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PubMed1988

The relationship between the Millon Clinical Multiaxial Inventory and the MMPI in a private outpatient mental health clinic population.

The concurrent validity of the MCMI as compared to the MMPI was assessed by administering both tests to 106 newly admitted outpatients and calculating the intercorrelations between these two tests. Of the 20 MCMI scales, 12 were found to correlate with the MMPI in a manner that suggested that they do measure some degree of personality dysfunction, emotional disturbance, or specific psychological symptomatology. Eight of the MCMI scales failed to show correlations that would indicate that they effectively measure any of the pathological personality characteristics or clinically significant symptom patterns known to be measured by the MMPI.

Adolescent↗
PubMed1999

Revising and assessing axis II, Part I: developing a clinically and empirically valid assessment method.

OBJECTIVE: Personality pathology is difficult to measure. Current instruments have problems with validity and rely on a direct-question format that may be inappropriate for the assessment of personality. In addition, they are designed specifically to address current DSM-IV categories and criteria, which limits their utility in making meaningful revisions of those criteria. These problems suggest the need for consideration of alternative approaches to assessing and revising axis II. METHOD: This article describes the development and validation of an assessment tool designed to allow clinicians to provide detailed, clinically rich personality descriptions in a systematic and quantifiable form (the Shedler-Westen Assessment Procedure, or SWAP-200). A total of 797 randomly selected psychiatrists and psychologists used the SWAP-200 to describe either an actual patient or a hypothetical, prototypical patient with one of 14 personality disorders (one of the 10 DSM-IV axis II disorders or one of four disorders included in the appendix or in DSM-III-R) or a healthy, high-functioning patient. RESULTS: The data yielded aggregated descriptions of actual patients in each diagnostic category (N = 530) as well as aggregated descriptions of hypothetical, prototypical patients (N = 267). SWAP-200 descriptions of patients with personality disorders showed high convergent and discriminant validity on a variety of criteria. The diagnostic procedure lends itself to both categorical and dimensional personality disorder diagnoses. Descriptions of individual patients resemble MMPI profiles, based on the degree of match between the patient's profile and a criterion group, except that they are based on clinician observation rather than self-report. CONCLUSIONS: The SWAP-200 represents an approach to the measurement and classification of personality disorders that has potential for refining axis II categories and criteria empirically in ways that are both psychometrically and clinically sound.

Adult↗
PubMed2007

Dysfunctional attitudes and personality disorder comorbidity during long-term treatment of MDD.

A key component of how depression may impact personality pathology involves an understanding of how cognition and dysfunctional attitudes may change as a result of experiencing a depressive state, and how these changes may affect reporting of personality disorder symptoms. This study examines whether dysfunctional attitudes are related to the stability of personality disorder diagnoses. The sample comprised 64 outpatients who were treatment responders following an 8-week acute treatment phase for major depressive disorder (MDD), met criteria for remission throughout a 26-week continuation phase, and completed a personality disorder assessment Structured Clinical Interview for DSM-III-R Axis II Disorders (SCID-II) at the beginning and end of each treatment phase. The Dysfunctional Attitude Scale (DAS) was given to patients at the beginning of the continuation phase. We found that following successful treatment of the MDD, individuals with stable personality disorder diagnoses (e.g., meeting criteria for a personality disorder at both the beginning and endpoint of continuation treatment) had greater severity of dysfunctional attitudes (P =.001) at the beginning of the continuation treatment compared to those who never met criteria for a personality disorder during continuation treatment. Though there was no significant relationship between DAS scores and the stability of a Cluster A or Cluster B personality disorder diagnosis, there was a significant relationship between DAS scores and the stability of a Cluster C personality disorder diagnosis (P <.001). Outpatients who had a stable Cluster C personality disorder diagnosis had higher scores on the DAS at the beginning of continuation treatment compared to outpatients who never met criteria for a Cluster C diagnosis. This finding suggests that dysfunctional attitudes that persist beyond remission of MDD may be a marker for certain personality disorders that are stable across long-term treatment.

Adult↗
PubMed1979

[Separation of psychopathy-like states of residual organic origin from psychogenic pathocharacterologic personality development (clinico-electroencephalographic study)].

