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Clinical Psychology & Psychotherapy 2023Recent diagnostic developments suggest that paranoia is a transdiagnostic characteristic common to several personality disorders rather than a personality disorder per... (Review)
Review
Recent diagnostic developments suggest that paranoia is a transdiagnostic characteristic common to several personality disorders rather than a personality disorder per se. Nonetheless, empirical literature fails to provide comprehensive and univocal findings on whether and how paranoid presentations relate to different personality disorders. In the present scoping review, we map the empirical literature on paranoid presentations in personality disorders, considering the entire spectrum of paranoid manifestations (i.e., the paranoia hierarchy). In selecting original quantitative studies on paranoid presentations in personality-disordered patients, we screened 4,433 records in PsycArticles, PsycInfo and PUBMED. We eventually included 47 eligible studies in the review. Our synthesis indicates consistent empirical evidence of a wide range of paranoid presentations in Paranoid, Schizotypal and Borderline personality disorders. Conversely, little empirical literature exists on paranoid presentations in other personality disorders. Preliminary findings suggest broad-severity paranoid presentations, ranging from milder to severe forms, in Paranoid, Schizotypal and Borderline personality disorders. There is also some evidence of milder forms of paranoia in Avoidant, Antisocial and Narcissistic personality disorders. Conversely, there is poor evidence of paranoid presentations in Schizoid, Histrionic, Dependent or Obsessive-compulsive personality disorders. Research gaps and recommendations for improving empirical research on paranoid presentations in personality disorders are discussed.
Topics: Humans; Personality Disorders; Borderline Personality Disorder; Obsessive-Compulsive Disorder; Narcissistic Personality Disorder
PubMed: 37727949
DOI: 10.1002/cpp.2913 -
The Journal of Neuropsychiatry and... 2023Antisocial behaviors are common and problematic among patients with behavioral variant frontotemporal dementia (bvFTD). In the present study, the investigators aimed to...
OBJECTIVE
Antisocial behaviors are common and problematic among patients with behavioral variant frontotemporal dementia (bvFTD). In the present study, the investigators aimed to validate an informant-based questionnaire developed to measure the extent and severity of antisocial behaviors among patients with dementia.
METHODS
The Social Behavior Questionnaire (SBQ) was developed to measure 26 antisocial behaviors on a scale from absent (0) to very severe (5). It was administered to 23 patients with bvFTD, 19 patients with Alzheimer's disease, and 14 patients with other frontotemporal lobar degeneration syndromes. Group-level differences in the presence and severity of antisocial behaviors were measured. Psychometric properties of the SBQ were assessed by using Cronbach's alpha, exploratory factor analysis, and comparisons with a psychopathy questionnaire. Cluster analysis was used to determine whether the SBQ identifies different subgroups of patients.
RESULTS
Antisocial behaviors identified by using the SBQ were common and severe among patients with bvFTD, with at least one such behavior endorsed for 21 of 23 (91%) patients. Antisocial behaviors were more severe among patients with bvFTD, including the subsets of patients with milder cognitive impairment and milder disease severity, than among patients in the other groups. The SBQ was internally consistent (Cronbach's α=0.81). Exploratory factor analysis supported separate factors for aggressive and nonaggressive behaviors. Among the patients with bvFTD, the factor scores for aggressive behavior on the SBQ were correlated with those for antisocial behavior measured on the psychopathy scale, but the nonaggressive scores were not correlated with psychopathy scale measures. The k-means clustering analysis identified a subset of patients with severe antisocial behaviors.
CONCLUSIONS
The SBQ is a useful tool to identify, characterize, and measure the severity of antisocial behaviors among patients with dementia.
PubMed: 37415501
DOI: 10.1176/appi.neuropsych.20220135 -
Clinical Child and Family Psychology... Dec 2023Understanding and treatment of antisocial behavior have improved through efforts to subtype individuals based on similar risk factors and outcomes. In particular, the...
