Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Personality Disorders”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 163 records · Page 9Linked to original sources

Dual diagnosis in offenders with intellectual disability: setting research priorities: a review of research findings concerning psychiatric disorder (excluding personality disorder) among offenders with intellectual disability.

Studies of so-called 'dual diagnosis', i.e. intellectual disability (ID) with an additional psychiatric disorder, are reviewed with particular reference to offending behaviour. Because of the paucity of studies of psychopathology in offenders with ID, the present paper opens with studies of broader issues of psychopathology among people with ID, notably those with depression, schizophrenia, mild depressive disorder, other major psychotic disorders, anxiety/neurotic disorder, autistic spectrum disorders and attention deficit hyperactivity disorder. There follows a review of the most established and commonly used measurement scales for dual diagnosis in ID. The review then focuses directly on those studies which have looked at the issues of dual diagnosis among offenders with ID. In keeping with other reviews in this series, the latter studies are classified according to the same criteria. Based on this review, it is apparent that there are high-priority research questions which concern the extent and nature of psychopathology among offenders with ID, most notably those with autistic spectrum disorders.

Comorbidity↗

Brain maturation in conduct disorder versus borderline personality disorder.

Conduct disorder (CD) and borderline personality disorder (BPD) have been associated with abnormalities in brain function. The present study assessed whether adolescents with significant symptoms of CD and BPD display abnormal brain maturation. Participants recruited from the community were categorized as CD only, BPD only, CD plus BPD, or controls with neither CD nor BPD. Brain maturation was estimated by the amplitude difference in the P300 event-related brain potential between participants < versus > or = 17 years old. With increasing age, controls and BPD only participants exhibited a P300 amplitude decline. This pattern was not evident in the CD only and CD plus BPD groups. The different brain maturation patterns seen in adolescents with CD versus BPD symptoms may contribute to differences in age-of-onset, clinical course, and resistance to treatment.

Adolescent↗

Overlap between borderline and schizotypal personality disorders.

Borderline personality was split into two diagnostic categories in DSM-III: borderline personality disorder (BPD) and schizotypal personality disorder (SPD). There remains a great deal of diagnostic overlap between these two categories despite modifications in DSM-III-R. This report discusses four possible hypotheses for this overlap: (1) an independent, random association; (2) artifactual overlap due to imperfections in the criteria sets; (3) a synergistic association of the two personality disorders; and (4) a manifestation of dimensional psychopathology. Empirical evidence for each of the first three hypotheses is weak and contradictory. Recent biologic and treatment studies appear to most strongly support the use of dimensional models of "borderline" and "schizotypal" personality traits.

Borderline Personality Disorder↗

Influence of child and adolescent psychiatric disorders on young adult personality disorder.

OBJECTIVE: This study examines associations between childhood psychopathology and young adult personality disorder in a random sample of 551 youths, who were 9 to 16 years old at first assessment. METHOD: Subjects were evaluated for DSM-III-R psychiatric disorders. Information was obtained prospectively from youths and their mothers at three points over 10 years. The predictive effects of prior axis I disorders and adolescent axis II personality disorder clusters A, B, and C on young adult personality disorder were examined in logistic regression analyses. RESULTS: The odds of young adult personality disorder increased given an adolescent personality disorder in the same cluster. Prior disruptive disorders, anxiety disorders, and major depression all significantly increased the odds of young adult personality disorder independent of an adolescent personality disorder. In addition, comorbidity of axis I and axis II disorders heightened the odds of young adult personality disorder relative to the odds of a disorder on a single axis. CONCLUSIONS: Assessment of personality pathology before late adolescence may be warranted. Childhood or adolescent axis I disorders may set in motion a chain of maladaptive behaviors and environmental responses that foster more persistent psychopathology over time. Identification and treatment of childhood disorder may help to reduce that risk.

Adolescent↗

Reconceptualizing personality disorder categories using personality trait dimensions: introduction to special section.

