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Results for “Personality Disorders”

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At least 19 recordsLinked to original sources
PubMed1994

Personality disorder, personality traits, impulsive violence, and completed suicide in adolescents.

OBJECTIVE: This study was designed to assess the association between personality disorders, personality traits, impulsive violence, and suicide. METHOD: Personality disorders and traits in 43 adolescent suicide victims and 43 community controls were assessed from the parents, using semistructured interviews and self-report forms. RESULTS: Probable or definite personality disorders were more common in suicide victims than in controls, particularly Cluster B (impulsive-dramatic) and C type (avoidant-dependent) disorders. Suicide victims also showed greater scores on lifetime aggression, even after controlling for differences in psychopathology between suicides and controls. CONCLUSIONS: Personality disorders and the tendency to engage in impulsive violence are critical risk factors for completed suicide.

Adolescent↗
PubMed1996

Response to light therapy in seasonal affective disorder: personality disorders and temperament as predictors of outcome.

Outcome after 6 days of morning light therapy in subjects fulfilling criteria for winter seasonal affective disorder (SAD) was examined. Responders had significantly fewer previous episodes of SAD. Patients with a diagnosis of any DSM-III-R, axis II personality disorder, were significantly less likely to respond to light therapy than patients without axis II pathology. Poor treatment outcome was also significantly associated with: one or more personality disorders in cluster C, avoidant personality disorder, high number of positive criteria for self-defeating personality disorder and high score on the harm avoidance scale of the Tridimensional Personality Questionnaire. Temperament accounted for 25% of the variance in treatment outcome.

Adult↗
PubMed2003

Affective disorders, personality and personality disorders.

OBJECTIVE: The article deals with the complex conceptual history and current concepts on the relationship between personality, personality disorders and affective disorders. It is discussed whether these concepts represent distinct clinical entities or whether they lie on a continuum. METHOD: We reviewed the classical literature from the 19th and the first half of the 20th centuries as well as analysed recent empirical data in order to summarize the current knowledge on this topic with respect to its historical origin. As a particular example, the position of the depressive personality disorder is evaluated. RESULTS: Considerable heterogeneity can be seen, both theoretically and empirically. The two major concepts are based either on a continuum model or favour distinct clinical entities, corresponding to a more dimensional or category-orientated recording method. CONCLUSION: The relationship between personality disorders and affective disorders is still unclear and is a highly debated issue. There is as yet no consensus, but a certain shift to dimensional models can be recognized.

History, 19th Century↗
PubMed1990

Occupational therapy with patients with multiple personality disorder: personal reflections.

Patients with multiple personality disorder are being admitted to acute care psychiatric units with increasing frequency. Occupational therapists have been confronted with setting treatment goals and designing interventions for this population with little information available in the occupational therapy literature. This paper describes how one therapist, the author, reviewed psychiatric and psychological literature on multiple personality disorder to delineate a role for occupational therapists who are working with this special population on an acute care psychiatric unit within the context of existing programs.

Adult↗
PubMed1999

An exploration of links between early parenting experiences and personality disorder type and disordered personality functioning.

Reports of early parenting were assessed using two measures, the Parental Bonding Index (PBI) and the Measure of Parenting Style (MOPS), in a sample of 265 patients with DSM-defined major depressive disorder. Psychiatrists then rated the extent to which sample members evidenced the personality "styles" underpinning 15 separate personality disorders, returning personality vignette scores. The extent of disordered functioning was also assessed across "parameters" and "domains" by psychiatrists, referrers, and family members, using a range of measures. Those with higher scores on vignettes measuring borderline, anxious, depressive, and self-defeating personality style rated parents as uncaring, overcontrolling, and abusive. When vignettes were consolidated into scores akin to the DSM clusters, the most consistent links between perceived dysfunctional parenting were with the Cluster C (anxious), and Cluster B (dramatic) styles and were nonsignificant for Cluster A (eccentric) style. Meeting criteria for an increasing number of personality disorder clusters was associated with increasing levels of adverse parenting. Multiple regression analyses indicated that disordered functioning (as assessed by the three independent rater groups) was most distinctly associated with paternal indifference and maternal overcontrol.

Adult↗
PubMed2007

The Personality Disorders Institute/Borderline Personality Disorder Research Foundation Randomized Control Trial for Borderline Personality Disorder: reliability of Axis I and II diagnoses.

