International Personality Disorder Examination Research Articles

DSM IV, DSM-5, and the Five-Factor Model: The Diagnosis of Personality Disorder With Intellectual and Developmental Disabilities

ABSTRACTIn DSM-5 there has been a move to dimensional personality disorder (PD) diagnosis, incorporating personality theory in the form of the five-factor model (FFM). It proposes an alternative assessment system based on diagnostic indicators and the FFM, while retaining DSM-IV categorical criteria. Four individuals with intellectual disability are assessed for PD utilizing the Assessment of Global Personality Functioning Index (AGPF), the International Personality Disorder Examination (IPDE), and, in terms of the FFM, through an adapted version of the NEO-PI short form. PD ratings (self, staff, and observer) tended to converge for borderline, antisocial, and narcissistic PDs. NEO-PI ratings converged on Neuroticism, Extraversion, and Openness, with discrepancies on Agreeableness and Conscientiousness (staff rating lower). A structured DSM-5 system is easily usable but takes more time than a diagnostic interview.

Personality Traits in Asexual People

Asexuality is a not much studied sexual orientation, even more, inside the sexological world; there are no much conversations about asexuality. Because of being a clinical sexologist in Paraguay and with the experience of meeting with two persons who came to consult if being asexual is something to be concerned about or not, this study aims to find out the personality traits of people self-identified as asexual and to collaborate with more knowledge regarding this sexual orientation. Members of Online Communities focused on Asexuality themes, using the snow-ball strategy by contacting persons inside these online communities and these persons contacting other members and so on. Online application (Google form) of the IPDE – International Personality Disorder Examination Test (Abbreviated version) of the World Health Association. 64 persons self-identified as asexual answered the test. 68.8% were women; 23.4% men; 1.6% transgender and 12.5% choose none of the previous options. Participants were from 7 countries (Argentina, Chile, Spain, Honduras, México, Perú and Uruguay). The minimum age was 17 years old and the maximum 54. Using all answers of the 64 persons, and the majority between options of true of false as a positive answer for each question of the test, the main personality trait was EVITATIVE. This trait is a patron of social inhibition, incompetence feeling and hypersensitivity to negative evaluation.

Severe war-related trauma and personality pathology: a case-control study

BackgroundExposure to war-related trauma has long been recognised to have an adverse effect on mental health. We attempted to investigate whether people who have clinically significant personality-related problems 15 years after a war are more likely to have been exposed to severe war-related trauma than those who do not have significant personality difficulties.MethodsA case –control study was conducted in southern Croatia, fifteen years after the 1991–1995 war. We recruited 268 participants: 182 cases who scored positively on the International Personality Disorder Examination scale (IPDE), and 86 controls who were IPDE negative. Severity of war-related trauma was assessed according to the 17 items on the Harvard Trauma Questionnaire (HTQ) trauma event scale, which were considered to be of severe (catastrophic) nature based on the ICD-10 description of catastrophic trauma and the opinion of trauma experts. All participants also completed measures of mental health (depression, anxiety and PTSD), social functioning and current substance misuse.ResultsCases (IPDE positive) were eight times more likely to report exposure to severe war-related trauma than controls. This association increased after adjustments for demographic factors (OR = 10.1, 95% CI 5.0 to 20.4). The types of severe trauma most frequently reported were either the participants’own life being in direct danger or witnessing extreme violence inflicted on others or the result of violence towards others (murder, torture, seeing burned or disfigured bodies). Prevalences of depression, anxiety and PTSD were high among IPDE positive participants 15 years after exposure to war trauma. Their level of interpersonal dysfunction was considerably higher than that in controls (OR = 10.39, 95% CI 3.51 to 30.75). Alcohol consumption in cases was significantly higher with a mean of 14.24 units per week (sd = 11.03) when compared to controls whose mean number of alcohol units was 9.24 (sd = 7.25), t (73) = 2.16, p < 0.05, mean difference 4.99 (95% CI = 0.39 to 9.60). Similarly, a significantly higher number of cases reported current substance misuse (8.2% vs. 0.0%) X2 (1, n = 268) = 7.51, p < 0.05).ConclusionExposure to severe war-related trauma is a risk factor for interpersonal dysfunction15 years after people were exposed to an armed conflict. These findings have implications for assessing and meeting the long-term mental health needs of people in war-affected regions. Further research needs to be done to increase our understanding about the relationship between severe war trauma and personality related problems.

