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PubMed2001

Predicting DMS-IV cluster B personality disorder criteria from MMPI-2 and Rorschach data: a test of incremental validity.

Despite their frequent conjoint clinical use, the incremental validity of Rorschach (Rorschach, 1921/1942) and MMPI (Hathaway & McKinley, 1943) data has not been adequately established, nor has any study to date explored the incremental validity of these tests for predicting Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) personality disorders (PDs). In a reanalysis of existing data, we used select Rorschach variables and the MMPI PD scales to predict DSM-IV antisocial, borderline, histrionic, and narcissistic PD criteria in a sample of treatment-seeking outpatients. The correlational findings revealed alimited relation between Rorschach and MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) variables, with only 5 of 30 correlations reaching significance (p <.05). Hierarchical regression analyses showed that both the MMPI and Rorschach data add incrementally in the prediction of DSM-IV borderline and narcissistic PD total criteria scores. The findings were less clear for the incremental value of Rorschach and MMPI-2 data in predicting the total number of DSM-IV histrionic PD criteria, which were best predicted by Rorschach data, and antisocial PD criteria, which were best predicted by MMPI-2 data. In addition to providing evidence of the incremental validity of Rorschach data, these findings also shed light on the psychological characteristics of the DSM-IV Cluster B PDs.

Adult↗
PubMed1989

Personality characteristics of the mothers of children with disruptive behavior disorders.

The biological mothers of 100 outpatient children aged 6-13 years completed the Minnesota Multiphasic Personality Inventory (MMPI). Mothers of children given DSM-III diagnoses of conduct disorder (CD; n = 13) had significantly higher scores on MMPI scales associated with antisocial behavior (Pd and Ma), histrionic behavior (Hs and Hy), and disturbed adjustment (Sc). In contrast, the children's diagnosis of attention deficit disorder with hyperactivity (ADD/H; n = 22) was not significantly associated with any maternal MMPI elevations, and the CD x ADD/H interactions were not significant for any MMPI scale. These results indicate that CD is linked to maternal personality disorder, but ADD/H is not.

Adolescent↗
PubMed2005

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

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.

Adolescent↗
PubMed2005

Personality disorders in medical students: measuring by IPDE-10.

OBJECTIVES: The purpose of the present study was to investigate the personality disorders (PDs) of fifth year medical students of Chiang Mai University according to International Classification of Disease -10 (ICD-10) system by using IPDE-10. MATERIAL AND METHOD: A group of ninety-nine out of 150 of fifth-year medical students of Chiang Mai University undertook personality disorder inventory - International Personality Disorder Examination ICD-10 screening questionnaires (IPDE-ICD 10). Those who received diagnoses of personality disorders were subsequently interviewed by the authors to find definite diagnoses. RESULTS: The prevalence rate of PDs was 9%. The proportion of all PDs was as follows; 1%, 3%, 2%, 2%, and 1% for paranoid, impulsive, histrionic, anankastic, and dependent, respectively. The rate of probable diagnoses of PDs ranged from 1%-22.8%. CONCLUSION: The prevalence rate found in the medical students group did not differ from that in other populations. The benefit of ICD diagnosis system was discussed.

Adult↗
PubMed1993

Diagnosis of disruptive behavior disorders using the Millon Adolescent Personality Inventory.

Millon Adolescent Personality Inventory differential diagnosis of disruptive behavior disorder vs no behavior disorder was investigated. Results were twice cross-validated. Millon adolescent Scales 4, 5, 6, G, SS, and TT were closely related to diagnosis of behavior disorder. Two psychometric rules averaged 70% hits and 35% false positives over three samples, Rule 1 of > 2 elevations (baserate score > 63) among Scales 6-G-SS-TT and Rule 2 of Scale 4 elevated with Scale 5 or with one of 6-G-SS-TT. An ancillary rule was highly specific to behavior disorder (90%). Two broad dimensions or factors appeared to be represented in the key scales; Scales 4 and 5 exemplified a histrionic-narcissistic factor, while the 6-G-SS-TT combination typified behavioral conflict and instability.

Adolescent↗
PubMed2002

Assessment of dysfunctional beliefs in borderline personality disorder.

This study had two aims: to test the hypothesis that borderline personality disorder (BPD) patients hold numerous dysfunctional beliefs associated with a variety of Axis II disorders, and to construct a BPD belief scale which captures these beliefs. Beliefs were measured using the Personality Belief Questionnaire (PBQ) which is designed to assess beliefs associated with various personality disorders, although not specifically BPD. Eighty-four BPD patients and 204 patients with other personality disorders (OPD) were randomly split into two study samples. Fourteen PBQ items were found to discriminate BPD from OPD patients in both samples. These items came from the PBQ Dependent, Paranoid, Avoidant, and Histrionic scales and reflect themes of dependency, helplessness, distrust, fears of rejection/abandonment/losing emotional control, and extreme attention-seeking behavior. A BPD beliefs scale constructed from these items showed good internal consistency and diagnostic validity among the 288 study patients. The scale may be used to assist in diagnosis and cognitive therapy of BPD.

