Millon Clinical Multiaxial Inventory Research Articles

Contact sex offenders with adult and minor victims: Psychopathological and criminological differences

BackgroundEffective classification of individuals who commit sexual offences is important for their assessment, treatment, and risk management. Victim age has often been used as a distinguishing factor between perpetrators. ObjectiveThis study aimed to analyse the distinctive psychopathological and criminological characteristics of contact sexual offenders with adult and minor victims. Participants and settingThe study involved 97 adult males who were serving a prison sentence in Spain for at least one contact sexual offence against an adult or a minor. MethodsResearchers gathered data on criminological variables concerning the offender, victim, and modus operandi from prison records and interviews. Participants completed the Millon Clinical Multiaxial Inventory-III (MCMI-III) in a second session, and between-group differences were analysed. ResultsSex offenders with minor victims (SOMV) had significantly lower scores than sex offenders with adult victims (SOAV) on the Antisocial (r = −0.283, p = .005) and Sadistic (r = −0.209, p = .04) personality subscales, and on the Alcohol (r = −0.426, p < .001) and Drug dependence (r = −0.332, p = .001) syndrome subscales. SOAV were also more likely to use violence and/or intimidation, use a weapon, offend against female victims, offend against an intimate partner, commit their offences in public places, serve other ongoing prison sentences, and report a history of alcohol and substance abuse. SOMV were older and more likely to offend against family members. ConclusionsThese results suggest that there are key differences between SOAV and SOMV that should be considered in tailored prevention programmes for each subgroup of offenders.

Ethnic Differences in the Prevalence of Compulsive and Histrionic Traits among Pilots in the UAE: A Comparative Study

This study aims to examine the prevalence rates of compulsive and histrionic characteristics among pilots from diverse demographic backgrounds such as South Asian, Middle Eastern, and Western pilots. The research aims to identify differences in personality traits and explore potential correlations within each ethnic group of commercial pilots. The data was provided by sixty pilots, equally representing three different ethnic groups, with twenty participants in each demographic. To collect the data, the researchers used a measuring tool designed to reveal signs of mental disorders, known as the Millon Clinical Multiaxial Inventory (MCMI). According to ANOVA results, there is a notable difference in prevalence rates for compulsive and histrionic traits among the three different ethnic groups (F (2,87) = 4.76, p =0.00057). Overall, the results showed that South Asian pilots had more compulsive traits than Middle Eastern and Western pilots. On the other hand, Middle Eastern pilots were found to have a higher occurrence of histrionic traits compared to their counterparts from South Asia and Westen pilots. The correlation analysis confirmed that there was a substantial link between histrionic and compulsive traits (r = 0.51, p &lt; 0.05). A similar trend was seen for Middle Eastern pilots, where a weakly positive link (r = 0.24, p &lt; 0.05) was visible. On the other hand, the Western pilots showed a weak, inverse correlation between compulsive and histrionic characteristics (r = - 0.14, p&lt;00), displaying unique profiles within this group in terms of their mutual interaction. These results offer a profound understanding of the relationship between ethnicity and personality traits in pilots.

An Explanatory Model to Predict Pediatric Psychosis Spectrum Based on Parent Psychiatric Profile and Children and Adolescents Comorbid Disorders as a Mediator Construct.

Objective: Psychosis is one of the most vital disorders in children and youths. The definite pathophysiology of schizophrenia and other psychotic disorders in the growth period has remained ambiguous. Therefore, the purpose of the current study was to investigate the predictive value of parental psychiatric disorders and the mediator role of comorbid disorders of children and youths. Method : The sample, consisting of 29884 individuals aged between 6 to 18 years old from the Iranian population, were selected by multistage cluster sampling during September 22, 2016 to January 3, 2018. Parents were requested to complete a survey around their potential psychiatric disorders, based on their Millon's Clinical Multiaxial Inventory-III (MCMI-III). The Semi-Structured Interview (Kiddie-SADS-Present, Lifetime Form (K-SADS-PL)) was utilized to analyze psychiatric disorders concurring to the DSM. Results: The fit indices of the model show that the research model has a good fit and the psychiatric disorders of parents directly and indirectly through comorbid disorders are effective on the psychosis symptoms of children and adolescents (RMSEA=0.06, CFI=0.89, PGFI=0.75, PNFI=0.75).The incidence of Schizotypal Personality Disorder, Anxiety, Bipolar Spectrum Disorder, PTSD, Schizophrenia Spectrum and Delusional Disorder were statistically higher in parents of psychotic children and adolescents. However, Borderline Personality Disorder was more frequent among their mothers while Alcohol Dependency and Drug Dependency were significantly more prevalent among their fathers. Conclusion: The outcomes of our study showed that there were statistically significant differences between the mean scores of each scale assessed by Millon's inventory between parents of psychotic versus non-psychotic pediatric cases. In addition, psychiatric disorders were more common among children and youths with psychosis spectrum in comparison with the general population.

