-
Clinical Psychology Review Jun 2023The aim of this systematic review and meta-analysis was to investigate the diagnostic, the dimensional mean-level, and rank-order stability of personality disorders... (Meta-Analysis)
Meta-Analysis Review
The aim of this systematic review and meta-analysis was to investigate the diagnostic, the dimensional mean-level, and rank-order stability of personality disorders (PDs) and PD criteria over time. EMBASE, PsycInfo, PubMed, and Web of Science were searched for peer-reviewed studies published in either English, German, or French between the first publication of the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980 and December 20, 2022. Inclusion criteria were a prospective longitudinal study design, assessing the stability of PDs or PD criteria over at least two measurement occasions at least one month apart, and using the same assessment at baseline and follow-up. Effect sizes included proportion of enduring cases (i.e., diagnostic stability), test-retest correlations (i.e., dimensional rank-order stability), and within-group standardized mean differences (i.e., dimensional mean-level stability), based on the first and last available measurement occasion. From an initial pool of 1473 studies, 40 were included in our analyses, covering 38,432 participants. 56.7% maintained the diagnosis of any PD, and 45.2% maintained the diagnosis of borderline PD over time. Findings on the dimensional mean-level stability indicate that most PD criteria significantly decreased from baseline to follow-up, except for antisocial, obsessive-compulsive, and schizoid PD criteria. Findings on the dimensional rank-order stability suggested moderate estimates, except for antisocial PD criteria, which were found to be high. Findings indicated that both PDs and PD criteria were only moderately stable, although between study heterogeneity was high, and stability itself depended on several methodological factors.
Topics: Humans; Longitudinal Studies; Prospective Studies; Personality Disorders; Diagnostic and Statistical Manual of Mental Disorders
PubMed: 37116251
DOI: 10.1016/j.cpr.2023.102284 -
European Journal of Psychotraumatology 2023Borderline personality disorder (BPD) is characterized by symptoms associated with difficulties in emotion regulation, altered self-image, impulsivity, and instability... (Meta-Analysis)
Meta-Analysis Review
Borderline personality disorder (BPD) is characterized by symptoms associated with difficulties in emotion regulation, altered self-image, impulsivity, and instability in personal relationships. A relationship has been found between BPD symptoms and altered neuropsychological processes. Studies of event-related potentials (ERP) measured with electroencephalogram (EEG) have found neural correlates related to BPD symptoms. Of note is the P300 component, considered a potential mental health biomarker for trauma-associated disorders. However, no meta-analysis has been found to demonstrate this relationship. To evaluate the relationship between the P300 component and BPD symptoms. To evaluate the relationship of other ERP components with BPD symptoms. The method and procedure were adjusted to the PRISMA checklist. The search was performed in three databases: WOS, Scopus and PubMed. A Random Effects Model was used to perform the analysis of the studies. In addition, a meta-regression was performed with % women, Gini and GDP. Finally, a descriptive analysis of the main results found between P300, other ERP components (LPP, P100 and ERN/Ne) and BPD symptoms was performed. From a review of 485 articles, a meta-analysis was performed with six articles that met the inclusion criteria. A moderate, positive relationship was found between the P300 component and BPD symptoms (REM = .489; < .001). It was not possible to perform meta-analyses for other ERP components (LPP, P100 and ERN/Ne) due to the low number of articles found. The idea that P300 could be considered for use as a biomarker to identify altered neural correlates in BPD is reinforced. In addition, a moderating effect of inequality (Gini) was detected.
Topics: Humans; Female; Male; Borderline Personality Disorder; Evoked Potentials; Electroencephalography; Impulsive Behavior; Biomarkers
PubMed: 38214169
DOI: 10.1080/20008066.2023.2297641 -
Personality Disorders Jan 2023Tests of statistical interactions (or tests of moderation effects) in personality disorder research are a common way for researchers to examine nuanced hypotheses...