Validation of the Paulhus Deception Scales (PDS) in the UK and examination of the links between PDS and personality

PurposeThe purpose of this paper is to evaluate the Paulhus Deception Scales (PDS) (Paulhus, 1998) for use in the UK. Given the forensic use of the PDS, this study aimed to examine whether the subscales of impression management (IM) and self-deception enhancement (SDE) predict anti-social personality and narcissistic personality, respectively.Design/methodology/approachA UK general population sample completed the PDS and the International Personality Disorder Examination personality screening tool (Loranger, 1999). Findings were compared to original Canadian/US norms. Exploratory structural equation modelling (ESEM) and factor analytic techniques were applied to the data.FindingsAverage total and IM scores were significantly higher in the UK than in the original sample. The tool demonstrated good internal consistency. The initial two-factor model showed relatively poor fit, which was significantly improved by application of the novel ESEM approach. Higher IM scores significantly predicted lower anti-social personality. Higher SDE scores significantly predicted narcissistic personality.Originality/valueThe PDS is applicable in the UK, however, users should use UK norms. When assessing people, especially in a “high stakes” forensic setting, IM should not be considered socially deviant. Those with high-SDE scores have been found to be narcissistic; consequently, in clinical practice, high-SDE scorers may need further violence or personality evaluation.

The structure of personality disorders within a depressed sample: Implications for personalizing treatment

BackgroundPersonality disorders (PDs) and major depressive disorder (MDD) are both significant public health burdens. They are frequently comorbid, and this comorbidity predicts poorer treatment outcomes and lower maintenance of treatment effects. Although there is growing consensus on the structure of personality pathology in non-depressed individuals, there is limited research on the structure of personality pathology in individuals experiencing MDD. MethodAs part of the Predictors of Remission in Depression to Individual and Combined Treatment (PReDICT) randomized controlled trial, 192 treatment-naïve subjects meeting DSM-IV-TR criteria for MDD completed the International Personality Disorder Examination (IPDE). Using this sample, a principal components analysis explored the factor structure of the IPDE. ResultsA three-factor model comprised three factors labeled “NADA” (Negative Affectivity, Disinhibition, and Antagonism),” “Social Anxiety,” and “Antisociality.” Factor intercorrelations were small-to-moderate, and the sum score of the three factors was highly correlated (r=0.94) with the total IPDE score. LimitationsPersonality pathology was assessed with one instrument, and sample size was smaller than ideal for factor analytic research. ConclusionsConsistent with prior factor-analytic findings, a three-factor solution provided the most clinically and theoretically useful model. This finding lends support for the personality disorders retained in DSM-5 and some support for a model of personality pathology aligned with the personality traits found in the leading nonclinical models of personality. The obtained factors are potential moderators of clinical interventions and may serve as an avenue to personalizing treatments.

Psychosocial risk factors and clinical profile associated with attempted suicide in young adult and adolescent patients in conflict zone-Kashmir

Background: Several efforts have been made in the past to study psychosocial risk factors and clinical profile associated with attempted suicide, but only few have addressed the issues of youth in a conflict area Kashmir. Aims: To study psychosocial risk factors and clinical profile associated with attempted suicide in young adult and adolescent patients in conflict zone-Kashmir. Material and Method: It was a hospital-based study in which 200 young adults and adolescent patients who were admitted following unsuccessful suicide attempts to the emergency and referred to Department of Psychiatry, Govt. Medical College, Srinagar, Jammu and Kashmir, India. Selected patients were subjected to Mini International Neuropsychiatric interview (MINI) and International Personality Disorder Examination (IPDE) for evaluation of symptoms and diagnosis. Subjects of age less than 15 years and more than 34 years have been excluded. Results: Majority of the suicide attempters 65% were < 24 years of age with adolescent over represented in the sample (Mean = 21.24 ± 4.66), females were 58%, low socioeconomic status (86%), oral agents (most common method) was used by 84%, 64% had expressed suicidal or death wishes before act and 72% made an impulsive attempt. Eighty-two percent of the suicide attempters were suffering from some psychiatric illness at that time. Out of which 40% had mood disorder with predominance of major depressive disorder, 15% had personality disorders, and 9% had posttraumatic stress disorder. Conclusion: Knowledge of clinical phenomenology may assist in identification and early intervention of youth who are at high risk. Overall, findings indicate a strong and immediate relationship between suicide attempt and psychiatry morbidity.

