Histrionic Personality Traits Research Articles

Psychopatological disorders and personality traits in plastic surgeons’ and cosmetologists’ patients

In the view of growing number of patients consulting plastic surgeons and cosmetologists, evaluation of psychopathological disorders and personality traits of these patients is of great importance. The purpose of this screening study was to evaluate and to compare pathocharacterological and pathopsychological traits of plastic surgeons and cosmetologists’ patients. The study used psychometric method. The validated scales used were Leonhard Personality Inventory, NEO-PI-R, SAS, SDS, HCL-32- R1, Holmes and Rahe stress scale, SAF. We included all patients who have applied to the Institute of Plastic Surgery and Cosmetology from February 2012 to June 2012 and who gave Inform Consent. Study sample consists of 123 patients (103 women), 18-70 years. In the group of cosmetologists’ patients (n=92; 76 women; mean age 44,6+-2,5 years) histrionic and anxiety-phobic personality traits predominated. Constitutionally determined or gained extroversion, expressivity, impulsivity and emotional instability were detected. Anxiety symptoms were detected in 32,4% of patients; depressive symptoms were detected in 35,8% of patients. In the group of plastic surgeons’ patients (n=31; 27 women; mean age 36,7+-1,8 years) pedantic, sticking and disthymic personality traits predominated. Introversion, high level of self-control and detachment were detected. Anxiety symptoms were detected in 22,9% of patients; depressive symptoms were detected in 21,7% of patients. Our data give evidence of statistically significant differences in pathocharacterological and pathopsychological traits of plastic surgeons and cosmetologists’ patients. About one-third of these patients report about symptoms of depression, anxiety and hypomania. Complex diagnostic examination needed in order to determine nosological diagnosis and treatment strategies.

The Concept of Self and Emotional Involvement in Living Kidney Donation: A Psychometric Investigation

ObjectiveThe aim of our study was to analyze, from a psychological point of view, living kidney donor personality, examining a sample of 18 living kidney donors. Patients and methodsThe personality study was performed using The Millon Clinical Multiaxial Inventory-III in 18 potential kidney donors, 6 of whom were genetically and 12 emotionally related individuals. ResultsOur study showed the presence of narcissistic, histrionic, and obsessive-compulsive personality traits in living kidney donors. ConclusionsIt is necessary to explore the development of motivation for living donation in order to achieve and maintain a harmonious relationship with the recipient while respecting their individuality.

Attachment, affective temperament, and personality disorders: A study of their relationships in psychiatric outpatients

BackgroundAs the result of extensive translational and cross-disciplinary research, attachment theory is now a construct with significant neuropsychiatric traction. The correlation of attachment with other influential conceptual models (i.e. temperament and personality) is therefore of interest. Consequently, we explored how two attachment dimensions (attachment anxiety and attachment avoidance) correlated with measures of temperament and personality in 357 psychiatric outpatients. MethodsWe performed a retrospective review of four questionnaires (the Experiences in Close Relationship scale (ECR-R), Temperament and Character inventory (TCI), Temperament Evaluation of the Memphis, Pisa, Paris and San Diego questionnaire (TEMPS-A), and Personality Self-Portrait Questionnaire (PSQ)). Frequency measures and correlations were examined, as was the predictive value of attachment security for a personality disorder (PD). ResultsSignificant, robust correlations were found between attachment anxiety and (1) several negative affective temperaments (dysthymic and cyclothymic); (2) several indices of personality pathology (low self-directedness (TCI), DSM-IV paranoid, borderline, histrionic, avoidant and dependent personality traits). Attachment avoidance had fewer large correlations. In an exploratory model, the negative predictive value of attachment security for a PD was 86%. LimitationsSubjects were a relatively homogeneous subset of ambulatory psychiatric outpatients. PD diagnoses were via self-report. ConclusionsClinically, these findings highlight the significant overlap between attachment, affective temperament, and personality and support the value of attachment as a screen for PDs. More broadly, given our growing understanding of the neurobiology of attachment (i.e. links with the oxytocin system), these results raise interesting questions about underlying biological systems and psychiatric treatment.

Gender differences of axis I and II comorbidity in subjects diagnosed with attention-deficit hyperactivity disorder as adults.