Understanding and treatment of antisocial behavior have improved through efforts to subtype individuals based on similar risk factors and outcomes. In particular, the presence of psychopathic traits is associated with distinct etiological factors and antisocial behavior that begins early in life, is aggressive, persistent, and less likely to normalize with traditional treatments, relative to individuals low on psychopathy or its childhood precursor, callous-unemotional (CU) traits. However, important distinctions can be made within individuals with CU/psychopathic traits according to the presence of elevated anxiety symptoms and/or adverse childhood experiences, known as secondary psychopathy/CU traits. This paper provides a broad and brief overview of theory and empirical literature supporting the existence of secondary psychopathy/CU variants as a distinct subtype of childhood antisocial behavior. It outlines the Emotionally Sensitive Child-Adverse Parenting Experiences-Allostatic (Over)Load (ESCAPE-AL) model for the developmental psychopathology of secondary psychopathic/CU traits and discusses research and theory supporting this perspective. Future research directions for testing this conceptual model and its implications for assessing and treating high-risk individuals with secondary CU/psychopathic traits are discussed.
Topics: Humans; Parenting; Conduct Disorder; Aggression; Antisocial Personality Disorder; Anxiety; Emotions
PubMed: 37735279
DOI: 10.1007/s10567-023-00455-2 -
Psychoradiology 2023Although sex differences in antisocial behavior are well-documented, the extent to which neuroanatomical differences are related to sex differences in antisocial...
BACKGROUND
Although sex differences in antisocial behavior are well-documented, the extent to which neuroanatomical differences are related to sex differences in antisocial behavior is unclear. The inconsistent results from different clinical populations exhibiting antisocial behaviors are mainly due to the heterogeneity in etiologies, comorbidity inequality, and small sample size, especially in females.
OBJECTIVE
The study aimed to find sexual dimorphic brain regions associated with individual differences in antisocial behavior while avoiding the issues of heterogeneity and sample size.
METHODS
We collected structural neuroimaging data from 281 college students (131 males, 150 females) and analyzed the data using voxel-based morphometry.
RESULTS
The gray matter volume in three brain regions correlates with self-reported antisocial behavior in males and females differently: the posterior superior temporal sulcus, middle temporal gyrus, and precuneus. The findings have controlled for the total cortical gray matter volume, age, IQ, and socioeconomic status. Additionally, we found a common neural substrate of antisocial behavior in both males and females, extending from the anterior temporal lobe to the insula.
CONCLUSION
This is the first neuroanatomical evidence from a large non-clinical sample of young adults. The study suggests that differences in males and females in reading social cues, understanding intentions and emotions, and responding to conflicts may contribute to the modulation of brain morphometry concerning antisocial behavior.
PubMed: 38666132
DOI: 10.1093/psyrad/kkad031 -
Journal of Racial and Ethnic Health... Oct 2023Youth drug use has reached global epidemic proportions with unequal distribution among communities with low income, immigrants, or ethnic status.
BACKGROUND
Youth drug use has reached global epidemic proportions with unequal distribution among communities with low income, immigrants, or ethnic status.
PURPOSE
This study seeks to understand the association between micro-level factors and youth drug use behavior among 2693 low-income, ethnic, and immigrant youths in Pomona, CA, USA. The study uneath's unique evidence and intervention elements necessary to resolve youth drug use in Pomona.
METHODS
We used social cognitive theory as a conceptual framework, and performed correlation and multiple linear regression analysis in a cross-sectional design.
RESULTS AND DISCUSSION
The results reveal that attitudes, perceptions, and behavior related to friends, participants, family, and adults in the participant's life and ease of access to drugs are associated with youth drug use. Variables related to friends and participants show a relatively stronger association with youth drug use in comparison to variables related to parents and adults in participants' lives. Equally, drug and non-drug antisocial behavior of friends and participants show a stronger association with youth drug use relative to prosocial behavior. Also, when a diverse set of predictor variables are combined together, their association to the outcome variable is stronger than that of a single variable.
RECOMMENDATIONS
Future interventions in Pomona should prioritize strategies which target participants and friends over activities targeting parents and adults. Interventions targeting antisocial behavior should be prioritized over prosocial behavior. Program implementers should also develop unique evidence and tools which will help parents influence the drug use behavior of youths in Pomona and similar communities.