Burden of care in the caregivers of patients with anxiety disorders

Introduction: Anxiety disorders are one of the frequently encountered psychiatric disorders in psychiatric clinics which have significant impact on the psychosocial well-being of the patient as well as their caregivers. Study Design and Aims: This study is a non- invasive, cross sectional study of 91 patients with anxiety disorder (except obsessive compulsive disorder) aimed to assess the burden of care on their key-relatives and to study various socio demographic and clinical variables of the patient in relation to burden of care on key-relatives. Methodology: Patients diagnosed with anxiety disorders other than obsessive compulsive disorder and their key relatives satisfying the selection criteria were enrolled in the study. Assessment was done on semi-structured proforma, ICD 10 DCR, SCAN (Schedules for Clinical Assessment in Neuropsychiatry), International Personality Disorder Examination (IPDE), Burden assessment schedule, Hamilton Anxiety Rating Scale (HAM-A). Result: Total adjusted burden score in our study was 40.41 which is suggestive of mild burden. It was found that the burden of care was higher in male gender, married individuals, in joint families, among spouses, urban background, in the age group 41 to 50 years, low income group particularly on farmers and laborers. Generalized anxiety disorder was associated with more burden of care in comparison to other anxiety disorders. Conclusion: Key relatives of patients with anxiety disorder have significant burden of care in different domains along the socio-demographic strata.

Personality Traits in Patients Affected with Flood - A Hospital Based Study

A flood is an overflow of water that submerges land which is usually dry. Disasters not only have impact on the morbidity and mortality of the local population but also disrupt progress and destroy the outcome of developmental efforts over several years, often pushing nations’ quest for progress back by several decades. A typical pattern of mental, emotional, and physical response is observed in the majority of people after exposure to any disaster. The combination of cloud bursts, floods, and landslides triggered on 4th 5th and 6th September 2014 affected almost whole of Kashmir and some areas of Jammu as well. Research in this area can provide newer insights in prevention and management of patients who seem vulnerable in developing personality disorder. Aims: 1) To study socio demographic characteristics of patients affected with flood. 2) To study personality traits in these patients Methods and Materials: It was a cross-sectional observational study carried out in tertiary hospital in Srinagar. Patients affected with flood referred to psychiatry for opinion and willing to participate were included. Socio demographic details were obtained through self designed proforma. International personality disorder examination (IPDE) was used to diagnose personality traits in such patients. Results: Majority of the patients affected with flood (68%) were of young age group (15-27) years with male predominance (62%) were unmarried (38%) and belonged to Muslim (94%) Nuclear (58%) family. Histrionic personality (27%) was found to be personality traits in majority of the patients followed by dissocial personality (16%). Conclusion: Patient affected with flood at our setting had a distinctive pattern which was different from the norm.

Psychiatric Co-Morbidity in Patients with Attempted Suicide- A Hospital Based Study

