International Personality Disorder Examination Research Articles

Personality Dimension, Suicidal Intent, and Lethality: A Cross-sectional Study of Suicide Attempters with or Without Personality Disorders

Background: Although personality disorders (PD) are known risk factors for suicide attempts, studies on personality dimension are scarce, which may provide further insights for interventions. Methods: The relationship between personality dimension, lethality, intent, and quality of life (QOL) was studied in suicide attempters with or without PD. We used the international personality disorder examination (IPDE) dimensional score, the scale for assessment of lethality of suicide attempt (SALSA), suicide intent scale (SIS), and WHOQOL-BREF QOL scale, to assess a sample of suicide attempters admitted to a general hospital. Results: PD was present in 43.2% and 57.9% of them had more than one PD. Comparison of attempters with or without PD suggested that the lethality of attempts and QOL were comparable, whereas self-reported suicide intent was significantly low in patients with PD. A higher proportion of PD patients reported relational problems as the reason for the attempt. The personality dimensional score was significantly higher for female attempters from urban backgrounds than for those with previous attempt histories. It was negatively correlated with the lethality of attempts and suicide intent. Conclusion: It is important to explore the personality dimension of the suicide attempters, along with PD, that may highlight additional risks and suggest the need for specific support.

Impulsivity in antisocial personality disorder and obsessive-compulsive personality disorder in prison population

This study examined impulsivity in antisocial personality disorder (ASPD) and obsessive-compulsive personality disorder (OCPD) in the context of criminal offending. Participants completed the Demographic, Criminal, and Institutional Behavior Interview, the International Personality Disorder Examination, the Symptom Checklist-90-Revised, and the Impulsive Behavior Scale, that the APD and OCPD groups can commit the same crimes (against people and against objects). The results revealed that ASPD and OCPD groups can commit the same crimes (against human and against objects), although they differ in terms of impulsivity [Negative Urgency (UN), Sensation Seeking (BS) and Positive Urgency (UP)], with the OCPD group scoring lower on these dimensions. In the ASPD group, those who had committed crimes against human scored higher in UN, BS and UP than those who had committed crimes against objects. In the OCPD group, those who had committed crimes against human scored higher on UN and lower on BS and UP than those who had committed crimes against objects. The importance of analyzing personality disorder profiles for a better understanding of criminal behavior is emphasized.

Analysis of writing in personality disorders in prison population

AbstractWriting involves the activation of different processing modes than reading comprehension, and therefore the level of activation varies depending on the moment and the task.Objectivesto analyze the profiles in terms of the proposed coding from the PROESC in terms of personality disorders [Antisocial Personality Disorder (ASPD) with drugs possession and consumption crimes (DPCC) and Obsessive-Compulsive Personality Disorder (OCPD)] with gender violence crimes (GVC) in the prisoners.DesignThe sample was composed of 194 men. The participants were divided into two groups. Group 1 (ASPD; DPCC) consisted of 81 men, and Group 2 (OCPD; GVC) consisted of 113 men.Main outcome measuresThey completed the Demographic, Offense, and Behavioral Interview in Institutions, the International Personality Disorders Examination (IPDE), and Writing Processes Evaluation Battery (PROESC).ResultsGroup 2 made more mistake than Group 1 in narratives tasks.ConclusionParticipants know phoneme-grapheme correspondence rules, language disturbances of a reiterative and persistent nature may appear in those who show compulsive behavior.

Correction criteria for the qualitative analysis of the prison population: drugs possession/consumption and gender violence.

