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At least 19 recordsLinked to original sources

[Personality and personality disorders I. Universality and sensitivity of dimensional personality models as diagnostic systems for personality disorders].

OBJECTIVE: A dimensional diagnostic system for personality disorders (PD) postulates continuous transitions from normal to disordered personalities (continuity hypothesis) and universal validity of basic personality dimensions (universal hypothesis). In the present study three dimensional personality models that claim to provide a systematic representation of the overall domain of personality disorders were compared: the Big-Five model proposed by Costa and McCrae, the psychobiological model proposed by Cloninger and colleagues, and the "Dimensional Assessment of Personal Pathology (DAPP)" model proposed by Livesley and colleagues. METHOD: The "Six Factor Test" (SFT) measuring the Big-Five factors of personality, the "Temperament and Character Inventory (TCI)" measuring 4 temperament and 3 character dimensions, and the DAPP measuring 18 basic traits and 4 second ordered factors were administered to general population subjects (n = 156), and a clinical sample (n = 220) including a subsample of 69 patients with at least one diagnosis of DSM-IV PD. Group comparisons, regression analyses, and facet theoretical analyses were conducted. RESULTS: The nonmetric similarity analyses of the three personality models show a nearly identical radex-representation of the second ordered factors in the non-clinical and clinical sample reflecting an universal validity of 4 basic personality dimensions and confirming the universal hypothesis. In comparison with the BIG-Five concept and the psychobiological model the DAPP model seems to be more sensitive to differentiate PD patients from controls with a reclassification rate of 94.5 %. CONCLUSIONS: The Big-Five model, the DAPP and the TCI represent a substantially similar domain despite their different conceptualization. However, the DAPP was more sensitive to differences between PD patients and controls, offered a more comprehensive account of PD, and could differentiate the two groups more effectively.

Character↗

[A study of cyclothymic personality in personality type theory: a structural interpretation of syntonic and immodithymic personalities in the cyclothymic personality type].

This study was undertaken to explore various fundamental characteristics of the cyclothymic personality type. The subjects were 474 students who were classified into three basic personality types -cyclothymic, schizothymic and collathymic- on the basis of their performance on the VERAC Personality Inventory (VPI). Analyses of two questionnaires (TSPS and Self-Differential) completed by the subjects indicated that students classified as cyclothymic had a stronger tendency to recognize their own personality type and to adjust images which could or might be recognized by others. To explore the cyclothymic personality in greater detail, this group was classified into two sub-types -hypomanic and immodithymic types- and two additional tests (EPPS and EFT) were administered to these subjects. Analysis of the responses to these tests revealed that (a) the differences between the two sub-types in EPPS coincided to some degree with earlier reports in the clinical literature, (b) there was no difference between the sub-types in terms of reaction time or number of errors in EFT, and (c) the differences obtained between EPPS and EFT were not so clear as those obtained among the three basic personality types. Overall, these results supported the contention that cyclothymic personality type is a viable sub-category in personality type theory.

Adolescent↗

[Personality, accentuated traits and personality disorders. A contribution to dimensional diagnosis of personality disorders].

A dimensional diagnostic system for personality disorders (PD) postulates continuous transition from normal to disordered personalities (continuity hypothesis) and universal validity of basic personality dimensions (universal hypothesis). The present study investigates the validity of Leonhard's concept of attenuated personalities that define a conceptual link between normal personality dimensions and PD. Nine possible continuous transitions between three conceptual levels (Big Five personality factors, nine attenuated personality traits, nine PD) were tested by questionnaire data obtained from a mentally healthy (n = 166) and a clinical sample (n = 78). Both samples differed significantly in nearly all variables. However, they showed substantial similarity concerning the (in)validity of single continua and the complex structure of all variables as analyzed by multidimensional scaling. The concept of attenuated personalities could be validated for six out of nine tested continua and can be recommended for application in dimensional models of personality and personality disorders.

Adult↗

An assessment of the Standardized Assessment of Personality as a screening instrument for the International Personality Disorder Examination: a comparison of informant and patient assessment for personality disorder.