The Personality Disorder Institute/Borderline Personality Disorder Research Foundation randomized control trial (PDI/BPDRF RCT) is a randomized control trial comparing three treatments for borderline personality disorder (BPD). An important issue for any RCT is diagnostic reliability, demonstration of which is necessary to evaluate claims of a treatment's efficacy for a given population. The present paper examines the interrater reliability of Axis I and II disorders in the context of a high base rate of BPD features for participants referred for inclusion in the RCT. Our results indicate good to excellent levels of interrater reliability for all Axis I and II disorders in this context. Assessors were able to reliably diagnose BPD, exclusionary criteria, and comorbid diagnoses. This data is important for comparing findings and sample composition across different studies using similar sampling strategies, especially as treatments are increasingly being developed and tested for BPD.

Adult↗
PubMedDate not supplied

Comorbid personality disorders in subjects with panic disorder: do personality disorders increase clinical severity?

Personality disorders are common in subjects with panic disorder. Personality disorders have been shown to affect the course of panic disorder. The purpose of this study was to examine which personality disorders affect clinical severity in subjects with panic disorder. This study included 122 adults (71 women, 41 men) who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition ( DSM-IV ) criteria for panic disorder (with or without agoraphobia). Clinical assessment was conducted by using the Structured Clinical Interview for DSM-IV Axis I Disorders, the Structured Clinical Interview for DSM-IV Axis II Personality Disorders, and the Panic and Agoraphobia Scale, Global Assessment Functioning Scale, Beck Depression Inventory, and State-Trait Anxiety Inventory. Patients who had a history of sexual abuse were assessed with Sexual Abuse Severity Scale. Logistic regressions were used to identify predictors of suicide attempts, suicidal ideation, sexual abuse, and early onset of disorder. The rates of comorbid Axes I and II psychiatric disorders were 80.3% and 33.9%, respectively, in patients with panic disorder. Patients with panic disorder with comorbid personality disorders had more severe anxiety, depression, and agoraphobia symptoms, had earlier ages at onset, and had lower levels of functioning. The rates of suicidal ideation and suicide attempts were 34.8% and 9.8%, respectively, in subjects with panic disorder. The rate of patients with panic disorder and a history of childhood sexual abuse was 12.5%. The predictor of sexual abuse was borderline personality disorder. The predictors of suicide attempt were comorbid paranoid and borderline personality disorders, and the predictors of suicidal ideation were comorbid major depression and avoidant personality disorder in subjects with panic disorder. In conclusion, this study documents that comorbid personality disorders increase the clinical severity of panic disorder. Borderline personality disorder may be the predictor of a history of sexual abuse and early onset in patients with panic disorder. Paranoid and borderline personality disorders may be associated with a high frequency of suicide attempts in patients with panic disorder.

Child↗
PubMed2004

The Personality Disorders Institute/Borderline Personality Disorder Research Foundation randomized control trial for borderline personality disorder: rationale, methods, and patient characteristics.

The Personality Disorder Institute/Borderline Personality Disorder Research Foundation randomized control trial (PDI/BPDRF RCT) is a controlled outcome study for borderline personality disorder (BPD), in which 90 participants were randomized to one of three manualized and monitored, active psychosocial treatment conditions. These treatments are: (a) Transference-Focused Psychotherapy (TFP; Clarkin, Yeomans, & Kernberg, 1999), a treatment for BPD based on object-relational and psychoanalytic principles first applied to BPD by Kernberg (1996), notable for its particular emphasis on interpretation of object relations activated in the ongoing therapeutic relationship; (b) Dialectical Behavior Therapy (DBT; Linehan, 1993), a popular treatment for BPD, with evidence of efficacy (Linehan, Armstrong, Suarez, Allmon, & Heard, 1991) that emphasizes a balance between acceptance and change in its combination of cognitive-behavioral and Zen principles; and (c) supportive psychotherapy (Rockland, 1992), another object-relational and psychoanalytically based treatment for BPD which, in contrast to TFP, eschews transference interpretation and places primary emphasis on development of a collaborative engagement with the patient to foster identity development. Patients received medication, if clearly indicated, according to the treatment algorithm developed by Soloff (2000). This article describes the significance and rationale of the study and the overall design, methods, plan of analysis, and demographic characteristics of the recruited sample of patients.