People with language difficulties cannot face challenges related to social skills. Those language disorders affect academic, work environments, and social interaction, leading to maladaptive and aggressive behaviors. Young inmates are at high risk of experiencing unrecognized language deficiencies. It is, therefore, necessary to analyze linguistic pathologies that can influence criminal behavior (drugs possession/consumption and gender violence crimes). There are many standardized tests to evaluate and detect language difficulties in adults in English. However, there are relatively few options in Spanish; there are no tests that evaluate language qualitatively and in depth. Most of the research is conducted with children and adolescents. To propose a reliable coding system for the correction and interpretation of narratives (essays and narratives) from the Battery for the Evaluation of Writing Processes (PROESC) in the prisoners charged of drugs possession or consumption and gender violence crimes. The sample was composed of 287 men. They completed the Demographic, Offense, and Behavioral Interview in Institutions, the International Personality Disorders Examination (IPDE), and PROESC. We found that the proposed coding system presented high concordance, that is, high inter-rater reliability. The classification system for the correction and interpretation of narratives was shown to be reliable.

Differentiating between intrapsychic symptoms and behavioral expressions of borderline personality disorder in relation to childhood emotional maltreatment and emotion dysregulation: an exploratory investigation

ABSTRACT Background: Borderline personality disorder (BPD) is a severe mental disorder, characterized by pronounced instability in emotions, self-image, and interpersonal relationships. Experiences of childhood maltreatment are among the risk factors for BPD. While self-damaging and aggressive acts often occur, not every person with the disorder shows markedly dysregulated behaviour. Internalized symptoms, such as shame, loneliness, and self-disgust tend to be more pervasive and persist after clinical remission. Objective: Here we investigated associations between BPD symptom severity, childhood maltreatment, and emotion regulation difficulties. We further explored if the Borderline Symptom List (BSL) could potentially be used to differentiate between internalized symptoms (intrapsychic strain) and externalized symptoms (dysregulated behaviours) in future research. Method: 187 women with at least mild BPD symptoms (65% having a diagnosis of BPD) completed the BSL 23 including its 11-item supplement (BSL-S), the Childhood Trauma Questionnaire (CTQ), and Difficulties in Emotion Regulation Scale (DERS). Participants further underwent a semi-structured clinical interview to assess BPD criteria (International Personality Disorder Examination, IPDE). Multivariate models and regression-based bootstrapping analyses were performed to test direct and indirect effects. Results: Childhood trauma severity, especially emotional abuse, positively predicted BPD symptom severity. A significant indirect effect through emotion regulation difficulties was found (k 2=.56). When exploring associations with BPD criteria (IPDE), the BSL-23 mean significantly correlated with separation anxiety, identity and mood problems, chronic emptiness, suicidal ideation, and dissociation, while the BSL-S correlated with self-harming impulsive behaviour and anger outbursts. Conclusions: Findings complement previous research, highlighting the role of childhood maltreatment and emotion regulation difficulties in BPD. While our findings need to be seen as preliminary and interpreted with caution, they suggest that the BSL may be used to differentiate between internalized symptoms and behavioural expressions of BPD in future research. Such a distinction might help to deepen the understanding of this complex heterogenous disorder.

Maladaptive Personality Traits of Inpatients with Self-Harm Behavior and Its Association with Suicide Intent Severity.

Introduction: Inpatients with self-harm behavior utilize a high proportion of health care resources, and determining their suicide risk may be challenging. This study examines how maladaptive personality traits in people who self-harm are associated with suicide intent severity. Methods: This was a 5-month cross-sectional study. The International Personality Disorders Examination (IPDE) ICD-10 questionnaire, Beck's Suicide Intent Scale (SIS), and the Depression Anxiety Stress Scale (DASS) 21 were administered. Sociodemographic and clinical data were recorded with STATA version 10.1 for statistical analyses. Results: Thirty-seven out of 40 (92.50%) inpatients participated in this study. About two-thirds (n = 24, 64.86%) were first-time self-harmers, with self-poisoning (n = 33, 89.19%) being the most common method. About two-thirds (n = 24, 64.86%) had low to moderate suicide intent. The most common diagnosis was adjustment disorder (n = 21, 56.76%). Around one-third had at least severe ratings for depressive, anxiety, and stress symptoms. All screened positive for at least one class of maladaptive personality traits, with the majority (n = 33, 89.19%) having more than one class of maladaptive personality traits. The three most prevalent classes of maladaptive personality traits were anankastic (n = 28, 75.68%), schizoid (n = 25, 67.57%), and paranoid (n = 23, 62.16%). Only dissocial traits were positively correlated with suicide intent severity (regression coefficient = 1.37, p = .017) following adjustment for the most important confounder, DASS 21. Discussion: Maladaptive personality traits were common in inpatients with self-harm behavior, with dissocial traits being positively correlated with suicide intent severity. This finding may inform suicide prevention strategies for patients who self-harm.