PubMed: 37884855
DOI: 10.1007/s40615-023-01839-4 -
Development and Psychopathology Feb 2024Adverse environments are linked to elevated youth antisocial behavior. However, this relation is thought to depend, in part, on genetic susceptibility. The present study...
Adverse environments are linked to elevated youth antisocial behavior. However, this relation is thought to depend, in part, on genetic susceptibility. The present study investigated whether polygenic risk for antisociality moderates relations between hostile environments and stable as well as dynamic antisocial behaviors across adolescence. We derived two antisocial-linked polygenic risk scores (PRS) ( = 721) based on previous genome-wide association studies. Forms of antisocial behavior (nonaggressive conduct problems, physical aggression, social aggression) and environmental hostility (harsh parenting and school violence) were assessed at age 13, 15, and 17 years. Relations to individual differences stable across adolescence (latent stability) vs. time-specific states (timepoint residual variance) of antisocial behavior were assessed via structural equation models. Higher antisocial PRS, harsh parenting, and school violence were linked to stable elevations in antisocial behaviors across adolescence. We identified a consistent polygenic-environment interaction suggestive of differential susceptibility in late adolescence. At age 17, harsher parenting was linked to higher social aggression in those with higher antisocial PRS, and lower social aggression in those with lower antisocial PRS. This suggests that genetics and environmental hostility relate to stable youth antisocial behaviors, and that genetic susceptibility moderates home environment-antisocial associations specifically in late adolescence.
PubMed: 38329116
DOI: 10.1017/S095457942400004X -
Neuropsychobiology 2024Dual diagnosis in individuals with cocaine use disorders (CUDs) presents a mental health challenge marked by an increased susceptibility to disabling morbidities and...
Dysregulation of Plasma Growth Factors and Chemokines in Cocaine Use Disorder: Implications for Dual Diagnosis with Schizophrenia and Antisocial Personality Disorder in an Exploratory Study.
INTRODUCTION
Dual diagnosis in individuals with cocaine use disorders (CUDs) presents a mental health challenge marked by an increased susceptibility to disabling morbidities and premature mortality. Despite extensive research on depression and anxiety, other prevalent comorbidities, such as psychotic and personality disorders, have received less attention. This study explores inflammation-related mediators as potential biomarkers for CUD and dual diagnosis with schizophrenia (SCZ) or antisocial personality disorder (APD).
METHODS
This exploratory study included 95 participants, comprising 40 healthy subjects and 55 abstinent patients with CUD. Lifetime CUD was diagnosed either as single diagnosis (CUD group, N = 25) or as a dual diagnosis (DD group. N = 30) with SCZ (CUD+SCZ subgroup) or APD (CUD+APD subgroup). Participants were clinically assessed, and the plasma concentrations of growth factors (i.e., G-CSF, BDNF, and VEGF-A) and chemokines (i.e., CCL11/eotaxin-1, CCL2/MCP-1, and CXCL12/SDF-1) were determined and log(10)-transformed for analysis.
RESULTS
Growth factors and chemokines were dysregulated by CUD and psychiatric diagnoses. Specifically, patients in the CUD group exhibited significantly lower concentrations of G-CSF and CCL11/eotaxin-1 than the control group. In contrast, the DD group showed significantly higher concentrations of all analytes than both the CUD and control groups. Additionally, no differences in these analytes were observed between the CUD+SCZ and CUD+APD subgroups within the DD group. Regarding cocaine-related variables, significant associations were identified in the CUD group: an inverse correlation between the age at first cocaine use and the concentrations of BDNF and CCL2/MCP-1; and a positive correlation between the duration of the cocaine abstinence and the concentrations of BDNF and CCL11/eotaxin-1. Lastly, a logistic regression model incorporating all these analytes demonstrated high discriminatory power in distinguishing patients with CUD alone from those with dual diagnosis.
CONCLUSIONS
Individuals with dual diagnosis of CUD exhibit elevated concentrations of growth factors and chemokines, distinguishing them from those with CUD alone. It is unclear whether the differences in these inflammatory mediators are specific to the presence of SCZ and APD. The study highlights potential biomarkers and associations, providing valuable insights into the intricate interplay of CUD and psychiatric disorders to enhance clinical diagnosis and therapeutics.