To investigate gender differences in psychiatric comorbidity patients diagnosed with attention-deficit hyperactivity disorder (ADHD) as adults. Interviews about current ADHD symptoms and psychiatric comorbidity on axis I and II (Structured Clinical Interview for DSM-IV axis I and axis II) were conducted in a clinical cohort of 168 patients (78 women, 90 men). Independent information on childhood and current symptoms was collected from parents, partners and patient files. The lifetime prevalence of psychiatric comorbidity on axis I reached 92%, and current comorbidity, including autism spectrum disorders and Tourette's syndrome, was 47%. Women had a higher lifetime prevalence of mood and eating disorders compared with men, where substance-use disorders were more frequent. Ten per cent of patients fulfilled diagnostic criteria for a personality disorder. When excluding the general diagnostic criteria, 46% of the patients endorsed the specific criteria for at least one personality disorder. Gender differences were identified with predominance of histrionic personality traits in women and conduct disorder in men. Patients diagnosed with ADHD as adults display an extremely high lifetime axis I comorbidity with a gender-specific pattern similar to the general population. No gender differences were identified with regard to personality disorders; however, an increased prevalence of deviant personality traits was confirmed. This study stresses the importance of evaluating comorbidity among patients diagnosed with ADHD as adults to secure optimal treatment.

Managing the Approach-Avoidance Dialectic in Treating a Complex Veteran With Panic and Posttraumatic Stress Disorder

Cognitive-behavioral therapy (CBT) is the treatment of choice for panic disorder (PD); however, the effectiveness of the treatment is often thought to be diminished in the presence of comorbid conditions. PD and posttraumatic stress disorder (PTSD) commonly co-occur in veteran populations, potentially complicating the effective treatment of each disorder. The individual presented in this case is a female veteran in her mid-50s who received treatment for PD and presented with significant comorbidities (PTSD, histrionic personality traits, major depressive disorder, and chronic suicidality). She participated in an intensive weekend treatment for PD that involved psychoeducation, cognitive restructuring, and interoceptive exposure. This case illustrates the challenges in implementing a manualized treatment for panic with a diagnostically complex veteran and the improvement in panic symptoms despite comorbid presentation.

Measures to Assess Maladaptive Variants of the Five-Factor Model

The five-factor model (FFM) is the predominant dimensional model of general personality structure. A considerable body of research supports the hypothesis that personality disorders can be conceptualized as extreme or maladaptive variants of the domains and facets of the FFM. However, existing measures of the FFM are confined largely to the normal variants. The purpose of this special section of the Journal of Personality Assessment is to provide the development and initial validation of self-report inventory scales to assess obsessive–compulsive, borderline, narcissistic, avoidant, and dependent personality traits from the perspective of the FFM, which complement the similarly constructed existing measures for psychopathic, histrionic, and schizotypal personality traits.

Transsexualism, 1 Personality Disorders, and Spinal Cord Injury

The case of a 62-year-old transsexual female admitted to the trauma service after a car accident is presented. The patient developed new onset of paralysis and pain three days after admission, just as the hospital was preparing to discharge her. Physicians on the trauma, neurology, physical therapy, and psychiatry services initially diagnosed a conversion disorder and nearly missed a spinal cord injury. The literature on transgenderism, conversion disorder, and personality disorders is reviewed. Discussion raises issues of countertransference related to transgender patients as well as patients with histories of addiction and histrionic personality traits.

Personalidad y síndromes clínicos : un estudio con el MCMI-III basado en una muestra española = Personality and clinical síndromes : a study with the MCMI-III in a Spanish sample

This work presents a research carried out in Spain with 7011 patients who completed the Millon Clinical Multiaxial Inventory (MCMI-III). Prevalence and percentages of clinical personality traits and clinical syndromes were studied, fi nding a higher prevalence of compulsive, narcissistic, and histrionic personality traits, and of the clinical anxiety syndrome. Also, we found (a) higher ratings in men than in women for traits/syndromes narcissistic, paranoid, antisocial, schizoid, thought disorder, substance abuse and alcohol abuse scales; and (b) higher ratings in women than in men for traits/syndromes depressive, dependent, avoidant, borderline, negativistic, aggressivesadistic, dysthymic, somatoform, and posttraumatic stress disorder. Correlations between the personality scales and the clinical syndromes (i.e., Axis II and Axis I variables), controlling for the effect of sex, were statistically signifi cant (the compulsive, narcissistic, and histrionic scales correlated negatively).

