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Personality and Mental Health Nov 2022Mild traumatic brain injury (mTBI) poses risk to the neurocognitive, emotional, and financial well-being of affected individuals. While aggression and impulsivity have...
Mild traumatic brain injury (mTBI) poses risk to the neurocognitive, emotional, and financial well-being of affected individuals. While aggression and impulsivity have been examined in relation to mTBI, little work has been done to evaluate the relationship between history of mTBI and personality disorder (PD). The authors examined the associations between history of mTBI and PD in a control group without history of mTBI (N = 1189) and individuals with history of mTBI (N = 267). Results demonstrated that any PD diagnosis is a significant risk factor for mTBI (p < 0.001). Cluster B diagnoses, particularly borderline and antisocial PD, were independently significant risk factors for mTBI. These data suggest a role for screening for a history of mTBI in patients with PDs and associated traits.
Topics: Humans; Brain Concussion; Personality Disorders; Impulsive Behavior; Antisocial Personality Disorder; Aggression
PubMed: 35598165
DOI: 10.1002/pmh.1550 -
Expert Opinion on Pharmacotherapy Mar 2021
Topics: Borderline Personality Disorder; Humans; Personality Disorders
PubMed: 33432834
DOI: 10.1080/14656566.2021.1873277 -
Current Opinion in Psychiatry Jan 2022This review examines the prevalence of personality disorder in those with mental state disorder. Some challenges disentangling these psychopathologies are delineated and... (Review)
Review
PURPOSE OF REVIEW
This review examines the prevalence of personality disorder in those with mental state disorder. Some challenges disentangling these psychopathologies are delineated and advances in understanding broadly are reviewed.
RECENT FINDINGS
Recent taxonomic changes to a dimensionally based classification system in the ICD-11 and DSM of mental disorders-V's alternative model of personality disorder include requiring cut offs to examine clinical outcomes akin to those in hypertension. These new criteria affect personality disorder prevalence where it is comorbid with mental state disorder, although more robust the dimensional approach complicates understanding both theoretically and practically. Such issues include: deciding the cut off for 'pathology', understanding if psychopathology is related to mental state disorder, personality disorder or both, and consideration of the clinical value of comorbidity.
SUMMARY
There is overlap between personality pathology and all types of mental state disorder. However, the shift to a dimensional framework of personality pathology means new methods to define and measure this comorbidity are needed. Dimensional conceptualisation of personality pathology challenges the underlying ontology of comorbidity in this area.
Topics: Comorbidity; Diagnostic and Statistical Manual of Mental Disorders; Humans; International Classification of Diseases; Mental Disorders; Personality Disorders; Prevalence
PubMed: 34855696
DOI: 10.1097/YCO.0000000000000761 -
Current Opinion in Psychology Feb 2021Psychophysiological research methods allow important insights into normative and pathological functioning of the human organism. This position paper briefly reviews... (Review)
Review
Psychophysiological research methods allow important insights into normative and pathological functioning of the human organism. This position paper briefly reviews existing studies, investigating the psychophysiological concomitants of personality pathology, with an emphasis on developmental aspects. Focussing on measures, indexing autonomic nervous system (ANS) activity at rest, and its reactivity to experimental challenge, the narrative synthesis of the literature highlights current challenges in the field. Findings on the psychophysiological concomitants of personality pathology are mixed. Inconsistencies among studies arise from differences between disorders and heterogeneity within distinct diagnostic categories. The majority of studies addressed borderline personality disorder, illustrating robust alterations in ANS function linked to severe experiences of early maltreatment and trauma, and associated symptoms of dissociation. However, important life-style and secondary health-related factors (i.e. physical activity, smoking) influencing ANS function are frequently neglected. Adapting a dimensional approach to personality pathology and longitudinal research designs seem promising to advance the filed in the years to come.
