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Current Psychiatry Reports Jul 2021Childhood trauma is an important risk factor for the development of personality disorders (PDs), yet most research has been devoted to categorical models of personality... (Review)
Review
PURPOSE OF REVIEW
Childhood trauma is an important risk factor for the development of personality disorders (PDs), yet most research has been devoted to categorical models of personality pathology. Considering the introduction of a dimensional PD model with ICD-11, we review current findings related to various forms of childhood trauma, and PDs, operationalized in the form of personality functioning and maladaptive traits. We focus on the magnitude of associations and examine specific relationships between emotional and physical trauma with areas of personality functioning and single traits.
RECENT FINDINGS
Two studies showed a strong association between childhood trauma and personality dysfunction. Seven studies, including clinical and forensic samples, demonstrated heterogeneous associations between various forms of childhood trauma and maladaptive traits. Overall, four studies indicated a slightly stronger association between personality dysfunction, maladaptive trait expression, and higher levels of emotional trauma than for physical or sexual trauma. Regarding specific trait domains and childhood trauma, most studies yielded the strongest associations for either psychoticism or detachment. Research on childhood trauma and dimensional PD models (i.e., personality functioning and traits) has the potential to contribute to a better understanding of their complex relationship. However, high intercorrelations among different types of childhood trauma, areas of personality functioning, and trait domains increase the difficulty of disentangling single effects. More research is needed including clinical and non-Western samples, especially considering the upcoming ICD-11 classification.
Topics: Diagnostic and Statistical Manual of Mental Disorders; Humans; International Classification of Diseases; Personality; Personality Disorders; Personality Inventory
PubMed: 34279729
DOI: 10.1007/s11920-021-01265-5 -
Journal of Personality Disorders Jun 2021Research shows that parental personality pathology is associated with borderline personality disorder features and internalizing/externalizing symptoms in offspring....
Research shows that parental personality pathology is associated with borderline personality disorder features and internalizing/externalizing symptoms in offspring. However, studies have been limited by -based assessments of parental personality pathology. The authors leveraged evidence that interpersonal problems described by the Interpersonal Circumplex align with Criterion A of the Alternative Model for Personality Disorders and therefore used a measure of interpersonal problems to capture parental personality pathology. The authors hypothesized that parental interpersonal problems would be associated with a latent variable of borderline features in adolescent offspring. They also examined whether this relation with offspring borderline features existed above and beyond relations with offspring internalizing/externalizing symptoms, age, and gender. The sample included 524 inpatient adolescents ( = 15.31, 62.4% female) and their parents (80.5% female). Parental interpersonal problems demonstrated unique relationships with adolescent borderline features and externalizing symptoms, but not internalizing symptoms. Implications of the results, limitations, and future directions are discussed.
Topics: Adolescent; Borderline Personality Disorder; Diagnostic and Statistical Manual of Mental Disorders; Female; Humans; Male; Parents; Personality; Personality Disorders
PubMed: 33764823
DOI: 10.1521/pedi_2021_35_518 -
American Journal of Psychotherapy Jan 2022Antisocial personality disorder (ASPD) is a common condition associated with interpersonal and social violence, and current treatments are unsatisfactory. Mentalizing,...
Antisocial personality disorder (ASPD) is a common condition associated with interpersonal and social violence, and current treatments are unsatisfactory. Mentalizing, which has developmental roots in attachment processes, offers a framework to reconsider treatment for ASPD, in which dysfunction of the attachment system temporarily inhibits affect regulation and reduces mentalizing abilities, resulting in impulsivity and relational reactivity. Mentalization-based treatment for ASPD (MBT-ASPD), which focuses on the mental and relational processes central to personality disorder rather than on anger management and violent behavior, is a promising intervention. Implemented as a group psychotherapy, MBT-ASPD targets the mentalizing vulnerabilities and attachment patterns of patients by using a semi-structured group process focused on personal formulation and by establishing group values to promote learning from other members and generating "we-ness." The treatment then emphasizes mentalizing in relationships. This article discusses the mentalizing model of ASPD and outlines strategies for MBT-ASPD from a therapy group conducted in Great Britain.