The categorical model of personality disorders has been widely criticized, and many argue for it to be reconceptualized or replaced by a dimensional model rooted in personality trait research. Such criticisms have forged a much needed integration between the previously distinct research areas of normal and abnormal personality. The five articles in this special section provide compelling evidence for the usefulness of personality traits for describing and explaining the complexities of personality disorders among widely varying samples using very different assessment strategies.

Humans↗

The convergent and discriminant validity of the MCMI as a measure of the DSM-III personality disorders.

The personality scales of the Millon Clinical Multiaxial Inventory (MCMI) were constructed and validated to measure the typology developed by Millon (1981). The ability of the MCMI to measure the DSM-III personality disorders has not yet been empirically evaluated. The current study found better convergent validity for the DSM-III personality disorders that are consistent with Millon's typology (i.e., the avoidant and the dependent) than for the disorders that are inconsistent (i.e., the antisocial and the passive-aggressive). However, the results may reflect some advantages Millon's typology might have over the DSM-III. The discriminant validity of all four scales was limited, due in part to the overlap among the MCMI scales and the DSM-III personality disorders. We discuss implications of the results for the revision of the MCMI and the DSM-III.

Adult↗

Attitude to personality disorder among prison officers working in a dangerous and severe personality disorder unit.

BACKGROUND: It is well established that staff attitudes to personality disordered patients are commonly negative, characterised by pessimism and rejection. A recent study in forensic psychiatric hospitals has described the psychological and social factors underlying positive attitudes, and suggested that staff with more positive attitudes perform better and are less stressed. AIM: To assess whether it is possible to predict which staff will adjust positively to working with personality disordered people. More specifically to confirm links between attitude to personality disorder and: job performance; perception of managers; personal well-being; burnout; and interaction rates with inmates. METHODS: The opening of a new Dangerous and Severe Personality Disorder unit within a UK prison allowed a longitudinal study of prison officers to be performed, in which a number of measures, including the Attitude to Personality Disorder Questionnaire (APDQ), were collected at three fixed points (at baseline, eight and sixteen months after the opening of the unit). RESULTS: Attitude to Personality Disorder varied over the course of the study, and changes in attitude were linked to events experienced by individual officers. More positive attitude to personality disorder was associated with improved general health and job performance, decreased burnout, and favourable perception of managers. CONCLUSIONS: Attitude to Personality Disorder has important outcomes, and is responsive to the psychosocial environment. Its measurement is not useful for staff selection, because of low stability over lengthy time periods. The APDQ has been demonstrated to be valid measure of attitude to PD, and potentially useful for outcome studies, or benchmarking between units.

Absenteeism↗

"Patterns of comorbidity" among DSM-III-R and ICD-10 personality disorders as observed with a new inventory for the assessment of personality disorders.

Although DSM-III-R and ICD-10 suggest the assignment of multiple personality diagnoses, a high degree of overlap may be an indicator of insufficiently distinct and too inclusive types of personality. We studied this problem with a new inventory in an unselected clinical sample. The Aachen List of Items for the Registration of Personality Disorders (AMPS) integrates the different types of disordered personality according to DSM-III-R, ICD-10, and four subaffective categories, which largely follow the typologies of Kraepelin, K. Schneider, and Kretschmer. The prevalence rate of each personality disorder was calculated in a consecutive group of 231 patients. Patterns of comorbidity were computed using odds ratios. More than one personality disorder was found in 41% according to DSM-III-R. ICD-10 showed a significantly higher degree of overlap. Interesting comorbidity patterns are discussed in comparison with several North American studies. Results indicate that clear-cut categorical personality diagnoses are not likely to be set up.

Adult↗

New perspectives on schizotypal personality disorder.

