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The British Journal of Psychiatry : the... Dec 2018Personality disorder is a severe health issue. However, the epidemiology of personality disorders is insufficiently described and surveys report very heterogeneous... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Personality disorder is a severe health issue. However, the epidemiology of personality disorders is insufficiently described and surveys report very heterogeneous rates.AimsWe aimed to conduct a meta-analysis on the prevalence of personality disorders in adult populations and examine potential moderators that affect heterogeneity.
METHOD
We searched PsycINFO, PSYNDEX and Medline for studies that used standardised diagnostics (DSM-IV/-5, ICD-10) to report prevalence rates of personality disorders in community populations in Western countries. Prevalence rates were extracted and aggregated by random-effects models. Meta-regression and sensitivity analyses were performed and publication bias was assessed.
RESULTS
The final sample comprised ten studies, with a total of 113 998 individuals. Prevalence rates were fairly high for any personality disorder (12.16%; 95% CI, 8.01-17.02%) and similarly high for DSM Clusters A, B and C, between 5.53 (95% CI, 3.20-8.43%) and 7.23% (95% CI, 2.37-14.42%). Prevalence was highest for obsessive-compulsive personality disorder (4.32%; 95% CI, 2.16-7.16%) and lowest for dependent personality disorder (0.78%; 95% CI, 0.37-1.32%). A low prevalence was significantly associated with expert-rated assessment (versus self-rated) and reporting of descriptive statistics for antisocial personality disorder.
CONCLUSIONS
Epidemiological studies on personality disorders in community samples are rare, whereas prevalence rates are fairly high and vary substantially depending on samples and methods. Future studies investigating the epidemiology of personality disorders based on the DSM-5 and ICD-11 and models of personality functioning and traits are needed, and efficient treatment should be a priority for healthcare systems to reduce disease burden.Declaration of interestNone.
Topics: Adult; Comorbidity; Developed Countries; Humans; Personality Disorders; Prevalence
PubMed: 30261937
DOI: 10.1192/bjp.2018.202 -
PloS One 2023Thigmotaxis is an innate predator avoidance behaviour of rodents. To gain insight into how injury and disease models, and analgesic drug treatments affect thigmotaxis,... (Meta-Analysis)
Meta-Analysis
Thigmotaxis is an innate predator avoidance behaviour of rodents. To gain insight into how injury and disease models, and analgesic drug treatments affect thigmotaxis, we performed a systematic review and meta-analysis of studies that assessed thigmotaxis in the open field test. Systematic searches were conducted of 3 databases in October 2020, March and August 2022. Study design characteristics and experimental data were extracted and analysed using a random-effects meta-analysis. We also assessed the correlation between thigmotaxis and stimulus-evoked limb withdrawal. This review included the meta-analysis of 165 studies We report thigmotaxis was increased in injury and disease models associated with persistent pain and this increase was attenuated by analgesic drug treatments in both rat and mouse experiments. Its usefulness, however, may be limited in certain injury and disease models because our analysis suggested that thigmotaxis may be associated with the locomotor function. We also conducted subgroup analyses and meta-regression, but our findings on sources of heterogeneity are inconclusive because analyses were limited by insufficient available data. It was difficult to assess internal validity because reporting of methodological quality measures was poor, therefore, the studies have an unclear risk of bias. The correlation between time in the centre (type of a thigmotactic metric) and types of stimulus-evoked limb withdrawal was inconsistent. Therefore, stimulus-evoked and ethologically relevant behavioural paradigms should be viewed as two separate entities as they are conceptually and methodologically different from each other.
Topics: Rats; Animals; Mice; Rodentia; Open Field Test; Pain; Antisocial Personality Disorder; Databases, Factual
PubMed: 37682863
DOI: 10.1371/journal.pone.0290382 -
Neuroscience and Biobehavioral Reviews Jan 2018Psychopathy is a personality construct that has been related to important emotional deficits. These findings have led to a growing interest in exploring if psychopathic... (Meta-Analysis)
Meta-Analysis Review
Psychopathy is a personality construct that has been related to important emotional deficits. These findings have led to a growing interest in exploring if psychopathic traits are associated with emotional intelligence (EI). However, the literature exploring this association has revealed conflicting results. The aim of the present study was to provide a reliable estimate of the relationship between psychopathy traits and EI (measured as performance-based ability) through meta-analysis. A quantitative and systematic review of the literature using Scopus, Medline, Pubmed, and PsicINFO showed a total of 13 studies meeting inclusion criteria with a combined sample of 2401 participants. The meta-analysis revealed a significant negative relationship between both constructs, showing that higher psychopathic trait scores are related to lower EI levels. We propose several future research lines to clarify possible gaps and ambiguities in the current literature and a set of interesting clinical implications for the prevention, evaluation, and treatment of psychopathic traits by including EI factors in traditional models of psychopathy.