Adult↗
PubMed1994

[Prediction of somatization disorders in pre-pubertal girls].

Several studies of female adult populations suggest that somatization problems appear during adolescence and that they are related to behavioural problems during childhood. This study uses Cloninger's personality model to verify the link between personality traits and the beginning of somatization problems in elementary school girls. This model is based on the interaction of three dimensions: novelty seeking, harm avoidance and social reward dependence. Subjects were part of a longitudinal study of the social adjustment of children from Montreal and Val d'Or families. Evaluations of the girls' behaviour in kindergarten were used to establish personality types according to Cloninger's model. The somatization problems were assessed at age ten following interviews with mothers and girls, and ratings by mothers and teachers. The results showed that somatization problems at age ten were more likely when novelty seeking and harm avoidance were high in kindergarten. The kindergarten girls with 'passive-aggressive' or 'explosive-schizoid' personality profiles were more at risk of higher levels of somatization problems at age ten. However, Cloninger's hypothesized link between high levels of somatization problems and the 'histrionic' personality profile was not confirmed.

Adolescent↗
PubMed2001

A comparison of self-concept and personality disorders in women with pain accounted for by psychological factors, women with major depression, and healthy controls.

OBJECTIVE: Do patients with pain accounted for by psychological factors (P) differ in their self-concept and personality disorders from patients with major depression (D) and healthy controls (C)? METHOD: Thirty hospitalized P-patients (DSM-IV, 307.80) and 30 hospitalized D-Patients (DSM-III-R) were given the Beck Depression Inventory on admission (BDI-1) and at discharge (BDI-2). Together with BDI-2, patients filled out the Personality Disorder Questionnaire for DSM-III-R (PDQR) and the Frankfurt Self-Concept Scales (FSKN). Thirty-two healthy comparisons (C) completed the same questionnaires. RESULTS: BDI-2 showed no significant differences between groups P and D, a prerequisite for the comparison of psychological traits. PDQR differed in the three groups. D showed more dependent, obsessive-compulsive, and histrionic personality features than group P. The three groups differed in FSKN total score and all 10 subscales (C (healthiest self-concept) > P > D). Groups P and D were different (P > D) in total score and subscales: performance, problem coping, confidence in behavior and decision taking, and self-esteem. Ten P-patients with pathological BDI-2 (P(D)) had significantly more disturbed PDQR and FSKN scores than the non-depressed (P(ND)), and closely resembled the D-patients. CONCLUSIONS: Personality disorders and self-concept are not homogenous in female patients with P. Subgroup P(ND) differs from patients with depression (fewer personality disorders, better self-concept), whereas subgroup P(D) closely resembles them.

Major Depressive Disorder↗
PubMedDate not supplied

Comorbidity of axis I and axis II diagnoses in a sample of Egyptian patients with neurotic disorders.

Neurosis and personality disorder (PD) are two of the most used but least clarified and understood terms in psychiatry. The separation of PD by the American Psychiatric Association in DSM-III and -IV as a discrete axis of classification has been a major advance in psychiatric nosology. Also with the advent of DSM-III and its multiaxial system, it was recognized that both PD and clinical syndromes can coexist, and in some cases this coexistence may have implications on treatment response and prognosis. This study was performed on 200 neurotic patients in an attempt to investigate possible correlations between various neurotic subcategories and personality types. Our results confirm that PD and personality abnormality are significantly higher in neurotic patients than in controls and need to be considered in diagnostic assessment. Some comorbidity was shown between borderline PD and somatoform disorder; compulsive PD and obsessive-compulsive disorder (OCD), and generalized anxiety disorder (GAD); and avoidant PD and phobia. However, our data failed to show a correlation between the presence of an additional PD and particular neurotic symptomatology. It seems that the association between neurotic disorders and PD should not be taken to indicate a direct causative relationship. It is likely that personality is just one of the predisposing factors that influence the individual response to psychological trauma and determine the form of neurosis. The most prevalent PD was found to be PD NOS, followed by borderline, compulsive, avoidant, and finally histrionic PDs. The term, multiple PD, should be given substance to characterize the diagnosis as a disorder, rather than leaving it at its current status of what seems to be a nondistinct clinical picture. Extensive research has to be undertaken in an attempt to decide which specific PDs most deserve to be included in the official nomenclature.

Adult↗
PubMed2003

Twelve month test-retest reliability of a Japanese version of the Structured Clinical Interview for DSM-IV Personality Disorders.