1 Registrar, Department of Psychiatry, SKIMS MC, Srinagar 2 Professor & HOD, Department of Psychiatry, MGM medical College, Navi Mumbai 3 Post Graduate, Department of Hospital Administration, SKIMS, Srinagar 4 Senior Resident, Department of Hospital Administration, SKIMS, Srinagar 5 Associate Professor, Department of Psychiatry, MGM medical College, Navi Mumbai 6 Post Graduate, Department of Psychiatry, SKIMS MC, Srinagar Corresponding Author Mohammed Sarwar Mir Email: mohammedsarwarmir@gmail.com Abstract Suicide is fatal act that represents the person’s wish to die. There is a range, however, between thinking about suicide and acting it out. Some persons have ideas of suicide that they will never act on. In all countries, suicide is now one of the three leading causes of death among people. Until recently, the suicide rate was highest for the elderly, but now suicide predominates in younger people. In psychological sciences, the term stress is used to denote an influence that is disquieting or disruptive to a person’s emotional status that cannot be mastered or encompassed within a reasonable period of time. Since there is paucity of relevant data from Maharashtra, this study was designed to find the personality traits in patients of suicidal attempt in a tertiary care teaching hospital in Navi Mumbai. Hundred successive patients presents with history of attempted suicide who filled inclusion and exclusion criteria were taken up for the study and administered the International Personality Disorder Examination (IPDE) scale for evaluation of personality traits. Each patient was informed about the purpose of interview; his/her consent was obtained and strict confidentiality was ensured. General description, demographic data and psychiatric history were recorded using the self designed proforma and the IPDE. Majority of the suicide attempters (58%) were of young age group (18-25) years with female predominance (62%) were unmarried (59%) and belonged to Hindu (87%). Major Depressive Disorder was main psychiatric co-morbidity seen with 28% followed by alcohol dependence (21%) and panic disorder with 13%. Major Depressive Disorder was predominant co-morbidity found in patients of attempted suicide.

Prevalence rates of borderline personality disorder symptoms: a study based on the Netherlands Mental Health Survey and Incidence Study-2.

BackgroundDespite increasing knowledge of the prevalence of borderline personality disorder (BPD) in the general population, and rising awareness of mental disorders both as a categorical and a dimensional construct, research is still lacking on the prevalence of the number of BPD symptoms and their associated consequences, such as comorbidity, disability, and the use of mental health services) in the general population.MethodsData were obtained from the second wave of the Netherlands Mental Health Survey and Incidence Study-2 (N = 5303), a nationally representative face-to-face survey of the general population. BPD symptoms were measured by means of questions from the International Personality Disorder Examination. Comorbidity of common mental disorders was assessed with the Composite International Diagnostic Interview version 3.0.ResultsOf the total population studied, 69.9 % reported no BPD symptoms, while 25.2 % had 1–2 symptoms, 3.8 % had 3–4 symptoms, and 1.1 % had ≥ 5 BPD symptoms. The number of BPD symptoms reported was found to be positively associated with not living with a partner, having no paid job, and/or having a comorbid mood, anxiety or substance use disorder. Even after adjustment for sociodemographic characteristics and comorbidity, the number of BPD symptoms turned out to be uniquely associated with disability. It also showed a positive relationship with using services for dealing with mental health problems, although this relationship was strongly affected by the presence of comorbid disorders.ConclusionsBecause even a relatively low number of BPD symptoms appears to be associated with psychiatric comorbidity and functional disability, not only full-blown BPD but also subthreshold levels of BPD symptoms need to be identified in clinical practice and research.

Resilience Factors in Women with Severe Early-Life Maltreatment

Introduction: Early-life maltreatment (ELM) has long-lasting negative consequences and is the most important general risk factor for mental disorders. Nevertheless, a number of maltreated children grow up to become healthy adults and have therefore been called ‘resilient'. The aim of the current study is to investigate ‘resilience factors' in the context of severe ELM. Method: The study was part of the large multicenter project Understanding and Breaking the Intergenerational Cycle of Abuse (UBICA). A total of 89 women were examined, 33 with ELM and at least one lifetime mental disorder (nonresilient), 19 with ELM but without lifetime mental disorders (resilient), and 37 without ELM and without lifetime mental disorders (controls). ELM and other circumstances before the age of 18 years were assessed with the Childhood Experience of Care and Abuse (CECA) Interview. Additional relevant person and situation factors were measured with the Structured Clinical Interview for Mental Disorders (SCID-I), International Personality Disorder Examination (IPDE), Difficulties in Emotion Regulation Scale (DERS), Vulnerable Attachment Style Questionnaire (VASQ), Barratt Impulsiveness Scale (BIS), NEO Five-Factor Inventory (NEO-FFI), and Multiple-Choice Vocabulary Intelligence Test (MWT-B). Factor analyses and paired t tests were performed to identify those variables which differentiate best between the three groups. In addition, a discriminant analysis was conducted to detect the accuracy of assigning women to their specific group. Results: The factor analyses revealed 10 resilience factors based on which we could correctly assign 80% of the women to their group in the discriminant analysis. t tests of factor scores showed that resilient and nonresilient maltreated women mainly differed in current individual attributes (e.g. impulsivity, attachment style), while resilient and nonresilient maltreated women differed from controls in both their current individual attributes and their view of their situation as a child. Conclusion: The 4 variables neuroticism, extraversion, vulnerable attachment, and perceived loneliness during childhood were identified as most important in differentiating all three examined groups. Therefore, prevention and intervention programs focusing on the individual's development of secure attachment and social competence may be of particular importance in the context of ELM.

