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Archives of Clinical Neuropsychology :... Jul 2023As personality changes and personality disorders are frequently observed in multiple sclerosis (MS), personality may be a prognostic factor for this disease. The present...
OBJECTIVE
As personality changes and personality disorders are frequently observed in multiple sclerosis (MS), personality may be a prognostic factor for this disease. The present study investigated the influence of personality on disability, progression, and treatment adherence in MS.
METHOD
Personality was assessed in 41 patients with Relapsing-Remitting MS (30 females; mean age = 42.63 years) using the NEO Personality Inventory-3rd edition. Disability was measured with the Expanded Disability Status Scale, and treatment adherence information was collected from the Swiss MS Cohort. Correlation, multiple linear and partial least square regressions were performed to examine relations between personality, disability, and treatment adherence in MS.
RESULTS
After accounting for age and time since disease onset, our analysis revealed that Neuroticism (β = 0.32, p = 0.01) and its Vulnerability facet (β = 0.28, p < 0.05) predicted greater disability, whereas Extraversion (β = -0.25, p = 0.04) and its Activity facet (β = -0.23, p < 0.05) predicted milder disability. Regarding disability progression, correlational analysis revealed that it was negatively correlated with Extraversion (r = -0.44, p = 0.02) and the Feelings facet of Openness (r = -0.41, p = 0.03), but regressions failed to highlight any predictive links. No significant results could be demonstrated for treatment adherence.
CONCLUSIONS
Overall, our study showed that some personality traits can impact disability in MS, indicating that these should be considered in clinical practice, as they could be used to adapt and improve patients' clinical support.
Topics: Female; Humans; Adult; Multiple Sclerosis; Neuropsychological Tests; Personality; Multiple Sclerosis, Relapsing-Remitting; Personality Disorders
PubMed: 36764662
DOI: 10.1093/arclin/acad010 -
Comprehensive Psychiatry Apr 2024Impulsivity is a common cognitive issue across several psychiatric illnesses but is most frequently associated with the DSM-5 Disruptive, Impulse Control and Conduct...
PURPOSE
Impulsivity is a common cognitive issue across several psychiatric illnesses but is most frequently associated with the DSM-5 Disruptive, Impulse Control and Conduct Disorders, ADHD, and addictive disorders. We hypothesized that a wide range of psychiatric disorders would be associated with elevated impulsivity, not just those commonly linked to impulsiveness. This study aimed to explore the relationship between impulsivity and various psychiatric disorders in young adults.
PROCEDURES
700 non-treatment seeking participants (aged 18-29 years) were enrolled from the general community, provided demographic information, and underwent a psychiatric evaluation to screen for various psychiatric disorders. Each participant then completed the Barratt Impulsiveness Scale (BIS), a self-report measure of impulsivity, followed by the Stop Signal Task (SST), a computerized stop-attention task that measures impulse control. Impulsivity levels across psychiatric disorders were examined by analyzing z-scores relative to controls.
MAIN FINDINGS
Patients with bulimia nervosa, comorbid panic disorder with agoraphobia, and borderline personality disorder showed the highest levels of attentional, motor, and non-planning impulsivity, respectively. The effect size of the difference in total BIS impulsivity was large (d > 0.8) for several conditions including eating, personality, addictive, and mood disorders. The effect size of the difference in impulsivity was not large for any of the measures of ADHD. As compared to other psychiatric disorders analyzed, trichotillomania showed the greatest levels of impulsivity as measured by SST.
PRINCIPAL CONCLUSIONS
This data indicates that a wide range of psychiatric disorders exhibit heightened impulsivity with findings differing across various cognitive domains. Comorbidity resulted in unique findings of elevated impulsivity. This may suggest utility in viewing impulsivity as a transdiagnostic factor for a broad range of psychiatric disorders. Future studies should analyze comorbidities and whether patient psychiatric medication impacts these findings.
Topics: Humans; Young Adult; Impulsive Behavior; Personality Disorders; Mood Disorders; Trichotillomania; Behavior, Addictive
PubMed: 38184857
DOI: 10.1016/j.comppsych.2023.152449 -
Current Psychiatry Reports May 2024Physical pain is an underrecognized area of dysregulation among those with borderline personality disorder (BPD). Disturbances are observed within the experience of... (Review)
Review
PURPOSE OF REVIEW
Physical pain is an underrecognized area of dysregulation among those with borderline personality disorder (BPD). Disturbances are observed within the experience of acute, chronic, and everyday physical pain experiences for people with BPD. We aimed to synthesize research findings on multiple areas of dysregulation in BPD in order to highlight potential mechanisms underlying the association between BPD and physical pain dysregulation.