Adult↗
PubMed1996

Clinical study of the relation of borderline personality disorder to Briquet's syndrome (hysteria), somatization disorder, antisocial personality disorder, and substance abuse disorders.

OBJECTIVE: The criteria for borderline personality disorder seem to select patients with very high rates of Briquet's syndrome (hysteria), somatization disorder, antisocial personality disorder, and substance abuse disorders. This study was undertaken to determine whether systematic assessment of patients with borderline personality disorder would reveal characteristic features of that condition which would distinguish it from these other disorders. METHOD: Eighty-seven white female patients (75 in St. Louis and 12 in Milan, Italy) who had borderline personality disorder according to both the DSM-III-R criteria and the Revised Diagnostic Interview for Borderlines were further examined with the DSM-III-R Checklist and the Perley-Guze Hysteria Checklist to determine their patterns of psychiatric comorbidity. RESULTS: Every patient had at least one additional DSM diagnosis. Patients in St. Louis and Milan averaged five and four additional diagnoses, respectively. Eighty-four percent of the patients in St. Louis met criteria for either somatization disorder, Briquet's syndrome, antisocial personality disorder, or substance abuse disorders. Patterns of comorbidity for panic (51%), generalized anxiety disorder (55%), and major depression (87%) in St. Louis were consistent with those in other studies. CONCLUSIONS: The data indicate that the boundaries for the borderline condition are not specific and identify a high percentage of patients with these other disorders. Furthermore, the comorbidity profiles closely resemble the psychiatric profiles of patients with these disorders. If the borderline syndrome is meant to include all of these disorders, its usefulness as a diagnosis is limited. Until the fundamental features of borderline personality disorder that distinguish it from the others are identified, it is recommended that clinicians carefully assess patients for these other diagnoses. Efforts should be made to change the borderline personality disorder criteria by shifting away from overlap with the criteria for the other disorders.

Adult↗
PubMed2004

Borderline personality disorder, antisocial personality disorder and risk-taking among heroin users: findings from the Australian Treatment Outcome Study (ATOS).

AIM: To determine the relationship between borderline personality disorder (BPD), antisocial personality disorder (ASPD) and harm among current heroin users. DESIGN: Cross-sectional survey. SETTING: Sydney, Australia. PARTICIPANTS: 615 current heroin users. FINDINGS: Forty-six percent met criteria for BPD, 71% for ASPD, and 38% met criteria for both diagnoses. ASPD was related to attempted suicide, lifetime overdose, polydrug use, depression and overall psychological distress. BPD was also related to each of these risk domains, and to needle risk and recent suicide as well. When analysed separately, both BPD and ASPD thus appeared to predict harm. For the purposes of further analysis, the relationships between BPD, ASPD and harm, the sample was divided into four independent diagnostic groups: no diagnosis (ND, 21%), ASPD only (ASPD, 33%), BPD only (BPD, 7%), ASPD plus BPD (DUAL, 38%). The division of the sample into four distinct diagnostic groups produced substantially different results. There were strong relationships between BPD and attempted suicide, needle sharing and psychopathology. In none of these domains did the ASPD group significantly differ from the ND group. Also, the levels of harm among the DUAL group were identical to BPD, suggesting no additive risk from ASPD. Thus, while initial analyses suggested an increased risk for ASPD patients for suicide and psychopathology, these relationships disappeared after BPD was taken into account. The only domain in which there appeared to be an additive risk for ASPD and BPD was heroin overdose. CONCLUSIONS: The extensive comorbidity between BPD and ASPD means that, unless BPD is controlled for, artefactual relationships may emerge between ASPD and harm.

Adolescent↗
PubMed1997

Impact of comorbid personality disorders and personality disorder symptoms on outcomes of behavioral treatment for cocaine dependence.

Studies have revealed a significant adverse impact of comorbid personality disorders on treatment tenure and outcome in a variety of psychiatric and substance abuse populations. We investigated whether this negative relationship also exists among 137 urban, poor, cocaine abusers in behaviorally oriented treatment. Axis II diagnoses were generated categorically using the SCID-II as well as dimensionally using numbers of SCID-II symptoms within diagnostic categories. Contrary to expectations, there were no significant differences between subjects with and without various categorical personality disorders on any outcome measures. Categorical Axis II diagnoses were also minimally correlated with drug use severity, depression, and anxiety at intake, indicating that these were not potential coveriates of outcome. However, dimensional analyses of personality symptoms generated from the SCID-II accounted for substantial proportions of variance in treatment outcomes. Implications of these data for Axis II assessment and drug treatment planning are discussed.