BACKGROUND: The International Personality Disorder Examination (IPDE) has been developed as a standardized interview for personality disorders. While it has good psychometric properties, its length makes it difficult to use in the community in population research, particularly outside psychiatric settings. The informant-based Standard Assessment of Personality (SAP), which has been in use since 1981, could serve as a valid screen to detect likely personality disordered individuals who would then receive a definitive diagnosis by IPDE. This study aimed to compare the two instruments in their capacity to detect personality disorder according to ICD-10 taxonomy and to estimate the efficiency of the use of the two together in a case-finding exercise. METHOD: Ninety psychiatric out-patients in Bangalore, India, were assessed for personality disorder using the two methods. Assessment was conducted by a pair of trained interviewers in random order and by random allocation to interviewer. RESULTS: Overall agreement between the two instruments in the detection of ICD-10 personality disorder was modest (kappa = 0.4). The level of agreement varied according to personality category, ranging from kappa 0.66 (dependent) to kappa 0.09 (dyssocial). The SAP proved to have a high negative predictive value (97%) for IPDE as the gold standard, suggesting its potential as a screen in samples where the expected prevalence of personality disorder is low. CONCLUSION: A two-stage approach to epidemiological studies of personality disorder may be practicable.

Adult↗

Antisocial personality disorder among drug abusers. Relations to other personality diagnoses and the five-factor model of personality.

Antisocial personality disorder among drug abusers has been associated with poor drug abuse treatment outcome and greater human immunodeficiency virus infection risk compared with drug abusers without the disorder. Despite this, less is known about the personality trait dimensions of antisocial drug abusers, or about the prevalence of axis II comorbidity among this group. Similarly, little is known about the personality trait dimensions of antisocial drug abusers compared with those with axis II diagnoses other than antisocial or those with no personality diagnosis. The present study compared the personality traits of 203 outpatient opioid drug abusers categorized into either a pure antisocial group (i.e., antisocial diagnosis only), mixed antisocial group (i.e., antisocial plus another axis II diagnosis), other axis II group (i.e., axis II diagnosis other than antisocial), or a non-axis II group. Psychiatric diagnoses were made using a structured interview and personality traits of the four groups were compared using a self-report measure of the five-factor model of personality. As predicted, the mixed group was significantly more prone to neuroticism compared with the pure group, with higher scores on the vulnerability to stress and hostility facets. The mixed group also had a greater score on the neuroticism domain compared with the non-axis II group, with higher scores on five of the six facets. Significant differences were also found on agreeableness. The mixed group had lower scores on this domain (i.e., had higher interpersonal antagonism) compared with the non-axis II group. Somewhat surprisingly, the agreeableness score for the pure group was not significantly different from those of the remaining three groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗

Six basic dimensions of personality and a seventh factor of generalized dysfunctional personality: a diathesis system covering all personality disorders.

The five-factor model (FFM) of personality has recently been claimed to be comprehensive for all dimensionally conceived personality disorders (PDs). This assumption is refuted on the grounds of a principal component analysis conducted for three basic factor inventories (FFPI, NEO-FFI, Hamburg Personality Inventory), 22 explorative facet scales for normal personality and a questionnaire inventory (Inventory of Clinical Personality Accentuations) of 24 PD scales. Seven substantial orthogonal Varimax factors were found explaining 73% of the total variance. The five factors of the FFM were replicated. In addition, a new basic factor 'risk and competition seeking' (basic dimension 'risk', BD-R) emerged replicating findings of Andresen. The massive seventh factor was substantially loaded by all 24 PD scales and interpreted as 'general dysfunctional personality' (GDP). Most of the highly loaded scales describe varying forms of cognitive aberration. Together with GDP, the six-factor model now explains about 73% of all PD scales, thus, a virtually comprehensive descriptive diathesis system is achieved. Without GDP and BD-R, only 25% can be accounted for by the FFM. Five of the six normal dimensions will be loaded with positive and negative signs by some PDs. Neuroticism (BD-N) is still unique regarding its positive substantial correlations with almost all PD scales. BD-N is also the only normal factor which is correlated with GDP at about 0.50. A geometric model for the relationships between basic and clinical factors is presented.

Adult↗

Avoidant personality disorder, generalized social phobia, and shyness: putting the personality back into personality disorders.

With increasing recognition of social phobia as a common and often debilitating disorder, interest is developing in its boundaries with other disorders such as avoidant personality disorder and temperamental constructs such as shyness. Such interest reflects the more general debate concerning Axis I disorders, personality disorders, and what is considered normal personality variance. This review summarizes the available literature comparing avoidant personality disorder (APD), generalized social phobia (GSP), and shyness. In studies comparing APD and GSP, comorbidity rates have varied from approximately 25% to numbers high enough that the ability to diagnose one disorder without the other was questioned. Comparisons of the characteristics of APD and GSP have yielded few qualitative differences, although some studies have shown evidence that APD may represent a more severe form of GSP with respect to levels of symptoms, fear of negative evaluation, anxiety, avoidance, and depression. Personality dimensions including, but not limited to, shyness have been found to be strongly associated with GSP and APD, and there is some evidence that persons who suffer from social anxiety also suffer from fears and avoidance across nonsocial domains. In conclusion, although there is evidence that shyness, GSP, and APD exist along a continuum, the factors that constitute this continuum may need to be revised.

