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Neuroscience and Biobehavioral Reviews Aug 2021Bipolar disorder (BD) and borderline personality disorder (BPD) are serious and prevalent psychiatric diseases that share common phenomenological characteristics:... (Review)
Review
Bipolar disorder (BD) and borderline personality disorder (BPD) are serious and prevalent psychiatric diseases that share common phenomenological characteristics: symptoms (such as anxiety, affective lability or emotion dysregulation), neuroimaging features, risk factors and comorbidities. While several studies have focused on the link between stress and peripheral inflammation in other affective disorders such as anxiety or depression, fewer have explored this relationship in BD and BPD. This review reports on evidence showing an interplay between immune dysregulation, anxiety and stress, and how an altered acute neuroendocrine stress response may exist in these disorders. Moreover, we highlight limitations and confounding factors of these existing studies and discuss multidirectional hypotheses that either suggest inflammation or stress and anxiety as the primum movens in BD and BPD pathophysiology, or inflammation as a consequence of the pathophysiology of these diseases. Untangling these associations and implementing a transdiagnostic approach will have diagnostic, therapeutic and prognostic implications for BD and BPD patients.
Topics: Anxiety; Anxiety Disorders; Bipolar Disorder; Borderline Personality Disorder; Humans; Inflammation
PubMed: 33930472
DOI: 10.1016/j.neubiorev.2021.04.017 -
Acta Psychologica May 2024This study explored demographic, ideological, self-rating and personality traits correlates of the Dark Tetrad (DT4) which measures Narcissism (Special),...
This study explored demographic, ideological, self-rating and personality traits correlates of the Dark Tetrad (DT4) which measures Narcissism (Special), Machiavellianism (Crafty), Psychopathy (Wild), and Sadism (Mean) traits. In total, 447 adults completed three tests: a bright-side, work-related, personality test (HPTI: High Performance Type Indicator), a dark-side test (Short Dark Tetrad) and a number of self-ratings. Correlations and regressions showed that all four dark traits were associated with low Adjustment (Neuroticism), but also with high Risk-Taking and Competitiveness (low Agreeableness). The various measures accounted for a third of the variance in explaining the Mean (Sadistic) score, and 40 % for Special (Narcissism). Trait Competitiveness was most closely associated with all four dark traits.
Topics: Adult; Humans; Machiavellianism; Antisocial Personality Disorder; Sadism; Cognition; Neuroticism; Personality
PubMed: 38502994
DOI: 10.1016/j.actpsy.2024.104222 -
The Australian and New Zealand Journal... Mar 2022Persistence is said to be a feature of personality disorder, but there are few long-term prospective studies of the condition. A total of 200 patients with anxiety and... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Persistence is said to be a feature of personality disorder, but there are few long-term prospective studies of the condition. A total of 200 patients with anxiety and depressive disorders involved in a randomised controlled trial initiated in 1983 had full personality status assessed at baseline. We repeated assessment of personality status on three subsequent occasions over 30 years.
METHODS
Personality status was recorded using methods derived from the Personality Assessment Schedule, which has algorithms for allocating Diagnostic and Statistical Manual of Mental Disorders (DSM) and the 11th International Classification of Diseases (ICD-11) categories. The category and severity of personality diagnosis were recorded at baseline in the randomised patients with DSM-III anxiety and depressive diagnoses. The same methods of assessing personality status was repeated at 2, 12 and 30 years after baseline.
RESULTS
Using the ICD-11 system, 47% of patients, mainly those with no personality disturbance at baseline, retained their personality status; of the others 16.8% improved and 20.4% worsened to more severe disorder. In DSM-III diagnosed patients, those diagnosed as Cluster A and Cluster C increased in frequency (from 14% to 40%, p < 0.001, and 21.5% to 36%, p < 0.001, respectively) over follow-up, while those with Cluster B showed little change in frequency (22% to 18%, p = 0.197).
CONCLUSION
In this population of patients with common mental disorders, personality status showed many changes over time, inconsistent with the view that personality disorder is a persistent or stable condition. The increase in diagnoses within the Cluster A and C groups suggests personality disorder generally increases in frequency as people age.
Topics: Cohort Studies; Diagnostic and Statistical Manual of Mental Disorders; Humans; Neurotic Disorders; Personality; Personality Disorders; Prospective Studies
PubMed: 34250845
DOI: 10.1177/00048674211025624 -
Journal of Personality Apr 2023Peer groups represent a critical developmental context in adolescence, and there are many well-documented associations between personality and peer behavior at this age....
OBJECTIVE
Peer groups represent a critical developmental context in adolescence, and there are many well-documented associations between personality and peer behavior at this age. However, the precise nature and direction of these associations are difficult to determine as youth both select into, and are influenced by, their peers.
