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The authors offer their theory that multiple personality represents a "special instance" of borderline personality disorder, that the introjects are composed of a representation of the self, a representation of the object, and an affective bond.
The diagnostic criteria for BPD such as the DSM-III(-R) and DCR, based on polythetic format for prototypal categories, has not always been able to result in accurate clinical diagnosis of BPD. Reasons posited for this were that DSM-III(-R) criteria consist of symptom items based on descriptive phenomenology, even for Axis II personality diagnosis, and that descriptions of the criteria were vague because of the standardization of vocabulary which aimed at improved inter-rater reliability. With the polythetic "yes/no" format, diagnosis was influenced by the determination of only one item; furthermore, different combinations of items yielding a heterogeneous membership might lead to the same diagnosis. It was, therefore, considered difficult to perform an accurate diagnosis of BPD in clinical practices using the existing general diagnostic criteria, and it was realized that the development of new diagnostic criteria for BPD was necessary. For those reasons, we generated a Clinical BPD Scale (CBS) as diagnostic evaluation scale of BPD with considering advantages for clinical use. This reconstituted some features of BPD which have been reported by many researchers, synthesizing symptomatic elements and personality structural elements. CBS is composed of four clusters, Two of these four clusters are evaluated by four grade anchor points which are provided for the rating of the severity of symptoms, and that are illustrated on the radarchart for comprehensive evaluation of the severity of the disorder. CBS was confirmed to have a high degree of validity, and achieved a satisfactory degree of inter-rater reliability by ANOVA ICC, and it has been found in application of CBS to several cases in the clinical practice that the degree of severity of each symptom could be clarified and differential diagnosis was possible with this diagnostic scale. Furthermore, the outcome of treatment could be confirmed at any time during the clinical follow up. In addition, through the dimensions, it is possible to grasp the severity, and further, through spectrum and hierarchy. We considered diagnostic area of BPD and its position by CBS correlating the other closely related disorders.
This article covers developments occurring from the beginning of October 1991 to the end of September 1992. During this period, the federal government considered the issues of health care rationing, the medical rights of residents in long-term care facilities, and advance directives. The federal courts decided cases involving section 504 and its application to medical treatment decisions, the due process rights of persons needing medical care, and the liberty to accept or refuse medical treatment. The states continued to consider legislation on advance directives and surrogate decision making. Numerous state courts heard cases involving such issues as the removal of life-sustaining treatment from never-competent persons, the definitions of living human being and personhood with respect to individuals with substantial disabilities, and the legalization of lethal injections and assisted suicide.
Premorbid personalities are studied in 65 monopolar endogennous depressives (ICD-Nos. 296.0, 296.2) and in 45 bipolar depressives (ICD-No. 296.3) by a retrospective self-rating evaluation after recovery. The instruments used are two questionnaires of v. Zerssen, especially constructed for that purpose, along with the AUPI questionnaire, which is based on Eysenck's system of personality description. The two groups are compared according to each test scale. Significant differences result in two of the scales. Monopolar depressives score higher than bipolars in the scale representing Tellenbach's "melancholic type". This can be described with terms such as orderly, strenous, and conscientious. Bipolars show more extroversion than monopolars. None of the patients' groups can be distinguished fr-m the normal population in any of the AUPI scales (extroversion, neuroticism, and psychoticism).
A comparison of the Minnesota Multiphasic Personality Inventory profiles of 21 men and 17 women who had amyotrophic lateral sclerosis (ALS) with the profiles of 50,500 general medical patients showed no marked deviations. The validating scales of the men and the women were similar to those of the general medical population. There was no evidence of increased defensiveness in the group with ALS, as measured by either the L or the K scale, when compared with the general medical population. Individual patient interviews also showed no characteristic personality profile for ALS patients.
The purpose of this study was to investigate the individual and social determinants of rural nurses' willingness to care for people with AIDS (PWAs). Willingness to care was viewed as a function of nurses' personal attitudes about AIDS care and PWAs; the influence of normative (significant others), comparative (the nursing profession), and generalized (the rural community) reference group norms on these attitudes; and how much importance respondents placed on membership in these reference groups. Responses to a mailed questionnaire from 615 rural nurses were analyzed. Individual determinants were nurses' feelings of preparedness and favorable attitudes about their personal safety when administering care. Social determinants were the degree of upset of respondents' significant others about their caring for AIDS patients and favorable attitudes of the respondents about professional and social concerns related to AIDS.