Gender-based violence and its long-term impact on women’s mental health in Andalusia (Spain): risk and protective factors

The aim of this research was to examine the relationship between surviving gender-based violence (GBV) and the long-term presence of clinical symptoms and psychological distress. This was a cross-sectional study of 105 women, 54 of whom had experienced GBV more than three years prior to the study. Participants ranged in age from 24 to 73 years old. They were assessed using a semi-structured interview, instruments to assess self-esteem, maladjustment, perceived stress, social support and resilience, and the Millon Clinical Multiaxial Inventory-III (MCMI-III). Between-group differences and linear regression analyses were used to determine which variables had the greatest impact on the current psychological health status of women survivors of GBV. We found differences in levels of self-esteem, maladjustment, social support and perceived stress. There were also differences in most of the MCMI-III scales, indicating a pattern of depression and paranoid personality. Experiencing GBV in childhood was found to be predictive of increased pathology and emotional distress. Social support has been shown to be a protective factor for anxiety and post-traumatic stress disorder. GBV should be treated as a distinct form of violence that requires specific treatment, rather than as just another form of interpersonal violence.

Factor Structure of the Fourth Edition of the Millon Clinical Multiaxial Inventory

Objective: The aim of the present study was to examine the construct validity (factorial) of the fourth edition of the Millon Clinical Multiaxial Inventory (MCMI-IV) with an emphasis on personality patterns and personality disorders. Methods and Materials: Given the nature of standardization, this study employed an analytical cross-sectional method. This method examined the current status and situation and included both descriptive and correlational methods. The statistical population of this study comprised all individuals who visited counseling centers or treatment clinics in Tehran from June 2022 to September 2022. Participants were at least 18 years old, had completed at least five grades of schooling, and had either sought initial treatment or continued their treatment at these centers or had been referred to them. In this study, a purposive sampling method was used to select 500 visitors from counseling centers in Tehran. The measurement tool included the standardized Millon Clinical Multiaxial Inventory (fourth edition). To analyze the data statistically, the KMO index, Bartlett's test, and factor analysis were performed using SPSS-26 software. Findings: The results of the factor analysis in this study of visitors to family counseling centers in Tehran indicated that four factors were identified: 1) styles of clinical personality patterns, 2) severe personality pathology, 3) clinical syndromes, and 4) severe clinical syndromes. Conclusion: These results demonstrate that the MCMI-IV has a distinct factor structure that can effectively measure personality and clinical characteristics. This factor analysis enhances the construct validity of the test and improves the accuracy of measuring the intended characteristics. Based on the findings of the present study, it can be concluded that the fourth edition of the MCMI has a suitable factor structure and can be used as a reliable tool for measuring personality and clinical characteristics. These findings can aid researchers, counselors, and physicians in diagnosing and treating personality and clinical disorders.

Dissimulation in forensic psychiatric evaluations, a case-control study of the Millon Clinical Multiaxial Inventory-III.

The forensic setting can affect a subject's behaviour.Dissimulation is a mechanism of minimization or concealment of a psycho-pathological condition.The MCMI-III can be a useful tool for a forensic psychiatrist or forensic psychologist in assessing dissimulation.

