Patterns Of Psychopathology Research Articles

Behaviour and Psychopathology in Preschool Children with William Syndrome and the Effects of Age, Sex and Cognition.

The current study compared the prevalence of cognitive and psychopathological impairments among 24 preschool children with Williams syndrome (WS) (aged 2.20 to 5.97years) and 53 controls without WS and screened for developmental or psychological diagnoses (aged 2.21 to 5.89years) matched on chronological age and sex distribution. Associations between sex, chronological age, early development and psychopathology were also investigated. The Child Behavior Checklist-Preschool Version (CBCL) and the Mullen Scales of Early Learning were administered. Higher reported rates of Attention Problems, Emotional Reactivity, Somatic Complaints, Withdrawal, Affective Problems and Total Problems were found in preschool children with WS. There were no significant group differences in prevalence rates of all other CBCL domains. Attention Problems were the most prevalent psychopathology in preschool children with WS (33% falling in the clinically significant range), followed by Affective Problems (29% in clinically significant range), then Anxiety Problems (17%) or Attention Deficit/Hyperactivity Problems (17%). Among children without WS, the highest prevalence rates of psychopathology were for Attention Problems (4% falling in the clinically significant range), Aggressive Behaviour (4%), Sleep Problems (4%) and Oppositional Defiant Problems (4%). There were no significant associations between sex or chronological age and CBCL-reported psychopathology for either group. In addition, there were no significant relationships between CBCL ratings and verbal ability, nonverbal ability or overall developmental level in either group. Findings highlight variations in the pattern of psychopathology among preschool children with WS compared to those without WS, which needs to be considered in clinical management and future research.

B - 79 Examining the MMPI-2-RF Profiles of Diagnosed Autistic Adults

Abstract Objective The current study examined the psychopathology and personality trait presentation in Autistic adults utilizing the Minnesota Multiphasic Personality Inventory-2-Restructured Form. We sought to identify patterns in the overall MMPI-2-RF score profiles of adults with autism spectrum disorder as well as to explore group differences between an ASD sample and a non-ASD group. Method Archival data was collected from a private clinic specializing in differential diagnosis in the Midwestern United States. 26 participants in the ASD group (57.7% male; 18–60 years old; 65.4% Caucasian) and 26 participants in the non-ASD group (53.9% male; 19–62 years old; 76.9% Caucasian) were matched using a one-to-one propensity score match with verbal composite score, age, and sex as the variables. The non-ASD group included clients administered the MMPI-2-RF and diagnosed with Major Depressive Disorder and/or Generalized Anxiety Disorder. Results Results showed statistically significant group differences on three validity scales as well as the scales of Ideas of Persecution, Dysfunctional Negative Emotions, Aberrant Experiences, Behavior-Restricting Fears, Juvenile Conduct Problems, Disaffiliativeness, Psychoticism-Revised, and Thought Dysfunction. Conclusion Several statistically significant and clinically relevant group differences were identified such as on scales of Aberrant Experiences and Disaffiliativeness which may be explained by social alienation & maladjustment experienced by autistic adults. Furthermore, differences on validity scales assessing infrequent responses and Uncommon Virtues may reflect rigid thinking. Findings also align with past research showing higher levels of anxiety, depression, and suicidality experienced by Autistic individuals. Overall, we established a pattern of elevated psychopathology and personality trait presentation in autistic adults which may be used to guide treatment interventions.

Impact of Delusions and Hallucinations on Clinical Insight Dimensions in Schizophrenia Spectrum Disorders

Introduction: Insight in psychosis has been conceptualized as a continuous, dynamic, and multidimensional phenomenon. This study aims to determine the impact of delusions and hallucinations in different dimensions of clinical insight in schizophrenia spectrum disorders. Methods: Cross-sectional multicenter study including 516 patients (336 men) diagnosed with schizophrenia spectrum disorders. Based on dichotomized scores of Positive and Negative Syndrome Scale (PANSS) items P1 (delusions) and P3 (hallucinations), patients were assigned to four groups according to current clear presence of delusions (scores 4 or above 4 in PANSS item P1) and/or hallucinations (scores 4 or above 4 in PANNS item P3). Insight was assessed using the three main dimensions of the Scale of Unawareness of Mental Disorder (SUMD). Results: Around 40% of patients showed unawareness of illness; 30% unawareness of the need for treatment; and 45% unawareness of the social consequences of the disorder. Patients with current clear presence of delusions had higher overall lack of awareness, regardless of current clear presence of hallucinations. Similarly, the clear presence of delusions showed a greater predictive value on insight than the presence of hallucinations, although the implication of both in the prediction was modest. Conclusions: Our results confirm that lack of insight is highly prevalent in schizophrenia spectrum disorders, particularly when patients experience delusions. This study adds insight-related data to the growing symptom-based research, where specific types of psychotic experiences such as hallucinations and delusions could form different psychopathological patterns, linking the phenomenology of delusions to a lack of clinical insight.

