-
Current Opinion in Psychiatry Jan 2023People and communities around the world face many crises, including increasing burdens from disease, psychopathology, burn-out, social distrust, and acts of hate and... (Review)
Review
PURPOSE OF REVIEW
People and communities around the world face many crises, including increasing burdens from disease, psychopathology, burn-out, social distrust, and acts of hate and terrorism. Personality disorder is arguably both a root cause and a consequence of these problems, creating a vicious cycle of suffering caused by fears, immoderate desires, and social distrust that are inconsistent with rational goals and prosocial values. Fortunately, recent advances in understanding the biopsychosocial basis and dynamics of development in personality and its disorders offer insights to address these problems in effective person-centered ways.
RECENT FINDINGS
Fundamental advances have been made recently in the understanding of the psychobiology and sociology of personality in relationship to health, and in basic mechanisms of personality change as a complex process of learning and memory. Promotion of self-awareness and intentional self-control releases a strong tendency for people to seek coherence of their emotions and habits with what gives their life meaning and value.
SUMMARY
People have a strong drive to cultivate personalities in which their emotions and habits are reliably in accord with reasonable goals and prosocial values. Person-centered therapeutics provide practical ways to promote a virtuous cycle of increasing well being for individuals and their communities and habitats.
Topics: Humans; Temperament; Personality Disorders; Personality; Emotions; Psychopathology
PubMed: 36449732
DOI: 10.1097/YCO.0000000000000833 -
Journal of Psychiatric Research Apr 2023Metacognition and Insight are related to hard-to-treat disorders and among them is Borderline Personality Disorder (BPD). We recruited 190 BPD patients and measured...
Metacognition and Insight are related to hard-to-treat disorders and among them is Borderline Personality Disorder (BPD). We recruited 190 BPD patients and measured Insight, Metacognition, Impulsivity, and BPD traits. Results showed BPD's significant links with Insight and Metacognition. Metacognition significantly correlated with two Impulsivity dimensions, whereas Insight significantly correlated with most of them. Regressions analysis revealed a significant relationship between Insight and Metacognition on Impulsivity and Borderline traits. Mediation analysis proved the indirect effect of Metacognition/Insight on Borderline traits through Impulsivity at a significative level. Both seem relevant for research and therapeutic application in BPD following different dynamics even if the limitation of our study stands in its gender ratio and possible comorbidity issues. Urgency appears as a critical factor to assess, notably with Positive emotion-based impulsivity.
Topics: Humans; Borderline Personality Disorder; Metacognition; Impulsive Behavior; Comorbidity; Phenotype
PubMed: 36863299
DOI: 10.1016/j.jpsychires.2023.02.023 -
Current Psychiatry Reports Apr 2021The aim of this review article is to give an overview over recent experimental neurobiological research on dissociation in borderline personality disorder (BPD), in... (Review)
Review
PURPOSE OF REVIEW
The aim of this review article is to give an overview over recent experimental neurobiological research on dissociation in borderline personality disorder (BPD), in order to inform clinicians and to stimulate further research. First, we introduce basic definitions and models that conceptualize dissociation from a transdiagnostic perspective. Then, we discuss recent findings in BPD.
RECENT FINDINGS
Stress-related dissociation is a key symptom of BPD, closely linked to other core domains of the disorder (emotion dysregulation, identity disturbances, and interpersonal disturbances). The understanding of neurobiological correlates of dissociation across different psychiatric disorders (e.g., dissociative disorders, post-traumatic stress disorder) is steadily increasing. At the same time, studies explicitly focusing on dissociation in BPD are still scarce. There is evidence for adverse effects of dissociation on affective-cognitive functioning (e.g., interference inhibition), body perception, and psychotherapeutic treatment response in BPD. On the neural level, increased activity in frontal regions (e.g., inferior frontal gyrus) and temporal areas (e.g., inferior and superior temporal gyrus) during symptom provocation tasks and during resting state was observed, although findings are still diverse and need to be replicated. Conceptual differences and methodological differences in study designs and sample characteristics (e.g., comorbidities, trauma history) hinder a straightforward interpretation and comparison of studies. Given the potentially detrimental impact of dissociation in BPD, more research on the topic is strongly needed to deepen the understanding of this complex clinical condition.