Tests of statistical interactions (or tests of moderation effects) in personality disorder research are a common way for researchers to examine nuanced hypotheses relevant to personality pathology. However, the nature of statistical interactions makes them difficult to reliably detect in many research scenarios. The present study used a flexible, simulation-based approach to estimate statistical power to detect trait-by-trait interactions common to psychopathy research using the Triarchic model of Psychopathy and the Psychopathic Personality Inventory. Our results show that even above-average sample sizes in these literatures (e.g., = 428) provide inadequate power to reliably detect trait-by-trait interactions, and the sample sizes needed to detect interaction effect sizes in realistic scenarios are extremely large, ranging from 1,300 to 5,200. The implications for trait-by-trait interactions in psychopathy are discussed, as well as how the present findings might generalize to other areas of personality disorder research. We provide recommendations for how to design research studies that can provide informative tests of interactions in personality disorder research, but also highlight that a more realistic option is to abandon the traditional approach when testing for interaction effects and adopt alternative approaches that may be more productive. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Topics: Humans; Personality Inventory; Personality Disorders; Antisocial Personality Disorder; Personality; Phenotype
PubMed: 35737564
DOI: 10.1037/per0000582 -
Psychiatria Danubina Dec 2022Sex-related disturbance including sexual dreams contributes to psychiatric disorders, but whether personality disorder functioning styles are linked with sexual dreams...
BACKGROUND
Sex-related disturbance including sexual dreams contributes to psychiatric disorders, but whether personality disorder functioning styles are linked with sexual dreams especially in frequent dreamers remains unsettled SUBJECTS AND METHODS: One hundred and seventy one healthy volunteers (controls) and 81 frequent sexual dreamers (fsDreamers) were invited to answer the Sexual Dream Experience Questionnaire (SDEQ) and the Parker Personality Measure (PERM).
RESULTS
Compared to controls, fsDreamers scored significantly higher on SDEQ Joyfulness, Familiarity, Bizarreness and the annual frequency, and on all PERM styles except Schizoid and Obsessive-Compulsive. Sexual dream contents were associated with Borderline, Histrionic and Narcissistic styles in controls, and with Paranoid, Schizotypal, Borderline, Histrionic, Avoidant, and Passive-Aggressive styles in fsDreamers.
CONCLUSIONS
Personality involvement in etiology of sexual dreams has been illustrated by the elevated sexual experience and personality disorder functioning style scores and their prominent inter-correlations, especially in frequent sexual dreamers.
Topics: Humans; Personality Disorders; Personality; Sexual Behavior; Happiness; Surveys and Questionnaires
PubMed: 36752253
DOI: No ID Found -
Psychopathology 2023Borderline personality disorder (BPD) is a complex condition marked by heterogeneity. People with BPD have a profusion of symptoms spread across various levels of lived... (Review)
Review
Borderline personality disorder (BPD) is a complex condition marked by heterogeneity. People with BPD have a profusion of symptoms spread across various levels of lived experience, such as identity, affectivity, and interpersonal relationships. Researchers and clinicians have often resorted to the structuring concept of Self to organize the fragmentation of their experience at the identity level. Notably, using the concept of the narrative self, Fuchs proposed to interpret BPD as a fragmentation of narrative identity. This interpretation of BPD, widely shared, has been challenged by Gold and Kyratsous, who have proposed a complementary understanding of the self through the idea of agency, and to which Schmidt and Fuchs in turn have countered. This article proposes to contribute to this discussion from a phenomenological perspective. First, we will briefly review the discussions around narrative interpretation of BPD. From the problems left unresolved by the discussion, we will then justify the necessity to proceed with a stratification of the self from a phenomenology method. Third, from the thought of the Hungarian phenomenologist László Tengelyi, we will continue with an archaeology of the self, in three layers - self-institution, self-formation, and minimal self - integrating Schmidt and Fuchs' concepts of self, in addition to those of Gold and Kyratsous, but also, to a lesser extent, those of Dan Zahavi. Finally, we will proceed with a phenomenological reconfiguration of the experiences and manifestations associated with the identity axis of BPD.
Topics: Humans; Borderline Personality Disorder; Interpersonal Relations; Narration; Self Concept
PubMed: 36137507
DOI: 10.1159/000526222 -
Journal of Psychosomatic Research Dec 2021Difficulties in the assessments of Somatoform Disorders (SD) and Personality Disorders (PD) regarding operationalization, arbitrary thresholds, and reliability led to a... (Review)
Review
OBJECTIVE
Difficulties in the assessments of Somatoform Disorders (SD) and Personality Disorders (PD) regarding operationalization, arbitrary thresholds, and reliability led to a shift from categorical to dimensional models in the DSM-5. Empirical research data postulates a continuous level of severity in both groups of diseases. The aim of this systematic review was to investigate the overlap between somatization and personality pathology.