Sex Differences in Psychopathology Following Potentially Traumatic Experiences

Various psychopathology may follow trauma; however, sex differences in these ranging manifestations of posttraumatic psychopathology remain understudied. To investigate sex-specific incidence of posttraumatic psychopathology. This population-based cohort study of Danish national health registries included a cohort of individuals who experienced a potentially traumatic event (PTE) from 1994 to 2016. Individuals were further categorized by presence of any pretrauma psychopathology. A comparison group of individuals who experienced a nontraumatic stressor (nonsuicide death of a first-degree relative) was examined as a reference cohort. At least 1 of 8 PTEs (eg, physical assault, transportation accident) derived through health registry International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes, with additional qualifiers to improve classification accuracy. Incidence of 9 categories of ICD-10 psychiatric disorders recorded in registries within 5 years of PTEs. The standardized morbidity ratios (SMRs) for psychopathology outcomes were also calculated to compare individuals experiencing PTEs with those experiencing a nontraumatic stressor. This study included 1 398 026 individuals who had been exposed to trauma (475 280 males [34.0%]; 922 750 females [66.0%]). The group of males who had been exposed to trauma were evenly distributed across age, while most females in the trauma-exposed group were aged 16 to 39 years (592 385 [64.2%]). Males and females were equally distributed across income quartiles and predominantly single. Following PTEs, the most common diagnosis was substance use disorders for males (35 160 [7.4%]) and depressive disorders for females (29 255 [3.2%]); incidence proportions for these and other disorders were higher among males and females with any pretrauma psychopathology. Certain PTEs had elevated onset of various psychiatric disorders and some sex differences emerged. Following physical assault, associations were found with schizophrenia or psychotic disorders for males (SMR, 17.5; 95% CI, 15.9-19.3) and adult personality disorders for females (SMR, 16.3; 95% CI, 14.6-18.3). For noninterpersonal PTEs, males had larger SMRs for substance use, schizophrenia or psychotic disorders, and adult personality disorders (SMR, 43.4; 95% CI, 41.9-45.0), and females had larger SMRs for depressive disorders (SMR, 19.0; 95% CI, 18.6-19.4). Sex differences were also observed, particularly when considering pretrauma psychopathology. For example, among interpersonal PTEs, males were most likely to develop substance use disorders after physical assault, whereas females were more likely to develop various disorders, with stronger associations seen for females without pretrauma psychiatric diagnoses. Among noninterpersonal PTEs, exposure to toxic substance showed robust associations with psychopathology, particularly in those without pretrauma psychopathology, with sex-specific differences across psychiatric categories. Mental disorders after trauma were wide-ranging for males and females, and sex differences in patterns of posttraumatic psychopathology were more pronounced when accounting for pretrauma psychopathology. Findings provide new insights for sex-relevant PTEs and their mental health consequences. It also outlines future directions for advancing understanding of a constellation of posttraumatic psychopathology in males and females.

Exploring the psychopathological profile of fibromyalgia: insights from the personality assessment inventory and its association with disease impact.

