Personality Disorders

More than 20 years ago Habib Davanloo coined the term unlocking of the unconscious to describe how the psychodynamic concept of the human unconscious can become accessible using the technique of Intensive Short-Term Dynamic Psychotherapy (ISTDP). According to Davanloo, the possibility that unconscious material will be revealed is greatly increased when therapeutic efforts promote dominance of the unconscious therapeutic alliance over unconscious resistance. When these ingredients are present there is a psychic shift that allows unacceptable painful feelings to come to the surface. Toward adding further empirical support for the concept, in this article we compare outcomes between patients who experienced one or more major unlocking of the unconscious (N = 57) to those who did not experience major unlocking (N = 32) during ISTDP treatment. Significant and widespread differences were seen between these two groups, those with major unlocking had greater symptom reduction, interpersonal...

Recent theoretical and empirical work suggests that adults with borderline personality disorder (BPD) have difficulty regulating both shame and anger, and that these emotions may be functionally related in clinically relevant ways (e.g., . The covariation of shame with anger-related emotions has important clinical implications for interventions targeting shame and uncontrolled anger in BPD. However, no studies have examined shame, anger, and their covariation in adolescents who may be at risk for developing BPD. Therefore, this study focuses on associations between BPD symptoms and patterns of covariation between daily experiences of shame and angerrelated affects (i.e., hostile irritability) in a community sample of adolescent girls using ecological momentary assessment. Multilevel models revealed that girls with greater BPD symptoms who reported greater mean levels of shame across the week also tended to report more hostile irritability, even after controlling for guilt. Additionally, examination of within-person variability showed that girls with greater BPD symptoms reported more hostile irritability on occasions when they also reported greater concurrent shame, but this was only the case in girls of average socioeconomic status (i.e., those not receiving public assistance). Unlike shame, guilt was not associated with hostile irritability in girls with greater BPD symptoms. Results suggest that shame may be a key clinical target in the treatment of anger-related difficulties among adolescent girls with BPD symptoms.

Although the use of schema modes in schema-focused therapy (SFT) has been very popular since its introduction, Young's schema mode concept remained largely empirically untested. In order to provide insight into the mode conceptualization of personality disorders (PDs), the current study assessed the relationships between 14 schema modes and all PDs. Relationships between dimensional PD scores and selfreported mode scores were tested in a mixed study group of 489 participants, consisting of axis I and axis II patients, and non-patients. Psychopathology was assessed by means of the Structured Clinical Interview for DSM-IV axis I and axis II disorders (SCID I and SCID II) or the Structural Interview for DSM-IV Personality Disorders (SIDP-IV), and modes were assessed by the Schema Mode Inventory. Kendall's partial tau coefficients, controlling each PD-mode correlation for all other PD scores, indicated unique mode profiles for all PDs and corroborated most of the hypothesized PD-mode correlations, supporting the construct validity of the mode model. Nevertheless, the high number of correlations found for some PDs raises concerns about the specificity of the mode model. Implications for both research and therapy are discussed.

Gresham, F. M. & Elliott, S. N. (2016). Inventário de Habilidades Sociais, Problemas de Comportamento e Competência Acadêmica para Crianças: SSRS Manual de aplicação, Apuração e Interpretação [Del Prette, Z. A. P., Freitas, L. C., Bandeira, M. & Del Prette, A.  Autores da adaptação e padronização brasileira]. São Paulo: Pearson.

Ver detalhes aqui: http://www.casadopsicologo.com.br/ssrs-inventario-de-habilidades-sociais-problemas-de-comportamento-e-competencia-academica-para-criancas-kit-completo.html#.Vq4xseanfqh