Comorbidity↗

Dimensional personality profiles of borderline personality disorder in comparison with other personality disorders and healthy controls.

The present study examined the sensitivity and clinical specificity of dimensional personality profiles associated with borderline personality disorder (BPD) by comparing three groups of patients: (a) patients with BPD according to DSM-IV criteria (n = 31); (b) patients with other DSM-IV PD (n = 31); and (c) general population controls (n = 31). All three samples were matched for age and gender and the two patient samples were matched for chronicity and depressive symptoms. All patients were given the Six-Factor Test measuring the five-factor model of personality (FFM), the Temperament and Character Inventory (TCI), and the Dimensional Assessment of Personality Pathology (DAPP). Nonparametric statistics were applied to analyze the data (Mann-Whitney-U-tests for group comparisons; Spearman's coefficients for correlational analyses). Neuroticism (FFM), Self-Directedness (TCI), and Emotional Dysregulation (DAPP) were identified as general markers of personality pathology, which were significantly interrelated in all three samples. BPD patients also showed a specific profile compared with other PD patients with lower scores on Agreeableness (FFM), higher scores on Novelty Seeking and Self-Transcendence (TCI), and higher scores on the DAPP higher-order dimensions of Emotional Dysregulation, Dissocial Behavior, and Inhibitedness. Results support the assumption that BPD can be characterized by dimensional approaches with sufficient sensitivity in comparison with healthy controls and specificity in comparison with other PD patients.

Adult↗

Complementary approaches to the assessment of personality disorder. The Personality Assessment Schedule and Adult Personality Functioning Assessment compared.

BACKGROUND: Current concepts and measures of personality disorder are in many respects unsatisfactory. AIMS: To establish agreement between two contrasting measures of personality disorder, and to compare subject-informant agreement on each. To examine the extent to which trait abnormality can be separated from interpersonal and social role dysfunction. METHOD: Fifty-six subjects and their closest informants were interviewed and rated independently. Personality functioning was assessed using a modified Personality Assessment Schedule (M-PAS), and the Adult Personality Functioning Assessment (APFA). RESULTS: Subject-informant agreement on the M-PAS was moderately good, and agreement between the M-PAS and the APFA, across and within subjects and informants, was comparable to that for the M-PAS. This was equally the case when M-PAS trait plus impairment scores and trait abnormality scores were used. CONCLUSIONS: The M-PAS and the APFA are probably assessing similar constructs. Trait abnormalities occur predominantly in an interpersonal context and could be assessed within that context.

Adult↗

[Personality and personality disorders II. The Specificity of the DAPP-model as a diagnostic system for personality disorders].

The 'Dimensional Assessment of Personality Pathology - Basic Questionnaire' (DAPP) measures 18 traits to provide a systematic representation of the overall domain of personality disorders (PD). The present study investigated the relationships between DAPP personality profiles and dimensional assessments of DSM-IV PD in general population subjects (n = 156), and a sample of 220 nonpsychotic psychiatric patients (including n = 67 PD patients). Using nonmetric multidimensional scaling models the similarities between the 18 DAPP-factors and the dimensional scores of the 12 DSM-IV PD (inclusive appendix) were graphically represented in a 2-dimensional similarity-system. Here each DSM-IV PD dimension could be described by a distinct profile of DAPP-factors. Overall results support the assumption that PD can be represented by a dimensional system of personality traits with sufficient sensitivity and specificity.

Humans↗

[Prevalence of serum anti-Helicobacter pylori IgG antibody in persons with severe motor and intellectual disabilities--comparison between institutionalized persons and persons living at home].

The seroprevalence of an anti-Helicobacter pylori antibody (ELISA) was investigated in institutionalized persons with severe motor and intellectual disabilities (SMID). The rate of seropositivity was significantly higher in persons with SMID under 29 years of age than in age-matched controls and in institutionalized patients with muscular dystrophy. No difference in seropositivity among SMID patients was found between those in our and other institutions. Therefore, it is speculated that Helicobacter pylori infection occurs soon after the institutionalization of SMID patients. Persons with SMID living at home, in their teens and twenties, had lower seropositivity than that of institutionalized patients but higher than controls. These data implicate the life style of persons with SMID and long-term institutionalization as one of important risk factors of Helicobacter pylori infection.