Topics: Borderline Personality Disorder; Dissociative Disorders; Emotions; Frontal Lobe; Humans; Stress Disorders, Post-Traumatic
PubMed: 33909198
DOI: 10.1007/s11920-021-01246-8 -
Psychopathology 2023The progressively improving understanding of the borderline personality disorder (BPD) has led to an increased interest in the better clarification of the integrated... (Review)
Review
The progressively improving understanding of the borderline personality disorder (BPD) has led to an increased interest in the better clarification of the integrated role of biological and psychosocial factors in the underlying pathophysiology of this condition. The influence of early childhood interactions and stress exposure in shaping our personalities during adulthood cannot be emphasized enough. In this review, we discuss the critical role of parenting-related factors including maladaptive parenting, parenting styles, and parenting psychopathology as early childhood influences in the developmental psychopathology of BPD. Protective factors that may impact the development of this disorder and possible preventive interventions are also briefly reviewed.
Topics: Child, Preschool; Humans; Adult; Parenting; Borderline Personality Disorder; Psychopathology; Personality
PubMed: 35640542
DOI: 10.1159/000524802 -
Current Psychiatry Reports Apr 2021We review the recent evidence suggesting that circadian rhythm disturbance is a common unaddressed feature of borderline personality disorder (BPD); amelioration of... (Review)
Review
PURPOSE OF REVIEW
We review the recent evidence suggesting that circadian rhythm disturbance is a common unaddressed feature of borderline personality disorder (BPD); amelioration of which may confer substantial clinical benefit. We assess chronobiological BPD studies from a mechanistic and translational perspective and highlight opportunities for the future development of this hypothesis.
RECENT FINDINGS
The emerging circadian phenotype of BPD is characterised by a preponderance of comorbid circadian rhythm sleep-wake disorders, phase delayed and misaligned rest-activity patterns and attenuated amplitudes of usually well-characterised circadian rhythms. Such disturbances may exacerbate symptom severity, and specific maladaptive personality dimensions may produce a liability towards extremes in chronotype. Pilot studies suggest intervention may be beneficial, but development is limited. Endogenous and exogenous circadian rhythm disturbances appear to be common in BPD. The interface between psychiatry and chronobiology has led previously to novel efficacious strategies for the treatment of psychiatric disorders. We believe that better characterisation of the circadian phenotype in BPD will lead to a directed biological target for treatment in a condition where there is a regrettable paucity of accessible therapies.
Topics: Borderline Personality Disorder; Circadian Rhythm; Humans; Phenotype; Sleep; Sleep Disorders, Circadian Rhythm
PubMed: 33835306
DOI: 10.1007/s11920-021-01236-w -
Journal of Personality Disorders Jun 2021Symptomatic disorders often co-occur with borderline personality disorder (BPD). This study's purpose was to compare the rates of comorbidity reported by adult and...
Symptomatic disorders often co-occur with borderline personality disorder (BPD). This study's purpose was to compare the rates of comorbidity reported by adult and adolescent inpatients with BPD, including complex comorbidity (i.e., a combination of disorders of affect and impulsivity). One hundred four adolescents (aged 13-17) and 290 adults (aged 18-35) with BPD were interviewed using an age-appropriate semistructured interview for the assessment of symptomatic disorders. Lifetime rates of mood disorders and ADHD were quite similar for the two study groups. However, rates of anxiety disorders, including PTSD, substance use disorders, eating disorders, and complex comorbidity were significantly higher among adults than adolescents. Taken together, the results of this study suggest that broadly defined disorders of both affect and impulsivity are more common among adults than adolescents with BPD. They also suggest that a pattern of complex comorbidity is even more distinguishing for these two groups of borderline patients.
Topics: Adolescent; Adult; Anxiety Disorders; Borderline Personality Disorder; Comorbidity; Feeding and Eating Disorders; Humans; Impulsive Behavior
PubMed: 33779275
DOI: 10.1521/pedi_2021_35_502 -
Personality and Mental Health Feb 2021Current UK evidence on the prevalence of personality disorder in homicide is lacking. The aims were to estimate the prevalence of personality disorder in homicide...
BACKGROUND
Current UK evidence on the prevalence of personality disorder in homicide is lacking. The aims were to estimate the prevalence of personality disorder in homicide perpetrators from court reports and carry out a dimensional assessment in keeping with the new ICD-11 classification of the prevalence of severe personality disorder. Associations between severe personality disorder and sociodemographic, historical and offence-related characteristics were then explored.