Exploring the associations between dark triad personality and psychopathology in convicted offenders: Identifying their role in reincarceration

AbstractDysfunctional personality and psychopathological characteristics are increasingly studied in offenders separately, but only a few studies have analysed their relationship in this specific population. In this research, we focus on the so‐called Dark Triad personality, consisting of the Machiavellian, the narcissistic and the psychopathic personalities. The main objective of this study was to examine the association between Dark Triad personality and psychopathology and also to know the role of these mental health variables in recidivism. Participants were 63 offenders (44 men and 19 women) from two different penitentiary institutions. Sociodemographic data as well as clinical and personality characteristics were recorded. Psychopathology was assessed with the third version of the Millon Clinical Multiaxial Inventory and dark personality with the Short Dark Triad. Results of descriptive statistical analyses revealed a high prevalence of psychopathology in convicted participants and reincarcerated offenders. Correlational analyses showed a strong relation between the Dark Triad personality and psychopathology, being the psychopathic personality the one with the highest association. Finally, we found that the psychopathological variables contributing most to the discrimination of reincarcerated participants were substance and alcohol abuse disorders and in relation to dysfunctional personality were psychopathy and narcissism, the latter in negative direction. These data highlight the relevance of a necessity for research exploring long‐term patterns of re‐incarceration for both men and women, including mental health disorders and personality models. The importance of taking into account the relationship between variables in preventive and treatment interventions inside and outside penitentiary institutions is discussed.

Preliminary psychometric properties of the Chinese version of the structured interview of personality organization (STIPO-CH)

BackgroundKernberg originally proposed the psychoanalytic concept of personality organization (PO), which measures personality pathology from a dimensional approach with multiple scales and can be evaluated using the Structured Interview of Personality Organization (STIPO) from six domains: identity, object relations, primitive defenses, coping vs. rigidity, aggression, and moral values. The present study translated the original version into the Chinese STIPO (STIPO-CH) version and evaluated its reliability and validity.MethodsThe STIPO-CH was administered to 49 non-clinical subjects. They also completed the Chinese version of the Inventory of Personality Organization and the Millon Clinical Multiaxial Inventory to evaluate criterion-related reliability. Interrater reliability was assessed with intraclass correlations. An item analysis was carried out to explore the structure and internal consistency.ResultsInterrater reliability (intraclass correlations) ranged from 0.98 to 0.99. Results suggested acceptable internal consistency for identity and moral values. The correlations between STIPO-CH domains and self-report questionnaires indicated that construct validity and criterion-related validity were acceptable to good.ConclusionsOverall, this study presents preliminary psychometric properties of STIPO-CH. Limitations regarding the sample, interviewers, and cultural differences are discussed. Future research is highly recommended.

Examining the predictive potential of depressed mood and alcohol misuse on risky driving.

Male driving while impaired (DWI) offenders are at heightened risk for engaging in risky driving. Males in a depressed mood are also more prone to alcohol misuse, which may further contribute to risky driving. This manuscript investigates the predictive potential of combined depressed mood and alcohol misuse on risky driving outcomes 3 and 9years after baseline in male DWI offenders. At baseline, participants completed questionnaires assessing depressed mood (Major Depression scale of the Millon Clinical Multiaxial Inventory-III), alcohol misuse (Alcohol Use Disorders Identification Test), and sensation-seeking (Sensation Seeking Scale-V). Risky driving data (Analyse des comportements routiers; ACR3) were collected at follow-up 3years after baseline. Driving offence data were obtained for 9years after baseline. There were 129 participants. As 50.4% of the sample were missing ACR3 scores, multiple imputation was conducted. In the final regression model, R2 = 0.34, F(7,121) = 8.76, P < 0.001, alcohol misuse significantly predicted ACR3, B = 0.56, t = 1.96, P = 0.05. Depressed mood, however, did not significantly predict ACR3 and sensation-seeking was not a significant moderator. Although the regression model predicting risky driving offences at Year 9 was significant R2 = 0.37, F(10,108) = 6.41, P < 0.001, neither depressed mood nor alcohol misuse was a significant predictor. These findings identify alcohol misuse as a predictor of risky driving 3years after baseline among male DWI offenders. This enhances our prediction of risky driving, extending beyond the widely researched acute impacts of alcohol by exploring chronic patterns.