Topics: Antisocial Personality Disorder; Borderline Personality Disorder; Humans; Mentalization; Psychotherapy, Group; Violence
PubMed: 34915724
DOI: 10.1176/appi.psychotherapy.20210023 -
Personality Disorders Jan 2023Most research on personality disorders (PDs) relies upon self-reported information, commonly collected via standardized self-report inventories or structured interviews.... (Review)
Review
Most research on personality disorders (PDs) relies upon self-reported information, commonly collected via standardized self-report inventories or structured interviews. Such data might, for instance, be culled from archival records from applied evaluative contexts or collected as part of dedicated anonymized research studies. Many factors-such as disengagement, distractibility, or motivation to appear in a certain manner-may influence whether self-reported information accurately reflects an examinee's genuine personality characteristics. Despite resultant risks to the validity of collected data, very few measures used in PD research include embedded indicators of response validity. In this article, we review the need for validity measures and strategies that exist to identify invalid self-report data, and we offer several suggestions for PD researchers to consider in order to detect invalid self-reported information and improve the quality of their data. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Topics: Humans; Motivation; Personality Disorders; Self Report
PubMed: 36848077
DOI: 10.1037/per0000608 -
Psychopathology 2023Anorexia nervosa (AN) is a highly debilitating disease which frequently results in chronification and often originates in adolescence. Personality traits have been...
OBJECTIVE
Anorexia nervosa (AN) is a highly debilitating disease which frequently results in chronification and often originates in adolescence. Personality traits have been associated with the onset and maintenance of AN; moreover, study results indicated a worse treatment outcome in patients with AN and comorbid personality disorder (PD). However, research on PD in adolescent AN is scarce.
METHODS
The sample consists of 73 female adolescent patients with AN. We investigated comorbid PD and AN symptom severity performing the International Personality Disorder Examination (IPDE) and the Eating Disorder Inventory 2 (EDI-2).
RESULTS
Almost a third (27.4%) of all participants were diagnosed with comorbid PD. They had significantly higher EDI-2 total scores reflecting overall stronger symptom severity, as well as significantly higher scores in the subscales "ineffectiveness," "interpersonal distrust," "interoceptive awareness," "asceticism," "impulse regulation," and "social insecurity."
CONCLUSION
PD is an important and frequent comorbid condition in adolescent AN and should be addressed in diagnostic and treatment planning. Early diagnosis of comorbidity could have an impact on choosing specialized treatment for adolescents with AN and PD in order to enhance the outcome.
Topics: Humans; Adolescent; Female; Anorexia Nervosa; Personality Disorders; Comorbidity; Personality; Treatment Outcome; Personality Inventory
PubMed: 36450269
DOI: 10.1159/000527555 -
Child and Adolescent Mental Health May 2022The characteristic features of personality disorder that are found in older people are also present in young people. These features are currently not diagnosed as...
The characteristic features of personality disorder that are found in older people are also present in young people. These features are currently not diagnosed as personality problems by most UK practitioners, through a mixture of fear and prejudice, which is used to justify this avoidant diagnostic behaviour. A simple solution is offered. State that personality function is 'disordered' in those who cross the threshold for diagnosis but emphasise that it is often ephemeral and can be managed.
Topics: Adolescent; Aged; Avoidance Learning; Fear; Humans; Personality Disorders; Prejudice
PubMed: 35289067
DOI: 10.1111/camh.12551 -
Family Medicine and Community Health Sep 2020The purpose of this study was to explore the views of patients with personality disorder on their experiences of prescribing practices by general practitioners (GPs) and...
OBJECTIVE
The purpose of this study was to explore the views of patients with personality disorder on their experiences of prescribing practices by general practitioners (GPs) and psychiatrists, and their expectations of primary and secondary mental health services.
DESIGN
This was a qualitative study involving two focus groups. Discussion in the focus groups was recorded, transcribed verbatim and then analysed by a thematic analysis process to generate the key themes.
SETTING
The study took place at a specialist outpatient personality disorder service in the UK.
