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PubMed1995

[Pathologic personality, temperament and treatment].

The relationships between affective disorders and personality disorders remain controversial. The inefficacy of therapeutics in depressed subjects with a personality disorder is often due to an inadequate therapeutic. A few clinical arguments and experimental data corroborate the hypothesis of a commun substratum for affective disorders and personality disorders. A few studies demonstrate an efficacy in specific cases of lithium, neuroleptics and antidepressants (particularly MAOI) in borderline subjects with an affective disorder. We may too use pragmatic psychotherapies targeted on specific problems of each patient.

Antidepressive Agents↗
PubMed1996

Profile patterns, consistency, and change in the Millon Clinical Multiaxial Inventory-II in cocaine abusers.

This study examined the MCMI-II in samples of cocaine-dependent subjects who were receiving treatment in three separate residential facilities. Profile characteristics, patterns of scale stability, and change are reported. MCMI-II elevations are found in all three samples on the Antisocial, Aggressive/Sadistic, Narcissistic, Passive-Aggressive, Borderline, Drug Dependence, and Alcohol Dependence scales at both intake into treatment and discharge. Moderate stability coefficients are found on Basic Personality, Pathological Personality, and Symptom scales. Although some statistically significant mean scale changes between intake and discharge are noted in each sample, few involve change from clinically elevated to below clinical levels.

Adult↗
PubMed2006

Factor structure of the Dimensional Assessment of Personality Pathology-Basic Questionnaire and its relationship with the revised NEO personality inventory in a Japanese sample.

The Dimensional Assessment of Personality Pathology, Basic Questionnaire (DAPP-BQ) was developed to assess 18 personality traits that provide a systematic representation of personality disorder. This study investigates the reliability and validity of the Japanese version of the DAPP-BQ and the relationship between the DAPP-BQ and Revised NEO Personality Inventory (NEO-PI-R) in a heterogeneous general population sample (n = 1485). Internal consistency (coefficient alpha) and test-retest reliability over a 3-week period was satisfactory for all scales. Factor analysis yielded 4 factors labeled "emotional dysregulation," "dissocial behavior," "inhibition," and "compulsivity" that accounted for 76.0% of the total variance. Subsequently, we investigated the relationships between the 18 dimensions and the 5 dimensions of the NEO-PI-R in a second heterogeneous general population sample (n = 717). Combined factor analysis of the 2 scales again yielded 4 factors accounting for 70.4% of the total variance. Finally, we used multiple regression analyses to examine the extent to which the 5 NEO-PI-R scales could be used to predict individual DAPP-BQ scales. These indicated that the NEO-PI-R does not have content that covers some DAPP-BQ dimensions, especially conduct problems, narcissism, and stimulus seeking.

Adult↗
PubMed1995

Posttraumatic stress disorder and the MCMI-II.

This study investigated the MCMI-II profile characteristics of 39 veterans diagnosed with Posttraumatic Stress Disorder. Characteristics of the mean group profile were similar to prior findings reported in the literature on the MCMI and Posttraumatic Stress Disorder with highest mean elevations found on the Avoidant, Passive-Aggressive, Schizoid, and Antisocial basic personality scales, the Borderline and Schizotypal pathological personality scales, and with elevations on the Anxiety, Dysthymia, Alcohol Dependence, Drug Dependence, and Major Depression clinical syndrome scales. A multivariate analysis of variance comparing the group with Posttraumatic Stress Disorder with a non-PTSD comparison group of 39 on the basic personality, pathological personality, and the clinical syndrome scales of the MCMI-II was not statistically significant. Nonetheless, univariate analyses of variance comparing the two groups on the individual modifier scales and the individual personality and clinical syndrome scales of the MCMI-II using a Bonferroni adjusted probability indicated significant differences on the Desirability and Histrionic scales. Response-style bias as a possible factor in MCMI-II profiles for the group with Posttraumatic Stress Disorder is also discussed.

Adult↗
PubMed2005

The relationship between attachment styles and Cluster B personality disorders in prisoners and forensic inpatients.

The relationship between attachment styles and Cluster B personality disorders were examined among prisoners, forensic inpatients and controls from the general population. Forensic inpatients and prisoners reported significantly less frequently the secure attachment style (Relationship Questionnaire) and significantly more the fearful attachment style compared to the normal controls. Both forensic groups could not be distinguished from each other. Further, prisoners, forensic inpatients and controls could not be differentiated on the basis of the dismissing nor the preoccupied attachment style. With respect to personality pathology, almost all relationships between Cluster C pathology, on the one hand, and attachment styles, on the other, were significant. Cluster A pathology was clearly related to the secure and fearful attachment style. With respect to cluster B pathology, the results were more specific but also less clear. The results were strongly dependent on the way the personality pathology variables were treated, as either categorical or dimensional. None of the cluster B personality pathology variables were associated with the fearful attachment style and histrionic personality pathology was negatively associated with the dismissing attachment style. Antisocial personality features were associated with a dismissing attachment style. Borderline personality pathology, when treated as a categorical variable, was significantly related to the preoccupied attachment style. These results show that (1) cluster A and cluster C pathology are more strongly associated with attachment than cluster B, (2) treating personality data as either dimensional or categorical is of major importance to the conclusions that can be drawn, (3) it is important to control for the influence of co-morbid personality pathology when examining the relationship between (Cluster B) personality pathology and attachment.