Clustering psychopathology in male anabolic-androgenic steroid users and nonusing weightlifters.

Prior research has demonstrated that personality disorders and clinical psychiatric syndromes are common among users of anabolic-androgenic steroids (AAS). However, the prevalence, expression, and severity of psychopathology differ among AAS users and remain poorly understood. In this study, we examine the existence of potential clinically coherent psychopathology subgroups, using cluster procedures. A sample of 118 male AAS users and 97 weightlifting nonusers was assessed using the Millon Clinical Multiaxial Inventory-III (MCMI-III), measuring personality disorders and clinical syndromes. Group differences in MCMI-III scales were assessed using Wilcoxon-Mann-Whitney tests and Fisher's exact test. Agglomerative hierarchical clustering was used to identify clusters based on MCMI-III scale scores from the whole sample. AAS users displayed significantly higher scores on all personality disorder (except narcissistic) and clinical syndrome scales compared to nonusing weightlifters. The clustering analysis found four separate clusters with different levels and patterns of psychopathology. The "no psychopathology" cluster was most common among nonusing weightlifters, while the three other clusters were more common among AAS users: "severe multipathology," "low multipathology," and "mild externalizing." The "severe multipathology" cluster was found almost exclusively among AAS users. AAS users also displayed the highest scores on drug and alcohol dependence syndromes. AAS users in our sample demonstrated greater psychopathology than the nonusing weightlifters, with many exhibiting multipathology. This may pose a significant challenge to clinical care for AAS users, particularly as there appears to be significant variation in psychopathology in this population. Individual psychiatric profiles should be taken into consideration when providing treatment to this group. As a group, AAS users displayed markedly greater psychopathology than nonusing weightlifters. Multipathology was common among AAS users. Four different subgroups of personality profiles were identified with distinct patterns of pathology and severity. The cross-sectional nature of the study precludes inferences about causality. The study is limited by possible selection bias, as participants choosing to be involved in research may not be entirely representative for the group as a whole. The study is vulnerable to information bias, as the results are based on self-report measures and interviews.

The effectiveness of combined therapy on overcompensation coping strategies in histrionic personality disorder patients

Objective: This study aimed to evaluate the effectiveness of a combination of Schema Therapy and ACT (Acceptance and Commitment Therapy) in reducing overcompensation coping strategies associated with early maladaptive schemas in patients diagnosed with histrionic personality disorder (HPD). Methods: A randomized quasi-experimental design with a comparison group was used, involving pre-test, post-test, and a two-month follow-up assessment. Participants were 30 HPD patients selected from three psychology centers in 2021–2022 in Tehran who met the inclusion criteria for HPD diagnosis based on clinical interviews and Millon Clinical Multiaxial Inventory-III (MCMI-III). Patients were randomly assigned to either the intervention or waitlist group. The intervention group received ten 90-minute sessions of combined therapy. MCMI-III and the Young Compensation Inventory (YCI) were used as research instruments. Multivariate analysis of covariance was used to control for pre-treatment differences between the intervention and waitlist groups and to assess the effect of the intervention on the outcome measures. Results: The intervention group had significantly lower MCMI-III Disclosure scores and lower YCI levels immediately post-treatment and at the two-month follow-up assessment compared to the waitlist control group. The effect sizes for these comparisons were large to very large, indicating a significant and clinically meaningful improvement in the intervention group. Conclusions: The findings suggest that combined Schema Therapy and ACT may be effective in reducing overcompensation coping strategies in HPD patients. The study's limitations included the absence of random sampling in the first stage of screening. Future research should aim to replicate these findings with larger samples and diverse populations.

Different personality profiles in patients with cluster headache: a data-driven approach.

