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PubMed1995

Familial aggregation of adolescent personality disorders.

OBJECTIVE: A family study of DSM-III-R personality disorders was conducted in the families of 66 clinically referred adolescents to examine the validity of personality disorder diagnoses in adolescents. METHOD: Semistructured interviews of Axis I and II disorders, including the Structured Clinical Interview for DSM-III-R Personality Disorders, were used to directly interview 66 clinically referred adolescents and their adult first-degree family members, combining family study and family history data. RESULTS: The relatives of adolescents with avoidant personality disorder had an increased prevalence of avoidant and cluster A (schizoid, schizotypal, and paranoid) personality disorders. The relatives of adolescents with borderline personality disorder demonstrated increased rates of borderline and avoidant personality disorders, even after adjusting for comorbidity. CONCLUSIONS: The results of this study support the validity of Axis II diagnoses, particularly avoidant and borderline disorders, in adolescents.

Adolescent↗
PubMed2001

Skills training as an adjunctive treatment for personality disorders.

Personality disorders are usually treated with either psychodynamic or supportive psychotherapy, with psychotropic medication often used as an adjunctive treatment. However, patients with personality disorders pose special treatment issues, because their problems are pervasive and long-standing and they have entrenched deficits in many areas of functioning. In this article, the authors consider the role of skills training in the treatment of personality disorders. They describe a two-pronged approach to the treatment of personality disorders based on a model of deficit compensation. Because skills training has only been investigated in a very limited way in personality disorders, the authors first review research on the use of skills training in Axis I disorders as background for a discussion of ways in which skills training may be applicable to the treatment of Axis II disorders. They describe a number of skills training approaches (social skills training, anger management, and conversational skills) that can be used for a variety of different Axis I disorders. Skills training approaches that are targeted to specific types of disorders (substance use disorders, schizophrenia, anxiety disorders, adolescent problems) are also described. The authors then review what is known about the use of skills training in borderline personality disorder and avoidant personality disorder, and propose skills training approaches that may be useful for patients with paranoid personality disorder and antisocial personality disorder. Case examples are provided to demonstrate how skills training for personality disorders can be applied in clinical practice.

Journal Article↗
PubMed2003

Child and adolescent psychiatric disorders predicting adult personality disorder: a follow-up study.

The objective of this study was to examine associations between childhood and adolescent psychiatric disorders and adult personality disorders in a group of former child psychiatric inpatients. One hundred and fifty-eight former inpatients with a mean age of 30.5 +/- 7.1 years at investigation had their childhood and adolescent Axis I disorders, obtained from their medical records, coded into DSM-IV diagnoses. Personality disorders in adulthood were assessed by means of the DSM-IV and ICD-10 Personality Questionnaire (DIP-Q). The predictive effects of child and adolescent Axis I disorders on adult personality disorders were examined with logistic regression analyses. The odds of adult schizoid, avoidant, dependent,borderline and schizotypal personality disorders increased by almost 10, five, four, three and three times, respectively, given a prior major depressive disorder. Those effects were independent of age, sex and other Axis I disorders. In addition, the odds of adult narcissistic and antisocial personality disorders increased by more than six and five times, respectively, given a prior disruptive disorder, and the odds of adult borderline, schizotypal, avoidant and paranoid personality disorders increased between two and three times given a prior sub-stance-related disorder. The results illustrate an association between mental disorders in childhood and adolescence and adult personality disorders. Identification and successful treatment of childhood psychiatric disorders may help to reduce the risk for subsequent development of an adult personality disorder.

Adolescent↗
PubMed1992

Psychiatric morbidity in the families of paranoid and non-paranoid schizophrenia patients.

A total of 1018 and 812 first degree relatives (FDR) of schizoprencies and controls respectively, were studied to find out the psychiatric morbidity in the families of paranoid and non-paranoid schizophrenia patients. The risk of schizophrenia and affective disorders was found to be independent of the probands subtype diagnosis. The risk for schizoid-schizotypal and paranoid personality disorders was found to be increased in the first degree relatives of paranoid schizophrenic, as compared to non-paranoid schizophrenic, thus suggesting that the psychopathology in the FDR may differ with the subtype diagnosis of the proband.

Adolescent↗
PubMed1997

Mnemonics for DSM-IV personality disorders.

The paper presents several mnemonics to assist clinicians in recalling DSM-IV diagnostic criteria for personality disorders. The mnemonics are acronyms, and each letter is associated with a specific criterion. Each acronym reflects a facet of the related disorder; for example, the acronym for the diagnostic criteria for paranoid personality disorder is SUSPECT, and for histrionic personality disorder it is PRAISE ME. The mnemonics have been used to teach students and residents the conceptual nature of DSM-IV disorders and to help them remember the criteria.

