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Results for “PERSONALITY, PATHOLOGICAL”

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PubMed1995

Avoidant personality traits distinguish social phobic and panic disorder subjects.

The purpose of this study was to show that, as a group, patients with social phobia and panic disorder differ with respect to personality traits, further validating the distinction between these anxiety disorders. To show this, we compared the response of 46 subjects with social phobia with the response of 72 subjects with panic disorder with or without agoraphobia on the Personality Diagnostic Questionnaire. The subjects, who were recruited for treatment studies, completed this personality questionnaire after they had been off psychotropic medication for at least 1 week. Responses to the Personality Diagnostic Questionnaire showed that the social phobics had more severe personality pathology. These subjects had higher anxious and schizoid cluster scores and differed from panic subjects in having more avoidant personality traits. Panic subjects had more dependent traits. The results indicate that social phobic and panic disorder patients are distinguishable on the basis of personality characteristics. They also show that the generalized situational subtype of social phobia is closely associated with avoidant personality disorder and that these may be differing categorizations of a single disturbance.

Adult↗

PubMed1996

[Münchhausen syndrome by proxy between two adults].

OBJECTIVES: Münchhausen syndrome by proxy has been well described in the case of a women producing or pretending symptoms in one of her children, leading that child to have numerous medical interventions. The case of two adults has been seldom described and the differences in the psychopathological features of the two situations are not well known. METHODS: We report our observation of a Münchhausen syndrome in a married couple where the wife injected tranquilizers to her husband, inducing repeated episodes of coma. Complex interactions between the pathological personalities of the husband and wife were present. Prominent features of the wife's personality included a narcissistic deficiency, poor defenses and signs of depression. DISCUSSION: Practioners should be aware of this peculiar pathology to avoid delayed diagnosis and its dramatic consequences. Appropriate medical, psychiatric, as well as legal measures must be taken.

Adolescent↗

PubMed1996

Laxative abuse among women with eating disorders: an indication of psychopathology?

OBJECTIVE: The results of the scant research on laxative abuse among women with eating disorders suggest that laxative abuse is a diagnostic indicator of greater psychopathology. We further investigated the relationship of history of laxative abuse to eating and related attitudes, impulsivity, and personality pathology. METHOD: Women assessed in an outpatient clinical setting and diagnosed with anorexia nervosa, binge-eating/purging type (n = 51) or bulimia nervosa, purging type (n = 280) completed measures of laxative abuse, eating and related attitudes, and personality psychopathology at intake. RESULTS: More than one-half of both groups had abused laxatives at some point. History of laxative abuse was unrelated to eating disorder diagnostic category, current age or body weight, history of stealing, self-induced injury, having attempted suicide, interpersonal distrust, maturity fears, or compulsive or dependent personality features. Compared to nonabusers, laxative abusers demonstrated more perfectionism and avoidant personality features. Significant statistical interactions among variables revealed that bulimia nervosa patients who had abused laxatives exhibited the most pathological scores on scales measuring drive for thinness, body dissatisfaction, ineffectiveness, lack of interoceptive awareness, and passive-aggressive and borderline personality features. Anorexia nervosa patients who had abused laxatives had the highest scores on the histrionic scale. DISCUSSION: Results are discussed with regard to past research and clinical implications. We propose that laxative abuse among eating disordered women may serve different functions depending on diagnosis and underlying personality dynamics.

Adolescent↗

PubMed1991

The depressed borderline: one disorder or two?

Depression in the borderline patient may present as a reactive mood state, an expression of character, or an independent comorbid affective disorder. The symptom picture is most often heterogeneous, "atypical," and chronic. Pharmacologic trials with tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) produce modest improvement on a variety of symptoms, though not always on depression. Medication effects on depressed mood in borderline personality disorder (BPD) are independent of comorbid diagnoses of major depression, atypical depression, or hysteroid dysphoria. Residual symptoms are the rule. A literature review, including studies of comorbidity, longitudinal followup, family history, and laboratory and pharmacotherapy studies, suggests that the borderline patient has both a core biologic affective dysregulation and a pathologic personality organization. The combination of constitutional and psychodynamic etiologies for borderline pathology requires consideration of both pharmacotherapy and psychotherapy in any comprehensive treatment.

Borderline Personality Disorder↗

PubMed1999

The relationship among three models of personality psychopathology: DSM-III-R personality disorder, TCI scores and DSQ defences.