Fibromyalgia (FM) is a complex rheumatic disorder characterized by chronic nociplastic pain and central sensitization. Psychopathological conditions can influence FM symptoms, which worsen their condition. However, not all patients with FM have psychopathological disorders, indicating a heterogeneous population. To investigate the psychopathological profile and personality disorders in patients with FM and its relationship impact on this disease. An observational and cross-sectional comparative study was conducted with a sample of 90 women, mean age 48.7 years (SD = 8.12), from Hospital del Mar, Barcelona. The Personality Assessment Inventory (PAI) and the Fibromyalgia Impact Questionnaire (FIQ) were used for assessment. FM patients predominantly exhibited psychopathological profiles resembling affective disorders (37.7%) and Cluster C personality disorders (58.8%). The severity of FM's impact was related to affective disorder symptoms, hypervigilance, derealization, somatization, and Cluster B personality disorder (emotional instability). Different rheumatic symptoms correlated with specific psychopathological patterns. Increased somatic symptoms on the FIQ were related to an unstable and dependent personality, while heightened emotional symptoms on the FIQ were associated with avoidance, borderline traits, and passive-aggressive reactions. Recognizing psychopathological aspects is crucial for managing FM. The PAI is a valuable tool for establishing its psychopathological multidimensional profile, which predominantly shows an affective spectrum conditions and comorbid Cluster C personality disorder, exacerbating the disease's impact.

Do latent profiles of self-reported anxiety, depression, and PTSD map onto clinician ratings? An examination with intimate partner violence survivors

ObjectiveStudies exploring latent profiles of mental health in trauma survivors have largely relied on self-report, making it unclear whether these patterns correspond with clinician-assessed psychopathology. The purpose of the current study was to examine latent profiles of self-reported PTSD, depression, and anxiety in a sample of 387 women who had experienced intimate partner violence (IPV) and investigate whether profiles mapped onto clinician-rated measures of the same outcomes. MethodParticipants completed a series of semi-structured interviews and self-report measures assessing PTSD, depression, and anxiety. ResultsLatent profile analyses revealed a 3-profile solution characterized by Low (22.48 %), Moderate (37.98 %), and High (39.53 %) self-reported symptomology. Clinician ratings were significant predictors of membership in the low vs. moderate vs. high symptomology profiles. However, normalized means showed discrepancies between self-report and clinician assessment regarding which issue was rated most severe. ConclusionsResults suggest that while latent modeling approaches relying on self-report may adequately approximate common underlying patterns of psychopathology, they have limitations in identifying which disorders are most salient for clinical intervention.

Cumulative comorbidity between neurodevelopmental, internalising, and externalising disorders in childhood: a network approach

Cumulative comorbidity of mental disorders is common, but the extent and patterns of comorbid psychopathology in childhood are not well established. The current study aimed to elucidate the emergent patterns of cumulative mental disorder comorbidity in children using network analysis of diagnoses recorded between birth and age 12 years. Participants were 90,269 children (mean age 12.7 years; 51.8% male) within the New South Wales Child Development Study (NSW-CDS)—a longitudinal record-linkage cohort study of Australian children born in NSW between 2002 and 2005. Binary indicators for eight types of mental disorder were derived from administrative health records. Patterns of conditional association between mental disorders were assessed utilising network analysis. Of 90,269 children, 2268 (2.5%) had at least one mental disorder by age 12 years; of the 2268 children who had at least one mental disorder by age 12 years, 461 (20.3%) were diagnosed with two or more different disorders out of the eight disorder types included in analyses. All disorders were either directly or indirectly interconnected, with childhood affective and emotional disorders and developmental disorders being most central to the network overall. Mental disorder nodes aggregated weakly (modularity = 0.185) into two communities, representative of internalising and externalising disorders, and neurodevelopmental and sleep disorders. Considerable sex differences in the structure of the mental disorder comorbidity networks were also observed. Developmental and childhood affective and emotional disorders appear to be key to mental disorder comorbidity in childhood, potentially reflecting that these disorders share symptoms in common with many other disorders.

Characterising subgroups of people with severe COVID anxiety by latent profile analysis

BackgroundPeople with severe COVID anxiety have had experiences of the COVID-19 pandemic which are overwhelming, and have led to patterns of behaviours that add little protective benefit but are at the expense of other priorities in life. It appears to be a complex social and psychological phenomenon, influenced by demographic and social factors. Identifying subgroups of people with severe COVID anxiety would better place clinicians to assess and support this distress where indicated. MethodsMeasurement tools assessing depression, generalised and health anxiety, obsessive-compulsive symptoms, personality difficulty and alcohol use from 284 people living in United Kingdom with severe COVID anxiety were explored with latent profile analysis. Further analyses examined the associations of identified clusters with demographic and social factors and daily functioning, quality of life and protective behaviours. ResultsA model with 4 classes provided the best fit. Distinct patterns of psychopathology emerged which were variably associated with demographic factors and COVID behaviours. LimitationsGiven the complex aetiology of COVID anxiety a number of factors which might better cluster subgroups are likely to have gone uncollected. Moreover, using data collected at a single time-point limits these results' ability to conclude whether observed relationships were the product of the pandemic or longstanding. ConclusionsPeople living with severe COVID anxiety are a heterogenous group. This analysis adds to evidence that certain health behaviours and demographic factors are inextricably linked to poor mental health in people with COVID anxiety, and that targeting health behaviours with specific intervention might be beneficial.