RECENT FINDINGS
Potential biological mechanisms include altered neural responses to painful stimuli within cognitive-affective regions of the brain, as well as potentially low basal levels of endogenous opioids. Emotion dysregulation broadly mediates dysregulation of physical pain. Certain psychological experiences may attenuate acute physical pain, such as dissociation, whereas others, such as negative affect, may exacerbate it. Social challenges between patients with BPD and healthcare providers may hinder appropriate treatment of chronic pain. Dysregulated physical pain is common in BPD and important in shaping health outcomes including elevated BPD symptoms, chronic pain conditions, and risk for problematic substance use.
Topics: Borderline Personality Disorder; Humans; Chronic Pain; Acute Pain
PubMed: 38598062
DOI: 10.1007/s11920-024-01498-0 -
Scientific Reports May 2024Evidence links immune system alterations to major psychiatric disorders. The few previous studies on personality traits or personality disorders (PDs) indicate that...
Evidence links immune system alterations to major psychiatric disorders. The few previous studies on personality traits or personality disorders (PDs) indicate that immunometabolic dysregulation may be prevalent in this population. This study aimed to investigate relationships between personality traits, PDs, and immunometabolic markers in peripheral blood. We hypothesized that neuroticism would be correlated with elevated leptin. Participants were recruited as young adults seeking care for general psychiatric disorders. They responded to a personality inventory and were assessed for PDs, and reevaluated again at a 12 years follow-up. Blood samples were collected at the follow-up and analyzed for 29 immunometabolic markers. A positive correlation was found between the personality trait neuroticism and leptin (ρ = 0.31, p = 0.02). An exploratory analysis also revealed a positive correlation between brain-derived neurotrophic factor (ρ = 0.36, p < 0.01) and neuroticism. These findings remained after adjusting for other variables in general linear models. There were no relationships between PDs and any immunometabolic markers. Results both confirm previous findings of correlations between the immunometabolic system and personality traits and suggest directions for future research.
Topics: Humans; Female; Male; Personality Disorders; Biomarkers; Adult; Personality; Young Adult; Neuroticism; Leptin; Brain-Derived Neurotrophic Factor; Personality Inventory; Adolescent
PubMed: 38773198
DOI: 10.1038/s41598-024-62214-9 -
BMC Psychology Oct 2023Because of the importance of the cross-cultural study of hyperbolic temperament in increasing knowledge related to borderline personality disorder (BPD), the present...
OBJECTIVE
Because of the importance of the cross-cultural study of hyperbolic temperament in increasing knowledge related to borderline personality disorder (BPD), the present study was conducted to test the reliability, construct, criterion, and discriminant validity of the Hyperbolic Temperament Questionnaire (HTQ) in three Iranian samples.
METHODS
Using a cross-sectional design, the HTQ 11-item version translated into Farsi was provided to three selected samples (total N = 558, 72% female, 18 to 77 years old with an average of 30.2 and a standard deviation of 10.3). The samples included non-personality disorder samples (n = 194), samples with BPD symptoms (n = 104), and samples with other personality disorder symptoms (n = 260). Data were collected using multiple validating measurements. Factor analysis was used to verify that the HTQ is unidimensional and correlations and regression models were used to examine its associations with other constructs.
RESULTS
Factor analysis confirmed the single-factor structure of the HTQ in two non-personality disorder and BPD samples. The internal consistency of all items and the total scale were acceptable across the samples (α = 0.87 to 0.91). Positive correlations with maladaptive constructs such as negative affectivity and interpersonal sensitivity and negative correlations with adaptive constructs supported the criterion validity of HTQ. The HTQ was specifically related to borderline symptoms, even after controlling for similar constructs such as depression.
CONCLUSION
The 11-item version of HTQ has acceptable reliability and validity in Iranian samples. Using this short tool for rapid screening of cases with BPD before common procedures such as clinical interviews helps to save diagnostic time and costs.