BACKGROUND: Current systems of describing personality pathology have significant shortcomings. A polydiagnostic approach is used to study the relationship between psychological, psychoanalytical and psychopathological models of personality. METHODS: The subjects were 256 patients enrolled in treatment studies of major depression and bulimia nervosa. Subjects were assessed using the Temperament and Character Inventory (TCI), the Defense Style Questionnaire (DSQ) and the Structured Clinical Interview for DMS-III-R personality disorders (SCID-II). RESULTS: Subjects had high rates of DSM-III-R personality disorders with 52% having at least one personality disorder. Cluster A personality disorders were correlated with low reward dependence, high harm avoidance and low self-directedness and cooperativeness. Cluster B personality disorders were related to high novelty seeking and low self-directedness and cooperativeness. Cluster C personality disorders were correlated with high harm avoidance and low novelty seeking and low self-directedness. Immature defences were related to DSM-III-R personality symptoms, but individual defences were not related to personality clusters in a predictable way. Immature defences were strongly related to low self-directedness and cooperativeness. Both TCI self-directedness scores and immature defence scores were moderately predictive of the presence and number of personality disorders. CONCLUSION: A widely accepted clinical nosology (DSM-III-R personality disorders) rated using a clinical interview correlates reasonably predictably with two theoretical models derived from different paradigms and rated using self-reports. This might be seen as providing concurrent validity for all three models. However, serious methodological shortcomings confront studies of this type, including sample selection and measurement of personality dysfunction. One way to begin to resolve these problems is to study which personality measures are best related to treatment response and prognosis.

Adolescent↗

PubMed1992

Factorial structure of traits delineating personality disorders in clinical and general population samples.

Categorical and dimensional models for classifying personality disorders were evaluated by comparing the structure of personality pathology in a clinical sample (n = 158) with the structure in a general population sample (n = 274). Subjects completed 100 personality scales. Separate factor analyses revealed similar structures in the 2 samples. An underlying structure in a combined sample showed limited agreement with the concepts of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1987). Fifteen factors were retained: Generalized Distress, Rejection, Restricted Expression, Compulsivity, Stimulus Seeking, Insecure Attachment, Diffidence, Intimacy Problems, Oppositionality, Interpersonal Disesteem, Conduct Problems, Cognitive Dysfunction, Affective Reactivity, Narcissism, and Social Apprehensiveness. The results are consistent with a dimensional representation of personality disorder.

Adult↗

PubMed1997

Note on concurrent validation of the personality assessment inventory in law enforcement.

This study compared the Personality Assessment Inventory and MMPI-168 profiles of 9 law enforcement applicants with published MMPI profiles to provide concurrent validation for the use of the Personality Assessment Inventory to assess personality pathology of peace officer applicants. The sample showed subclinical elevations of the Positive Impression and Treatment Rejection scales on the Personality Assessment Inventory and subclinical elevations on the MMPI validity scales of Lie and Correction and the clinical scales of Psychopathic Deviate and Hypomania. The applicants' mean MMPI profile provided concurrent validation for the use of the Personality Assessment Inventory in this decision on fitness to serve.

Adult↗

PubMed2002

[Personality and personality disorders I. Universality and sensitivity of dimensional personality models as diagnostic systems for personality disorders].

OBJECTIVE: A dimensional diagnostic system for personality disorders (PD) postulates continuous transitions from normal to disordered personalities (continuity hypothesis) and universal validity of basic personality dimensions (universal hypothesis). In the present study three dimensional personality models that claim to provide a systematic representation of the overall domain of personality disorders were compared: the Big-Five model proposed by Costa and McCrae, the psychobiological model proposed by Cloninger and colleagues, and the "Dimensional Assessment of Personal Pathology (DAPP)" model proposed by Livesley and colleagues. METHOD: The "Six Factor Test" (SFT) measuring the Big-Five factors of personality, the "Temperament and Character Inventory (TCI)" measuring 4 temperament and 3 character dimensions, and the DAPP measuring 18 basic traits and 4 second ordered factors were administered to general population subjects (n = 156), and a clinical sample (n = 220) including a subsample of 69 patients with at least one diagnosis of DSM-IV PD. Group comparisons, regression analyses, and facet theoretical analyses were conducted. RESULTS: The nonmetric similarity analyses of the three personality models show a nearly identical radex-representation of the second ordered factors in the non-clinical and clinical sample reflecting an universal validity of 4 basic personality dimensions and confirming the universal hypothesis. In comparison with the BIG-Five concept and the psychobiological model the DAPP model seems to be more sensitive to differentiate PD patients from controls with a reclassification rate of 94.5 %. CONCLUSIONS: The Big-Five model, the DAPP and the TCI represent a substantially similar domain despite their different conceptualization. However, the DAPP was more sensitive to differences between PD patients and controls, offered a more comprehensive account of PD, and could differentiate the two groups more effectively.

Character↗

PubMed2005

Borderline personality features in childhood: a short-term longitudinal study.