Topics: Antisocial Personality Disorder; Emotional Intelligence; Humans
PubMed: 29217464
DOI: 10.1016/j.neubiorev.2017.12.003 -
Journal of Child Psychology and... May 2016Children and adolescents with callous unemotional (CU) traits are at risk of severe and persistent antisocial behavior. It is commonly assumed that these children are... (Review)
Review
BACKGROUND
Children and adolescents with callous unemotional (CU) traits are at risk of severe and persistent antisocial behavior. It is commonly assumed that these children are difficult to treat but it has been proposed that they may benefit from being involved in interventions that go beyond typical parent training programs. This systematic review sought to answer two previously unanswered questions: do interventions involving young people reduce levels of CU traits? Do CU traits predict the effectiveness of interventions for antisocial behavior involving young people?
METHOD
Studies were included that adopted an randomized controlled trial, controlled or open trial design and that had examined whether treatment was related to reductions in CU traits or whether CU traits predicted or moderated treatment effectiveness.
RESULTS
Treatments used a range of approaches, including behavioral therapy, emotion recognition training, and multimodal interventions. 4/7 studies reported reductions in CU traits following treatment. There was a mixed pattern of findings in 15 studies that examined whether CU traits predicted treatment outcomes following interventions for antisocial behavior. In 7/15 studies, CU traits were associated with worse outcomes, although three of these studies did not provide data on baseline antisocial behavior, making it difficult to evaluate whether children with high CU traits had shown improvements relative to their own behavioral baseline, despite having the worst behavioral outcomes overall. CU traits did not predict outcomes in 7/15 studies. Finally, a single study reported that CU traits predicted an overall increased response to treatment.
CONCLUSIONS
Overall, the evidence supports the idea that children with CU traits do show reductions in both their CU traits and their antisocial behavior, but typically begin treatment with poorer premorbid functioning and can still end with higher levels of antisocial behavior. However, there is considerable scope to build on the current evidence base.
Topics: Adolescent; Antisocial Personality Disorder; Child; Humans; Outcome Assessment, Health Care
PubMed: 26686467
DOI: 10.1111/jcpp.12494 -
Annals of the New York Academy of... Jan 2023Punitive school discipline deploys surveillance, exclusion, and corporal punishment to deter or account for perceived student misbehavior. Yet, education and legal... (Review)
Review
Punitive school discipline as a mechanism of structural marginalization with implications for health inequity: A systematic review of quantitative studies in the health and social sciences literature.
Punitive school discipline deploys surveillance, exclusion, and corporal punishment to deter or account for perceived student misbehavior. Yet, education and legal scholarship suggests it fails to achieve stated goals and exacerbates harm. Furthermore, it is disproportionately imposed upon Black, Latinx, Native/Indigenous, LGBTQIA, and disabled students, concentrating its harms among marginalized young people. Its implications for health, however, are less clear. Using public health theories of sociostructural embodiment, we propose a framework characterizing pathways linking societal ideologies (e.g., racism) to punitive discipline with implications for health and health inequity and then present our systematic review of the punitive school discipline-health literature (N = 19 studies) conducted in accordance with PRISMA guidelines. Data were extracted on guiding theories, study characteristics, measurement, methods, and findings. This literature links punitive school discipline to greater risk for numerous health outcomes, including persistent depressive symptoms, depression, drug use disorder in adulthood, borderline personality disorder, antisocial behavior, death by suicide, injuries, trichomoniasis, pregnancy in adolescence, tobacco use, and smoking, with documented implications for racial health inequity. Using our adapted framework, we contextualize results and recommend avenues for future research. Our findings support demands to move away from punitive school discipline toward health-affirming interventions to promote school connectedness, safety, and wellbeing.
Topics: Adolescent; Humans; Students; Schools; Problem Behavior; Substance-Related Disorders; Social Sciences; Punishment
PubMed: 36385456
DOI: 10.1111/nyas.14922 -
Frontiers in Psychology 2019The emergence of enduring antisocial personality changes in previously normal individuals, or "acquired sociopathy," has consistently been reported in patients with...