METHODS
Six hundred court reports from a national case series of homicide perpetrators in England and Wales were analysed using a document-derived version of the Personality Assessment Schedule (PAS-DOC), providing categorical and dimensional personality assessments. The prevalence of personality disorder and severe personality disorder was estimated. Factors associated with the diagnosis of severe personality disorder were examined.
RESULTS
The prevalence of personality disorder using the PAS-DOC was 56.3% (95% confidence interval 52.3%, 60.3%), compared with 16% as diagnosed in reports. Severe personality disorder was present in 62% (n = 338) of all those with a personality disorder and was significantly associated with homicides of strangers and previous violence.
CONCLUSIONS
Severe personality disorder is highly prevalent among perpetrators of homicide, and the finding that it is more prevalent when strangers are the victims stresses both the need for early identification of those at risk of developing severe personality disorder and the development of appropriate early preventive interventions. There is also a need for the development of effective treatment and interventions for those with established severe personality disorder and better identification of this level of disorder by psychiatrists. The forthcoming ICD-11 classification should help in this endeavour. © 2021 The Authors Personality and Mental Health Published by John Wiley & Sons Ltd.
Topics: England; Homicide; Humans; Personality Disorders; Prevalence; Violence
PubMed: 33569927
DOI: 10.1002/pmh.1503 -
Archives of Iranian Medicine Jun 2021This study investigated how the parents' personality disorders may be related to substance use disorder in children and adolescents.
BACKGROUND
This study investigated how the parents' personality disorders may be related to substance use disorder in children and adolescents.
METHODS
The study was a cross-sectional study in which 28,540 children and adolescents (aged 6 to 18 years) and their parents participated between 2015 and 2016. The diagnosis of substance use was made using the Kiddie Schedule for Affective Disorders and Schizophrenia--Present and Lifetime Version (K-SADS-PL) interview and the personality disorders were assessed using Millon Clinical Multiaxial Inventory - Third Edition (MCMI-III). The parents were also surveyed for their personality assessed with MCMI.
RESULTS
The results showed that the paranoid personality disorder in father (odds ratio [OR] = 8.34, 95% CI, = 0.042) and borderline personality disorder in mother (OR = 4.6, 95% CI, = 0.049) increase the chance of substance use in children.
CONCLUSION
The findings suggest that in designing preventive programs for substance use, the personality characteristics of the parents need to be taken into account.
Topics: Adolescent; Child; Cross-Sectional Studies; Humans; Parents; Personality Disorders; Reproducibility of Results; Substance-Related Disorders
PubMed: 34488311
DOI: 10.34172/aim.2021.69 -
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 -
BMC Psychiatry Apr 2022Major depressive disorder (MDD) is a global public health concern that is notably underdiagnosed and undertreated due to its complexity and subjective diagnostic...
BACKGROUND
Major depressive disorder (MDD) is a global public health concern that is notably underdiagnosed and undertreated due to its complexity and subjective diagnostic methods. A holistic diagnostic procedure, which sufficiently considers all possible contributors to MDD symptoms, would improve MDD diagnosis and treatment. This study aims to explore whether personality and coping styles can predict MDD status and differentiate between depressed patients and healthy individuals.
METHODS
Seventy healthy controls (N = 54 females) were matched to 70 MDD patients for age, sex, ethnicity, and years of education. MDD severity was measured using the Hamilton Depression Rating Scale, while personality traits and coping styles were measured by the Ten-Item Personality (TIPI) and Brief COPE questionnaires, respectively. Logistic regression analyses were conducted to investigate the diagnostic and predictive potential of personality and coping styles. Receiver operating characteristic (ROC) analyses were also conducted to examine their discriminative ability to distinguish between depressed and healthy individuals.
RESULTS
Introversion, lack of organisation skills, and neuroticism were statistically significant in predicting MDD status. Dysfunctional coping strategies, such as denial and self-blame, were also shown to significantly predict MDD status. ROC analyses found both the TIPI questionnaire (AUC = 0.90), and dysfunctional coping (as measured by Brief COPE) (AUC = 0.90) to be excellent predictors of MDD.
CONCLUSIONS
Our findings demonstrate the diagnostic and predictive potential of personality and coping styles for MDD in the clinical setting. They also demonstrate the remarkable ability of personality and coping styles to differentiate between depressed patients and healthy controls.
Topics: Adaptation, Psychological; Depressive Disorder, Major; Female; Humans; Male; Personality; Personality Disorders; Personality Inventory
PubMed: 35484526
DOI: 10.1186/s12888-022-03942-y