Subtypes of borderline personality disorder in a day-clinic setting-Clinical and therapeutic differences.

This preliminary study aims at extending existing empirical evidence on subtypes of borderline personality disorders (BPDs) by identifying subtypes among patients with BPD, comparing their characteristics to the trait domains of the dimensional model of the International Classification of Diseases, 11th Revision (ICD-11; World Health Organization [WHO], 2022), and examining differences in sociodemographic, clinical, and therapeutic outcome variables. Data of N = 109 patients were subjected to cluster analysis based on the International Personality Disorder Examination variables for BPD and analyzed regarding differences in clinical and therapeutic variables. Clustering suggested a three-cluster solution, namely, internalizing (n = 35), externalizing (n = 28), and mixed subtype (n = 46). Subtypes showed differences in clinical variables and therapeutic outcomes with the internalizing showing more affective disorders and the mixed subtype showing the lowest therapeutic change in borderline-specific symptoms. Together, the present results correspond to the model of the ICD-11 (WHO, 2022). Clinical and treatment implications are being discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A psychological profile of drivers convicted of driving under the influence of alcohol

Driving under the influence of alcohol (driving while intoxicated [DWI]) is a rather large social problem. It can be influenced by the driver’s personality, risk perception, difficulties related to hyperactivity, or attention deficit and alcohol dependencies; all of which share complex relations with each other, increasing the probability of criminal behaviour while driving and of road accidents. The purpose of this study is to explore the way in which personality, personality disorders, risk perception and behaviour while driving, hyperactivity or attention deficit, and the problematic consumption of alcohol are expressed in a sample of Spanish drivers who had been found guilty of committing DWI offences. These results are compared with those recorded for a sample of drivers with no history of such violations. For this study, a total of 115 subjects sentenced to perform road safety-related community service work (CSW) as a result of DWI convictions, as well as 97 drivers with no violations, were evaluated using Driver Behaviour Questionnaire (DBQ) tests, the NEO Five-Factor Inventory (NEO-FFI), the International Personality Disorder Examination (IPDE), the Adult ADHD Self-Report Scale Version 1.1, and the Alcohol Use Disorders Identification Test (AUDIT). Our results reveal that DWI traffic offenders exhibit risky consumption and signs of dependence (on alcohol and/or other drugs), and low levels of risk perception that are significantly lower than those observed for drivers without infractions. The logistic regression model provides data that supports the implication of a low perception of risk while driving under the influence of alcohol or other drugs, the violation of rules, extroverted personality traits, openness and cordiality, the indications of possible paranoid and antisocial PDs, and a below-university level of education as predictors of road crime due to DWI. This statistical solution offers a classificatory model with adequate internal and external validity. This scientific evidence could be useful for the design and improvement of prevention and reinsertion plans.

Editorial introductions.

Editorial introductions.

Clinical Practice Guidelines for Assessment and Management of Patients with Borderline Personality Disorder.

Clinical Practice Guidelines for Assessment and Management of Patients with Borderline Personality Disorder.