The emergence of enduring antisocial personality changes in previously normal individuals, or "acquired sociopathy," has consistently been reported in patients with bilateral injuries of the ventromedial prefrontal cortex. Over the past three decades, cases of acquired sociopathy with (a) bilateral or (b) unilateral sparing of the ventromedial prefrontal cortex have been reported. These cases indicate that at least in a few individuals (a') neural structures beyond the ventromedial prefrontal cortex are also critical for normal social behavior, and (b') the neural underpinnings of social cognition may be lateralized to one cerebral hemisphere. Moreover, researchers have presented evidence that lesion laterality and gender may interact in the production of acquired sociopathy. In the present review, we carried out a comprehensive literature survey seeking possible interactions between gender and hemispheric asymmetry in acquired sociopathy. We found 85 cases of acquired sociopathy due to bilateral ( = 48) and unilateral ( = 37) hemispheric injuries. A significant association between acquired sociopathy and right hemisphere damage was found in men, whereas lesions were bilateral in most women with acquired sociopathy. The present survey shows that: (i) the number of well-documented single-cases of acquired sociopathy is surprisingly small given the length of the historical record; (ii) acquired sociopathy was significantly more frequent in men after an injury of the right or of both cerebral hemispheres; and (iii) in most women who developed acquired sociopathy the injuries affected both cerebral hemispheres. These findings may be especially valuable to neuroscientists and to functional neurosurgeons in particular for the planning of tumor resections as well as for the choice of the best targets for therapeutic neuromodulation.
PubMed: 30941065
DOI: 10.3389/fpsyg.2019.00346 -
Neuroscience and Biobehavioral Reviews Sep 2015Previous work in animals has shown that dopamine (DA) in cortex and striatum plays an essential role in stress processing. For the first time, we systematically reviewed... (Review)
Review
Previous work in animals has shown that dopamine (DA) in cortex and striatum plays an essential role in stress processing. For the first time, we systematically reviewed the in vivo evidence for DAergic stress processing in health and psychopathology in humans. All studies included (n studies=25, n observations=324) utilized DA D2/3 positron emission tomography and measured DAergic activity during an acute stress challenge. The evidence in healthy volunteers (HV) suggests that physiological, but not psychological, stress consistently increases striatal DA release. Instead, increased medial prefrontal cortex (mPFC) DAergic activity in HV was observed during psychological stress. Across brain regions, stress-related DAergic activity was correlated with the physiological and psychological intensity of the stressor. The magnitude of stress-induced DA release was dependent on rearing conditions, personality traits and genetic variations in several SNPs. In psychopathology, preliminary evidence was found for stress-related dorsal striatal DAergic hyperactivity in psychosis spectrum and a blunted response in chronic cannabis use and pain-related disorders, but results were inconsistent. Physiological stress-induced DAergic activity in striatum in HV may reflect somatosensory properties of the stressor and readiness for active fight-or-flight behavior. DAergic activity in HV in the ventral striatum and mPFC may be more related to expectations about the stressor and threat evaluation, respectively. Future studies with increased sample size in HV and psychopathology assessing the functional relevance of stress-induced DAergic activity, the association between cortical and subcortical DAergic activity and the direct comparison of different stressors are necessary to conclusively elucidate the role of the DA system in the stress response.
Topics: Antisocial Personality Disorder; Brain; Dopamine; Humans; Neuroimaging; Radionuclide Imaging; Stress, Psychological
PubMed: 26196459
DOI: 10.1016/j.neubiorev.2015.07.008 -
Frontiers in Psychiatry 2019Personality disorders (PDs) are one of the major problems for the organization of public health systems. Deepening the link between personality traits and...