Topics: Humans; Female; Adolescent; Young Adult; Adult; Middle Aged; Aged; Male; Iran; Temperament; Reproducibility of Results; Cross-Sectional Studies; Surveys and Questionnaires; Borderline Personality Disorder
PubMed: 37798773
DOI: 10.1186/s40359-023-01364-3 -
Borderline Personality Disorder and... Sep 2023Borderline personality disorder (BPD) is a severe mental disorder frequently seen in individuals with recurrent self-harm behaviour. To what extent there are...
BACKGROUND
Borderline personality disorder (BPD) is a severe mental disorder frequently seen in individuals with recurrent self-harm behaviour. To what extent there are distinguishing characteristics between self-harming adolescents who meet the criteria for a full diagnosis of BPD, a sub-threshold number of BPD criteria and those who don't have BPD, with respect to clinical characteristics, is still uncertain and could have important clinical implications.
METHODS
Data from 103 adolescents with recurrent self-harm behaviour recruited from child and adolescent psychiatric outpatient clinics were collected through clinical interviews and self-reports. Bivariate analyses comparing participants with or without a diagnosis of BPD were performed. Group differences based on the number of BPD criteria fulfilled (few-if-any BPD: 0-2 criteria, sub-threshold BPD: 3-4 criteria, full-syndrome BPD: 5 or more criteria) were tested and regression analyses performed.
RESULTS
Adolescents with a diagnosis of BPD (28.2%) had significantly higher numbers of co-morbid DSM-5 disorders, suicide attempts and self-harm methods. They also reported significantly higher levels of suicidal ideation, depression, anxiety and impulsivity, compared with adolescents without BPD. Adolescents with sub-threshold BPD (20.4%) place themselves in the intermediate position between participants with full-syndrome BPD and participants with few-if-any BPD, in terms of these symptoms. Higher levels of emotional regulation difficulties and a lower level of global functioning were significantly associated with fulfilling a higher number of BPD criteria.
CONCLUSION
Adolescents with recurrent self-harm who meet diagnostic criteria for a full-syndrome BPD or sub-threshold BPD seem to have difficulties within the same spectrum. They seem dimensionally, but not categorically, different with respect to the severity of their difficulties. These adolescents need interventions aimed at their dysfunctional self-harm behaviour, emotional regulation difficulties and BPD symptoms at an earlier, rather than at a later stage of symptom development.
PubMed: 37705040
DOI: 10.1186/s40479-023-00234-z -
Psychiatry Research Oct 2023Prevalence rates and correlates of personality disorders (PD) are relevant to health care policy and planning.
INTRODUCTION
Prevalence rates and correlates of personality disorders (PD) are relevant to health care policy and planning.
OBJECTIVES
To present normative data for self-reported ICD-11 personality disorder (PD) features including tentative cut-off scores and prevalence rates for severity levels along with psychosocial correlates.
METHODS
The Personality Disorder Severity ICD-11 (PDS-ICD-11) scale and criterion measures of impairment were administered to a social-demographically stratified sample of Danish citizens (N = 8,941) of which 3,044 delivered complete data. Item-Response Theory (IRT) was employed to indicate cut-offs based on standard deviations from the latent mean.
RESULTS
The unidimensionality of the PDS-ICD-11 score was supported and IRT analysis suggested norm-based thresholds at latent severity levels. Expected associations with criterion measures were found.
CONCLUSION
The normative data portray ICD-11 PD features in the general population and allow for interpretation of PDS-ICD-11 scores (e.g., scores of 12, 16, and 19 may indicate mild, moderate, and severe dysfunction), which may inform health care policy and planning. A total weighted prevalence of 6.9 % of the Danish general population is estimated to have clinically significant personality dysfunction, proportionally composed of Mild (4.8 %), Moderate (1.2 %), and Severe (0.9 %) levels. Future research should corroborate these findings using relevant clinical samples and methods.
Topics: Humans; Prevalence; International Classification of Diseases; Personality Disorders; Self Report; Personality; Denmark
PubMed: 37748238
DOI: 10.1016/j.psychres.2023.115484 -
Journal of Clinical Medicine Oct 2023Borderline personality disorder (BPD) has long suffered from overshadowing in adolescents and hopelessness from the psychiatrists themselves. Comprehensive guidelines... (Review)
Review
BACKGROUND
Borderline personality disorder (BPD) has long suffered from overshadowing in adolescents and hopelessness from the psychiatrists themselves. Comprehensive guidelines for this age group are lacking.
