has a biological profile and may be expressed differently in different patients. Four core elements are suggested to play a major role in the development of BPD: interpersonal stress, affective instability, impulsivity, and dissociation and self-injurious behavior. Genetic and environmental factors lead to brain alterations that are the basis for specific presentations of the disorder, such as self-injurious and impulsive aggressive behavior.

  9. 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…

  10. Increased serum prolactin in borderline personality disorder.

    PubMed

    Atmaca, Murad; Korkmaz, Sevda; Ustundag, Bilal; Ozkan, Yusuf

    2015-01-01

    Although there is an important interaction between serotonergic system, prolactin and suicidal behavior, and impulsivity, no investigation examined the prolactin values in borderline personality disorder in which suicidal behavior and impulsivity are core symptom dimensions. In this context, in the present investigation, we planned to measure serum prolactin levels in the patients with borderline personality disorder. The study comprised 15 patients with borderline personality disorder and 15 healthy controls. Prolactin values were measured in both patients and control subjects. The patients had abnormally higher mean value of prolactin compared to those of healthy controls (48.66 ± 36.48 mg/dl for patients vs. 15.20 ± 7.81 mg/dl for healthy controls). There was no correlation between prolactin values and any demographic variables for both the patients and control subjects. In conclusion, our present results suggest that prolactin values increased in the patients with borderline personality disorder and are required to be replicated by more comprehensive and detailed further studies to decipher the exact roles of prolactin increase.

  11. Evidence-Based Assessment of Personality Disorders

    ERIC Educational Resources Information Center

    Widiger, Thomas A.; Samuel, Douglas B.

    2005-01-01

    The purpose of this article is to provide a foundation for the development of evidence-based guidelines for the assessment of personality disorders, focusing in particular on integrated assessment strategies. The general strategy recommended herein is to first administer a self-report inventory to alert oneself to the potential presence of…

  12. [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.

  13. Nicotine dependence and psychiatric disorders.

    PubMed

    Salín-Pascual, Rafael J; Alcocer-Castillejos, Natasha V; Alejo-Galarza, Gabriel

    2003-01-01

    Nicotine addiction is the single largest preventable cause of morbidity and mortality in the Western World. Smoking is not any more just a bad habit, but a substance addiction problem. The pharmacological aspects of nicotine show that this substance has a broad distribution in the different body compartnents, due mainly to its lipophilic characteristic. There are nicotinic receptors as members of cholinergic receptors' family. They are located in neuromuscular junction and in the central nervous system (CNS). Although they are similar, pentameric structure with an ionic channel to sodium, there are some differences in the protein chains characteristics. Repeated administration of nicotine in rats, results in the sensitization phenomenon, which produces increase in the behavioral locomotor activity response. It has been found that most psychostimulants-induced behavioral sensitization through a nicotine receptor activation. Nicotine receptors in CNS are located mainly in presynaptic membrane and in that way they regulated the release of several neurotransmitters, among them acetylcholine, dopamine, serotonin, and norepinephrine. In some activities like sleep-wake cycle, nicotine receptors have a functional significance. Nicotine receptor stimulation promotes wake time, reduces both, total sleep time and rapid eye movement sleep (REMS). About nicotine dependence, this substance full fills all the criteria for dependence and withdrawal syndrome. There are some people that have more vulnerability for to become nicotine dependent, those are psychiatric patients. Among them schizophrenia, major depression, anxiety disorders and attention deficit disorder, represent the best example in this area. Nicotine may have some beneficial effects, among them are some neuroprotective effects in disorders like Parkinson's disease, and Gilles de la Tourette' syndrome. Also there are several evidences that support the role of nicotine in cognitive improvement functions like attention

  14. Multiple personality disorder: scientific and medicolegal issues.

    PubMed

    Dinwiddie, S H; North, C S; Yutzy, S H

    1993-01-01

    Despite the intense study it has received since its inclusion in DSM-III, multiple personality disorder (MPD) largely remains an unvalidated construct. Definitional problems remain (there is not even agreement in the field as to whether a diagnosis of MPD truly means the existence of more than one personality), while the vagueness and liberality of existing criteria give the clinician little guidance in diagnosis. In forensic settings, diagnosis of MPD is even more problematic, since there is substantial evidence that the disorder cannot currently be phenomenologically distinguished from malingering. It also remains to be demonstrated that evaluators can determine whether alter personalities, if they exist, are truly unaware of each other, lack control over other alters' behavior, or are unable to know right from wrong.

  15. Core features of personality disorder: differentiating general personality dysfunctioning from personality traits.

    PubMed

    Berghuis, Han; Kamphuis, Jan H; Verheul, Roel

    2012-10-01

    The distinction between general personality dysfunctioning (GPD) and specific personality traits (SPT) is an important focus of attention in the proposed revisions of the DSM-5. The present study explores the distinction between GPD and SPT using the self-report questionnaires General Assessment of Personality Disorder (GAPD) and Severity Indices for Personality Problems (SIPP-118) to measure GPD, and the NEO-PI-R to measure SPT. The sample consisted of 424 psychiatric patients. Using principal component analysis, GPD and SPT appeared to be clearly distinct components of personality. Our GPD model consisted of three factors, i.e., Self-identity dysfunctioning, Relational dysfunctioning, and Prosocial functioning. This model remained by and large intact when combined with SFT factors. Our findings support the distinction between personality traits and personality dysfunction laid down in the recent proposal by the Personality and Personality Disorders Work Group of the DSM-5 Task Force.

  16. 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

  17. 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

  18. 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.

  19. [Personality disorders and psychopathology following trauma. Reflection on diagnostic classification].

    PubMed

    Wöller, W; Kruse, J

    2003-11-01

    Pervasive personality disorders have been shown to be long-term sequelae of cumulative childhood physical and sexual traumatization. This finding is not reflected in DSM-IV and ICD-10 classifications where post-traumatic stress disorder is confined to intrusions, avoidance, numbing, and hyperarousal. However, there is growing evidence that trauma etiology should be taken into account in planning treatment for personality disorders. It is not yet clear whether childhood traumatization is more strongly associated with borderline personality disorder than with other personality disorders. The finding of a substantial overlap between borderline personality disorder and dissociative identity disorder gives rise to discussions concerning the relationship of these two pathologies.

  20. Personality disorder comorbidity with major depression and response to treatment with sertraline or citalopram.

    PubMed

    Ekselius, L; von Knorring, L

    1998-09-01

    The purpose of this study was to investigate the frequency of DSM-III-R personality disorders in depressed patients treated in primary care, and to examine the effect of sertraline or citalopram on the diagnosis of personality disorders. A total of 308 patients with a major depressive disorder were assessed with the Swedish version of the Structured Clinical Interview for Personality Disorders (SCID) screen questionnaire, before and after 24 weeks double-blind treatment with sertraline (50-150 mg/day) or citalopram (20-60 mg/day). Following treatment, significant reductions in the frequency of paranoid, borderline, avoidant and dependent personality disorder diagnoses were seen in both treatment groups. When the personality disorders were analysed as continuous, dimensional personality traits significant reductions were seen for most personality categories. To elucidate if the observed reductions in personality disorder criteria could be explained by the improvement in depressive symptomatology, a series of multiple regressions were made. Reduction of depression scores was of some importance for the changes in most personality disorders. However, the multiple R never exceeded 0.24 (cluster C). Type of drug was of importance only as concerns obsessive-compulsive personality disorder. Overall, the results suggest that sertraline and citalopram may be beneficial in the treatment of certain personality disorder traits in patients with major depressive disorders.

  1. 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

  2. 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

  3. Antisocial personality disorder: a current review.

    PubMed

    Glenn, Andrea L; Johnson, Alexandria K; Raine, Adrian

    2013-12-01

    The Diagnostic and Statistical Manual of Mental Disorders (DSM 5) classification of antisocial personality disorder (ASPD) describes individuals who engage in repetitive irresponsible, delinquent, and criminal behavior. The diagnosis is highly controversial, with many researchers and clinicians arguing that the category is too heterogeneous, overinclusive, and demonstrates considerable overlap with other disorders. This review focuses on recent studies that have improved our understanding of the characteristics of individuals who fit the ASPD definition by exploring how subtypes differ and how comorbid conditions influence the presentation of ASPD. In addition, we discuss research on the etiology of ASPD that has identified genetic and environmental factors that may contribute to the development and persistence of antisocial behavior, and brain imaging research that has improved our understanding of the relationships between ASPD and other psychopathology. Finally, we discuss promising preliminary research on treatment for this disorder.

  4. 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.

  5. 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

  6. Personality disorders from a phenomenological perspective.

    PubMed

    Dörr Zengers, O

    2008-01-01

    Different studies have questioned the capacity of the categorical diagnostics to establish a clear distinction between the existence or not of a determined personality disorder. The dimensional perspective would approach more to reality, in the measure that it tries to measure the different intensity degrees in which these disorders are present in the patients. But its application is very laborious and besides, presupposes that those categories whose nuances it pretends to measure really exist. The foresaid leads us to appeal to phenomenological perspective, which seems to be more adequate for the study of complex realities, as it is the case of the personality and its disorders. The essential features of the phenomenological method in the sense of Husserl are described, as well as his contribution to the study of personality disorders. This can be summarized in three fundamental points: the ideal types, introduced in psychiatry by Karl Jaspers, the existential types, by Ludwig Binswanger, and the dialectic typologies and polarities, by Wolfgang Blankenburg and the undersigned. This author defines and develops each one of these concepts, aiming to show their advantages with respect to the categorical and dimensional systems.

  7. Effects of personality disorder and impulsivity on emotional adaptations in prison among women offenders.

    PubMed

    Mahmood, Senik T; Tripodi, Stephen J; Vaughn, Michael G; Bender, Kimberly A; Schwartz, Rachel D

    2012-12-01

    The present study sought to better understand the influence of personality disorders and impulsivity on women's ability to adapt to incarceration. We analyzed the influence of personality disorders as screened with the structured clinical interview for personality disorders, and impulsivity as assessed with the Barratt impulsivity scale on depression and anxiety, sleeping problems, and feeling afraid of being attacked in prison among a large sample of women incarcerated in a Virginia prison. Results from regression models indicated that schizotypal, borderline, avoidant and dependent personality disorders and cognitive impulsivity were significant predictors of symptoms of anxiety and depression net of demographic covariates. Women possessing a diagnosis of paranoid personality disorder were at increased odds of having difficulty sleeping in prison and borderline, dependent, and paranoid personality disorder were at increased odds of experiencing fear in prison. Women who had been in prison before were significantly less likely to experience these problems. Implications of study findings for policies and practices involving women offenders are discussed.

  8. 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.

  9. Multiple personality disorder in criminal law.

    PubMed

    Steinberg, M; Bancroft, J; Buchanan, J

    1993-01-01

    The authors review the recent literature on multiple personality disorder (MPD), the most severe and chronic of the dissociative disorders, in relation to court cases of competence to stand trial, the insanity defense, and research on malingerers feigning MPD. Issues relevant in the assessment of competency and insanity are described. Features characteristic of MPD, including amnesia and alterations in consciousness and personality, have varying degrees of influence over the criminal behavior of an individual with MPD. As in other psychiatric disorders, the influence of MPD on an individual's competence to stand trial, and sanity, can be evaluated systematically. This article discusses a specific diagnostic tool, the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D), an extensively field tested instrument that is potentially quite useful in forensic assessment of suspects manifesting dissociative symptoms and disorders. The particular advantages of the SCID-D will be reviewed in the context of some well known criminal cases involving MPD. Further research using diagnostic interviews for the systematic assessment of dissociative symptoms and MPD in criminal cases will continue to clarify the influence of these symptoms in a forensic context.

  10. Cognitive-behavioral therapies for personality disorders.

    PubMed

    Rafaeli, Eshkol

    2009-01-01

    Cognitive-behavioral therapy (CBT) has been strongly identified as a time-limited treatment approach for Axis-I disorders, but CBT models for addressing personality disorders - enduring patterns of relational and emotional difficulties - are gaining greater attention. This review touches on three influential models: Beck's cognitive therapy (CT), Young's schema focused therapy (SFT), and Linehan's dialectical behavior therapy (DBT), presenting the rationale for their development, main theoretical components, and a brief discussion of their goals and means, along with a review of the growing evidence base supporting their effectiveness. The need for integrative models for treatment of this population is noted.

  11. [Schizotypal personality disorder--diagnosis and treatment].

    PubMed

    Lammers, Claas-Hinrich

    2006-02-23

    Schizotypal personality disorder is relatively common disorder, and is considered to be a mild form of schizophrenia. It is characterized by such "psychotic" symptoms as ideas of reference, odd or magical thinking, perceptual illusions and an inappropriate or flattened affect. In their contact with others, patients show odd expression and behavior. Since, numerous schizotypal symptoms can be treated successfully with atypical antipsychotic medication, the patient should be referred to a psychiatrist or neurologist. The mainstay of psychotherapy consists in crisis management, development of self-awareness of the problem, breaking down social isolation and general unspecific support in coping with daily problems. PMID:16566102

  12. 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

  13. The borderline personality disorder and gay people.

    PubMed

    Silverstein, C

    1988-01-01

    This paper examines the diagnostic category called Borderline Personality Disorder (BPD) and its relationship to gay people. It discusses the psychoanalytic definition of borderline personalities, and to it adds a cultural definition. In the light of these cultural variables, the diagnosis is defined as a metaphor for the complexities and confusions of modern life. These confusions are important in the lives of gay people, who, it is suggested, are currently more prone to be diagnosed as BPD. Through the life study of a gay man, both the psychoanalytic and cultural variables are identified, then generalized to the problems of gay people in our transitional society.

  14. DSM-5 and personality disorders: where did axis II go?

    PubMed

    Trestman, Robert L

    2014-01-01

    The past decade has seen a period of extensive research into the etiology, pathophysiology, assessment, and treatment of personality disorders. Concomitantly, a group of experts in the field were brought together to form the Personality and Personality Disorder Work Group for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), charged with the responsibility of updating the diagnostic approach to personality disorders. This article is a review of some of the history of the American Psychiatry Association's approach to the recognition and diagnosis of personality disorders over the past half century, the process of developing the recommendations for a DSM-5 personality disorder diagnosis and the elimination of the multiaxial system, and how DSM-5 has left us with essentially no changes of relevance to the practice of forensic psychiatry in the process for diagnosing personality disorders or in the specific diagnoses of personality disorder.

  15. Developmental antecedents of borderline personality disorder.

    PubMed

    Helgeland, Margareth I; Torgersen, Svenn

    2004-01-01

    Developmental antecedents of borderline personality disorders (BPDs) were examined in 25 DSM-IV-diagnosed subjects with BPD and 107 non-borderline control subjects on the basis of medical records and 28 years follow-up. Abuse, neglect, environmental instability, paternal psychopathology, and lower score on protective factors differentiated significantly between the groups. Environmental instability and lower score on protective factors such as artistic talents, superior school performance, above average intellectual skills, and talents in other areas were found to be independent predictors of BPD diagnosis. The results of this study suggest that both abuse and neglect, unpredictable and unstable early environment, as well as deficit in protective factors may substantially contribute to the development of BPD in persons constitutionally predisposed for the disorder. The results of the study also suggest that future research should address the impact of social and cultural context, as well as the absence of protective factors, on the development of the BPD.

  16. Borderline personality disorder and emotional intelligence.

    PubMed

    Peter, Mathell; Schuurmans, Hanneke; Vingerhoets, Ad J J M; Smeets, Guus; Verkoeijen, Peter; Arntz, Arnoud

    2013-02-01

    The present study investigated emotional intelligence (EI) in borderline personality disorder (BPD). It was hypothesized that patients with BPD (n = 61) compared with patients with other personality disorders (PDs; n = 69) and nonpatients (n = 248) would show higher scores on the ability to perceive emotions and impairments in the ability to regulate emotions. EI was assessed with the Mayer-Salovey-Caruso Emotional Intelligence Test (Mayer, Salovey, and Caruso [New York: MHS, 2002]). As compared with the PD group and the nonpatient group, the patients with BPD displayed the anticipated deficits in their ability to understand, whereas no differences emerged with respect to their ability to perceive, use, and regulate emotions. In addition, a negative relationship was found between the severity of BPD and total EI score. However, this relationship disappeared when intelligence quotient was partialled out. These results suggest that BPD is associated with emotion understanding deficits, whereas temporary severity of BPD is associated with emotion regulation deficits.

  17. [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

  18. Schema therapy for borderline personality disorder.

    PubMed

    Kellogg, Scott H; Young, Jeffrey E

    2006-04-01

    This article presents the Schema Therapy (Young, Klosko, & Weishaar, 2003) approach to the treatment of borderline personality disorder. Schema therapy draws on the cognitive-behavioral, attachment, psychodynamic, and emotion-focused traditions and conceptualizes patients who have borderline personality disorder as being under the sway of five modes or aspects of the self. The goal of the therapy is to reorganize this inner structure. To this end, there are four core mechanisms of change that are used in this therapy: (1) limited reparenting, (2) experiential imagery and dialogue work, (3) cognitive restructuring and education, and (4) behavioral pattern breaking. These interventions are used during the three phases of treatment: (1) bonding and emotional regulation, (2) schema mode change, and (3) development of autonomy.

  19. Antisocial personality disorder--stable and unstable subtypes.

    PubMed

    Ullrich, Simone; Coid, Jeremy

    2010-04-01

    There have been criticisms that the criteria for antisocial personality disorder (ASPD) are over-dependent on criminal behavior. This study aimed to identify unrelated criteria of social and behavioral problems and instability, and to investigate their associations in a representative household sample of adults in the UK. Approximately one third of adults with ASPD did not fulfill any of the criteria for instability. They were less aggressive and involved in illegal activities but expressed less remorse for their behaviors. Instability in ASPD was mediated primarily through comorbid anxiety disorders and borderline personality disorder. The concept of Secondary Psychopathy, which has not generally been applied to ASPD, demonstrated many similarities to the unstable subtype.

  20. 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

  1. 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.

  2. 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…

  3. Borderline Personality Disorder in Transition Age Youth with Bipolar Disorder

    PubMed Central

    Yen, Shirley; Frazier, Elisabeth; Hower, Heather; Weinstock, Lauren M.; Topor, David R.; Hunt, Jeffrey; Goldstein, Tina R.; Goldstein, Benjamin I.; Gill, Mary Kay; Ryan, Neal D.; Strober, Michael; Birmaher, Boris; Keller, Martin B.

    2015-01-01

    Objectives To determine the longitudinal impact of Borderline Personality Disorder (BPD) on the course and outcome of Bipolar Disorder (BP) in a pediatric BP sample. Method Participants (N=271) and parents from the Course and Outcome of Bipolar Youth (COBY) study were administered structured clinical interviews and self-reports on average every 8.7 months over a mean of 93 months starting at age 13.0 +/- 3.1 years. The Structured Interview for DSM-IV Personality Disorders (SIDP-IV) was administered at the first follow-up after age 18 to assess for symptoms of BPD. BPD operationalized at the disorder, factor, and symptom level, was examined as a predictor of poor clinical course of BP using all years of follow-up data. Results The number of BPD symptoms was significantly associated with poor clinical course of BP, above and beyond BP characteristics. Affective dysregulation was most strongly associated with poor course at the factor level; the individual symptoms most strongly associated with poor course were dissociation/stress-related paranoid ideation, impulsivity, and affective instability. Conclusions BPD severity adds significantly to the burden of BP illness and is significantly associated with a more chronic and severe course and outcome beyond what can be attributable to BP characteristics. PMID:25865120

  4. Gender differences in borderline personality disorder: findings from the Collaborative Longitudinal Personality Disorders Study.

    PubMed

    Johnson, Dawn M; Shea, M Tracie; Yen, Shirley; Battle, Cynthia L; Zlotnick, Caron; Sanislow, Charles A; Grilo, Carlos M; Skodol, Andrew E; Bender, Donna S; McGlashan, Thomas H; Gunderson, John G; Zanarini, Mary C

    2003-01-01

    A majority of the literature on borderline personality disorder (BPD) focuses on its occurrence in women or does not specifically assess for gender differences in clinical presentations. Some studies report that men with BPD may be more likely to be diagnosed with substance use disorders, as well as paranoid, passive-aggressive, narcissistic, sadistic, and antisocial personality disorders (PDs). Additionally, women with BPD appear to be more likely to report histories of adult physical and sexual abuse and to meet diagnostic criteria for post-traumatic stress disorder (PTSD) and eating disorders. The purpose of the present study was to further examine gender differences in BPD. Using baseline data from the Collaborative Longitudinal Personality Disorders Study (CLPS), men and women who met criteria for BPD were compared on current axis I and II disorders, BPD diagnostic criteria, childhood trauma histories, psychosocial functioning, temperament, and personality traits. Men with BPD were more likely to present with substance use disorders, and with schizotypal, narcissistic, and antisocial PDs, while women with BPD were more likely to present with PTSD, eating disorders, and the BPD criterion of identity disturbance. Generally speaking, women and men with BPD displayed more similarities than differences in clinical presentations. The differences that did emerge are consistent with those found in epidemiological studies of psychopathology and therefore do not appear unique to BPD. Additionally, many gender differences traditionally found in epidemiological samples did not emerge in BPD subjects. For example, no difference was found in rates of major depressive disorder, a condition that is more prevalent in females. Thus, BPD pathology may be a prevailing characterization that can attenuate usual gender-based distinctions.

  5. 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

  6. Suicidality in DSM IV cluster B personality disorders. An overview.

    PubMed

    Pompili, Maurizio; Ruberto, Amedeo; Girardi, Paolo; Tatarelli, Roberto

    2004-01-01

    Personality disorders are a considerable risk factor for suicidal behavior. In psychological autopsy studies, individuals with personality disorders are frequently found among suicide victims. Suicidal attempts (which are a major risk factor for completed suicide) are also an important issue among affected patients. We performed careful MedLine, Excerpta Medica, PsycLit and PsycINFO searches from 1980 to 2004. Search terms were "suicide", "personality disorders", "mortality", "follow-up". We identified studies dealing with suicide and the following areas of interest: borderline personality disorder, narcissistic personality disorder, antisocial personality disorder, comorbidity (especially with affective disorder and substance abuse disorder) and risk factors for suicide in personality disorders. Despite the fact that comorbidity with DSM-IV Axis I disorders often impairs a correct judgment of suicidality in personality disorders, this overview showed that some personality disorders have a stronger link to suicide and that identifiable risk factors may be used for the development of preventive measures. Given the fact that personality disorders have high prevalence in the general population, prediction and prevention of suicide among these individuals is a problem of public health.

  7. [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

  8. [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,

  9. 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…

  10. Childhood trauma and personality disorder: toward a biological model.

    PubMed

    Lee, Royce

    2006-02-01

    Cross-sectional and prospective associations of personality disorder with childhood trauma provide an important clue regarding the biological mechanism of personality disorder. In this review, empirical literature from several domains is summarized. These include relevant findings from behavioral genetics, preclinical models of early life parental care, and clinical translational studies of personality disorder. Identification of the biological mechanism by which childhood trauma exerts an effect on personality disorder may require modification of the conceptualization of personality disorder, either as a set of categories or dimensions.

  11. Psychological interventions for antisocial personality disorder

    PubMed Central

    Gibbon, Simon; Duggan, Conor; Stoffers, Jutta; Huband, Nick; Völlm, Birgit A; Ferriter, Michael; Lieb, Klaus

    2014-01-01

    Background Antisocial personality disorder (AsPD) is associated with a wide range of disturbance including persistent rule-breaking, criminality, substance use, unemployment, homelessness and relationship difficulties. Objectives To evaluate the potential beneficial and adverse effects of psychological interventions for people with AsPD. Search methods Our search included CENTRAL Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, PsycINFO, ASSIA, BIOSIS and COPAC. Selection criteria Prospective, controlled trials in which participants with AsPD were randomly allocated to a psychological intervention and a control condition (either treatment as usual, waiting list or no treatment). Data collection and analysis Three authors independently selected studies. Two authors independently extracted data. We calculated mean differences, with odds ratios for dichotomous data. Main results Eleven studies involving 471 participants with AsPD met the inclusion criteria, although data were available from only five studies involving 276 participants with AsPD. Only two studies focused solely on an AsPD sample. Eleven different psychological interventions were examined. Only two studies reported on reconviction, and only one on aggression. Compared to the control condition, cognitive behaviour therapy (CBT) plus standard maintenance was superior for outpatients with cocaine dependence in one study, but CBT plus treatment as usual was not superior for male outpatients with recent verbal/physical violence in another. Contingency management plus standard maintenance was superior for drug misuse for outpatients with cocaine dependence in one study but not in another, possibly because of differences in the behavioural intervention. However, contingency management was superior in social functioning and counselling session attendance in the latter. A multi-component intervention utilising motivational interviewing principles, the ‘Driving Whilst Intoxicated program’, plus

  12. 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.

  13. [Diagnosis and psychoanalytic psychotherapy for personality disordered persons].

    PubMed

    Minakawa, Kuninao

    2011-01-01

    The author uses PubMed searches on clinical studies on personality disorders and finds that the borderline personality disorder is most extensively researched. Mary Zanarini summeries there are four kinds of psychotherapies that are proved to be effective in the treatment of BPD patients, including mentalization based treatment, transference focused therapy, dialectic behavior therapy and schema focused therapy. They are all effective to improve the severity of impulsivity and self-destructiveness. The author then reviews McGlashan's series of extensive follow-up studies on BPD and other mental disorders at Chestnut Lodge back in 1980's. The data tells us that both symptomatic stability and level of social adaptation in the long term outcome of BPDs varied to be very poor to recovered. The outcome seem to be heavily relied on the intimate relationship BPDs could enjoy or not. This finding was also noted in a five year Tokyo BPDs follow-up studies by Moriya, Ikuta and Minakawa in 1990's. Both impulsivity and self-destructiveness get always worse along with loss or threatened loss of love object. Therefore all psychotherapies for BPDs should be directed to improve their pathological object relations although it would be extremely difficult to attain. The author finally points it out that the primary prevention of BPDs should be designed and begin a program on a trial basis in a community soon because there are many empirical studies to show the mothers with BPD tend to be frightened by her baby and/or frighten her baby and this pattern of communication is the first epigenetic expression of BPDs.

