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BMJ (Clinical Research Ed.) Sep 2023
Topics: Humans; Personality Disorders
PubMed: 37666510
DOI: 10.1136/bmj-2019-050290 -
Fortschritte Der Neurologie-Psychiatrie Aug 2015In this article, we review the history of the construct of narcissism and the diagnostic criteria for narcissistic personality disorder. We then discuss some etiological... (Review)
Review
In this article, we review the history of the construct of narcissism and the diagnostic criteria for narcissistic personality disorder. We then discuss some etiological models of narcissism and introduce the model of Jeffrey Young, who developed Schema Therapy (ST) as an alternative to standard cognitive therapy for patients with personality disorders. ST differs from standard cognitive therapies in important respects, including limited reparenting, a focus on the patient's basic needs, and emotional activating techniques in addition to cognitive and behavioral ones. We then discuss Young's theory of basic needs, early maladaptive schemas, and schema modes. According to ST theory, narcissists are traumatized in the schema domain having to do with attachment needs. They are prone to vulnerable emotions in response to narcissistic injuries, although they often do not show these emotions directly. Instead, they use maladaptive coping strategies, resulting in emotional states, known as "schema modes". This includes the Self-Aggrandizer mode and Detached Self-Soother mode, in which a superior, arrogant self-presentation and addictive or compulsive behavior serve a self-regulatory function. These concepts are illustrated by case examples of patients with Narcissistic Personality Disorder.
Topics: Cognitive Behavioral Therapy; Humans; Personality Disorders; Personality Tests
PubMed: 26327479
DOI: 10.1055/s-0035-1553484 -
Current Psychiatry Reports Nov 2023Sadistic pleasure-the enjoyment of harm-infliction to others-can have devastating interpersonal and societal consequences. The goal of the current review is to... (Review)
Review
PURPOSE OF REVIEW
Sadistic pleasure-the enjoyment of harm-infliction to others-can have devastating interpersonal and societal consequences. The goal of the current review is to illuminate the nomological net of traits related to sadism. We aim to achieve an understanding of the current empirical status on the link between sadism and personality disorders, psychopathy, the Dark Triad, and basic personality traits in clinical and community-based samples.
RECENT FINDINGS
The field is dominated by self-report studies on the Dark Triad with convenience samples. The link with DSM personality disorders has hardly been empirically studied. Existing evidence shows that sadism is most strongly related to increased psychopathic personality traits. Sadism can originate both from the interpersonal, affective, and behavioural basis of dark personality traits. There are diverging ideas on the differential status between sadism, psychopathy, and other dark traits. Research is needed on the causal impact of the broader range of personality disorders on sadism, in more diverse samples, including behavioural assessments of sadistic pleasure, as well as on the interplay of such personality traits with situational and affective aspects, and victim attitudes.
Topics: Humans; Sadism; Personality Disorders; Antisocial Personality Disorder; Personality
PubMed: 37856033
DOI: 10.1007/s11920-023-01466-0 -
Lancet (London, England) Feb 2015
Topics: Humans; Personality Disorders
PubMed: 25706202
DOI: 10.1016/S0140-6736(15)60272-0 -
Annual Review of Clinical Psychology May 2017There has been a surge in interest in and research on narcissism and narcissistic personality disorder (NPD). Despite or because of this increased attention, there are... (Review)
Review
There has been a surge in interest in and research on narcissism and narcissistic personality disorder (NPD). Despite or because of this increased attention, there are several areas of substantial debate that surround the construct, including descriptions of grandiose and vulnerable dimensions or variants, questions regarding the existence of a consensual description, central versus peripheral features of narcissism, distinctions between normal and pathological narcissism, possible etiological factors, the role of self-esteem in narcissism, where narcissism should be studied, how it can be assessed, and its representation in diagnostic nosologies. We suggest that a failure to distinguish between grandiose (i.e., overtly immodest, self-centered, entitled, domineering) and vulnerable (e.g., self-centered, distrustful, neurotic, introverted) presentations of narcissism has led to a less cohesive and coherent literature and that trait-based models of personality and personality disorder can bring greater clarity to many of these important debates.
Topics: Humans; Narcissism; Personality Disorders
PubMed: 28301765
DOI: 10.1146/annurev-clinpsy-032816-045244 -
Schizophrenia Bulletin Oct 2018The interaction of personality pathology and schizophrenia has conceptually been a topic of considerable interest in psychiatry. Recent advances in taxonomy and... (Review)
Review
The interaction of personality pathology and schizophrenia has conceptually been a topic of considerable interest in psychiatry. Recent advances in taxonomy and assessment of relevance to the clinician and researcher is presented. Cluster A and avoidant personality disorders are regarded as risk factors or antecedents for the development of schizophrenia. Some features of borderline personality disorder may resemble schizophrenia. With both a hierarchical structure and symptom-focused classification systems, personality pathology and personality disorder comorbidities can be overlooked. They can remain untreated because they are seen as part of the psychotic syndrome or superseded. A case formulation of a patient with schizophrenia is likely enriched by considering both these facets and may highlight comorbid personality disorder that warrants independent treatment.
