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Results for “PERSONALITY, PATHOLOGICAL”

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At least 19 recordsLinked to original sources

PubMed2006

Reduced platelet [3H]paroxetine binding in anorexia nervosa: relationship to eating symptoms and personality pathology.

Alterations in serotonin function have been implicated in both anorexia and bulimia nervosa, and previous studies suggest associations between serotonin function and variations in pathological personality traits. Women meeting DSM-IV criteria for anorexia nervosa (AN, 16 with the restricting subtype and 14 with the binge-purge subtype) and 49 healthy control women (CW) provided blood samples for analyses of platelet [(3)H]paroxetine binding. Participants also filled out questionnaires tapping eating disorder symptoms, depression, and personality pathology. Compared with CW, women with restricting and binge-purge AN had significantly lower levels of paroxetine binding (respectively: 1012 + 487 vs. 560 + 253 vs. 618 + 217 fmol/mg protein). Simple correlation analyses showed that, within AN but not within controls, paroxetine binding was inversely related to dieting preoccupations, affective instability, anxiousness, compulsivity, restricted expression and social avoidance but independent of age, body mass index, depression, and other eating symptoms. Findings suggest that reduced peripheral serotonin transporter density in AN relates to increased dieting preoccupations, affective instability and anxiousness-fearfulness.

Adolescent↗

PubMed2005

Assessing adolescent personality pathology.

BACKGROUND: Personality pathology constitutes a major form of psychopathology in adolescents. AIMS: To examine the reliability and validity of a Q-sort instrument for assessing adolescent personality pathology designed for clinically experienced informants. METHOD: A sample of 294 randomly selected psychiatrists and psychologists each provided data on a current patient, aged 14-18 years. Clinicians completed several measures, including the Shedler-Westen Assessment Procedure for Adolescents (SWAP-200-A). RESULTS: Factor analysis identified II dimensions of adolescent personality: psychopathology/malignant narcissism, dysphoria/inhibition, psychological health, histrionic sexualisation, schizotypy, sexual conflict, emotional dysregulation, anxious obsessionality, peer rejection, delinquent behaviour and attentional dysregulation. These correlated in predicted ways with a range of criterion variables, including measures of adaptive functioning, Axis II pathology, the Five Factor Model and the Child Behavior Checklist. CONCLUSIONS: The SWAP-200-A shows promise as an instrument for assessing personality pathology in adolescents. Trait dimensions such as delinquent behaviour and emotional dysregulation may prove useful additions to a classification of personality.

Adolescent↗

PubMed2005

Self- and peer perspectives on pathological personality traits and interpersonal problems.

This study compares the relationship between personality disorders and interpersonal problems as obtained by self-report and peer-report measures. Participants (N = 393) were administered self- and peer-report versions of the Peer Inventory for Personality Disorder and the Inventory of Interpersonal Problems-64. Canonical analyses demonstrated similar relationships between personality disorder features and interpersonal problems as measured by either self or peer. Analyses between self and peer found little shared variance across sources, indicating a large method variance. Results indicate that although similar constructs are identified by self and peers in their understanding of personality pathology and associated interpersonal problems, self-report information overlaps very little with information obtained from peers, underscoring the importance of obtaining multiple sources of information.

Adolescent↗

PubMed2002

[Models for understanding personality pathology].

BACKGROUND: The prevalence of personality disorders is high and patients with personality disorders are known to be difficult to treat. The assessment of different types of personality disorders has been facilitated by the development of explicit diagnostic criteria. However, the diagnostic manuals have tended to be atheoretical, defining and classifying personality disorders mainly on a descriptive level of behaviour and symptoms. There is no consensus on a theoretical understanding of personality pathology. The concept of personality disorder is currently under debate and investigation, theoretically as well as empirically. MATERIAL AND METHODS: This paper presents some of the major theories of personality disorders that are currently discussed in the literature. RESULTS: The models represent different schools of thought, lean on different methodological assumptions, and focus on different aspects of personality. The theories are to varying degrees focused on aetiology, classification and treatment. A major trend is to supplement theories developed within the context of clinical psychiatry with models from normal psychology. INTERPRETATION: Personality disorder is a complex phenomenon. Different theories are probably useful for different aspects of personality pathology and for different groups of personality disorders. More empirical research is needed in order to clarify the validity of the different models.