Humans↗
PubMed1983

Personality disorders.

Personality disorders are characterized by inflexible maladaptive traits that cause significant impairment in social and occupational functioning. Categories of personality disorders include paranoid, schizoid, histrionic, narcissistic, antisocial, borderline, avoidant, dependent, compulsive and passive-aggressive. The inflexible nature of these disorders and the lack of an alternative behavioral repertoire result in an inability to cope with environmental pressure. The goal of management is the development of healthier behavioral responses to stress. A personality change in older patients suggests organic disease.

Adolescent↗
PubMed1989

Comorbidity for borderline and schizotypal personality disorders. A study of alcoholic women.

Twenty-six women alcoholics who fulfilled the criteria for a pure borderline personality disorder (BPD) were compared with 16 women alcoholics who also fulfilled the criteria of a schizotypal personality disorder (called mixed borderline disorder, MBD) based on personal interviews including SADS, SIB, Childhood Environment Scale (CES), and the Premorbid Adjustment Scale (PAC). The MBD women had fewer alcoholic relatives, poorer relationships with parents and siblings, a more deviant score on CES and PAC, a higher incidence of nervous children, and a poorer social network. They also reported more losses and a greater frequency of depressive symptoms during childhood and adolescence, earlier contact with psychiatry, and more frequent hospitalizations. They had a higher frequency of a nonalcoholic axis I disorder (mainly depressive and anxiety disorders), as well as a greater frequency of a paranoid personality disorder. The results show that the MBD women were more psychopathologically disturbed and support a possible link between MBD and affective disorders. The findings also indicate that MBD may be a clinical entity that should be differentiated from the pure BPD group both in clinical work and forthcoming research.

Adult↗
PubMed1975

A study of transsexuals seeking gender reassignment.

The authors report the results. of a computerized psychodiagnostic assessment of 19 males and 1 female seeking sex-reassignment surgery. The most pervasive finding was hysterical personality trend (13 of 20 cases). Twelve patients exhibited psychotic trends: 6 showed psychotic thinking on test scores, and 6 received computer-preferred diagnoses of paranoid or schizoid personality. However, most of these 12 patients were not considered psychotic on interview, and those who had sex-reassignment surgery had good results

Antisocial Personality Disorder↗
PubMed2001

[Personality disorders and psychiatric comorbidity in obsessive-compulsive disorder and anorexia nervosa].

The aim of this prospective longitudinal study was to examine the course of adolescent anorexia nervosa and obsessive-compulsive disorder (OCD) (fulfilling DSM-III-R criteria) to compare psychiatric comorbidity and personality disorders of both groups. Because anorexia nervosa patients are mainly female, we compared them only with female OCD patients. Ten years after discharge the whole sample (32 female patients; 100%) of a group of 39 (32 female; 7 male) anorexia nervosa patients could be reexamined personally. 25 (61%) female patients of a group of 116 patients (41 female; 75 male) with obsessive-compulsive disorder were also reexamined. The anorexia nervosa patients were interviewed using the Structured Interview for Anorexia and Bulimia nervosa (SIAB [39]) to assess eating disorder symptomatology. To examine comorbid psychiatric disorders we used the Composite International Diagnostic Interview, WHO [44] and SCID-II [45] for personality disorders. One fourth of the patients with anorexia nervosa (AN) and 20% of the patients with obsessive-compulsive disorder had a personality disorder according to DSM-III-R. Most of them were "Cluster C"-personality disorders (AN: 28%; OCD: 20%). In the group of the female OCD patients 8% schizoid, 4% schizotype and 12% paranoid personality disorders were observed. The most prevalent psychiatric disorders were anxiety (AN: 28%; OCD: 20%) and affective disorders (AN: 16%; OCD: 16%). Our results support the view that in the course of anorexia nervosa and in obsessive-compulsive disorder there is a high prevalence of psychiatric comorbidity and "Cluster C"-personality disorders according to DSM-III-R. These results might confirm a model of a high vulnerability of the serotonergic neurotransmitter system in patients with anorexia nervosa or OCD.

Adolescent↗
PubMed1989

DSM-III personality disorder diagnoses in a nonpatient sample. Demographic correlates and comorbidity.