  14. 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.

  15. Treatment of Borderline Personality Disorder in Youth

    PubMed Central

    Biskin, Robert S.

    2013-01-01

    Objectives: Borderline personality disorder (BPD) is frequently encountered in both adult and youth populations. There is a robust literature supporting psychotherapy for adults with BPD, but the literature supporting its use for BPD in youth is more limited. Methods: A literature review was conducted using the keywords “borderline personality disorders” and “adolescence.” Relevant articles were reviewed for inclusion. Results: Several specialized treatments have been studied with mixed results. Dialectical behaviour therapy has no randomized controlled trials in adolescents, emotion regulation training has not demonstrated superiority of treatment as usual, and cognitive analytic therapy has demonstrated more rapid recovery but little difference at follow-up. Mentalization-based treatment has one study supporting its use in self-harming adolescents. Pharmacotherapy has no evidence supporting its use in this population. Conclusions: Structured therapy may be the most important therapeutic component in this population. PMID:23970912

  16. Schizotypal personality disorder: a current review.

    PubMed

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

    2014-07-01

    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.

  17. Multiple personality disorder. A psychoanalytic perspective.

    PubMed

    Marmer, S S

    1991-09-01

    This article links multiple personality disorder (MPD) and dissociation to related theories of defense, resistance, and development in treatment. Trauma, conflict, and deficiency all play contributing roles in the genesis of MPD; the blend of each ingredient may be decisive in each patient. Internal conflict and deficiency tend to be overlooked, whereas trauma is emphasized. Other psychoanalytic concepts, such as transitional phenomena, identity, aggression, repetition, and the seeking after quiescence, are applied to MPD. In the discussion of working through, emphasis is placed on the process nature of MPD and on strategic integration.

  18. Pathology versus statistical infrequency: potential sources of gender bias in personality disorder criteria.

    PubMed

    Anderson, K G; Sankis, L M; Widiger, T A

    2001-10-01

    The antisocial, narcissistic, dependent, histrionic, and borderline personality disorders often obtain differential sex prevalence rates. One explanation has been that the diagnostic criteria for these personality disorders have different gender implications for maladaptivity (e.g., perhaps the dependent personality disorder diagnostic criteria are considered by clinicians to be more pathological for women than for men). This hypothesis was explored in two studies that obtained judgments by professional clinicians of the maladaptivity and statistical infrequency of personality disorder diagnostic criteria. Significant differences across gender were obtained for the frequency of diagnostic criteria but not for their maladaptivity. The personality disorder diagnostic criteria appear to be gender neutral with respect to their implications for maladaptivity.

  19. 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.

  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. Shame in patients with narcissistic personality disorder.

    PubMed

    Ritter, Kathrin; Vater, Aline; Rüsch, Nicolas; Schröder-Abé, Michela; Schütz, Astrid; Fydrich, Thomas; Lammers, Claas-Hinrich; Roepke, Stefan

    2014-02-28

    Shame has been described as a central emotion in narcissistic personality disorder (NPD). However, there is a dearth of empirical data on shame in NPD. Patients with NPD (N=28), non-clinical controls (N=34) and individuals with borderline personality disorder (BPD, N=31) completed self-report measures of state shame, shame-proneness, and guilt-proneness. Furthermore, the Implicit Association Test (IAT) was included as a measure of implicit shame, assessing implicit shame-self associations relative to anxiety-self associations. Participants with NPD reported higher levels of explicit shame than non-clinical controls, but lower levels than patients with BPD. Levels of guilt-proneness did not differ among the three study groups. The implicit shame-self associations (relative to anxiety-self associations) were significantly stronger among patients with NPD compared to nonclinical controls and BPD patients. Our findings indicate that shame is a prominent feature of NPD. Implications for diagnosis and treatment are discussed.

  2. 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.

  3. Disentangling depressive personality disorder from avoidant, borderline, and obsessive-compulsive personality disorders.

    PubMed

    Huprich, Steven K; Zimmerman, Mark; Chelminski, Iwona

    2006-01-01

    Several studies have found that 3 personality disorders (PDs) tend to share moderate rates of comorbidity with depressive PD: avoidant, borderline, and obsessive-compulsive. This study sought to evaluate the diagnostic criteria of each disorder in an effort to understand where areas of overlap may occur and to modify criteria sets where reasonable to reduce any degree of overlap. One thousand two hundred psychiatric outpatients were interviewed with the Structured Interview for DSM-IV Personality Disorders. The highest degree of comorbidity was observed between avoidant PD and depressive PD. Logistic regression analyses indicated that 2 criteria-avoidant criterion 5 and depressive criterion 2-could be removed from the diagnostic criteria sets and reduce the rates of overlap by as much as 15%. A factor analysis of the criteria of all 4 PDs indicated that there is a common clustering of many of the symptoms of avoidant, borderline, depressive, and obsessive-compulsive PDs and that borderline symptoms tend to cluster together most consistently. Avoidant and obsessive-compulsive personality symptoms clustered in ways that may reflect a problem of how to engage with others, suggestive of an approach-avoidance conflict. Depressive PD symptoms clustered in a way suggestive of problems with anger that is directed toward oneself and others. The factor analysis results suggest that an organization of symptoms around themes of conflict may provide useful ways of understanding the personality patterns of these 4 disorders.

  4. 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…

  5. Familial Characteristics of Individuals with Borderline Personality Disorder Diagnosis.

    ERIC Educational Resources Information Center

    Bernhardt, James Lawrence

    This paper explores the findings and current state of research on the familial characteristics of persons with borderline personality disorder (BPD). A review of the borderline personality disorder emphasizes the development of the term, etiological issues, and treatment issues related to BPD. Two formal approaches for obtaining accurate diagnosis…

  6. Biological markers in schizotypal personality disorder.

    PubMed

    Siever, L J

    1985-01-01

    The establishment of the new diagnostic category, Schizotypal Personality Disorder (SPD), has stimulated biological studies of patients with this disorder. Such studies offer the potential of better understanding the diagnosis and treatment of SPD as well as more clearly defining the boundaries of the schizophrenic disorders. SPD has been studied in the clinical setting, in family studies of schizophrenia, and in the biological high-risk paradigm. In most cases, biological variables associated with schizophrenia have been evaluated. Decreased activities of plasma amine oxidase and platelet monoamine oxidase have been associated with SPD in the families of schizophrenics and in "biological high-risk" studies. Smooth pursuit eye movement (SPEM) impairment has also been associated with SPD in a "biological high-risk" study of college students. Inferior backward masking performance has been demonstrated in SPD patients in the clinical setting. Other studies using psychophysiological measures have been applied to subjects with psychological characteristics similar to DSM-III SPD and found biological abnormalities similar to those reported in schizophrenia. These studies are consistent with the possibility that some individuals with SPD may share common psychobiological abnormalities with schizophrenic individuals and may sharpen our understanding of SPD and its relationship to schizophrenia.

  7. Increased morbid risk for schizophrenia-related disorders in relatives of schizotypal personality disordered patients.

    PubMed

    Siever, L J; Silverman, J M; Horvath, T B; Klar, H; Coccaro, E; Keefe, R S; Pinkham, L; Rinaldi, P; Mohs, R C; Davis, K L

    1990-07-01

    To evaluate whether probands from a clinical sample diagnosed as having DSM-III schizotypal and/or paranoid personality disorder have a familial relationship to the schizophrenia-related disorders, the morbid risk for schizophrenia-related disorders and other psychiatric disorders were evaluated in the first-degree relatives of patients with schizotypal and/or paranoid personality disorder and compared with the corresponding risk for these disorders in the first-degree relatives of patients with other non-schizophrenia-related personality disorders. The morbid risk for all schizophrenia-related disorders, and specifically for schizophrenia-related personality disorders, was significantly greater among the relatives of the probands with schizotypal and/or paranoid personality disorder than among the relatives of probands with other personality disorder. The morbid risk for other psychiatric disorders did not differ significantly between the first-degree relatives of the schizotypal/paranoid personality disorder and the other personality disorder control proband samples. These results suggest a specific familial association between schizophrenia-related disorders, particularly schizophrenia-related personality disorders, and clinically diagnosed schizotypal patients.

  8. 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

  9. Relationship between personality disorder dimensions and verbal memory functioning in a community population.

    PubMed

    Park, Subin; Hong, Jin Pyo; Lee, Hochang B; Samuels, Jack; Bienvenu, O Joseph; Chung, Hye Yoon; Eaton, William W; Costa, Paul T; Nestadt, Gerald

    2012-03-30

    Based on the Baltimore Epidemiologic Catchment Area (ECA) follow-up survey, we examined relationships between dimensions of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) personality disorders and both subjective and objective memory functioning in a community population. Our study subjects consisted of 736 individuals from the ECA follow-up study of the original Baltimore ECA cohort, conducted between 1993 and 1996 and available for assessment in the Hopkins Epidemiology Study of Personality Disorders from 1997 to 1999. Subjects were assessed for DSM-IV personality disorders using a semi-structured instrument, the International Personality Disorder Examination, and were asked about a subjective appraisal of memory. Verbal memory function, including immediate recall, delayed recall, and recognition, were also evaluated. Multiple linear regression analyses were used to determine associations between personality dimensions of DSM-IV Axis II traits and subjective and objective memory functioning. Scores on schizoid and schizotypal personality dimensions were associated with subjective and objective memory dysfunction, both with and without adjustment for Axis I disorders. Borderline, antisocial, avoidant, and dependent personality disorder scores were associated with subjective memory impairment only, both with and without adjustment for Axis I disorders. This study suggests that subjective feelings of memory impairment and/or objective memory dysfunction are associated with specific personality disorder dimensions.

  10. 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…

  11. The spectrum of borderline personality disorder: a neurophysiological view.

    PubMed

    Stone, Michael H

    2014-01-01

    Borderline Personality Disorder (BPD) has been defined as a personality disorder in all editions of DSM since 1980; namely, DSM III through V. The criteria are a mixture of symptoms and traits; the etiology, a heterogeneous array of genetic, constitutional, and environmental factors. Until recently the diagnosis relied on clinical descriptions. In the last two decades, neurophysiological data, including MRI and fMRI, have established correlates in various brain regions, particularly those involving the frontal lobes and various limbic structures, that show promise of providing a more substantial basis for diagnosis-relying primarily on (internal) brain changes, rather than on (external) clinical observation. Some of the changes in BPD consist of decreased volume in the orbitofrontal and dorsolateral prefrontal cortices and smaller volume in both the amygdala and hippocampus, though with heightened reactivity in the amygdala. Similar abnormalities have been noted in bipolar disorders (BDs) and in ADHD, both of which often accompany BPD and share certain clinical features. Persons with strong genetic predisposition to BDs can develop BPD even in the absence of adverse environmental factors; those with extreme adverse environmental factors (chiefly, early sexual molestation) can develop BPD in the absence of bipolar vulnerability. In some BPD patients, both sets of factors are present. As ideal treatment depends on careful analysis of these factors, neurophysiological testing may permit both more rational, brain-based diagnostic decisions and more appropriate therapeutic strategies.

  12. 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

  13. 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

  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.

  15. Emotional Granularity and Borderline Personality Disorder

    PubMed Central

    Suvak, Michael K.; Litz, Brett T.; Sloan, Denise M.; Zanarini, Mary C.; Barrett, Lisa Feldman; Hofmann, Stefan G.

    2011-01-01

    This study examined the affective dysregulation component of borderline personality disorder (BPD) from an emotional granularity perspective, which refers to the specificity in which one represents emotions. Forty-six female participants meeting criteria for BPD and 51 female control participants without BPD and Axis I pathology completed tasks that assessed the degree to which participants incorporated information about valence (pleasant–unpleasant) and arousal (calm–activated) in their semantic/conceptual representations of emotions and in using labels to represent emotional reactions. As hypothesized, participants with BPD emphasized valence more and arousal less than control participants did when using emotion terms to label their emotional reactions. Implications and future research directions are discussed. PMID:21171723

  16. Alliance building and narcissistic personality disorder.

    PubMed

    Ronningstam, Elsa

    2012-08-01

    Building a therapeutic alliance with a patient with pathological narcissism or narcissistic personality disorder is a challenging process. A combined alliance building and diagnostic strategy is outlined that promotes patients' motivation and active engagement in identifying their own problems. The main focus is on identifying grandiosity, self-regulatory patterns, and behavioral fluctuations in their social and interpersonal contexts while engaging the patient in meaningful clarifications and collaborative inquiry. A definition of grandiosity as a diagnostic characterological trait is suggested, one that captures self-criticism, inferiority, and fragility in addition to superiority, assertiveness, perfectionism, high ideals, and self-enhancing and self-serving interpersonal behavior. These reformulations serve to expand the spectrum of grandiosity-promoting strivings and activities, capture their fluctuations, and help clinicians attend to narcissistic individuals' internal experiences and motivation as well as to their external presentation and interpersonal self-enhancing, self-serving, controlling, and aggressive behavior. A case example illustrates this process. PMID:22729478

  17. 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

  18. Beyond borderline personality disorder: the mindful brain.

    PubMed

    Chafos, Vanessa H; Economou, Peter

    2014-10-01

    Numerous studies have showed an improvement in symptoms characteristic of borderline personality disorder (BPD) when mindfulness-based interventions were integrated into the daily lives of individuals with BPD. Although these studies have examined the etiology and diagnostic prognosis of BPD, and have discussed the use of mindfulness-based treatments, few researchers have attempted to interpret the neuroscientific findings, which have showed an increase in gray matter in key areas of the brain in clients with BPD who engaged in mindfulness practice. Some clients who had originally met a minimum of five of the DSM-IV-TR diagnostic criteria for BPD no longer did so upon engaging in mindfulness-based treatment. This article highlights the efficacy of mindfulness-based interventions with an emphasis on meditation, which leads to overall better psychological functioning in clients with BPD in three key areas: impulsivity, emotional irregularity, and relationship instability. PMID:25365830

  19. Hypersensitivity in Borderline Personality Disorder during Mindreading

    PubMed Central

    Kotchoubey, Boris; Sieswerda, Simkje; Dinu-Biringer, Ramona; Berger, Moritz; Veser, Sandra; Essig, Marco; Barnow, Sven

    2012-01-01

    Background One of the core symptoms of borderline personality disorder (BPD) is the instability in interpersonal relationships. This might be related to existent differences in mindreading between BPD patients and healthy individuals. Methods We examined the behavioural and neurophysiological (fMRI) responses of BPD patients and healthy controls (HC) during performance of the ‘Reading the Mind in the Eyes’ test (RMET). Results Mental state discrimination was significantly better and faster for affective eye gazes in BPD patients than in HC. At the neurophysiological level, this was manifested in a stronger activation of the amygdala and greater activity of the medial frontal gyrus, the left temporal pole and the middle temporal gyrus during affective eye gazes. In contrast, HC subjects showed a greater activation in the insula and the superior temporal gyri. Conclusion These findings indicate that BPD patients are highly vigilant to social stimuli, maybe because they resonate intuitively with mental states of others. PMID:22870240

  20. 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.

  1. 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

  2. Retention or deletion of personality disorder diagnoses for DSM-5: an expert consensus approach.

    PubMed

    Mullins-Sweatt, Stephanie N; Bernstein, David P; Widiger, Thomas A

    2012-10-01

    One of the official proposals for the fifth edition of the American Psychiatric Association's (APA) diagnostic manual (DSM-5) is to delete half of the existing personality disorders (i.e., dependent, histrionic, narcissistic, paranoid, and schizoid). Within the APA guidelines for DSM-5 decisions, it is stated that there should be expert consensus agreement for the deletion of a diagnostic category. Additionally, categories to be deleted should have low clinical utility and/or minimal evidence for validity. The current study surveyed members of two personality disorder associations (n = 146) with respect to the utility, validity, and status of each DSM-IV-TR personality disorder diagnosis. Findings indicated that the proposal to delete five of the personality disorders lacks consensus support within the personality disorder community.

  3. Metacognitive mastery dysfunctions in personality disorder psychotherapy.

    PubMed

    Carcione, Antonino; Nicolò, Giuseppe; Pedone, Roberto; Popolo, Raffaele; Conti, Laura; Fiore, Donatella; Procacci, Michele; Semerari, Antonio; Dimaggio, Giancarlo

    2011-11-30

    Individuals with personality disorders (PDs) have difficulties in modulating mental states and in coping with interpersonal problems according to a mentalistic formulation of the problem. In this article we analyzed the first 16 psychotherapy sessions of 14 PD patients in order to explore whether their abilities to master distress and interpersonal problems were actually impaired and how they changed during the early therapy phase. We used the Mastery Section of the Metacognition Assessment Scale, which assesses the use of mentalistic knowledge to solve problems and promote adaptation. We explored the hypotheses that a) PD patients had problems in using their mentalistic knowledge to master distress and solve social problems; b) the impairments were partially stable and only a minimal improvement could be observed during the analyzed period; c) patients' mastery preferences differed from one another; d) at the beginning of treatment the more effective strategies were those involving minimal knowledge about mental states. Results seemed to support the hypotheses; the patients examined had significant difficulties in mastery abilities, and these difficulties persisted after 16 sessions. Moreover, the attitudes towards problem-solving were not homogenous across the patients. Lastly, we discuss implications for assessment and treatment of metacognitive disorders in psychotherapy.

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

    PubMed

    Brüne, Martin

    2016-02-28

    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.

  5. Personality disorders as maladaptive, extreme variants of normal personality: borderline personality disorder and neuroticism in a substance using sample.

    PubMed

    Samuel, Douglas B; Carroll, Kathleen M; Rounsaville, Bruce J; Ball, Samuel A

    2013-10-01

    Although the current diagnostic manual conceptualizes personality disorders (PDs) as categorical entities, an alternative perspective is that PDs represent maladaptive extreme versions of the same traits that describe normal personality. Existing evidence indicates that normal personality traits, such as those assessed by the five-factor model (FFM), share a common structure and obtain reasonably predictable correlations with the PDs. However, very little research has investigated whether PDs are more extreme than normal personality traits. Utilizing item-response theory analyses, the authors of the current study extend previous research to demonstrate that the diagnostic criterion for borderline personality disorder and FFM neuroticism could be fit along a single latent dimension. Furthermore, the authors' findings indicate that the borderline criteria assessed the shared latent trait at a level that was more extreme (d = 1.11) than FFM neuroticism. This finding provides further evidence for dimensional understanding of personality pathology and suggests that a trait model in DSM-5 should span normal and abnormal personality functioning, but focus on the extremes of these common traits.

  6. Brief cognitive therapy for avoidant personality disorder.

    PubMed

    Rees, Clare S; Pritchard, Rhian

    2015-03-01

    Avoidant personality disorder (APD) is associated with a high level of impairment in multiple areas of functioning. However, research on the treatment of APD is scarce, and there is an absence of empirically evaluated effective treatment approaches available. This study offers a preliminary investigation of the use of brief cognitive therapy to treat APD. Two individuals, both with a principal diagnosis of APD, but who also possessed a number of comorbidities, participated in 12 weekly sessions. A series of diagnostic symptom severity, global functioning, and self-report measures were completed at pretreatment, posttreatment and at 6-week follow-up. In addition, regular monitoring of each participant's strength of belief in 4 personally identified cognitions associated with APD was completed. Reductions in APD symptoms, associated negative affect, and increases to quality of life were observed for both participants at posttreatment and follow-up phases. Results suggest that brief cognitive therapy may be an effective treatment for APD and that further studies with larger samples are warranted.

  7. 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

  8. 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.

  9. Does Borderline Personality Disorder Manifest Itself Differently in Patients With Bipolar Disorder and Major Depressive Disorder?

    PubMed

    Zimmerman, Mark; Morgan, Theresa A; Young, Diane; Chelminski, Iwona; Dalrymple, Kristy; Walsh, Emily

    2015-12-01

    Perugi and colleagues (2013) recently reported that some features of borderline personality disorder (BPD) significantly predicted a diagnosis of bipolar disorder among depressed patients. They interpreted these findings as indicating that some BPD criteria are nonspecific and are indicators of bipolar disorder rather than BPD, whereas other criteria are more specific to BPD. In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, the authors tested the hypothesis that BPD presents itself differently in psychiatric outpatients diagnosed with bipolar disorder or major depressive disorder. The authors found that the patients with bipolar disorder were significantly more likely to report impulsive behavior and transient dissociation. No criterion was significantly more common in the BPD patients with MDD. The authors therefore do not consider the BPD criteria to be nonspecific with regard to the distinction between BPD and bipolar disorder.

  10. Ten year rank-order stability of personality traits and disorders in a clinical sample

    PubMed Central

    Hopwood, Christopher J.; Morey, Leslie C.; Donnellan, M. Brent; Samuel, Douglas B.; Grilo, Carlos M.; McGlashan, Thomas H.; Shea, M. Tracie; Zanarini, Mary C.; Gunderson, John G.; Skodol, Andrew E.

    2012-01-01

    Objective To compare the 10-year retest stability of normal traits, pathological traits, and personality disorder dimensions in a clinical sample. Method Ten-year rank order stability estimates for the Revised NEO Personality Inventory, Schedule for Nonadaptive and Adaptive Personality, and Diagnostic Interview for DSM-IV Personality Disorders were evaluated before and after correcting for test-retest dependability and internal consistency in a clinical sample (N = 266). Results Dependability corrected stability estimates were generally in the range of .60–.90 for traits and .25–.65 for personality disorders. Conclusions The relatively lower stability of personality disorder symptoms may indicate important differences between pathological behaviors and relatively more stable self-attributed traits and imply that a full understanding of personality and personality pathology needs to take both traits and symptoms into account. The Five-Factor Theory distinction between basic tendencies and characteristic adaptations provides a theoretical framework for the separation of traits and disorders in terms of stability in which traits reflect basic tendencies that are stable and pervasive across situations, whereas personality disorder symptoms reflect characteristic maladaptations that are a function of both basic tendencies and environmental dynamics. PMID:22812532

  11. [Etiological and therapeutic aspects of schizoid and schizotypal personality disorder].

    PubMed

    Sass, H; Jünemann, K

    2001-09-01

    Following the introduction to the history of the concepts of abnormal personality, with regard to the schizoid and schizotypal forms, we present their systematic assessment in the modern classification systems.Both, the schizoid and schizotypal forms, are usually considered as schizophrenia-spectrum disorders. Biological and clinical data indicate relations to other axis-I disorders as well. However there are few systematic and strictly controlled studies on the psychotherapeutic and pharmacological treatment of schizotypal and schizoid personality disorders. Basic theoretic assumptions concerning both treatment concepts - for personality disorders in general, and especially in schizoid and schizotypal personality disorder - are given. Finally the role of neuroleptics and antidepressants for schizophrenia-spectrum disorders is discussed. New possibilities may emerge from the use of the recently developed atypical drugs, but further research in randomised studies is needed. Current prospective studies on early detected schizophrenia-spectrum disorders will broaden our knowledge about prevention and therapy.

  12. Metacognitive dysfunctions in personality disorders: correlations with disorder severity and personality styles.

    PubMed

    Semerari, Antonio; Colle, Livia; Pellecchia, Giovanni; Buccione, Ivana; Carcione, Antonino; Dimaggio, Giancarlo; Nicolò, Giuseppe; Procacci, Michele; Pedone, Roberto

    2014-12-01

    Metacognitive impairment is crucial to explaining difficulties in life tasks of patients with personality disorders (PDs). However, several issues remain open. There is a lack of evidence that metacognitive impairments are more severe in patients with PDs. The relationship between severity of PD pathology and the extent of metacognitive impairment has not been explored, and there has not been any finding to support the linking of different PDs with specific metacognitive profiles. The authors administered the Metacognitive Assessment Interview to 198 outpatients with PDs and 108 outpatients with no PDs, differentiating overall severity from stylistic elements of personality pathology. Results showed that metacognitive impairments were more severe in the group with PDs than in the control group, and that metacognitive dysfunctions and the severity of the PD were highly associated. Positive correlations were found between specific metacognitive dysfunctions and specific personality styles. Results suggest that metacognitive impairments could be considered a common pathogenic factor for PDs.

  13. 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.

  14. Borderline personality disorder: a review and reformulation from evolutionary theory.

    PubMed

    Molina, Juan D; López-Muñoz, Francisco; Stein, Dan J; Martín-Vázquez, María José; Alamo, Cecilio; Lerma-Carrillo, Iván; Andrade-Rosa, Cristina; Sánchez-López, María V; de la Calle-Real, Mario

    2009-09-01

    A number of authors have provided a useful evolutionary perspective on personality disorders, arguing that personality traits can be conceptualized in terms of evolutionary strategies. If we consider personality traits not as illnesses but as stable evolutionary strategies, the characteristic features of borderline personality disorder may respond to a behavioral pattern which, although deviating from the norm, would be in the service of survival of the species. Early environments involving factors such as childhood physical/sexual abuse may prove useful for explanation of personality traits based on gene-environment interaction, potentially providing a model for understanding borderline personality traits. We also review the question of whether personality traits exist in animals to also provide a translational perspective. We propose that certain traits in borderline personality disorder may derive from evolved mechanisms which in the short-term serve to help respond to adversity, but which when activated in an ongoing way prove maladaptive.

