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Personality Disorders Jul 2014Narcissistic personality disorder (NPD) is associated with an assortment of characteristics that undermine interpersonal functioning. A lack of empathy is often cited as... (Review)
Review
Narcissistic personality disorder (NPD) is associated with an assortment of characteristics that undermine interpersonal functioning. A lack of empathy is often cited as the primary distinguishing feature of NPD. However, clinical presentations of NPD suggest that empathy is not simply deficient in these individuals, but dysfunctional and subject to a diverse set of motivational and situational factors. Consistent with this presentation, research illustrates that empathy is multidimensional, involving 2 distinct emotional and cognitive processes associated with a capacity to respectively understand and respond to others' mental and affective states. The goal of this practice review is to bridge the gap between our psychobiological understanding of empathy and its clinical manifestations in NPD. We present 3 case studies highlighting the variability in empathic functioning in people with NPD. Additionally, we summarize the literature on empathy and NPD, which largely associates this disorder with deficient emotional empathy, and dysfunctional rather than deficient cognitive empathy. Because this research is limited, we also present empathy-based findings for related syndromes (borderline and psychopathy). Given the complexity of narcissism and empathy, we propose that multiple relationships can exist between these constructs. Ultimately, by recognizing the multifaceted relationship between empathy and narcissism, and moving away from an all or nothing belief that those with NPD simply lack empathy, therapists may better understand narcissistic patients' behavior and motivational structure.
Topics: Adult; Empathy; Female; Humans; Male; Personality Disorders
PubMed: 24512457
DOI: 10.1037/per0000061 -
Dialogues in Clinical Neuroscience Jun 2013Personality disorders have a complex relationship with the law that in many ways reflects their complexity within the clinical and research communities. This paper... (Review)
Review
Personality disorders have a complex relationship with the law that in many ways reflects their complexity within the clinical and research communities. This paper addresses expert testimony about personality disorders, outlines how personality disorders are assessed in forensic cases, and describes how personality disorders are viewed in different legal contexts. Reasons are identified why personality disorders are not generally accepted as significant mental illness within the legal system, including high incidence of personality dysfunction in criminal populations, frequent comorbidity of personality disorders making it difficult to determine direct causation, and difficulty determining where on a continuum personality traits should be defined as illness (or not). In summary, the legal system, to a significant degree, mirrors the clinical conception of personality disorders as not severe mental diseases or defects, not likely to change, and most often, under volitional control.
Topics: Forensic Psychiatry; Humans; Personality; Personality Disorders
PubMed: 24174894
DOI: 10.31887/DCNS.2013.15.2/sjohnson -
Turk Psikiyatri Dergisi = Turkish... 2019Narcissism is a recurring topic of psychoanalysis since its beginningand has gained a place in everyday language of modern societies.However, there still exist gaps and... (Comparative Study)
Comparative Study Review
Narcissism is a recurring topic of psychoanalysis since its beginningand has gained a place in everyday language of modern societies.However, there still exist gaps and limitations in our knowledge ofnarcissistic personality disorder (NPD), which presents the need forbetter integration of already existent theoretical conceptualisations ofthe disorder. In the present paper, we have examined the theories of,Otto Kernberg and Heinz Kohut, the two most influential, howeverdisagreeing, psychoanalytic thinkers on the topic. For the purpose ofthe comparative review, we have examined multiple convergences anddivergences of their theories. We have examined the development ofnormal narcissism of infancy and childhood, which is essential forhealthy development of the individual; characteristics and course ofpathology conceptualisation, in which we also addressed the cause andsource of the pathology; attitudes and behaviours relating to objectrelations; classification of the pathology; and treatment applications.The review indicates that, despite divergences, both theories represent avaluable theoretical perspective of the disorder, which can be observedin the modern application of these theories in different evidence basedpsychoanalytic treatments.
Topics: Humans; Narcissism; Personality Disorders; Psychoanalytic Theory; Psychotherapy
PubMed: 31487379
DOI: No ID Found -
Annual Review of Clinical Psychology 2014Antecedents of personality disorder in childhood and adolescence have been a neglected area in official taxonomies of mental disorders such as the International... (Review)
Review
Antecedents of personality disorder in childhood and adolescence have been a neglected area in official taxonomies of mental disorders such as the International Classification of Diseases or the different editions of the Diagnostic and Statistical Manual of Mental Disorders. An evolving research field, however, underscores the importance of antecedents for understanding psychopathology and personality pathology in adulthood. The current article summarizes the history, updates reviews, and incorporates new research findings into an integrative scheme for conceptualizing personality pathology in childhood and adolescence. Implications of this model for assessment, future research, and intervention are discussed.