Passive-Aggressive (Negativistic) Personality Disorder (NEGPD), listed in Appendix B of the DSM-IV, is not an officially recognized personality disorder. Its future as a discrete disorder is uncertain (Widiger, 2003). Yet, NEGPD occupies a role in some theoretical formulations of personality pathology (Millon & Davis, 1996), and many clinicians believe that passive-aggressive traits are not adequately represented by other PDs (Westen, 1997). In this study, 1158 psychiatric outpatients were assessed for Axis I and Axis II disorders. Thirty-five (3.02%) met criteria for NEGPD. Participants with NEGPD did not differ significantly from those without NEGPD on demographic variables. The internal consistency of the DSM-IV's seven NEGPD items was 0.50. Corrected itemtotal correlations for the 7 criteria averaged 0.27. Participants with NEGPD had higher rates of lifetime anxiety disorders, and almost 90% had an additional PD. An exploratory factor analysis suggested a twofactor solution that accounted for 43.4% of the variance. The first factor reflected the belief that life is unfair, while the second factor seemed to reflect modes of anger expression. A confirmatory factor analysis showed that the two-factor model fit the data better than a unidimensional model. We discuss implications of these results for the future of the NEGPD diagnosis. Passive-Aggressive (Negativistic) Personality Disorder (NEGPD) has a long history in the classification of mental disorders. In fact, descriptive features that typify the disorder have been depicted in significant detail by many prominent clinicians for nearly a century under a variety of headings (Millon & Radovanov, 1995).Years before World War II, clinical theorists portrayed diversely labeled "characters" and "dispositions" whose characteristics might now be classified under the passive-aggressive personality disorder designation (Millon, 1993).

Background: There is an increasing probability that the psychiatrist will, willingly or not, come into contact with mentally ill offenders in the course of their practice. There are increasing rates of violence, substance abuse and other psychiatric disorders that are of legal importance. Therefore, the aim of this work was to investigate the rates of different mental disorders in 100 court reports and to investigate the characteristics of mentally ill offenders. Methods: All cases referred from different departments of the legal system to the forensic committee for assessment of legal accountability over 13-months duration were included. A specially designed form was prepared for data collection. Cases were classified into five groups: murder, robbery, financial offences, violent and simple offences and a group for other offences. Data were subjected to statistical analysis and comparisons between different groups of subjects were performed by analysis of variance (ANOVA).

This study examined if the effects of peer smoking, family smoking, and parenting on smoking development during adolescence are moderated by personality characteristics of adolescents. Longitudinal data were obtained from 428 adolescents (aged M ϭ 13.4, SD ϭ .50) and their parents. Latent Growth Curve models assessed the development of smoking as a function of predictors and if effects of smoking-specific parenting and exposure to smoking were moderated by adolescents' Big Five personality dimensions. Findings revealed that having peers who smoked was associated with an increased likelihood of being a smoker at baseline. Further, significant interactions revealed that adolescents lower in agreeableness were more likely to be a smoker at baseline if they had an older sibling who smoked or if their parents engaged in frequent smoking-related discussions with them and that effective smoking-specific conversation was more strongly related to smoking at baseline among adolescents who were highly emotionally stable. No interactions predicted growth in smoking over time yet significant main effects showed that growth in smoking was associated with higher levels of extraversion, lower levels of emotional stability, and less effective parental smoking-specific communication. This study highlights the relevance of personality-target interventions and policy programs directed at parents and peers.

The aim of the study was to assess the prevalence of personality disorders in a group of outpatients with bipolar I disorder. The Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II) was administered to 90 bipolar outpatients who met the DSM-III-R criteria and 58 control subjects. Of the patients and controls, 47.7% and 15.5%, respectively, had at least one personality disorder. At least one personality disorder in clusters A, B, and C and obsessivecompulsive, paranoid, histrionic, and borderline personality disorders were significantly more prevalent in bipolars. Suicide attempts were more frequent in patients with a history of personality disorder.