Topics: Humans; Male; Cocaine-Related Disorders; Adult; Schizophrenia; Female; Antisocial Personality Disorder; Chemokines; Diagnosis, Dual (Psychiatry); Brain-Derived Neurotrophic Factor; Biomarkers; Middle Aged; Intercellular Signaling Peptides and Proteins; Vascular Endothelial Growth Factor A; Chemokine CCL2
PubMed: 38768577
DOI: 10.1159/000536265 -
PloS One 2023There was a large spike in gun purchases and gun violence during the first year of the COVID-19 pandemic in the United States. We used an online U.S. national survey (N...
Who bought a gun during the COVID-19 pandemic in the United States?: Associations with QAnon beliefs, right-wing political attitudes, intimate partner violence, antisocial behavior, suicidality, and mental health and substance use problems.
There was a large spike in gun purchases and gun violence during the first year of the COVID-19 pandemic in the United States. We used an online U.S. national survey (N = 1036) to examine the characteristics of people who purchased a gun between March 2020 and October 2021 (n = 103) and compared them to non-gun owners (n = 763) and people who own a gun but did not purchase a gun during the COVID-19 pandemic (n = 170). Compared to non-gun owners, pandemic gun buyers were younger and more likely to be male, White race, and to affiliate with the Republican party. Compared to non-gun owners and pre-pandemic gun owners, pandemic gun buyers exhibited extreme elevations on a constellation of political (QAnon beliefs, pro-gun attitudes, Christian Nationalism, approval of former President Donald Trump, anti-vax beliefs, COVID-19 skepticism; mean Cohen's d = 1.15), behavioral (intimate partner violence, antisocial behavior; mean d = 1.38), mental health (suicidality, depression, anxiety, substance use; mean d = 1.21), and personality (desire for power, belief in a dangerous world, low agreeableness, low conscientiousness; mean d = 0.95) characteristics. In contrast, pre-pandemic gun owners only endorsed more pro-gun attitudes (d = 0.67), lower approval of President Joe Biden (d = -0.41) and were more likely to be male and affiliate with the Republican party relative to non-gun owners. Pandemic gun buyers represent an extreme group in terms of political and psychological characteristics including several risk-factors for violence and self-harm.
Topics: Humans; Male; Female; Antisocial Personality Disorder; Pandemics; Mental Health; COVID-19; Suicide; Intimate Partner Violence; Substance-Related Disorders; Attitude
PubMed: 37643192
DOI: 10.1371/journal.pone.0290770 -
JAMA Network Open Jan 2024The suicidal risk of psychopathology in adolescence is suggested to differ based on its longitudinal trajectory, but the comorbidity of these symptom trajectories has...
IMPORTANCE
The suicidal risk of psychopathology in adolescence is suggested to differ based on its longitudinal trajectory, but the comorbidity of these symptom trajectories has not been well examined. This study comprehensively clustered trajectories of multiple psychopathological and behavioral symptoms and examined their associations with suicidal thoughts in adolescence.
OBJECTIVE
To determine which categories and trajectories of psychopathological and behavioral symptoms are associated with suicidal thoughts in adolescence, accounting for comorbid symptoms.
DESIGN, SETTING, AND PARTICIPANTS
This population-based cohort study in Japan used data from the Tokyo Teen Cohort (TTC) study, which was established in 2012 and is currently ongoing. Data from 3 waves of surveys conducted at ages 10, 12, and 16 years from October 2012 to September 2021 were used. Of the adolescents in the cohort, participants with at least 2 evaluations of psychopathological and behavioral symptoms were included. Data were analyzed from December 2022 to March 2023.
EXPOSURE
Latent class growth analysis was used to cluster the trajectory of each psychopathological and behavioral symptom.
MAIN OUTCOMES AND MEASURES
The associations between symptom trajectories and suicidal thoughts at age 16 were examined. Suicidal thoughts were assessed using a self-report questionnaire. Psychopathological and behavioral symptoms were assessed using the 8 subscale scores of the caregiver-report Child Behavior Checklist.
