Personality Disorder Research Articles

Alexithymia and Personality Pathology.

Alexithymia is an important transdiagnostic risk factor for many psychopathologies. To explore its relevance for personality disorders, we examined the association between alexithymia and maladaptive personality traits, as conceptualized within the DSM-5-TR Alternative Model for Personality Disorders (i.e., negative affect, detachment, antagonism, disinhibition, psychoticism). Participants (N = 651) completed a battery of psychometric questionnaires. Regressions revealed that alexithymia facets accounted for a significant 15% of the variance in negative affect, 22% in detachment, 11% in antagonism, 18% in disinhibition, and 25% in psychoticism. Latent profile analysis showed that profiles with more severe personality pathology were generally characterized by more severe levels of alexithymia. Overall, our data highlight that alexithymia is important in understanding personality dysfunction. All facets of alexithymia, across both positive and negative emotions, are linked to each maladaptive personality trait. The assessment and targeting of alexithymia may therefore be of high relevance for the treatment of personality pathology.

Compulsive buying disorder: Conceptualization based on addictive, impulsive, and obsessive-compulsive features and comorbidity

BackgroundThis study sought to examine the conceptualization of compulsive buying disorder in a sample of adults drawn from the community and its associated mental health correlates. MethodsAn online survey of “Personality, Mental Health, and Well-Being” was distributed to 300 adults aged 18–75 years. The survey measured a range of behaviors, such as buying behavior, alcohol and drug use, impulse control disorders, and dimensional constructs of impulsivity and obsessive-compulsiveness. ResultsA total of 294 participants (54.7% female) completed the survey and were included in the analysis. The overall frequency of probable compulsive buying disorder was 5.4% (n = 16). Compared to adults without compulsive buying disorder, those with probable compulsive buying disorder were significantly less likely to identify as heterosexual and were significantly more likely to endorse attention-deficit hyperactivity disorder, drug use problems, symptoms of borderline personality disorder, binge eating disorder, and had higher levels of compulsivity plus impulsivity. ConclusionCompulsive buying disorder appears to be fairly common in adults and appears to have symptom or diagnostic overlap with obsessive-compulsive problems, addictive disorders, and impulse control disorders. Findings highlight the need for careful clinical screening to identify often overlooked comorbidities and treat them on an individual patient basis, as well as the need to conduct high-quality clinical trials for compulsive buying disorder itself and to explore its presentation longitudinally at large scale.

A Qualitative Exploration of Help-Seeking and Experiences of Diagnosis Among Men With Borderline Personality Disorder.

Borderline personality disorder (BPD) is frequently understood as a diagnosis applicable mainly to women, despite population studies suggesting similar prevalence between men and women. The scarce available information suggests that compared to women, men may face additional gender-related barriers to diagnosis and treatment when attempting to engage with support and treatment for BPD-related difficulties. The current study presents a qualitative in-depth exploration of the help-seeking and diagnosis experiences of four men with BPD. Using Interpretive Phenomenological Analysis, three themes were generated: (1) "There's just no help out there": barriers to treatment; (2) self-understanding and insight; and (3) the importance of emotional and psychological connection with health care professionals and close family and friends. Having a greater understanding of male-specific experiences of BPD could improve the helpseeking journeys of men with BPD through early identification, accurate and timely diagnosis, to relevant and effective treatment and support.

“I get the referral because nobody else wants to work with this person”: A critical realist analysis of social workers providing care to people living with borderline personality disorder

Borderline personality disorder (BPD) is a mental health condition characterized by unstable relationships, self-image, and emotions, as well as impulsive behaviors and high rates of morbidity and mortality. Provider-based stigmatization of individuals with BPD is associated with poor health outcomes and increased mortality risk. However, little is known about social workers' experiences in providing care to people living with BPD (PLBPD). This study explored social workers' perspectives on the impact of stigma on care for PLBPD. Between April 2020 and January 2021, qualitative semi-structured interviews were conducted with 41 social workers practicing across the continuum of care (e.g., community services and hospitals) in Ontario, Canada. Data were analyzed using Critical Realist Analysis. Four primary themes emerged: (1) stigmatization of PLBPD due to the complexity of their needs (e.g., avoidance, blame, name-calling by providers); (2) lack of BPD-specific training and education in social work curricula; (3) observed stigmatization of PLBPD by social workers and other professionals (e.g., psychologists and physicians); and (4) suggestions for improving care experiences for PLBPD. Results suggest that provider-based stigma remains a significant quality of care issue affecting PLBPD. Further research is needed to understand the scope of these issues among diverse PLBPD populations, within social work practice, and across interprofessional care settings.