A group of overweight persons who achieved a substantial weight loss over a 6-month period were compared with a group of overweight persons who showed an unsubstantial weight change and a normal weight control group. All groups were evaluated before the weight program began and at a 6-month follow-up. The substantial weight loss group showed a number of significant changes after weight reduction. Body image rating shifted in the direction of evaluating onself as less heavy, eating was rated as less good and more heavy, and a greater feeling of self-control was indicated. Over time, the change group learned to limit the number of emotional and environmental cues that were discriminative stimuli for eating behavior. There also were more frequent reports of eating in response to cues of hunger after substantial weight loss.
Studies of the personality of the pathological gambler have consisted primarily of case reports and findings on the MMPI. This article presents data on a sample of 70 pathological gamblers, 70 alcoholics in treatment, and 70 medical/surgical controls on the California Personality Inventory (CPI). Gamblers and alcoholics differed significantly from hospitalized controls on a number of scales, particularly on measures of socialization, ego control, and flexibility. Differences between the gamblers and alcoholics were few, with a trend for the alcoholics to be similar to the gamblers and intermediate between the other two groups. Implications for the treatment of the pathological gambler are discussed.
Using data gathered during nearly four years of field work among the Fulbe of Upper Volta and their ex-slaves the Riimaaybe, the author argues that the major differences between the dominant personality types of these two groups cannot be due to child rearing practices because those practices are identical. He then accounts for the differences by taking personality to the portrayal of one's sense of self and the latter to derive chiefly from perception of one's location in the social structure. The implications of this analysis are drawn upon to elucidate the reasons why it is so widely believed that parental practices are of crucial importance to character formation.
The Tridimensional Personality Questionnaire (TPQ) was tested in four subgroups of eating-disorder patients: anorectic-restrictors (AN-R), anorectic-bulimics (AN-B), normal weight bulimics (BN), and bulimics with a past history of anorexia (B-AN). Normal controls and patients were matched for gender and age. All subjects completed the Beck Depression Inventory (BDI) in addition to the TPQ. AN-Rs scored lower on the Novelty Seeking scale than the bulimic groups and controls, and the two normal weight bulimic groups had higher Novelty Seeking scores than the controls. On the Harm Avoidance scale, all eating disorder groups scored significantly higher than the control group. In addition, the AN-Rs scored lower than the AN-Bs and B-ANs. The Harm Avoidance scale and depression scores were positively correlated while the Reward Dependence scale and depression scores were negatively correlated. Differences between diagnostic groups on the Novelty Seeking and Persistence scales remained clearly significant when depression was partialled out. These results are discussed in terms of the Tridimensional Personality Questionnaire as a stable measure of traits with eating disorder subjects.
The principal aim of this study was to assess personal relatedness and attachment patterns in 12-month-old infants of mothers with borderline personality disorder (BPD). We also evaluated maternal intrusive insensitivity toward the infants in semistructured play. We videotaped 10 mother-infant dyads with borderline mothers and 22 dyads where the mothers were free from psychopathology, in three different settings: a modification of Winnicott's Set Situation in which infants faced an initially unresponsive ("still-face") stranger, who subsequently tried to engage the infant in a game of give and take; the Strange Situation of Ainsworth and Wittig; and a situation in which mothers were requested to teach their infants to play with miniature figures and a toy train. In relation to a set of a priori predictions, the results revealed significant group differences as follows: (a) compared with control infants, toward the stranger the infants of mothers with BPD showed lower levels of "availability for positive engagement," lower ratings of "behavior organization and mood state," and a lower proportion of interpersonally directed looks that were positive; (b) in the Strange Situation, a higher proportion (8 out of 10) of infants of borderline mothers were categorized as Disorganized; and (c) in play, mothers with BPD were rated as more "intrusively insensitive" toward their infants. The results are discussed in relation to hypotheses concerning the interpersonal relations of women with BPD, and possible implications for their infants' development.
The literature pertaining to the stability and course of personality disorders is briefly reviewed. Available data suggest that PD diagnoses demonstrate only moderate stability and that--although generally associated with a plethora of negative outcomes--they can show improvement over time. This paper highlights the pervasiveness of diagnostic co-occurrence and its implications for continued investigation of the question of PD stability. In addition to examining the stability (and outcome) of PDs, longitudinal studies need to consider continuities between diagnoses. The Collaborative Longitudinal Personality Disorder Study (CLPS) is described briefly vis-a-vis some of these major issues.