Topics: Adolescent; Adolescent Development; Child; Child Development; Humans; Models, Psychological; Personality Development; Personality Disorders
PubMed: 24471374
DOI: 10.1146/annurev-clinpsy-032813-153634 -
Journal of Abnormal Psychology Aug 2011Clinical and population-based samples show high comorbidity between Substance Use Disorders (SUDs) and Axis II Personality Disorders (PDs). However, Axis II disorders...
Clinical and population-based samples show high comorbidity between Substance Use Disorders (SUDs) and Axis II Personality Disorders (PDs). However, Axis II disorders are frequently comorbid with each other, and existing research has generally failed to distinguish the extent to which SUD/PD comorbidity is general or specific with respect to both specific types of PDs and specific types of SUDs. We sought to determine whether ostensibly specific comorbid substance dependence-Axis II diagnoses (e.g., alcohol use dependence and borderline personality disorder) are reflective of more pervasive or general personality pathology or whether the comorbidity is specific to individual PDs. Face-to-face interview data from Wave 1 and Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions were analyzed. Participants included 34,653 adults living in households in the United States. We used hierarchical factor models to statistically partition general and specific personality disorder dimensions while simultaneously testing for specific PD-substance dependence relations. Results indicated that substance dependence-Axis II comorbidity is characterized by general (pervasive) pathology and by Cluster B PD pathology over and above the relationship to the general PD factor. Further, these relations between PD factors and substance dependence diagnoses appeared to largely account for the comorbidity among substance dependence diagnoses in the younger but not older participants. Our findings suggest that a failure to consider the general PD factor, which we interpret as reflecting interpersonal dysfunction, can lead to potential mischaracterizations of the nature of certain PD and SUD comorbidities.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Comorbidity; Diagnosis, Dual (Psychiatry); Diagnostic and Statistical Manual of Mental Disorders; Female; Humans; Male; Middle Aged; Models, Psychological; Personality Disorders; Prevalence; Substance-Related Disorders
PubMed: 21604829
DOI: 10.1037/a0023539 -
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 -
Journal of Consulting and Clinical... Oct 2008Pathological personality is strongly linked with interpersonal impairment, yet no study to date has examined the relationship between concurrent personality pathology...
Pathological personality is strongly linked with interpersonal impairment, yet no study to date has examined the relationship between concurrent personality pathology and dysfunction in marriage--a relationship that most people find central to their lives. In a cross-sectional study of a community sample of married couples (N = 82), the authors used multilevel modeling to estimate the association of self- and spouse-reported symptoms of personality disorder (PD) with levels of marital satisfaction and verbal aggression and perpetration of physical violence. Inclusion of self- and spouse report of total PD symptoms resulted in improved model fit and greater variance explained, with much of the improvement coming after the addition of spouse report. The incremental validity of spouse report for several of the 10 PD scales was supported for marital satisfaction and verbal aggression, particularly for the Borderline and Dependent PD scales.
Topics: Adult; Aged; Aggression; Cross-Sectional Studies; Diagnostic and Statistical Manual of Mental Disorders; Family Conflict; Female; Humans; Male; Marital Therapy; Middle Aged; Personal Satisfaction; Personality Disorders; Personality Inventory; Psychometrics; Reproducibility of Results; Spouse Abuse; Young Adult
PubMed: 18837594
DOI: 10.1037/a0013346 -
Actas Espanolas de Psiquiatria Nov 2019Personality disorders (PD) and substance use disorders (SUD) have a high prevalence and an important health and socioeconomic impact so, it is interesting to study the...
INTRODUCTION
Personality disorders (PD) and substance use disorders (SUD) have a high prevalence and an important health and socioeconomic impact so, it is interesting to study the relationship between them. The objectives of the study are: to compare the prevalence of SUD between patients with and without diagnosis of PD, to analyze if any PD is related to the SUD, and if a specific PD is associated with a specific SUD.