Borderline personality disorder is a particularly devastating, yet understudied form of psychopathology. One of the most significant gaps in existing knowledge is the lack of systematic, prospective empirical attention to the developmental precursors of borderline personality. The present investigation was an exploratory attempt to address this limitation through (a) development of a psychometrically sound self-report instrument that assesses borderline personality features in childhood, the Borderline Personality Features Scale for Children (BPFS-C); (b) examination of the stability of BPF in childhood; (c) evaluation of gender differences in BPF in childhood; and (d) evaluation of the specificity of the BPFS-C for assessing borderline personality features. These goals were achieved through the prospective study of a normative sample of 400 (54% female) fourth though sixth graders who were assessed during the Fall of Year 1, Spring of Year 1, and Fall of Year 2. The use of linear mixed modeling techniques provided evidence for the construct validity of the BPFS-C. Further, borderline personality features as assessed with the BPFS-C were found to be moderately stable over the course of the study, with girls reporting higher levels of BPF than boys. Results also demonstrated that children's scores on the BPFS-C were uniquely related to indicators of borderline personality pathology above and beyond their scores on the Children's Depression Inventory. The implications of these results for the study of the development and etiology of borderline pathology are discussed.

Aggression↗

PubMed1995

[Psychological study of rape victims].

This paper covers a study of rape victims, according to the records of Clinic for Gynekology and Obstetrics in Novi Sad, in terms of the late psychological and psychiatric consequences. Several methods were used: special questionnaire, Minnesota Multiphasic Personality Inventory for estimating personality and selfdescriptive scale of depression, Beck Depression Inventory. Results emphasize that the group with the highest rape risk consists of female persons aged from 22 to 30 years, single, without children and with lower education level. Psychological and psychiatric and analysis shows pathological personality of victims in most cases. All victims tested, expressed intensive or mild degree of depression. Analysis of offense situation points to significant degree of victimization.

Adolescent↗

PubMed2001

Predicting recurrence of major depressive disorder in young adults: a prospective study.

Sixty-five young adults with remitted major depressive disorder (MDD) were followed for 18 months. Recurrence of MDD was reported by 41.5% of the initial sample and 49.1% of those who completed the study (n = 53). Survival analyses were used to identify predictors of recurrence so that individuals at greatest risk could be targeted for intervention. Potential predictors included measures of comorbid psychopathology (Axis II pathology, and current and lifetime nonmood Axis I diagnoses), depression-specific clinical features (number of episodes, past treatment, and suicidality), and self-reported cognitive and interpersonal constructs (hope, dysfunctional attitudes, and interpersonal problems). Only personality pathology (specifically, the total dimensional and Cluster B dimensional scores on the International Personality Disorder Examination) significantly predicted hazard of recurrence.

Adolescent↗

PubMed1979

[Clinico-psychopathologic features of non-process forms of deviant behavior in adolescence].

Clinico-psychopathological traits of non-process forms of deviant behaviour in adolescents were studied in the framework of pathological personality formation. Two variants in the development of the disease were distinguished: favourable and unfavourable. Some differential diagnostic criteria are outlined which permit to delineate this form of borderline pathology from a debut of schizophrenia in adolescency. The study includes a consideration of the disturbed system of relationships of the personality in the adolescents examined.

Adolescent↗

PubMed2000

The DSM classification of personality disorder: clinical wisdom or empirical truth? A response to Alvin R. Mahrer's problem 11.

In a recent issue of the Journal of Clinical Psychology Alvin R. Mahrer (1999, pp. 1147-1156) outlined 11 problems facing the field of psychotherapy. Problem 11 states that psychotherapy rests on a foundation of truths that have not been tested in ways that could find them to be false. This point is especially pertinent to the DSM classification of personality disorders. None of the DSM-IV categories of personality disorder were discovered through empirical research. Rather, they were hypothesized by psychiatrists and psychologists, and put into writing. A review of the relevant literature reveals that empirical research findings rarely agree with the DSM conceptions of personality disorder classification. It is concluded that only through continuing empirical research efforts can we discover how nature "intended" personality pathology to be classified.

Diagnosis, Differential↗

PubMed2006

Assessing personality change in psychotherapy with the SWAP-200: a case study.

Many studies document the efficacy of psychotherapy for acute syndromes such as depression, but less is known about personality change in patients treated for personality pathology. The Shedler-Westen Assessment Procedure (SWAP-200; Westen & Shedler, 1999a, 1999b) is an assessment tool that measures a broad spectrum of personality constructs and is designed to bridge the gap between the clinical and empirical traditions in personality assessment. In this article, we demonstrate the use of the SWAP-200 as a measure of change in a case study of a patient diagnosed with borderline personality disorder. We collected assessment data at the start of treatment and after 2 years of psychotherapy. The findings illustrate the personality processes targeted in intensive psychotherapy for borderline personality.

Adult↗

PubMed2002

Personality impairment in male pedophiles.