Contextual-compassion training for borderline personality disorder with long lasting symptoms: a randomized clinical trial

Long-term follow-up studies have shown that the symptoms of borderline personality disorder (BPD) tend to remit over time. However, many patients present long lasting symptoms (LLS), including low mood, emptiness, and persistent impairment in psychosocial adjustment. Given the high rate of LLS in BPD patients, new treatment strategies are needed. We conducted a randomized clinical trial (RCT) to evaluate the efficacy of a novel intervention that combines self-compassion and contextual-based skills for patients with persistent symptoms. Sixty BPD individuals with LLS who had received dialectical behavior therapy skills training (DBT-ST) in the previous six months were recruited and randomized to receive the experimental intervention or treatment as usual (TAU) for 12 weeks. All participants were evaluated pre- and post-intervention and at 3-months follow-up. The primary outcome measure was self-reported well-being. Other clinical variables were also evaluated, including depressive symptoms, BPD symptoms, functionality, self-compassion, and self-criticism. Participants in the experimental arm showed a significant increase in indicators of well-being (e.g., happiness and quality of life) and a significant decrease in depressive symptoms. These results were sustained—and even continued to improve—at the three-month follow-up. No significant changes were observed in BPD severity, self-criticism, or self-compassion. More RCTs are needed to test the efficacy of new interventions targeting this population with persistent symptoms, not only to reduce symptoms but also to promote well-being and personal recovery.

Effect of metacognitive interpersonal therapy on brain structural connectivity in borderline personality disorder: Results from the CLIMAMITHE randomized clinical trial

BackgroundRecently, we showed that Metacognitive Interpersonal Therapy (MIT) is effective in improving clinical symptoms in borderline personality disorder (BPD). Here, we investigated whether the effect of MIT on clinical features is associated to microstructural changes in brain circuits supporting core BPD symptoms. MethodsForty-seven BPD were randomized to MIT or structured clinical management, and underwent a clinical assessment and diffusion-weighted imaging before and after the intervention. Fractional anisotropy (FA), mean, radial, and axial diffusivities maps were computed using FSL toolbox. Microstructural changes were assessed (i) voxel-wise, with tract based spatial statistics (TBSS) and (ii) ROI-wise, in the triple network system (default mode, salience, and executive control networks). The effect of MIT on brain microstructure was assessed with paired tests using FSL PALM (voxel-wise), Linear Mixed-Effect Models or Generalized Linear Mixed Models (ROI-wise). Associations between microstructural and clinical changes were explored with linear regression (voxel-wise) and correlations (ROI-wise). ResultsThe voxel-wise analysis showed that MIT was associated with increased FA in the bilateral thalamic radiation and left associative tracts (p < .050, family-wise error rate corrected). At network system level, MIT increased FA and both interventions reduced AD in the executive control network (p = .05, uncorrected). LimitationsThe DTI metrics can't clarify the nature of axonal changes. ConclusionsOur results indicate that MIT modulates brain structural connectivity in circuits related to associative and executive control functions. These microstructural changes may denote activity-dependent plasticity, possibly representing a neurobiological mechanism underlying MIT effects. Trial registrationClinicalTrials.govNCT02370316 (https://clinicaltrials.gov/study/NCT02370316).

Substance use by homeless clinic attenders in Sydney.

Describe patterns of substance use and comorbid conditions among clinic attenders in homeless shelters in Sydney. Retrospective cohort study of 2498 people who attended a psychiatric clinic at one of three homeless hostels between February 2008 and May 2020. Multivariable logistic regression was used to identify factors associated with self-reported substance use, psychiatric diagnosis and measures of social function. A total of 2041 of the 2498 (81.7%) reported the harmful use of at least one substance, with alcohol (61.8%), cannabis (50.9%) and stimulant drugs (34.9%) the three most common. Those reporting the regular use of two or more substances (1466, 58.7%) were more likely to have a history of early life and adult trauma, a diagnosis of personality disorder, a criminal conviction, receive the Disability Support Pension, be chronically homeless and sleep in the open. The study found a high rate of polysubstance use among homeless clinic attenders in Sydney, and an increase in the prevalence of substance use compared to previous studies. Substance use is both a cause and a consequence of homelessness, and services to address substance use have to be part of any program to reduce homelessness and sleeping in the open.

