Comorbid Disorders In Individuals Research Articles

Premorbid functioning in adolescence associates with comorbid disorders in individuals at ultra-high risk for psychosis: A brief report.

This study examines associations between premorbid adjustment and comorbid disorders in individuals at ultra-high risk (UHR) for psychosis. Premorbid social and academic adjustment data were collected from 146 UHR individuals using the Premorbid Adjustment Scale. Comorbid disorders were determined by the Structural Clinical Interview for DSM-IV. Logistic regressions showed lower premorbid social adjustment associated with personality disorders. Lower premorbid academic adjustment associated with affective disorders. More specifically, poor premorbid social adjustment in early and late adolescence associated with personality disorders. Lower premorbid social adjustment in late adolescence and lower premorbid academic adjustment in early adolescence associated with affective disorders. Partly corroborating evidence from schizophrenia samples, our findings suggest that poor premorbid adjustment relate to distinct comorbid disorders in UHR individuals. If replicated, it indicates that premorbid adjustment deficits may be a key area for targeted interventions improving the clinical prognosis of UHR individuals.

Parents in couple therapy: An intervention targeting marital and coparenting relationships.

This article describes the treatment framework and core therapeutic principles of the integrative brief systemic intervention (IBSI), a manualized six‐session intervention intended for parents seeking couple therapy. IBSI aims to work on the couple's presenting problem, considering its specific impact in the marital and coparenting domains. The basic premise of IBSI is to consider that, when working with couples who have children, therapeutic work on their coparenting alliance may be used as a lever, as both parents may be particularly motivated to improve their relationship for their children's benefit. Increasing the coparenting alliance may then facilitate work on deeper conflicts within the marital relationship. The core therapeutic principles of IBSI are: (1) joining with the couple as romantic partners and a coparenting team from the start of the therapeutic process; (2) supporting the parents in increasing their awareness regarding their children's behavior and emotional experiences when facing their parents’ conflicts; and (3) working on the spill‐ and cross‐over effects between marital and coparenting relationships (i.e., exploring how conflict or positivity spills over from one relationship to the other or crosses over from one partner to the other). Therapeutic work following these main therapeutic principles is expected to improve the quality of both relationships. A clinical case is provided to illustrate the core therapeutic principles of IBSI.

Personality Disorders

Personality can be defined as an organizational system of self that shapes the manner in which a person interacts with his or her environment. Personality traits develop in adolescence or early adulthood and are thought to be shaped by early childhood experiences and enduring throughout a lifetime. Personality traits that prevent an individual from being able to function in society or that cause significant distress are diagnosed as personality disorders. A thorough history is needed to rule out other psychiatric and medical disorders. This chapter reviews the diagnostic criteria, differential diagnosis, comorbidity, prevalence, etiology (including genetics and neurobiology), prognosis, and treatment of paranoid, schizoid, schizotypal, borderline, antisocial, narcissistic, histrionic, avoidant, obsessive-compulsive, and dependent personality disorders. A discussion of the relevance of personality disorders to primary care practices and approaches to managing such patients is also included. Tables describe the diagnostic criteria of each personality disorder. Figures illustrate the prevalence of personality disorders in the general and psychiatric populations; schizotypal personality disorder in the community, general population, and clinical population; childhood trauma in individuals with personality disorder; and comorbid disorders in individuals with borderline personality disorder. A model of brain processing in borderline personality disorder is also featured. This chapter contains 5 highly rendered figures, 10 tables, 230 references, and 5 MCQs.

Personality Disorders

Personality can be defined as an organizational system of self that shapes the manner in which a person interacts with his or her environment. Personality traits develop in adolescence or early adulthood and are thought to be shaped by early childhood experiences and enduring throughout a lifetime. Personality traits that prevent an individual from being able to function in society or that cause significant distress are diagnosed as personality disorders. A thorough history is needed to rule out other psychiatric and medical disorders. This chapter reviews the diagnostic criteria, differential diagnosis, comorbidity, prevalence, etiology (including genetics and neurobiology), prognosis, and treatment of paranoid, schizoid, schizotypal, borderline, antisocial, narcissistic, histrionic, avoidant, obsessive-compulsive, and dependent personality disorders. A discussion of the relevance of personality disorders to primary care practices and approaches to managing such patients is also included. Tables describe the diagnostic criteria of each personality disorder. Figures illustrate the prevalence of personality disorders in the general and psychiatric populations; schizotypal personality disorder in the community, general population, and clinical population; childhood trauma in individuals with personality disorder; and comorbid disorders in individuals with borderline personality disorder. A model of brain processing in borderline personality disorder is also featured. This chapter contains 5 highly rendered figures, 10 tables, 230 references, and 5 MCQs.

Personality Disorders

Personality can be defined as an organizational system of self that shapes the manner in which a person interacts with his or her environment. Personality traits develop in adolescence or early adulthood and are thought to be shaped by early childhood experiences and enduring throughout a lifetime. Personality traits that prevent an individual from being able to function in society or that cause significant distress are diagnosed as personality disorders. A thorough history is needed to rule out other psychiatric and medical disorders. This chapter reviews the diagnostic criteria, differential diagnosis, comorbidity, prevalence, etiology (including genetics and neurobiology), prognosis, and treatment of paranoid, schizoid, schizotypal, borderline, antisocial, narcissistic, histrionic, avoidant, obsessive-compulsive, and dependent personality disorders. A discussion of the relevance of personality disorders to primary care practices and approaches to managing such patients is also included. Tables describe the diagnostic criteria of each personality disorder. Figures illustrate the prevalence of personality disorders in the general and psychiatric populations; schizotypal personality disorder in the community, general population, and clinical population; childhood trauma in individuals with personality disorder; and comorbid disorders in individuals with borderline personality disorder. A model of brain processing in borderline personality disorder is also featured. This chapter contains 5 highly rendered figures, 10 tables, 230 references, and 5 MCQs.