Adolescent↗

[Freiburg Personality Inventory scores of patients with chronic polyarthritis in comparison with persons with arthrotic manifestations--no indication of a typical polyarthritis personality].

Patients with rheumatoid arthritis and arthrosis (33 females and 11 males in each group) were compared in terms of scores in the Freiburger Personality Inventory. After matching subjects of both groups for sex and age, t-tests for correlating samples were applied. No significant differences were found in any scale; in three of them significance was just missed (5% less than p less than 10%). Given the number of comparisons, this is not surprising; in addition, personality characteristics, as assessed by these scales, do not agree with descriptions of rheumatoid arthritis patients as given in the literature. Our results, hence, do not lend support to the assumption of a typical personality in patients with rheumatoid arthritis. Elevated scores as found in other studies are most likely to reflect symptoms of joint ache rather than psychopathology.

Adult↗

Personality and PTSD II: personality assessment of PTSD-diagnosed Vietnam veterans using the cloninger tridimensional personality questionnaire (TPQ).

Examined Tridimensional Personality Questionnaire (TPQ) responses of 53 Vietnam veterans with Combat-Related Posttraumatic stress disorder. When compared with normative data, veterans were found to be high on harm avoidance (HA), low on reward dependence (RD), and high on novelty seeking (NS). High HA and high NS scores were predictive of increased PTSD symptom severity as assessed by the MMPI-2 PK (PTSD)scale, Mississippi Combat Scale for PTSD (M-PTSD), and Beck Depression Inventory (BDI). Low RD was associated with higher scores on both the MMPI-2 PK and M-PTSD scales. The observed "high HA-low RD-high NS" TPQ configuration is consistent with previous research findings/clinical observations, and provides insights into a pattern of dysfunctional personality traits often observed in this population.

Adult↗

Enhancing target variance in personality impressions: highlighting the person in person perception.

D. A. Kenny (1994) estimated the components of personality rating variance to be 15, 20, and 20% for target, rater, and relationship, respectively. To enhance trait variance and minimize rater variance, we designed a series of studies of personality perception in discussion groups (N = 79, 58, and 59). After completing a Big Five questionnaire, participants met 7 times in small groups. After Meetings 1 and 7, group members rated each other. By applying the Social Relations Model (D. A. Kenny and L. La Voie, 1984) to each Big Five dimension at each point in time, we were able to evaluate 6 rating effects as well as rating validity. Among the findings were that (a) target variance was the largest component (almost 30%), whereas rater variance was small (less than 11%); (b) rating validity improved significantly with acquaintance, although target variance did not; and (c) no reciprocity was found, but projection was significant for Agreeableness.

Adult↗

Use of antihypertensive drug therapy in older persons in an academic nursing home.

OBJECTIVES: To determine the prevalence of hypertension and the appropriate treatment of hypertension in older persons in an academic nursing home. DESIGN: The charts of all persons aged > or = 59 years currently residing in a nursing home affiliated with Westchester Medical Center/New York Medical College were analyzed by two geriatrics fellows according to a protocol designed by one of the authors (W.S.A.). SETTING: An academic nursing home affiliated with Westchester Medical Center/New York Medical College. PARTICIPANTS: The study population included 96 men and 159 women, mean age 77 +/- 9 years (range, 59-100 years). RESULTS: Hypertension was present in 129 of 255 persons (51%). Clinical cardiovascular disease or target organ damage or diabetes mellitus was present in 121 of 129 persons (94%) with hypertension. Hypertension was poorly controlled in 21 of 129 persons (16%). Of 129 persons with hypertension, 70 (54%) were treated with angiotensin-converting enzyme (ACE) inhibitors or angiotensin II type 1 receptor blockers, 61 persons (47%) with beta blockers, 43 persons (33%) with diuretics, 36 persons (28%) with calcium channel blockers, 5 persons (4%) with alpha blockers, and 5 persons (4%) with other antihypertensive drugs. Of 54 persons with hypertension and diabetes mellitus, 37 persons (69%) were treated with ACE inhibitors or angiotensin II type 1 receptor blockers. Of 58 persons with hypertension and coronary artery disease, 33 persons (57%) were treated with ACE inhibitors or angiotensin II type 1 receptor blockers, 31 persons (53%) with beta blockers, 20 persons (34%) with diuretics, 18 persons (31%) with calcium channel blockers, 2 persons (4%) with alpha blockers, and 4 persons (7%) with other antihypertensive drugs. Of 31 persons with hypertension and heart failure, only 5 persons (16%) had measurement of left ventricular ejection fraction. Of 31 persons with hypertension and heart failure, 30 persons (97%) were treated with diuretics, 21 persons (68%) with ACE inhibitors or angiotensin II type 1 receptor blockers, 18 persons (58%) with beta blockers, and 8 persons (26%) with calcium channel blockers. CONCLUSIONS: Of older persons with hypertension in an academic nursing home, 16% had poor control of their hypertension. There was overuse of calcium channel blockers and alpha blockers and underuse of diuretics, beta blockers, and ACE inhibitors in treating hypertension. Physician education needs to be intensified to provide better medical care of older persons with hypertension through the use of optimal doses of drugs found to be effective and safe by evidence-based studies.