  15. 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…

  16. 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,…

  17. 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

  18. Defense mechanisms in schizotypal, borderline, antisocial, and narcissistic personality disorders.

    PubMed

    Perry, J Christopher; Presniak, Michelle D; Olson, Trevor R

    2013-01-01

    Numerous authors have theorized that defense mechanisms play a role in personality disorders. We reviewed theoretical writings and empirical studies about defenses in schizotypal, borderline, antisocial, and narcissistic personality disorders, developing hypotheses about these differential relationships. We then examined these hypotheses using dynamic interview data rated for defenses in a study of participants (n = 107) diagnosed with these four personality disorder types. Overall, the prevalence of immature defenses was substantial, and all four disorders fit within the broad borderline personality organization construct. Defenses predicted the most variance in borderline and the least variance in schizotypal personality disorder, suggesting that dynamic factors played the largest role in borderline and the least in schizotypal personality. Central to borderline personality were strong associations with major image-distorting defenses, primarily splitting of self and other's images, and the hysterical level defenses, dissociation and repression. Narcissistic and antisocial personality disorders shared minor image-distorting defenses, such as omnipotence or devaluation, while narcissistic also used splitting of self-images and antisocial used disavowal defenses like denial. Overall, differential relationships between specific defenses and personality disorder types were largely consistent with the literature, and consistent with the importance that the treatment literature ascribes to working with defenses.

  19. 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.

  20. 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

  1. The structure of personality disorders in individuals with posttraumatic stress disorder.

    PubMed

    Wolf, Erika J; Miller, Mark W; Brown, Timothy A

    2011-10-01

    Research on the structure of personality disorders (PDs) has relied primarily on exploratory analyses to evaluate trait-based models of the factors underlying the covariation of these disorders. This study used confirmatory factor analysis to evaluate whether a model that included both PD traits and a general personality dysfunction factor would account for the comorbidity of the PDs better than a trait-only model. It also examined if the internalizing/externalizing model of psychopathology, developed previously through research on the structure of Axis I disorders, might similarly account for the covariation of the Axis II disorders in a sample of 245 veterans and nonveterans with posttraumatic stress disorder. Results indicated that the best fitting model was a modified bifactor structure composed of nine lower-order common factors. These factors indexed pathology ranging from aggression to dependency, with the correlations among them accounted for by higher-order Internalizing and Externalizing factors. Further, a general factor, reflecting a construct that we termed boundary disturbance, accounted for additional variance and covariance across nearly all the indicators. The Internalizing, Externalizing, and Boundary Disturbance factors evidenced differential associations with trauma-related covariates. These findings suggest continuity in the underlying structure of psychopathology across DSM-IV Axes I and II and provide empirical evidence of a pervasive, core disturbance in the boundary between self and other across the PDs.

  2. 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

  3. [Psychiatric disorders and childhood trauma in prisoners with antisocial personality disorder].

    PubMed

    Kopp, D; Spitzer, C; Kuwert, P; Barnow, S; Orlob, S; Lüth, H; Freyberger, H J; Dudeck, M

    2009-03-01

    Previous studies indicate high prevalence rates of mental disorders and trauma among prisoners. Based on a sample of 102 male German prisoners, the comorbidity and childhood trauma experiences in 72 criminals with antisocial personality disorder were investigated. Furthermore, associations of antisocial personality disorder and early traumatic experiences with the age at first conviction and the lifetime months of imprisonment were examined. Subjects had high rates of comorbid lifetime and current disorders as well as childhood trauma experiences. Physical abuse in childhood and adolescence was identified as a predictor for lifetime months of imprisonment, antisocial personality disorder was found to be a predictor for the age at first conviction. Our findings confirm the hypothesis of prisoners with antisocial personality disorder being a severely traumatized population with serious mental disorders. Traumatic childhood experiences and antisocial personality disorder are associated with criminality variables. This has important implications on preventive treatments as well as on how prison services are addressing these problems.

  4. Borderline Personality Disorder in Suicidal Adolescents

    PubMed Central

    Yen, Shirley; Gagnon, Kerry; Spirito, Anthony

    2015-01-01

    The diagnosis of Borderline Personality Disorder (BPD) in adolescents has been controversial. Thus, few studies have examined BPD in suicidal adolescents, even though it is strongly associated with suicidal behaviors in adults. This study examines differences between suicidal adolescents with (n=47) and without (n=72) BPD on history and characteristics of suicidal behavior, Axis I comorbidity, affect regulation, and aggression. Assessments were completed with both adolescents and parents, and consensus ratings based on best available data were analyzed. BPD participants were more likely to have a past history of suicide attempts and to have been admitted due to a suicide attempt (vs. suicidal ideation). There were no significant differences in self-injurious behaviors or degree of suicidal ideation. BPD participants also had more psychiatric comorbidity and higher aggression scores, but no significant differences in affective dysregulation compared to suicidal adolescents without BPD. Diagnostic stability over 6 months was modest. Our results demonstrate that compared to other acutely suicidal adolescents, the clinical profile of BPD participants is unique and suggests an increased risk for suicidal behaviors. This extends upon other studies which support the construct validity of BPD during adolescence and suggests that BPD should be considered in suicide risk assessment for adolescents. PMID:24343935

  5. 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.

  6. Social cognition in borderline personality disorder.

    PubMed

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

    2012-01-01

    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

  7. 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.

  8. 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

  9. 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

  10. The modern assessment of personality disorders. Part 1: definition and typology of personality disorders.

    PubMed

    Mombour, W; Bronisch, T

    1998-01-01

    The general definition of personality disorders (PD) has found agreement in many classification systems and has remained relatively stable over many decades. However, a closer look at the history of the classification of various PD reveals that there are changes from generation to generation: a continuous variation in our cultural norms means that some types are 'renormalised' from time to time and that others are added. On the other hand, a comparison of the descriptions and classifications of PD by Schneider, the DSM and ICD systems shows substantial agreement on many types of PD.

  11. Personality Disorders in Obsessive-Compulsive Disorder: A Comparative Study versus Other Anxiety Disorders

    PubMed Central

    Pena-Garijo, Josep; Edo Villamón, Silvia; Ruipérez, M. Ángeles

    2013-01-01

    Objective. The purpose of this paper is to provide evidence for the relationship between personality disorders (PDs), obsessive compulsive disorder (OCD), and other anxiety disorders different from OCD (non-OCD) symptomatology. Method. The sample consisted of a group of 122 individuals divided into three groups (41 OCD; 40 non-OCD, and 41 controls) matched by sex, age, and educational level. All the individuals answered the IPDE questionnaire and were evaluated by means of the SCID-I and SCID-II interviews. Results. Patients with OCD and non-OCD present a higher presence of PD. There was an increase in cluster C diagnoses in both groups, with no statistically significant differences between them. Conclusions. Presenting anxiety disorder seems to cause a specific vulnerability for PD. Most of the PDs that were presented belonged to cluster C. Obsessive Compulsive Personality Disorder (OCPD) is the most common among OCD. However, it does not occur more frequently among OCD patients than among other anxious patients, which does not confirm the continuum between obsessive personality and OCD. Implications for categorical and dimensional diagnoses are discussed. PMID:24453917

  12. Associations between psychosocial problems and personality disorders among Egyptian adolescents.

    PubMed

    Elbheiry, Abd-Elraqeep; Emam, Mahmoud

    2013-01-01

    The study investigated the relationship between psychosocial problems and personality disorders among a sample of 817 Egyptian adolescents (408 males and 409 females). Using 15 subscales from the Adolescent Psychopathology Scale (APS-long form) we assessed prevalence rates of a number of internalizing and externalizing psychosocial disorders. Additionally, we investigated whether there are gender differences in psychopathology among Egyptian adolescents and to what extent can psychosocial problems predict specific personality disorders. Stepwise multiple regression analyses showed that the participants experienced higher levels of PD, AV, and BD. Gender differences were found in certain personality disorders as well as in externalizing and internalizing psychosocial problems. A number of externalizing and internalizing psychosocial problems were highly predictive of specific personality disorders.

  13. 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

  14. 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

  15. Patients with antisocial personality disorder. Are they bad or mad?

    PubMed

    Cusack, J R; Malaney, K R

    1992-03-01

    Antisocial personality disorder is the psychiatric diagnosis most closely linked to explosive and criminal behavior. This diagnosis is easily documented but challenges a clinician's diagnostic skill because of the patient's propensity for masquerade and pathologic lying. The essential feature of antisocial personality disorder is a pattern of irresponsible and antisocial behavior beginning in childhood or early adolescence and continuing into adulthood. The differential diagnosis should include substance abuse, adult antisocial behavior, psychotic and organic illness, and other personality disorders. Suggested medical and psychiatric treatment includes rapidly establishing firm behavior limits and performing a mental status examination to evaluate thought processes and suicidal and homicidal intent.

  16. 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

  17. 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

  18. 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.

  19. 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.

  20. 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

  1. 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

  2. Milestones in the history of personality disorders.

    PubMed

    Crocq, Marc-Antoine

    2013-06-01

    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.

  3. Relationships of Dissociative Disorders and Personality Traits in Opium Addicts on Methadone Treatment

    PubMed Central

    Ghafarinezhad, Alireza; Rajabizadeh, Ghodratollah; Shahriari, Vahid

    2013-01-01

    Background Drug abuse is a major public health problem. Some believe that when dissociation fails to defend against emotional, physical, or sexual trauma, the person will find relief from unpleasant thoughts and emotions in opium use. On the other hand, personality disorders are considered as important predictors of treatment outcomes in drug abusers. Due to lack of adequate research in this regard, we evaluated dissociative disorders and personality traits of opium addicts on methadone treatment. Methods This cross-sectional analytic study included 111 non-psychotic subjects on methadone treatment (case group) and 69 non-addicts (control group). After recording demographic characteristics, Dissociative Experiences Scale (DES) and Millon Multiaxial Inventory III were applied to assess dissociative symptoms and clinical personality patterns of all participants. Findings Dissociative symptoms were significantly more common in the case group than in the control group (P = 0.044). While hysterionic personality disorder was more frequent in the control group (P = 0.008), sadistic, antisocial, and schizotypal personality disorders were significantly more common in the case group (P = 0.008, 0.002, and 0.023, respectively). Conclusion We found relations between history of drug dependence, dissociative symptoms, and personality disorders. Therefore, the mentioned disorders need to be kept in mind while planning addiction treatment modalities and identifying high risk groups. PMID:24494154

  4. Assessing interpersonal aspects of schizoid personality disorder: preliminary validation studies.

    PubMed

    Kosson, David S; Blackburn, Ronald; Byrnes, Katherine A; Park, Sohee; Logan, Caroline; Donnelly, John P

    2008-03-01

    In 2 studies, we examined the reliability and validity of an interpersonal measure of schizoid personality disorder (SZPD) based on nonverbal behaviors and interpersonal interactions occurring during interviews. A total of 556 male jail inmates in the United States participated in Study 1; 175 mentally disordered offenders in maximum security hospitals in the United Kingdom participated in Study 2. Across both samples, scores on the Interpersonal Measure of Schizoid Personality Disorder (IM-SZ) exhibited adequate reliability and patterns of correlations with other measures consistent with expectations. The scale displayed patterns of relatively specific correlations with interview and self-report measures of SZPD. In addition, the IM-SZ correlated in an expected manner with features of psychopathy and antisocial personality and with independent ratings of interpersonal behavior. We address implications for assessment of personality disorder.

  5. 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…

  6. [Personality disorders in adolescence: conceptual issues and treatment approaches].

    PubMed

    Schmeck, Klaus

    2008-01-01

    Objective of this paper is to search for answers for the question if it is justified to use the diagnosis of personality disorder already in adolescence. Recent research data confirm that the stability of basic personality traits is only gradually lower in adolescence compared to adulthood. Using the diagnostic criteria of adults there is not much of a difference concerning prevalence rate and stability in adolescence and adulthood. Meta-analyses reveal that patients with personality disorders can successfully be treated with specalized treatment programs so that personality disorders should not be viewed as life-course persistent. It is argued that an early assessment with standardized procedures can help to identify adolescents with personality disorders so that specialized treatment approaches can be started. In adulthood there is empirical evidence for the use of Dialectical-Behavior Therapy DBT, Transference Focused Psychotherapy TFP, Mentalization-based Therapy MBT and Schema-focused Psychotherapy SFT for the use in patients with personality disorders. These treatment approaches have to be adapted to the special situation of adolescents so that their use can help to prevent these early developing disorders to become chronic.

  7. Oxytocin can hinder trust and cooperation in borderline personality disorder

    PubMed Central

    Simeon, Daphne; Hamilton, Holly; Kim, Suah; Crystal, Sarah; Braun, Ashley; Vicens, Victor; Hollander, Eric

    2011-01-01

    We investigated the effects of intranasal oxytocin (OXT) on trust and cooperation in borderline personality disorder (BPD), a disorder marked by interpersonal instability and difficulties with cooperation. Although studies in healthy adults show that intranasal OXT increases trust, individuals with BPD may show an altered response to exogenous OXT because the effects of OXT on trust and pro-social behavior may vary depending on the relationship representations and expectations people possess and/or altered OXT system functioning in BPD. BPD and control participants received intranasal OXT and played a social dilemma game with a partner. Results showed that OXT produced divergent effects in BPD participants, decreasing trust and the likelihood of cooperative responses. Additional analyses focusing on individual differences in attachment anxiety and avoidance across BPD and control participants indicate that these divergent effects were driven by the anxiously attached, rejection-sensitive participants. These data suggest that OXT does not uniformly facilitate trust and pro-social behavior in humans; indeed, OXT may impede trust and pro-social behavior depending on chronic interpersonal insecurities, and/or possible neurochemical differences in the OXT system. Although popularly dubbed the ‘hormone of love’, these data suggest a more circumspect answer to the question of who will benefit from OXT. PMID:21115541

  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. 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…

  10. The Treatment of Borderline Personality Disorder within a Distressed Relationship.

    ERIC Educational Resources Information Center

    Koch, Alberta; Ingram, Timothy

    1985-01-01

    Suggests an integrated systemic-psychodynamic approach to the treatment of characterological disorders within conjoint marital therapy. Draws from object relations and systemic therapies in developing a treatment approach to marriages which include at least one borderline personality disorder spouse. A case example illustrates the…

  11. 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…

  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.

  13. Personality risk profile for conduct disorder and substance use disorders in youth.

    PubMed

    Anderson, Kristen G; Tapert, Susan F; Moadab, Ida; Crowley, Thomas J; Brown, Sandra A

    2007-10-01

    The five factor model of personality is a useful metric to describe personality profiles associated with maladaptive functioning. Using the NEO-Five Factor Inventory (NEO-FFI), we examined a conceptually based profile of high neuroticism, low agreeableness and low conscientiousness among 243 youth (aged 13-18 years) with varying degrees of conduct disorder (CD) and substance use disorders (SUD). Comparisons of the NEO-FFI personality dimensions between CD/SUD youth and adolescent siblings (N=173), and relations between the personality dimensions and behavioral indicators of conduct disorder and substance involvement were examined. Youth with CD and SUD had greater neuroticism, lower agreeableness, and lower conscientiousness than siblings of a similar age. The NEO-FFI scales predicted aggression and substance involvement for both probands and siblings in this cross-sectional investigation. These findings support the role for personality in models of the etiology and persistence of conduct disorder and substance use disorders. PMID:17408870

  14. 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…

  15. Personality Disorders and Mindreading: Specific Impairments in Patients With Borderline Personality Disorder Compared to Other PDs.

    PubMed

    Semerari, Antonio; Colle, Livia; Pellecchia, Giovanni; Carcione, Antonino; Conti, Laura; Fiore, Donatella; Moroni, Fabio; Nicolò, Giuseppe; Procacci, Michele; Pedone, Roberto

    2015-08-01

    The capacity of understanding mental states is a complex function which involves several components. Single components can be selectively impaired in specific clinical populations. It has been suggested that impairments in mindreading are central for borderline personality disorder (BPD). However, empirical findings are inconsistent, and it is debatable whether BPD presents a specific profile of mindreading impairments. The aim of this study is to compare BPD and other PDs in mindreading. Seventy-two patients with BPD and 125 patients with other PD diagnoses were assessed using the Metacognition Assessment Interview. BPD showed difficulties in two mindreading functions, differentiation and integration, even when the severity of psychopathology was controlled. These results suggest a specific mindreading impairment in BPD and a strong relationship between these impairments and the severity of psychopathology.

  16. The case of an aging person with borderline personality disorder and possible dementia.

    PubMed

    Helmes, Edward; Steward, Lynda

    2010-08-01

    There is little literature on older adults with borderline personality disorder during neuropsychological assessment. Here we report on a 59-year-old woman with borderline personality disorder who referred herself for assessment because she feared the onset of dementia. Results showed an above average level of intelligence, with scores on memory tests that ranged from well below to well above average in a pattern that was not consistent with a dementia or with common forms of neurologically based memory impairments. A test of memory malingering was within normal limits. Results are discussed in terms of somatization within this personality disorder.

  17. Ten-Year Course of Borderline Personality Disorder

    PubMed Central

    Gunderson, John G.; Stout, Robert L.; McGlashan, Thomas H.; Shea, M. Tracie; Morey, Leslie C.; Grilo, Carlos M.; Zanarini, Mary C.; Yen, Shirley; Markowitz, John C.; Sanislow, Charles; Ansell, Emily; Pinto, Anthony; Skodol, Andrew E.

    2011-01-01

    Context Borderline personality disorder (BPD) is traditionally considered chronic and intractable. Objective To compare the course of BPD’s psychopathology and social function with that of other personality disorders and with major depressive disorder (MDD) over 10 years. Design A collaborative study of treatment-seeking, 18-to 45-year-old patients followed up with standardized, reliable, and repeated measures of diagnostic remission and relapse and of both global social functioning and subtypes of social functioning. Setting Nineteen clinical settings (hospital and outpatient) in 4 northeastern US cities. Participants Three study groups, including 175 patients with BPD, 312 with cluster C personality disorders, and 95 with MDD but no personality disorder. Main Outcome Measures The Diagnostic Interview for DSM-IV Personality Disorders and its follow-along version (the Diagnostic Interview for DSM-IV Personality Disorders–Follow-Along Version) were used to diagnose personality disorders and assess changes in them. The Structured Clinical Interview for DSM-IV Axis I Disorders and the Longitudinal Interval Follow-up Evaluation were used to diagnose MDD and assess changes in MDD and in social function. Results Eighty-five percent of patients with BPD remitted. Remission of BPD was slower than for MDD (P<.001) and minimally slower than for other personality disorders (P<.03). Twelve percent of patients with BPD relapsed, a rate less frequent and slower than for patients with MDD (P<.001) and other personality disorders (P=.008). All BPD criteria declined at similar rates. Social function scores showed severe impairment with only modest albeit statistically significant improvement; patients with BPD remained persistently more dysfunctional than the other 2 groups (P<.001). Reductions in criteria predicted subsequent improvements in DSM-IV Axis V Global Assessment of Functioning scores (P<.001). Conclusions The 10-year course of BPD is characterized by high rates of

  18. 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.

  19. 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

  20. Development of Antisocial Personality Disorder in Detained Youths: The Predictive Value of Mental Disorders

    ERIC Educational Resources Information Center

    Washburn, Jason J.; Romero, Erin Gregory; Welty, Leah J.; Abram, Karen M.; Teplin, Linda A.; McClelland, Gary M.; Paskar, Leah D.

    2007-01-01

    Antisocial personality disorder (APD) is a serious public and mental health concern. Understanding how well conduct disorder (CD) and other mental disorders predict the development of APD among youths involved in the juvenile justice system is critical for prevention. The authors used a stratified random sample of 1,112 detained youths to examine…

  1. European views on personality disorders: a conceptual history.

    PubMed

    Berrios, G E

    1993-01-01

    A historical account is offered of the European origins of the DSM-III-R category, personality disorder, and a differentiation is made between the history of terms, patterns of behaviors, and concepts. The concept of "disorder of character (personality)" developed in the nineteenth century, and was possible after notions such as character, constitution, temperament, and self received a psychological definition, and after the insanities became transformed into "psychoses." Terms such as "type" and "trait" were in turn ushered into the nineteenth century by faculty psychology and the phrenological tradition. Until the end of that century, "personality" referred to the subjective aspects of the self, and "personality disorder" meant alteration of consciousness (e.g., hysterical dissociation); the behavioral patterns dealt with by DSM-III-R as personality disorders were then called disorders of character and explained as states of volitional failure, or loss of coherence between cognitive, emotional, and conative functions, or of "automatism," i.e., the manifestation of lower (more primitive or animal) forms of behavior escaping the control of higher (human) ones. Character types and disorders were first considered as forms of attenuated insanity, and later on were made into a separate group whose membership could be attained via the visitation of a degeneration taint, neurological disease (e.g., encephalitis), or plain ill-breeding. The relevance of the intellectual background of the nineteenth century to these diagnostic changes is also discussed.

  2. Accurately diagnosing and treating borderline personality disorder: a psychotherapeutic case.

    PubMed

    Johnson, Ashley B; Gentile, Julie P; Correll, Terry L

    2010-04-01

    The high prevalence of comorbid bipolar and borderline personality disorders and some diagnostic criteria similar to both conditions present both diagnostic and therapeutic challenges. This article delineates certain symptoms which, by careful history taking, may be attributed more closely to one of these two disorders. Making the correct primary diagnosis along with comorbid psychiatric conditions and choosing the appropriate type of psychotherapy and pharmacotherapy are critical steps to a patient's recovery. In this article, we will use a case example to illustrate some of the challenges the psychiatrist may face in diagnosing and treating borderline personality disorder. In addition, we will explore treatment strategies, including various types of therapy modalities and medication classes, which may prove effective in stabilizing or reducing a broad range of symptomotology associated with borderline personality disorder.

  3. 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

  4. 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.

  5. 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

  6. 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

  7. 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

  8. Personality disorders in later life: questions about the measurement, course, and impact of disorders.

    PubMed

    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.

  9. 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

  10. 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

  11. 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.

  12. Positive Affective and Cognitive States in Borderline Personality Disorder

    PubMed Central

    Reed, Lawrence Ian; Zanarini, Mary C.

    2011-01-01

    The aim of the current study was to compliment previous studies identifying negative states present in borderline personality disorder 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 borderline patients (and axis II comparison participants). 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, 4 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

  13. Refining personality disorder subtypes and classification using finite mixture modeling.

    PubMed

    Yun, Rebecca J; Stern, Barry L; Lenzenweger, Mark F; Tiersky, Lana A

    2013-04-01

    The current Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnostic system for Axis II disorders continues to be characterized by considerable heterogeneity and poor discriminant validity. Such problems impede accurate personality disorder (PD) diagnosis. As a result, alternative assessment tools are often used in conjunction with the DSM. One popular framework is the object relational model developed by Kernberg and his colleagues (J. F. Clarkin, M. F. Lenzenweger, F. Yeomans, K. N. Levy, & O. F. Kernberg, 2007, An object relations model of borderline pathology, Journal of Personality Disorders, Vol. 21, pp. 474-499; O. F. Kernberg, 1984, Severe Personality Disorders, New Haven, CT: Yale University Press; O. F. Kernberg & E. Caligor, 2005, A psychoanalytic theory of personality disorders, in M. F. Lenzenweger & J. F. Clarkin, Eds., Major Theories of Personality Disorder, New York, NY: Guilford Press). Drawing on this model and empirical studies thereof, the current study attempted to clarify Kernberg's (1984) PD taxonomy and identify subtypes within a sample with varying levels of personality pathology using finite mixture modeling. Subjects (N = 141) were recruited to represent a wide range of pathology. The finite mixture modeling results indicated that 3 components were harbored within the variables analyzed. Group 1 was characterized by low levels of antisocial, paranoid, and aggressive features, and Group 2 was characterized by elevated paranoid features. Group 3 revealed the highest levels across the 3 variables. The validity of the obtained solution was then evaluated by reference to a variety of external measures that supported the validity of the identified grouping structure. Findings generally appear congruent with previous research, which argued that a PD taxonomy based on paranoid, aggressive, and antisocial features is a viable supplement to current diagnostic systems. Our study suggests that Kernberg's object relational model offers a

  14. 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.

  15. Trauma, genes, and the neurobiology of personality disorders.

    PubMed

    Goodman, Marianne; New, Antonia; Siever, Larry

    2004-12-01

    A model for personality dysfunction posits an interaction between inherited susceptibility and environmental factors such as childhood trauma. Core biological vulnerabilities in personality include dimensions of affective instability, impulsive aggression, and cognition/perceptual domains. For the dimension of impulsive aggression, often seen in borderline personality disorder (BPD), the underlying neurobiology involves deficits in central serotonin function and alterations in specific brain regions in the cingulate and the medial and orbital prefrontal cortex. The role of trauma in the development of personality disorder and especially for BPD remains unclear. Although recent studies suggest that BPD is not a trauma-spectrum disorder and that it is biologically distinct from posttraumatic stress disorder, high rates of childhood abuse and neglect do exist for individuals with personality dysfunction. Personality symptom clusters seem to be unrelated to specific abuses, but they may relate to more enduring aspects of interpersonal and family environments in childhood. Whereas twin and family studies indicate a partially heritable basis for impulsive aggression, studies of serotonin-related genes to date suggest only modest contributions to behavior. Gene-environment interactions involving childhood maltreatment are demonstrated in recent studies on antisocial behaviors and aggressive rhesus monkeys and highlight the need for further research in this important area.

