-
Journal of Medicine and Life Apr 2022Personality disorders can lead to difficult social or occupational functional processes rooted in chronic maladaptive thoughts, feelings, and behaviors. This study aimed...
Personality disorders can lead to difficult social or occupational functional processes rooted in chronic maladaptive thoughts, feelings, and behaviors. This study aimed to investigate factors of personality disorder in prisoners from the central prison of Sanandaj, Iran. We conducted a cross-sectional study, which included all prisoners in the central prison of Sanandaj, Iran. The study sample includes 343 prisoners, of which 329 were male, and 14 were female, selected by randomized multistage sampling method. Participants filled in Millon's multi-axis clinical questionnaire. The data were analyzed using Chi-square, multiple logistic regression, and bootstrap analysis. There were 183 participants without personality disorders (53.4%) and 99 participants (28.9%) with cluster B personality disorders (narcissistic, histrionic, anti-social, and borderline). Male gender (OR=0.07) and elementary education level (OR=0.18) have a significant relationship with cluster A personality disorders (paranoid, schizoid, schizotypal). Cluster B has a significant relationship only with the elementary education level (OR=0.27). Cluster C (avoidant, dependent, obsessive-compulsive personality disorder) has a significant relationship with male gender (OR=0.20), elementary education level (OR=0.30), unemployment (OR=2.64), theft crime types (OR=0.38) and disputes and assaults (OR=0.18). Based on these results, psychological and psychiatric interventions in prisoners are suggested.
Topics: Cross-Sectional Studies; Female; Humans; Iran; Logistic Models; Male; Personality Disorders; Prisoners
PubMed: 35646191
DOI: 10.25122/jml-2021-0317 -
Aesthetic Plastic Surgery Feb 2022Body dysmorphic disorder (BDD) and other psychological problems are more common in cosmetic surgery applicants.
BACKGROUND
Body dysmorphic disorder (BDD) and other psychological problems are more common in cosmetic surgery applicants.
OBJECTIVE
The aim of this study was to investigate the frequency of the symptoms of BDD and narcissistic personality disorder in rhinoplasty candidates.
MATERIALS AND METHODS
This descriptive cross-sectional study was performed on rhinoplasty applicants. All subjects were evaluated by BDD and narcissistic personality questionnaires (NPI-16).
RESULTS
A total of 380 patients were studied. Our findings showed that the prevalence of mild, moderate, and severe BDD symptoms was 31.6%, 43.4% and 25%, respectively. The mean BDD scores were not significantly different in variables such as gender, age, marital status, history of cosmetic surgery, education, place of residence, and income. 29.5% of the subjects had symptoms of narcissism. There was no significant relationship between the symptoms of narcissism and variables such as gender, age, marital status, history of cosmetic surgery, place of residence, and income. Higher education was associated with higher rates of narcissistic personality disorder (p-value = 0.021).
CONCLUSIONS
According to the results of the study, there was no statistically significant relationship between BDD score and demographic parameters. Also, association between narcissistic personality disorder and demographic characteristics was not significant except for education.
LEVEL OF EVIDENCE IV
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Topics: Body Dysmorphic Disorders; Cross-Sectional Studies; Humans; Personality Disorders; Rhinoplasty; Surgery, Plastic
PubMed: 34820690
DOI: 10.1007/s00266-021-02603-x -
Social Psychiatry and Psychiatric... Apr 2021The epidemiology of personality disorder is poorly understood. This study aims to describe the population in contact with mental health services with a diagnosis of...
PURPOSE
The epidemiology of personality disorder is poorly understood. This study aims to describe the population in contact with mental health services with a diagnosis of personality disorder and compare service use between this group and those with a diagnosis of depression.
METHODS
Investigation of a routinely collected clinical data set across New Zealand was conducted. We used data from 2008 to 2017 and 1-year data from 2016, the most complete dataset. This allowed for variation over the years and confirmation within a 1-year prevalence. These data were analysed focusing on patients with a primary diagnosis of any personality disorder and the subset with borderline personality disorder (BPD). BPD was chosen as the most common clinical personality disorder diagnosis and that most researched.
RESULTS
8884 (2.8%) of the population in contact with mental health services carried a primary diagnosis of personality disorder. Personality diagnosis other than antisocial personality disorder (ASPD) in men and borderline personality disorder (BPD) in either gender was negligible. Rates of personality pathology increased with social deprivation and were commonest in young adults. Multi-morbidity was the norm, with internalising disorder common. Maori diagnosed with PD were over-represented both in the patient group and by population.
CONCLUSION
Borderline personality disorder and antisocial personality disorder are routinely diagnosed in routine clinical practice in New Zealand; however, other categorical diagnoses are not made. Patients with PD are significant users of resources in comparison to depressed patients. Resource utilisation was significantly greater in those with PD, in particular use of inpatient services compared to those with depression.