METHOD
We thus examined the phenotypic, genetic, and environmental links between antisocial and prosocial peer characteristics and several personality traits from middle childhood to late adolescence (ages 11, 14, and 17 years) in a longitudinal twin sample (N = 3762) using teacher ratings of personality and self-reports of peer characteristics.
RESULTS
Less adaptive trait profiles (i.e., high negative emotionality, low conscientiousness, and low agreeableness) were associated with more antisocial and fewer prosocial peer characteristics across time. Associations between personality traits related to emotionality (negative emotionality and extraversion) and peer behavior were largely attributable to shared genetic influences, while associations between personality traits related to behavioral control (conscientiousness and agreeableness) and peer behavior were due to overlapping genetic and shared environmental influences.
CONCLUSIONS
Overall, results suggest a set of environmental presses that push youth toward both behavioral undercontrol and antisocial peer affiliations, making the identification of such influences and their relative importance a critical avenue of future work.
Topics: Humans; Adolescent; Child; Personality; Twins; Personality Disorders; Antisocial Personality Disorder; Peer Group
PubMed: 35686934
DOI: 10.1111/jopy.12741 -
Current Psychiatry Reports Sep 2023This systematic review aimed to distil recent literature investigating psychosocial factors which may account for the association between personality disorder (PD) and... (Review)
Review
PURPOSE OF REVIEW
This systematic review aimed to distil recent literature investigating psychosocial factors which may account for the association between personality disorder (PD) and suicide attempt or suicide death.
RECENT FINDINGS
Suicide risk is particularly elevated in people with PD compared to those with no, or many other, mental health diagnoses. Despite this, suicide prevention strategies for PD populations have not progressed markedly in recent years. It is critical, therefore, to identify additional factors associated with suicide in PD populations. Of the 34 studies included in this review, most identified a relationship between personality disorder and suicide attempt and/or death. Historical interpersonal factors (e.g., childhood trauma), drug and alcohol use, and ideation-to-enaction factors were commonly associated with suicide-related outcomes. Interventions that provide interpersonal support may reduce suicide attempts. Limitations of the review include the heterogeneity of studies and small sample sizes.
Topics: Humans; Adverse Childhood Experiences; Alcohol Drinking; Personality Disorders; Social Support; Suicide Prevention
PubMed: 37642809
DOI: 10.1007/s11920-023-01440-w -
BMC Psychiatry Aug 2022Low personal agency is the concept of attributing successes and failures to external factors rather than personal characteristics. Previous research supported links...
BACKGROUND
Low personal agency is the concept of attributing successes and failures to external factors rather than personal characteristics. Previous research supported links between low personal agency and symptoms of borderline personality disorder (BPD). The present research followed patients in an outpatient dialectical behavioural therapy (DBT) group from intake to 12 months follow up to examine the impact of personal agency on outcome.
METHODS
Patients (N = 57, age 18-72, 91.5% female) were assessed at intake, after three months of DBT treatment, and 12 months follow up on measures of symptoms and personal agency. Three separate measures were used to assess treatment outcomes: the BPD Checklist, the Personality Inventory for DSM-5 (PID-5), and the Mental Health Inventory (MHI-5).
RESULTS
Mixed model analyses found BPD symptoms significantly reduced as a result of DBT treatment and were maintained at follow-up. However, 47% of participants continued to meet BPD criteria 12 months later, despite treatment. Regression analyses indicated that low personal agency at intake was associated with higher BPD symptom severity at post-treatment and 12 month follow up. In addition, low personal agency at intake was associated with greater levels of negative affectivity at post-treatment. Personal agency did not relate to levels of depression and anxiety.
CONCLUSIONS
Despite the reductions in BPD symptomology, personal agency did not significantly change over time. Those with lower agency at intake continued to do more poorly at follow up. We speculate that poor outcomes may be contributed to by patients' lack of engagement in recovery due to poor agency and an external locus of control. As such, therapeutic approaches, like DBT, may require additional strategies to appropriately target low personal agency. Further research is needed to understand if other treatment protocols may facilitate positive change in personal agency.
Topics: Adolescent; Behavior Therapy; Borderline Personality Disorder; Diagnostic and Statistical Manual of Mental Disorders; Dialectical Behavior Therapy; Female; Humans; Longitudinal Studies; Male; Outpatients; Treatment Outcome
PubMed: 35996102
DOI: 10.1186/s12888-022-04214-5 -
BMC Psychiatry Mar 2024Personality disorders (PDs) are associated with an inferior quality of life, poor health, and premature mortality, leading to heavy clinical, familial, and societal... (Review)
Review
Personality disorders (PDs) are associated with an inferior quality of life, poor health, and premature mortality, leading to heavy clinical, familial, and societal burdens. The International Classification of Diseases-11 (ICD-11) makes a thorough, dramatic paradigm shift from the categorical to dimensional diagnosis of PD and expands the application into adolescence. We have reviewed the recent literature on practical implications, and severity and trait measures of ICD-11 defined PDs, by comparing with the alternative model of personality disorders in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), by mentioning the relevance in forensic and social concerns, and by referencing the developmental implication of life span, especially in adolescence. Study results strongly support the dimensional utility of ICD-11 PD diagnosis and application in adolescence which warrants early detection and intervention. More evidence-based research is needed along the ICD-11 PD application, such as its social relevance, measurement simplification, and longitudinal design of lifespan observation and treatment.