The purpose of the present study was to examine the long-interval test-retest reliability of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM-IV) Axis II Personality Disorders (SCID-II) Japanese version. One hundred and twenty outpatients with anxiety disorders completed the self-report SCID-II personality questionnaire (SCID-II-PQ) and structured interviews, and then again 12 months later. In the SCID-II-PQ, 70.8% and 71.7% of the patients had a personality disorder (PD) at the first evaluation and second evaluation 12 months later, respectively, and Cohen's kappas ranged from 0.29 for paranoid PD to 0.83 for histrionic PD, and overall kappa was 0.56. In the SCID-II interviews, 47.5% and 41.7% of the patients fulfilled the criteria for PD at the first and the second evaluations, respectively. At least one PD was identified in 49 subjects (40.8%), of whom 65.3% had one PD, 30.6% had two PD, 2% had three PD, and 2% had four PD; the most frequently diagnosed PD were from cluster C (60.9%). The overall base rate of 12 PD was 7%, and overall kappa was 0.87. Cohen's kappas ranged from 0.86 for obsessive-compulsive PD to 0.93 for avoidant PD and schizoid PD, and were comparable with those in the previous interrater studies. The test-retest reliability of the SCID-II-PQ was moderately good, and after the SCID-II interview the test-retest reliability of the SCID-II appeared to be of almost perfect reliability. This first long-interval, large-sample, non-Western-language research on the test-retest reliability of the SCID-II for DSM-IV indicated its usefulness and excellent reliability.

Adult↗
PubMedDate not supplied

Personality traits associated with panic disorder: change associated with treatment.

Eighty-two subjects with panic disorder completed the Personality Diagnostic Questionnaire (PDQ) before treatment and again after a period of relatively stable improvement 3 years later. At baseline, panic subjects scored higher than normal control subjects, who had been matched for age and sex, on avoidant, dependent, histrionic, and paranoid personality subscales. Improvement in panic symptoms after 3 years was associated with reductions in these same subscale scores. Examination of individual items that distinguished panic from normal subjects showed themes of dependency, lack of self-confidence, emotional instability, and sensitivity to criticism that reflected demoralization in the panic disorder subjects. To a large extent, the findings reveal nonspecific, state-dependent effects of panic and agoraphobic symptoms on the personality functioning and morale of patients with panic disorder.

Alprazolam↗
PubMed1990

A Rorschach investigation of narcissism and hysteria in antisocial personality.

We investigated Rorschach responses associated with narcissism and hysteria in a group of antisocial personality disordered offenders. The Rorschach protocols of 42 subjects who met the criteria from the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev. [DSM-III-R]; American Psychiatric Association, 1987) for antisocial personality disorder were analyzed using Exner's (1986) criteria for pairs, reflections, and personal responses, and Gacono's (1988) criteria for the impressionistic response. Severe, or primary psychopaths (n = 21), scoring greater than or equal to 30 on the Hare (1980) Psychopathy Checklist (PCL), were compared to moderate, or secondary pscyhopaths (n = 21), scoring less than 30 on the PCL. The mean number of pair and impressionistic responses did not significantly differ for the two antisocial groups. The highly psychopathic group, however, did exhibit a significantly greater mean number of reflection and personal responses. We discuss pair and reflection responses and their relationship to narcissism in psychopathic disturbance. We recommend interpreting the personal response within the context of the psychopathic character and view personal responses as expressions of narcissism and omnipotence in highly psychopathic subjects. We also hypothesize that the impressionistic responses are indicative of primitive dissociative processes and hysteria in psychopathic subjects, and that their presence provides construct validity for the work of Guze (1976) and others who suggested an underlying histrionic dimension to psychopathy.

Adolescent↗
PubMed1982

Patients with psychogenic abdominal pain: six years' observation in the medical setting.

The author presents data on 24 patients with psychogenic abdominal pain who were followed by nonpsychiatric physicians for up to 6 years. Twenty were women, many of whose symptoms related to loss. Several personality patterns were observed, including histrionic personality, depression, pain-prone personality, and hypochondriasis. No patient sought psychiatric care, although 4 patients eventually required psychiatric hospitalization. Two patients had medical disorders that contributed to the symptoms, and 1 patient died of carcinoma. Pain resolved in only 1 of the patients, but psychosocial functioning improved in half. Those with a shorter duration of pain and no abnormal personality patterns had a better prognosis.

Abdomen↗
PubMed1994

Characterologic subtypes of the borderline personality disorder. With a note on prognostic factors.