  16. Borderline personality traits and disorder: predicting prospective patient functioning

    PubMed Central

    Hopwood, Christopher J.; Zanarini, Mary C.

    2011-01-01

    Objective Decisions about the composition of personality assessment in DSM-V will be heavily influenced by the clinical utility of candidate constructs. This study addressed one aspect of clinical utility by testing the incremental validity of five-factor model personality traits and Borderline Personality Disorder (BPD) symptoms for predicting prospective patient functioning. Method Five-factor personality traits and BPD features were correlated with one another and predicted 2, 4, 6, 8, and 10-year psychosocial functioning scores for 362 personality-disordered patients. Results Traits and symptom domains related significantly and pervasively to one another and to prospective functioning. FFM extraversion and agreeableness tended to be most incrementally predictive of psychosocial functioning across all intervals; cognitive and impulse action features of BPD features incremented FFM traits in some models. Conclusions These data suggest that BPD symptoms and personality traits are important long-term indicators of clinical functioning that both overlap with and increment one another in clinical predictions. Results support the integration of personality traits and disorders in DSM-V. PMID:20658814

  17. 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

  18. 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…

  19. Becoming one person: living with dissociative identity disorder.

    PubMed

    Stickley, T; Nickeas, R

    2006-04-01

    Dissociative identity disorder is a rare diagnosis, although people currently with a diagnosis of psychosis may in fact be experiencing what is associated with the disorder. This article is co-authored by a nurse and a person who has lived with alters (multiple personalities) for nearly all of her life. Because of the rarity of the diagnosis, there is much misunderstanding and ignorance among lay people and mental health professionals. This article therefore clarifies historical and contemporary issues surrounding this particular mental health problem both through examining the literature and through narrative of the person's experience. Special attention is given to the reality of coping with the difficulties that dissociative identity disorder create.

  20. 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

  1. 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

  2. Some comments on nomology, diagnostic process, and narcissistic personality disorder in the DSM-5 proposal for personality and personality disorders.

    PubMed

    Pincus, Aaron L

    2011-01-01

    I comment on the DSM-5 proposal for personality disorders (PDs), including discussion of the proposal's nomological revisions and their implications, the development and prioritization of a set of general criteria for PD, the shift to prototype matching of narrative descriptions for assessment of personality impairments and prominent PD types, and the recommendation to delete five PD diagnoses. Although the general criteria for PD are promising, implementation of prototype ratings for both functional impairments and PD types remains psychometrically questionable. In addition, revising the format and content of the diagnostic criteria while simultaneously deleting five diagnoses confounds evaluation of the revisions for the purposes indicated in the proposal. Finally, the performance of prior DSM criteria sets should not be the primary basis for considering the ontological status of prominent types because of construct definition problems with the criteria sets and criterion problems with DSM-based PD research. These concerns were highlighted in the case of Narcissistic PD-a diagnosis slated for deletion despite significant evidence for its clinical utility and validity when data beyond DSM criteria is considered. Changes of this magnitude are needed, but rigorous scientific evaluation is necessary before evolving from a proposal to the officially published DSM-5.

  3. 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

  4. 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.

  5. Premorbid personality aspects in mood and schizophrenic disorders.

    PubMed

    Heerlein, A; Santander, J; Richter, P

    1996-01-01

    This study examines premorbid personality traits from a self-reported and family-reported perspective on a group of unipolar major depression (n = 27), bipolar (n = 21), and schizophrenic (n = 16) recovered inpatients, and a control group (n = 21). Using the Munich Personality Test (MP-T Scales) of von Zerssen for self-reporting and family-reporting personality traits, and the Kischkel scale for the measurement of "intolerance of ambiguity," we found more "rigidity," less "esoteric tendencies," and more "intolerance of ambiguity" among unipolar depressive patients. Schizophrenic patients showed more esoteric tendencies and less "extraversion." Results confirm the hypothesis supported by many authors regarding a particular personality structure in unipolar major depression characterized by rigidity and ambiguity intolerance. This personality pattern for unipolar depressives seems to be different from the depressive personality disorder proposed by DSM-IV. Schizophrenic individuals differ by means of their self- and family-reported extraversion. Clinical and theoretical implications of these findings are discussed.

  6. 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

  7. 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

  8. Crime and multiple personality disorder: a case history and discussion.

    PubMed

    Perr, I N

    1991-01-01

    The application of the concept of multiple personality disorder (MPD) is one of the most complex and controversial issues facing forensic psychiatrists. The case presented is one in which a diagnosis of multiple personality disorder is not only well documented, but was so diagnosed at least 10 years before the ultimate homicide. Nonetheless, consideration of the legal issues was difficult. Other cases, particularly the Bianchi case, reflect the clinical difficulties in diagnosis. Subsequent cases have reflected a judicial review of the issues and a trend to disallow the concept of MPD as a defense; the author suggests that forensic psychiatrists incorporate these opinions in their future judgments.

  9. 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.

  10. Dracula. Disorders of the self and borderline personality organization.

    PubMed

    Raines, J M; Raines, L C; Singer, M

    1994-12-01

    It has been proposed that Bram Stoker's novel Dracula can best be understood as a dramatic, hyperbolic, and fantastic expression of themes consistent with contemporary psychoanalytic conceptions of borderline personality disorder organization. Such an understanding may, in turn, shed further light on the nature of the intrapsychic world and experiences of borderline patients. Excerpts from the novel can be used to support the conceptualization of recent contributions to object relations theory and the understanding of borderline personality organization. It is uncanny how consistent Dracula's characteristics are to the generally seen complaints of patients suffering from this disorder.

  11. 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.

  12. 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

  13. Contributions from personality- and psychodynamically oriented assessment to the development of the DSM-5 personality disorders.

    PubMed

    Huprich, Steven K

    2011-07-01

    Advances in personality assessment over the past 20 years have notably influenced the proposed assessment and classification of personality disorders in the Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM-5]). However, a considerable body of personality assessment and psychodynamically oriented assessment research has significant relevance to the way in which personality disorders are evaluated that appears to have gone unrecognized in the current proposals for DSM-5. In this article, I discuss the ways in which some of these 2 bodies of literature can and should inform the DSM-5 so that the diagnostic nomenclature can be more scientifically and comprehensively informed and consequently improve the clinical utility of a diagnostic system in need of considerable revision.

  14. Hyperbolic temperament and borderline personality disorder

    PubMed Central

    Hopwood, Christopher J.; Thomas, Katherine M.; Zanarini, Mary C.

    2011-01-01

    Zanarini and Frankenburg (2007) described the “essential nature” of borderline psychopathology as involving intense and chronic inner pain deriving from a hyperbolic temperament that is mediated through interpersonal behaviors. These interpersonal behaviors can either provoke kindling events that promote the expression of borderline pathology or buffer against borderline symptoms. This study was designed to test this general hypothesis and to articulate both the temperamental and the mediating constructs implicated in this theory more specifically. A questionnaire containing the elements of this theory was administered to non-clinical (N = 545), clinical (N = 316) and treatment (N = 50) samples. Covariance analyses supported a hyperbolic temperament factor and four mediating factors labeled passive, agentic, validation seeking, and detached. Overall, validity correlations conformed to predictions in showing a strong association between hyperbolic temperament and borderline and other forms of personality pathology, and in demonstrating varying relations between the mediating factors with adaptivity, including psychiatric improvements in a treatment trial. The place of this theoretical model of borderline pathology beside other theories that tend to emphasize personality traits or interpersonal patterns are discussed, and clinical implications of the model are highlighted. PMID:22518203

  15. Diagnosis and subtypes of adolescent antisocial personality disorder.

    PubMed

    Jones, Meredith; Westen, Drew

    2010-04-01

    The present study examined the application of the Antisocial Personality Disorder (APD) diagnosis to adolescents and investigated the possibility of subtypes of APD adolescents. As part of a broader study of adolescent personality in clinically-referred patients, experienced clinicians provided personality data on a randomly selected patient in their care using the SWAP-II-A personality pathology instrument. Three hundred thirteen adolescents met adult DSM-IV diagnostic criteria for APD. To characterize adolescents with the disorder, we aggregated the data to identify the items most descriptive and distinctive of APD adolescents relative to other teenagers in the sample (N = 950). Q-factor analysis identified five personality subtypes: psychopathic-like, socially withdrawn, impulsive-histrionic, emotionally dysregulated, and attentionally dysregulated. The five subtypes differed in predictable ways on a set of external criteria related to global adaptive functioning, childhood family environment, and family history of psychiatric illness. Both the APD diagnosis and the empirically derived APD subtypes provided incremental validity over and above the DSM-IV disruptive behavior disorders in predicting global adaptive functioning, number of arrests, early-onset severe externalizing pathology, and quality of peer relationships. Although preliminary, these results provide support for the use of both APD and personality-based subtyping systems in adolescents.

  16. Temperament and the structure of personality disorder symptoms.

    PubMed

    Mulder, R T; Joyce, P R

    1997-01-01

    This paper attempts to construct a simplified system for the classification of personality disorders, and relates this system to normally distributed human personality characteristics. One hundred and forty-eight subjects with a variety of psychiatric diagnoses were evaluated using the SCID-II structured clinical interview for personality disorders. A four-factor solution of personality disorder symptoms was obtained and we labelled these factors 'the four As': antisocial, asocial, asthenic and anankastic. The factors related to the four temperament dimensions of the Tridimensional Personality Questionnaire (TPQ), but less closely to Eysenck Personality Questionnaire (EPQ) dimensions. The four factors were similar to those identified in a number of studies using a variety of assessment methods and this lends some credibility to our findings. It suggests that a more parsimonious set of trait descriptors could be used to provide simpler, less overlapping categories that retain links with current clinical practice. In addition, these factors can be seen as extremes of normally distributed behaviours obtained using the TPQ questionnaire.

  17. Axis II comorbidity in borderline personality disorder is influenced by sex, age, and clinical severity.

    PubMed

    Barrachina, Judith; Pascual, Juan C; Ferrer, Marc; Soler, Joaquim; Rufat, M Jesús; Andión, Oscar; Tiana, Thais; Martín-Blanco, Ana; Casas, Miquel; Pérez, Víctor

    2011-01-01

    Borderline personality disorder (BPD) is a severe psychiatric disorder that has a high clinical heterogeneity and frequent co-occurrence with other personality disorders (PDs). Although several studies have been performed to assess axis II comorbidity in BPD, more research is needed to clarify associated factors. The aim of this study was to determine the prevalence of co-occurrent axis II disorders in a large sample of patients with BPD and to investigate the influence of sex, age, and severity on this comorbidity. Data were collected from 484 patients with BPD through 2 semistructured interviews. We analyzed the frequency of axis II comorbidity and assessed differences regarding sex, age, and severity of BPD. About 74% of patients with BPD had at least 1 co-occurrent axis II disorder. The most common were paranoid, passive-aggressive, avoidant, and dependent PDs. Significant sex differences were found. Women presented more comorbidity with dependent PD, whereas men showed higher rates of comorbidity with antisocial PD. We also observed a significant positive correlation between age and the number of co-occurrent axis II disorders in women with BPD. Another finding was the positive correlation between BPD severity and the number of co-occurrent axis II disorders. These findings suggest that comorbidity with other axis II disorders and sex, age, and severity should be taken into account when developing treatment strategies and determining the prognosis of BPD.

  18. 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.

  19. Personality traits and personality disorders in older women: an explorative study between normal development and psychopathology.

    PubMed

    Henriques-Calado, Joana; Duarte-Silva, Maria Eugénia; Keong, Ana Marta; Sacoto, Carlota; Junqueira, Diana

    2014-01-01

    The relationships between Axis II personality disorders (DSM-IV) and the Five-Factor Model (FFM) were explored in older women. The sample consists of 90 participants (M = 72.29 years, SD = 7.10) who were administered the NEO-Five-Factor Inventory and the Personality Diagnostic Questionnaire. The highest prevalence of A and C clusters and obsessive-compulsive personality disorder was observed. Also, elevated neuroticism and decreased agreeableness and openness appear as valuable traits in the description of psychopathology. The study of maladaptive personality functioning within an aging population can be described with the same traits that underlie normal personality functioning, extending the range of psychopathology to a dimensional approach.

  20. Impact of dissociation on treatment of depressive and anxiety spectrum disorders with and without personality disorders

    PubMed Central

    Prasko, Jan; Grambal, Ales; Kasalova, Petra; Kamardova, Dana; Ociskova, Marie; Holubova, Michaela; Vrbova, Kristyna; Sigmundova, Zuzana; Latalova, Klara; Slepecky, Milos; Zatkova, Marta

    2016-01-01

    Objective The central goal of the study was to analyze the impact of dissociation on the treatment effectiveness in patients with anxiety/neurotic spectrum and depressive disorders with or without comorbid personality disorders. Methods The research sample consisted of inpatients who were hospitalized in the psychiatric department and met the ICD-10 criteria for diagnosis of depressive disorder, panic disorder, generalized anxiety disorder, mixed anxiety–depressive disorder, agoraphobia, social phobia, obsessive compulsive disorder, posttraumatic stress disorder, adjustment disorders, dissociative/conversion disorders, somatoform disorder, or other anxiety/neurotic spectrum disorder. The participants completed these measures at the start and end of the therapeutic program – Beck Depression Inventory, Beck Anxiety Inventory, a subjective version of Clinical Global Impression-Severity, Sheehan Patient-Related Anxiety Scale, and Dissociative Experience Scale. Results A total of 840 patients with anxiety or depressive spectrum disorders, who were resistant to pharmacological treatment on an outpatient basis and were referred for hospitalization for the 6-week complex therapeutic program, were enrolled in this study. Of them, 606 were statistically analyzed. Data from the remaining 234 (27.86%) patients were not used because of various reasons (103 prematurely finished the program, 131 did not fill in most of the questionnaires). The patients’ mean ratings on all measurements were significantly reduced during the treatment. Also, 67.5% reached at least minimal improvement (42.4% showed moderate and more improvement, 35.3% of the patients reached remission). The patients without comorbid personality disorder improved more significantly in the reduction of depressive symptoms than those with comorbid personality disorder. However, there were no significant differences in change in anxiety levels and severity of the mental issues between the patients with and without

  1. [Psychopathological symptoms and personality traits in alcohol-dependent patients: a comparative study].

    PubMed

    Bravo de Medina, Ricardo; Echeburúa, Enrique; Aizpiri, Javier

    2007-01-01

    The aim of this paper was to describe the psychopathological and personality profile associated with alcohol dependence and to compare it with those of non-addictive disorders and the normal population. The sample consisted of 158 alcohol-dependent participants attending a psychiatric outpatient clinic, 120 psychiatric patients with non-addictive disorders and 103 participants from the general population chosen to match the patient samples for age, gender and socioeconomic level. All participants were assessed with different instruments related to personality (Impulsiveness Scale, Sensation-Seeking Scale and STAI), psychopathology (SCL-90-R, BDI and Maladjustment Scale) and personality disorders (MCMI-II). Patients from the clinical groups presented more symptoms of anxiety and depression than the healthy participants and had more problems adjusting to everyday life, but there were no differences between the two clinical groups. Alcohol-dependent patients were more impulsive and sensation-seeking than the other two groups. Histrionic, narcissistic and antisocial personality disorders were specific to the alcohol-dependent patients. The implications of this study for further research are discussed.

  2. Paranoid personality disorder in the United States: the role of race, illicit drug use, and income.

    PubMed

    Raza, Gina T; DeMarce, Josephine M; Lash, Steven J; Parker, Jefferson D

    2014-01-01

    Differential rates of schizophrenia and paranoia symptoms have been found for Black and White individuals. Paranoid personality disorder shares symptoms with schizophrenia, yet has received minimal attention with regard to potential racial differences. In a sample consisting of 180 substance use disorder treatment-seeking individuals, the association between the diagnosis of paranoid personality disorder and the variables of race, cannabis use disorder, and income were examined. Results extended previous findings to paranoid personality disorder, supporting the hypothesis that Black individuals would be diagnosed with higher rates of paranoid personality disorder. Cannabis use disorder status and income did not predict paranoid personality disorder diagnoses. PMID:25176118

  3. Paranoid personality disorder in the United States: the role of race, illicit drug use, and income.

    PubMed

    Raza, Gina T; DeMarce, Josephine M; Lash, Steven J; Parker, Jefferson D

    2014-01-01

    Differential rates of schizophrenia and paranoia symptoms have been found for Black and White individuals. Paranoid personality disorder shares symptoms with schizophrenia, yet has received minimal attention with regard to potential racial differences. In a sample consisting of 180 substance use disorder treatment-seeking individuals, the association between the diagnosis of paranoid personality disorder and the variables of race, cannabis use disorder, and income were examined. Results extended previous findings to paranoid personality disorder, supporting the hypothesis that Black individuals would be diagnosed with higher rates of paranoid personality disorder. Cannabis use disorder status and income did not predict paranoid personality disorder diagnoses.

  4. Manualized treatment for substance abusers with personality disorders: dual focus schema therapy.

    PubMed

    Ball, S A

    1998-01-01

    The presence of an untreated personality disorder may be associated with worse compliance and outcome in substance abuse treatment. Therapeutic attention to the symptoms of personality disorder may reduce the severity of substance abuse and other Axis I symptoms which potentially contribute to relapse. A 24-week manual-guided individual cognitive-behavioral therapy approach has been developed that integrates relapse prevention with targeted intervention for early maladaptive schemas (enduring negative beliefs about oneself, others, and events) and coping styles. This Dual Focus Schema Therapy is being compared to 12-Step Drug Counseling for opioid-dependent individuals with personality disorders in an ongoing study funded by the National Institute on Drug Abuse. This article reviews Young's (1994) schema-focused theory and approach and summarizes the treatment manual, which integrates relapse prevention for substance abuse.

  5. [Personality disorders and psychopathy in men convicted for severe intimate partner violence].

    PubMed

    Fernández-Montalvo, Javier; Echeburúa, Enrique

    2008-05-01

    In this paper, a study of personality disorders and psychopathy in imprisoned male batterers is carried out. A sample of 76 batterers sentenced for a severe offence of violence against their intimate partner was selected. All the participants were assessed with the MCMI-II before beginning a treatment program in prison for gender violence. Likewise, all participants were assessed with the PCL-R in order to identify psychopathic symptoms. According to the results, 86.8% of the sample showed at least one personality disorder. The most prevalent one was the Obsessive-compulsive Personality Disorder (57.8% of cases), followed by the Dependent Personality Disorder (34.2% of cases) and Paranoid Personality Disorder (25%). Regarding psychopathy, the results of PCL-R showed that there were 11 people (14.4% of the sample) who met the criteria for psychopathy or probable psychopathy. Finally, implications of this study for clinical practice and future research in this field are commented upon.

  6. Mortality Among Persons With Obsessive-Compulsive Disorder in Denmark

    PubMed Central

    Meier, Sandra M.; Mattheisen, Manuel; Mors, Ole; Schendel, Diana E.; Mortensen, Preben B.; Plessen, Kerstin J.

    2016-01-01

    IMPORTANCE Several mental disorders have consistently been found to be associated with decreased life expectancy, but little is known about whether this is also the case for obsessive-compulsive disorder (OCD). OBJECTIVE To determine whether persons who receive a diagnosis of OCD are at increased risk of death. DESIGN, SETTING, AND PARTICIPANTS Using data from Danish registers, we conducted a nationwide prospective cohort study with 30 million person-years of follow-up. The data were collected from Danish longitudinal registers. A total of 3 million people born between 1955 and 2006 were followed up from January 1, 2002, through December 31, 2011. During this period, 27 236 people died. The data were analyzed primarily in June 2015. MAIN OUTCOMES AND MEASURES We estimated mortality rate ratios (MRRs), adjusted for calendar year, age, sex, maternal and paternal age, place of residence at birth, and somatic comorbidities, to compare persons with OCT with persons without OCD. RESULTS Of 10 155 persons with OCD (5935 women and 4220 men with a mean [SD] age of 29.1 [11.3] years who contributed a total of 54 937 person-years of observation), 110 (1.1%) died during the average follow-up of 9.7 years. The risk of death by natural or unnatural causes was significantly higher among persons with OCD (MRR, 1.68 [95% CI, 1.31–2.12] for natural causes; MRR, 2.61 [95% CI, 1.91–3.47] for unnatural causes) than among the general population. After the exclusion of persons with comorbid anxiety disorders, depression, or substance use disorders, OCD was still associated with increased mortality risk (MRR, 1.88 [95% CI, 1.27–2.67]). CONCLUSIONS AND RELEVANCE The presence of OCD was associated with a significantly increased mortality risk. Comorbid anxiety disorders, depression, or substance use disorders further increased the risk. However, after adjusting for these and somatic comorbidities, we found that the mortality risk remained significantly increased among persons with OCD

  7. Alcohol disorder amongst forcibly displaced persons in northern Uganda

    PubMed Central

    Roberts, Bayard; Felix Ocaka, Kaducu; Browne, John; Oyok, Thomas; Sondorp, Egbert

    2011-01-01

    Background Alcohol use may be a coping mechanism for the stressors related to forced displacement. The aim of this study was to investigate levels and determinants of alcohol disorder amongst internally displaced persons (IDPs) in northern Uganda. Methods A cross-sectional survey with 1206 adult IDPs was conducted in Gulu and Amuru districts. Alcohol disorder was measured using the AUDIT instrument. Multivariate logistic regression was used to explore demographic, socio-economic, displacement and trauma exposure determinants of alcohol disorder. Findings The prevalence of probable alcohol disorder was 17% of all respondents, and 66% amongst those who drank alcohol once a month or more frequently. Factors associated with alcohol disorder included men compared to women, older age, and experiencing a higher number of traumatic events. These findings can help identify potentially vulnerable groups and target responses more effectively. PMID:21481540

  8. 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…

  9. Aggression, impulsivity, and psychopathic traits in combined antisocial personality disorder and substance use disorder.

    PubMed

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

    2013-01-01

    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.

  10. 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…

  11. 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…

  12. 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…

  13. 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.

  14. Aspects of personality in patients with anxiety disorders undergoing capsulotomy.

    PubMed

    Mindus, P; Nyman, H; Rosenquist, A; Rydin, E; Meyerson, B A

    1988-01-01

    Capsulotomy is an established psychosurgical intervention for anxiety disorders. While the effectiveness of the intervention in reducing target symptoms is undisputed, the issue of negative personality changes following capsulotomy is of great concern. We studied prospectively personality traits in nine consecutive patients undergoing capsulotomy for anxiety disorder, using the Rorschach test and a personality inventory, the Karolinska Scales of Personality (KSP), administered before and one year after operation. The protocols were evaluated under blind conditions by an independent assessor who had access to no data other than the age and sex of the patients. The Rorschach findings were used in two main comparison procedures: between the patients pre- and postoperative scores, and between that group and three reference groups. The KSP data were compared both with an age-stratified non-patient control group and with data obtained from groups of neurotic patients. In summary, the capsulotomy patients' personalities, as expressed in their Rorschach interpretations, remained intact, and significant reductions were noted in scales reflecting anxiety and hospitality. Statistically significant changes were also noted after operation in 10 of the 17 scales included in the KSP. While pathological scores were observed preoperatively in many scales, all the postoperative scores but one (Socialization) were within the normal range. Scores on the Socialization scale remained low, which is often the case in chronic patients. It is concluded that the patients displayed more normal personality features after operation than before and that adverse personality changes are not likely to occur after capsulotomy. PMID:3223360

  15. 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

  16. Service Delivery to Persons with Communication Disorders in Micronesia.

    ERIC Educational Resources Information Center

    Stewart, Jean L.; Martinez, Velma A.

    1986-01-01

    Summarizes factors which make delivery of human services extremely difficult in Micronesia, noting problems of geographic distance and isolation and cultural and linguistic diversity. Presents a plan for providing services to persons with communication disorders using a speech-language pathologist and an audiologist with doctorates to supervise…

  17. 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.…

  18. 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.

  19. 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.

  20. 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.

  1. 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

  2. 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…

  3. 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…

  4. The Function of Aggression in Personality Disordered Patients

    ERIC Educational Resources Information Center

    Daffern, Michael; Howells, Kevin

    2009-01-01

    It has been suggested that psychological interventions for personality disorders should focus on improving adaptive expression of the functional needs expressed through problematic behaviors such as aggression. The measurement of function is a necessary condition for devising a function-based treatment approach. Two studies that employ a method…

  5. 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.…

  6. 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)

  7. A Behavioral Continuum: A Look at Personality Disorders.

    ERIC Educational Resources Information Center

    Harris, George; Kirk, Nancy A.

    1985-01-01

    Suggests that narcissistic, borderline, and antisocial personality disorders are not discrete diagnostic categories, but that they lie along a continuum and have in common the dimensions of degree of self-centeredness and degree of differentiation. Presents evidence supporting existence of continuum of behavior rather than discrete diagnostic…

  8. 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)

  9. 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…

  10. The role of labeling processes in diagnosing borderline personality disorder.

    PubMed

    Henry, K A; Cohen, C I

    1983-11-01

    Normal men exhibited more characteristics of borderline personality disorder than did normal women on a questionnaire. In light of that finding, the authors suggest that labeling processes may be a contributing factor in the overrepresentation of women among patients diagnosed as borderline.