RESULTS
This study included 2780 adolescents (1306 female participants [47.0%]). Of the 1920 adolescents with data on suicidal thoughts, 158 (8.2%) had suicidal thoughts. The median (IQR) age was 10.2 (10.0-10.3) years at the first evaluation, 11.9 (11.8-12.1) years at the second evaluation, and 16.3 (16.1-16.5) years at the last evaluation. The clustering pattern of trajectories varied depending on symptom categories. After adjusting for each symptom trajectory and confounders, adolescents with persistent high withdrawn symptoms (odds ratio [OR], 1.88; 95% CI, 1.10-3.21) and those with increasing somatic symptoms (OR, 1.97; 95% CI, 1.16-3.34) had a significantly higher risk of suicidal thoughts than adolescents without these symptoms. There was no interaction between these symptom trajectories and the risk of suicidal thoughts.
CONCLUSIONS AND RELEVANCE
This cohort study found that persistent withdrawn symptoms and increasing somatic symptoms during early to midadolescence were associated with an increased risk of suicidal thoughts in midadolescence, even after accounting for comorbid symptoms and confounders. Attention should be paid to the suicidal risk associated with these symptoms, particularly when they persist or increase in the longitudinal follow-up.
Topics: Child; Adolescent; Humans; Female; Cohort Studies; Medically Unexplained Symptoms; Suicidal Ideation; Behavioral Symptoms; Antisocial Personality Disorder
PubMed: 38270951
DOI: 10.1001/jamanetworkopen.2023.53166 -
Addiction (Abingdon, England) Aug 2023Alcohol use disorder is comorbid with numerous other forms of psychopathology, including externalizing disorders (e.g. conduct disorder) and, to a lesser extent,...
BACKGROUND AND AIMS
Alcohol use disorder is comorbid with numerous other forms of psychopathology, including externalizing disorders (e.g. conduct disorder) and, to a lesser extent, internalizing conditions (e.g. depression, anxiety). Much of the time, overlap among alcohol use disorder and other conditions is explored at the disorder level, assuming that criteria are co-equal indicators of other psychopathology, even though alcohol use disorder criteria span numerous varied domains. Emerging evidence suggests that there are symptom clusters within the construct of alcohol use disorder that relate differentially with important external criteria, including psychopathology and allied personality traits (e.g. impulsivity, novelty-seeking). The present study mapped individual alcohol use disorder criteria onto internalizing and externalizing dimensions.
DESIGN AND PARTICIPANTS
We used multivariate and factor analytical modeling and data from two large nationally representative samples of past year drinkers (n = 25 604; 19 454).
SETTING
United States.
MEASUREMENTS
Psychopathology was assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule, yielding alcohol use disorder criteria, internalizing diagnoses (i.e. major depressive disorder, dysthymia, social anxiety disorder, generalized anxiety disorder, specific phobia, agoraphobia and panic disorder) and externalizing diagnoses and symptoms (i.e. antisocial personality disorder, conduct disorder and three impulsivity items drawn from borderline personality disorder criteria). Alcohol consumption was assessed in terms of past-year drinking frequency, usual amount of alcohol consumed on drinking days, binge drinking frequency, intoxication frequency, and maximum number of drinks in a 24-hour period.
FINDINGS
Four different patterns emerged. First, several alcohol use disorder criteria were relatively weakly associated with externalizing and internalizing. Secondly, withdrawal was associated with internalizing, but this association was not specific to distress. Thirdly, there was a general lack of specificity between alcohol use disorder criteria and narrower forms of internalizing, despite what might be predicted by modern models of addiction. Fourthly, recurrent use in hazardous situations reflected higher degrees of externalizing and lower internalizing liability.
CONCLUSIONS
Different symptom combinations appear to yield differential expressions of alcohol use disorder that are disorder-specific, or reflect broader tendencies toward externalizing, internalizing or both.
Topics: Humans; Alcoholism; Depressive Disorder, Major; Anxiety Disorders; Alcohol Drinking; Comorbidity
PubMed: 36606740
DOI: 10.1111/add.16121