Topics: Antisocial Personality Disorder; Borderline Personality Disorder; Humans; Male; New Zealand; Personality; Personality Disorders; Prevalence; Young Adult
PubMed: 32394007
DOI: 10.1007/s00127-020-01876-y -
Current Opinion in Psychiatry Jan 2015The aim of this review is twofold: to review recent literature on personality disorders, published in 2013 and the first half of 2014; and to use recent theoretical work... (Review)
Review
PURPOSE OF REVIEW
The aim of this review is twofold: to review recent literature on personality disorders, published in 2013 and the first half of 2014; and to use recent theoretical work to argue for a contextually grounded approach to culture and personality disorder.
RECENT FINDINGS
Recent large-sample studies suggest that U.S. ethnoracial groups differ in personality disorder diagnostic rates, but also that minority groups are less likely to receive treatment for personality disorder. Most of these studies do not test explanations for these differences. However, two studies demonstrate that socioeconomic status partly explains group differences between African-Americans and European Americans. Several new studies test the psychometric properties of instruments relevant to personality disorder research in various non-Western samples. Ongoing theoretical work advocates much more attention to cultural context. Recent investigations of hikikomori, a Japanese social isolation syndrome with similarities to some aspects of personality disorder, are used to demonstrate approaches to contextually grounded personality disorder research.
SUMMARY
Studies of personality disorder must understand patients in sociocultural context considering the dynamic interactions between personality traits, developmental histories of adversity and current social context. Research examining these interactions can guide contextually grounded clinical work with patients with personality disorder.
Topics: Culture; Humans; Personality Disorders; Psychometrics; Risk Factors; Social Environment
PubMed: 25415498
DOI: 10.1097/YCO.0000000000000120 -
Current Psychiatry Reports Mar 2017Impulsivity is a multifaceted construct and an important personality trait in various mental health conditions. Among personality disorders (PDs), especially cluster B... (Review)
Review
PURPOSE OF REVIEW
Impulsivity is a multifaceted construct and an important personality trait in various mental health conditions. Among personality disorders (PDs), especially cluster B PDs are affected. The aims of this review are to summarize the relevant findings of the past 3 years concerning impulsivity in cluster B PDs and to identify those subcomponents of self-reported impulsivity and experimentally measured impulse control that are most affected in these disorders.
RECENT FINDINGS
All studies referred to antisocial (ASPD) or borderline PD (BPD), and none were found for narcissistic or histrionic PD. In ASPD as well as BPD, self-report scales primarily revealed heightened impulsivity compared to healthy controls. In experimental tasks, ASPD patients showed impairments in response inhibition, while fewer deficits were found in delay discounting. BPD patients showed specific impairments in delay discounting and proactive interference, while response inhibition was less affected. However, after inducing high levels of stress, deficits in response inhibition could also be observed in BPD patients. Furthermore, negative affect led to altered brain activation patterns in BPD patients during impulse control tasks, but no behavioral impairments were found. As proposed by the DSM-5 alternative model for personality disorders, heightened impulsivity is a core personality trait in BPD and ASPD, which is in line with current research findings. However, different components of experimentally measured impulse control are affected in BPD and ASPD, and impulsivity occurring in negative emotional states or increased distress seems to be specific for BPD. Future research could be focused on measures that assess impulsive behaviors on a momentary basis as this is a promising approach especially for further ecological validation and transfer into clinical practice.
Topics: Adult; Antisocial Personality Disorder; Borderline Personality Disorder; Delay Discounting; Disruptive, Impulse Control, and Conduct Disorders; Female; Humans; Male; Proactive Inhibition
PubMed: 28251591
DOI: 10.1007/s11920-017-0768-8 -
Current Psychiatry Reports Feb 2016Although the relationship between dreaming and psychopathology has been studied quite extensively, research on dreaming in patients with personality disorders has been... (Review)
Review
Although the relationship between dreaming and psychopathology has been studied quite extensively, research on dreaming in patients with personality disorders has been very scarce. In patients with borderline personality disorder, negatively toned dreams and heightened nightmare frequency have been found-characteristics not determined by co-morbid depression or posttraumatic stress disorder. The review includes suggestions for future studies as the existing results clearly indicate that this line of research is most interesting. Lastly, clinical recommendations especially regarding the treatment of the often found co-morbid nightmare disorder will be given.
Topics: Borderline Personality Disorder; Comorbidity; Depression; Depressive Disorder; Dreams; Humans; Personality Disorders; Stress Disorders, Post-Traumatic
PubMed: 26781553
DOI: 10.1007/s11920-015-0653-2 -
Journal of Personality Disorders Jun 2023Change in treatment of narcissistic personality disorder (NPD) has been considered difficult to attain. Aspects of narcissistic pathology, including interpersonal...
Change in treatment of narcissistic personality disorder (NPD) has been considered difficult to attain. Aspects of narcissistic pathology, including interpersonal enhancement, avoidance, aggressivity, and control, have contributed to challenges in forming a therapeutic alliance and pursuing treatment towards attainable goals for change and remission. This study, based on a qualitative review of therapists' case reports of individual psychotherapy with eight patients diagnosed with NPD, is the first to identify and explore patterns, processes, and indicators of change in pathological narcissism. All patients showed significant improvement in personality and life functioning, including engagement in work or education and long-term close relationships, with remission of the NPD diagnosis. The process of change was gradual, with some noticeable changes occurring in specific life contexts. Additional factors indicating and contributing to change included patients' motivation and commitment to psychotherapy, reflective ability, emotion regulation, sense of agency, and interpersonal and social engagement.