The paper deals with a clinical and EEG characteristic of 2 groups of patients: 1) with psychopathlike conditions, due to early organic brain lesions (trauma during delivery, postnatal brain infections, etc), and 2) psychogenic pathological personality development in the presence of mild residual-organic brain insufficiency. Residual organic insufficiency in the first group is the main etiopathogenitical factor of disordered behaviour in children and adolescents. In the second group a psychogenically induced situation is one of the important factors of disturbed behaviour.

Adolescent↗
PubMed2001

College students with tattoos and piercings: motives, family experiences, personality factors, and perception by others.

The motives, family experiences, and personality characteristics of 341 college students with and without tattoos or piercings were studied. Participants completed Lippa's 1991 measures of the Big Five personality factors, a shortened version of the Body Cathexis Scale, a series of questions about their childhood experiences, and questions about risk-taking behaviors. In addition, reasons to have or not have body modifications and the perceptions of people with body modifications were investigated. Of the 116 men and 186 women, 25% and 33%, respectively, had at least one tattoo or body piercing. There were very few differences in the childhood experiences or personality characteristics of people with or without body modifications. Although people with body modifications did not differ from people without modifications on the Big Five personality measures, people without modifications perceived people with modifications as much different from themselves on these measures. These results indicate that tattoos and piercings in college students are associated with significantly more risk-taking behavior, greater use of alcohol and marijuana, and less social conformity. However, the traditional stereotype that body modifications are indicators of social or personal pathology does not describe contemporary college students.

Adolescent↗
PubMed1995

Minnesota Multiphasic Personality Inventory correlates of panic disorder with agoraphobia: changes with treatment.

Forty-seven patients meeting DSM-III-R criteria for panic disorder with agoraphobia (PAG) were assessed by the Minnesota Multiphasic Personality Inventory (MMPI) at baseline and after 8 weeks of treatment with imipramine, clomipramine and placebo. At pre-treatment patients had higher MMPI scores than the local normative data, the highest scores being for depression, hypochondria and hysteria. At week 8 the scores of most MMPI scales were significantly reduced. In addition, patients who showed clinical improvement had pre- and post-treatment scores lower than the unimproved patients. The results suggest that the abnormal MMPI profile found in PAG patients reflects the clinical state and that personality pathology relates to treatment outcome. The reduction in MMPI scores was associated with response to active treatment. We conclude that therapeutic interventions that successfully reduce PAG symptoms also modify personality scores.

Adolescent↗
PubMedDate not supplied

Latent structure of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition personality disorder criteria.

AIMS: This study investigated the internal construct validity of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) personality disorders and explored alternative models to characterize the personality disorder traits. The relationship between the obtained personality disorder dimensions and measures of functioning and disability was examined. METHODS: The subjects in the study were 742 community-residing individuals who participated in the Hopkins Epidemiology of Personality Disorders Study. The presence of DSM-IV personality disorder traits was assessed by psychologists using the International Personality Disorder Examination (IPDE). Confirmatory factor analysis was performed on all the IPDE criteria for each of the 10 personality disorders using the Mplus program. Exploratory factor analysis of all personality disorder traits was completed using the same program. Factor scores were correlated with subjects' GAF ratings and number of missed days from work for physical and psychological reasons. RESULTS: A single underlying factor was found for the IPDE item criteria of avoidant and dependent personality disorder, with less evidence for the other 8 personality disorders. Five factors were retained as the dimensional accounting for the personality disorder criteria. These factors were named compulsive, neurotic avoidant, aloof, impulsive callous, and egocentric. Of the five factors, 4 were associated with evidence of diminished functioning. CONCLUSIONS: The IPDE pathological personality traits did not empirically cluster according to the current DSM-IV axis II diagnostic system but instead defined 5 relatively independent PD symptom dimensions that were related to functional impairments.

Adult↗
PubMed1991

Neuroscience, modularity and personality theory: conceptual foundations of a model of complex human functioning.

The purpose of this paper is to lay the groundwork for the development of a scientific theory of complex human functioning. We first discuss the assumptions on which our thinking is based, then advance the argument that behavior, and human activity in general, may be more fully understood in light of current data on the structural organization of the central nervous system. The brain is organized as a modular, distributed, self-organizing system, which is in constant transaction with the environment. Because of its plasticity, structural and functional change occurs in the brain as a result of experience throughout life. It is our thesis that complex human behavior is organized in a similar manner - that is, human personality and behavior manifest themselves as modular systems. The insights provided by an understanding of the relationship of brain and behavior may enhance the capacity to explain both normal and pathological personality functioning.