Topics: Comorbidity; Humans; Personality; Personality Disorders; Schizophrenia
PubMed: 29688529
DOI: 10.1093/schbul/sby053 -
Continuum (Minneapolis, Minn.) Jun 2015This article reviews the current information about the diagnostic criteria, pathophysiology, and treatment of personality disorders. These disorders are common in the... (Review)
Review
PURPOSE OF REVIEW
This article reviews the current information about the diagnostic criteria, pathophysiology, and treatment of personality disorders. These disorders are common in the general population and even more common in medical settings. Rigid thinking and inflexible behavior patterns are characteristic of all personality disorders. The related impairment in social adaptation and associated morbidity and mortality are described.
RECENT FINDINGS
Recent advances have led to a change in the way these disorders are classified. Personality disorders are now understood to be heritable and biologically based. Neurobiological, metabolic, and brain structural differences exist in individuals with these disorders. Historically, personality disorders, or Axis II disorders, have been seen as distinct from the more biological Axis I disorders. This multiaxial diagnostic structure has now been abandoned, eliminating the artificial partitioning off of personality disorders.
SUMMARY
In this article, the epidemiology, etiology, classification, and treatment of the various personality disorders are reviewed. Emphasis is placed on the need for compassion when working with patients with personality disorders and an understanding that the nature of these disorders engenders interpersonal conflict. Although the bulk of available research focuses on borderline personality disorder, significant findings related to a variety of personality disorders are presented.
Topics: Adult; Female; Humans; Male; Middle Aged; Personality Disorders; Psychiatric Status Rating Scales; Young Adult
PubMed: 26039856
DOI: 10.1212/01.CON.0000466668.02477.0c -
American Journal of Psychotherapy Mar 2023Transference-focused psychotherapy (TFP) is an empirically supported individualized psychotherapy for patients with borderline personality disorder. This review... (Review)
Review
OBJECTIVE
Transference-focused psychotherapy (TFP) is an empirically supported individualized psychotherapy for patients with borderline personality disorder. This review highlights its development and current status.
METHODS
A review of the theoretical background underpinning TFP and empirical advances in the development of TFP provide perspective.
RESULTS
Otto Kernberg's object relations model of personality and its implications for assessment and diagnosis of personality disorders are described. The authors review the programmatic research that has been developed and has demonstrated the efficacy of TFP. In view of the empirical studies that have demonstrated the successful outcomes and processes of TFP for patients with borderline personality disorder, compared with other approaches, TFP has been applied to a broader range of difficulties related to patients' self-functioning and interpersonal functioning across the range of severities in personality pathology, consistent with the Alternative DSM-5 Model for Personality Disorders. The authors discuss borderline personality organization in the context of interpersonal, neurocognitive, and self-regulatory dysfunction, including preliminary findings.
CONCLUSIONS
The theoretical and empirical advances in TFP lead to future directions for research evaluating personality disorder and its treatment.
Topics: Humans; Transference, Psychology; Psychotherapy; Personality Disorders; Borderline Personality Disorder; Object Attachment
PubMed: 36221977
DOI: 10.1176/appi.psychotherapy.20220017 -
Medicine, Science, and the Law Oct 2019
Topics: Attitude of Health Personnel; Countertransference; Evidence-Based Practice; Health Knowledge, Attitudes, Practice; Health Personnel; Humans; Personality Disorders; Professional-Patient Relations; Psychiatry
PubMed: 31638484
DOI: 10.1177/0025802419880782 -
Annual Review of Clinical Psychology May 2020An important advance in understanding and defining mental disorders has been the development of empirical approaches to mapping dimensions of dysfunction and their... (Review)
Review
An important advance in understanding and defining mental disorders has been the development of empirical approaches to mapping dimensions of dysfunction and their interrelatedness. Such empirical approaches have consistently observed intercorrelations among the many forms of psychopathology, leading to the identification of a general factor of psychopathology (the p factor). In this article, we review empirical support for p, including evidence for the stability and criterion validity of p. Further, we discuss the strong relationship between p and both the general factor of personality and the general factor of personality disorder, substantive interpretations of p, and the potential clinical utility of p. We posit that proposed substantive interpretations of p do not explain the full range of symptomatology typically included in p. The most plausible explanation is that p represents an index of impairment that has the potential to inform the duration and intensity of a client's mental health treatment.
Topics: Humans; Mental Disorders; Personality; Personality Disorders
PubMed: 32040926
DOI: 10.1146/annurev-clinpsy-071119-115848