Cluster headache (CH) is usually comorbid to mood spectrum disorders, but the psychopathological aspects are poorly explored. We aimed at identifying discrete profiles of personality traits and their association with clinical features. Based on the personality scales of the Millon Clinical Multiaxial Inventory-III, principal component analysis (PCA) identified psychological patterns of functioning of 56 CH patients. PCA outcomes were used for hierarchical cluster analysis (HCA) for sub-groups classification. Eighty-seven percent of patients had personality dysfunctions. PCA found two bipolar patterns: (i) negativistic, sadic-aggressive, borderline, and compulsive traits were distinctive of the psychological dysregulation (PD) dimension, and (ii) narcissistic, histrionic, avoidant, and schizoid traits loaded under the social engagement (SE) component. PD was associated with disease duration and psychopathology. SE was related to educational level and young age. HCA found three groups of patients, and the one with high PD and low SE had the worst psychological profile. Personality disorders are common in CH. Our data-driven approach revealed distinct personality patterns which can appear differently among patients. The worst combination arguing against mental health is low SE and high PD. Linking this information with medical history may help clinicians to identify tailored-based therapeutic interventions for CH patients.

Prevalence of Personality Disorders in Adults With Attention Deficit Hyperactivity Disorder (ADHD)

Objective: To estimate the prevalence of PDs according to Millon’s evolution-based model among adult ADHD outpatients. Method: Cross-sectional study of consecutive patients referred to an adult ADHD clinic. PDs were evaluated with Millon Clinical Multiaxial Inventory–III (MCMI-III). Results: One-hundred-eighty-one participants had valid MCMI-III, of whom147 were diagnosed with ADHD. Mean age: 32.97, SD:11.56, females: 74 (50.3%). Among the 147 participants with ADHD, 29 (19.7%) did not meet criteria for any PD, 43 (29.3%) met the criteria for one PD, 34 (23.1%) for two PDs and the rest three or more. Most common PD was Dependent (n = 58) followed by Depressive (n = 45). Inattentive sub-type was associated with dependent PD, while combined type with antisocial, negativistic (passive/aggressive) and sadistic PD. Conclusion: Particular personality profiles were more common with different ADHD subtypes. Given the developmental origins of PD, further research may help identify possible links with childhood difficulties.

Investigating the Relationship between Behavioral Activation and Inhibition Systems (BIS/BAS) and Effortful Control (EC) with Clinical Symptoms and Personality Disorders in Patients with Substance Abuse Disorders

Objective: Substance abuse is considered one of the most important factors that threaten well-being and health, so it is important to identify the factors related to this disorder. This study aimed to investigate the relationship between behavioral activation and inhibition systems (BIS/BAS) and effortful control (EC) or clinical symptoms and personality disorders in patients with substance abuse disorders. Method: The descriptive research method was correlation type. The researched population was all the people suffering from substance abuse in 2022 who had visited Jask City addiction treatment centers in the first half of this year, 112 of them were selected using the cluster random sampling method. The measurement tools include the Drug Abuse Screening Test (DAST-20), Carver and White's BIS/BAS Scale (1994), short form of Adult Temperament Questionnaire (ATQ), Symptom Checklist 90-R (SCL-90-R), and Millon Clinical Multiaxial Inventory – Third Edition (MCMI-III). Finally, the collected data were analyzed using Pearson's correlation test and multiple regression under SPSS-23 software. Results: The research data analysis revealed a significant correlation between clinical symptoms and personality disorders. BIS/BAS and effortful control were predictive variables, and their role in predicting most clinical and personality variables was meaningful. Conclusion: In general, the results of this research showed that there is a relationship BIS/BAS and EC with clinical symptoms and personality disorders in patients with substance abuse disorders.

Predicting Clinical Personality Patterns Based on Personality Traits in Clients of Counseling Centers