Topics: Humans; Personality Disorders; Personality; Psychotherapy; Narcissism; Therapeutic Alliance
PubMed: 37367820
DOI: 10.1521/pedi.2023.37.3.337 -
American Journal of Psychotherapy Mar 2023This article demonstrates the contribution of Otto Kernberg's object relations theory of personality pathology to the current understanding of the nature and assessment...
This article demonstrates the contribution of Otto Kernberg's object relations theory of personality pathology to the current understanding of the nature and assessment of personality pathology and diagnosis. The article introduces recent advances in psychiatric nosology and presents differing views on the meaning of the general severity criterion common to all personality pathology (i.e., level of personality functioning as described in criterion A of the Alternative DSM-5 Model for Personality Disorders). Next, the significance of Kernberg's theory to recent nosological advances is discussed, with a focus on two important features: first, a definition of personality that goes beyond signs and symptoms to include structural motivational components, in the domains of self- and interpersonal functioning, that are common to all personality manifestations and that fulfill an intrapsychic, organizing function; second, identity formation and consolidation as the ultimate end point of healthy personality functioning. That these cornerstone features of Kernberg's theory, articulated more than 50 years ago, align with the most up-to-date conceptualization of personality pathology confirms that Kernberg's theory represents an idea whose time has finally come.
Topics: Humans; Personality Disorders; Personality; Object Attachment; Motivation; Diagnostic and Statistical Manual of Mental Disorders; Borderline Personality Disorder
PubMed: 36353849
DOI: 10.1176/appi.psychotherapy.20220016 -
The International Journal of Social... Sep 2023Homeless people present high rates of psychopathology, including personality disorders. Given the link between personality disorders and attachment, and the potential... (Review)
Review
BACKGROUND
Homeless people present high rates of psychopathology, including personality disorders. Given the link between personality disorders and attachment, and the potential importance of these two traits for understanding homeless populations.
AIMS
Our aim was to review all studies focusing on attachment and on the full assessment of personality disorders in the homeless.
METHOD
Overall, 213 studies were screened through title and abstract. Of these, 63 articles were chosen for full-text assessment.
RESULTS
A total of 14 articles met eligibility criteria and were included in the present review. Six studies evaluated personality disorders and eight studies assessed attachment in the homeless. In general, reports suggested that personality disorders are highly common in the homeless, with frequencies ranging between 64% and 79% for any personality disorder. The most common personality diagnoses were paranoid (14%-74%), borderline (6%-62%), avoidant (14%-63%), and antisocial (4%-57%) personality disorders. Attachment reports differed in the methods used and presented diverse results and correlates. Even so, insecure types of attachment dominated in the homeless, accounting for 62% to 100% of the samples.
CONCLUSIONS
The high prevalence of personality disorders and insecure types of attachment in the homeless may impact intervention strategies for these people. The available literature evaluating attachment and the full assessment of personality disorders in the homeless is scarce, which supports the need for more research on these two topics.
Topics: Humans; Personality Disorders; Psychopathology; Ill-Housed Persons; Prevalence; Personality; Borderline Personality Disorder
PubMed: 36951386
DOI: 10.1177/00207640231161201 -
Current Opinion in Psychiatry Jan 2021This review explores recent literature on the applicability of the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) and International... (Review)
Review
PURPOSE OF REVIEW
This review explores recent literature on the applicability of the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) and International Classification of Disease, 11th Revision (ICD-11) personality disorder classification systems across countries and cultural contexts.
RECENT FINDINGS
Several studies examining the cultural validity and utility of DSM-5 and ICD-11 personality disorder have been conducted in a number of language and cultural groups that are different from those in which the tools were originally developed. These studies, using quantitative methods, have largely supported the applicability of the new dimensional and trait approaches to classifying personal disorders. Studies qualitatively exploring the views of service users and clinicians on the development or operationalization of DSM-5 and ICD-11 personality disorder report that a lay summary of diagnostic constructs thatreflect concern about language of diagnostic criteria as well the lived experience of service users would be found useful. Clinicians found the dimensional system of ICD-11 slightly more useful than the categorical system of ICD-10 on several utility scales, but the studies on ICD-11 have been much less in view of its latter appearance.
SUMMARY
DSM-5 and ICD-11 personality disorder have shown a preliminary evidence of improved utility across cultures. More studies, including those reflecting the views of service users, are needed to confirm this early observation across many more cultural and linguistic groups.
Topics: Algeria; Brazil; Cross-Cultural Comparison; Diagnostic and Statistical Manual of Mental Disorders; Europe; Humans; International Classification of Diseases; Personality; Personality Disorders; Research Design; Singapore; United States
PubMed: 33044250
DOI: 10.1097/YCO.0000000000000659