  11. 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)…

  12. 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…

  13. 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

  14. 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

  15. 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.…

  16. 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…

  17. Personality disorders and criminal law: an international perspective.

    PubMed

    Sparr, Landy F

    2009-01-01

    At the International War Crimes Tribunal for the Former Yugoslavia (ICTY), a detention camp guard, charged with acts of murder and torture, advanced a plea of diminished responsibility. Defense psychiatrists testified that he had a personality disorder that influenced his ability to control his behavior, but a prosecution expert testified that the guard did not meet Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria. Thus, the unresolved question of how the law defines a mental disease or defect for purposes of mitigation or excuse was transposed to an international setting. It has been argued in a variety of jurisdictions and national legal systems that exculpatory mental disorders must be serious, and personality disorders should not qualify. In fact, it has been proposed that the volitional aspect of excuse defenses be eliminated, and definitions of mental disease or defect narrowed. Others have argued that such exclusions are too restrictive and arbitrary. This article examines the criminal defense at ICTY and traces its origin in national jurisdictions. Mental incapacity defenses based on personality disorders are more often used in The Netherlands, England, Germany and Belgium, but seldom in Canada and rarely in the United States and Sweden.

  18. Vocational functioning in schizotypal and paranoid personality disorders.

    PubMed

    McGurk, Susan R; Mueser, Kim T; Mischel, Rebecca; Adams, Rebecca; Harvey, Philip D; McClure, Margaret M; Look, Amy E; Leung, Winnie W; Siever, Larry J

    2013-12-15

    Impaired vocational functioning is a hallmark of schizophrenia, but limited research has evaluated the relationships between work and schizophrenia-spectrum personality disorders, including schizotypal (SPD) and paranoid personality disorder (PPD). This study compared employment history and job characteristics of 174 individuals drawn from the community or clinic, based on four personality disorder groups: SPD Only, PPD Only, SPD+PPD, and No SPD or PPD. Symptoms and cognitive functioning were also assessed. Both PPD and/or SPD were associated with lower rates of current employment, and a history of having worked at less cognitively complex jobs than people without these disorders. Participants with PPD were less likely to have a history of competitive work for one year, whereas those with SPD tended to have worked at jobs involving lower levels of social contact, compared with those without these disorders. When the effects of symptoms and cognitive functioning were statistically controlled, PPD remained a significant predictor of work history, and SPD remained a significant predictor of social contact on the job. The findings suggest that impaired vocational functioning is an important characteristic of SPD and PPD.

  19. Identity disturbance in adolescence: associations with borderline personality disorder.

    PubMed

    Westen, Drew; Betan, Ephi; Defife, Jared A

    2011-02-01

    Although establishing a coherent identity is often viewed as a normative developmental task of adolescence, an important question is whether forms of identity disturbance seen in adult personality disorders can also be distinguished in adolescents. If so, such disturbances would constitute an essential target for research and clinical interventions. The goal of this study is to investigate the nature of identity disturbance in an adolescent clinical sample and to explore its links with personality pathology, particularly borderline personality disorder. A national random sample of 139 psychiatrists and clinical psychologists completed a battery of instruments on a randomly selected adolescent patient in their care, including measures of Axis II symptoms and the Identity Disturbance Questionnaire-Adolescent Version, an instrument designed for clinically experienced observers that assesses a wide range of manifestations of potential identity disturbance among adolescents. Factor analysis of the Identity Disturbance Questionnaire--Adolescent Version yielded four clinically and conceptually coherent factors that resembled dimensions previously identified in adults: lack of normative commitment, role absorption, painful incoherence, and lack of consistency. As in adults, identity disturbance in adolescents is a clinically meaningful, multidimensional construct exhibiting significant relationships with different forms of severe personality pathology, most notably borderline personality disorder. As such, identity disturbance can be a manifestation of psychopathology above and beyond the typical Sturm und Drang (storm and stress) of adolescence.

  20. 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.

  1. Personality and changes in comorbidity patterns among anxiety and depressive disorders.

    PubMed

    Spinhoven, Philip; de Rooij, Mark; Heiser, Willem; Smit, Jan H; Penninx, Brenda W J H

    2012-11-01

    This prospective study examined the prognostic value of the Big Five personality model for changes in comorbidity patterns of emotional disorders both from a person- and trait-centered perspective. Moreover, it is investigated whether the predictive effect of personality can be attributed to symptom severity at baseline. We followed a cohort of 2566 persons (18-65 years) recruited in primary and specialized mental health care during two years. Personality dimensions at baseline were assessed with the NEO-FFI. The Diagnostic and Statistical Manual of Mental Disorders (4th ed.)-based diagnostic interviews with the CIDI allowed assessment of changes in comorbidity patterns of anxiety and depressive disorders over two years. Data were analyzed with latent class analysis (LCA) and latent transition analysis (LTA). LCA identified a four-class latent comorbidity class solution (Few Disorders, Fear Disorders, Distress Disorders, and Comorbid Fear and Distress Disorders) and a five-class latent personality class solution (High Resilients, Medium Resilients, Low Overcontrollers, Medium Overcontrollers, and High Overcontrollers). LTA showed that the likelihood of remaining in the same latent class was larger than that of transitioning to a less severe comorbidity class. Also, after correcting for symptom severity, medium and high Overcontrollers as well as participants with lower levels of conscientiousness were less likely to transition to a less severe comorbidity class. In particular, the individual trait of conscientiousness may be less dependent on current levels of anxiety and depressive symptoms and be a key pathoplastic or even predisposing variable in anxiety and depression and needs more theoretical and empirical study.

  2. 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

  3. [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

  4. 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

  5. [Childhood trauma in the etiology of borderline personality disorder].

    PubMed

    Kuritárné, Ildikó Szabó

    2005-01-01

    Serious, prolonged intrafamilial childhood sexual abuse is considered to be the main etiological factor in about half of the patients with borderline personality disorder in the USA. Special features of childhood interpersonal trauma leading to the development of borderline personality disorder are the seriousness of the trauma and the fact that it is sexual in nature. Serious intrafamilial childhood abuse can lead not only to the classic post-traumatic stress syndrome, but can influence all aspects of personality development, including the distortion of the sense of identity, self-regulation, and the patterns of interpersonal relations. Viewed from the perspective of the trauma concept, the entire range of adult borderline symptoms are considered as being the consequences of severe complex traumatic experiences. Other clinicians regard such an abuse as a marker of the severity of familial dysfunction and emphasize the role of other pathogenic factors, such as biparental neglect and biological vulnerability of the pre-borderline child.

  6. Personality-dependent dispersal cancelled under predation risk.

    PubMed

    Cote, Julien; Fogarty, Sean; Tymen, Blaise; Sih, Andrew; Brodin, Tomas

    2013-12-22

    Dispersal is a fundamental life-history trait for many ecological processes. Recent studies suggest that dispersers, in comparison to residents, display various phenotypic specializations increasing their dispersal inclination or success. Among them, dispersers are believed to be consistently more bold, exploratory, asocial or aggressive than residents. These links between behavioural types and dispersal should vary with the cause of dispersal. However, with the exception of one study, personality-dependent dispersal has not been studied in contrasting environments. Here, we used mosquitofish (Gambusia affinis) to test whether personality-dependent dispersal varies with predation risk, a factor that should induce boldness or sociability-dependent dispersal. Corroborating previous studies, we found that dispersing mosquitofish are less social than non-dispersing fish when there was no predation risk. However, personality-dependent dispersal is negated under predation risk, dispersers having similar personality types to residents. Our results suggest that adaptive dispersal decisions could commonly depend on interactions between phenotypes and ecological contexts.

  7. 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.

  8. Alexithymia in personality disorders: correlations with symptoms and interpersonal functioning.

    PubMed

    Nicolò, Giuseppe; Semerari, Antonio; Lysaker, Paul H; Dimaggio, Giancarlo; Conti, Laura; D'Angerio, Stefania; Procacci, Michele; Popolo, Raffaele; Carcione, Antonino

    2011-11-30

    Impairment in the ability to recognize and make sense of emotions has been hypothesized to be present in a sub-sample of people suffering from personality disorder (PD). In particular it is possible that difficulty recognizing and expressing feelings, or alexithymia, is related to many of the symptoms and problems in making sense of social interactions which are hallmarks of PD. In this study we measured levels of alexithymia with the Toronto Alexithymia Scale-20 and explored its correlations with the overall presence of PD and different PD diagnoses, symptoms, and interpersonal difficulties. Results were largely consistent with the hypothesis. Higher levels of alexithymia were related to high levels of global psychopathology and with dysfunctional representation of interpersonal relations. A sub-sample of patients, mostly suffering from avoidant, dependent, passive-aggressive and depressive PD, had alexithymic features and, in particular reported difficulties describing their feelings to others. A patient with cluster B PD featured no alexithymia. Implications of this study for future research and treatment are discussed.

  9. 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

  10. 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

  11. The ironic fate of the personality disorders in DSM-5.

    PubMed

    Skodol, Andrew E; Morey, Leslie C; Bender, Donna S; Oldham, John M

    2013-10-01

    An alternative model for the diagnosis of personality disorders (PDs), based on assessments of impairments in personality functioning and of pathological personality traits, was intended for the official classification in the Diagnostic and Statistical Manual for Mental Disorders-Fifth Edition (DSM-5), but was instead placed in Section III, "Emerging Measures and Models." This article attempts to describe forces in play during the development of DSM-5 that may have contributed to this outcome, from the perspectives of the Chair of the Personality and Personality Disorders Work Group (PPDWG) and three of its members. These include a failed imperative to shift away from the Diagnostic and Statistical Manual for Mental Disorders-Fourth Edition (DSM-IV) categories toward a dimensional perspective on psychopathology, dynamics within the American Psychiatric Association DSM-5 Task Force and PPDWG and the roles and impact of individuals and groups in the PD community. From these considerations, we present some suggestions for how the field might move forward in the future. A new opportunity exists to use the proposed alternative model as a foundation for research. In the immediate future, with the existence of two different models of PDs in DSM-5, studies can be done comparing the models to each other and to other models with respect to reliability and antecedent, concurrent, and predictive validity. If the Section III model continues to perform as early studies suggest, it may migrate into Section II of a planned DSM-5.1. This valuable research, already underway, will shape future editions of the DSM, by providing data to articulate a clearer vision, with broader representation of reliable and valid models. Going forward, personal investments must be put aside for the benefit of the greater good.

  12. [Differential diagnosis between Schizotypal Personality Disorder and Autism Spectrum Disorders: a case report].

    PubMed

    Ünver, Buket; Öner, Özgür; Yurtbaşı, Pınar

    2015-01-01

    Schizotypal personality disorder is characterized by social and interpersonal deficits marked by discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior. Inappropriate or constricted affect, reduced capacity for relationships, lack of close friends and reduced capacity for social life are the symptoms that overlap both schizotypal personality disorder and autism spectrum disorders. The making of differential diagnosis may be difficult since several symptoms are similar between these disorders. In this study, we discussed the differential diagnosis issues on the basis of an adolescent case. Odd appearance, magical thoughts, reference thoughts suggests Schizotypal Personality Disorder whereas lack of eye contact at 2 years old, a preference to be isolated and play alone and referral to a child psychiatrist at 4 years old suggest Autism Spectrum Disorders. Based on the results of psychological assessment, Wechsler Intelligence Scale for Children-Revised (WISC-R) profile is compatible with autistic children's profiles. Based on Schizotypal Personality Questionnaire, the patient's anxiety, lack of close friends, constricted affect symptoms which take place in the category of interpersonal schizotypy seems to overlap with lack of communication of Autism Spectrum Disorders. This case report indicates that, separation of autism and schizophrenia, a very important historical breakthrough in autism research, may be blurred in cases with less typical clinical pictures representing autistic and schizophrenic "spectrum" diagnosis.

  13. [Comparative assessment of cognitive styles forming personal behavior in health and borderline personality disorder].

    PubMed

    Zakharov, N P

    2006-01-01

    The author suggests a cognitive-analytical concept of personality focusing on cognitively mediated processes of cyclic interaction of different levels of consciousness and subconsciousness represented in the form of emotional-behavioral potential and functional-dynamic system. A cognitive type (cognitype)--a type of personality-centered cognitive operations that determines the pattern of behavioral cycle and distinctive features of social adaptation--is singled out as an integrative basic individual and psychological component of personality. Presented is classification of personality cognitypes, their adaptive and maladaptive variants, correlations between cognitypes and anomalies of personality. The principles of psychotherapy of maladaptive behavior, borderline and addictive disorders (positive reintegration of personality) are substantiated.

  14. 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.

  15. The heritability of Cluster B personality disorders assessed both by personal interview and questionnaire.

    PubMed

    Torgersen, Svenn; Myers, John; Reichborn-Kjennerud, Ted; Røysamb, Espen; Kubarych, Thomas S; Kendler, Kenneth S

    2012-12-01

    Whereas the heritability of common personality traits has been firmly established, the results of the few published studies on personality disorders (PDs) are highly divergent, with some studies finding high heredity and others very low. A problem with assessing personality disorders by means of interview is errors connected with interviewer bias. A way to overcome the problem is to use self-report questionnaires in addition to interviews. This study used both interview and questionnaire for assessing DSM-IV Cluster B personality disorders: antisocial personality disorder (APD), borderline (BPD), narcissistic (NPD), and histrionic (HPD). We assessed close to 2,800 twins from the Norwegian Institute of Public Health Twin Panel using a self-report questionnaire and, a few years later, the Structured Interview for DSM-IV Personality (SIDP-IV). Items from the self-report questionnaire that best predicted the PDs captured by the interview were then selected. Measurement models combining questionnaire and interview information were applied and were fitted using Mx. Whereas the heritability of Cluster B PDs assessed by interview was around .30, and around .40-.50 when assessed by self-report questionnaire, the heritability of the convergent latent factor, including information from both interview and self-report questionnaire was .69 for APD, .67 for BPD, .71 for NPD, and .63 for HPD. As is usually found for personality, the effect of shared-in families (familial) environment was zero. In conclusion, when both interview and self-report questionnaire are taken into account, the heritability of Cluster B PD appears to be in the upper range of previous findings for mental disorders.

  16. The Heritability of Cluster B Personality Disorders Assessed both by Personal Interview and Questionnaire

    PubMed Central

    Torgersen, Svenn; Myers, John; Reichborn-Kjennerud, Ted; Røysamb, Espen; Kubarych, Thomas S.; Kendler, Kenneth S.

    2013-01-01

    Whereas the heritability of common personality traits has been firmly established, the results of the few published studies on personality disorders (PDs) are highly divergent, with some studies finding high heredity and others very low. A problem with assessing personality disorders by means of interview is errors connected with interviewer bias. A way to overcome the problem is to use self-report questionnaires in addition to interviews. This study used both interview and questionnaire for assessing DSM-IV Cluster B personality disorders: antisocial personality disorder (APD), borderline (BPD), narcissistic (NPD), and histrionic (HPD). We assessed close to 2,800 twins from the Norwegian Institute of Public Health Twin Panel using a self-report questionnaire and, a few years later, the Structured Interview for DSM-IV Personality (SIDP-IV). Items from the self-report questionnaire that best predicted the PDs captured by the interview were then selected. Measurement models combining questionnaire and interview information were applied and were fitted using Mx. Whereas the heritability of Cluster B PDs assessed by interview was around .30, and around .40–.50 when assessed by self-report questionnaire, the heritability of the convergent latent factor, including information from both interview and self-report questionnaire was .69 for APD, .67 for BPD, .71 for NPD, and .63 for HPD. As is usually found for personality, the effect of shared-in families (familial) environment was zero. In conclusion, when both interview and self-report questionnaire are taken into account, the heritability of Cluster B PD appears to be in the upper range of previous findings for mental disorders. PMID:23281671

  17. 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…

  18. 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

  19. Low body weight in male children and adolescents with schizoid personality disorder or Asperger's disorder.

    PubMed

    Hebebrand, J; Henninghausen, K; Nau, S; Himmelmann, G W; Schulz, E; Schäfer, H; Remschmidt, H

    1997-07-01

    This study explored the hypothesis that body weight is reduced in male children and adolescents with schizoid personality disorder or Asperger's disorder. The body weights of 33 consecutively admitted male subjects with one of these disorders were retrospectively assessed with percentiles for the body mass index (BMI). The mean percentile (+/- SD) for the BMI was 31.6 +/- 27.6 and differed significantly from the expected value of 50 (P<0.001). Ten subjects had a BMI of < or = 10th age percentile. Post hoc comparisons revealed that BMI percentiles were (a) reduced to a similar extent in patients with schizoid personality disorder and Asperger's disorder and (b) reduced to a greater extent in patients with abnormal eating behaviour. During childhood and adolescence both diagnoses are associated with an increased risk of being underweight. Population-based BMI percentiles are useful for detecting associations between specific psychopathological syndromes and body weight.

  20. 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…

  1. Gene-environment studies and borderline personality disorder: a review.

    PubMed

    Carpenter, Ryan W; Tomko, Rachel L; Trull, Timothy J; Boomsma, Dorret I

    2013-01-01

    We review recent gene-environment studies relevant to borderline personality disorder, including those focusing on impulsivity, emotion sensitivity, suicidal behavior, aggression and anger, and the borderline personality phenotype itself. Almost all the studies reviewed suffered from a number of methodological and statistical problems, limiting the conclusions that currently can be drawn. The best evidence to date supports a gene-environment correlation (rGE) model for borderline personality traits and a range of adverse life events, indicating that those at risk for BPD are also at increased risk for exposure to environments that may trigger BPD. We provide suggestions regarding future research on GxE interaction and rGE effects in borderline personality.

  2. Personality and substance use disorders: a prospective study.

    PubMed

    Sher, K J; Bartholow, B D; Wood, M D

    2000-10-01

    The personality systems of Cloninger (as measured by the Tridimensional Personality Questionnaire [TPQ]) and Eysenck (as measured by the Eysenck Personality Questionnaire [EPQ]) both have been linked to substance use and abuse. The current study examined the predictive utility of both systems for substance use disorder (SUD) diagnoses, both cross-sectionally and prospectively. Participants (N = 489 at baseline) completed the EPQ and TPQ and were assessed via structured diagnostic interview at baseline and 6 years later (N = 457 at follow-up). Both the EPQ and TPQ scales demonstrated bivariate cross-sectional and prospective associations with SUDs. Within each system, those dimensions marking a broad impulsive sensation-seeking or behavioral disinhibition trait were the best predictors prospectively, although the 2 systems were differentially sensitive to specific diagnoses. These relations remained significant even with autoregressivity, other concurrent SUD diagnoses, and multiple personality dimensions statistically controlled.

  3. Taxometric analyses of paranoid and schizoid personality disorders.

    PubMed

    Ahmed, Anthony Olufemi; Green, Bradley Andrew; Buckley, Peter Francis; McFarland, Megan Elizabeth

    2012-03-30

    There remains debate about whether personality disorders (PDs) are better conceptualized as categorical, reflecting discontinuity from normal personality; or dimensional, existing on a continuum of severity with normal personality traits. Evidence suggests that most PDs are dimensional but there is a lack of consensus about the structure of Cluster A disorders. Taxometric methods are adaptable to investigating the taxonic status of psychiatric disorders. The current study investigated the latent structure of paranoid and schizoid PDs in an epidemiological sample (N=43,093) drawn from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) using taxometric analyses. The current study used taxometric methods to analyze three indicators of paranoid PD - mistrust, resentment, and functional disturbance - and three indicators of schizoid PD - emotional detachment, social withdrawal, and functional disturbance - derived factor analytically. Overall, taxometrics supported a dimensional rather than taxonic structure for paranoid and schizoid PDs through examination of taxometric graphs and comparative curve fit indices. Dimensional models of paranoid and schizoid PDs better predicted social functioning, role-emotional, and mental health scales in the survey than categorical models. Evidence from the current study supports recent efforts to represent paranoid and schizoid PDs as well as other PDs along broad personality dimensions.

  4. 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.

  5. Impulsive phenomena, the impulsive character (der Triebhafte Charakter) and DSM personality disorders.

    PubMed

    Perry, J Christopher; Körner, Annett C

    2011-10-01

    Impulsive phenomena have frequently been associated with personality disorders, beginning with Reich's description of the impulsive-character (Reich, 1925/1975). However, questions remain regarding the cooccurrence of a wide variety of impulsive phenomena and whether an underlying structure influences the differential association of impulses to individual personality disorders. Adults entering residential treatment for treatment-refractory disorders were interviewed about their lifetime histories of 33 impulse items, following independent diagnostic interviews. Factor analysis suggested 12 underlying dimensions of impulsive phenomena, explaining 68% of the variance. Borderline and antisocial PDs had the highest impulse scores, followed by self-defeating, narcissistic, depressive, and passive-aggressive PDs. Schizoid, avoidant, obsessive-compulsive, and dependent types were negatively associated with impulsive phenomena. Individuals with the highest impulse scores showed higher levels of borderline, antisocial and either self-defeating or passive-aggressive personality pathology, and were characterized by high Neuroticism and Openness and low Agreeableness on the NEO-FFI. Personality disorders and the NEO-FFI personality traits both predicted unique variance in impulsive phenomena, with the former predominating. Our findings bear striking similarities to Reich's (1925/1975) descriptions of the impulsive character.

  6. 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

  7. 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.

  8. Dissociation in borderline personality disorder: a detailed look.

    PubMed

    Korzekwa, Marilyn I; Dell, Paul F; Links, Paul S; Thabane, Lehana; Fougere, Philip

    2009-01-01

    The objective of the present study was to assess in detail the whole spectrum of normal and pathological dissociative experiences and dissociative disorder (DD) diagnoses in borderline personality disorder (BPD) as diagnosed with the Revised Diagnostic Interview for Borderlines. Dissociation was measured comprehensively in 21 BPD outpatients using the Structured Clinical Interview for DSM-IV Dissociative Disorders-Revised, the Multidimensional Inventory of Dissociation (MID), the Dissociative Experiences Scale pathological taxon analysis, and the Somatoform Dissociation Questionnaire. The frequencies of DDs in this BPD sample were as follows: 24% no DD, 29% mild DD (dissociative amnesia and depersonalization disorder), 24% DD Not Otherwise Specified (DDNOS), and 24% dissociative identity disorder. With regard to the dissociative experiences endorsed, almost all patients reported identity confusion, unexplained mood changes, and depersonalization. Even those BPD patients with mild DD reported derealization, depersonalization, and dissociative amnesia. BPD patients with DDNOS reported frequent depersonalization, frequent amnesia, and notable experiences of identity alteration. BPD patients with dissociative identity disorder endorsed severe dissociative symptoms in all categories. Analysis of the MID pathological dissociation items revealed that 32% of the items were endorsed at a clinically significant level of frequency by more than 50% of our BPD patients. In conclusion, the frequencies of Diagnostic and Statistical Manual of Mental Disorders (4th ed.) DDs in these patients with BPD were surprisingly high. Likewise, the "average" BPD patient endorsed a wide variety of recurrent pathological dissociative symptoms.

  9. 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

  10. 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…

  11. Violence and personality disorders: clinical and forensic implications.

    PubMed

    Esbec, E; Echeburúa, E

    2010-01-01

    Several studies have provided strong evidence that personality disorders (PD) represent a significant clinical risk for violence. This review has aimed to examine the relationship of greater risk for violence among persons with certain PD in terms of four fundamental personality dimensions: 1) impulse control; 2) affect regulation; 3) threatened egotism or narcissism; and 4) paranoid cognitive personality style. Two of these dimensions -impulse control and affect regulation- are probably substantially affected by virtually all PDs linked to violence. Narcissism or threatened egotism and paranoid cognitive personality style have also been empirically linked to violence and mental disorder. PD symptoms have proven to be even stronger predictors of violence than the PDs per se. In fact, increased symptoms of DSM-IV cluster A or cluster B PD, such as paranoid, narcissistic and antisocial PD symptoms, correlate significantly with violence. Finally, there are three important principles about the relationship between PDs and violence: 1) PDs are rarely egosyntonic; 2) most patients and violent situations that come to clinical attention involve comorbid conditions; and 3) violence and risk of violence are often associated with substance abuse. Implications of this review for further research are discussed.

  12. 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…

  13. Personality traits and vulnerability or resilience to substance use disorders.

    PubMed

    Belcher, Annabelle M; Volkow, Nora D; Moeller, F Gerard; Ferré, Sergi

    2014-04-01

    Clear evidence supports a genetic basis for substance use disorders (SUD). Yet, the search to identify individual gene contributions to SUD has been unsuccessful. Here, we argue for the study of endophenotypes within the frame of individual differences, and identify three high-order personality traits that are tied to specific brain systems and genes, and that offer a tractable approach to studying SUD. These personality traits, and the genes that moderate them, interact dynamically with the environment and with the drugs themselves to determine ultimately an individual's vulnerability or resilience to developing SUD.

  14. Personality Traits and Vulnerability or Resilience to Substance Use Disorders

    PubMed Central

    Belcher, Annabelle M.; Volkow, Nora D.; Moeller, F. Gerard; Ferré, Sergi

    2014-01-01

    Clear evidence supports a genetic basis for Substance Use Disorders (SUD). Yet the search to identify individual gene contributions to SUD has been quite unsuccessful. Here we argue for the study of endophenotypes within the frame of individual differences, and identify three high-order personality traits that are tied to specific brain systems and genes, and that offer a tractable approach to studying SUD. These personality traits, and the genes that moderate them, interact dynamically with the environment and with the drugs themselves to ultimately determine an individual’s vulnerability or resilience to developing SUD. PMID:24612993

  15. Genetic and environmental contributions to the co-occurrence of depressive personality disorder and DSM-IV personality disorders.