Accuracy and bias in self-perceptions of performance were studied in a managerial group-discussion task. Ss ranked their own performance and were ranked by the 5 other group members and by 11 assessment staff members. Although the self-perceptions showed convergent validity with the staff criterion, Ss were less accurate when judging themselves than when judging their peers. On average, Ss evaluated their performance slightly more positively than their performance was evaluated by either the peers or the staff; however, this general self-enhancement effect was dwarfed by substantial individual differences, which ranged from self-enhancement to self-diminishment bias and were strongly related to four measures of narcissism. Discussion focuses on issues in assessing the accuracy of self-perceptions and the implications of the findings for individual differences in self-perception bias and the role of narcissism. Self-insight, or the accuracy of self-perception, has been an issue of long-standing concern to philosophers and social scientists. Among contemporary psychologists, two different points of view predominate. According to one view, perceptions of self are based on a socially shared reality, ensue from the same processes as the perceptions of others, and are best thought of as accurate reflections of behavior and experience. According to the other view, self-perceptions are fundamentally distorted, self-serving, and consistently more positive than is justified by the perceptions of others. In this article, we argue that each of these views is incomplete. In particular, we demonstrate that self-evaluations in a specific situation contain both valid and This article is based in part on an honors thesis submitted by Richard W. Robins to

At least 1 in 600 adultswoundthemselvessufficientlyto needhospitaltreatment. More men than womendo it, althoughmorewomenreceivepsychological treatment.Manyhavea history of sexualor physicalabuse.Self-woundingdiffersfrom otherself-harmin beingaimedneither at mutilation nor at death. Self-wounding coerces others and relieves personaldistress. Repeatedself-woundingis one criterionof borderlinepersonalitydisorderbut we prefer to considerit an ‘¿ addictive' behaviourratherthan an expression of a widerdisorder. Psychological management may need to be augmented by drug or social treatment. Carers, including professional carers,usuallyneedhelpto containthe turbulencethat self-woundingproduces.

The Shedler-Westen Assessment Procedure (SWAP) is a personality assessment instrument designed for use by expert clinical assessors. Critics have raised questions about its psychometrics, most notably its validity across observers and situations, the impact of its fixed score distribution on research findings, and its test-retest reliability. We review empirical data addressing its validity, emphasizing the multitrait-multimethod approach to evaluating test validity. To evaluate the hypothesis that the fixed, asymmetric score distribution artifactually inflates correlations between SWAP profiles, we conducted Monte Carlo simulations and also presented empirical data from a large patient sample. We observed a mean correlation of zero between simulated SWAP profiles, indicating that the score distribution does not impact the correlation coefficients. Empirical correlations between SWAP profiles of actual patients were small and similar to those obtained using Diagnostic and Statistica...