The Impact of Personality Disorders and Severity of Dependence in Psychosocial Problems

The comorbidity between Personality Disorders and Substance Use Disorders is well documented. Relationships between these two mental disorders are complex, and their concomitance generates poorer therapeutic prognosis and more severe psychosocial problems than either disorder alone. The purpose of this study was to compare three models of the relationship between personality disorders, substance use disorders and substance-related problems. Substance use disorder patients (n = 199) were recruited from outpatient centers for drug abuse care. The International Personality Disorder Examination Screening Questionnaire, European Addiction Severity Index and Substance Dependence Severity Scale were administered. For statistical analysis, t test, Pearson correlations and structural equation models were used. Patients with comorbidity showed more severe substance use disorder and more substance-related problems than patients without comorbidity. The three models fit well to the data, but two model with the effect mediation of severity of substance dependence between personality disorders and substance-related problems explained more variance observed. Considering the impact of personality disorders on family/social functioning, legal status and employment in these patients, integrated treatment models are needed to provide efficient care.

The SAPAS, Personality Traits, and Personality Disorder.

Many argue that current categorical personality disorder (PD) classification systems should be more dimensional and consider personality traits. The present study examined whether a brief PD screening tool, the Standardized Assessment of Personality: Abbreviated Scale (SAPAS) primarily screened for traits of low emotional stability, low extraversion, and low agreeableness, rather than PD per se. A general community sample (n = 237) completed the SAPAS, a personality trait measure, and the International Personality Disorder Examination (IPDE) screening questionnaire. Regressions showed that the SAPAS provided substantial incremental validity over personality trait scores in predicting total IPDE scores, indicating that the SAPAS captures variance unique to PD, rather than just extremes of general disposition. The SAPAS is an empirically valid rapid PD screen for nonclinical populations, correctly identifying 78% of individuals who screen positively for PD on the IPDE. However, the SAPAS was not effective for screening antisocial PD, limiting its utility in forensic settings.

Associations between personality disorder characteristics and treatment outcomes in people with co-occurring alcohol misuse and depression.

BackgroundPersonality disorders are highly comorbid with alcohol misuse and depressive symptomatology; however, few studies have investigated treatment outcomes in this population. The aim of this study was to examine relationships between baseline personality disorder cluster profiles and overall and treatment-related changes for those with co-occurring alcohol misuse and depression.MethodsSecondary analysis was conducted using a subset of data (N = 290) from two randomised controlled trials of psychological interventions for co-occurring alcohol misuse and depression, which did not specifically target personality disorders. Baseline dimensional personality disorder cluster scores were derived from the International Personality Disorder Examination Questionnaire (IPDEQ). Four treatment conditions were compared: a brief integrated intervention, followed by no further treatment, or nine further sessions of integrated-, alcohol-, or depression-focused treatment. Associations between IPDEQ scores and changes in alcohol use, depressive symptoms and functioning from baseline to the 6- and the 12-month follow-ups were of primary interest.ResultsPersonality disorder cluster scores moderately negatively impacted on overall change (primarily Cluster C), as well as treatment-related outcomes (primarily Cluster A), particularly changes in depressive symptoms and psychosocial functioning. Longer interventions appeared to be more effective in the longer-term (e.g., at 12-month follow-up), with integrated interventions relatively more effective than single-focused ones for individuals with higher personality disorder cluster scores.ConclusionsGreater attention needs to be paid to particular personality disorder clusters during the assessment and treatment of individuals with co-occurring alcohol misuse and depression. Integrated interventions, incorporating motivational interviewing and cognitive behaviour therapy, may provide a useful therapeutic framework. Integrated interventions also provide opportunities for adjunctive components focussing on other issues and coping strategies (e.g., to offset negative affective states), potentially tailored to the characteristics and needs of individual participants.