    PubMed

    Ørstavik, Ragnhild E; Kendler, Kenneth S; Røysamb, Espen; Czajkowski, Nikolai; Tambs, Kristian; Reichborn-Kjennerud, Ted

    2012-06-01

    One of the main controversies with regard to depressive personality disorder (DPD) concerns the co-occurrence with the established DSM-IV personality disorders (PDs). The main aim of this study was to examine to what extent DPD and the DSM-IV PDs share genetic and environmental risk factors, using multivariate twin modeling. The DSM-IV Structured Interview for Personality was applied to 2,794 young adult twins. Paranoid PD from Cluster A, borderline PD from Cluster B, and all three PDs from Cluster C were independently and significantly associated with DPD in multiple regression analysis. The genetic correlations between DPD and the other PDs were strong (.53-.83), while the environmental correlations were moderate (.36-.40). Close to 50% of the total variance in DPD was disorder specific. However, only 5% was due to disorder-specific genetic factors, indicating that a substantial part of the genetic vulnerability to DPD also increases the vulnerability to other PDs.

  16. Personality disorders in the DSM-5: current status, lessons learned, and future challenges. Introduction.

    PubMed

    Widiger, Thomas A; Krueger, Robert F

    2013-10-01

    Provides an introduction to a special section of Personality Disorders: Theory, Research, and Treatment. The purpose of this special section is to provide a discussion of the current status, lessons learned, and future challenges for the classification of personality disorders.

  17. 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.

  18. 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

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

    PubMed

    Johnson, Sally C; Elbogen, Eric B

    2013-06-01

    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.

  20. 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

  1. Temperament, character, and attachment patterns in borderline personality disorder.

    PubMed

    Fossati, A; Donati, D; Donini, M; Novella, L; Bagnato, M; Maffei, C

    2001-10-01

    The aim of this study was to assess the specificity of the association between temperamental vulnerability, character deficits, and Borderline personality disorder (BPD), controlling for the effects of attachment patterns. A total of 44 BPD patients were compared with 98 non-BPD patients with other cluster B Personality Disorder (PD) diagnoses, 39 patients with any cluster A or cluster C PD diagnoses, 70 patients with no PD diagnosis, and 206 nonclinical patients. All patients were administered the Temperament and Character Inventory, the Parental Bonding Instrument, and the Attachment Style Questionnaire. Multivariate and univariate tests showed that BPD patients differed significantly from all control groups on Novelty Seeking and Cooperativeness. These differences remained significant when controlling for the effect of attachment.

  2. Applying principles of intercultural communication to personality disorder therapy.

    PubMed

    Leising, Daniel

    2008-09-01

    Psychotherapy with patients who were diagnosed with a personality disorder bears a strong resemblance to intercultural communication. I suggest conceptualizing the situation of a patient with a personality disorder as being similar to that of an overseas traveller. Like the traveller, the patient faces the task of getting along in a social environment that does not share many of his or her ingrained values regarding 'appropriate' interpersonal behaviour. In order to reduce the potential for misunderstandings and interpersonal problems, the patient would benefit from (a) learning about the culturally accepted rules of interacting and (b) partly adopting those rules. Borrowing from training manuals for intercultural communication, I suggest a number of therapeutic principles that specifically address the discrepancies between the patient's habits and internalized values, and the cultural conventions that govern the social environment in which the patient lives. PMID:18426694

  3. 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.

  4. [Treatment of schizoid personality disorder: Reflections of a cinephile].

    PubMed

    Gamache, Dominick; Diguer, Louis

    2012-01-01

    While treatment of personality disorders in general is often described as difficult and filled with many obstacles, knowledge is still limited regarding the specific treatment challenges for DSM's Cluster A individuals. The purpose of this paper is to explore these challenges, as illustrated by the case study of a schizoid patient who underwent psychodynamic therapy for over a year. Deep and unconscious interpersonal fears that complicated treatment, and how these fears had to be taken into account in therapeutic interventions, will be explored. Strong countertransference reactions, especially those evoked by long silences and constant management of optimal therapeutic distance, will also be discussed. This paper also proposes some reflections on the limitations of DSM's conceptualization of the schizoid personality disorder, and how a dynamic understanding of relational fears and ambivalence in these patients may be crucial to treatment.

  5. Multimethod Investigation of Interpersonal Functioning in Borderline Personality Disorder

    PubMed Central

    Stepp, Stephanie D.; Hallquist, Michael N.; Morse, Jennifer Q.; Pilkonis, Paul A.

    2011-01-01

    Even though interpersonal functioning is of great clinical importance for patients with borderline personality disorder (BPD), the comparative validity of different assessment methods for interpersonal dysfunction has not yet been tested. This study examined multiple methods of assessing interpersonal functioning, including self- and other-reports, clinical ratings, electronic diaries, and social cognitions in three groups of psychiatric patients (N=138): patients with (1) BPD, (2) another personality disorder, and (3) Axis I psychopathology only. Using dominance analysis, we examined the predictive validity of each method in detecting changes in symptom distress and social functioning six months later. Across multiple methods, the BPD group often reported higher interpersonal dysfunction scores compared to other groups. Predictive validity results demonstrated that self-report and electronic diary ratings were the most important predictors of distress and social functioning. Our findings suggest that self-report scores and electronic diary ratings have high clinical utility, as these methods appear most sensitive to change. PMID:21808661

  6. Cerebellar Cognitive Affective Syndrome Presented as Severe Borderline Personality Disorder

    PubMed Central

    Pesic, Danilo; Peljto, Amir; Lukic, Biljana; Milovanovic, Maja; Svetozarevic, Snezana; Lecic Tosevski, Dusica

    2014-01-01

    An increasing number of findings confirm the significance of cerebellum in affecting regulation and early learning. Most consistent findings refer to association of congenital vermis anomalies with deficits in nonmotor functions of cerebellum. In this paper we presented a young woman who was treated since sixteen years of age for polysubstance abuse, affective instability, and self-harming who was later diagnosed with borderline personality disorder. Since the neurological and neuropsychological reports pointed to signs of cerebellar dysfunction and dysexecutive syndrome, we performed magnetic resonance imaging of brain which demonstrated partially developed vermis and rhombencephalosynapsis. These findings match the description of cerebellar cognitive affective syndrome and show an overlap with clinical manifestations of borderline personality disorder. PMID:24715924

  7. Personality differences between eating-disordered women and a nonclinical comparison sample: a discriminant classification analysis.

    PubMed

    Narduzzi, K J; Jackson, T

    2000-06-01

    The present study evaluated the extent to which eating-disordered and nonclinical comparison samples could be differentiated on self-reported personality measures of autonomy and sociotropy and a projective measure of dependency. Sixty-two women meeting diagnostic criteria for eating disorder and a nonpsychiatric comparison group of 62 women completed the autonomy and sociotropy subscales of the Personal Style Inventory-II and the Rorschach Oral Dependency Scale (ROD). A discriminant classification analysis indicated 85.5% of eating-disordered subjects and 88.7% of control subjects were identified accurately from their scores on autonomy, sociotropy. and ROD. Results suggest that the experience of eating disorders is associated with a mixed clinical presentation characterized by issues related to sociotropy-dependency, and especially, achievement-related vulnerabilities. Potentially fruitful areas for future study include assessing the utility of autonomy and sociotropy as predictors of eating disturbances in prospective research and evaluating their utility in predicting treatment prognosis among patients with eating disorders. PMID:10877460

  8. The narcissism epidemic: commentary on modernity and narcissistic personality disorder.

    PubMed

    Twenge, Jean M; Miller, Joshua D; Campbell, W Keith

    2014-04-01

    Comments on the original article by Paris (see record 2012-18549-001) regarding narcissistic personality disorder. The current authors agree with Paris that modern life is making people more narcissistic. In fact, the authors demonstrate with this commentary, the case for increasing narcissism is even stronger than presented in his article. An explain that expressing individualism and lack of social support play key roles in this increase. However, the current authors question the idea that therapy is building narcissism. PMID:24796568

  9. Personality and personality disorders in the DSM-5: introduction to the special issue.

    PubMed

    Miller, Joshua D; Levy, Kenneth N

    2011-01-01

    In this introduction to the special section on Personality and Personality Disorders in DSM-5, the editors briefly describe the major changes proposed by the Work Group on Personality Disorders for DSM-5. They then introduce and describe the key points in the target articles by the Work Group as well as in the commentaries. The aim of this section is to present an arena for the articulation and discussion of the rationale of the proposed changes and the logic and evidence for these proposed changes. Special attention is paid to points of contention, debate, and controversy with regard to the proposed changes. It is the editors' goal to facilitate an open discussion of these issues in an effort to promote a scientifically based and clinically useful product.

  10. In-depth study of personality disorders in first-admission patients with substance use disorders

    PubMed Central

    2012-01-01

    Background Assessment of comorbid personality disorders (PDs) in patients with substance use disorders (SUDs) is challenging due to symptom overlap, additional mental and physical disorders, and limitations of the assessment methods. Our in-depth study applied methods to overcome these difficulties. Method A complete catchment area sample of 61 consecutively admitted patients with SUDs, with no previous history of specialized treatment (addiction clinics, psychiatry) were studied, addressing PDs and associated clinical and demographic variables. The thorough assessments included the Psychiatric Research Interview for Substance and Mental Disorders and the Structured Clinical Interview for DSM-IV Axis II Personality Disorders. Results Forty-six percent of the SUD patients had at least one PD (16% antisocial [males only]; 13% borderline; and 8% paranoid, avoidant, and obsessive-compulsive, respectively). Cluster C disorders were as prevalent as Cluster B disorders. SUD patients with PDs were younger at the onset of their first SUD and at admission; used more illicit drugs; had more anxiety disorders, particularly social phobia; had more severe depressive symptoms; were more distressed; and less often attended work or school. Conclusion The psychiatric comorbidity and symptom load of SUD patients with PDs differed from those of SUD patients without PDs, suggesting different treatment needs, and stressing the value of the assessment of PDs in SUD patients. PMID:23107025

  11. Human iPSC-derived neurons and lymphoblastoid cells for personalized medicine research in neuropsychiatric disorders

    PubMed Central

    Gurwitz, David

    2016-01-01

    The development and clinical implementation of personalized medicine crucially depends on the availability of high-quality human biosamples; animal models, although capable of modeling complex human diseases, cannot reflect the large variation in the human genome, epigenome, transcriptome, proteome, and metabolome. Although the biosamples available from public biobanks that store human tissues and cells may represent the large human diversity for most diseases, these samples are not always sufficient for developing biomarkers for patient-tailored therapies for neuropsychiatric disorders. Postmortem human tissues are available from many biobanks; nevertheless, collections of neuronal human cells from large patient cohorts representing the human diversity remain scarce. Two tools are gaining popularity for personalized medicine research on neuropsychiatric disorders: human induced pluripotent stem cell-derived neurons and human lymphoblastoid cell lines. This review examines and contrasts the advantages and limitations of each tool for personalized medicine research. PMID:27757061

  12. 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.

  13. Paranoid personality traits in a panic disorder population: a pilot study.

    PubMed

    Reich, J; Braginsky, Y

    1994-01-01

    To better understand the relationship between panic disorder and paranoid personality, panic disorder patients (N = 28) who were referred to an anxiety disorder clinic in a community mental health center were evaluated for paranoid personality traits on a standardized personality self-report instrument. Paranoid personality disorder was found in 54% of subjects. Paranoid subjects were found to have an earlier age of onset, longer duration of illness, and more psychopathology. Possible etiologies and implications for treatment of these findings are discussed.

  14. Nicotine dependence and psychosis in Bipolar disorder and Schizoaffective disorder, Bipolar Type

    PubMed Central

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

    2016-01-01

    Objective 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. Methods 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=1591), and Schizoaffective Disorder, Bipolar Type (N=1544). Participants were classified with or without nicotine dependence. Diagnostic groups were compared to controls (N=10065) using logistic regression. Results 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). Conclusions Bipolar disorder patients experiencing more severity of psychosis have more risk of nicotine dependence. PMID:26467098

  15. Extreme cognitions in bipolar spectrum disorders: associations with personality disorder characteristics and risk for episode recurrence.

    PubMed

    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

    2015-03-01

    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 are also associated with poor illness course in BSDs. The present study evaluated associations among 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 3years. 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.

  16. 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

  17. Olanzapine improves social dysfunction in cluster B personality disorder.

    PubMed

    Zullino, Daniele F; Quinche, Philippe; Häfliger, Thomas; Stigler, Michael

    2002-07-01

    Treatment with antipsychotics is a common approach for personality disorder. Conventional antipsychotics may be efficacious particularly against psychoticism, but less against other symptoms in these patients. They are, furthermore, associated with adverse drug reactions poorly tolerated by patients with personality disorder. Atypical antipsychotics have a more convenient pharmacological profile with a lower risk for extrapyramidal symptoms and a broader therapeutic profile, showing some efficacy against impulsivity, aggressivity and affective symptoms. The medical records of ten patients with a DSM-IV diagnosis of a cluster B personality disorder who had received olanzapine treatment were reviewed. A mirror-image design anchored to the start date of olanzapine treatment and extending 8 weeks in either direction was used. The assessment consisted of a qualitative chart review and a retrospective completion of the GCI-C and an adapted French version of the SDAS, using the observer-rated items. The olanzapine dose range was 2.5-20 mg during the 8 weeks of observation. The mean SDAS score (items 1-15) was 28.8+/-8.4 for the 8 weeks preceding olanzapine prescription and was improved to 13.6+/-5.8 after 8 weeks of treatment.

  18. [Schema Therapy: An Approach for Treating Narcissistic Personality Disorder].

    PubMed

    Dieckmann, E; Behary, W

    2015-08-01

    In this article, we review the history of the construct of narcissism and the diagnostic criteria for narcissistic personality disorder. We then discuss some etiological models of narcissism and introduce the model of Jeffrey Young, who developed Schema Therapy (ST) as an alternative to standard cognitive therapy for patients with personality disorders. ST differs from standard cognitive therapies in important respects, including limited reparenting, a focus on the patient's basic needs, and emotional activating techniques in addition to cognitive and behavioral ones. We then discuss Young's theory of basic needs, early maladaptive schemas, and schema modes. According to ST theory, narcissists are traumatized in the schema domain having to do with attachment needs. They are prone to vulnerable emotions in response to narcissistic injuries, although they often do not show these emotions directly. Instead, they use maladaptive coping strategies, resulting in emotional states, known as "schema modes". This includes the Self-Aggrandizer mode and Detached Self-Soother mode, in which a superior, arrogant self-presentation and addictive or compulsive behavior serve a self-regulatory function. These concepts are illustrated by case examples of patients with Narcissistic Personality Disorder.

  19. Personality traits in the differentiation of major depressive disorder and bipolar disorder during a depressive episode.

    PubMed

    Araujo, Jaciana Marlova Gonçalves; dos Passos, Miguel Bezerra; Molina, Mariane Lopez; da Silva, Ricardo Azevedo; Souza, Luciano Dias de Mattos

    2016-02-28

    The aim of this study was to determine the differences in personality traits between individuals with Major Depressive Disorder (MDD) and Bipolar Disorder (BD) during a depressive episode, when it can be hard to differentiate them. Data on personality traits (NEO-FFI), mental disorders (Mini International Neuropsychiatric Interview Plus) and socioeconomic variables were collected from 245 respondents who were in a depressive episode. Individuals with MDD (183) and BD (62) diagnosis were compared concerning personality traits, clinical aspects and socioeconomic variables through bivariate analyses (chi-square and ANOVA) and multivariate analysis (logistic regression). There were no differences in the prevalence of the disorders between socioeconomic and clinical variables. As for the personality traits, only the difference in Agreeableness was statistically significant. Considering the control of suicide risk, gender and anxiety comorbidity in the multivariate analysis, the only variable that remained associated was Agreeableness, with an increase in MDD cases. The brief version of the NEO inventories (NEO-FFI) does not allow for the analysis of personality facets. During a depressive episode, high levels of Agreeableness can indicate that MDD is a more likely diagnosis than BD.

  20. Recent advances in the biological study of personality disorders.

    PubMed

    New, Antonia S; Goodman, Marianne; Triebwasser, Joseph; Siever, Larry J

    2008-09-01

    While it is premature to provide a simple model for the vulnerability to the development of either borderline (BPD) or schizotypal (SPD) personality disorder, it is clear that these heritable disorders lend themselves to fruitful neurobiological exploration. The most promising findings in BPD suggest that a diminished top-down control of affective responses, which is likely to relate to deceased responsiveness of specific midline regions of prefrontal cortex, may underlie the affective hyperresponsiveness in this disorder. In addition, genetic and neuroendocrine and molecular neuroimaging findings point to a role for serotonin in this affective disinhibition. Clearly SPD falls within the schizophrenia spectrum, but precisely the nature of what predicts full-blown schizophrenia as opposed to the milder symptoms of SPD is not yet clear.

  1. 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

  2. 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.

  3. The criminal responsibility of people with multiple personality disorder.

    PubMed

    Saks, E

    1995-01-01

    Because multiple personality disorder (MPD) is more frequently diagnosed today than in the past, it is likely that more multiples will plead insanity. The courts are in a state of disarray as to how best to respond to these pleas. This article considers multiples' responsibility on three interpretations of the status of their alters: that they are different people; that they are different personalities; or that they are parts of one complex, deeply divided personality. On all three theories multiples are nonresponsible. Nevertheless, three rare circumstances exist under which multiples should be found guilty. The article concludes by indicating the kinds of issues psychiatry might explore to further assist the law in its analysis of the criminal responsibility of multiples.

  4. 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…

  5. Assumptions in borderline personality disorder: specificity, stability and relationship with etiological factors.

    PubMed

    Arntz, A; Dietzel, R; Dreessen, L

    1999-06-01

    The specificity and stability of a set of assumptions hypothesized to be characteristic of Borderline Personality Disorder (BPD) was investigated. BPD patients (n = 16) were compared to cluster-C personality disorder patients (n = 12) and to normal controls (n = 15). All subjects were female and diagnosed with SCID-I and -II. Subjects rated a short version of the Personality Disorder Beliefs Questionnaire (PDBQ), with six sets of 20 assumptions each, hypothesized to be characteristic of avoidant, dependent, obsessive-compulsive, paranoid, histrionic and borderline personality disorder. The BPD assumptions (Cronbach alpha = 0.95) proved to be the most specific to BPD patients. Subjects rated the shortened PDBQ again after viewing an emotional video fragment one week later. Despite increased negative emotions, the PDBQ ratings remained relatively stable. Confirming the cognitive hypothesis, regression analyses indicated that the BPD assumptions mediate the relationship between self-reported etiological factors from childhood (sexual abuse and emotional/physical abuse) and BPD pathology assessed with the SCID-II. It is suggested that a set of assumptions is characteristic of BPD, and is relatively stable despite the instability of the behaviour of people diagnosed as having BPD.

  6. Specific personality traits and general personality dysfunction as predictors of the presence and severity of personality disorders in a clinical sample.

    PubMed

    Berghuis, Han; Kamphuis, Jan H; Verheul, Roel

    2014-01-01

    This study examined the associations of specific personality traits and general personality dysfunction in relation to the presence and severity of Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) personality disorders in a Dutch clinical sample. Two widely used measures of specific personality traits were selected, the Revised NEO Personality Inventory as a measure of normal personality traits, and the Dimensional Assessment of Personality Pathology-Basic Questionnaire as a measure of pathological traits. In addition, 2 promising measures of personality dysfunction were selected, the General Assessment of Personality Disorder and the Severity Indices of Personality Problems. Theoretically predicted associations were found between the measures, and all measures predicted the presence and severity of DSM-IV personality disorders. The combination of general personality dysfunction models and personality traits models provided incremental information about the presence and severity of personality disorders, suggesting that an integrative approach of multiple perspectives might serve comprehensive assessment of personality disorders.

  7. 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.

  8. The General Assessment of Personality Disorder (GAPD): factor structure, incremental validity of self-pathology, and relations to DSM-IV personality disorders.

    PubMed

    Hentschel, Annett G; Livesley, W John

    2013-01-01

    Recent developments in the classification of personality disorder, especially moves toward more dimensional systems, create the need to assess general personality disorder apart from individual differences in personality pathology. The General Assessment of Personality Disorder (GAPD) is a self-report questionnaire designed to evaluate general personality disorder. The measure evaluates 2 major components of disordered personality: self or identity problems and interpersonal dysfunction. This study explores whether there is a single factor reflecting general personality pathology as proposed by the Diagnostic and Statistical Manual of Mental Disorders (5th ed.), whether self-pathology has incremental validity over interpersonal pathology as measured by GAPD, and whether GAPD scales relate significantly to Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]) personality disorders. Based on responses from a German psychiatric sample of 149 participants, parallel analysis yielded a 1-factor model. Self Pathology scales of the GAPD increased the predictive validity of the Interpersonal Pathology scales of the GAPD. The GAPD scales showed a moderate to high correlation for 9 of 12 DSM-IV personality disorders.

  9. Proposed changes in personality and personality disorder assessment and diagnosis for DSM-5 Part I: Description and rationale.

    PubMed

    Skodol, Andrew E; Clark, Lee Anna; Bender, Donna S; Krueger, Robert F; Morey, Leslie C; Verheul, Roel; Alarcon, Renato D; Bell, Carl C; Siever, Larry J; Oldham, John M

    2011-01-01

    A major reconceptualization of personality psychopathology has been proposed for DSM-5 that identifies core impairments in personality functioning, pathological personality traits, and prominent pathological personality types. A comprehensive personality assessment consists of four components: levels of personality functioning, personality disorder types, pathological personality trait domains and facets, and general criteria for personality disorder. This four-part assessment focuses attention on identifying personality psychopathology with increasing degrees of specificity, based on a clinician's available time, information, and expertise. In Part I of this two-part article, we describe the components of the new model and present brief theoretical and empirical rationales for each. In Part II, we will illustrate the clinical application of the model with vignettes of patients with varying degrees of personality psychopathology, to show how assessments might be conducted and diagnoses reached.

  10. Comorbidity of mood and substance use disorders in patients with binge-eating disorder: associations with personality disorder and eating disorder pathology†

    PubMed Central

    Becker, Daniel F.; Grilo, Carlos M.

    2015-01-01

    Objective Binge-eating disorder (BED) is associated with elevated rates of mood and substance use disorders, but the significance of such comorbidity is ambiguous. We compared personality disorder and eating disorder psychopathology in four subgroups of BED patients: those with mood disorders, those with substance use disorders, those with both, and those with neither. Method Subjects were 347 patients who met DSM-IV research criteria for BED. Semistructured interviews evaluated lifetime DSM-IV axis I disorders, DSM-IV personality disorder features, and eating disorder psychopathology. Results Among these patients, 129 had co-occurring mood disorder, 34 had substance use disorder, 60 had both, and 124 had neither. Groups differed on personality disorder features, with those having mood disorder and both mood and substance use disorders showing the highest frequencies. Although groups did not differ on body mass index or binge eating frequency, they did differ on eating disorder psychopathology with the groups having mood disorder and both comorbidities demonstrating higher eating, weight, and shape concerns. No differences were observed between groups with respect to ages of onset for specific eating behaviors, but some differences were observed for ages of disorder onset. Conclusion Mood and substance use disorders co-occur frequently among patients with BED. Compared with previous work, the additional comparison group (those with both mood and substance use disorders) and the control group (those with neither) afforded better discrimination regarding the significance of these comorbidities. Our findings suggest approaches to subtyping BED based on psychiatric comorbidity, and may also have implications for treatment. PMID:25700727

  11. Borderline personality disorder and bipolar disorder: what is the difference and why does it matter?

    PubMed

    Paris, Joel; Black, Donald W

    2015-01-01

    Borderline personality disorder (BPD) and bipolar disorder (types I and II) are frequently confused because of their symptomatic overlap. Although affective instability is a prominent feature of each, the pattern is entirely different. BPD is characterized by transient mood shifts that occur in response to interpersonal stressors, whereas bipolar disorder is associated with sustained mood changes. These disorders can be further distinguished by comparing their phenomenology, etiology, family history, biological studies, outcome, and response to medication. Their distinction is of great clinical importance because misdiagnosis can deprive the patient of potentially effective treatment, whether it is psychotherapy for BPD or medication for bipolar disorder. On the basis of a comprehensive literature review, guidelines for differential diagnosis are suggested, and priorities for further research are recommended.

  12. Borderline personality disorder and bipolar disorder: what is the difference and why does it matter?

    PubMed

    Paris, Joel; Black, Donald W

    2015-01-01

    Borderline personality disorder (BPD) and bipolar disorder (types I and II) are frequently confused because of their symptomatic overlap. Although affective instability is a prominent feature of each, the pattern is entirely different. BPD is characterized by transient mood shifts that occur in response to interpersonal stressors, whereas bipolar disorder is associated with sustained mood changes. These disorders can be further distinguished by comparing their phenomenology, etiology, family history, biological studies, outcome, and response to medication. Their distinction is of great clinical importance because misdiagnosis can deprive the patient of potentially effective treatment, whether it is psychotherapy for BPD or medication for bipolar disorder. On the basis of a comprehensive literature review, guidelines for differential diagnosis are suggested, and priorities for further research are recommended. PMID:25536097

  13. Frequency of Psychiatric Disorders in Children of Opioid or Methamphetamine-Dependent Patients

    PubMed Central

    Parvaresh, Noushin; Mazhari, Shahrzad; Nazari-Noghabi, Maryam

    2015-01-01

    Background Addiction is one of the main problems of human societies, which is more common in developing countries. In addition, it causes to personal and social problems and family problem. The aim of this study was to examine the prevalence of psychiatric disorders in children 5-15 years old of opioid or methamphetamine dependence patients. Methods For this study, three groups including: (1) children of parents addicted to opium, (2) children of parents addicted to methamphetamine, and (3) control group were examined. Child symptom inventory-4 (CSI-4) questionnaires completed by non-hospitalized guardian and control group; then make interviews with the children by the Kiddie-schedule for affective disorders and schizophrenia (K-SADS). Data were analyzed by chi-square test and ANOVA. Findings Survey showed that the frequency of attention deficit hyperactivity disorder (ADHD), major depressive disorder (MDD), generalized anxiety disorder, obsessive-compulsive disorder, specific phobia (SP), and separation anxiety disorder in children of addicted parents were more than a non-addicted parent. However, there was no significant difference between the two groups in the frequency of conduct disorder, social phobia, and oppositional defiant disorders (ODDs). Conclusion Parental addiction can lead to an increase in some psychiatric disorders in the children. Therefore follow-up, early diagnosis, treatment, and prevention of these disorders in children of the drug-dependent parent are necessary to reduce health costs and improve the health system. PMID:26885350

  14. 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

  15. [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

  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.