Personality disorders (PDs) are one of the major problems for the organization of public health systems. Deepening the link between personality traits and psychopathological drifts, it seems increasingly essential for the often dramatic repercussions that PDs have on social contexts. Some of these disorders, such as borderline PD, antisocial PD, in their most tragic expression, are the basis of problems related to crime, sexual violence, abuse, and mistreatment of minors. Many authors propose a dimensional classification of personality pathology, which has received empirical support from numerous studies over the last 20 years based on more robust theoretical principles than those applied to current nosography. The present study investigates the nature of the research carried out in the last years on the personality in the clinical field exploring the contents of current research on personality relapses, evaluating, on the one hand, the emerging areas of greatest interest and others, those that they stopped generating sufficient motivations in scholars. This study evaluates text patterns regarding how the terms "personality" and "mental health" are used in titles and abstracts published in PubMed in the last 5 years. We use a topic analysis: Latent Dirichlet Allocation that expresses every report as a probabilistic distribution of latent topics that are represented as a probabilistic distribution of words. A total of 7,572 abstracts (from 2012 to 2017) were retrieved from PubMed for the query on "mental health" and "personality." The study found 30 topics organized in eight hierarchical clusters that describe the type of current research carried out on personality and its clinical relapse. The hierarchical clusters latent themes were the following: social dimensions, clinical aspects, biological issues, clinical history of PD, internalization and externalization symptoms, impulsive behaviors, comorbidities, criminal behaviors. The results indicate that the concept of personality is associated with a wide range of conditions. The study of personality and mental health still proceeds, mainly, according to a practical-clinical approach; too little moves, however, according to an innovative research approach, but the work shows the common commitment of scholars to a new way of dealing with the study of personality.
PubMed: 31998157
DOI: 10.3389/fpsyt.2019.00938 -
The American Journal of Drug and... Sep 2021While males are more likely diagnosed with cannabis use disorder (CUD), females are more susceptible to developing and maintaining CUD. Yet, for both sexes, CUD is... (Meta-Analysis)
Meta-Analysis
BACKGROUND
While males are more likely diagnosed with cannabis use disorder (CUD), females are more susceptible to developing and maintaining CUD. Yet, for both sexes, CUD is associated with high rates of comorbid mental illness (MI).
OBJECTIVES
To identify and compare sex differences in the prevalence of comorbid CUD amongst individuals with/without MIs.
METHODS
This systematic review generated pooled odds ratios (OR) and 95% confidence intervals (CI) from 37 studies (including clinical trials, cohort, and case-control studies) among individuals with and without MIs, quantifying sex differences in rates of comorbid CUD. A meta-analysis was also completed.
RESULTS
In the CUD-only group, males were twice as likely to have CUD than females (OR = 2.0, CI = 1.9-2.1). Among MIs, males were more likely than females to have CUD comorbid with schizophrenia (OR ~2.6, CI = 2.5-2.7) and other psychotic, mood, and substance use disorders (1> OR <2.2, CI = 0.7-2.6). The reverse association (females > males) was observed for anxiety disorders and antisocial personality disorder (OR = 0.8, CI = 0.7-1.0). Among females, MIs increased the likelihood of having CUD, except for psychotic disorders and depression. A meta-analysis was inconclusive due to high heterogeneity across studies. Thus, comparisons across MI groups were not possible.
CONCLUSION
While males are more likely to be diagnosed with CUD, there are important sex differences in the prevalence of CUD across MI diagnoses that should be taken into account when approaching CUD prevention and determining treatment efficacy.
Topics: Comorbidity; Female; Humans; Male; Marijuana Abuse; Mental Disorders; Odds Ratio; Prevalence; Sex Distribution; Sex Factors
PubMed: 34280058
DOI: 10.1080/00952990.2021.1946071 -
International Journal of Environmental... Apr 2021Numerous studies have shown that youth with behavioral disorders (BD) present an increased risk for developing severe and persistent antisocial behaviors in adulthood.... (Review)
Review
UNLABELLED
Numerous studies have shown that youth with behavioral disorders (BD) present an increased risk for developing severe and persistent antisocial behaviors in adulthood. Retrospective research notes that not all children and adolescents follow a negative trajectory and explains this heterogeneity in particular by the severity of CU traits. Our study examines how these traits affect the functioning of children and adolescents with BD.
METHOD
A systematic literature review conducted through various databases and using different keywords made it possible to analyze 52 studies published from 2015 to 2020 that measured the bidirectional effects of CU traits on the functioning of young.
RESULTS
Out of the 52 studies, 47 analyzed links between CU traits and neurobiological or mental health, 20 examined family and school contexts, eight focused on social adjustment, 10 on social interactions and 19 measured links with cognitive functioning, especially executive functions.
CONCLUSION
Consistent with previous recommendations in the field, our findings emphasize the importance of assessing the presence of UC traits in early childhood to prevent the emergence of comorbid disorders and to target multimodal (early) interventions to influence the life trajectories of youth with high CU traits.
Topics: Adolescent; Adult; Antisocial Personality Disorder; Child; Child, Preschool; Conduct Disorder; Emotions; Humans; Problem Behavior; Retrospective Studies
PubMed: 33925165
DOI: 10.3390/ijerph18094712