Behavior↗

PubMed2006

Evidence for a single latent class of Diagnostic and Statistical Manual of Mental Disorders borderline personality pathology.

Borderline personality disorder (BPD) has been described as clinically heterogeneous, with numerous subtypes of the disorder posited. The present study investigated this potential heterogeneity by conducting both confirmatory factor analysis and latent class analysis of consensus ratings of Diagnostic and Statistical Manual of Mental Disorders (DSM) Revised Third Edition BPD criteria in a mixed clinical and nonclinical sample (n = 411). Confirmatory factor analysis results suggested that a single factor fit the data most parsimoniously. Latent class analysis results supported 2 latent classes: those with a high likelihood of BPD symptoms (n = 171) and those with a low likelihood (n = 240). The borderline latent class was more inclusive than diagnoses made based on DSM-III-R thresholds and improved prediction of symptom severity and interpersonal dysfunction, suggesting the clinical importance of 3 or more BPD criteria. Future research on subtypes of BPD may benefit by focusing on variables that supplement the DSM criteria.

Adult↗

PubMed2003

Personality pathology and cognitive-behavioral treatment of fear of flying.

Studies have been inconclusive about the influence of personality pathology on treatment outcome in anxiety disorders. In general, it has been presumed that treatment outcome is negatively influenced by the presence of personality pathology. This is a study of the prevalence of personality pathology among persons who were seeking help for fear of flying. Moreover, the effects of personality pathology on the results of a multimodal, standardized, cognitive-behavioral fear of flying treatment program employed by an agency that specializes in treating people with fear of flying were studied. Personality pathology was determined with a self-report questionnaire, which provides ICD-10 diagnoses of personality disorders and dimensional severity scores for personality pathology. Treatment outcome was assessed with three different fear of flying questionnaires. Based on clinical judgment after individual-case conceptualization, participants (N=922) were assigned to a particular treatment for fear of flying. Self-report data for fear of flying were collected at pretreatment and at 3, 6 and 12-month follow-ups in 659 participants who followed the 2-day treatment program. Moreover, the number of flights made in the year following treatment was determined.The results of this study showed that participants with personality pathology, mainly from cluster C (anxiety), report greater fear of flying before treatment than participants without personality pathology. After treatment fear of flying was significantly reduced. Presence of personality pathology was not predictive of the number of flights after treatment and scores on the VAFAS scale at short or long term. Only on two questionnaires for fear of flying collected at short-term participants with personality pathology obtained significantly higher scores, although the size of the differences was relatively small. It was concluded that participants with personality pathology also benefited from fear of flying treatment and that the presence of personality pathology although cannot be regarded as a contra indication for a standardized, cognitive-behavioral group treatment.

Adolescent↗

PubMed1997

Era-related changes in the Japanese cultural and social structure and conformist personality pathology--with a particular emphasis on borderline personality disorder.

We discussed relationship between the change of social structure and the specific conformist personality pathology, that is, Morita shinkeishitsu and borderline personality disorder. Morita shinkeishitsu that has been regarded as a basic pathology of broad range of neurosis is seldom seen in daily practice these days. On the other hand, borderline personality disorder that is a relatively new diagnostic domain is regarded as having a contemporary pathology, for example impulsivity, drug and sex abuse, and fragile interpersonal relationship. We consider that Morita shinkeshitsu corresponds to an industrialized society and that borderline personality disorder corresponds to a post industrialized (information based) society. This assumption should be leaded to the further discussion from a point of view of treatment.

Borderline Personality Disorder↗

PubMed1982

Personality pathology underlying chronic prostatitis.

Personality testing was performed on 56 patients with clinical symptoms of chronic prostatitis. The psychological methods used were RO, TAT, FAM and Beck's Depression Inventory. Q factor analysis of the patients was performed and yielded four factors representing four different personality pathologies, i.e. psychosomatic structure, alexithymic personality, borderline personality and narcissistic personality. The duration of the somatic symptoms correlated positively with the severity of the psychic symptoms. The etiology of the different pathologies expressed by the patients with chronic prostatitis was, according to the researchers, the same. All are disorders of the pregenital level and all can be interpreted as a consequence of disturbance of the first object relationships, the key factor being defective fantasy development.