  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. Personality dysfunction and complex posttraumatic stress disorder among chronically traumatized Bosnian refugees.

    PubMed

    Palić, Sabina; Elklit, Ask

    2014-02-01

    A proposal for the inclusion of complex posttraumatic stress disorder (CPTSD) in the upcoming ICD-11 has been put forward. Using self-report, we investigated the resemblance between disorders of extreme stress not otherwise specified (DESNOS) and both axis I and II syndromes among 116 treatment-seeking Bosnian refugees. In this sample, the prevalence of DESNOS overlapped to a large degree with the prevalence of schizotypal and paranoid personality disorders (PDs). There was, however, also a large prevalence of axis I syndromes in the group. Thus, DESNOS in the refugees can be categorized as an axis I or II disorder depending on the chronicity and the severity of functional impairment. DESNOS and PD-like states were even observed among the refugees with no history of childhood maltreatment. No large differences were observed between DESNOS and PD regarding sex. The symptom constellation of CPTSD in the ICD-11 is partially supported. However, CPTSD might resemble PD to a considerable degree.

  19. Borderline personality disorder and related traits in forensic psychiatry.

    PubMed

    Reid, William H

    2009-05-01

    Persons with borderline personality disorder (BPD) and related traits appear in many forensic psychiatry settings. Their clinical hallmarks affecting judgment, insight, impulsivity, motivations, and regulation of emotions, as well as their frequently chaotic lives (internal and external), inaccurate perceptions, rationalizations, and comorbid syndromes can have a marked effect on many civil, criminal, and institutional (eg, corrections) issues. Individuals with BPD are overrepresented in civil, criminal, and child custody forensic situations. The character psychopathology of these individuals is substantial, but is often not obvious to laypersons, including lawyers, judges, and jurors. The presence of BPD rarely affects basic responsibility for the person's actions, nor does it usually compromise most forms of competency. Function, not diagnosis, is the key arbiter of forensic relevance. BPD is associated with an increase in the likelihood of doctor-patient problems, including patient complaints and lawsuits that may not be deserved. Forensic professionals evaluating persons with BPD and related traits should be aware of personal and professional bias, particularly that associated with true countertransference.

  20. 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

  1. 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.

  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. 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

  4. New Onsets of Substance Use Disorders in Borderline Personality Disorder Over Seven Years of Follow-ups: Findings from the Collaborative Longitudinal Personality Disorders Study

    PubMed Central

    Walter, Marc; Gunderson, John G.; Zanarini, Mary C.; Sanislow, Charles A.; Grilo, Carlos M.; McGlashan, Thomas H.; Morey, Leslie C.; Yen, Shirley; Stout, Robert L.; Skodol, Andrew E.

    2008-01-01

    Aims The purpose of the study was to examine whether patients with borderline personality disorder (BPD) have a higher rate of new onsets of substance use disorders (SUD) than do patients with other personality disorders (OPD). Design This study uses data from the Collaborative Longitudinal Personality Disorder Study (CLPS), a prospective naturalistic study with reliable repeated measures over 7 years of follow-up. Setting Multiple clinical sites in four northeastern US cities. Participants 175 patients with BPD and 396 patients with OPD (mean age 32.5 years), were assessed at baseline and at 6, 12, 24, 36, 48, 60, 72, and 84 months. Measurements The Structured Clinical Interview for DSM-IV Axis I Disorders and the Diagnostic Interview for DSM-IV Personality Disorders were used at baseline, the Follow-Along Version of the DIPD-IV and the Longitudinal Interval Follow-Up Evaluation at the follow-up evaluations. Kaplan-Meier analyses were calculated to generate the time to new onsets. Findings BPD patients showed a shorter time to new onsets of SUD. Thirteen percent of BPD patients developed a new alcohol use disorder, and 11% developed a new drug use disorder, as compared to rates of 6% and 4% respectively for OPD. Non-remitted BPD and remitted BPD patients did not differ significantly in rates of new onsets of SUD. Conclusions BPD patients have a high vulnerability for new onsets of SUDs even when their psychopathology improves. These findings indicate some shared etiological factors between BPD and SUD and underscore the clinical significance of treating SUD when it co-occurs in BPD patients. PMID:19133893

  5. An empirical test of schema mode conceptualizations in personality disorders.

    PubMed

    Lobbestael, Jill; Van Vreeswijk, Michiel F; Arntz, Arnoud

    2008-07-01

    Although the use of schema modes in schema-focused therapy (SFT) has been very popular since its introduction, Young's schema mode concept remained largely empirically untested. In order to provide insight into the mode conceptualization of personality disorders (PDs), the current study assessed the relationships between 14 schema modes and all PDs. Relationships between dimensional PD scores and self-reported mode scores were tested in a mixed study group of 489 participants, consisting of axis I and axis II patients, and non-patients. Psychopathology was assessed by means of the Structured Clinical Interview for DSM-IV axis I and axis II disorders (SCID I and SCID II) or the Structural Interview for DSM-IV Personality Disorders (SIDP-IV), and modes were assessed by the Schema Mode Inventory. Kendall's partial tau coefficients, controlling each PD-mode correlation for all other PD scores, indicated unique mode profiles for all PDs and corroborated most of the hypothesized PD-mode correlations, supporting the construct validity of the mode model. Nevertheless, the high number of correlations found for some PDs raises concerns about the specificity of the mode model. Implications for both research and therapy are discussed.

  6. Historical comment on DSM-III schizoid and avoidant personality disorders.

    PubMed

    Livesley, W J; West, M; Tanney, A

    1985-11-01

    The authors examine the DSM-III distinction between schizoid and avoidant personality disorders. This distinction is based on Millon's biosocial learning theory and his interpretation of Kretschmer's personality types. The authors argue that this separation of a continuous distribution is historically misconceived and serves to obscure the significant features of schizoid personality. They examine Kretschmer's conceptualization of schizoid personality for the implications it carries for the development of a classification of personality disorder, suggesting that Kretschmer's approach implies a "polythetic" model of personality disorder that conceptualizes disorders as categories of dimensions.

  7. The correlates of obsessive-compulsive, schizotypal, and borderline personality disorders in obsessive-compulsive disorder.

    PubMed

    Melca, Isabela A; Yücel, Murat; Mendlowicz, Mauro V; de Oliveira-Souza, Ricardo; Fontenelle, Leonardo F

    2015-06-01

    We assessed correlates of obsessive-compulsive (OCPD), schizotypal (SPD) and borderline (BPD) personality disorders in 110 obsessive-compulsive disorder (OCD) patients. We found OCD patients with OCPD (20.9%) to exhibit higher rates of hoarding and bipolar disorders, increased severity of hoarding and symmetry, lower prevalence of unacceptable thoughts involving sex and religion and less non-planning impulsivity. Conversely, OCD patients with SPD (13.6%) displayed more frequently bipolar disorder, increased severity of depression and OCD neutralization, greater prevalence of "low-order" behaviors (i.e., touching), lower low-planning impulsivity and greater "behavioral" compulsivity. Finally, in exploratory analyses, OCD patients with BPD (21.8%) exhibited lower education, higher rates of several comorbid psychiatric disorders, greater frequency of compulsions involving interpersonal domains (e.g. reassurance seeking), increased severity of depression, anxiety and OCD dimensions other than symmetry and hoarding, more motor and non-planning impulsivity, and greater "cognitive" compulsivity. These findings highlight the importance of assessing personality disorders in OCD samples.

  8. How To Eliminate Narcissism Overnight: DSM-V and the Death of Narcissistic Personality Disorder.

    PubMed

    Pies, Ronald

    2011-02-01

    The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition appears likely to eliminate the diagnosis of narcissistic personality disorder. There are significant problems with the discriminant validity of the current narcissistic personality disorder critiera set; furthermore, the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition's narrow focus on "grandiosity" probably contributes to the wide disparity between low narcissistic personality disorder prevalence rates in epidemiological studies and high rates of narcissistic personality disorder in clinical practice. Nevertheless, the best course of action may be to refine the narcissistic personality disorder criteria, followed by careful field testing and a search for biomarkers, rather than wholesale elimination of the narcissistic personality disorder category. The construct of "malignant narcissism" is also worthy of more intense empirical investigation.

  9. Personality-dependent dispersal cancelled under predation risk

    PubMed Central

    Cote, Julien; Fogarty, Sean; Tymen, Blaise; Sih, Andrew; Brodin, Tomas

    2013-01-01

    Dispersal is a fundamental life-history trait for many ecological processes. Recent studies suggest that dispersers, in comparison to residents, display various phenotypic specializations increasing their dispersal inclination or success. Among them, dispersers are believed to be consistently more bold, exploratory, asocial or aggressive than residents. These links between behavioural types and dispersal should vary with the cause of dispersal. However, with the exception of one study, personality-dependent dispersal has not been studied in contrasting environments. Here, we used mosquitofish (Gambusia affinis) to test whether personality-dependent dispersal varies with predation risk, a factor that should induce boldness or sociability-dependent dispersal. Corroborating previous studies, we found that dispersing mosquitofish are less social than non-dispersing fish when there was no predation risk. However, personality-dependent dispersal is negated under predation risk, dispersers having similar personality types to residents. Our results suggest that adaptive dispersal decisions could commonly depend on interactions between phenotypes and ecological contexts. PMID:24197414

  10. 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

  11. Is alcohol dependence best viewed as a chronic relapsing disorder?

    PubMed

    Cunningham, John A; McCambridge, Jim

    2012-01-01

    This 'For Debate' paper starts by recognizing the growing trend towards considering alcohol dependence as a chronic relapsing disorder. We argue that the adoption of this model results from focusing on those in treatment for alcohol dependence rather than considering the larger number of people in the general population who meet criteria for alcohol dependence at some point in their lives. The majority of the general population who ever experience alcohol dependence do not behave as though they have a chronic relapsing disorder: they do not seek treatment, resolve their dependence themselves and do not relapse repeatedly. We suggest that caution is therefore needed in using the chronic relapsing disorder label. Our primary concerns are that this formulation privileges biological aspects of dependence to the detriment of psychological and social contributions, it inhibits much-needed developments in understanding alcohol dependence and leads to inefficient distributions of public health and clinical care resources for alcohol dependence. We invite debate on this issue.

  12. 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

  13. Interpersonal Functioning in Obsessive-Compulsive Personality Disorder

    PubMed Central

    Cain, Nicole M.; Ansell, Emily B.; Simpson, H. Blair; Pinto, Anthony

    2014-01-01

    The core symptoms of obsessive-compulsive personality disorder (OCPD) often lead to interpersonal difficulties. However, little research has explored interpersonal functioning in OCPD. The current study examined interpersonal problems, interpersonal sensitivities, empathy, and systemizing, the drive to analyze and derive underlying rules for systems, in a sample of 25 OCPD individuals, 25 individuals with comorbid OCPD and obsessive-compulsive disorder (OCD), and 25 healthy controls. We found that OCPD individuals reported hostile-dominant interpersonal problems and sensitivities with warm-dominant behavior by others while OCPD+OCD individuals reported submissive interpersonal problems and sensitivities with warm-submissive behavior by others. Individuals with OCPD, with and without OCD, reported less empathic perspective taking relative to healthy controls. Finally, we found that OCPD males reported a higher drive to analyze and derive rules for systems than OCPD females. Overall, results suggest that there are interpersonal deficits associated with OCPD and the clinical implications of these deficits are discussed. PMID:25046040

  14. Patient-reported outcomes in borderline personality disorder.

    PubMed

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

    2014-06-01

    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.

  15. [A cognitive approach of the borderline personality disorder].

    PubMed

    Keegan, Eduardo

    The development of cognitive models and treatments for borderline personality disorder over the last two decades has been remarkable. This article presents the main ideas of the models developed by Aaron T. Beck and Arthur Freeman, Jeffrey Young and Marsha Linehan. These theories have generated psychotherapies that have proven their efficacy in controlled empirical studies in a difficult to treat population. The models of Beck Freeman and Young are based on the concept of schema. Linehan's dialectical behavior therapy is based on a biosocial transactional conception of the disorder. All these models emphasize the importance of negative experiences in early development. The article presents the structure of these treatments and describes their specific interventions.

  16. [Schema therapy for personality disorders. A critical review].

    PubMed

    Roediger, E; Zarbock, G

    2015-01-01

    In the 10 years since schema therapy was first recognized in Germany it has become widespread among practitioners and has taken a place among the so-called third wave therapies. The overall goal of schema therapy is conceptualizing and treating personality disorders or traits reinforcing axis I disorders. Early maladaptive schemas result from a child's unmet emotional core needs. In a limited reparenting therapy relationship these interpersonal situations are re-experienced and rescripted under the therapist's control. Schema therapy integrates elements of existing models and techniques into a consistent case conceptualization as the bedrock for understanding and changing maladaptive coping behavior. This review article gives a comprehensive overview about the model, the therapy relationship and the application of the experiential techniques in relation to already developed approaches (including the current evidence). The strengths and weaknesses are briefly discussed.

  17. 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

  18. 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

  19. Improving Assessment of Personality Disorder Traits Through Social Network Analysis

    PubMed Central

    Clifton, Allan; Turkheimer, Eric; Oltmanns, Thomas F.

    2015-01-01

    When assessing personality disorder traits, not all judges make equally valid judgments of all targets. The present study uses social network analysis to investigate factors associated with reliability and validity in peer assessment. Participants were groups of military recruits (N = 809) who acted as both targets and judges in a round-robin design. Participants completed self- and informant versions of the Multisource Assessment of Personality Pathology. Social network matrices were constructed based on reported acquaintance, and cohesive subgroups were identified. Judges who shared a mutual subgroup were more reliable and had higher self-peer agreement than those who did not. Partitioning networks into two subgroups achieved more consistent improvements than multiple subgroups. We discuss implications for multiple informant assessments. PMID:17760855

  20. Neurocognitive models of aggression, the antisocial personality disorders, and psychopathy

    PubMed Central

    Blair, R

    2001-01-01

    This paper considers neurocognitive models of aggression and relates them to explanations of the antisocial personality disorders. Two forms of aggression are distinguished: reactive aggression elicited in response to frustration/threat and goal directed, instrumental aggression. It is argued that different forms of neurocognitive model are necessary to explain the emergence of these different forms of aggression. Impairments in executive emotional systems (the somatic marker system or the social response reversal system) are related to reactive aggression shown by patients with "acquired sociopathy" due to orbitofrontal cortex lesions. Impairment in the capacity to form associations between emotional unconditioned stimuli, particularly distress cues, and conditioned stimuli (the violence inhibition mechanism model) is related to the instrumental aggression shown by persons with developmental psychopathy.

 PMID:11723191

  1. 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

  2. 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.

  3. Assessing aggression in persons with autism spectrum disorders: an overview.

    PubMed

    Matson, Johnny L; Cervantes, Paige E

    2014-12-01

    Aggression is a commonly co-occurring problem with autism spectrum disorders (ASD). Comorbid aggression can be every bit as debilitating as core symptoms of ASD itself. As a result, careful identification of aggression, the context in which it occurs, and factors that maintain the behavior all have important implications for treatment. As a result, researchers have begun to develop methods and measures to assess aggression among persons with ASD. The purpose of this paper was to review measures that have been used to assess aggression among persons with ASD. We located 25 different assessment methods for both children and adults. The current status and future directions of this area of research are discussed.

  4. Identifying Latent Trajectories of Personality Disorder Symptom Change: Growth Mixture Modeling in the Longitudinal Study of Personality Disorders

    PubMed Central

    Hallquist, Michael N.; Lenzenweger, Mark F.

    2013-01-01

    Although previous reports have documented mean-level declines in personality disorder (PD) symptoms over time, little is known about whether personality pathology sometimes emerges among nonsymptomatic adults, or whether rates of change differ qualitatively among symptomatic persons. Our study sought to characterize heterogeneity in the longitudinal course of PD symptoms with the goal of testing for and describing latent trajectories. Participants were 250 young adults selected into two groups using a PD screening measure: those who met diagnostic criteria for a DSM-III-R PD (PPD, n = 129), and those with few PD symptoms (NoPD, n = 121). PD symptoms were assessed three times over a four-year study using semistructured interviews. Total PD symptom counts and symptoms of each DSM-III-R PD were analyzed using growth mixture modeling. In the NoPD group, latent trajectories were characterized by stable, minor symptoms; the rapid or gradual remission of subclinical symptoms; or the emergence of symptoms of Avoidant, Obsessive-Compulsive, or Paranoid PD. In the PPD group, three latent trajectories were evident: rapid symptom remission, slow symptom decline, or a relative absence of symptoms. Rapid remission of PD symptoms was associated with fewer comorbid disorders, lower negative emotionality, and greater positive emotionality and constraint, whereas emergent personality dysfunction was associated with comorbid PD symptoms and lower positive emotionality. In most cases, symptom change for one PD was associated with concomitant changes in other PDs, depressive symptoms, and anxiety. These results indicate that the longitudinal course of PD symptoms is heterogeneous, with distinct trajectories evident for both symptomatic and nonsymptomatic individuals. The prognosis of PD symptoms may be informed by an assessment of personality and comorbid psychopathology. PMID:23231459

  5. Identifying latent trajectories of personality disorder symptom change: growth mixture modeling in the longitudinal study of personality disorders.

    PubMed

    Hallquist, Michael N; Lenzenweger, Mark F

    2013-02-01

    Although previous reports have documented mean-level declines in personality disorder (PD) symptoms over time, little is known about whether personality pathology sometimes emerges among nonsymptomatic adults, or whether rates of change differ qualitatively among symptomatic persons. Our study sought to characterize heterogeneity in the longitudinal course of PD symptoms with the goal of testing for and describing latent trajectories. Participants were 250 young adults selected into two groups using a PD screening measure: those who met diagnostic criteria for a DSM-III-R PD (PPD, n = 129), and those with few PD symptoms (NoPD, n = 121). PD symptoms were assessed three times over a 4-year study using semistructured interviews. Total PD symptom counts and symptoms of each DSM-III-R PD were analyzed using growth mixture modeling. In the NoPD group, latent trajectories were characterized by stable, minor symptoms; the rapid or gradual remission of subclinical symptoms; or the emergence of symptoms of avoidant, obsessive-compulsive, or paranoid PD. In the PPD group, three latent trajectories were evident: rapid symptom remission, slow symptom decline, or a relative absence of symptoms. Rapid remission of PD symptoms was associated with fewer comorbid disorders, lower Negative Emotionality, and greater Positive Emotionality and Constraint, whereas emergent personality dysfunction was associated with comorbid PD symptoms and lower Positive Emotionality. In most cases, symptom change for one PD was associated with concomitant changes in other PDs, depressive symptoms, and anxiety. These results indicate that the longitudinal course of PD symptoms is heterogeneous, with distinct trajectories evident for both symptomatic and nonsymptomatic individuals. The prognosis of PD symptoms may be informed by an assessment of personality and comorbid psychopathology. PMID:23231459

  6. Identifying latent trajectories of personality disorder symptom change: growth mixture modeling in the longitudinal study of personality disorders.

    PubMed

    Hallquist, Michael N; Lenzenweger, Mark F

    2013-02-01

    Although previous reports have documented mean-level declines in personality disorder (PD) symptoms over time, little is known about whether personality pathology sometimes emerges among nonsymptomatic adults, or whether rates of change differ qualitatively among symptomatic persons. Our study sought to characterize heterogeneity in the longitudinal course of PD symptoms with the goal of testing for and describing latent trajectories. Participants were 250 young adults selected into two groups using a PD screening measure: those who met diagnostic criteria for a DSM-III-R PD (PPD, n = 129), and those with few PD symptoms (NoPD, n = 121). PD symptoms were assessed three times over a 4-year study using semistructured interviews. Total PD symptom counts and symptoms of each DSM-III-R PD were analyzed using growth mixture modeling. In the NoPD group, latent trajectories were characterized by stable, minor symptoms; the rapid or gradual remission of subclinical symptoms; or the emergence of symptoms of avoidant, obsessive-compulsive, or paranoid PD. In the PPD group, three latent trajectories were evident: rapid symptom remission, slow symptom decline, or a relative absence of symptoms. Rapid remission of PD symptoms was associated with fewer comorbid disorders, lower Negative Emotionality, and greater Positive Emotionality and Constraint, whereas emergent personality dysfunction was associated with comorbid PD symptoms and lower Positive Emotionality. In most cases, symptom change for one PD was associated with concomitant changes in other PDs, depressive symptoms, and anxiety. These results indicate that the longitudinal course of PD symptoms is heterogeneous, with distinct trajectories evident for both symptomatic and nonsymptomatic individuals. The prognosis of PD symptoms may be informed by an assessment of personality and comorbid psychopathology.

  7. Borderline personality disorder features predict negative outcomes 2 years later.

    PubMed

    Bagge, Courtney; Nickell, Angela; Stepp, Stephanie; Durrett, Christine; Jackson, Kristina; Trull, Timothy J

    2004-05-01

    In a sample of 351 young adults, the authors assessed whether borderline personality disorder (BPD) features prospectively predicted negative outcomes (poorer academic achievement and social maladjustment) over the subsequent 2 years, over and above gender and both Axis I and Axis II psychopathology. Borderline traits were significantly related to these outcomes, with impulsivity and affective instability the most highly associated. The present findings suggest that the impulsivity and affective instability associated with BPD leads to impairment in relating well with others, in meeting social role obligations, and in academic or occupational achievement. Therefore, these may be especially important features to target in interventions for BPD.

  8. A MRI study of fusiform gyrus in schizotypal personality disorder.

    PubMed

    Dickey, Chandlee C; McCarley, Robert W; Voglmaier, Martina M; Niznikiewicz, Margaret A; Seidman, Larry J; Frumin, Melissa; Toner, Sarah; Demeo, Susan; Shenton, Martha E

    2003-11-01

    The fusiform gyrus is important for face and object recognition, is abnormal in schizophrenia, but has not been studied in schizotypal personality disorder (SPD). Thin-slice MR images showed no differences, either in right, left or total fusiform gyri volumes, between subjects with SPD (N=21) and normal controls (N=19). However, there was a correlation between severity of illusions and magical thinking suffered by the SPD subjects and smaller right fusiform gyrus volumes. This suggests that future studies may be useful in determining the functional competence of this gyrus in SPD.

  9. Racism: a symptom of the narcissistic personality disorder.

    PubMed

    Bell, C C

    1980-07-01

    Despite the criticism that psychoanalytic models are not applicable to social phenomena, knowledge of the dynamics of narcissistic development aids in understanding a particular kind of racist individual. Specifically, racist attitudes may be indicative of a narcissistic personality disorder or of a regression to primitive narcissistic functioning secondary to environmental forces. The differentiation between the narcissistic racist, the stress-induced racist, and the socially misinformed racist is discussed utilizing clinical paradigms discovered in psychotherapy. Life experiences and religion are discussed as possible aids in the transformation of primary narcissism into secondary narcissism.

  10. The Neurobiological Basis of Adolescent-onset Borderline Personality Disorder

    PubMed Central

    Goodman, Marianne; Mascitelli, Kathryn; Triebwasser, Joseph

    2013-01-01

    Objective: Over the past two decades, neurobiological studies in adult onset borderline personality disorder have made important strides, but inquiry into adolescent-onset BPD is still in its infancy and our understanding of the neurobiology of adolescent BPD remains highly tentative. Methods: This paper highlights recent findings in genetics, neuroendocrinology and neuroimaging for adult and adolescent-onset BPD. Results: Neurobiological studies of adolescent-onset BPD to date have focused mainly on volumetric studies of various brain regions and measurements of HPA axis components, with comparatively few publications on brain functioning. Conclusion: Such information is essential to developing more effective screening, treatment and preventive strategies. PMID:23970910

  11. 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.

  12. Standardising antisocial personality disorder: the social shaping of a psychiatric technology.

    PubMed

    Pickersgill, Martyn

    2012-05-01

    The Diagnostic and Statistical Manual of Mental Disorders (DSM) is one of the most influential and controversial terminological standards ever produced. As such, it continues to provide a valuable case study for sociologists of health and illness. In this article I take as my focus one particular DSM category: antisocial personality disorder (ASPD). The analysis charts the shifting understandings of personality disorders associated with antisocial behaviour in the DSM and in US psychiatry more broadly from 1950 to the present day. Memos, letters and minutes produced by the DSM-III committee and held in the American Psychiatric Association (APA) archives ground the discussion. Finally, the article explores more recent constructions of antisocial personality disorder and examines the anticipatory discourse pertaining to the rewriting of this category expected in the forthcoming DSM-5. In presenting an in-depth socio-historical narrative of the development - and potential future - of standards for pathological antisociality, this analysis casts new light on the ASPD construct. In particular, by considering it as a technology, I elaborate how processes of path dependency constrain innovation and how imaginaries of users and publics are implicated in the APA debates constitutive of this.

  13. Preoccupied attachment and emotional dysregulation: specific aspects of borderline personality disorder or general dimensions of personality pathology?