METHODS
Until July 2020, we conducted a systematic literature search with PubMed, Web of Science and SCOPUS. We specifically reviewed current empirical data on the Alternative Model of Personality Disorders (AMPD) and Somatic Symptom Disorder (SSD) and SD. Data was drawn out using predefined data panels. Results were reflected in the context of the Hierarchical Taxonomy of Psychopathology (HiTOP) model. Risk of bias was assessed due to blinding, randomization, selective reporting, incomplete data, and attribution bias.
RESULTS
A total of eight studies (N = 2979) met the inclusion criteria. Whereas categorical measures revealed mixed results, positive correlations between SD/SSD and dimensionally measured personality functioning were present in four studies (N = 1741). In three studies (N = 2025) correlations between SD/SSD and neuroticism/negative affectivity (d = 0.22-1.041) were present. Moreover, harm avoidant (d = 0.526 - 0.826) and self-defeating traits (d = 0.892) revealed significant associations with somatization.
CONCLUSIONS
Dimensional personality assessments are highly neglected in patients with SSD and warrant further research. However, in line with the HiTOP model, there is tentative evidence that somatization can be described as an independent personality trait, which shows most striking overlaps with self-pathologies (Criterion A) and the trait of negative affectivity (Criterion B).
Topics: Diagnostic and Statistical Manual of Mental Disorders; Humans; Medically Unexplained Symptoms; Personality; Personality Disorders; Reproducibility of Results
PubMed: 34715494
DOI: 10.1016/j.jpsychores.2021.110646 -
Acta Psychiatrica Scandinavica Oct 2022Childhood attention-deficit /hyperactivity disorder (ADHD) is known to be associated with adult Borderline Personality Disorder (BPD). We investigated if any of the...
OBJECTIVE
Childhood attention-deficit /hyperactivity disorder (ADHD) is known to be associated with adult Borderline Personality Disorder (BPD). We investigated if any of the subdimensions of childhood ADHD, that is, impulsivity, inattention, or hyperactivity was more prominent in this association.
METHODS
In a nation-wide cohort (N = 13,330), we utilized parent reported symptoms of childhood ADHD and clinically ascertained adult BPD diagnoses. The summed total scores of ADHD symptoms and its three subdimensions were used and standardized for effect size comparison. Associations were analyzed using Cox regression with sex and birth-year adjustments. Secondary outcomes were BPD-associated traits (i.e., self-harm and substance use) analyzed using logistic- and linear regression respectively.
RESULTS
ADHD symptom severity was positively associated with BPD with a hazard ratio (HR) of 1.47 (95% confidence interval [CI]: 1.22-1.79) per standard deviation increase in total ADHD symptoms. Impulsivity was the most prominent subdimension with the only statistically significant association when analyzed in a model mutually adjusted for all ADHD subdimensions-HR for inattention: 1.15 (95% CI: 0.85-1.55), hyperactivity: 0.94 (95% CI: 0.69-1.26), impulsivity: 1.46 (95% CI: 1.12-1.91). In secondary analyses, weak positive associations were seen between total ADHD symptom score and self-harm and substance use. In analyses by subdimensions of ADHD, associations were weak and most prominent for inattention in the model with self-harm.
CONCLUSION
Childhood ADHD symptoms were associated with subsequent development of BPD diagnosis and appeared to be driven primarily by impulsivity. Our findings are important for understanding the association between childhood symptoms of ADHD and subsequent BPD.
Topics: Adult; Attention Deficit Disorder with Hyperactivity; Borderline Personality Disorder; Cognition; Humans; Impulsive Behavior
PubMed: 35833692
DOI: 10.1111/acps.13476 -
Ideggyogyaszati Szemle Sep 2023
Epilepsy is one of the most common neurological disorders. Therapeutic success shows high variability between patients, at least 20-30% of the cases are... (Review)
Review
Epilepsy is one of the most common neurological disorders. Therapeutic success shows high variability between patients, at least 20-30% of the cases are drug-resistant. It can highly affect the social status, interpersonal relationships, mental health and the overall quality of life of those affected.
.
Although several studies can be found on the psychiatric diseases associated with epilepsy, only a few researches focus on the occurrence of personality disorders accompanying the latter. The aim of this review is to help clinicians to recognize the signs of personality disorders and to investigate their connection and interaction with epilepsy in the light of current experiences.