Aim: We explored therapists' and clients' experiences of alliance rupture events for the first 15 sessions of each of eight cases; therapists were each paired with one client who had a personality disorder. Method: All sessions were videotaped and rated with the Rupture Resolution Rating System. Approximately 1 week after a rupture, clients and therapists were individually interviewed about the causes of the rupture, how the rupture evolved, the impact of the rupture on the therapeutic process, and experiences during the event. The interviews were analyzed by five judges using consensual qualitative research (CQR; Hill, 2011). Results: Typically, rupture events involved a repetition of a previous rupture event, the rupture emerged when the client was not prepared to respond to the therapist's intervention, both therapists and clients felt confused and ambivalent, and confrontation events activated intense and negative feelings. We discuss the implications for practice, training, and research.But: nous avons exploré les expériences d’événements de rupture de l'alliance de thérapeutes et de patients au cours des 15 premières séances de huit cas; chaque thérapeute était couplé avec un client ayant un trouble de personnalité. Méthode: toutes les séances ont été enregistrées en vidéo et codées avec le system de cotation des ruptures résolution. Environ une semaine après une rupture, client et thérapeute étaient interviewés individuellement à propos des causes de la rupture, comment la rupture a évolué, l'impact de la rupture sur le processus thérapeutique, ainsi que l'expérience durant l’événement. Les entretiens ont été analysés par cinq juges utilisant la recherche qualitative consensuelle (CQR; Hill, 2011). Résultats : typiquement, les événements de rupture impliquaient la répétition d'un événement de rupture précédent ; la rupture émergeait quand le client n’était pas préparé à répondre à l'intervention du thérapeute; clients et thérapeutes se sentaient tous les deux confus et ambivalents, et les événements de confrontation activaient des sentiments négatifs intenses. Nous discutons des implications pour la pratique, la formation et la recherche.Objectivo: Exploramos as experiências de rupturas na aliança terapêutica de terapeutas e clientes nas primeiras 15 sessões de 8 casos psicoterapêuticos. Os terapeutas foram emparelhados com um cliente com perturbação de personalidade.Método: Todas as sessões foram filmadas e gravadas e cotadas com o Sistemas de Codificaçao de Resolução de Rupturas (Rupture Resolution Rating System). Aproximadamente 1 semana depois da ruptura, clientes e terapeutas foram individualmente entrevistados sobre as causas da ruptura, sobre a evolução da ruptura, sobre o impacto da ruptura no processos terapêutico e sobre experiências durante o evento. As entrevistas foram analisadas por cinco juízes usando investigação qualitativa consensual (consensual qualitative research - CQR; Hill, 2011).Resultados: Tipicamente, os eventos de ruptura envolveram a repetição de um evento de ruptura anterior, a ruptura emergia quando o cliente não estava preparado para responder à intervenção do terapeuta, tanto o terapeuta como cliente se sentiram confusos e ambivalentes, e os eventos de confronto activaram sentimentos negativos e intensos. Os autores discutem as implicações para a prática, treino e investigação.Objetivo: Se exploraron las vivencias subjetivas tanto de terapeutas como de clientes en relación a eventos de ruptura de la alianza durante las primeras 15 sesiones de cada uno de 8 casos estudiados. Se tomaron pares con terapeuta/cliente en los cuales estos últimos tenían trastornos de personalidad.Método: todas las sesiones fueron video-filmadas y evaluadas con el Sistema de Puntuación de Resolución de Ruptura. Aproximadamente una semana después de la ruptura de la alianza, clientes y terapeutas fueron entrevistados en forma individual a fin de explorar las causas de la ruptura, cómo fue evolucionando el proceso que culminó en la ruptura, el impacto de la misma en el proceso terapéutico y cómo fue vivido subjetivamente el momento mismo de la ruptura. Las entrevistas fueron analizadas por cinco jueces usando los criterios de la Investigación Cualitativa Consensuada (CQR; Hill, 2011).Resultados: Típicamente, la ruptura resultó ser una repetición de situaciones previas de ruptura y surgía cuando el paciente no estaba preparado para responder a la intervención del terapeuta, cuando tanto terapeutas como clientes estaban confusos y ambivalentes, y cuando ciertas situaciones de confrontación activaban sentimientos intensos y negativos. Se discuten las implicaciones para la práctica clínica, la formación y la investigación.

Studies of birth cohorts show evidence of greater risk of violence among patients with schizophrenia compared to the general population. However, the contribution of schizophrenia to violence is heavily debated and remains unclear. This debate has spurred research whose focus can be associated with one of the following areas: psychotic symptoms, personality disorders (in particular psychopathy), mentalizing abilities, substance abuse and demographic factors. The aim of the current review is to evaluate the predictive role of these risk factors in the occurrence of violence among patients with schizophrenia. We identified two different trajectories for violent behavior in schizophrenia: one pertains to patients with no prior history of violence or criminal behavior and for whom positive symptoms appear to explain violent behavior, and another where personality pathology, including psychopathy, predict violence, regardless of other symptomatology associated with schizophrenia. Furthermore, emergent data suggest that specific mentalizing profiles can be associated with the occurrence of violence in schizophrenia, an issue that warrants further consideration in future research.► Positive symptoms predict violence in patients without premorbid antisocial conduct. ► Psychopathy predicts violence in schizophrenia above and beyond psychotic symptoms. ► Violence in schizophrenia can be associated with specific mentalizing profiles. ► Detection and treatment of first-episode psychosis is essential to abating violence.

The aim of this study was to investigate the risk factors of family structure, personality traits, and other variables among adolescent prostitutes. The subjects comprised 158 adolescent prostitutes in a halfway house as the case group and 65 high school girls as the control group. Data were collected by using questionnaires about demographic information, the Junior Eysenck Personality Questionnaire and the Parental Bonding Instrument. A high rate of tobacco, alcohol and drug use was found in the case group. Numerous factors distinguished the cause-effect relationship among adolescent prostitutes. Of all risk factors studied, maternal protection, paternal care, neurotic characteristics, tobacco use, discontinuous schooling and a dysfunctional family had the most direct effect. These results provide useful information for the evaluation of and interventions with adolescent prostitution.