Topics: Adolescent; Humans; International Classification of Diseases; Quality of Life; Personality Disorders; Diagnostic and Statistical Manual of Mental Disorders; Mortality, Premature; Personality
PubMed: 38454364
DOI: 10.1186/s12888-024-05640-3 -
Personality Disorders May 2022Several psychiatric conditions (e.g., substance use, mood, and personality disorders) are characterized, in part, by greater delay discounting (DD)-a decision-making... (Meta-Analysis)
Meta-Analysis Review
Several psychiatric conditions (e.g., substance use, mood, and personality disorders) are characterized, in part, by greater delay discounting (DD)-a decision-making bias in the direction of preferring smaller, more immediate over larger, delayed rewards. Narcissistic personality disorder (NPD) is highly comorbid with substance use, mood, and other personality disorders, suggesting that DD may be a process underpinning risk for NPD as well. This meta-analysis examined associations between DD and theoretically distinct, clinically relevant dimensions of narcissism (i.e., grandiosity, entitlement, and vulnerability). Literature searches were conducted and articles were included if they were written in English, published in a peer-reviewed journal, contained measures of DD and narcissism and reported their association, and used an adult sample. Narcissism measures had to be systematically categorized according to clinically relevant dimensions (Grijalva et al., 2015; Wright & Edershile, 2018). Seven studies met inclusion criteria ( = 2,705). DD was positively associated with narcissism ( = .21; 95% confidence interval [.10, .32]), with this association being largely attributable to measures of trait grandiosity that were used in each study ( = .24; 95% confidence interval [.11, .37]). No studies included diagnostic NPD assessments. These findings provide empirical evidence that DD is related to trait narcissism and perhaps risk for NPD (e.g., grandiosity listed in Criterion B of the Fifth Edition, alternative model of personality disorders). Considering the positive evidence from this review, and the dearth of research examining DD in individuals with NPD, investigators studying NPD may consider incorporating DD measures in future studies to potentially inform clinical theory and novel adjunctive treatment options. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Topics: Adult; Comorbidity; Delay Discounting; Diagnostic and Statistical Manual of Mental Disorders; Humans; Narcissism; Personality Disorders
PubMed: 34990195
DOI: 10.1037/per0000528 -
Current Opinion in Psychology Feb 2021The development of personality pathology is an interactive process between biologically based susceptibilities, interpersonal patterns, and contextual factors across the... (Review)
Review
The development of personality pathology is an interactive process between biologically based susceptibilities, interpersonal patterns, and contextual factors across the lifespan. In this paper, we argue that these interactions begin before birth. We describe the perinatal period (i.e. pregnancy and up to one year postpartum) as a sensitive developmental window during which regulatory and stress response systems that confer risk for personality pathology begin forming. In addition, we present converging evidence for significant associations between perinatal factors and later life personality disorders. Finally, we present this perinatal perspective through the lens of dynamical systems theory and emphasize the promise of this framework for guiding future personality disorder research, prevention, and intervention.
Topics: Female; Humans; Personality; Personality Disorders; Pregnancy
PubMed: 33444894
DOI: 10.1016/j.copsyc.2020.12.003 -
Psychopathology 2020This paper reviews maladaptive trait development (DSM-5 Section III Criterion B), the development of DSM-5 Section II borderline personality disorder, and research on... (Review)
Review
This paper reviews maladaptive trait development (DSM-5 Section III Criterion B), the development of DSM-5 Section II borderline personality disorder, and research on the development of identity, self-direction, empathy/mentalizing, and intimacy (DSM-5 Section III Criterion A). Combined, these previously disparate literatures begin to point to an integrated developmental theory of personality pathology, which suggests that Criterion A concepts (identity, self-direction, empathy, and intimacy) coalesce around the development of self, marking a discontinuous (qualitative) developmental shift. This developmental shift is a function of the demands placed on individuals to take on independent adult role function, combined with biologically-based maturational cognitive and emotional advances during adolescence. Section II personality disorder ensues when an integrated and coherent sense of self fails to develop, resulting in nonfulfilment of adult role function. In this sense, Criterion A self function can account for the onset of Section II personality disorder in adolescence, while Criterion B provides a useful descriptive account of continuous aspects of personality function over time.
Topics: Adolescent; Female; Humans; Male; Personality Disorders; Personality Inventory
PubMed: 32464626
DOI: 10.1159/000507588