Personality Disorder in Adolescent Patients with Anorexia Nervosa

Objective: Anorexia nervosa (AN) is a highly debilitating disease which frequently results in chronification and often originates in adolescence. Personality traits have been associated with the onset and maintenance of AN; moreover, study results indicated a worse treatment outcome in patients with AN and comorbid personality disorder (PD). However, research on PD in adolescent AN is scarce. Methods: The sample consists of 73 female adolescent patients with AN. We investigated comorbid PD and AN symptom severity performing the International Personality Disorder Examination (IPDE) and the Eating Disorder Inventory 2 (EDI-2). Results: Almost a third (27.4%) of all participants were diagnosed with comorbid PD. They had significantly higher EDI-2 total scores reflecting overall stronger symptom severity, as well as significantly higher scores in the subscales “ineffectiveness,” “interpersonal distrust,” “interoceptive awareness,” “asceticism,” “impulse regulation,” and “social insecurity.” Conclusion: PD is an important and frequent comorbid condition in adolescent AN and should be addressed in diagnostic and treatment planning. Early diagnosis of comorbidity could have an impact on choosing specialized treatment for adolescents with AN and PD in order to enhance the outcome.

Relationship of DRD5 and MAO-B VNTR polymorphisms with paranoid and antisocial personality disorders in polydrug users.

Although multiple studies have shown the role genetics plays in personality disorders and in addictions, few have studied the genetic aspects of their comorbidity. Here, we carried out a cross-sectional study in a sample comprising 303 Caucasian polydrug-consuming patients. The presence of personality disorders was evaluated using the International Personality Disorder Examination, and genes related to dopamine, serotonin and monoamine oxidase (MAO) were genotyped. A significant relationship was observed between the bp 279 DRD5 variable number of tandem repeat (VNTR) polymorphism and paranoid personality disorder . The bp 182 and bp 184 alleles of the MAOB VNTR were also associated with antisocial personality disorder. Among patients with addictions, paranoid personality disorder should also be considered in addition to the importance of antisocial and borderline personality disorders. The higher frequency of the bp 279 DRD5 VNTR allele found in patients with paranoid personality disorder, as well as the associations between alleles of the MAOB VNTR and antisocial personality disorder, support the monoaminergic bases of these personality disorders, especially when dealing with patients with addictions.

High convergent validity among the five-factor model, PID-5-SF, and PiCD.

In the last 10 years, 2 instruments (the Personality Inventory for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [PID-5] and the Personality Inventory for International Classification of Diseases, 11th Revision [PiCD]) have been developed to measure the dimensional approach to personality disorders (PDs). Several studies have analyzed the relationships between both instruments and the five-factor model, although the PiCD has received less attention than the PID-5, given its more recent publication. For instance, the PiCD has never been related to the Revised NEO Personality Inventory (NEO-PI-R). The aims of the present article were to explore the convergent validity of the NEO-PI-R, a short version of the PID-5 (PID-5-SF), and the PiCD, to compare these dimensional approaches as for their ability to predict categorical PDs measured through the screening questionnaire of the International Personality Disorder Examination and to explore the nature of 2 controversial pathological domains: Psychoticism (from the PID-5-SF) and Anankastia (from the PiCD). A total of 1,565 people from the Spanish general population completed the NEO-PI-R, PID-5-SF, and PiCD. A total of 758 also filled out the International Personality Disorder Examination. Results show a high convergent validity of the five-factor model, the PID-5-SF, and the PiCD. Especially relevant from a clinical perspective is the great convergence between the 2 measures of dimensional PDs. In light of the results, the personality correlates of Psychoticism are reconsidered, and the location of Anankastia as the opposite pole of Disinhibition instead of as a separate domain, suggested by previous authors, is supported. The advantages of a dimensional approach to PDs and the practical implications for their assessment are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Psychometric properties of the Five-Factor Personality Inventory for ICD-11 (FFiCD) in Spanish community samples.