The home for histrionism

AbstractOne of the official proposals for the fifth edition of the American Psychiatric Association's diagnostic manual (DSM‐5) is to provide a dimensional model in which 37 traits are included within six broad domains. One of the more important traits within this model is ‘histrionism’ because another proposal for DSM‐5 is to delete the histrionic diagnostic category. The only way to recover histrionic traits in DSM‐5 will be through the dimensional model. Histrionism, though, is included within the domain of antagonism of this dimensional model, despite the fact that previous research has consistently placed histrionic personality disorder within extraversion. The current study tests empirically whether histrionic personality traits are optimally placed within the domain of extraversion or antagonism through tests involving seven alternative measures of histrionic personality disorder, five scales to assess the DSM‐5 components of histrionism, 10 measures of various histrionic personality traits and two alternative measures of extraversion. The results of the study provide support for placing histrionism within antagonism and clarify the inconsistency of the DSM‐5 placement with the existing research, but also indicate that a more complete and accurate understanding of histrionism would include extraversion. The implications of the findings for DSM‐5 and future research are discussed. Copyright © 2010 John Wiley & Sons, Ltd.

Sexting Behaviors Among Young Hispanic Women: Incidence and Association with Other High-risk Sexual Behaviors

Several legal cases in the United States in which adolescents were charged with child pornography distribution after sharing nude photographs of themselves with romantic partners or others have highlighted the issue of sexting behaviors among youth. Although policy makers, mental health workers, educators and parents have all expressed concern regarding the potential harm of sexting behaviors, little to no research has examined this phenomenon empirically. The current study presents some preliminary data on the incidence of sexting behavior and associated high risk sexual behaviors in a sample of 207 predominantly Hispanic young women age 16-25. Approximately 20% of young women reported engaging in sexting behavior. Sexting behaviors were not associated with most other high-risk sexual behaviors, but were slightly more common in women who found sex to be highly pleasurable or who displayed histrionic personality traits.

Associations of treatment resisting (Type R) and treatment seeking (Type S) personalities in medical students

AbstractMost people with personality pathology do not seek help for treatment. This has been formally recognized in the descriptions of treatment resisting (Type R) and treatment seeking (Type S) personalities, but the distribution of these in non‐clinical populations is not known. The associations of Type R and Type S were examined in relationship to personality status using the NEO‐FFI questionnaire and the Schedule for Non‐adaptive and Adaptive Personalities (SNAP) in an unselected population of medical students. One hundred forty‐seven students completed the questionnaires and 60 completed the SNAP interview. Nineteen (13%) of the sample were classified as Type S personalities, the remainder were Type R. Seven (12%) of the sample who completed the SNAP had a personality disorder, three with depressive, three with antisocial and one with obsessive–compulsive personality disorder, and all of these were Type R personalities. Type S personalities had significantly higher scores for neuroticism on the NEO‐FFI (p < 0.002) and showed high correlations with borderline personality traits (r = 0.42), but were negatively associated with antisocial (r = −0.24), histrionic (−0.13) or narcissistic (r = −0.11) personality traits. In this population only a minority of people, those with borderline personality traits and high neuroticism scores, are amenable to interventions aimed at personality change. Copyright © 2009 John Wiley & Sons, Ltd.

Family functioning among depressive and dissociative (conversion) patients.

To campare the family functioning, level of depression, anxiety and histrionic personality traits among depressive and dissociative (conversion) patients. A cross-sectional study. The Psychiatry Unit of Government Lady Reading Hospital, Peshawar, on depressive and dissociative (conversion) patients admitted from January to May 2004. Purposive sampling technique was used for the assignment of 75 patients (n=75) with depressive illness and 75 patients (n=75) with dissociative (conversion) disorders groups who fulfilled International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD 10), criteria. Test package was administered individually to all the patients and scores compared for the groups. On family APGAR scale, no significant difference (t=-2.472, p=0.16) was found between the scores of the two groups. Patients with depressive illness scored high on Hamilton Rating Scale for Depression with mean score of 26.92 and on Hamilton Rating Scale for Anxiety with mean score of 23.45, while dissociative group scored high on Hysteria (Hy) sub-scale of Minnesota Multiphasic Personality Inventory (MMPI) with mean score of 13.17. Dysfunctional family pattern is one of the contributing factor in developing and maintaining mental illnesses like depression and dissociative (conversion) disorders.