PARTICIPANTS
A total of seven participants took part in the study. They were purposively sampled from an NHS specialist outpatient personality disorder service. All participants had a primary diagnosis of emotionally unstable personality disorder and their age ranged from 20 to 52 years.
RESULTS
Five key themes emerged. Participants felt that medication has a powerful impact on their mind and body but expressed confusion and uncertainty on how it is affecting them. Participants had a need for a good relationship with their doctors (GPs or psychiatrists). They described a feeling of being dismissed and not believed, expressing a desire to confront the 'powerful' position of their doctors by showing anger. The nature of the doctor-patient relationship was seen to moderate positively or negatively the experience of doctors' prescribing. Finally, there were key expectations of the primary-secondary care interface, including continuity of care, diagnostic clarity and a desire for different healthcare professionals to communicate with one another.
CONCLUSION
The doctor-patient relationship is an important medium for providing validation and seeking negotiation of therapeutic treatment strategies in patients with personality disorder. Given that personality disorder is associated with high rates of physical and mental health comorbidity, it is therefore vital for clinical guidelines and training packages to take more account of the relational aspects of prescribing in consultations for this patient group with a view to improve outcomes.
Topics: Adult; Female; General Practitioners; Humans; Male; Middle Aged; Patient Satisfaction; Personality Disorders; Physician-Patient Relations; Psychiatry; Qualitative Research; Young Adult
PubMed: 32958520
DOI: 10.1136/fmch-2020-000458 -
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 Affective Disorders Nov 2020Prior research has demonstrated a link between compulsive hoarding symptoms and personality traits; however, no studies have investigated the link between hoarding and...
BACKGROUND
Prior research has demonstrated a link between compulsive hoarding symptoms and personality traits; however, no studies have investigated the link between hoarding and personality traits utilizing a sample of individuals diagnosed with hoarding disorder (HD) using formal diagnostic criteria. The aim of the current study was to evaluate the frequency and type of personality traits in adults diagnosed with HD and to explore the associations among hoarding severity and personality disorder traits within this sample.
METHODS
Seventy-two veterans enrolled in an ongoing treatment trial for HD completed a battery of self-report measures during their initial assessment. Linear regression analyses were used to determine the unique variance accounted for by hoarding severity in predicting scores on the personality disorder scales from the Millon Clinical Multiaxial Inventory-III (MCMI-III).
RESULTS
The majority of participants had an elevated score on at least one of the MCMI-III Personality scales. The most frequently elevated scores were for the Avoidant, Dependent, Depressive, and Schizoid scales. Hoarding severity was a significant predictor of personality traits in 10 out of 14 MCMI-III scales.
LIMITATIONS
Given the exploratory nature of the investigation, we did not control for multiple comparisons or the presence of mood or anxiety disorders.
CONCLUSIONS
The elevated prevalence of co-occurring personality pathology in adults with HD indicates the importance of considering underlying personality structure when developing individualized treatment plans.
Topics: Adult; Anxiety Disorders; Hoarding Disorder; Humans; Personality; Personality Disorders; Personality Inventory
PubMed: 32697698
DOI: 10.1016/j.jad.2020.07.033 -
Personality and Mental Health May 2022Great progress has been made in furthering our understanding of the long-term course of personality pathology. However, our knowledge about the long-term outcomes of...
Great progress has been made in furthering our understanding of the long-term course of personality pathology. However, our knowledge about the long-term outcomes of personality disorder, thus far, is based on a polythetic and categorical definition of personality disorder. This special issue brings together a set of papers reporting on the results of the 30-year prospective study, the Nottingham Study of Neurotic Disorder, in addition to presenting a study protocol for a future study, the Boston (UK) Personality Project, and results from a study of lived experience of individuals who have been in treatment for personality challenges. Together, these papers highlight the value in viewing personality pathology not as a categorically defined disorder, but as a severity criterion related to functioning. This special issue paves the way for considering how to further refine and conceptualize the general severity criterion common to all manifestations (types) of personality disorder.
Topics: Humans; International Classification of Diseases; Personality; Personality Disorders; Prospective Studies
PubMed: 35581693
DOI: 10.1002/pmh.1549