Seven hundred ninety-seven first-degree relatives of normal controls and patients with a variety of psychiatric disorders were interviewed with the Diagnostic Interview Schedule and the Structured Interview for DSM-III Personality Disorders. Slightly more than one sixth of the sample received a personality disorder (PD) diagnosis, and of those with a PD, almost one fourth had more than one. The most prevalent diagnoses were mixed, passive-aggressive, antisocial, histrionic, and schizotypal PD. The demographic correlates and frequency of Axis I disorders in individuals with each specific PD were examined, and all but histrionic and passive-aggressive PDs had distinctive profiles.

Adult↗
PubMed1993

DSM-III-R personality disorders in parents of schizophrenic patients.

This study examines the frequency of DSM-III-R personality disorders in parents of 58 patients who were admitted consecutively to a New York State psychiatric hospital with a first admission for a schizophrenia-like psychosis. For comparison, a control group of 65 families were randomly recruited who were in the same age group and denied any psychiatric history in their immediate families. Significantly more parents of the patients had a diagnosed personality disorder than controls. These were classified as schizoid, schizotypal, histrionic, and sadistic types by DSM-III-R criteria. While paranoid personality disorder was frequent, it was equally distributed among both groups of parents. These data suggest that the genetic boundaries to a "schizophrenia spectrum" disorder may extend further than previously thought and particularly the specific characteristics that are common to a wide variety of these disorders need to be examined in further analyses.

Case-Control Studies↗
PubMed1994

Personality disorders among the relatives of schizophrenia patients.

In light of current linkage studies in schizophrenia, research on the "schizophrenia spectrum" deserves increased attention for an exact determination of the affected phenotype: Those disorders that have a much higher prevalence among biological relatives of schizophrenia patients are supposed to share common etiological factors with "core" schizophrenia. However, there is controversy over which of the DSM-III-R personality disorders should be included in the spectrum. In a controlled family study of inpatients with a DSM-III-R diagnosis of schizophrenia (n = 101), schizophreniform and schizoaffective disorders (n = 69), and unipolar major depression (n = 160), familial rates of personality disorders were assessed through personal interviews and compared with prevalence rates in 109 control families from the community. As predicted, schizotypal personality disorder occurred more frequently in the nonpsychotic relatives of schizophrenia probands (2.1%) than in the families of unscreened controls (0.3%). Paranoid personality disorder was more frequent in relatives of probands with unipolar depression (2.9%) than in relatives of schizophrenia patients (1.7%), and controls revealed the lowest rate (0.9%). Schizoid personality disorder, however, was extremely rare in all sample groups (between 0.3% and 0.7%), providing no sufficient statistical power for detection of group differences. Further analysis of the DSM-III-R criterion symptoms of schizotypal personality disorder demonstrated that items describing "negative" symptomatology are the main source of familial aggregation, but "psychotic-like" personality features are also contributing factors.

Adult↗
PubMed1999

Two-year stability of Psychosis Proneness Scales and their relations to personality disorder traits.

Two-year stability of Physical Anhedonia (PhA), Perceptual Aberration (PER), and Magical Ideation (MI) scale scores and their relation to personality disorder traits were examined. Additionally, the effects of a time-lagged (prospective) versus concurrent measurement of psychosis proneness and personality disorder traits were studied to examine the specificity of MI, PER, and PhA. With a non-college-student sample (n = 404), stability for PhA was sufficiently high, but for PER and MI, stability was moderate to low. The correlations between personality disorder traits and psychosis proneness scales demonstrate that simultaneous assessment leads to a more nonspecific pattern of associations for MI and PER, although the correlation to schizotypal personality disorder traits were the highest. However, prospectively only MI, but neither PER nor PhA, emerged as a significant predictor for schizotypal and paranoid personality disorder traits in multiple-regression analysis. This suggests that MI may allow for a more specific assessment of psychosis proneness than PER.

Adolescent↗
PubMed1984

Genetic and nosological aspects of schizotypal and borderline personality disorders. A twin study.

The aim of this study was to investigate etiological and nosological aspects of the schizotypal and borderline personality disorders. The sample consisted of 44 schizotypal, 15 schizotypal and borderline, and ten borderline same-sexed twin probands. The investigation of the co-twins indicated that genetic factors seemed to influence the development of the schizotypal, but not the borderline, personality disorders. The basic genetic core of the schizotypal syndrome seemed to consist of schizoid and paranoidlike features, and not psychoticlike cognitive and perceptual distortions. The study did not indicate any relationship between schizotypal and borderline personality disorders and affective and schizophrenic disorders. Further research is needed to confirm the independent status of the schizotypal syndrome in relation to the schizoid, avoidant, and paranoid personality disorders, and the borderline syndrome in relation to the histrionic , narcissistic, and antisocial personality disorders.

Adult↗