The best of both worlds? General principles of psychopathology in personalized assessment.

A complex systems approach to psychopathology proposes that general principles lie in the dynamic patterns of psychopathology, which are not restricted to specific psychological processes like symptoms or affect. Hence, it must be possible to find general change profiles in time series data of fully personalized questionnaires. In the current study, we examined general change profiles in personalized self-ratings and related these to four measures of treatment outcome (International Symptom Rating, 21-item Depression Anxiety and Stress Scale, daily symptom severity, and self-reflective capacity). We analyzed data of 404 patients with mood and/or anxiety disorders who completed daily self-ratings on personalized questionnaires during psychotherapy. For each patient, a principal component analysis was applied to the multivariate time series in order to retrieve an univariate person-specific time series. Then, using classification and regression methods, we examined these time series for the presence of general change profiles. The change profile classification yielded the following distribution of patients: no-shift (n = 55; 14%), gradual-change (n = 52; 13%), one-shift (n = 233; 58%), reversed-shift (n = 39; 10%) and multiple-shifts (n = 25; 6%). The multiple-shift group had better treatment outcome than the no-shift group on all outcome measures. The one-shift and gradual-change groups had better treatment outcome than the no-shift group on two and three outcome measures, respectively. Overall, this study illustrates that person-specific (idiographic) and general (nomothetic) aspects of psychopathology can be integrated in a complex systems approach to psychopathology, which may combine "the best of both worlds." (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Stress system concordance as a predictor of longitudinal patterns of resilience in adolescence.

Resilience promotes positive adaptation to challenges and may facilitate recovery for adolescents experiencing psychopathology. This work examined concordance across the experience, expression, and physiological response to stress as a protective factor that may predict longitudinal patterns of psychopathology and well-being that mark resilience. Adolescents aged 14-17 at recruitment (oversampled for histories of non-suicidal self-injury; NSSI) were part of a three-wave (T1, T2, T3) longitudinal study. Multi-trajectory modeling produced four distinct profiles of stress experience, expression, and physiology at T1 (High-High-High, Low-Low-Low, High-Low-Moderate, and High-High-Low, respectively). Linear mixed-effect regressions modeled whether the profiles predicted depressive symptoms, suicide ideation, NSSI engagement, positive affect, satisfaction with life, and self-worth over time. Broadly, concordant stress response profiles (Low-Low-Low, High-High-High) were associated with resilient-like patterns of psychopathology and well-being over time. Adolescents with a concordant High-High-High stress response profile showed a trend of greater reduction in depressive symptoms (B = 0.71, p = 0.052), as well as increased global self-worth (B = -0.88, p = 0.055), from T2 to T3 compared to the discordant High-High-Low profile. Concordance across multi-level stress responses may be protective and promote future resilience, whereas blunted physiological responses in the presence of high perceived and expressed stress may indicate poorer outcomes over time.

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.

An experimental investigation of spontaneous emotion regulation variability, negative affect, and posttraumatic stress disorder among traumatized refugees.

Emotion regulation (ER) may be an important psychological mechanism underpinning the development, and management, of posttraumatic stress disorder (PTSD) in refugees. Despite this, little is known about the ER strategies that refugees spontaneously deploy under stress, nor how effective different approaches may be at reducing distress. This was the first study to identify individual differences in patterns of spontaneous ER among refugees and explore their unique associations with negative affect and PTSD. Spontaneous reappraisal and suppression use was measured among 82 refugees following a 5-min exposure to trauma-salient images. Negative affect was indexed before and after the exposure task. Latent profile analysis (LPA) was conducted to identify distinct profiles of participants based on differing levels of ER use. LPA revealed two distinct profiles: a high ER variability profile (37%; high suppression/moderate-high reappraisal) and a low ER variability profile (63%; low suppression/moderate reappraisal). The low ER variability profile was associated with increased negative affect during the experimental paradigm, greater PTSD avoidance symptoms, and greater likelihood of insecure visa status compared with the high ER variability profile. Our findings suggest that a more variable ER approach in response to trauma-salient stressors results in lower distress and is associated with less severe PTSD symptoms. Better understanding the links between patterns of ER strategy use and psychopathology has important implications for the development of effective treatments for refugees. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Pattern of psychopathology and neurological soft signs among first episode psychotic patients in Neuropsychiatric Hospital, Sokoto