Anxiety in Children with High-Functioning Autism Spectrum Disorders: Significant Differences and the Moderating Effects of Social Impairments

Anxiety disorders are one of the most common comorbid disorders in individuals with autism spectrum disorders (ASDs). Although anxiety disorders are common amongst this population, little research has investigated how anxiety disorders manifest themselves differently across varying levels of functioning in ASDs. The current study investigated the differences in anxiety symptoms between those with high-functioning autism (HFA) and Asperger’s syndrome in comparison to typically developing controls and also examined the possible moderating effect of social deficits within these groups. Individuals with HFA and Asperger’s syndrome were not found to differ in levels of anxiety and both groups had significantly greater levels of anxiety when compared to controls. Social deficits were not found to significantly moderate the relationship of diagnosis with levels of anxiety, although this approached significance. Further investigation found that social deficits were a significant moderator in those with Asperger’s syndrome but only approached significance in those with Autistic Disorder.

The Impact of Bulimic Syndromes, Mood and Anxiety Disorders and Their Comorbidity on Psychosocial Impairment: What Drives Impairment in Comorbidity?

To examine associations between psychosocial impairment and comorbid disorders in bulimic syndromes. Participants (N = 391; 91% women) completed structured clinical interviews to determine the presence of Axis I disorders (bulimic syndromes, anxiety disorders and mood disorders) and current psychosocial functioning. Individuals with a current bulimic syndrome and comorbid anxiety disorder had worse psychosocial functioning than either disorder alone. In contrast, there was no additional effect of a current bulimic syndrome in individuals with a current mood disorder on psychosocial impairment. Findings highlight the importance of addressing comorbid disorders in individuals with bulimic syndromes to improve overall functioning and reduce risk of relapse.

Validity of Comorbid Psychiatric Disorders in Youngsters with Autism Spectrum Disorders

There is mounting evidence that the Diagnostic and Statistical Manual of Mental Disorders (DSM) provides an appropriate conceptualization for psychiatric disorders in individuals with autism spectrum disorders (ASDs). The current study examined symptoms of disruptive behavior, anxiety, and mood disorders and how IQ and language skills impacted their manifestation in a sample of 61 children with ASD and significant emotional/behavioral problems. Subsyndromal presentation and the role of behavior equivalents were also explored. Analyses indicated that children with IQ < 70 had fewer reported symptoms than those with IQ ≥ 70. Symptoms endorsement also varied based on language levels. Individuals with IQ < 70 were more likely to be subsyndromal for Generalized Anxiety Disorder and nonverbal individuals were more likely to be subsyndromal for Oppositional Defiant Disorder. Only one of the seven behavior equivalents was associated with internalized disorders. Special considerations may be necessary when applying some DSM criteria to assess comorbid disorders in individuals with ASDs.

Cognitive Behavioral Therapy for Panic Disorder and Comorbidity: More of the Same or Less of More?

This study compared the effects of a higher dose of cognitive behavioral therapy (CBT) for panic disorder versus CBT for panic disorder combined with “straying” to CBT for comorbid disorders in individuals with a principal diagnosis of panic disorder with or without agoraphobia. Sixty-five participants were randomly assigned to one of two treatment conditions, either CBT focused solely upon panic disorder and agoraphobia or CBT that simultaneously addressed panic disorder and agoraphobia and, to a lesser degree, the most severe comorbid condition. Results indicated a significant reduction in panic disorder severity and a decline in severity of comorbid diagnoses across both treatment conditions. However, individuals receiving CBT focused only on panic disorder were more likely to meet high end-state functioning at post-treatment, even in intent-to-treat analyses, and report zero panic attacks at the 1-year follow-up, although this effect was not retained in intent-to-treat analyses. At follow-up, CBT focu...

Cognitive behavioral therapy for panic disorder and comorbidity: More of the same or less of more?

This study compared the effects of a higher dose of cognitive behavioral therapy (CBT) for panic disorder versus CBT for panic disorder combined with “straying” to CBT for comorbid disorders in individuals with a principal diagnosis of panic disorder with or without agoraphobia. Sixty-five participants were randomly assigned to one of two treatment conditions, either CBT focused solely upon panic disorder and agoraphobia or CBT that simultaneously addressed panic disorder and agoraphobia and, to a lesser degree, the most severe comorbid condition. Results indicated a significant reduction in panic disorder severity and a decline in severity of comorbid diagnoses across both treatment conditions. However, individuals receiving CBT focused only on panic disorder were more likely to meet high end-state functioning at post-treatment, even in intent-to-treat analyses, and report zero panic attacks at the 1-year follow-up, although this effect was not retained in intent-to-treat analyses. At follow-up, CBT focused only on panic disorder yielded more substantial improvement in the most severe baseline comorbid condition, although not in intent-to-treat analyses, and a greater proportion of individuals in this treatment condition were rated as having no comorbid diagnoses, even in intent-to-treat analyses. These findings raise the possibility that remaining focused on CBT for panic disorder may be more beneficial for both principal and comorbid diagnoses than combining CBT for panic disorder with ‘straying’ to CBT for comorbid disorders.