Adult↗
PubMedDate not supplied

Treatment implications of Axis-II comorbidity in eating disorders.

In this article, we review the clinical research on the implications of comorbid personality disorders (PDs), pathological personality traits, and the expression and response to treatment of those with eating disorders (EDs) (i.e., anorexia and bulimia nervosa, and binge eating disorder). Obsessive-compulsive PDs and related traits, such as perfectionism and rigidity, appear to be clear-cut risk and maintenance factors for anorexia nervosa. In bulimia nervosa, trait impulsivity seems to be related to early termination from therapy and, according to at least some indices, poorer responses to treatment. Dramatic-Erratic PD features, generally more characteristic of binge-purge ED variants, clearly predict a protracted course for general psychiatric symptoms, but may have less prognostic value for eating symptoms. Recent guidelines from two influential bodies--the American Psychiatric Association (APA, 2000) and the United Kingdom's National Institute for Clinical Excellence (NICE, 2004)--both include the concept that "trait-oriented" interventions, targeting personality-linked components like perfectionism, affective instability, impulsivity, and interpersonal disturbances, may optimize treatment effects. In general, the literature supports the recommendation that clinicians should apply well-validated, symptom-focused therapies for the EDs; in addition, clinicians may wish to incorporate trait-focused interventions in patients in whom personality pathology contributes to suboptimal response.

Journal Article↗
PubMed1994

Comparison of personality disorders in different anxiety disorder diagnoses: panic, agoraphobia, generalized anxiety, and social phobia.

Recently there has been increasing interest in the relationship of the personality and the anxiety disorders. This paper presents comorbidity findings between DSM-III-R personality pathology and several DSM-III-R anxiety disorders and makes direct comparisons between anxiety groups. This is the most extensive comparison of this kind reported thus far. This report is on the first 475 anxiety patients who were recruited from multiple sites to take part in a naturalistic study of anxiety. All had a DSM-III-R diagnosis of panic, agoraphobia, social phobia, or generalized anxiety disorder (GAD). Previous studies which found a high comorbidity between the anxiety and the personality pathology were confirmed, with a significantly higher prevalence of personality pathology occurring with social phobia and GAD. Among our patients, all of whom had anxiety disorders, the presence of comorbid major depression is associated with an increase in the levels of comorbid personality pathology--as previously described in the literature. The relationship between low social functioning and the presence of personality pathology was confirmed, however, the relationship appears to be specific to certain areas of functioning, a new finding. There is a clinically important relationship between Personality Diagnostic Questionnaire--Revised personality pathology and the anxiety disorders characterized by different prevalences of personality disorders in different anxiety disorders and specific areas of social dysfunction.

Adult↗
PubMed2002

Do number of pain conditions influence emotional status?

This study was designed to evaluate psychological status of 150 individuals; 50 without chronic pain and without psychotherapeutic drug therapy, Group I or control group; 50 patients with chronic pain, Group II, chronic pain group with involvement of one region; and 50 chronic pain patients with involvement of two or more regions, Group III. All the participants were tested utilizing Millon Clinical Multiaxial Inventory -III (MCMI-III). Results were analyzed and compared for various clinical personality patterns including personality traits and personality disorders; severe personality pathology for schizotypal, borderline and paranoid personality pathology; and multiple clinical syndromes including generalized anxiety disorder, somatization disorder, major depression, bipolar manic disorder and dysthymic disorder, etc. There were no significant differences noted in clinical personality patterns or severe personality pathology. In the analysis of clinical syndromes, generalized anxiety disorder, somatization disorder, and depressive disorders were seen in a progressively greater proportion of patients in Groups I to III. In conclusion, this evaluation showed that abnormal clinical personality patterns are present in both groups of patients. Psychological abnormalities with generalized anxiety disorder, somatization disorder, and depression are commonly seen in chronic pain patients.

Journal Article↗
PubMed2002

Comparison of psychological status of chronic pain patients and the general population.