We all know one. Those armoured cockroach narcissists that can survive anything. It is said that cockroaches are some of the most adaptable creatures on earth. They are in-vulnerable survivors. But at what, and who’s cost? The costs and burdens of being ‘used up’ by narcissists, in their entitled need for never ending supply, are carried by the common or garden everyday creatures called Human Beings. It’s the humanness in us that makes us vulnerable. We feel, we have compassion, we can empathise and we have a natural instinct to support and protect others. We see this mechanism of care operational throughout the animal kingdom. Gabor Mate says it is a disservice to call someone a rat as rats are very empathic creatures and will support their kin. Paradoxically the narcissist will “rat out” their fellow man and expose them to undeserved punishment. All with the aim of their own embellishment and fuelling of omnipotence.

We lack knowledge of the temporal stability of major personality dimensions in patients with personality disorders (PDs). The Revised NEO Personality Inventory (NEO-PI-R) is a self-report instrument that operationalizes the Five-Factor Model of personality. This study investigated the relative stability, mean level stability, and individual level stability of the NEO-PI-R scores in patients with PDs (n ϭ 393) and patients with symptom disorders only (n ϭ 131). The NEO-PI-R was administered at admission to short-term day treatment and after an average of 19 months. The results showed a moderate to high degree of stability of NEO-PI-R scale scores with no substantial difference in stability between patients with and without PD. Changes in NEO-PI-R scores were associated with changes in symptom distress. Neuroticism was the least stable domain. The study indicates that the Five-Factor Modelof personality dimensions and traits are fairly stable in patients with PDs. The lower stability of Neuroticism may partly be explained by its inherent state aspects.

To evaluate observer bias and to estimate observer concordance for descriptions of personality changes in dementia, the authors examined the personality descriptions of dementia patients provided by 2 informants. Twenty-two patients with Alzheimer's disease were rated on the NEO-PI by each of 2 informants, the primary caregiver and another relative or friend. Each informant completed the NEO-PI to describe current behavior and premorbid behavior. Significant differences between premorbid and current descriptions were found for 4 of the 5 personality dimensions measured. There was substantial agreement between independent raters, as indicated by significant correlations between raters for 4 dimensions and the absence of significant differences between rater . averages. These results suggest that both primary caregivers and others who know a patient well may serve as informants for studies of personality in dementia.

A previous study in proximal myotonic myopathy (PROMM/DM-2) and myotonic dystrophy type 1 (DM-1) using brain positron emission tomography demonstrated a reduced cerebral blood flow in the frontal and temporal regions associated with cognitive impairment. The objective was to investigate further cognitive and behavioural aspects in a new series of patients with DM-1 and PROMM/DM-2. Nineteen patients with genetically determined PROMM/DM-2 and 21 patients with moderately severe DM-1 underwent neuropsychological testing and neuropsychiatric interviews. DM-1 and PROMM/DM-2 patients had significantly lower scores on tests of frontal lobe function compared to controls. Neuropsychiatric interviews demonstrated an avoidant trait personality disorder in both patient groups. Brain single photon emission computed tomography showed frontal and parieto-occipital hypoperfusion. The results suggest that there is a specific cognitive and behavioural profile in PROMM/DM-2 and in DM-1, and that this profile is associated with hypoperfusion in frontal and parieto-occipital regions of the brain. q

Since 2001 the armed services have discharged over 22,500 service members due to personality
disorders. Veterans discharged due to a personality disorder are usually not provided service
connected disability (SC) benefits because the military categorizes personality disorders as a
preexisting condition. However, PTSD and personality disorders seem to share a number of
symptoms and risk factors that may make distinguishing between them difficult. A definitive
method for diagnosing PTSD and personality disorder is being researched in order to insure that
veterans receive the correct diagnosis and that VA benefits are not being taken advantage of.
This literature review seeks to summarize the issues associated with misdiagnosis of PTSD and
personality disorders in combat veterans and to review the existing research regarding possible
relationships between PTSD and personality disorders.

