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Results for “Personality Disorders”

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PubMed1985

Depression in borderline personality disorder: lifetime prevalence at interview and longitudinal course of symptoms.

The author compared a group of patients with borderline personality disorder with groups of subjects with antisocial personality and bipolar II illness. The lifetime prevalence at interview of DSM-III major depression was high in all groups. Chronic depression demonstrated a specific relationship to borderline psychopathology. Prospectively, borderline psychopathology predicted high levels of depressive and anxiety symptoms. This relationship was reversed for depressive symptoms in patients with antisocial personality disorder, suggesting that when borderline and antisocial personality disorders occur together, some features may arise that differentiate patients with both disorders from those with either disorder alone.

Adolescent↗
PubMed1989

MMPI personality disorder scales and the MCMI: concurrent validity.

A set of DSM-III personality disorder scales recently were developed for the MMPI. The purpose of the present investigation was to provide data on the concurrent validity of these scales. Scores from both the overlapping and nonoverlapping MMPI personality disorder scales were compared against the criterion of the personality disorder scales of the MCMI in 47 psychiatric patients. In general, the MMPI personality scales correlated significantly with the corresponding MCMI scales. However, the antisocial (ANT), compulsive (CPS), and paranoid (PAR) scales of the MMPI failed to achieve adequate concurrent validity. For the ANT scale, this probably reflects conceptual differences between the Millon (1981) typology that underlies the MCMI and the DSM-III. The PAR scale appears to show some bias toward the assessment of paranoid and suspicious ideation, rather than paranoid personality characteristics.

Adjustment Disorders↗
PubMedDate not supplied

[Fluoxetine in the treatment of borderline personality disorder].

OBJECTIVE: This study evaluates the therapeutic effect of fluoxetine, a selective serotonin reuptake inhibitor, in borderline personality disorder. METHOD: 46 patients with borderline personality disorder according to DSM-III-R and Diagnostic Interview for Borderlines (DIB-R) criteria, were given fluoxetine 20-60 mg for seven weeks. They were evaluated each week using Brief Psychiatric Rating Scale (BPRS), Global Assessment of Functioning Scale (GAF), Hamilton Depression Rating Scale (HDRS) and a clinical Impulsivity Scale. RESULTS: There were significant improvements in BPRS, HDRS, GAF and Impulsivity Scale from the first week of the treatment. These improvements continued until the seven week of treatment. The favourable outcome was not only due to the improvement in depression and impulsivity scores, but also to the decline of global psychopathology. CONCLUSIONS: The data suggest that fluoxetine is an effective pharmacologic treatment for borderline personality disorder. These findings support the hypothesis of a 5-HT dysfunction in borderline personality disorder.

Adolescent↗
PubMed1997

Recent life events and suicide in personality disorders.

This study investigates the relationships between personality disorders, recent life events, and comorbid axis I disorders in suicide. Life events during the last week and last 3 months before suicide of 56 suicide victims with a DSM-III-R axis II personality disorder (PD) were compared with those of 56 age- and sex-matched comparison suicides with evidence of no PD. These victims were from a random sample of suicides representing a total 1-year nationwide suicide population in Finland. Life events had been more common among PD victims, particularly job problems, family discord, financial trouble, unemployment, and interpersonal loss; most victims with PD had had multiple life events. Events possibly dependent on the victim's own behavior had been much more common among the PD group, especially in the final week (70% vs. 23%). Age, gender, comorbid axis I diagnosis of alcoholism or depression, or PD cluster type B or C seemed to be less important factors in terms of excess events in the PD group. Thus, PD should be assessed as an important factor when analyzing the relationship between recent life events and suicide. Our findings suggest that interpersonal and job-related/financial problems may precede suicide closely among individuals with PD.

Adolescent↗
PubMed1989

Descriptive studies on narcissistic personality disorder.