Purpose: The relationship between personality traits and clinical personality patterns is crucial in understanding and improving therapeutic interventions in counseling settings. This study aims to explore how personality traits predict clinical personality patterns among clients attending counseling centers in Shahroud, thereby informing more effective and personalized counseling strategies. Methodology: This descriptive-correlational study involved 107 clients from public and private counseling centers in Shahroud. Participants, aged between 18 and 50, completed the Millon Clinical Multiaxial Inventory-III (MCMI-III) and the Big Five Personality Traits questionnaire. Data were analyzed using Pearson correlation coefficients and stepwise regression analysis to identify significant predictors among the personality traits for various clinical personality disorders. Findings: Neuroticism was found to be a significant predictor of Schizoid, Avoidant, Borderline, Paranoid, and Schizotypal Personality Disorders. Conversely, Agreeableness and Conscientiousness emerged as protective factors, inversely related to Narcissistic and Histrionic Personality Disorders. These results suggest that emotional dysregulation associated with high Neuroticism predisposes individuals to a range of personality disorders, while interpersonal warmth and self-discipline mitigate the risk. Conclusion: The study highlights the significant impact of personality traits on clinical personality patterns, emphasizing the importance of incorporating personality assessments into counseling practice. By understanding these relationships, counselors can tailor interventions to clients' unique personality profiles, enhancing therapeutic outcomes and promoting better mental health. Future research should aim to replicate these findings in diverse populations and explore longitudinal impacts and other personality frameworks.

Validity of Adult Psychopathology Model Using Psychiatric Patient Sample from a Developing Country: Confirmatory Factor Analysis

Objectives. This study is aimed at testing and validating the two-factor measurement model of the Millon Clinical Multiaxial Inventory (MCMI). Specifically, this paper reported construct validity, particularly focusing on convergent and discriminant validities of the internalizing-externalizing MCMI model of adult psychopathology using a psychiatric sample from a developing country, the Republic of Yemen. Methods. MCMI was distributed among 232 outpatients from the Hospital of Taiz City and two private psychiatry clinics in Yemen; data were collected using structured interviews over four months. We used exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to explore and confirm the latent structure MCMI and verify the evidence of convergent and discriminant validity. Results. The CFA results indicated that MCMI was a good fit for the internalizing-externalizing two-factor model of adult psychopathology, comparative fit index CFI = 0.95 , and RMSEA = 0.07 . The results of the CFA provide evidence of convergent and discriminant validity characterized by MCMI with the internalizing-externalizing model. Conclusion. The adult psychopathology of internalizing-externalizing is a valid measurement model of MCMI with ten personality disorders and eight clinical syndromes.

The stress response of intensive care unit medical doctors facing repeated severe emergencies.

This study assesses the psychopathological distress experienced by doctors working in an Intensive care unit (ICU) during the COVID-19 pandemic. These doctors were the same who faced the consequences of a previous natural disaster, a severe 6.3 magnitude earthquake. A second objective is to evaluate their current mental attitude, professional performances and coping strategies adopted in the pandemic in relation to the conditioning effect of that first emergency, the earthquake. Thirty-seven ICU medical doctors were recruited and assessed using Rapid Stress Assessment (RSA) rating scale, Symptom Checklist-90 Revised (SCL-90-R), Zung Self-Rating Anxiety Scale, Beck Depression Inventory, Beck Hopelessness Scale, Millon Clinical Multiaxial Inventory III. Comparison between exposure to the earthquake and COVID pandemic has been made in terms of professional role and psychological burden. Comparison between 2009 earthquake catastrophe and COVID pandemic conditions evidenced relevant changes in professional role, team, environment, shifts, and work organization. The doctors, who already experienced the 2009 earthquake reported a feeling of greater insecurity facing this latter catastrophe, the COVID pandemic, as well as perception of greater concern for their family and the global situation. However, having participated in the medical management of another emergency (the 2009 earthquake) appears to have contributed to limiting demoralization and psychological distress. The feeling of having greater decision-making possibilities and participation in the organization of work, strengthen coping skills in the face of the emergency.

Personality Pathology in Winter Depression: Prevalence and Treatment Trajectories in Cognitive-Behavioral Therapy and Light Therapy