Academic Medical Centers↗

Schizophrenia-related and affective personality disorder traits in relatives of probands with schizophrenia and personality disorders.

OBJECTIVE: The possible heterogeneity of the schizophrenia-related personality disorder traits associated with DSM-III criteria for schizotypal personality disorder was investigated using the family history method. A familial relationship to schizophrenia was hypothesized for schizophrenia-related personality disorder traits without coexisting affective personality disorder traits, pure schizophrenia-related personality disorder traits. Alternatively, a familial relationship with borderline personality disorder was hypothesized for schizophrenia-related personality disorder traits with comorbid affective personality disorder traits. METHOD: Criteria for schizophrenia-related and affective personality disorder traits were used to assess the 588 nonpsychotic first-degree relatives of 55 chronic schizophrenic probands and 67 probands with personality disorders. The probands with one or more DSM-III personality disorders were categorized as having schizotypal personality disorder without borderline personality disorder (pure schizotypal personality disorder), borderline personality disorder without schizotypal personality disorder (pure borderline personality disorder), both disorders, or neither. RESULTS: The morbid risk of all cases of schizophrenia-related personality disorder traits was higher in relatives of probands with schizophrenia and pure schizotypal personality disorder than in relatives of probands with neither schizotypal nor borderline personality disorder; however, it differed only slightly from that observed in the relatives of probands with both schizotypal and borderline personality disorders and pure borderline personality disorder. In contrast, the risk of pure schizophrenia-related personality disorder traits was higher in relatives of probands with schizophrenia and pure schizotypal personality disorder, while the risk of coexisting schizophrenia-related and affective personality disorder traits was lower in both of these groups than among the relatives of probands with both schizotypal and borderline personality disorders and pure borderline personality disorder. CONCLUSIONS: These results offer preliminary indications that schizotypal personality disorder features present without comorbid affective personality disorder traits may more specifically characterize the personality characteristics familially related to schizophrenia. Furthermore, they indicate that schizotypal personality disorder features as currently defined are found in relatives of patients other than those with schizophrenia or schizotypal personality disorder.

Adult↗

Comorbidity of borderline personality disorder with other personality disorders in hospitalized adolescents and adults.

OBJECTIVE: The authors examined the comorbidity of borderline personality disorder with other personality disorders in a series of consecutively admitted adolescents. For comparison, the comorbidity of borderline personality disorder with other personality disorders was also examined in a series of adults consecutively admitted to the same hospital during the same period. METHOD: A total of 138 adolescents and 117 adults were reliably assessed with the Personality Disorder Examination, a semistructured diagnostic interview for DSM-III-R personality disorders. Sixty-eight adolescents and 50 adults met the diagnostic criteria for borderline personality disorder. The co-occurrence of other personality disorders in the group of subjects with borderline personality disorder was statistically compared to that in the group without borderline personality disorder, for adolescents and adults separately. RESULTS: For the adults, Bonferroni-corrected chi-square analysis revealed significant diagnostic co-occurrence with borderline personality disorder for antisocial personality disorder only. For the adolescents, borderline personality disorder showed significant co-occurrence with schizotypal and passive-aggressive personality disorders. CONCLUSIONS: In the adults, borderline personality disorder was significantly comorbid only with another cluster B disorder. The adolescents, by comparison, displayed a broader pattern of comorbidity of borderline personality disorder, encompassing aspects of clusters A and C. These results suggest that the borderline personality disorder diagnosis may represent a more diffuse range of psychopathology in adolescents than in adults.

Adolescent↗