BACKGROUND: Despite the large body of literature on the psychological sequelae of childhood sexual abuse, the literature on the psychopathology of pedophiles is surprisingly underdeveloped. The present article explores the hypothesis that pedophiles evidence deficits in interpersonal functioning (lack of assertiveness and empathy, passive-aggressiveness) and in self-concept, which might contribute to the motivation for pedophilic acts, as well as elevated sociopathy, impulsivity, and propensity for cognitive distortions, which might underlie the inhibitory failure. METHOD: Twenty male heterosexual pedophiles (DSM-IV criteria) recruited from an outpatient clinic for sex offenders were compared with 24 demographically similar, healthy male controls using 3 personality instruments: the Millon Clinical Multiaxial Inventory-II, the Dimensional Assessment of Personality Impairment-Questionnaire, and the Temperament and Character Inventory. RESULTS: The data suggested that pedophiles have impaired interpersonal functioning, specifically, reduced assertiveness and elevated passive-aggressiveness, as well as impaired self-concept. Regarding disinhibitory traits, pedophiles demonstrated elevated sociopathy and propensity for cognitive distortions. CONCLUSION: Our data are consistent with previous reports of pathologic personality traits in pedophiles and lend support to a hypothesis that such pathology is related to both motivation for and failure to inhibit pedophilic behavior. Such information could potentially have important treatment implications.

Adult↗

PubMed1981

Premenstrual syndrome and personality traits: a study on 110 pregnant patients.

Five specific personality traits (emotivity, acceptance of sexual role, parental aptness, anxiety and depression) have been analyzed for this study of the premenstrual syndrome (PMS), conducted on a group of 110 women in advanced (8th month) pregnancy. The comparison of the results from the personality tests and from the overall assessment of the PMS (82%) establishes definite correlations between the syndrome's intensity and the tendency toward a pathologic personality. A further correlation of each personality trait and of the PMS shows that the greater deviation from normalcy affects not only those women who suffer from a severe PMS, but also those who complain of no premenstrual symptoms at all. Such a finding (as shown in the results of a separate previous study by our group) allows to conclude that a psychological normalcy or balance finds its equivalent in an absence, but more often in a scarce presence of premenstrual complaints, while an absolute absence or a very marked intensity of these complaints should correspond to the more extreme degrees of personality disturbance.

Adult↗

PubMedDate not supplied

A psychiatric study of nonorganic chronic headache patients.

Nonorganic chronic headache is a common, challenging presentation in clinical practice. The aim of this study was to investigate the frequency of associated psychiatric psychopathology, personality disorders, or traits. In addition, the study attempted to investigate possible relationships of nonorganic chronic headache with alexithymia, locus of control, and pain perception. Psychiatric pathology, personality traits, and pain profiles were examined in 100 randomized patients with chronic headache lacking an obvious organic basis, and they were compared with 100 subjects, 50 with headache of a known organic cause and 50 seemingly healthy persons, by using structured clinical interviews. Somatoform pain disorder was diagnosed in 43% of the nonorganic and 20% of the organic headache group. Nine percent of the former group had major depression, 16% had dysthymia, and 8% had both. In the organic group, 56% had no psychiatric disorder and 20% had somatoform pain disorder. Seventy-seven percent of the patients in the nonorganic pain group had personality disorders, mostly of the mixed and multiple types, compared with 24% of the organic headache patients. The study sample was more alexithymic than the other groups (in 65% of subjects) and had a culturally influenced locus of control and a pain profile characterized by dramatization, vagueness, lower pain threshold, and lower pain tolerance. The nonorganic chronic headache patients showed a high prevalence of somatoform, depressive, and other forms of psychiatric disorders. The high frequency of personality disorders, mostly the mixed and multiple types, the high alexithymic pattern, and low pain threshold and tolerance in the study group should be taken into consideration in the evaluation and management of nonorganic headache patients.

Adult↗

PubMed2002

Personality traits and pathology in older and younger incarcerated women.

Personality disorders were examined in 157 incarcerated women, using the Schedule for Nonadaptive and Adaptive Personality (SNAP; Clark, 1996) to assess 10 Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-III-R; American Psychiatric Association, 1987) diagnostic categories and dimensions and 15 domains of trait/temperament relevant to disordered personality. Similar to both community samples and incarcerated men, older women had lower rates of personality disorders than younger women, and the difference was mostly accounted for by differences in the Cluster B disorders. In an exploratory analysis of trait and temperament scales, the older women also scored lower in Aggression, Disinhibition, Entitlement, Exhibitionism, Impulsivity, and Manipulativeness while younger women scored lower in Workaholism and Propriety. These findings suggest that remission of antisocial behavior in women may be associated with changes in lower order personality traits or temperament.

Adult↗