At present, there are two models of pathological personality represented in two measurement instruments, the Personality Inventory for DSM-5 (PID-5) and the Personality Inventory for ICD-11 (PiCD). Although both instruments have shown high convergence, the PID-5 has the advantage of including facets that might offer greater predictive capacity. An alternative to the PiCD has recently been proposed to overcome this drawback, namely the Five-Factor Personality Inventory for ICD-11 (FFiCD). The present study aims to explore its internal structure and to offer additional validity evidence. Data were collected for a total of 1,409 community individuals from two populations in Spain. They responded to the FFiCD, PiCD, the PID-5/SF, and measures of personality functioning and personality disorder screening (Level of Personality Functioning Scale Self-Report [LPFS-SR] and International Personality Disorder Examination [IPDE]). The internal structure of the FFiCD was analyzed through exploratory factor analysis with oblique and bifactor rotations. The predictive capacity of the domains and facets was examined. The structure reported in the original study was replicated, as were the convergent validity data with respect to the PID-5/SF and the PiCD. Facets were grouped into four factors corresponding to the theoretical domains, including a bipolar Anankastia/Disinhibition factor. High correlations were found with the LPFS-SR, and the patterns of relationships with the IPDE shed light on which aspects of pathological personality contribute most to the 10 traditional personality disorders. In general, validity evidence is provided to support the use of the FFiCD, though four of the 20 facets merit revision so that a simpler factor structure can be obtained. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Abstract- Poster

BACKGROUNDAn aggressive patient presenting at a Mental Health Care Facility may be diagnosed with a psychotic disorder and administration of psychotropics may obscure the existence of a long-standing Personality Disorder.AIMSTo highlight the challenges in diagnosis and management of a case of non-psychotic aggression in a 22-year-old male with history of aggressive outbursts since childhood.METHODSStandardised scales like Brief Psychiatric Rating Scale (BPRS), Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HAM-D), and ICD 10 International Personality Disorder Examination (IPDE) were used to rule out any psychotic/mood disorders and to assess the personality of the patient, respectively.RESULTSTrial of psychotropics in the past and after in-patient treatment showed little response and the patient’s scores on IPDE suggested a mixed disorder comprising Dissocial Personality Disorder, Emotionally Unstable Personality Disorder: Impulsive Type and/or Borderline Type. The patient started showing improvement only with Dialectical Behaviour Therapy (DBT) and Family Therapy along with Sodium Valproate 500mg BD.CONCLUSIONPersonality Disorders may present with extreme aggression and poor response to psychotropics where we should consider entertaining a diagnosis of a Personality Disorder which carry poor prognosis and need Psychotherapeutic intervention more than Psychopharmacological intervention alone.

Management of Psychiatric Disorders in Patients with Stroke and Traumatic Brain Injury.

Management of Psychiatric Disorders in Patients with Stroke and Traumatic Brain Injury.

Writing Abilities in Compulsive Prisoners.

Research has found links between academic failure and criminal offending and suggest that many incarcerated young people have experienced significant behavioral and learning problems in school, which could result in criminal outcomes and poor academic performance. The objective of this study was to analyse writing disorders in impulsive and compulsive prisoners. The sample was composed of 194 male prisoners, of which 81 had been diagnosed with Antisocial Personality Disorder and 113 with Obsessive Compulsive Personality Disorder. Male participants were recruited at the Granada Prison Center. They completed the Demographic, Crime, and Institutional Behavior Interview; the International Personality Disorder Examination (IPDE); The Symptom Checklist (SCL-90-R) and Assessment Battery of Writing Processes (PROESC in its Spanish acronym). We found that prisoners with writing disorders generally have difficulties in the skills necessary to write properly due to impulsive and compulsive behavior.

Exploring the prevalence of personality disorder and the feasibility of using the SAPAS as a screening tool for personality disorder in an emergency department in India.

Personality disorders (PD) lead to frequent emergency department (ED) visits. Existing studies have evaluated high-risk ED populations in Western settings. PD screening tools, such as the Standardized Assessment of Personality - Abbreviated Scale (SAPAS), have thus far only been validated in Western populations. This study aimed to establish the screened prevalence of PD, and to evaluate the performance of the SAPAS as a screening tool within an ED setting in India. The study took place in the ED of a private multi-speciality hospital in Kolkata, India. All attendees were approached during two days per week over three months, except those who were medically unfit to participate. The SAPAS and the International Personality Disorder Examination (IPDE) were translated into Bengali and then used as screening tools for PD and as the reference standard for PD diagnosis. Out of 120 ED attendees approached, 97 participated (48 men and 49 women), of whom 24% met the criteria for a diagnosis of PD. A cut-off score of 4 on the SAPAS provided the best trade-off between sensitivity and specificity for detecting PD. The prevalence of PD was similar to Western samples, and the SAPAS showed promise for use in a non-Western setting.