AIMS
This narrative review aims to describe current recommendations for BPD and recent empirical evidence on effective treatments (both pharmacological and non-pharmacological) and preventive approaches. Innovative approaches, based on recent and original research on BPD adolescents, are also discussed.
RESULTS
Very low-certainty evidence has supported that medication has a positive effect on core BPD symptoms in adolescents. Medication prescribed for suicidal crises or associated disorders should be included in a global therapeutic plan, including efficacy reassessment, treatment duration, and a security plan. The overall benefit of structured psychotherapy for adolescents with BPD (cognitive behavioral therapy, mentalization-based therapy, dialectic behavioral therapy, and group therapy) is more important for self-harm behaviors than other BPD symptoms. Their specific efficacy, although difficult to distinguish from the overall non-specific effect of integrative care.
CONCLUSIONS
structured care of young BPD individuals should be based on the following principles: (1) setting the frame of care, including recognition of the diagnosis, and sharing information with patients and families about symptoms, prognosis, and putative psychological mechanisms involved; and (2) promoting comprehensive approaches, including both specific and non specific therapy, ecological interventions, community care, and preventive interventions in at-risk groups.
PubMed: 37892806
DOI: 10.3390/jcm12206668 -
Current Psychiatry Reports Nov 2023Unstable relationships are a core feature of borderline personality disorder (BPD). Impairments in trust processes (i.e., appraisal and learning regarding others'... (Review)
Review
PURPOSE OF REVIEW
Unstable relationships are a core feature of borderline personality disorder (BPD). Impairments in trust processes (i.e., appraisal and learning regarding others' trustworthiness) can subserve interpersonal problems associated with BPD, but the determinants, mechanisms, consequences, and variations in trust impairments among individuals with BPD remain poorly characterized. Thus, a better understanding of such impairments could help target interventions that address the interpersonal problems of individuals with BPD beyond emotion dysregulation, impulsivity, and aggression.
RECENT FINDINGS
We conducted a pre-registered systematic review of empirical studies on trust processes and BPD features (k = 29). Results are organized around a heuristic model of trust processes in BPD comprising the following stages: developmental factors, prior beliefs and dispositions, situation perception, emotional states, trust appraisal, behavioral manifestations, and trust learning. Based on the synthesis of the findings, we recommended directions for future research and clinical assessment and intervention, such as managing trust during the early stages of therapy and considering improvements in trust processes as a central mechanism of change in treating individuals with BPD.
Topics: Humans; Trust; Interpersonal Relations; Borderline Personality Disorder; Emotions; Aggression
PubMed: 37889465
DOI: 10.1007/s11920-023-01468-y -
International Journal of Environmental... Sep 2023Conduct a systematic review concerning the literature that reflects whether the callous and unemotional traits present in childhood and/or adolescence are precursors in... (Review)
Review
OBJECTIVE
Conduct a systematic review concerning the literature that reflects whether the callous and unemotional traits present in childhood and/or adolescence are precursors in the development of female psychopathy in adulthood.
MATERIALS AND METHODS
A systematic review involved consulting three databases-EBSCO, the Web of Science, and PubMed-for peer-reviewed and quantitative studies within the period 2000-2023. Nine articles with quality of three and above were included.
RESULTS
The presence of callous and unemotional traits designates a group of youth that show characteristics associated with psychopathy, specifically when predicting a more severe and chronic pattern of antisocial behaviour. Children with high rates of callous and unemotional traits, who show symptoms of attention deficit hyperactivity disorder in combination with severe conduct problems, are most likely to show features associated with psychopathy. The multidimensional psychopathy construct is considered a better predictor of future and stable antisocial behaviour than the callous and unemotional traits alone model.
CONCLUSIONS
According to the studies selected, the callous and unemotional traits in childhood seem to be precursors of female psychopathy in adulthood, but only because of the way they seem to enhance conduct problems, disruptive behaviour disorders, and, as a possible outcome, delinquency and antisocial traits, which may be precursors of future psychopathy.
Topics: Adolescent; Child; Female; Humans; Antisocial Personality Disorder; Databases, Factual; Phenotype; Problem Behavior; PubMed
PubMed: 37754645
DOI: 10.3390/ijerph20186786