Models of Person X Situation influences on social behavior and judgement have invoked two distinct mechanisms: a personality disposition and a situational press. In this study we conceptualized both influences in terms of a single underlying mechanism, construct accessibility. We pitted the characteristic ways that individuals perceive others against situational influences on accessibility (i.e., contextual priming) and tracked over time the relative power of these competing influences on the outcome of an impression-formation task. Subjects possessed either a chronically accessible (chronics) or an inaccessible (nonchronics) construct for either outgoing or inconsiderate behavior. As predicted, as the delay since the priming event lengthened (from 15 to 180 s), chronics were progressively more likely to use the chronically accessible construct instead of the primed alternative construct to categorize an ambiguous target behavior, whereas nonchronics' relative use of the primed and alternative constructs did not change as a function of postpriming delay.
As part of the International Sexuality Description Project, 16,954 participants from 53 nations were administered an anonymous survey about experiences with romantic attraction. Mate poaching--romantically attracting someone who is already in a relationship--was most common in Southern Europe, South America, Western Europe, and Eastern Europe and was relatively infrequent in Africa, South/Southeast Asia, and East Asia. Evolutionary and social-role hypotheses received empirical support. Men were more likely than women to report having made and succumbed to short-term poaching across all regions, but differences between men and women were often smaller in more gender-egalitarian regions. People who try to steal another's mate possess similar personality traits across all regions, as do those who frequently receive and succumb to the poaching attempts by others. The authors conclude that human mate-poaching experiences are universally linked to sex, culture, and the robust influence of personal dispositions.
Intimate and personal care is a major area of support and provision for people with intellectual disability (ID), particularly those with profound and multiple ID. However, its management and practice has largely been neglected outside the use of individual guidelines and same-gender intimate care policies, with little research evidence or theoretical literature to inform the planning, conduct and organization of associated care tasks. The present paper reports on the methodology and findings of an exploratory study designed to map the key management and practice issues, and suggest ways forward for the providers of services for people with ID in relation to the quality and outcomes of intimate and personal care.
For 2 weeks 40 volunteers received either 5 mg diazepam, t.i.d., or 10 mg chlordiazepoxide, t.i.d., and placebo. A choice reaction test, two coordination tests, and an attention test were administered to the subjects on the 14th day of each treatment. Thirty minutes before the tests, the subjects ingested either alcohol., 5g/kg or a placebo drink, incombination with the last capsule. After the test the subjects rated the quality of their treatment as placebo, tranquilizer, or stimulant. The psychological tests taken before the treatments were Eysenck's EPIC-NESI, Taylor's Manifest Anxiety Scale (MAS), and Cattell's 16 PF inventory. A multiple regression analysis was computed. Personality factor scores found to be associated with a strong effect of the benzodiazepines were 16 PF's A, C, L, N, and Q, and EPIC's E. The effect of alcohol was associated with a high score of 16 PFs B factor. Personality factors associated with "placebo reactors" and nonreactors were investigated, as well. Those subjects on placebo indicating their treatment to be active were classified as "placebo reactors". A discriminant analysis revealed that 16PF's O and I factors discriminated effectively "placebo reactors" from nonreactors, and EPIC's SE and 16 PF's L factor nonreactors from "reactors".
Conduct disorder (CD) and antisocial personality disorder (ASPD) are established risk factors for substance use disorders in both the general population and among persons with schizophrenia and other severe mental illnesses. Among clients with substance use disorders in the general population, CD and ASPD are associated with more severe problems and criminal justice involvement, but little research has examined their correlates in clients with dual disorders. To address this question, we compared the demographic, substance abuse, clinical, homelessness, sexual risk, and criminal justice characteristics of 178 dual disorder clients living in 2 urban areas between 4 groups: No CD/ASPD, CD Only, Adult ASPD Only, and Full ASPD. Clients in the Adult ASPD Only group tended to have the most severe drug abuse severity, the most extensive homelessness, and the most lifetime sexual partners, followed by the Full ASPD group, compared with the other 2 groups. However, clients with Full ASPD had the most criminal justice involvement, especially with respect to violent charges and convictions. The results suggest that a late-onset ASPD subtype may develop in clients with severe mental illness secondary to substance abuse, but that much criminal behavior in clients with dual disorders may be due to the early onset of the full ASPD syndrome in this population and not the effects of substance use disorders.
This article reviews prospective evidence linking certain classes of person variables to multiple disease end points. Included in the review is a consideration of the effects of hostility and anger, emotional suppression, depression, fatalism, and pessimism on coronary heart disease, cancer, and acquired immunodeficiency syndrome. A model is presented that integrates several of these variables into an overall conceptual scheme. In addition, several variables are identified that appear to moderate the strength of the relationships that are found between person variables and health. The article concludes with some suggested directions for future research.