Topics: Borderline Personality Disorder; Humans; Personality; Personality Disorders
PubMed: 33461056
DOI: 10.1016/j.copsyc.2020.12.004 -
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 -
Personality and Mental Health Feb 2021
Topics: Consensus; Humans; Personality; Personality Disorders
PubMed: 33624442
DOI: 10.1002/pmh.1504 -
Personality Disorders Jul 2022The current review examines the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) alternative model for personality disorders' (AMPD)... (Review)
Review
The current review examines the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) alternative model for personality disorders' (AMPD) operationalization of antisocial personality disorder (ASPD), particularly as it relates to the construct of psychopathy. We review the available literature on the AMPD conceptualization of ASPD, its potential improvement over previous versions of the DSM, and its relationship to established measures of psychopathy. In addition, we review the literature on the AMPD's psychopathy specifier, including its utility in differentiating between ASPD and psychopathy. We provide a critical commentary for what these findings mean moving forward and discuss areas for future research direction. We argue that the DSM-5 conceptualization of ASPD is a vast improvement over previous iterations of the diagnosis; however, we discuss potential limitations and disagreements that could arise in its overlap with the construct of psychopathy. Finally, we argue that work moving forward should focus more broadly on dimensional traits and their prediction of outcomes, rather than continuing to seek diagnostic accuracy in conceptualizing ASPD and/or psychopathy and that the AMPD provides a good framework for this work. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Topics: Antisocial Personality Disorder; Diagnostic and Statistical Manual of Mental Disorders; Humans; Personality; Personality Disorders; Phenotype
PubMed: 35787129
DOI: 10.1037/per0000525 -
The British Journal of Psychiatry : the... Feb 2020The diagnosis of personality disorder is sometimes tolerated but often reviled as a label to attach to people we do not like. This is hardly surprising when we consider...
The diagnosis of personality disorder is sometimes tolerated but often reviled as a label to attach to people we do not like. This is hardly surprising when we consider that problems in interpersonal relationships constitute the main feature of the disorder. But we cannot escape the fact that personality problems are extremely common and rejection on grounds of perceived undesirability is doltish. Both the DSM-5 (2013) alternative model and new ICD-11 classification of personality may help understanding as they are more in tune with science. Most of the previous classifications have failed to help practitioners or patients.
Topics: Diagnostic and Statistical Manual of Mental Disorders; Humans; International Classification of Diseases; Interpersonal Relations; Male; Personality; Personality Disorders
PubMed: 31148538
DOI: 10.1192/bjp.2019.125 -
Journal of Psychiatric Research Aug 2022Comorbid bipolar disorder (BP) and borderline personality disorder (BPD) presents a diagnostic challenge in its differentiation from each condition individually. We...
Comorbid bipolar disorder (BP) and borderline personality disorder (BPD) presents a diagnostic challenge in its differentiation from each condition individually. We aimed to use a machine learning (ML) approach to differentiate comorbid BP/BPD from both BP and BPD. Participants were assigned DSM diagnoses and compared on self-report measures examining personality, emotion regulation strategies and perceived parental experiences during childhood. 82 participants were assigned as BP, 52 as BPD and 53 as comorbid BP/BPD. ML-derived diagnoses had an accuracy of 79.6% in classifying BP/BPD vs. BP, and 61.7% in classifying BP/BPD vs. BPD. Stress-related paranoid ideation and other core borderline personality items were important in distinguishing BP/BPD vs. BP, whereas deficits in emotion regulation strategies were important in distinguishing BP/BPD vs. BPD. Impulsivity and anger were important across both analyses. We identified clinical variables more distinctive in comorbid BP/BPD, with superior accuracy in distinguishing from BP, and with lower accuracy compared to BPD alone. Such an additive model should assist in sharpening clinical decision making, with future machine learning examination of larger datasets likely to further improve diagnostic accuracy.
Topics: Bipolar Disorder; Borderline Personality Disorder; Comorbidity; Humans; Machine Learning; Personality Disorders; Self Report
PubMed: 35696742
DOI: 10.1016/j.jpsychires.2022.05.032 -
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