This study was designed to evaluate the psychological status of 50 individuals without chronic pain and without psychotherapeutic drug therapy, Group I, the control group; and Group II, a chronic pain group with 100 chronic pain patients. All the participants were tested utilizing Millon Clinical Multiaxial Inventory III (MCMI-III). Results were analyzed and compared for various clinical personality patterns, including personality traits and personality disorders; severe personality pathology for schizotypal, borderline and paranoid personality pathology; and multiple clinical syndromes, including generalized anxiety disorder, somatization disorder, major depression, bipolar manic disorder and dysthymic disorder, etc. There were no significant differences noted in clinical personality patterns or severe personality pathology. In the analysis of clinical syndromes, generalized anxiety disorder (40% vs 14%), somatization disorder (26% vs 0%), and major depression (22% vs 4%) were seen in a greater proportion of patients in the chronic pain group. The prevalence of psychological disorders in the control group was 24%, compared to 55% in chronic pain group. In conclusion, this evaluation showed that clinical personality patterns are present in both groups of patients. Psychological abnormalities such as generalized anxiety disorder, somatization disorder, and major depression are commonly seen in chronic pain patients.

Journal Article↗
PubMed2004

Multidimensional assessment of personality in patients with psychogenic non-epileptic seizures.

OBJECTIVES: To determine whether patients with psychogenic non-epileptic seizures (PNES) have evidence of maladaptive personality, and whether they have a single or several different typical pathological personality profiles. METHODS: Patients were recruited from the department of epileptology, Bonn, Germany. In all, 85 patients with PNES and 63 with epilepsy completed a postal questionnaire including the dimensional assessment of personality pathology - basic questionnaire (DAPP-BQ). The DAPP-BQ was also completed by 100 healthy volunteers. The groups were compared and the PNES group was subjected to cluster analysis. RESULTS: Patients with PNES had a greater degree of personality abnormality than clinical and non-clinical controls. There were several clusters of personality pathology. The profile of the largest cluster (n = 43) resembled that found in borderline personality disorder, that of the second largest (n = 37) was characterised by an overly controlled personality, that of the third (n = 4) was similar to the profile in avoidant personality disorder. Outcome differed between clusters. CONCLUSIONS: Maladaptive personality is common in patients with PNES. PNES are associated with several distinct profiles of pathological personality. This is relevant because outcome differed between profiles.

Adult↗
PubMed2003

Personality diagnoses in adolescence: DSM-IV axis II diagnoses and an empirically derived alternative.

OBJECTIVE: The study of personality pathology in adolescence is in its infancy. This article examined the applicability and limits of DSM-IV axis II personality disorder diagnoses in adolescents, assessed the validity of a method for assessing adolescent personality pathology, and began to develop an empirically grounded classification. METHOD: A total of 296 randomly selected clinicians described a patient age 14-18 in treatment for maladaptive personality patterns using axis II ratings scales and the Shedler-Westen Assessment Procedure-200 for Adolescents (SWAP-200-A), a Q-sort instrument for assessing adolescent personality pathology. After examining the nature and frequency of axis II disorders in the sample, the authors used Q-factor analysis to identify naturally occurring groupings of patients on the basis of shared personality features. RESULTS: Axis II diagnoses in adolescents resembled those in adults, although application of DSM-IV criteria appeared to overdiagnose antisocial and avoidant personality disorder in adolescents. Q analysis with the SWAP-200-A isolated five personality disorders (antisocial-psychopathic, emotionally dysregulated, avoidant-constricted, narcissistic, and histrionic) and one personality style. Patients' dimensional scores on each diagnostic prototype showed predictable associations with ratings of current axis II disorders, measures of adaptive functioning, and symptoms assessed with the Child Behavior Checklist. CONCLUSIONS: With some exceptions, personality pathology in adolescence resembles that in adults and is diagnosable in adolescents ages 14-18. Categories and criteria developed for adults may not be the optimal way of diagnosing adolescents. Data from samples of adolescents may prove useful in developing an empirically and clinically grounded classification of personality pathology in adolescents.

Adolescent↗
PubMed1999

Avoidant personality disorder and implicit schema-congruent information processing bias: a pilot study with a pragmatic inference task.

Cognitive theory of personality disorders hypothesizes that each personality disorder is characterized by typical maladaptive schemes and that these schemas direct the processing of information resulting in schema-congruent biases. With regard to the avoidant personality disorder, these hypotheses were put to an initial test in a pilot study, using a self-report questionnaire to asses DSM-III-R personality pathology, a belief questionnaire to assess avoidant schemas and a pragmatic inference task to assess schema-congruent implicit attributional bias. Participants were students (n = 57) who scored high or low on DSM-III-R avoidant personality pathology. As predicted from cognitive theory, DSM-III-R avoidant personality pathology was associated with avoidant beliefs (t(45.1) = 4.68, p < 0.001) and avoidant beliefs were associated with schema-congruent information processing bias (t(55) = 2.17, p = 0.02, one-tailed test). However, DSM-III-R avoidant personality pathology was not associated with schema-congruent information processing bias (t(55) = 0.17, p = 0.43, one-tailed test). In addition to avoidant beliefs, low self-esteem was also related to the information processing bias. Social phobia and general personality pathology, two other control variables, were not. The findings warrant further study using the pragmatic inference task in a clinical group.

Adolescent↗