Underlying dimensions of ICD-10 personality disorders: Risk factors, childhood antecedents, and adverse outcomes in adulthood

Previous studies have identified specific underlying dimensions of personality disorders with remarkable consistency. This study aimed to replicate the factor structure of personality disorders using ICD-10 dimensional scores from a sample of 366 male offenders. Factor analysis yielded three factors. Factor 1 demonstrated dissocial, paranoid, histrionic, and impulsive personality traits. Factor 2 reflected borderline, anxious, and avoidant PD symptoms. Factor 3 showed high loadings on schizoid PD traits and an inverse relation to anankastic personality. The factor structure was identical to a recent study using ICD-10 personality disorder scores and showed strong similarities to previous studies using DSM-III personality disorder dimensions. Factor 1 was substantially correlated with the psychopathy total score. Elevated scores on this factor were associated with adverse childhood experiences, early behavioural problems (conduct/hyperkinetic disorder), co-morbid substance abuse in adulthood, an earlier start of criminal career, and a higher number of sentences/offences. No risk factors or childhood antecedents could be identified for Factor 2. However, this factor was distinctively characterised by co-morbid affective and neurotic mental disorders in adulthood. Factor 3 was negatively associated with measures of cognitive functioning. The findings suggest specific pathways, courses, and outcomes of the identified personality disorder dimensions.

Eating disorders and personality: A methodological and empirical review

Methodological approaches utilized to evaluate models of the relationship between personality and eating disorders, as well as empirical support for each model, are reviewed. Limited prospective research suggests that negative emotionality, perfectionism, drive for thinness, poor interoceptive awareness, ineffectiveness, and obsessive-compulsive personality traits are likely predisposing factors. Limited family study research suggests that obsessive-compulsive personality disorder (OCPD) and anorexia nervosa share a common familial liability. Potential pathoplastic personality factors include Cluster B personality disorders and OCPD, which predict a poorer course and/or outcome, and histrionic personality traits and self-directedness, which predict a more favorable course and/or outcome. Future research should focus upon sophisticated prospective and family study research in order to best evaluate competing models of the eating disorder–personality relationship.

Premorbid adjustment and previous personality in schizophrenic patients

Psychosocial adjustment and premorbid personality are two factors that are frequently studied in order to elucidate the etiopathogenesis of schizophrenia. Premorbid adjustment alterations and personality disorders (principally those of the schizophrenia spectrum) have been considered vulnerability elements or have been linked with the early manifestations of a disease that is still underdeveloped (hypothesis of neurodevelopment). In this paper we review the literature. We also studied the relationship between premorbid adjustment (PAS scale) and previous personality disorders (SCID-II) in a sample of 40 patients with schizophrenia (DSM-III-R, DSM-IV, CIE-10), and statistically correlated them. The results show that premorbid adjustment correlates with avoidant, schizotypal and schizoid personality disorders: the more personality pathology found, the poorer is the premorbid psychosocial adjustment. Premorbid adjustment positively correlates with histrionic personality traits. The pathological traits of schizotypal and schizoid personalities account for up to 77% of the variance of the total premorbid adjustment in schizophrenic patients. Conclusion: The degrees of premorbid adjustment in schizophrenia are related to the different premorbid personality disorders of schizophrenic patients, which are mainly those most genetically related with schizophrenia, that is, the spectrum of the schizophrenia.

Mixed impressions: Reactions of strangers to people with pathological personality traits

This study builds on previous work investigating reactions to people with pathological personality traits based on thin slices of behavior ( Oltmanns, Friedman, Fiedler, & Turkheimer, 2004). Verbal and nonverbal aspects of the signal were separated and examined in a new sample of 150 target individuals (military recruits). Ratings were made after viewing or listening to a 30 s excerpt from an interview that had been conducted with each target person. Undergraduate students (408 total) served as raters in one of the following conditions: transcript, sound only, picture only, or full channel (sound and picture). In all conditions, people with higher scores on histrionic and narcissistic personality traits were rated in a more positive manner, and those with higher scores on schizoid and avoidant personality traits were rated more negatively. The consistency of ratings based on different sources indicates that important and somewhat redundant cues are available in both verbal and nonverbal channels. Initial reactions to people with pathological personality traits are influenced by both verbal and nonverbal cues.