SummaryThis review summarizes the recent literature about personality disorders among substance abusers. First, it will be shown that personality disorders are highly prevalent co-morbid conditions among addicted individuals. Second, it is argued that this co-morbidity is likely to be accounted for by multiple complex etiological relationships. Finally, the clinical relevance of routine assessment of (maladaptive) personality traits in individuals admitting for substance abuse treatment will be discussed.

Clinicians and legal practitioners have often assumed, uncritically, that sensational interests are predictive of sadistic personality disorder (SADPD). This association has never been empirically tested in a non-pathological sample. Using a sample of adults (N = 219) from two countries, a four-factor SADPD structure was identified. A latent variable model was used to test the hypothesis that Sensational Interests Questionnaire (SIQ) scores would be associated with SADPD scores, after the separation of general and specific variance. The general association was not significant, but a direct pathway from SIQ Criminal Identity to SADPD Antisocial was required, to improve model fit. SADPD was predicted largely by normal personality traits. Sensational interests are therefore not a simple signifier of deviance or sadism, in clinical and legal contexts. However, Criminal Identity may emerge as a risk factor for certain forms of antisocial behaviour, and should be investigated further.

The aim of this study was to as sess interrater re li abil ity and pro vide initial data bear ing on the va lid ity of a method of as sess ing per son al ity disor ders (PDs) that does not pre sume that pa tients can ac cu rately self-re port per son al ity pa thol ogy. In a sam ple of 24 out pa tients, two cli nician-judges in de pend ently ap plied the Shedler-Westen As sess ment Proce dure-200 (SWAP-200; Westen & Shedler, 1999a, 2000), a 200-item Q-sort pro ce dure for as sess ing per son al ity pa thol ogy, to data from the Clin i cal Di ag nos tic In ter view (Westen, 2002), a sys tem atic clin i cal in terview that mir rors and stan dard izes meth ods used by ex pe ri enced cli nicians to di ag nose per son al ity. In 16 of the 24 cases, the treat ing cli ni cian also in de pend ently de scribed the pa tient us ing the SWAP-200 Q-sort, based on lon gi tu di nal knowl edge of the pa tient over the course of treatment, blind to the in ter view data. Interrater re li abil ity was uni formly high, with me dian cor re la tions be tween in ter view ers at r > .80. In terviewer-treat ing cli ni cian cor re la tions were also high, with me dian conver gent va lid ity co ef fi cients at r > .80. Di ag nos tic over lap (discriminant va lid ity) was mod er ate for di men sional DSM-IV di ag no ses, re flect ing exten sive comorbidity among dis or ders, but min i mal for em pir i cally derived di ag no ses iden ti fied in prior re search. Treat ing cli ni cians' di men sional PD di ag no ses us ing this method also strongly pre dicted inter viewer-rated mea sures of adap tive func tion ing. The find ings pro vide pre lim i nary sup port for the re li abil ity and va lid ity of an al ter na tive to struc tured in ter views for di ag nos ing personality pathology, and suggest that the way to improve validity of personality diagnosis may not be to minimize clinical inference but to quantify it using psychometric instruments. The de vel op ment of struc tured in ter views to as sess per son al ity dis or ders (PDs) has made pos si ble tre men dous ad vances in the field since their emer-351

General Aim: We examined interpersonal experiences of patients with borderline personality disorder (BPD) using a time-contingent diary procedure to collect information about social interactions for 7 days. Method: We examined the (1) quantity of social interactions and (2) interpersonal and emotional experiences during social interactions for patients with BPD (BPD; N ϭ 42) compared with those with another personality disorder (OPD; N ϭ 46) and those without significant personality pathology (NOPD; N ϭ 23). Results: Results suggested that BPD patients have fewer social contacts compared with those in the NOPD group. Additionally, the BPD patients characterized their social interactions as more disagreeable, ambivalent, angry, empty, and sad compared with the OPD and NOPD groups. BPD patients reported experiencing more anxiety and less positive affect compared with the NOPD but not the OPD group. Conclusion: These findings highlight aspects of day-to-day interpersonal functioning that are specific to BPD.