MATERIAL AND METHODS
Cross-sectional study in 837 patients from centers of attention to drug addiction and mental health in Madrid, Spain. The Mini International Neuropsychiatric Interview (MINI) and the Personality Diagnostic Questionnaire-4+ (PDQ4+) are used to detect mental disorder and PD, respectively.
RESULTS
SUD is significantly higher in antisocial PD (p<0.01); sedative (p<0.01) and alcohol (p<0.05) use disorder in borderline PD; cocaine (p<0.05) and alcohol (p<0.01) use disorder in paranoid PD; and alcohol use disorder in histrionic PD (p<0.01). The SUD for cocaine is lower in obsessive- compulsive PD (p<0.05) and depressive PD (p<0.01). There is a positive correlation between the number of PD of a subject and the number of SUD that it presents. The risk of an alcohol [OR of 1,08 CI (1,01-1,16)] or sedatives [OR of 1,08 CI (1,001-1,17)] use disorders increases if an individual presents more than one type of PD.
CONCLUSIONS
There is not differences of SUD prevalence between PD and not PD groups. We found an association between SUD and PD of cluster B (antisocial, borderline and histrionic) and also with paranoid PD. The SUD are more common among man with the exception of sedatives.
Topics: Adult; Alcoholism; Antisocial Personality Disorder; Cocaine-Related Disorders; Cross-Sectional Studies; Depression; Diagnosis, Dual (Psychiatry); Female; Histrionic Personality Disorder; Humans; Male; Marijuana Abuse; Obsessive-Compulsive Disorder; Opioid-Related Disorders; Paranoid Personality Disorder; Personality Disorders; Prevalence; Spain; Substance Abuse Treatment Centers; Substance-Related Disorders
PubMed: 31869422
DOI: No ID Found -
Spanish Journal of Psychiatry and... 2024Population studies on social anxiety disorder (SAD) are relatively scarce and there is no previous reported evidence on prevalence or correlates of SAD in an Andalusian...
INTRODUCTION
Population studies on social anxiety disorder (SAD) are relatively scarce and there is no previous reported evidence on prevalence or correlates of SAD in an Andalusian general population sample.
MATERIAL AND METHODS
We used a random representative sample previously identified via standard stratification procedures. Thus, a final sample of 4507 participants were included (response rate 83.7%). Interviewees were thoroughly assessed on sociodemographic, clinical and psychosocial factors, including: exposures to threatening life events (TLEs), childhood abuse, personality disorder and traits (neuroticism, impulsivity, paranoia), global functioning, physical health and toxics consumption. SAD diagnosis was ascertained using the Mini International Neuropsychiatric Interview. Both, pooled prevalences (with 95% confidence intervals) and risk correlates for SAD were estimated using binary logistic regression.
RESULTS
Estimated prevalence for SAD was 1.1% (95% CI=0.8-1.4). Having a SAD diagnosis was independently and significantly associated with younger age, poorer global functioning, higher neuroticism and paranoia personality traits, having suffered childhood abuse and exposure to previous TLEs. Furthermore, SAD was significantly associated with comorbid personality disorder, major depression, panic disorder and alcohol abuse.
CONCLUSIONS
Among this large Andalusian population sample, the prevalence of SAD and its associated factors are relatively similar to previously reported international studies, although no population study had previously reported such a strong association with paranoia.
Topics: Humans; Phobia, Social; Female; Male; Adult; Middle Aged; Spain; Prevalence; Young Adult; Adolescent; Comorbidity; Aged; Personality Disorders
PubMed: 38720187
DOI: 10.1016/j.rpsm.2021.09.006 -
Ugeskrift For Laeger Jan 2022ICD-11 introduces a new diagnosis of complex PTSD and a fundamentally new approach to personality disorders. The two diagnoses share substantial features including... (Review)
Review
ICD-11 introduces a new diagnosis of complex PTSD and a fundamentally new approach to personality disorders. The two diagnoses share substantial features including impairment of self and interpersonal functioning and emotional dysregulation. This review outlines the overlap and boundaries between ICD-11 definitions of Complex PTSD and Personality Disorder. A set of principles related to trauma, onset, emotion dysregulation, self and interpersonal functioning, and dissociative and psychotic-like states are put forward to guide practitioners.
Topics: Dissociative Disorders; Humans; International Classification of Diseases; Personality Disorders; Stress Disorders, Post-Traumatic
PubMed: 35088694
DOI: No ID Found