Impact of IPDE-SQ personality disorders on the healthcare and societal costs of fibromyalgia patients: a cross-sectional study.

BackgroundData is lacking on comorbid personality disorders (PD) and fibromyalgia syndrome (FMS) in terms of prevalence, and associated healthcare and societal costs. The main aim of this study was to assess the prevalence of PD in FMS patients and to analyse whether the presence of comorbid PD is related to worse functional impairment and greater healthcare (medical visits, drug consumption, and medical tests) and societal costs.MethodsA cross-sectional study was performed using the baseline data of 216 FMS patients participating in a randomized, controlled trial carried out in three primary health care centres situated in the region of Barcelona, Spain. Measurement instruments included the International Personality Disorder Examination - Screening Questionnaire (IPDE-SQ), the Fibromyalgia Impact Questionnaire (FIQ), the Client Service Receipt Inventory (CSRI), and a socio-demographic questionnaire.ResultsMost patients (65 %) had a potential PD according to the IPDE-SQ. The most prevalent PD were the avoidant (41.4 %), obsessive-compulsive (33.1 %), and borderline (27 %). We found statistically significant differences in functional impairment (FIQ scores) between FMS patients with potential PD vs non-PD (59.2 vs 51.1; p < 0.001). Multivariate regression analyses revealed that higher FIQ total scores and the presence of potential PD were related to more healthcare costs (primary and specialised care visits).ConclusionsAs expected, PD are frequent comorbid conditions in patients with FMS. Our results suggest that the screening of comorbid PD in patients with FMS might be recommendable in order to detect potential frequent attenders to primary and specialised care.

Temperament traits and personality disorders. Predictors for personality disorders

ABSTRACTThe objective of this study is related to the hypothetical assumption that there are biologically set predispositions as predictors of behavioural and personality disorders. The present work focused on identification of specific inherent predispositions as predictors of behavioural and personality deviations. The examined population of 901 subjects was provided with a battery of self-rating questionnaires: Temperament Evaluation of the Memphis, Pisa, Paris and San Diego Autoquestionnaire (TEMPS-A) for assessment and diagnosis of the temperament, Eysenck Personality Questionnaire (EPQ) for the assessment and diagnosis of relatively constant personality characteristics, International Personality Disorder Examination (IPDE-s) screening autoquestionnaire for the assessment and diagnosis of personality disorders and State Trait Anxiety Inventory – Form Y (STAI-Y) autoquestionnaire for the assessment and diagnosis of personality and situational anxiety. The results for the represented population showed statistically significant relationships, ranging from weak to strong positive correlation between the types of temperament in TEMPS-A and the personality disorders identified in screening IPDE, with the exception of the hyperthymic temperament scale in which very low non-significant negative relationships were observed. The analysis did not show significant correlations between personality disorders and the hyperthymic temperament type according to TEMPS-A. This temperament type showed weak statistically significant correlations with personality disorders from different clusters. Based on the high values of the linear correlation coefficients, some conclusions could be made on the causal correlation between the presence of a certain type of temperamental predispositions and the registered manifestations of possible personality disorders, namely, which personality disorder is most likely to occur in the prevalence of which temperament.

Psychiatric comorbidity and severity of dependence on substance users: how it impacts on their health-related quality of life?

Objective: The aim of this study was to analyze the impact of psychiatric comorbidity and severity of dependence on health-related quality of life (HRQoL).Methods: One hundred and ninety-eight substance use disorder (SUD) patients were recruited from an outpatient center that provides treatment for SUD. The International Personality Disorder Examination Screening Questionnaire (IPDE-SQ), Mini International Neuropsychiatric Interview (MINI), Substance Dependence Severity Scale (SDSS) and Health-Related Quality of Life for Drug Abusers test (HRQoLDA test) were administered.Results: Patients with psychiatric comorbidity evaluated their HRQoL more negatively than patients without psychiatric comorbidity. An analysis of the relationship between severity of dependence and HRQoL scores indicated significant correlations among alcohol-, cocaine-, heroin- and cannabis-dependent patients. According to multivariate analyses, anxiety disorders, mood disorders, severity of dependence on alcohol, cannabis, cocaine, paranoid, borderline and avoidant personality disorders (PDs) were observed to have a major impact on HRQoL.Conclusions: SUD (severity of dependence on alcohol, cannabis and cocaine) and other mental disorders (anxiety disorders; mood disorders; paranoid, borderline and avoidant PDs) are involved in the deterioration of the SUD patients’ HRQoL. This study demonstrates the need for integrated treatment for SUD patients. Treating only a part of the problem (whether SUD or other mental disorders are present) is insufficient for improving quality of life.