Schizotypal personality disorder is the prototype of the schizophrenia-related personality disorders and has been demonstrated to have phenomenologic, biologic, treatment, and outcome characteristics similar to those of schizophrenic patients. These studies suggest that patients with schizotypal personality disorder, like schizophrenic patients, show cognitive impairment, but the impairment is more focal and involves primarily working memory, verbal learning, and sustained attention rather than generalized intellectual deficits. Schizotypal patients, like schizophrenic patients show reductions in temporal lobe volume, but seem to be spared the frontal volume reductions found in some studies of schizophrenic patients and in our laboratory. Better frontal "buffering" may prevent the more severe cognitive and social deterioration associated with schizophrenia. Furthermore, schizotypal patients appear to show less susceptibility to psychotic symptoms, in part perhaps because of better buffered subcortical dopaminergic activity as suggested by recent data from a SPECT/amphetamine paradigm, glucose metabolic study, and structural studies of basal ganglia. These findings are discussed in terms of a model of schizotypal personality disorder where schizotypal patients have better capacity for compensatory buffering in lateral and subcortical brain regions, protecting them from the more severe symptoms of chronic schizophrenia.

Amphetamines↗

The comorbidity of bipolar disorder and axis II personality disorders: prevalence and clinical correlates.

OBJECTIVES: Many studies have examined the prevalence and predictive validity of axis II personality disorders among unipolar depressed patients, but few have examined these issues among bipolar patients. The few studies that do exist suggest that axis II pathology complicates the diagnosis and course of bipolar disorder. This study examined the prevalence of axis II disorder in bipolar patients who were clinically remitted. METHODS: We assessed the co-occurrence of personality disorder among 52 remitted DSM-III-R bipolar patients using a structured diagnostic interview, the Personality Disorder Examination (PDE). RESULTS: Axis II disorders can be rated reliably among bipolar patients who are in remission. Co-diagnosis of personality disorder occurred in 28.8% of patients. Cluster B (dramatic, emotionally erratic) and cluster C (fearful, avoidant) personality disorders were more common than cluster A (odd, eccentric) disorders. Bipolar patients with personality disorders differed from bipolar patients without personality disorders in the severity of their residual mood symptoms, even during remission. CONCLUSIONS: When structured assessment of personality disorder is performed during a clinical remission, less than one in three bipolar patients meets full syndromal criteria for an axis II disorder. Examining rates of comorbid personality disorder in broad-based community samples of bipolar spectrum patients would further clarify the linkage between these sets of disorders.

Adolescent↗

Traumatic exposure and posttraumatic stress disorder in borderline, schizotypal, avoidant, and obsessive-compulsive personality disorders: findings from the collaborative longitudinal personality disorders study.

The association between trauma and personality disorders (PDs), while receiving much attention and debate, has not been comprehensively examined for multiple types of trauma and PDs. The authors examined data from a multisite study of four PD groups: schizotypal, borderline (BPD), avoidant, and obsessive-compulsive, and a major depression comparison group. Rates of traumatic exposure to specific types of trauma, age of first trauma onset, and rates of posttraumatic stress disorder are compared. Results indicate that BPD participants reported the highest rate of traumatic exposure (particularly to sexual traumas, including childhood sexual abuse), the highest rate of posttraumatic stress disorder, and youngest age of first traumatic event. Those with the more severe PDs (schizotypal, BPD) reported more types of traumatic exposure and higher rates of being physically attacked (childhood and adult) when compared to other groups. These results suggest a specific relationship between BPD and sexual trauma (childhood and adult) that does not exist among other PDs. In addition, they support an association between severity of PD and severity of traumatic exposure, as indicated by earlier trauma onset, trauma of an assaultive and personal nature, and more types of traumatic events.

Adolescent↗

Generalized social phobia versus avoidant personality disorder: differences in psychopathology, personality traits, and social and occupational functioning.

Four groups of patients with social phobia (SP) were compared with regard to psychopathologic characteristics, personality traits, and social and occupational functioning. Fifteen persons with discrete social phobia without any personality disorder (DSP), 28 persons with generalized social phobia (GSP) without any personality disorder, 24 persons with GSP with a single diagnosis of avoidant personality disorder (APD), and 23 persons with GSP with more than one PD were included in the present study. APD had higher levels of social phobic avoidance, depressive symptoms, neuroticism, introversion, and social and occupational impairment as compared with GSP. DSP was found to be the least severe condition. OPD was the most impaired on nearly all variables. Logistic regression analyses revealed that introversion and depressive symptoms were able to predict correctly the presence or absence of an APD in 85% of those with social phobia. These findings are discussed in the light of the severity continuum hypothesis of social phobia and APD and recommendations for future research are given.