Adaptation, Psychological↗
PubMed1998

Cognitive and affective representations of people and MCMI-II personality psychopathology.

Hibbard, Hilsenroth, Hibbard, and Nash (1995) found that affective, but not cognitive, dimensions of object representations were related to the severity of psychopathology among outpatients. In this study, the Social Cognition and Object Relations Scale (Western, Barends, Leigh, Mendel, & Silbert, 1990) developed for interview data (Relationship Episodes; Luborsky, 1990) was used to assess the object representations of 33 men and 38 women entering psychotherapy. The Millon Clinical Multiaxial Inventory-II was used to assess the personality traits of the 71 participants. The results support earlier findings that only affective dimensions of object representations are related to outpatient personality pathology.

Adult↗
PubMed2003

Patient and clinician agreement on personality using the SWAP-200.

The Shedler Westen Assessment Procedure (SWAP-200; Westen & Shedler, 1999a) is a clinician-rated assessment providing descriptions of personality disorder prototypes using a Q-sort procedure. This study aims to investigate the degree to which there is agreement between patients' and clinicians' accounts of personality pathology on a modified version of the SWAP-200 using Bland Altman analysis with the data from 23 clinician-patient pairs. Poor agreement was found between clinicians and patients on personality prototypes. Even the best agreement found between patients and clinicians on the avoidant prototype was poor--the patients' ratings were up to 43.5 per cent below and 32.9 per cent above the clinicians' ratings. This is an unacceptable degree of variation. The difference between the clinician and patient ratings are large when expressed as a percentage of the possible scores (as obtained on the clinician rating scale). The patient ratings vary between being 40.8 to 91.1% below the clinician ratings, and 32.9 to 99.7% above the clinician ratings.

Adult↗
PubMed1991

Jealousy: the pathology of passion.

Emotions may be rooted in biology but the process of cultural construction gives those emotions form and a language for their expression. The changing construction of jealousy in Western societies has transformed a socially sanctioned response to infidelity into a form of personal pathology which is the mere outward expression of immaturity, possessiveness and insecurity. This is a history of the stripping away of social, ethical and finally interpersonal meanings from an experience, to leave it as a piece of individual psychopathology. Fidelity and jealousy are constructed as they are because of the nature of the social and economic realities which drive our culture. The erosion of the area of human experience which could be identified with normal jealousy leaves the boundary between the pathological jealousy of psychiatry and normal experience increasingly problematic.

Delusions↗
PubMed1993

Office arthroscopy of the shoulder. A diagnostic alternative.

Office arthroscopy of the shoulder is a technically demanding procedure and is significantly more challenging than office arthroscopy of the knee. With the proper equipment and in the hands of an experienced shoulder arthroscopist, the procedure offers many advantages. Patients unanimously prefer office arthroscopy to MR imaging because of the ability to view their pathology personally in a medium more palatable and understandable than MR imaging. Office arthroscopy appears to be a safe, accurate, and cost-effective alternative to MR imaging for the diagnosis of shoulder pathology in select patients.

Arthroscopes↗
PubMedDate not supplied

Personality disorders in alcoholics and drug addicts.

This report examines the prevalence of personality disorders among hospitalized alcoholics and polydrug addicts and the extent and nature of the overlap between different axis II disorders. Subjects were 178 alcoholics admitted to a diagnostic unit of an addiction treatment institute and 86 polydrug addicts admitted to the therapeutic community of the same institute. Substance abuse was diagnosed according to DSM-III-R, and patients were assessed with the Structured Interview for DSM-III Personality Disorders (SIDP). In the alcohol group, 78% of the patients had at least one personality disorder and the average number of personality disorders was 1.8 per patient. In the polydrug group, 91% of the patients met criteria for at least one personality disorder and the average number of personality disorders was 4.0 per patient. No single "addictive personality" emerged. These findings raise questions about the validity and usefulness of the distinction between axis I and axis II disorders in patients with substance use disorders, and do not lend support to the validity of the categorical classification of personality pathology.

Adult↗
PubMed2004

A comparison of personality function among patients with seasonal depression, nonseasonal depression, and nonclinical participants.