Adult↗

PubMed2006

Personality pathology among individuals with a lifetime history of anorexia nervosa.

Anorexia nervosa (AN) appears to be associated with certain personality features. The degree to which personality pathology persists after the acute phase of illness is unclear. This study aimed to investigate personality pathology in a large sample (n = 153) of women with histories of AN using the Dimensional Assessment of Personality Pathology (DAPP) and to evaluate the persistence of pathological personality features by comparing women with acute (n = 83) and remitted AN (n = 55). Women with AN demonstrated high levels of emotional dysregulation, social inhibition and compulsivity relative to age-matched healthy women (n = 124). Identity problems, intimacy problems and schizotypal features were highlighted as important. The same 14 pathological personality dimensions were significantly elevated in both ill and remitted participants, though remitted individuals' scores were reduced on 4 of the subscales. These results indicate that pathological personality features in AN are persistent traits, although some features may become exaggerated in the acute phase.

Acute Disease↗

PubMed2002

Personality pathology and treatment outcome in major depression: a review.

OBJECTIVE: A longstanding belief among many clinicians is that patients with depression and comorbid personality pathology have a worse response to standard depression treatment. This presents potentially significant treatment implications, since personality pathology in depressed patients appears to be common. METHOD: PsycINFO and MEDLINE were systematically searched for studies relating personality to treatment outcome. Over 50 studies were obtained and grouped according to the method used to assess personality pathology. RESULTS: High neuroticism scores generally predicted worse outcome, especially over long-term follow-up. Tridimensional Personality Questionnaire scores did not have a consistent relationship to treatment outcome despite some promising initial findings. Most studies involved patients with comorbid personality disorders; these studies produced conflicting results. Other measures of personality pathology produced an array of findings ranging from a moderately worse outcome to no difference. CONCLUSIONS: Whether or not personality pathology significantly worsens outcome in patients with major depression appears to depend on study design, since the rate of personality pathology varies markedly depending on how it is measured. In addition, depressed patients with personality pathology appear less likely to receive adequate treatment in uncontrolled studies. Finally, studies rarely control for depression characteristics (e.g., chronicity, severity) that may influence outcome and be related to personality pathology. Overall, the best-designed studies reported the least effect of personality pathology on depression treatment outcome. Clinically, this suggests that comorbid personality pathology should not be seen as an impediment to good treatment response.

Comorbidity↗

PubMed2002

Relationship between attachment patterns and personality pathology in adolescents.

OBJECTIVE: To explore the relationship between attachment status and personality pathology in a large clinical sample of adolescents. METHOD: Two hundred ninety-four randomly selected psychiatrists and psychologists were each asked to provide data on a patient (aged 14-18 years) in treatment for maladaptive personality patterns. Clinicians completed several measures including a clinician-report attachment questionnaire, several measures of personality pathology, and a clinician-report version of the Child Behavior Checklist. RESULTS: In both dimensional and categorical analyses, secure attachment was negatively correlated with personality pathology and positively correlated with healthy functioning, whereas disorganized/unresolved attachment was strongly associated with multiple forms of personality pathology. Anxious/ambivalent attachment tended to be associated with measures of withdrawal, internalization, and introversion. Avoidant attachment style was not associated with any single form of personality pathology. CONCLUSION: The marked association between unresolved attachment and more severe psychopathology in adolescents, the lack of construct validity of avoidant personality disorder in adolescents, and the broader relations among attachment, personality, and psychopathology are discussed.

Adolescent↗

PubMed1998

Refining the measurement of axis II: a Q-sort procedure for assessing personality pathology.