Relationship Pattern of Personality Disorder Traits in Major Psychiatric Disorders: A Cross-Sectional Study.

Background:Normal personality development, gone awry due to genetic or environmental factors, results in personality disorders (PD). These often coexist with other psychiatric disorders, affecting their outcome adversely. Considering the heterogeneity of data, more research is warranted.Methods:This was a cross-sectional study on personality traits in psychiatric patients of a tertiary hospital, over 1 year. Five hundred and twenty-five subjects, aged 18–45 years, with substance, psychotic, mood, or neurotic disorders were selected by convenience sampling. They were evaluated for illness-related variables using psychiatric pro forma; diagnostic confirmation and severity assessment were done using ICD-10 criteria and suitable scales. Personality assessment was done using the International Personality Disorder Examination after achieving remission.Results:Prevalence of PD traits and PDs was 56.3% and 4.2%, respectively. While mood disorders were the diagnostic group with the highest prevalence of PD traits, it was neurotic disorders for PDs. Patients with PD traits had a past psychiatric history and upper middle socioeconomic status (SES); patients with PDs were urban and unmarried. Both had a lower age of onset of psychiatric illness. Psychotic patients with PD traits had higher and lower PANSS positive and negative scores, respectively. The severity of personality pathology was highest for mixed cluster and among neurotic patients. Clusterwise prevalence was cluster C > B > mixed > A (47.1%, 25.2%, 16.7%, and 11.4%). Among subtypes, anankastic (18.1%) and mixed (16.7%) had the highest prevalence. Those in the cluster A group were the least educated and with lower SES than others.Conclusions:PD traits were present among 56.3% of the patients, and they had many significant sociodemographic and illness-related differences from those without PD traits. Cluster C had the highest prevalence. Among patients with psychotic disorders, those with PD traits had higher severity of psychotic symptoms.

Alcohol use patterns and disorders among individuals with personality disorders in the Sao Paulo Metropolitan Area.

IntroductionAlcohol Use Disorders are frequently comorbid with personality disorders. However, the heterogeneity of the prevalence estimates is high, and most data come from high income countries. Our aim is to estimate the prevalence and association between alcohol use outcomes and the three DSM-5 clusters of personality disorders in a representative sample of the São Paulo Metropolitan Area.Materials and methodsA representative household sample of 2,942 adults was interviewed using the WHO Composite International Diagnostic Interview and the International Personality Disorder Examination Screening Questionnaire. Lifetime PD diagnoses were multiply imputed, and AUD diagnoses were obtained using DSM-5 criteria. We conducted cross-tabulations and logistic regression to estimate the associations between AUDs and PDs.Results and discussionOur study did not find significant associations of PDs with heavy drinking patterns or mild AUD. Cluster B PD respondents tended to show the highest conditional prevalence estimates of most alcohol use patterns and AUD, including its severity subtypes. When alcohol outcomes were regressed on all PD Clusters simultaneously, with adjustment for sex and age, only cluster B was significantly associated with past-year alcohol use (OR 3.0), regular drinking (OR 3.2), and AUDs (OR 8.5), especially moderate and severe cases of alcohol use disorders (OR 9.7 and 16.6, respectively). These associations between Cluster B PDs and these alcohol outcomes were shown to be independent of other PD Clusters and individuals´ sex and age.ConclusionThe main finding of our study is that AUDs are highly comorbid with PDs. The presence of Cluster B PDs significantly increases the odds of alcohol consumption and disorders and of more severe forms of AUDs. Considering the local context of poor treatment provision, more specific prevention and intervention strategies should be directed to this population.