Personality Profiles of Women and Men Arrested for Domestic Violence

Women arrested for intimate partner violence raise challenges for those working in domestic violence programs. Theoretically, there is no agreement about whether women are aggressive for the same reasons as men or merely victims fighting back in an abusive relationship. Practically, there is very little research to guide treatment of this population. In the current exploratory study, Millon Clinical Multiaxial Inventory-III (MCMI-III) personality profiles of 78 females referred by the courts to a domestic violence diversion program were compared to those of a matched sample of 78 males referred by the courts to the same program. Compared with male offenders, women were more likely to demonstrate elevated histrionic, narcissistic, and compulsive personality traits, and less likely to demonstrate dependant personality traits. Additionally, women in this study were more likely to display MCMI-III profiles indicating the presence of personality disorders. Implications of these findings for the treatment setting are discussed.

Bipolar II disorder: personality and outcome in two clinical samples

Objective: To compare the personality traits and disorders of patients with bipolar II disorder and major depression and to examine the impact on treatment outcome of a bipolar II diagnosis. Method: Patients from two clinical trials, a depressive sample (n = 195, 10% bipolar II) and a bulimic sample (n = 135, 16% bipolar II), were assessed for personality traits using DSM-IV criteria. Patients were randomised to treatments (fluoxetine or nortriptyline for depressive sample; cognitive behaviour therapy for bulimic sample) and followed for 3 years (depressive sample) or 5 years (bulimic sample) to assess the impact on outcome of a bipolar II diagnosis. Results: Bipolar II patients were assessed as having more borderline, histrionic and schizotypal personality traits than patients with major depression. A baseline bipolar II diagnosis did not impact negatively on treatment outcome, and less than 5% of bipolar II patients developed bipolar I disorder during follow up. Conclusions: The low rate of conversion of bipolar II to bipolar I disorder and the lack of adverse impact of the diagnosis on outcome, questions the need for antimanic or mood stabliser medication in most bipolar II patients.

Personality Disorders in Suicide Attempters and Completers: Preliminary Findings

Personality disorders may play an important role in understanding suicide risk. The present study was designed to examine the frequency and type of personality disorder traits relevant to suicidal behavior. Four groups of subjects were compared: Suicide completers (n = 15), suicide attempters (n = 14), depressed natural deaths (n = 13), and nondepressed natural deaths (n = 15). The Structured Interview for DSM-III-R Personality Disorders – Revised (SIDP-R) was used to gather information needed to rate the presence and severity of 11 personality disorders. No differences were observed across groups on the categorical presence or absence of the different personality disorder diagnoses. However, dimensional ratings revealed that suicide completers displayed significant elevations in narcissistic, histrionic, and borderline personality traits. Suicide attempters displayed significant elevations on paranoid, avoidant, schizotypal, dependent, and borderline personality traits. At the level of specific personality traits, suicide completers displayed a sense of entitlement toward others, tended to be preoccupied with feelings of envy, and were likely to feel devastated when close relationships came to an end. The present findings suggest that personality traits are related to suicidal behavior, and that a focus on the dichotomous presence or absence of a diagnostic category fails to identify less severe forms of personality pathology. This research was supported in part by a grant from the NIMH (MH 45488) to the second author. We thank Herb Meltzer, M.D. for assistance with the psychiatric diagnoses, and Deval Shah for assistance with data entry.

Associations between Plasma Glucose and DSM-III-R Cluster B Personality Traits in Psychiatric Outpatients

Associations between personality traits, measured with the Karolinska Scales of Personality, the Impulsiveness subscale from the Impulsiveness, Venturesomeness and Empathy (IVE) Inventory, and with self-assessed personality traits and disorders (SCID-II Screen Questionnaire), and plasma insulin, glucagon and glucose, respectively, were explored in a sample of 101 psychiatric outpatients of both sexes. No relationships between the peptide hormones and personality measures were found. However, fasting glucose values, which were all essentially within the normal biological variation, were significantly related to several personality measures. For males, a low blood glucose was associated with low stable general level of functioning, with high IVE Impulsiveness, and with self-assessed histrionic and narcissistic traits. High number of self-assessed personality traits for all cluster B personality disorders was strongly associated with high IVE Impulsiveness. The results of the present study support the generalizability of earlier findings from alcoholic impulsive offenders: in males, low blood glucose is associated with an extrovert and impulsive, acting-out behavior that includes the breaking of societal norms and rules. In contrast, for females a positive relationship between fasting glucose and self-assessed histrionic personality traits was found. Because no association between global level of functioning and glucose was found in women, these personality traits may not necessarily be maladaptive, as was the case for males.