The measurement of personality disorders (PDs) has proven to be a difficult enterprise. This article describes two initial studies of the validity and reliability of the Shedler-Westen Assessment Procedure (SWAP), a Q-sort procedure that quantifies clinical judgment, which may be useful both for assessing personality pathology and for empirically refining Axis II categories and diagnostic criteria. In the first study, 153 clinicians from a random national sample used a version of the Q-sort to describe either a prototype or actual patient with either a borderline, antisocial, histrionic, or narcissistic personality disorder. Correlations between aggregated prototype and actual patient profiles provided evidence for convergent and discriminant validity, and a cluster-analytic procedure (Q-factor analysis) produced revised criteria for the four disorders that minimized the problem of comorbidity. In Study 2, a pilot sample of patients were interviewed using a clinical research interview that mirrors the way clinicians assess personality and PDs. The study yielded promising results with respect to the possibility of obtaining reliable Q-sort descriptions based on an interview that resembles a clinical interview rather than the direct-question format used in current Axis II structured interviews. It also produced strong correlations between Q-sort descriptions made by interview and those made independently by the treating clinician, further supporting the validity of the instrument. The findings suggest the potential utility of the SWAP as a measure of PDs and as a method for empirically refining Axis II categories and criteria.

Adult↗

PubMed2004

Personality pathology and outcome in recurrently depressed women over 2 years of maintenance interpersonal psychotherapy.

BACKGROUND: Empirical data on the impact of personality pathology on acute treatment outcome for depression are mixed, in part because of challenges posed by assessing trait-like personality patterns while patients are in an active mood episode. To our knowledge, no previous study has examined the effect of personality pathology on maintenance treatment outcome. By maintenance treatment we refer to long-term treatment provided to prevent depression recurrence among remitted patients. METHOD: Structured Clinical Interviews for the DSM-III-R Personality Disorders (SCID-II) were obtained on a sample of 125 recurrently depressed women following sustained remission of the acute mood episode and prior to entering maintenance treatment. SCID-II interviews were then repeated following 1 and 2 years of maintenance interpersonal psychotherapy. RESULTS: At the pre-maintenance assessment, 21.6% of the sample met SCID-II personality disorder criteria. Co-morbid personality pathology was related to an earlier age of onset, more previous depressive episodes, and a greater need for adjunctive pharmacotherapy to achieve remission of the acute mood episode. Co-morbid personality pathology predicted both higher rates of depression recurrence and a shorter time to recurrence over the 2-year course of maintenance treatment. Notably, among those patients who remained depression-free, continuous levels of personality pathology steadily declined over the 2-year course of maintenance therapy. CONCLUSIONS: Results highlight the need for early and effective intervention of both episodic mood disorder and inter-episode interpersonal dysfunction inherent to the personality disorders. Future maintenance treatment trials are needed to clarify the relationship between episodic mood disorder and personality function over time.

Adult↗

PubMed1999

Dimensional assessment of personality pathology in patients with eating disorders.

This study examined patients with eating disorders on personality pathology using a dimensional method. Female subjects who met DSM-IV diagnostic criteria for eating disorder (n = 136) were evaluated and compared to an age-controlled general population sample (n = 68). We assessed 18 features of personality disorder with the Dimensional Assessment of Personality Pathology - Basic Questionnaire (DAPP-BQ). Factor analysis and cluster analysis were used to derive three clusters of patients. A five-factor solution was obtained with limited intercorrelation between factors. Cluster analysis produced three clusters with the following characteristics: Cluster 1 members (constituting 49.3% of the sample and labelled 'rigid') had higher mean scores on factors denoting compulsivity and interpersonal difficulties; Cluster 2 (18.4% of the sample) showed highest scores in factors denoting psychopathy, neuroticism and impulsive features, and appeared to constitute a borderline psychopathology group; Cluster 3 (32.4% of the sample) was characterized by few differences in personality pathology in comparison to the normal population sample. Cluster membership was associated with DSM-IV diagnosis -- a large proportion of patients with anorexia nervosa were members of Cluster 1. An empirical classification of eating-disordered patients derived from dimensional assessment of personality pathology identified three groups with clinical relevance.

Adolescent↗

PubMed2007

The big seven model of personality and its relevance to personality pathology.

Proponents of the Big Seven model of personality have suggested that Positive Valence (PV) and Negative Valence (NV) are independent of the Big Five personality dimensions and may be particularly relevant to personality disorder. These hypotheses were tested with 403 undergraduates who completed a Big Seven measure and markers of the Big Five and personality pathology. Results revealed that PV and NV incrementally predicted personality pathology dimensions beyond those predicted by multiple markers of the Big Five. However, factor analyses suggested that PV and NV might be best understood as specific, maladaptive aspects of positive emotionality and low agreeableness, respectively, as opposed to independent factors of personality. Implications for the description of normal and abnormal personality are discussed.