Although a large body of research has accumulated concerning the relationship between nonseasonal depression and personality, comparatively few studies have examined the relationship between seasonal affective disorder (SAD) and personality. This study compared dimensional aspects of personality in patients diagnosed with SAD (N = 60), nonseasonal depression (N = 273), and nonclinical controls (N = 297) using the Dimensional Assessment of Personality Pathology (DAPP-BQ; Livesley & Jackson, in press). Analysis by ANCOVA indicated that significant between-group differences occurred in several of the 18 DAPP-BQ dimensions, with patients with SAD exhibiting personality psychopathology that was intermediate between the nonclinical sample and patients with nonseasonal depression. The results demonstrated that the traits associated with seasonal and nonseasonal depression differ in degree, not kind.

Adult↗
PubMedDate not supplied

[Developmental stuttering and acquired stuttering: resemblances and differences].

INTRODUCTION: In this study the authors analyse, clinically, dysphemia (DP) and acquired stuttering (AS). AIMS. The aim of this study was to evaluate whether AS is a variant of DP or whether it is an entity that shares a common element: stuttered speech. PATIENTS AND METHODS: The authors studied 13 patients with AS and 36 with DP. In addition to the clinical evaluation, electroencephalogram (EEG) and cranial computerised axial tomography (CAT) scans were performed, with a special interest in secondary symptoms/signs, laterality profiles and pathological, personal and familial history. RESULTS: There was a notable predominance in males in both groups. AS began either in infancy or from any other age; DP only started in infancy. The most frequent organic pathology, for both DP and AS, was a severe traumatic brain injury, followed by cerebral anoxia/hypoxia, cerebrovascular accident (CVA) and others. One important element in both groups was the presence of stuttering and high percentages of left-handedness in the families. In AS, all patients were right-handed. None of the patients who experienced the onset of AS in infancy improved/yielded during adolescence. CONCLUSIONS: Both DP and AS are cases of "neurogenic" stuttering because they display organic and/or functional pathologies in the two groups, which invalidates the term "developmental", since AS also occurred in infancy. DP and AS have an element in common: they both share a genetic predisposition on which the organic/functional pathology then gives rise to the clinical symptoms, although this does not account for the absence of tics in AS.

Adolescent↗
PubMed2006

Neuroticism and affective instability: the same or different?

OBJECTIVE: The purpose of this study was to examine the correlates and consequences of two constructs related to affective experience: neuroticism and affective instability. METHOD: One hundred thirty-two patients were assessed at intake for axis I and II symptoms, general personality traits, and specific impairments, including impairments in interpersonal functioning. The data included responses to structured and semistructured interviews, self-reports of interpersonal problems, and reports of interpersonal problems from significant others. Clinical ratings of axis I and II symptoms and of impairment were made by using the LEAD (i.e., longitudinal, expert, all data) consensus approach. Ninety-one of the 132 patients were reassessed at 12-month follow-up. RESULTS: Neuroticism and affective instability manifested varied concurrent relations, with neuroticism being strongly related to an anxious, avoidant style and affective instability related to more externalizing personality styles. Prospectively, neuroticism predicted later symptoms, occupational impairment, and global dysfunction, whereas affective instability predicted romantic impairment. CONCLUSIONS: The findings suggest that neuroticism and affective instability--which are considered core aspects of personality pathology--are related but distinct constructs with unique correlates and different predictive abilities.

Adult↗
PubMed1999

Assessment of maladaptiveness: a core issue in the diagnosing of personality disorders.

Although an operationalized and commonly accepted definition of maladaptiveness is lacking, the delineation of personality traits as being adaptive or maladaptive is essential in diagnosing personality disorders (PDs). A way to explore the meaning of maladaptiveness is to compare how patients from all DSM-III-R PDs relate to different traits and dimensions of various dimensional models of personality. In the present study, the Karolinska Scales of Personality (KSP) were used in a sample of 94 psychiatric outpatients who were assessed according to severity of maladaption and according to type of predominant cluster type of deviant traits. Only one of four factors of the scores of the KSP subscales, "Interpersonal Aversiveness," was related to degree of maladaption, indicating high detachment, suspicion, irritability, dysphoria, and low socialization as core features of maladaptiveness. Three subscales of the KSP Socialization were all associated with maladaptiveness. However, one subscale, "Childhood Adjustment," was also related to the predominant cluster type of personality pathology.

Adaptation, Psychological↗