The researches reviewed in this study confirm that personality disorders and pathological personality traits are common in certain types of epilepsy and they affect many areas of patients’ lives. These studies draw attention to the importance of a multidisciplinary approach to this neurological disorder and to provide suggestions about the available help options. Considering the high frequency of epilepsy-related pathological personality traits that can have a great impact on the therapeutic cooperation and on the patients’ quality of life, it important that the neurologist recognizes early the signs of the patient’s psychological impairment. Thus they can get involved in organizing the support of both the patient and their environment by including psychiatrists, psychologists, social and self-help associations.
As interdisciplinary studies show, epilepsy is a complex disease and besides trying to treat the seizures, it is also important to manage the patient’s psychological and social situation. Cooperation, treatment response and quality of life altogether can be significantly improved if our focus is on guiding the patient through the possibilities of assistance by seeing the complexity and the difficulties of their situation.Topics: Humans; Quality of Life; Personality Disorders; Mental Disorders; Epilepsy; Seizures; Mental Health
PubMed: 37782064
DOI: 10.18071/isz.76.0297 -
European Child & Adolescent Psychiatry Sep 2023Acquiring age-appropriate social skills, arguably a major prerequisite for favorable psychosocial development in children, is targeted in a range of interventions....
Acquiring age-appropriate social skills, arguably a major prerequisite for favorable psychosocial development in children, is targeted in a range of interventions. Hence, identifying factors that limit this acquisition may inform preventative and treatment efforts. Personality disorders are characterized by pervasive and enduring dysfunctional interpersonal functioning, including parenting, and could thus entail risk for offspring in not developing adaptive interpersonal skills. However, no study has tested this possibility. A representative sample drawn from two birth cohorts of Norwegian 4-year-olds (n = 956) and their parents was followed up at ages 6, 8, and 10 years. Parents' personality disorder symptoms were measured dimensionally with the DSM-IV and ICD-10 Personality Questionnaire, and children's social skills were evaluated by the Social Skills Rating System. A difference-in-difference approach was applied to adjust for all unmeasured time-invariant confounders, and parental symptoms of depression and anxiety were entered as covariates. Increased Cluster B symptoms in parents of children aged 4 to 6 years predicted decreased social skill development in offspring (B = -0.97, 95% CI -1.58, -0.37, p = 0.002). On a more granular level, increased symptoms of borderline (B = -0.39, CI -0.65, -0.12, p = 0.004), histrionic (B = -0.55, CI -0.99, -0.11, p = 0.018), and avoidant (B = -0.46, CI-0.79, -0.13, p = 0.006) personality disorders in parents predicted decreased social skill development in offspring. Subclinical levels of borderline, histrionic and avoidant personality disorders in parents may impair the development of social skills in offspring. Successfully treating these personality problems or considering them when providing services to children may facilitate children's acquisition of social skills.
Topics: Child; Humans; Child, Preschool; Social Skills; Prospective Studies; Child of Impaired Parents; Parents; Personality Disorders
PubMed: 35235044
DOI: 10.1007/s00787-022-01965-0 -
Personality Disorders Jan 2023We critique the general state of methodological rigor in contemporary personality pathology research, focusing on challenges in study design, assessment, and data... (Review)
Review
We critique the general state of methodological rigor in contemporary personality pathology research, focusing on challenges in study design, assessment, and data analysis resulting from two pervasive problems: comorbidity and heterogeneity. To inform our understanding of this literature, we examined every article published in the two main specialty journals for personality pathology research- and the -in the 18-month period from January 2020 to June 2021 (a total of 23 issues and 197 articles). Our review of this database indicated that only three forms of personality pathology have generated substantial attention in the recent literature: borderline personality disorder (featured in 93 articles), psychopathy/antisocial personality disorder (39 articles), and narcissism/narcissistic personality disorder (28 articles), so we highlight them in our review. We discuss comorbidity-related problems that arise from group-based designs and recommend instead that researchers assess multiple forms of psychopathology as continuous dimensions. We offer separate recommendations for addressing heterogeneity in diagnosis- versus trait-based studies. For the former, we recommend that researchers (a) use measures that permit criterion-level analyses and (b) routinely report criterion-level results. For the latter, we emphasize the importance of examining specific traits when measures are known to be highly heterogeneous/multidimensional. Finally, we encourage researchers to work toward a truly comprehensive trait dimensional model of personality pathology. We suggest that this might include expanding the current alternative model of personality disorders to include additional content related to borderline features, psychopathy, and narcissism. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Topics: Humans; Personality Disorders; Personality; Comorbidity; Antisocial Personality Disorder; Psychopathology
PubMed: 36848072
DOI: 10.1037/per0000586