j Abstract Background Previous studies indicate that most individuals with obsessive-compulsive disorder (OCD) have comorbid personality disorders (PDs), particularly from the anxious cluster. However, the nature and strength of this association remains unclear, as the majority of previous studies have relied heavily on clinical populations. We analysed the prevalence of screen positive personality disorder in a representative sample of adults with OCD living in private households in the UK. Methods A secondary analysis of data from the 2000 British National Survey of Psychiatric Morbidity. The prevalence of PD, as determined by the SCID-II questionnaire, was compared in participants with OCD, with other neuroses and non-neurotic controls. Within the OCD group we also analysed possible differences relating to sex and subtypes of the disorder. Results The prevalence of any screen positive PD in the OCD group (N = 108) was 74%, significantly greater than in both control groups. The most common screen positive categories were paranoid, obsessive-compulsive, avoidant, schizoid and schizotypal. Compared to participants with other neuroses, OCD cases were more likely to screen positively for paranoid, avoidant, schizotypal, dependent and narcissistic PDs. Men with OCD were more likely to screen positively for PDs in general, cluster A PDs, antisocial, obsessive-compulsive and narcissistic categories. The presence of comorbid neuroses in people with OCD had no significant effect on the prevalence of PD. Conclusions Personality pathology is highly prevalent among people with OCD who are living in the community and should be routinely assessed, as it may affect help-seeking behaviour and response to treatment. SPPE 118

Stuttering is frequently associated with negative consequences which typically begin in early childhood. Despite this, no previous studies have investigated the presence of personality disorders among adults who stutter. Therefore, the aims of the present study were to screen for personality disorders among adults who stutter, and to compare these screening estimates with matched controls from a national population sample. Using a matched case-control design, participants were 94 adults seeking treatment for stuttering, 92 of whom completed the International Personality Disorders Examination Questionnaire (IPDEQ) as a first-stage screener, and 920 age-and gender-matched controls from the Australian National Survey of Mental Health and Well-Being (ANSMHWB). A conditional logistic regression model was used to estimate odds ratios for the primary outcome: first-stage presence of any personality disorder; as well as specific personality disorders. Based on first-stage screening, the presence of any personality disorder was significantly higher for adults in the stuttering group than matched controls, demonstrating almost threefold increased odds. This difference between groups remained significant for all specific personality disorders, with four-to sevenfold increased odds found for Dissocial, Anxious, Borderline, Dependent and Paranoid personality disorders, and two-to threefold increased odds found for Histrionic, Impulsive, Schizoid and Anankastic personality disorders. In conclusion, stuttering appears to be associated with a heightened risk for the development of personality disorders. These results highlight the need for research regarding the assessment and treatment of personality disorders among adults who stutter.

Most studies of borderline personality disorder have drawn patients from among hospital inpatients or outpatients. The aims of this study were to examine the nature of borderline personality disorder patients in everyday clinical practice and to use data from a sample of borderline personality disorder patients seen in the community to refine the borderline construct. Method: A random national sample of 117 experienced psychiatrists and psychologists from the membership registers of the American Psychiatric Association and American Psychological Association provided data on a randomly selected patient with borderline personality disorder (N=90) or dysthymic disorder (N=27) from their practice. The clinicians provided data on axis I comorbidity, axis II comorbidity, and adaptive functioning, as well as a personality description of the patient using the Shedler-Westen Assessment Procedure-200 (SWAP-200) Q-sort, an instrument designed for assessment and taxonomic purposes. Analyses compared borderline personality disorder and dysthymic disorder groups on variables of interest and aggregated SWAP-200 items across all borderline personality disorder patients to create a composite portrait of borderline personality disorder as seen in the community.