This article describes a series of empirical studies on narcissistic disturbances and the narcissistic personality disorder in psychiatric patients. The work began with a survey of the literature and a comparison of three diagnostic systems for narcissistic personality disorder that helped clarify the degree of concordance among the existing systematic descriptions. This work gave rise to the development of a semistructured interview: the Diagnostic Interview for Narcissism. This tool was then used for investigating the following two main questions about pathologic narcissism: (1) Which characteristics identify and best distinguish patients with pathologic narcissism from psychiatric patients with various other diagnoses? (2) Can the Diagnostic Interview for Narcissism identify and distinguish patients with narcissistic personality disorder from patients with other psychiatric disturbances or related personality disorders?

Humans↗
PubMed1992

An outcome study of psychotherapy for patients with borderline personality disorder.

OBJECTIVE: This study evaluated the effectiveness of well-defined outpatient psychotherapy for patients with borderline personality disorder. METHOD: Thirty patients with borderline personality disorder diagnosed according to the DSM-III criteria were given twice weekly outpatient psychotherapy for 12 months by trainee therapists who were closely supervised. The treatment approach was based on a psychology of self (this term being used in its broad sense), and strong efforts were made to ensure that all therapists adhered to the treatment model. Outcome measures included frequency of use of drugs (both prescribed and illegal), number of visits to medical professionals, number of episodes of violence and self-harm, time away from work, number of hospital admissions, time spent as an inpatient, score on a self-report index of symptoms, and number of DSM-III criteria (weighted for frequency, severity, and duration) fulfilled. RESULTS: The subjects showed statistically significant improvement from the initial assessment to the end of the year of follow-up on every measure. Moreover, 30% of the subjects no longer fulfilled the DSM-III criteria for borderline personality disorder. This improvement had persisted 1 year after the cessation of therapy. CONCLUSIONS: The results suggest that a specific form of psychotherapy is of benefit for patients with borderline personality disorder.

Adult↗
PubMedDate not supplied

[Biological markers in schizotypal and borderline personality disorders].

A preliminary but growing body of evidence supports the existence of biological substrates in personality disorders. Based on a review of the literature, the article deals with the major biological markers: genetic, cognitive, biochemical, electrophysiological and organic markers, of schizotypal and borderline personality disorders. In addition, the article compares these findings in these two types of pathological personality. In the field of genetics, we notice several indices in favour of a relationship between schizotypal personality disorder (SPD) and chronic schizophrenia. In contrast, in borderline personality disorder (BPD), indices were lacking for such a relationship between this disorder and one of the axis I diagnosis, or a clear genetic transmission. In the field of cognitive tests, we can note in both SPD and BPD, that the abnormalities which would be at the level of temporal and frontal lobes, may be implicated in the observable cognitive troubles in these two disorders. In the field of neurobiochemistry, the dopaminergic and serotonergic systems seem to be implicated in the etiology of SPD while several data point out the fact that several neurotransmitter systems (dopaminergic, serotonergic, noradrenergic and cholinergic) seem to be involved in the etiology of BPD. Finally, in the field of electrophysiology, we notice that some of these tests observed in SPD (smooth pursuit eye movements, evoked potentials, modification of the electrodermic response) seem reinforcing the relationship between SPD and schizophrenia while those observed in BPD seem reinforcing either a relationship between BPD and depression (sleep studies), or a relationship between BPD and schizophrenia (evoked potentials, smooth pursuit eye movements).

Biomarkers↗
PubMed1993

Personality disorder and treatment response in bulimia nervosa.

Thirty-nine female out-patients with bulimia nervosa were assessed for personality disorders using the PAS. All subjects then entered a therapeutic trial, comprising eight weeks of cognitive-behavioural therapy with follow-up after eight weeks and at one year. Thirty-nine per cent of the patients were diagnosed as having personality disorders. Patients with personality disorders were more depressed and had a lower BMI than those without. They also had a significantly poorer response to treatment, but the difference between groups did not reach significance when mood and BMI were controlled for. Personality disorder alone does not predict a poor response to treatment, but comorbidity with depression and low weight increases the likelihood of a poor response; these patients are unlikely to respond to brief psychotherapeutic interventions.