Adolescent↗

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

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.

Adult↗

Antisocial personality disorder in primary care patients with somatization disorder.

Antisocial personality disorder and somatization disorder (SD) have been associated in previous research conducted primarily in patients from the mental health setting. We tested the hypothesis that patients with SD from the primary care setting had less likelihood of having comorbid antisocial personality disorder in a sample of 118 patients with SD. Two methods for diagnosing antisocial personality disorder were used: the Diagnostic Interview Schedule (DIS) and the Structured Clinical Interview for DSM-III-R, axis II (SCID-II). Eight percent of the women and between 18% and 25% (depending on the method used) of the men had antisocial personality, a prevalence rate that clearly exceeds the rate found in the general population. However, in clinical work, only one in 10 women and one in six men with SD will have antisocial personality disorder. These findings are consistent with the shared biological substrate hypothesized for the two disorders.

Adult↗

Psychiatric rehabilitation model for borderline personality disorder.

Borderline personality disorder is a prevalent and chronic disorder characterized by significant morbidity and mortality. Limited success with current treatment approaches suggests that new models of treatment are needed. Aspects of the psychiatric rehabilitation model are applied to borderline personality disorder. This model has implications for the diagnosis and management of borderline personality disorder. The diagnosis of borderline personality disorder will be refined by characterizing the disabilities and handicaps that are associated with the disorder. The psychiatric rehabilitation model suggests that services be developed which provide a validating environment, the opportunity to enhance skills and a mechanism to accept input from families.

Borderline Personality Disorder↗

Clinical differentiation between major depression only, major depression with panic disorder and panic disorder only. Childhood, personality and personality disorder.

A consecutive sample of 298 nonpsychotic psychiatric outpatients was classified according to DSM-III and divided into 4 diagnostic groups: pure major depression, mixed major depression/panic disorder, pure panic disorder and a remaining group of other disorders. The patients' report of childhood relationship to parents and siblings, family atmosphere, their own personality characteristics as children and precipitating events were compared in the various groups. In addition, differences in personality and frequencies of personality disorders were investigated by means of various instruments. Our results show that the type of relationship to parents in childhood differed in the various groups. The mother seems to be the most crucial person for the development of depression, the father for the development of panic disorder. Patients with major depression are more obsessive and patients with panic disorder more infantile and avoidant with less control of their personality. Finally, patients with mixed conditions are more in accordance with the DSM-III anxious personality disorder cluster.

Adult↗

Schema modes and childhood abuse in borderline and antisocial personality disorders.

Complex personality disorders (PDs) have been hypothesized to be characterized by alternating states of thinking, feeling and behavior, the so-called schema modes (Young, Klosko, & Weishaar (2003). Schema therapy: A practioner's guide. New York: Guilford). The present study tested the applicability of this model to borderline personality disorders (BPD) and antisocial personality disorders (APD), and related it to a presumed common etiological factor, childhood trauma. Sixteen patients with BPD, 16 patients with APD and 16 nonpatient controls (all 50% of both sexes) completed a Schema Mode Questionnaire assessing cognitions, feelings and behaviors characteristic of six schema modes. Participants were interviewed to retrace abusive sexual, physical and emotional events before the age of 18. BPD as well as APD participants were characterized by four maladaptive modes (Detached Protector, Punitive Parent, Abandoned/Abused Child and Angry Child). APD displayed most characteristics of the Bully/Attack mode, though not significantly different from BPD. The Healthy Adult mode was of low presence in BPD and of high presence in APD and the nonpatients. Frequency and severity of the three kinds of abuse were equally high in both PD groups, and significantly higher than in nonpatients.

Adolescent↗