Personality disorders are highly comorbid with major depression; however, findings are mixed regarding their impact on depression treatment outcomes and trajectories. Limited research has studied personality pathology in winter depression, specifically. This study (1) explored the prevalence of personality pathology in winter depression and (2) examined its effects on winter depression treatment trajectories. Participants were 174 adults with Major Depression, Recurrent with Seasonal Pattern from a randomized clinical trial comparing group cognitive-behavioral therapy for seasonal affective disorder (CBT-SAD) and light therapy. Participants completed the Millon Clinical Multiaxial Inventory-III (MCMI-III; Millon et al., 1994) at baseline. The prevalence of MCMI-III-defined pathological personality traits and personality disorders in this sample was 98/174 (56.3%) with any trait and 65/174 (37.4%) with any disorder. Dependent was the most common elevation (65/174, 37.4%), trait (43/174, 24.7%), and disorder (22/174, 12.6%). Most participants with pathological personality elevations had only one personality disorder (58/174, 33.3%) and one pathological personality trait (82/174, 47.1%). Growth curve analysis revealed personality pathology predicted higher baseline depression scores, but the number of MCMI-III pathological personality elevations (i.e., traits and disorders) and personality disorders did not predict change in depression over the timeframe of pretreatment, weekly during treatment, posttreatment, and follow-ups one and two winters later in CBT-SAD or light therapy. Results suggest that personality pathology is not a negative prognostic indicator or prescriptive factor for winter depression treatment with CBT-SAD or light therapy, which may inform treatment algorithms and decision-making in practice.

Psychopathology among anabolic-androgenic steroid using and non-using female athletes in Norway

Anabolic-androgenic steroids (AAS) are primarily used to improve physical appearance and increase lean muscle mass. Due to their masculinizing properties, the majority of people using AAS are men; however, AAS use among females may increase with changing body ideals trending towards a more muscular appearance. AAS use among males have been associated with risk-taking behavior, and increased prevalence of personality disorders and psychopathology. As a result of low perceived prevalence and stigma among females who use AAS, the relationship between AAS use and psychopathology in this population is not well-known. AAS using women (n = 16) and weight-lifting controls (WLC) (n = 16) completed questionnaires regarding AAS use, health and training information. Psychopathology was evaluated using the Millon Clinical Multiaxial Inventory-III (MCMI-III). Group differences on demographic variables and scores on MCMI-III scales were evaluated with Mann-Whitney U tests. The clinical cut-off was then applied to all MCMI-III scales and groups were compared using Fisher's exact test. AAS consumers demonstrated significantly greater psychopathology than WLC on several scales. Externalizing personality disorder scales were elevated among those who use AAS relative to controls, such as borderline (p < 0.001), antisocial (p = 0.007) and sadistic (p = 0.002), and in addition depressive (p = 0.012), negativistic (p = 0.001) and masochistic (p = 0.029) personality disorders scales. Furthermore, all clinical syndromes were elevated among AAS consumers. AAS consumers thus demonstrated multi-pathology, and 56% (n = 9) of the group met the clinical criteria for six or more disorders. Females who use AAS experience in general increased levels of psychopathology compared to WLC. Clinicians should be aware of these traits and the challenges they present in providing care to this population.

Personality disorders as predictors for the conversion from major depressive disorder to bipolar disorder: A prospective cohort study

Studies suggest that personality disorders can predict mood disorders. The present study aims to assess whether personality traits in individuals with major depressive disorder (MDD) can predict the conversion to bipolar disorder (BD). This was a prospective cohort study conducted in two waves. In the first wave, 585 subjects were diagnosed with MDD; in the second wave, all of them were reevaluated in a three-year follow-up. Personality traits were evaluated, in the first phase, using the Millon Clinical Multiaxial Inventory (MCMI). MDD and BD diagnosis was performed by trained psychologists using a clinical structured interview based on diagnostics criteria of DSM IV, the Mini International Neuropsychiatric Interview, Plus version (MINI-PLUS). During the second wave, 468 individuals were reevaluated. Diagnostic conversion rate from MDD to BD was 12.4%. Higher mean scores in Antissocial, Borderline personality traits and in the sum of all Cluster B disorders were found among individuals who had converted to BD. In addition, individuals who converted to BD had lowest scores in obsessive-compulsive personality traits. Our findings suggest that Cluster B personality disorders can be considered as predictors of diagnostics conversion from MDD to BD. Also, it seems that obsessive-compulsive traits were lower among those individuals who have converted to BD. • Diagnostic conversion rate from MDD to BD was 12.4%. • Greater severity of symptoms in cluster B were found among subjects who converted to BD. • Individuals who converted to BD had lowest scores in obsessive-compulsive personality disorder.