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PubMed1987

Multiple neuroendocrinological responses in borderline personality disorder patients.

Male patients suffering from borderline personality disorder (n = 13), major depression (n = 13) or schizophrenia (n = 13) were investigated on several psychopathological (HDRS, BPRS) and neuroendocrinological (DST and TSH, PRL, GH responses to TRH) parameters. Comparisons were made between the borderline group and the other groups of patients. Borderline patients differed from schizophrenics psychopathologically (BPRS) and neuroendocrinologically (DST). Also, borderline patients differed from major depressives in the HDRS, but behaved like them concerning DST. Our findings support the hypothesis that there are neuroendocrinological similarities between borderline personality disorder and major depressive patients, especially on the hypothalamo-pituitary-adrenal axis.

Adult↗
PubMed1990

Comparisons of males and females with DSM-III dependent personality disorder.

To determine whether DSM-III dependent personality disorder (PD) differed in males and females, 30 females and 11 males with this diagnosis were selected from a psychiatric outpatient population. Standardized measures of Axis I, Axis II, and family history were used. There were no differences in age or in the prevalence of Axis I or Axis II disorders in males and females, indicating that females were probably not misdiagnosed as having dependent PD. However, relatives of males had significantly more major depressive disorder and DSM-III anxious personality disorder cluster, while relatives of females had significantly more panic disorder. This may indicate different predisposing factors to dependent PD in males and females.

Adult↗
PubMed2006

The validity of Cloninger's psychobiological model versus the five-factor model to predict DSM-IV personality disorders in a heterogeneous psychiatric sample: domain facet and residualized facet descriptions.

The validity of Cloninger's psychobiological model and the Five-Factor Model of personality to predict DSM-IV personality disorders was examined in a psychiatric in-patient sample of 130 individuals. Patients completed Dutch authorized versions of the TCI (Cloninger, Svrakic, & Przybeck, 1993) and the NEO PI-R (Costa & McCrae, 1992) and were also administered the ADP-IV (Schotte & De Doncker, 1994), a Dutch self-report questionnaire to assess Axis-II disorders. No personality-descriptive model proved to be superior in explaining personality disorder symptoms at the higher-order level: the TCI dimensions better explained the Obsessive-Compulsive and the Narcissistic disorders, whereas the FFM accounted for more variance of the Avoidant disorder. However, differences were apparent at the lower-order level with the NEO facets out performing the TCI subscales for six to four personality disorders. FFM facet-level predictions of Widiger, Trull, Clarkin, Sanderson, and Costa (2002) were partially confirmed, with substantially better results using residualized facet scores. A set of TCI subscale personality disorder relationships is suggested.

Adolescent↗
PubMed1994

Personality disorders: conceptual issues and responsibility.

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.

Antisocial Personality Disorder↗
PubMed1990

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

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.

Adolescent↗
PubMedDate not supplied

Developmental antecedents of borderline personality disorder.

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.

Adolescent↗
PubMed1994

Familial correlates of reduced central serotonergic system function in patients with personality disorders.

BACKGROUND: To test the hypothesis that evidence of reduced central serotonergic (5-HT) system function in probands with personality disorders is associated with an elevated morbid risk of psychopathological conditions putatively associated with 5-HT dysfunction in first-degree relatives of these probands. METHODS: Data were collected during a study of the 5-HT correlates of behavior in male patients with DSM-III personality disorders conducted at a Veterans Affairs medical center. Probands in this study were selected from those patients who had undergone both a fenfluramine hydrochloride challenge and a family history assessment. Axis II diagnosis were made according to DSM-III criteria after a structured interview of the proband, using the Structured Interview for Diagnosing Personality Disorders, given by two raters and a similar interview with a knowledgeable informant by another rater. RESULTS: Reduced prolactin responses to the 5-HT releasing/uptake inhibiting agent fenfluramine was associated with an elevated morbid risk of impulsive personality disorder traits in the first-degree relatives of patients with a primary DSM-III diagnosis of a personality disorder. Quantitative scores on assessments of impulsive aggression in the probands were not correlated with an increased morbid risk for impulsive personality disorder traits. A trend in the same direction was noted for affective personality disorder traits and alcoholism. CONCLUSIONS: These results suggest that a central 5-HT system abnormality in probands is associated with an increased risk of impulsive aggression in their first-degree relatives, and that assessment of central 5-HT system function in probands may be a more sensitive parameter for identification of this familial trait than the presence of impulsive aggressive behaviors in the proband.

Aggression↗
PubMed2000

Bad or Mad? Personality disorders and legal responsibility-the German situation.

Criminal offenders have a high rate of personality disorders (PDS), especially Antisocial Personality Disorders and psychopathy, but criminal acts are not necessarily the result of PD. Findings from psychiatric research suggest that the development of PD is influenced by genetic factors, that can result in deviant traits in temper, emotionality and cognitive style. There is general agreement that those peculiarities and vulnerabilities find their expression and structure only under a complex interplay of stimulating or impairing environmental influences. Do these genetic factors-or other factors-diminish a person's criminal responsibility? There is no difficulty in diagnosing PDs, but the challenging questions arise in forensic assessments of defendants for criminal responsibility who have a PD. This article discusses the German legal situation and special problems created by the term of "diminished" criminal responsibility. In contrast to the Anglo-American legal situation, the German criminal law obliges the court to order an indeterminate forensic - psychiatric confinement, in addition to punishment, if the offender had acted under diminished criminal responsibility and is now still considered to be dangerous. The convicted offender remains under the control of the criminal court during psychiatric hospitalization. The change from handling the personality disordered offender as a criminal to handling him as someone with a mental disorder creates a social option for extended state interventions, including indeterminate hospitalization.

Antisocial Personality Disorder↗
PubMed1997

Characteristics of borderline personality disorder associated with suicidal behavior.

OBJECTIVE: This study examined the relationship between characteristics of borderline personality disorder and suicidal behavior. The authors hypothesized that a specific feature of borderline personality disorder, impulsivity, and childhood trauma, a possible etiological factor in the development of impulsivity, would be associated with suicidal behavior. METHOD: Information on lifetime history of suicidal behavior was obtained from 214 inpatients diagnosed with borderline personality disorder by structured clinical interview. The authors examined the relationship between DSM-III-R criteria met and the following measures of suicidal behavior: presence or absence of a previous suicide attempt, number of previous attempts, and lethality and intent to die associated with the most lethal lifetime attempt. RESULTS: Impulsivity was the only characteristic of borderline personality disorder (excluding the self-destructive criterion) that was associated with a higher number of previous suicide attempts after control for lifetime diagnoses of depression and substance abuse. Global severity of pathology of borderline personality disorder was not associated with suicidal behavior. History of childhood abuse correlated significantly with number of lifetime suicide attempts. CONCLUSIONS: The trait of impulsivity is associated with number of lifetime suicide attempts and may therefore be a putative risk factor for a future suicide attempt. If so, impulsivity is a potential target therapeutically for prevention of future suicide attempts. The association between childhood abuse and number of lifetime suicide attempts is consistent with the hypothesis that childhood abuse is an etiological factor in the development of self-destructive behaviors.

Adolescent↗