Adult↗

PubMed2005

Do illness characteristics and familial risk differ between women with anorexia nervosa grouped on the basis of personality pathology?

BACKGROUND: In view of the potential utility of personality-based groupings in eating disorders (EDs), and the lack of studies using this approach in large samples of individuals with anorexia nervosa (AN), this study set out to examine (i) the nature of personality-based clusters of women with lifetime AN and (ii) if these clusters are associated with either clinical symptoms or aetiological variables. METHOD: The self-report Dimensional Assessment of Personality Pathology (DAPP) was completed by 153 women with a lifetime diagnosis of DSM-IV AN. A cluster analysis was used to identify personality-based subgroups. Clusters were then compared on clinical and aetiological variables. RESULTS: Three personality-based clusters were identified, defined by broad, avoidant and compulsive types of personality pathology. Dimensions of low dissocial behaviour, high inhibition and high compulsivity were common to all clusters, while dimensions related to emotional dysregulation appeared more heterogeneous. Clinical symptoms were not related to personality profile with the exception of a trend towards more fasting behaviour in the broad group. The compulsive cluster with the narrowest range of extreme personality traits reported the highest familial risk of eating pathology. CONCLUSIONS: The three clusters identified in our AN sample were similar to those previously identified in broader eating disordered samples. Personality-based clusters did not correspond overall to clinical symptoms but aetiological differences supported their validity. Broader personality pathology indicative of emotional dysregulation, problems with identity and relationships, in addition to core traits, may increase vulnerability to AN in those with less familial risk.

Adolescent↗

PubMed1998

Personality pathology and drinking in young men at high and low familial risk for alcoholism.

OBJECTIVE: Three groups varying in familial alcoholism risk were compared with respect to amount of alcohol consumption, presence of personality pathology, and the relationship between personality pathology and alcohol consumption. METHOD: Research subjects were young adult men recruited from local colleges, a trade school and the community. The risk groups included (1) a group with a biological alcoholic father and significant additional familial alcoholism (n = 106); (2) subjects with an alcoholic father, but without significant additional familial alcoholism (n = 100); and (3) a group with no paternal alcoholism and at most only one second/third-degree alcoholic relative (n = 190). Absolute daily ounces of alcohol was determined using a standard quantity-frequency scale. Prevalence of DSM-III-R personality disorders (PDs) was evaluated using the Personality Disorder Questionnaire-Revised both with and without application of an impairment and distress scale. Familial risk determination was based on agreement between four separate self-report assessments. RESULTS: The first group consumed significantly more alcohol than the other two groups, which did not differ in alcohol consumption. The first group's subjects were more likely to meet criteria for virtually all of the PD diagnoses than were the other two groups. A greater proportion of the second group's subjects qualified for various PDs than did the third group's subjects. Personality pathology was consistently or usually associated with more drinking in the first and third groups, respectively, but associated with less consumption in the second group. CONCLUSIONS: Young men with high-density familial alcoholism are at greater risk for the development of alcoholism than those with alcoholic fathers and little additional familial alcoholism. Relationships between personality pathology and alcohol consumption, and possibly the development of alcoholism, differ for the three risk groups.

Adult↗

PubMed2006

Clinical assessment of pathological personality traits.

OBJECTIVE: Research has raised questions about the ability of clinicians to make reliable diagnostic judgments about personality. The aim of this study was to assess the reliability and validity of the dimensional diagnosis of pathological personality traits with the Shedler-Westen Assessment Procedure-200 (SWAP-200) Q sort. METHOD: Two clinician/judges independently described 24 outpatients using the SWAP-200, based on a systematic clinical interview. Treating clinicians described the patients using the SWAP-200 based on their knowledge of the patients over the course of treatment while they were blind to interview data. RESULTS: Interrater reliability was high. Convergent and discriminant validity between interviewers and clinicians was also strong. A procedure recently developed for providing precise estimates of construct validity with contrast analysis applied to correlational data documented strong evidence of validity. CONCLUSIONS: Clinicians and independent interviewers can reliably assess complex personality traits associated with personality pathology using the SWAP-200.

Adult↗