Pattern of psychopathology and neurological soft signs among first episode psychotic patients in Neuropsychiatric Hospital, Sokoto

Mapping established psychopathology scales onto the Hierarchical Taxonomy of Psychopathology (HiTOP).

The Hierarchical Taxonomy of Psychopathology (HiTOP) organizes phenotypes of mental disorder based on empirical covariation, offering a comprehensive organizational framework from narrow symptoms to broader patterns of psychopathology. We argue that established self-report measures of psychopathology from the pre-HiTOP era should be systematically integrated into HiTOP to foster cumulative research and further the understanding of psychopathology structure. Hence, in this study, we mapped 92 established psychopathology (sub)scales onto the current HiTOP working model using data from an extensive battery of self-report assessments that was completed by community participants and outpatients (N = 909). Content validity ratings of the item pool were used to select indicators for a bifactor-(S-1) model of the p factor and five HiTOP spectra (i.e., internalizing, thought disorder, detachment, disinhibited externalizing, and antagonistic externalizing). The content-based HiTOP scales were validated against personality disorder diagnoses as assessed by standardized interviews. We then located established scales within the taxonomy by estimating the extent to which scales reflected higher-level HiTOP dimensions. The analyses shed light on the location of established psychopathology scales in HiTOP, identifying pure markers and blends of HiTOP spectra, as well as pure markers of the p factor (i.e., scales assessing mentalizing impairment and suspiciousness/epistemic mistrust).

Association between personality profiles and symptomatology patterns based on TCI and MMPI-2-RF in a transdiagnostic psychiatric sample: A person-centered approach

BackgroundThe temperament and character dimensions of personality appear to be networking structures that interact nonlinearly. Previous studies have attempted to classify temperament and character subtypes using a person-centered approach but have been unable to explore the relationship between the combination of temperament and character and psychopathology patterns in a transdiagnostic sample. The purpose of this study was to examine how symptomatology patterns differ according to individuals' personality profiles, employing a psychobiological model in a transdiagnostic psychiatric sample. MethodsParticipants were 1881 patients who visited the psychiatry department of a major medical hospital in Seoul, Korea, and completed both the Temperament Character Inventory (TCI) and the Minnesota Multiphasic Personality Inventory-2-Restructed Form (MMPI-2-RF) as part of their psychological evaluation. We performed two separate latent profile analyses using four temperament and four character indicators of the TCI to identify personality profiles and nine restructured clinical scales of the MMPI-2-RF to identify symptom patterns. ResultsFive personality classes emerged: “vulnerable-maladaptive,” “stable-adaptive,” “average,” “inhibited-neurotic,” and “impulsive-irrational.” Moreover, six symptom classes emerged: “non-distressed,” “depressed,” “emotionally-distressed,” “average,” “dysfunctional thoughts,” and “confused.” The personality profiles comprising a combination of rigid temperament and immature character were related to patterns of more severe subjective pain and symptoms. However, profiles with less rigid temperament and less immature character exhibited more diverse symptom patterns. ConclusionsThis study examined the relationship between personality profiles and symptomatology patterns, suggesting that understanding patients' personality profiles may be helpful in predicting symptom manifestation and establishing treatment plans.

Theory of Mind in migraine and medication-overuse headache: A cross-sectional study.