Adult↗
PubMed1998

Outcome research on the psychosocial treatment of personality disorders.

This brief overview of outcome research on psychosocial treatment of personality disorders first examines difficulties in using existing classifications of abnormal personality. A summary is offered of uncontrolled investigations of the treatment of personality disorders, a few controlled studies, and literature on the impact of comorbid personality disorder on treatment of Axis I symptomatology. The conclusions take into account the particular challenges of these disorders in the current health care context.

Clinical Trials as Topic↗
PubMed2000

Mood, personality disorder symptoms and disability in obsessive compulsive hoarders: a comparison with clinical and nonclinical controls.

Hoarding is a symptom of obsessive compulsive disorder (OCD), as well as a diagnostic criterion for obsessive compulsive personality disorder (OCPD). One recent study suggests that people who suffer from compulsive hoarding report more general psychopathology than people who do not [Frost, R.O., Krause, M.S., & Steketee, G. (1996). Hoarding and obsessive compulsive symptoms. Behavior Modification, 20, 116-132]. The present study addressed whether persons with OCD hoarding exhibit more depression, anxiety, OCD and personality disorders symptoms than community controls, OCD nonhoarders, or other anxiety disorder patients. Disability was also examined. Hoarding subjects were older than the other three groups, but age did not account for any of the differences observed among the groups. Compared to controls, OCD hoarding, nonhoarding OCD and anxiety disorder patients showed elevated YBOCS scores, as well as higher scores on depression, anxiety, family and social disability. Compared to nonhoarding OCD and anxiety disorder patients, OCD hoarding patients scored higher on anxiety, depression, family and social disability. Hoarding subjects had greater personality disorder symptoms than controls. However, OCD hoarding subjects differed from OCD nonhoarding and anxiety disorder subjects only on dependent and schizotypal personality disorder symptoms. The findings suggest that hoarding is associated with significant comorbidity and impairment compared to nonhoarding OCD and other anxiety disorders.

Adult↗
PubMed1996

Defense styles, hostility, and psychological risk factors in male patients with personality disorders.

The purpose of this study was to compare ratings of defense styles and hostility in male patients with personality disorders, to determine whether either of these is related to a borderline diagnosis, or to specific psychological risk factors. Subjects with personality disorders were divided into borderline personality disorder (BPD) (N = 61) and non-BPD (N = 60) groups were given both the Defense Style Questionnaire (DSQ) and the Buss-Durkee Guilt-Hostility Inventory (BDHI). Risk factors were measured by a developmental interview and the the Parental Bonding Index. The BPD group reported more maladaptive and image distorting defenses on the DSQ, as well as higher ratings on the BDHI. Ratings on both dependent measures were strongly related to diagnosis, and more weakly to measures of psychological risk factors. Thus, in men with personality disorders, immature defense styles and high levels of hostility are strongly associated with a borderline diagnosis.

Adolescent↗
PubMed2003

Pharmacotherapy for personality disorders.

Although there are many methodological uncertainties in the treatment of personality disorders, which make it difficult to be confident about efficacy, there is growing evidence that at least in some personality disorders, drug treatment may be of value. Borderline personality disorder is a condition in which treatment evidence is the most promising, but it is also one of the most difficult disorders to disentangle the mental state from personality components. In summary, there is reasonable evidence that antidepressants, particularly serotonin re-uptake inhibitors and monoamine oxidase inhibitors, have beneficial effects independent of their antidepressive ones and albeit, less favourable, evidence that antipsychotic drugs and mood stabilisers may also be of value. None of this evidence is yet sufficient to point to any specific drug treatment indications.

Antidepressive Agents, Tricyclic↗
PubMedDate not supplied

[Psychobiological approach to personality disorders].