The aim of the present study was to analyze the results of a cognitive-behavioral group therapy applied in an outpatient unit to treat drug addiction. The sample consisted of 130 males with an alcohol dependence disorder. Around 56% of the sample completed treatment – they were given therapeutic discharge. From those, 75.3% never resumed treatment, increasing to 77.7% when patients completed the check-up period after discharge. Follow-up from therapeutic discharge
varies from 2 to 18 years; 58% of patients with personality disorders completed treatment with therapeutic discharge. Cognitive-behavioral treatment, whose essential components are detailed in the present study, is effective for the group treatment of patients with alcohol dependence and a comorbid personality disorder.

This study exar;runed the factor structure of the BorderUne Personality Disorder suhscaJe of the Personality Beliefs Questionnaire (PBQ-BPD; Butler. . and the relationships between the emergent factors and psychopathology. The sample comprised 184 patients diagnosed v.1th borderline personality disorder (BPD). Exploratory factor analysis yielded three factors relatlng respectively to dependency. distrust. and the belief that one should act preemptively to avoid threat. Although the three factors were significantly associated With depression, only dependency and distrust significantly correlated with hopelessness. Distrust was the sale factor that correlated significantly With suicide ideation. These findings support the dimensional structure of the PBQ-BPD. Given its multidimensional structure. the'scaJe can be used as a measure of belief profiles associated with BPD and as an aid to conceptualizing beliefs underlying a range of psychopathology associated willi patients with BPD.

Background: A meta-analysis was conducted to identify the proportions of comorbid personality disorders (PD) in mood disorders. Methods: We found 122 empirical papers published in the period 1980-2010 on participants having mood disorders in addition to a comorbid PD. Mood disorders were classified as bipolar disorders (BD), major depressive disorders (MDD) and dysthymic disorders (DYS). Several moderators were coded as well.

A hierarchical biometric model is presented of the origins of comorbidity among substance dependence, antisocial behavior, and a disinhibited personality style. The model posits a spectrum of personality and psychopathology, united by an externalizing factor linked to each phenotype within the spectrum, as well as specific factors that account for distinctions among phenotypes within the spectrum. This model fit self-report and mother-report data from 1,048 male and female 17-year-old twins. The variance of the externalizing factor was mostly genetic, but both genetic and environmental factors accounted for distinctions among phenotypes within the spectrum. These results reconcile evidence for general and specific causal factors within the externalizing spectrum and offer the externalizing factor as a novel target for future research.

Objective: This study sought to understand affective instability among patients with borderline personality disorder by examining the degree of instability in six affective domains. The authors also examined the subjective intensity with which moods are experienced and the association between instability and intensity of affect.

The relevance of attachment theory and research for practice has become increasingly clear. The authors describe a series of studies with 3 aims: (a) to validate measures of attachment for use by clinicians with adolescents and adults, (b) to examine the relation between attachment and personality pathology, and (c) to ascertain whether factor analysis can recover dimensions of attachment reflecting both interpersonal and narrative style. In 3 studies, experienced clinicians provided psychometric data using 1 of 4 attachment questionnaires (2 adolescent and 2 adult samples). Attachment dimensions predicted both personality pathology and developmental experiences in predictable ways. Factor analysis identified 4 dimensions that replicated across adolescent and adult samples on the basis of a combination of interpersonal and narrative indicators: secure, dismissing, preoccupied, and incoherent/disorganized.

Louis Charland’s claim that DSM Cluster B personality disorders are moral rather than clinical kinds has recently triggered a lively debate. In order to deliver a reliable report of the latter, both (1) Charland’s arguments concerning the impossibility of identifying and treating personality disorders without applying a morally laden conceptual framework and (2) some critical responses they provoked are discussed. Then, in turn, the conceptual history of the notion of personality disorder is traced, including not only well-recognized contributions from (3) medical psychiatry, psychoanalysis, and DSM nosology, but also (4) an important, but often neglected, tradition of virtue and moral character. Finally, (5) the idea of a normatively neutral concept of personality disorder is scrutinized in the context of its logical dependence on the fact-value distinction. The latter dichotomy’s recent criticism, in particular, is employed to support Charland’s argument and to suggest that the normative character of personality disorders may go much deeper than this or that DSM formulation.