BackgroundTheory of Mind (ToM) is the ability to predict and anticipate others' behaviors through the mental state attribution process. This study aims to investigate the ToM in patients with medication-overuse headache (MOH) and episodic migraine (EM) and to compare it with healthy controls (HC).MethodsThis study enrolled patients with MOH, patients with EM, and HC. ToM was assessed through the Theory of Mind Assessment Scale (ThOMAS), which includes four subscales: Scale A, I-Me, Scale B, Other-Self, Scale C, I-Other, and Scale D, Other-Me, through the Reading the Mind in the Eyes test (RMET), which measures complex emotion recognition, and through the Toronto Alexithymia Scale (TAS-20), which measures alexithymia. Concomitant psychiatric disturbances were evaluated through the Hamilton Anxiety Rating Scale, the Hamilton Depression Rating Scale, and the Dissociative Experiences Scale-II.ResultsThe study involved 21 patients with EM, 22 patients with MOH, and 18 HC. In all the four subscales of the ThOMAS, there was a significant difference between HC, EM, and MOH patients: Scale A (p = 0.009), Scale B (p = 0.004), Scale C (p = 0.039), and Scale D (p = 0.008). In the RMET, MOH patients had worse performances than EM patients and HC (p = 0.039). MOH group exhibited higher levels of alexithymia when compared to the HC (p = 0.033) and higher levels of anxiety than HC (p = 0.001).ConclusionMOH patients showed a subtle psychopathological pattern characterized by impaired social adaptation.

The counterphobic matrix of cuckolding and troilism: The psychopathological origin of sexual sharing paraphilias

Background and aims: Based on the concept of “cuckolding” and “troilism”, it was hypothesized that underlying this paraphilia is a counterphobic attitude that positively reinforced produces the establishment of behavioural addiction. The purpose of this study is to confirm this hypothesis. Materials and methods: Clinical interview, based on narrative-anamnestic and documentary evidence and the basis of the Perrotta Human Emotions Model (PHEM) concerning their emotional and perceptual-reactive experience, and administration of the battery of psychometric tests published in international scientific journals by the author of this work: 1) Perrotta Integrative Clinical Interviews (PICI-2), to investigate functional and dysfunctional personality traits; 2) Perrotta Individual Sexual Matrix Questionnaire (PSM-Q), to investigate the individual sexual matrix; 3) Perrotta Affective Dependence Questionnaire (PAD-Q), to investigate the profiles of affective and relational dependence; 4) Perrotta Human Defense Mechanisms Questionnaire (PDM-Q), to investigate the defence mechanisms of the Ego. Results: In a population sample of 108 subjects (98 males and 10 females), the totality was found to exhibit at least 5 dysfunctional personality traits of the manic, borderline, narcissistic covert, masochistic, and dependent types, with secondary traits of the neurotic, bipolar, histrionic, and paranoid types. Always the totality of the sample shows the marked dysfunctionality of a sexual nature (especially in relational profiles) and the activation of defense mechanisms typical of psychopathological processes; in particular, at the PSM-Q the totality of the sample stated that the basis of their paraphilia is the establishment of a traumatic event of an affective, sentimental or sexual nature related to adolescence and adulthood that has generated in the person distrust in the relationship. Conclusions: At the origin of cuckolding and troilism, it is reasonable to deduce that there is a traumatic event of an affective, sentimental or sexual nature, occurring mainly in youth or early adulthood, which has negatively impacted the subject’s perception of the relational sphere. Such an event, capable of generating negative feelings of distressing origin, was then reworked and sublimated by the subject using a counterphobic attitude (the fear of being betrayed is replaced by the idea that granting the partner sexual freedom, after sharing, is sufficient to avoid the reoccurrence of the primary traumatizing event); the repetition of avoidant experiences of the danger of the primary phobia (betrayal) then generates in the subject the belief in the functioning of the mechanism, which therefore is repeated according to a cognitive-behavioural pattern of positive reinforcement, capable of establishing over time the behavioural dependence that underlies the paraphiliac disorder. Such a fear-prone psychopathological pattern, moreover, could be the same one that favours polygamous relational choice (at the expense of monogamous relational choice), net of environmental and social conditioning (e.g., Islamic contexts) that might naturally favour such choice. This counterphobic mechanism reinforced by positive reinforcement may underlie the onset of paraphilias and deserves further investigation.