Adult↗
PubMed2002

Substance use disorder and personality disorder.

Personality disorders (PDs) and substance use disorders (SUDs) frequently co-occur in both the general population and in clinical settings. Literature is reviewed documenting high comorbidity between these two classes of disorders, possible mechanisms of comorbidity, and the clinical implications of this comorbidity. Special emphasis is given to antisocial personality disorder (ASPD) and borderline personality disorder (BPD) as these disorders not only co-occur frequently with SUDs in the clinical populations and present clinical challenges, but also because recent research points to etiologic processes that are common to these specific PDs and SUDs. Although most attention on comorbidity between PDs and SUDs has focused on ASPD and BPD, it is also clear that other PDs (in particular, avoidant PD and paranoid PD) are prevalent among those suffering from SUDs.

Comorbidity↗
PubMed2004

Comparison of hospital-treated personality disorders and personality disorders in a general population sample.

The distribution of personality disorders (PDs) was explored in hospital-treated subjects and in a population subsample. This study forms a part of the Northern Finland 1966 Birth Cohort study. Hospital case records of psychiatric treatment periods of all cohort members (n=11,017) were reviewed and re-checked against DSM-III-R criteria. A subsample of the cohort members living in Oulu (n=1609) were invited to a two-stage psychiatric field survey with Structured Clinical Interview for DSM-III-R (SCID) as a diagnostic method. The most common PDs in hospital-treated sample were cluster B PDs (erratic). In the population subsample, cluster C PDs (anxious) formed the majority.

Adult↗
PubMed1993

Is there any specific personality disorder or personality disorder cluster that worsens the short-term treatment outcome of major depression?

This study attempted to identify a specific personality disorder (PD) or PD cluster that independently worsens the 4-month treatment outcome of major depression under adequate antidepressant. The material of the study was 96 consecutive outpatients with major depression. For the Axis I and Axis II diagnoses, the Structured Clinical Interview for DSM-III-R (SCID) was used. In the material, the presence of any PD significantly worsened the 4-month outcome. The discriminant function analysis, conducted to identify a specific PD or PD cluster that influences the outcome, found that the number of PD from only cluster A and the number of criteria met for only schizoid PD was significantly correlated with the 4-month outcome of depression.

Adult↗
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↗
PubMed2000

Major depression, double depression and personality disorders.

Personality disorders are much more common among depressive patients than among normal people. Until now, little research has been conducted into the prevalence of personality disorders among patients with both major depression and dysthymia (double depression). The subject of this study is whether depressive patients with dysthymia have more personality disorders than those with no dysthymia. The Vragenlijst voor Kenmerken van de Persoonlijkheid (a Dutch self-report based on the International Personality Disorder Examination) was completed for 211 outpatients with major depression. Approximately 60% of the patients suffer from one or more personality disorders. Depressive patients with dysthymia differ little from the patients without dysthymia, but patients with dysthymia have more cluster A disorders and are more avoidant. Depressive patients without dysthymia do not differ from the patients with dysthymia in terms of symptoms. Depressive patients with personality disorders have significantly more symptoms than the patients without these disorders. There is no interaction between dysthymia and personality disorder.

Adult↗
PubMed1993

A family study of self-reported personality traits and DSM-III-R personality disorders.

Personality traits and DSM-III-R personality disorders of first-degree relatives of patients with psychoses were studied using the NEO Five-Factor Inventory (NEO-FFI) and the Personality Diagnostic Questionnaire-Revised (PDQ-R), two self-report instruments. The relatives were compared on their scores for the five personality factors in the NEO-FFI, the prevalence of individual DSM-III-R personality disorders, and their scores for each personality disorder scale in the PDQ-R. The results suggest that there is no difference in personality traits and prevalence of personality disorders, including schizophrenia spectrum disorders, when relatives of patients with schizophrenia, bipolar disorder, and major depression are compared to each other. Relatives of patients with "atypical psychosis," psychotic disorders that do not meet DSM-III-R criteria for any specific nonorganic psychotic disorder, may be a distinctive group.

Adult↗