Borderline personality disorder (BPD), as defined by DSM, is heterogeneous with respect to the array of the personality traits patients may exhibit. Thus, the characterology of BPD admits of many subtypes. From the standpoint of DSM-Axis II, BPD is almost always associated with a complex personality pattern that meets criteria for several other Axis II disorders--which may then be viewed as characterologic subtypes. Usually these will be from the same "dramatic cluster" to which BPD itself belongs; namely, histrionic, narcissistic, or antisocial. But any of the Axis II disorders may be found in conjunction with BPD, "schizoid" being the rarest accompaniment. The Kraepelinian temperaments (depressive, manic, irritable, cyclothymic) constitute another set of subtypes. There is prognostic significance to these diagnostic subdivisions. Irritable and antisocial types predict poor outcome. The poorest prognosis results when antisociality is admixed with psychopathy. Obsessive-compulsive traits, especially self-discipline and orderliness, are associated with good outcome. A number of individual personality traits are found with especial frequency in BPD and may be viewed as finer-scale subtypes. Their presence influences the direction in which therapeutic efforts must be directed and also affects long-term outcome. These traits include mercurial, unreasonable, infantile, volatile, demanding, and going-to-extremes. In general, the nature and intensity of all the traits relevant to each BPD patient (especially those that are "offensive" or socially alienating), and the balance between negative and positive traits, account for much of the variance in ultimate response to treatment and in eventual outcome.

Aged↗
PubMed1990

DSM-III personality disorder dimensions.

Dimensional scores were computed for the 11 DSM-III personality disorders (PDs) in 797 relatives of psychiatric patients and never ill control subjects interviewed with the Structured Interview for DSM-III Personality Disorders. The distribution of scores for all 11 PD dimensions was skewed to the right. A principal components analysis with varimax rotation produced three factors that closely corresponded to DSM-III's suggested clustering of the PDs into eccentric, dramatic, and anxious types. Men scored significantly higher on the paranoid, schizoid, compulsive, antisocial, and narcissistic dimensions, whereas women had significantly higher histrionic, dependent, and avoidant scores. Age was negatively correlated with most of the PD dimensions, and the correlations were strongest with the four PDs in cluster 2 (histrionic, antisocial, narcissistic, and borderline). Each of the eight axis I disorders examined was associated with increased axis II pathology.

Adult↗
PubMedDate not supplied

[Personality disorders in patients with eating disorders: a controlled study].

A group of 24 eating-disordered female subjects (10 anorexia nervosa--AN--and 14 bulimia nervosa--BN--patients) were interviewed, using a semistructured interview for DSM-III-R Axis-II Personality Disorders (SCID-II). A group of 54 subjects without eating disorder acted as a control group. A high rate of personality disorder (PD) diagnoses occurred in eating disordered subjects (AN and BN patients), with a high prevalence of borderline, dependent, and self-defeating PD. Avoidant and obsessive-compulsive PD were more common in AN patients, whereas BN was associated with histrionic PD. Findings have implications for the assessment and diagnosis of eating-disordered patients and for treatment planning.

Adult↗
PubMed1998

[The syndrome of depressive depersonalization].

Nineteen patients (9 men, 10 women aged 22--38 years) with depressions were examined. The phenomena of anesthesia of ideatoric functions dominated in clinical picture of such depression. This depression is defined as the depression of estrangement. Psychopathologic differentiation of mental estrangement in the structure of depression and in similar disorders of self-consciousness which were formed in depressions under conditions of "transitional syndrome" (according to G.Gross) is outlined. This syndrome is characterised by irreversible negative disorders of "defective depersonalization". The following signs permit to distinguish depression of estrangement from "transitional syndrome": partiality of the estrangement's phenomenon; connection between psychopathologic formations and pathology of imagination (figurative expressiveness, demonstrativity, lability to psychogenic and medical actions); conformity of the syndrome's structure and characteristics of premanifested personality's structure (combination of hyperthymic features with histrionic and/or narcissic ones). "Apperceptive anesthesia" is suggested for designation of the variant of the depression described.

Adult↗
PubMed2004

Bipolar II disorder: personality and outcome in two clinical samples.

OBJECTIVE: To compare the personality traits and disorders of patients with bipolar II disorder and major depression and to examine the impact on treatment outcome of a bipolar II diagnosis. METHOD: Patients from two clinical trials, a depressive sample (n = 195, 10% bipolar II) and a bulimic sample (n = 135, 16% bipolar II), were assessed for personality traits using DSM-IV criteria. Patients were randomised to treatments (fluoxetine or nortriptyline for depressive sample; cognitive behaviour therapy for bulimic sample) and followed for 3 years (depressive sample) or 5 years (bulimic sample) to assess the impact on outcome of a bipolar II diagnosis. RESULTS: Bipolar II patients were assessed as having more borderline, histrionic and schizotypal personality traits than patients with major depression. A baseline bipolar II diagnosis did not impact negatively on treatment outcome, and less than 5% of bipolar II patients developed bipolar I disorder during follow up. CONCLUSIONS: The low rate of conversion of bipolar II to bipolar I disorder and the lack of adverse impact of the diagnosis on outcome, questions the need for antimanic or mood stabiliser medication in most bipolar II patients.

Adrenergic Uptake Inhibitors↗