Clinical and Psychopathological Features of Borderline Personality Disorder in Adolescence

Background: Borderline personality disorder (BPD) in adolescence has a high prevalence and a signicant polymorphism of the psychopathological structure which creates considerable difculties to conduct differential diagnostics and assessing comorbidity with other disorders. To date, special research has not been carried out to explore BPD in adolescents that highlights the relevance of the present study. Objectives: identication of the borderline personality disorder (BPD) clinical features, leading psychopathological syndromes and differential diagnostics criteria in adolescence. Patients and methods: 71 young patients (16–25 years old) with borderline personality disorder were examined by clinical psychopathological and psychometrical methods (PBQ-BPD, TAS, BIS-11). This study includes 28 women (39%) and 43 men (61%) who were examined as inpatient or outpatient in the Mental Health Research Centre in 2019–2021. Results: key symptoms complexes were identied and presented by affective instability, dissociative state with identity disturbance and addictive behavior. Based on the analysis of the clinical picture and the discovered patterns, three types of BPD in adolescents were identied: with an “affective storm” (type I); with a dominance of impulsive and addictive features such as “adrenaline addiction” (type II); with a dominance of “cognitive dissociation” and self-identity disorder (type III). Distinctive features of the clinical pictures of affective and behavioral disorders for each type of BPD in adolescence were found and psychopathological signs and their impact on further dynamics were determined, taking into account an auto-aggressive behavior and a high level of suicidality. Conclusions: the found psychopathological patterns of BPD formation in adolescence help to assess the disorders of personality and social functioning and to predict the risk of auto- aggression and suicidal activity for the diagnostic and prognostic assessment of borderline personality disorder in adolescence.

Henri Legrand du Saulle's 1873 book: "La Folie Héréditaire" (hereditary madness).

In his 1873 monograph "La Folie Héréditaire," the French Alienist Legrand du Saulle (LdS) first outlined his understanding of hereditary factors in insanity and then described in detail the theory of Hereditary Madness (HM) that emerged from the writings of his mentor Bénédict Morel. This form of insanity was thought to arise only in families with neuropathic traits. Degeneration theory, proposed by Morel, postulated a within-family "evolution" of increasingly severe psychopathology, typically beginning with mild neuropathic traits and associated idiosyncrasies, and progressing over generations to hereditary madness, mental retardation, epilepsy, and eventual sterility. LdS took strong positions in favor of (i) the heterogeneous transmission of mental illness within families, (ii) consideration of both direct and collateral relatives, and (iii) the inheritance of a predisposition to illness, not the illness itself. He carefully examined the wide range of psychopathology and physical stigmata that occurred in what he called "inheritors" of the neuropathic trait. A unique feature of his work was the use of familial patterns of psychopathology to define a psychiatric disorder. While the theory of HM did not gain wide popularity outside of 19th century France, the concept of neuropathic traits was used extensively in early 20th century psychiatric genetics.

Depressive and Anxious Temperaments as Predictors of Late Onset Bipolar Disorder? Preliminary Results of a "Real World" Exploratory Study.

IntroductionBipolar disorder (BD) onset typically occurs between 15 and 30 years, being diagnosed under the age of 50 in 90% of cases, named “non-late onset BD” (non-LOBD). However, clinical observation of late-onset BD (LOBD) raised some concern regarding a differential psychopathological pattern, outcomes and treatment, including a specific affective temperament vulnerability. Therefore, an exploratory study in the “real world” was carried out by investigating psychopathological and temperamental features of a psychogeriatric cohort of LOBD and non-LOBD subjects.MethodsA total of 180 patients affected with BD-I, BD-II, and Cyclothymic Disorder were screened in a Mood Disorder Outpatient Service, during the timeframe January 2019-August 2021. Out of 78 enrolled outpatients, 66 (33 non-LOBD, 33 LOBD) were recruited, by the retrospective collection of sociodemographic, cognitive, psychopathological and clinical assessment, including the short-version of the Temperament Evaluation of Memphis, Pisa, and San Diego (TEMPS-M).ResultsLOBD is significantly associated with higher rates of BD-II diagnosis (χ2 = 27.692, p < 0.001), depressive episodes (p = 0.025), mixed states (p = 0.009), predominant depressive and anxious affective temperaments (p < 0.001). Non-LOBD is significantly associated with higher endocrinological (χ2 = 6.988, p = 0.008) and metabolic comorbidity (χ2 = 5.987, p = 0.014), a diagnosis of BD-I, manic episodes, and predominant hyperthymic affective temperaments (p = 0.001). GDS (p < 0.001) and MSRS (p = 0.005) scores were significantly higher in LOBD.ConclusionFurther longitudinal studies with larger sample sizes and a control group are needed to determine whether LOBD may represent a distinct psychopathological entity from non-LOBD and evaluate differences (if any) in terms of prognosis and treatment between non-LOBD and LOBD.