    PubMed

    Scott, Lori N; Kim, Yookyung; Nolf, Kimberly A; Hallquist, Michael N; Wright, Aidan G C; Stepp, Stephanie D; Morse, Jennifer Q; Pilkonis, Paul A

    2013-08-01

    Emotional dysregulation and impaired attachment are seen by many clinical researchers as central aspects of borderline personality disorder (BPD). Alternatively, these constructs may represent general impairments in personality that are nonspecific to BPD. Using multitraitmultimethod models, the authors examined the strength of associations among preoccupied attachment, difficulties with emotion regulation, BPD features, and features of two other personality disorders (i.e., antisocial and avoidant) in a combined psychiatric outpatient and community sample of adults. Results suggested that preoccupied attachment and difficulties with emotion regulation shared strong positive associations with each other and with each of the selected personality disorders. However, preoccupied attachment and emotional dysregulation were more strongly related to BPD features than to features of other personality disorders. Findings suggest that although impairments in relational and emotional domains may underlie personality pathology in general, preoccupied attachment and emotional dysregulation also have specificity for understanding core difficulties in those with BPD.

  14. 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

  15. 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

  16. Pathological personality traits can capture DSM-IV personality disorder types.

    PubMed

    Miller, Joshua D; Few, Lauren R; Lynam, Donald R; MacKillop, James

    2015-01-01

    The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) includes an alternative diagnostic approach to the assessment of personality disorders (PDs) in Section III with the aim of stimulating further research. Diagnosis of a PD using this approach is predicated on the presence of personality impairment and pathological personality traits. The types of traits present (e.g., callousness vs. emotional lability) are used to derive DSM-IV PD scores. Concerns have been raised, however, that such a trait-based approach will yield PD constructs that differ substantially from those generated using the approaches articulated in previous iterations of the DSM. We empirically examined this issue in a sample of 109 adults who were currently receiving mental health treatment. More specifically, we examined the correlations between interview-based PD scores derived from DSM-IV to DSM-5 PD trait counts, and tested them in relation to the 30 specific facets of the five-factor model, as well as internalizing and externalizing symptoms. Overall, the DSM-IV PD scores and DSM-5 PD trait counts correlated significantly with one another (Mr = .63), demonstrated similar patterns of interrelations among the PDs, and manifested highly similar patterns of correlations with general personality traits and symptoms of psychopathology. These results indicate that the DSM-5 PD trait counts specified in the alternative DSM-5 PD diagnostic approach capture the same constructs as those measured using the more traditional DSM-IV diagnostic system.

  17. Personality disorder traits associated with risk for unipolar depression during middle adulthood.

    PubMed

    Johnson, Jeffrey G; Cohen, Patricia; Kasen, Stephanie; Brook, Judith S

    2005-09-15

    Data from the Children in the Community Study, a prospective longitudinal investigation, were used to investigate the association of personality disorder (PD) traits, evident by early adulthood, with risk for the development of unipolar depressive disorders by middle adulthood. Antisocial, borderline, dependent, depressive, histrionic, and schizotypal PD traits, identified between ages 14 and 22, were significantly associated with risk for dysthymic disorder (DD) or major depressive disorder (MDD) by a mean age of 33 after a history of unipolar depression and other psychiatric disorder was controlled statistically. Individuals without a history of unipolar depression who met diagnostic criteria for > or =1 PD by a mean age of 22 were at elevated risk for DD or MDD by a mean age of 33 years. Individuals identified as having a DSM-IV Cluster A (paranoid, schizoid, or schizotypal) or Cluster C (avoidant, dependent, obsessive-compulsive) PD by a mean age of 22 years were at elevated risk for recurrent or chronic unipolar depression. The findings of this study suggest that some types of PD traits that become evident by early adulthood may contribute to an increased risk for the development or recurrence of unipolar depressive disorders by middle adulthood.

  18. Locally Dependent Linear Logistic Test Model with Person Covariates

    ERIC Educational Resources Information Center

    Ip, Edward H.; Smits, Dirk J. M.; De Boeck, Paul

    2009-01-01

    The article proposes a family of item-response models that allow the separate and independent specification of three orthogonal components: item attribute, person covariate, and local item dependence. Special interest lies in extending the linear logistic test model, which is commonly used to measure item attributes, to tests with embedded item…

  19. 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.

  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. 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

  2. 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

  3. Disgust and implicit self-concept in women with borderline personality disorder and posttraumatic stress disorder.

    PubMed

    Rüsch, Nicolas; Schulz, Daniela; Valerius, Gabi; Steil, Regina; Bohus, Martin; Schmahl, Christian

    2011-08-01

    Disgust may be a key emotion and target for psychotherapeutic interventions in borderline personality disorder (BPD) and posttraumatic stress disorder (PTSD) at explicit and implicit-automatic levels. However, automatically activated disgust reactions in individuals with these disorders have not been studied. Disgust and its correlation with childhood abuse were assessed in women with BPD, but without PTSD; women with PTSD, but without BPD; women with BPD and PTSD; and healthy women. Disgust sensitivity, anxiety and depression were measured by self-report. Implicit disgust-prone (relative to anxiety-prone) self-concept was assessed using the Implicit Association Test. Women with BPD and/or PTSD reported more disgust sensitivity than controls. The implicit self-concept among patients was more disgust-prone (relative to anxiety-prone) than in controls. Women with BPD, with PTSD, or BPD and PTSD did not differ significantly in self-reported disgust levels or implicit disgust-related self-concept. Among women with BPD and/or PTSD, current psychiatric comorbidity (major depression, anxiety disorder, eating disorder, or substance-related disorder) did not affect disgust-related variables. More severe physical abuse in childhood was associated with a more anxiety-prone (less disgust-prone) implicit self-concept. Independent of psychiatric comorbidity, disgust appears to be elevated at implicit and explicit levels in trauma-related disorders. Psychotherapeutic approaches to address disgust should take implicit processes into account.

  4. [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

  5. [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.

  6. Taxonomic implications of three prospective studies on the course and outcome of personality disorders.

    PubMed

    Verheul, Roel

    2005-10-01

    The Children in the Community (CIC) Study (Cohen, Crawford, Johnson, & Kasen, this issue), the McLean Study of Adult Development (MSAD; Zanarini, Frankenburg, Hennen, Reich, & Silk, this issue), and the Collaborative Longitudinal Personality Disorders Study (CLPS; Skodol et al., this issue) are three large prospective studies on the course and outcome of psychiatric disorders, borderline personality disorder, and personality disorders, respectively. These studies, involving approximately 2,000 subjects, have yielded an enormous amount of scientifically and clinically relevant information. In this commentary, I primarily aim to discuss the implications for future revisions to the DSM classification of personality disorders.

  7. [Group psychotherapy of neuroses and personality disorders in regular soldiers].

    PubMed

    Araszkiewicz, A; Florkowski, A; Lucki, Z

    1994-01-01

    Environmental conditions cause neuroses and symptoms of personality disorders in regular soldiers. Military service in highly formalized and hierarchical conditions makes it impossible to: express emotions (particularly negative ones), to arrange one's own time, to choose the position and place of work. Another important psychotraumatic factor is excessive load of work and responsibility for the sake of "the service". Psychotherapy is the main part of neurotic and personality disorder therapy in regular soldiers. The social context is the bass for theoretical assumptions of psychotherapy carried out by the authors. Based on the theory of learning, the aims of the applied psychotherapy are: eagerness for the elimination of symptoms and changing the mode of behaviour. Group psychotherapy is carried out in stationary conditions, in groups of 8 to 13 patients, for 8-9 weeks. The applied methods are: debating psychotherapy, interaction-communicative methods, psychodrawing, musicotherapy, choreotherapy and relaxation techniques. As the result of the therapy, about 89% of symptomatic improvement and about 81% of the change of attitude and behaviour were obtained.

  8. 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

  9. 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

  10. The narcissistic personality disorder and the differential diagnosis of antisocial behavior.

    PubMed

    Kernberg, O F

    1989-09-01

    This article describes a dimension of antisocial behavior that links the narcissistic personality disorder with the antisocial personality disorder, with the syndrome of malignant narcissism as intermediate between the two. Starting with a critique of the DSM-III-R description of the antisocial personality disorder, the author reviews some salient contributions to the concept of the antisocial personality disorder derived from descriptive, sociologic, and psychoanalytic viewpoints. Cleckley's classic description forms the historical background for an updated description of the key characteristics of the antisocial personality disorder. What follows is a summary of the differential diagnosis of antisocial behavior as found in the antisocial personality disorder, the syndrome of malignant narcissism, the narcissistic personality disorders with antisocial behaviors, other severe personality disorders with antisocial features, neurotic personality disorders with antisocial features, symptomatic neuroses, and, finally, dissocial reactions. Prognostic and therapeutic considerations regarding the treatment of antisocial behavior are briefly summarized in the light of this differential diagnosis. A final section describes the psychodynamics of the syndrome of malignant narcissism and of the antisocial personality disorder.

  11. Social phobia and avoidant personality disorder: similar but different?

    PubMed

    Lampe, Lisa; Sunderland, Matthew

    2015-02-01

    Avoidant personality disorder (AvPD) is regarded as a severe variant of social phobia (SP), consistent with a dimensional model. However, these conclusions are largely drawn from studies based on individuals with SP, with or without comorbid AvPD. The present study hypothesized that there are qualitative differences between AvPD and SP that are undermined by limiting research to participants with SP. The authors sought to test this hypothesis by comparing three groups-SP only, AvPD only, and SP+AvPD-using data extracted from an epidemiological sample of 10,641 adults aged 18 years and over. Screening questions were used in the epidemiological survey to identify ICD-10 personality disorders; from this the author developed a proxy measure for DSM-IV AvPD. Axis I diagnoses, including DSM-IV SP, were identified using the Composite International Diagnostic Interview (CIDI). In this sample, the majority of those with AvPD did not also have SP: The authors found 116 persons with AvPD only, 196 with SP only, and 69 with SP+AvPD. There was little difference between any of the groups on sex, marital status, employment, education, or impairment variables. The SP+AvPD group reported more distress and comorbidity than the SP only and AvPD only groups, which did not differentiate from each other. More feared social situations were endorsed in the SP only group compared to the AvPD only group. Although the finding of few differences between SP only and AvPD only groups among the variables measured in this epidemiological survey fails to provide support for the hypothesis of qualitative differences, the finding that the AvPD only group appears more similar to the SP only group than to the SP+AvPD group also fails to provide support for the alternative continuity hypothesis. The greater distress and additional comorbidity with depression associated with SP+AvPD may be due to the additional symptom load of a second disorder rather than simply representing a more severe variant of

  12. 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…

  13. 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…

  14. 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…

  15. Exploring sleep disturbances in adolescent borderline personality disorder using actigraphy: a case report.

    PubMed

    Guilé, Jean Marc; Huynh, Christophe; Desrosiers, Lyne; Bouvier, Hélène; MacKay, Jacques; Chevrier, Elyse; Godbout, Roger; Breton, Jean-Jacques

    2009-01-01

    Actigraphy has been used in clinical pediatric populations for many years, including attention deficit-hyperactivity disorder and mood disorders to characterize circadian rhythms of motor activity, and as an alternative evaluation of sleep patterns. We present a case of an adolescent presenting with borderline personality disorder (BPD) and substance dependence for whom an investigation of sleep patterns using actigraphy and a sleep diary appeared to be useful in managing the case. Actigraphy contributed to the diagnostic clarification and disconfirmed the relevance of prescribing medication to this patient for sleep problems. Actigraphy is a cost-effective measure to evaluate sleep/wake patterns allowing for several-day-periods of observation. From the patient standpoint, actigraphy is less invasive than more in-depth investigation as polysomnography. Actigraphy might be a promising tool in those clinical occurrences when disentangling sleep disturbances from primary diagnosis or substance use is required.

  16. 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.

  17. Perceptual biases in facial emotion recognition in borderline personality disorder.

    PubMed

    Daros, Alexander R; Uliaszek, Amanda A; Ruocco, Anthony C

    2014-01-01

    Individuals with borderline personality disorder (BPD) have biases in facial emotion recognition, which may underlie many of the core features of this disorder. Although they are known to misperceive specific prototypic expressions of emotion (i.e., those displayed at full emotional intensity), patients with this disorder may also show biases in their perceptions of emotions that are expressed at lower levels of emotional intensity. Females with BPD (n = 31) and IQ- and demographically matched nonpsychiatric controls (n = 28) completed a task assessing the recognition of neutral as well as happy and sad facial expressions at mild, moderate, and prototypic emotional intensities. Whereas patients with BPD were more likely than controls to ascribe an emotion to a neutral facial expression, they did not consistently attribute a more negative or positive valence to these faces as compared with controls. Patients were also more likely to perceive mildly sad facial expressions as more intensely sad, and this finding could not be attributed to depressed mood. The results of this study suggest that perceptions of even subtle expressions of negative affect in faces may be subjectively magnified by individuals with BPD, although there was no consistent evidence for a negative perceptual bias for faces displaying a neutral expression. These biases in facial emotion perception for patients with BPD may contribute to difficulties understanding others' emotional states and to problems engaging effectively in social interactions.

  18. [Personality changes in opioid-dependent subjects in a methadone maintenance treatment program].

    PubMed

    Trémeau, F; Darreye, A; Leroy, B; Renckly, V; Ertlé, S; Weibel, H; Khidichian, F; Macher, J-P

    2003-01-01

    Personality disorders and particularly antisocial personality disorders (APD) are quite frequent in opioid-dependent subjects. They show various personality traits: high neuroticism, high impulsivity, higher extraversion than the general population. Previous studies have reported that some but not all personality traits improved with treatment. In a previous study, we found a low rate of APD in a French population of opioid-dependent subjects. For this reason, we evaluated personality traits at intake and during maintenance treatment with methadone. Methods - The form A of the Eysenck Personality Inventory (EPI) was given to opioid addicts at intake and after 6 and 12 months of methadone treatment. Results - 134 subjects (96 males and 38 females) took the test at intake, 60 completed 12 months of treatment. After 12 months, the EPI Neuroticism (N) and the Extraversion-introversion (E) scale scores decreased significantly. The N score improved in the first 6 months, while the E score improved only during the second 6 months of treatment. Compared to a reference group of French normal controls, male and female opioid addicts showed high N and E scores. Demographic data and EPI scores of patients who stayed in treatment for 12 months did not differ significantly from those of dropouts (n=23). Patients with a history of suicide attempts (SA) started to use heroin at an earlier age and they showed a higher E score and a tendency for a higher N score at intake. Discussion - The two personality dimensions of the EPI changed during MMT, and the N score converged towards the score of normal controls. Opioid addicts differ from normal controls mostly in their N score. The EPI did not help to differentiate 12-month completers from dropouts. Higher E scores in patients with an SA history might reflect a higher impulsivity, which has been linked to suicidality in other patient groups.

  19. The validity of the Personality Diagnostic Questionnaire-4 Narcissistic Personality Disorder scale for assessing pathological grandiosity.

    PubMed

    Hopwood, Christopher J; Donnellan, M Brent; Ackerman, Robert A; Thomas, Katherine M; Morey, Leslie C; Skodol, Andrew E

    2013-01-01

    Although controversy surrounds the definition and measurement of narcissism, the claim that pathological grandiosity is central to the construct generates little disagreement. Yet representations of pathological grandiosity vary across measures of narcissism, leading to conceptual confusion in the literature. The validity of a DSM-based measure of pathological narcissism, the Personality Diagnostic Questionnaire-4 Narcissistic Personality Disorder scale (PDQ-4 NPD), was evaluated in 1 clinical and 3 nonclinical samples (total N=2,391) for its ability to measure pathological grandiosity. Findings were generally supportive: average scores were higher in the clinical than nonclinical samples and the PDQ-4 NPD scale correlated most strongly with (a) other measures of NPD; (b) other DSM Cluster B personality disorders; (c) traits involving antagonism, hostility, and assertiveness; and (d) interpersonal distress and disaffiliative dominance. However, the low internal consistency of the PDQ-4 NPD scale and unexpected associations with Cluster A and obsessive-compulsive features point to potential psychometric weaknesses with this instrument. These findings are useful for evaluating the PDQ-4 NPD scale and for informing ongoing debates regarding how to define and assess pathological narcissism.

  20. The validity of the Personality Diagnostic Questionnaire-4 Narcissistic Personality Disorder scale for assessing pathological grandiosity.

    PubMed

    Hopwood, Christopher J; Donnellan, M Brent; Ackerman, Robert A; Thomas, Katherine M; Morey, Leslie C; Skodol, Andrew E

    2013-01-01

    Although controversy surrounds the definition and measurement of narcissism, the claim that pathological grandiosity is central to the construct generates little disagreement. Yet representations of pathological grandiosity vary across measures of narcissism, leading to conceptual confusion in the literature. The validity of a DSM-based measure of pathological narcissism, the Personality Diagnostic Questionnaire-4 Narcissistic Personality Disorder scale (PDQ-4 NPD), was evaluated in 1 clinical and 3 nonclinical samples (total N=2,391) for its ability to measure pathological grandiosity. Findings were generally supportive: average scores were higher in the clinical than nonclinical samples and the PDQ-4 NPD scale correlated most strongly with (a) other measures of NPD; (b) other DSM Cluster B personality disorders; (c) traits involving antagonism, hostility, and assertiveness; and (d) interpersonal distress and disaffiliative dominance. However, the low internal consistency of the PDQ-4 NPD scale and unexpected associations with Cluster A and obsessive-compulsive features point to potential psychometric weaknesses with this instrument. These findings are useful for evaluating the PDQ-4 NPD scale and for informing ongoing debates regarding how to define and assess pathological narcissism. PMID:23101760

  1. 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

  2. Development of Antisocial Personality Disorder in Detained Youth: The Predictive Value of Mental Disorders

    PubMed Central

    Washburn, Jason J.; Romero, Erin Gregory; Welty, Leah J.; Abram, Karen M.; Teplin, Linda A.; McClelland, Gary M.; Paskar, Leah D.

    2009-01-01

    Antisocial personality disorder (APD) is a serious public and mental health concern. Understanding how well conduct disorder (CD) and other mental disorders predict the development of APD among youth involved in the juvenile justice system is critical for prevention. This study used a stratified random sample of 1112 detained youth to examine the development of APD at a three-year follow-up interview. Nearly one fifth of male juvenile detainees later developed APD; approximately one quarter of male juvenile detainees with CD at baseline later developed APD. Significantly more males than females developed APD; no differences were found by race/ethnicity. Having five or more symptoms of CD, dysthymia, alcohol use disorder, or generalized anxiety disorder was significantly associated with developing modified APD (M-APD; APD without the CD requirement). Some disorders were strong predictors of APD; however, none were adequate screeners for identifying which detainees would later develop M-APD. The findings of this study have implications for interventions and further research in developmental psychopathology. PMID:17469880

  3. 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.

  4. Alcohol dependence as a chronic pain disorder

    PubMed Central

    Egli, Mark; Koob, George F.; Edwards, Scott

    2013-01-01

    Dysregulation of pain neurocircuitry and neurochemistry has been increasingly recognized as playing a critical role in a diverse spectrum of diseases including migraine, fibromyalgia, depression, and PTSD. Evidence presented here supports the hypothesis that alcohol dependence is among the pathologies arising from aberrant neurobiological substrates of pain. In this review, we explore the possible influence of alcohol analgesia and hyperalgesia in promoting alcohol misuse and dependence. We examine evidence that neuroanatomical sites involved in the negative emotional states of alcohol dependence also play an important role in pain transmission and may be functionally altered under chronic pain conditions. We also consider possible genetic links between pain transmission and alcohol dependence. We propose an allostatic load model in which episodes of alcohol intoxication and withdrawal, traumatic stressors, and injury are each capable of dysregulating an overlapping set of neural substrates to engender sensory and affective pain states that are integral to alcohol dependence and comorbid conditions such as anxiety, depression, and chronic pain. PMID:22975446

  5. 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

  6. 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

  7. Lifelong eccentricity and social isolation. II: Asperger's syndrome or schizoid personality disorder?

    PubMed

    Tantam, D

    1988-12-01

    Several scales are described for measuring aspects of eccentricity and social isolation; in particular, for assessing schizoid and schizotypal personality and for rating abnormal non-verbal expression. The latter is shown to be reliable, and the former to have a measure of validity. There was an association between schizoid personality traits and abnormalities of speech and non-verbal expression. However, abnormal non-verbal expression, but not schizoid personality traits or DSM-III schizotypal personality disorder, was particularly likely to occur in those subjects who had evidence of neurological deficit, and childhood symptoms indicative of developmental disorder. Abnormal non-verbal expression, but not personality disorder, was also associated with other characteristic features of Asperger's syndrome, such as unusual, 'special' interests. It is suggested that Asperger's syndrome is a distinct syndrome from either schizoid or schizotypal personality disorder, but may be a risk factor for the development of schizoid personality disorder.

  8. Associations Between Changes in Normal Personality Traits and Borderline Personality Disorder Symptoms over 16 years

    PubMed Central

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

    2014-01-01

    There has been significant movement toward conceptualizing borderline personality disorder (BPD) with normal personality traits. However one critical assumption underlying this transition, that longitudinal trajectories of BPD symptoms and normal traits track together, has not been tested. We evaluated the prospective longitudinal associations of changes in five-factor model traits and BPD symptoms over the course of 16 years using parallel process latent growth curve models in 362 patients with BPD (N=290) or other PDs (N=72). Moderate to strong cross-sectional and longitudinal associations were observed between BPD symptoms and Neuroticism, Extraversion, Agreeableness, and Conscientiousness. This study is the first to demonstrate a longitudinal link between changes in BPD symptoms and changes in traits over an extended interval in a clinical sample. These findings imply that changes in BPD symptoms occur in concert with changes in normal traits, and support the proposed transition to conceptualizing BPD, at least in part, with trait dimensions. PMID:25364942

  9. 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

  10. 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

  11. 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

  12. Substance use disorders and Cluster B personality disorders: physiological, cognitive, and environmental correlates in a college sample.

    PubMed

    Taylor, Jeanette

    2005-01-01

    Substance use disorders (SUDs) and Cluster B personality disorders (PDs) are both marked by impulsivity and poor behavioral control and may result in part from shared neurobiological or executive cognitive functioning deficits. To examine the potential utility of such models in explaining variance in SUDs and PDs at the lower end of symptom expression and impairment, 123 (73 female) volunteer college students were administered 2 measures of executive cognitive functioning; a task assessing autonomic reactivity to aversive noise blasts; a life events and a peer substance use measure; and structured clinical interviews to assess symptoms of substance abuse/dependence and antisocial, borderline, histrionic, and narcissistic PDs. As expected, symptoms of SUDs and PDs were significantly positively correlated. Antisocial PD, alcohol and cannabis use disorder symptoms were significantly positively related to proportion of friends who use alcohol and drugs regularly and drug use among romantic partners. Number of negative life events was positively related to PD symptoms and to alcohol use disorder symptoms. Executive cognitive functioning was not related to SUD and PD symptoms in the expected direction. Findings suggest that, among higher functioning young adults, environmental factors may be particularly relevant to our understanding of SUDs and certain PDs.

  13. 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…

  14. 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

  15. 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

  16. 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.

  17. Why do people with eating disorders drop out from inpatient treatment?: the role of personality factors.

    PubMed

    Pham-Scottez, Alexandra; Huas, Caroline; Perez-Diaz, Fernando; Nordon, Clémentine; Divac, Snezana; Dardennes, Roland; Speranza, Mario; Rouillon, Frédéric

    2012-09-01

    Dropout rates from inpatient treatment for eating disorders are very high and have a negative impact on outcome. The purpose of this study was to identify personality factors predictive of dropout from hospitalization. A total of 64 adult patients with anorexia nervosa consecutively hospitalized in a specialized unit were included; 19 patients dropped out. The dropout group and the completer group were compared for demographic variables, clinical features, personality dimensions, and personality disorders. There was no link between clinical features and dropout, and among demographic variables, only age was associated with dropout. Personality factors, comorbidity with a personality disorder and Self-transcendence dimension, were statistically predictive of premature termination of hospitalization. In a multivariate model, these two factors remain significant. Personality traits (Temperament and Character Inventory personality dimension and comorbid personality disorder) are significantly associated with dropout from inpatient treatment for anorexia nervosa. Implications for clinical practice, to diminish the dropout rate, will be discussed.

  18. Associations between Antisocial Personality Disorder and Sex on Discounting Rates.

    PubMed

    Andrade, Leonardo F; Riven, Levi; Petry, Nancy M

    2014-12-01

    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.

  19. 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

  20. Defense Mechanisms in Adolescence as Predictors of Adult Personality Disorders.

    PubMed

    Strandholm, Thea; Kiviruusu, Olli; Karlsson, Linnea; Miettunen, Jouko; Marttunen, Mauri

    2016-05-01

    Our study examines whether defense styles and separate defenses in depressed adolescent outpatients predict adult personality disorders (PDs). We obtained data from consecutive adolescent outpatients who participated in the Adolescent Depression Study at baseline and at the 8-year follow-up (N = 140). Defense styles were divided into mature, neurotic, image-distorting, and immature and a secondary set of analyses were made with separate defenses as predictors of a PD diagnosis. Neurotic, image-distorting, and immature defense styles in adolescence were associated with adulthood PDs. Neurotic defense style associated with cluster B diagnosis and image-distorting defense style associated with cluster A diagnosis. Separate defenses of displacement, isolation, and reaction formation were independent predictors of adult PD diagnosis even after adjusting for PD diagnosis in adolescence. Defense styles and separate defenses predict later PDs and could be used in the focusing of treatment interventions for adolescents.