Identifying ADHD in adults using the international personality disorder examination screening questionnaire

Background: Attention deficit hyperactivity disorder (ADHD) is frequently diagnosed concurrently with a personality disorder (PD) in adulthood. Both are trait-like chronic disorders with substantial similarities.Aim: To measure the accuracy of the International Personality Disorder Examination screening questionnaire (IPDE-SQ) in identifying ADHD in adults from a psychiatric population.Method: Participants (n = 119) from mental health services completed an ADHD interview and the IPDE-SQ.Main results: Although many IPDE-SQ subscales demonstrated good sensitivity in identifying ADHD, a potential 11-item scale from IPDE-SQ components had excellent sensitivity (84%) and specificity (82%).Conclusions: An 11-item subscale from the IPDE-SQ shows potential as a screening instrument for ADHD in an adult psychiatric population.

Associations of borderline personality with pain, problems with medications and suicidality in a community sample of chronic non-cancer pain patients prescribed opioids for pain

ObjectiveBorderline personality disorder (BPD) is common in patients with chronic non-cancer pain (CNCP). BPD patients often report worse pain and are more likely to abuse opioid medication. Although the prevalence of suicidality is high in both CNCP patients and those with BPD, no studies have examined the interrelationship of BPD, CNCP and suicidality. This article aims to examine the prevalence and associations of BPD in a large community sample of CNCP patients and the association with medication problems and suicidality. MethodsData from a national sample of 978 CNCP patients prescribed pharmaceutical opioids for CNCP. The screener from the International Classification of Diseases, version 10, International Personality Disorder Examination was used to identify patients with symptoms of BPD. ResultsOne in five CNCP patients (19.1%) screened positive for BPD. BPD was associated with a number of demographic and clinical features, such as daily benzodiazepine use, and was independently associated with lifetime pharmaceutical opioid dependence [odds ratio (OR) 2.49, 95% confidence interval (95% CI) 1.42–4.38], past 12-month suicidal thoughts (OR 2.9, 95% CI 1.90–4.39) and lifetime suicide attempts (OR 3.19, 95% CI 2.16–4.72). ConclusionsBPD symptoms were prevalent among people prescribed opioids for CNCP and are associated with a number of adverse consequences. Further, those screening positive were at elevated risk of suicidal behaviors. Careful opioid prescription monitoring and appropriate referrals by clinicians are warranted in BPD with CNCP.

Toward resolution of a longstanding controversy in personality disorder diagnosis: Contrasting correlates of schizoid and avoidant traits

Although the construct validity and clinical utility of separate schizoid and avoidant personality disorder (PD) categories has been controversial since avoidant PD was first introduced in DSM-III, few studies have compared individuals with schizoid versus avoidant features on variables relevant to their contrasting personality dynamics. Those few investigations that exist have yielded inconclusive results. In this study a mixed-sex sample of nonclinical participants (N=123) completed the International Personality Disorder Examination Screening Questionnaire (IPDE-SQ) and self-report measures of attachment style, defense style, empathy, internalized shame, need to belong, rejection sensitivity, and social anhedonia. High levels of social anhedonia were uniquely predictive of schizoid features; high levels of need to belong and internalized shame were uniquely predictive of avoidance. These findings support retaining the two PD categories in future versions of the DSM. Supplementary analyses revealed that among women—but not men—schizoid and avoidant traits were positively and significantly intercorrelated; it may be that women show more of a blended schizoid–avoidant profile, whereas men display the more prototypical categorical profile where either schizoid or avoidant features predominate.