UNLABELLED: Current categorical classifications of the personality disorders are based on psychological perspectives. Consequently, biological research using these models has been unsuccessful since the nosological categories do not come out from the psychobiological systems underlying personality psychopathology. By contrast, biological research on dimensional models of personality has been more useful. All dimensional models agree on a neurotic-inhibitory dimension and an exploratory dimension of personality but they differ on other primary traits like dependence, emotionality or impulsiveness. However, gathering together all biological data support the existence of five biological axes of personality: a cognitive axis, a mood axis, an anxious-inhibitory axis, an exploratory axis and a action-control axis. CONCLUSION: Considering these biological axes is bringing a new perspective on the classification of personality disorder and gives way to new pharmacological therapeutic options.

Antidepressive Agents, Tricyclic↗
PubMed1988

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

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.

Autistic Disorder↗
PubMed2002

Personality disorders and time to remission in generalized anxiety disorder, social phobia, and panic disorder.

BACKGROUND: This investigation assessed the effect of personality disorders (PersDs) on time to remission in patients with generalized anxiety disorder, social phobia, or panic disorder. METHODS: Selected Axis I and II predictors of time to remission during 5 years of follow-up were assessed in 514 patients with 1 or more of these anxiety disorders who participated in the Harvard/Brown Anxiety Research Program, a multisite, prospective, longitudinal, naturalistic study. RESULTS: The presence of a PersD predicted a 30% lower likelihood of generalized anxiety disorder remission, a 39% lower likelihood of social phobia remission, and no difference in likelihood of panic disorder remission. More specifically, a lower likelihood of remission from generalized anxiety disorder was predicted by the presence of avoidant PersD (34% lower) and dependent PersD (14% lower). The presence of avoidant PersD predicted a 41% lower likelihood of social phobia remission. The presence of major depressive disorder did not account for these findings. CONCLUSIONS: Our findings provide new data on the pernicious effect of PersDs on the course of generalized anxiety disorder and social phobia but not panic disorder, suggesting that PersDs have a differential effect on the outcome of anxiety disorders.

Adult↗
PubMed2004

Context-processing deficits in schizotypal personality disorder.

Research suggests that schizotypal personality disorder (SPD) is a part of the spectrum of schizophrenia-related illnesses. This article hypothesizes that a deficit in the representation and maintenance of context is a core cognitive disturbance in schizophrenia and that SPD individuals should demonstrate context-processing deficits. To test this hypothesis, the authors administered 3 versions of their AX-CPT task, designed to assess context processing, to 35 healthy controls and 26 individuals with DSM-IV SPD. They also administered working memory and selective attention tasks. SPD individuals displayed context representation deficits similar to those found in schizophrenia but did not show the same additional deficits in context maintenance. Context processing was strongly associated with working memory and selective attention performance in the SPD individuals.

Adult↗
PubMed2004

Obsessive-compulsive personality disorder and behavioral disinhibition.

Although obsessive-compulsive personality disorder (OCPD) is an Axis II diagnosis that is not commonly associated with behavioral disinhibition, the literature contains reports of occasional explosive aggressive outbursts. Existing explanations of OCPD etiology do not address the coexistence of compulsive and impulsive features witnessed in some subpopulations of patients. In this study, the authors present a compensatory theory of OCPD in an effort to explain clinical observations of an unexpectedly large number of OCPD diagnoses among patients clinic referred and self-referred for aggression problems.

Aggression↗
PubMedDate not supplied

The management of self-inflicted burn injuries and disruptive behavior for patients with borderline personality disorder.

One of the greatest behavioral and ethical challenges faced by a burn team is the treatment of a patient whose burn injury is the result of parasuicidal behavior. Parasuicidal behavior is defined as intentional self-injurious behavior that, although not fatal, may result in tissue damage or risk of death. There are a number of reasons, usually psychiatric, that patients engage in parasuicidal behavior; however, our contention is that the majority of these patients have a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis II diagnosis of borderline personality disorder. We describe the nature of borderline personality disorder and how it leads to disruptive behavior, including self-harm behavior, on the burn unit, We also argue that if staff members fail to recognize the borderline personality disorder diagnosis, it will lead to responses from staff that can heighten disruptive behavior. We present a series of recommendations for treating such patients with burns and an illustrative case report.

Adult↗