The ‘Predelinquent’ and the Community: Psychiatric Surveillance and Predictive Policing in Interwar Berkeley

Summary Through the 1920s and 1930s, the Berkeley Police Department, renowned as a centre of scientific training and investigation, developed new programmes of predictive policing targeting ‘predelinquent’ youth. Led by Chief August Vollmer, schools, charities, social services and families throughout Berkeley were coordinated in the ongoing detection of early signs of developing psychoses and personality disorders believed to lead to future criminality. Implying a malleable trajectory of habit formation which might be perverted or corrected, predelinquency warranted psychiatric surveillance across the community to assist Berkeley’s police in identifying, mapping and correcting at-risk children. This paper examines how, through the psychiatric category of predelinquency, law enforcement enrolled the community in networks of pre-emptive surveillance with new responsibilities for reporting and correction. In turn, I examine how predelinquency shifted to accommodate various local priorities and anxieties, whereby predictive policing’s conceptions of potential threat or improvability reproduced the boundaries of the normative American community.

Technology as a Threat to Local Values and Culture Among Students: A Case Study in Sabah, Malaysia

The technological and cultural revolution, driven by media manipulation and intensified by social media's cross-border communication, threatens local values and culture (LVC) in any society. In Malaysia, emerging lifestyles significantly challenge LVC, especially among students. Limited research has examined how educators in Sabah perceive the impact of technology on student behaviours related to LVC, leaving a gap in understanding the region's cultural and educational challenges. This study explores educators’ perspectives regarding technological influences in Sabah. Utilising a qualitative case study, nine educators from different educational levels were interviewed individually to explore students’ behaviours in reflecting the LVC in Sabah, Malaysia, particularly in Kota Kinabalu and Tawau. The thematic analysis resulted in four themes, i.e., (a) personality development, (b) technological weakness, (c) emotional intelligence, and (d) suggestions to address student development and digital literacy. The study presented an argument with the previous findings concerning personality disorders in defending LVC due to technological influences. The study suggests the importance of defending LVC in shaping a civilised society. It also contributes new findings on the students' abilities to overcome the challenges of technological influences.

Forensic Psychiatry Analysis and Methods for Assessing The Mental Health of A Serial Killer.

Psychosis is a mental illness that causes an alteration in the notion of reality, where a world of its own is formed in the mind of the psychotic, in other words, he lives in a delirium and suffers hallucinations, hearing voices and having bizarre visions. Objectives: To carry out a literature review on Forensic Psychiatry and how to assess the mental health of a serial killer. Method: The methodology used was a literature review. The research was carried out by means of an electronic search for scientific articles published on the Scielo (Scientific Electronic Library Online) and Lilacs (Latin American Health Sciences Literature) and Pubmed websites. The health terminologies consulted in the Health Sciences descriptors (DeCS/BIREME) were used; regarding Forensic Psychiatry and how to assess the mental health disorder of a serial killer.The inclusion criteria were: original article, published in Portuguese and English, freely accessible, in full, on the subject, in electronic format and published in the last years (2010 to 2024), totaling 26 articles. Results and Discussion: While antisocial personality disorder is a medical diagnosis, the term “psychopathy”, which belongs to the psychiatric-forensic sphere, can be understood as a “legal diagnosis”. There is still no effective treatment for so-called “serial killers”. Conclusion: Personality disorders, especially the antisocial type, still represent a real challenge for forensic psychiatry today. The most appropriate and fair place for its sufferers, as well as homogeneous treatment recommendations, are still unanswered questions.

CHILDHOOD SEXUAL ABUSE IMPACT ON ADULTHOOD

Introduction – Child sexual abuse (CSA) occurs when a kid or younger person is forced or persuaded to engage in sexual activity, whether the child is conscious of what is taking place. According to global databases, in one-third of countries in the world, at least 5% of young women reported experiences of sexual abuse in childhood. Mental health issues, behavioral manifestations, and interpersonal outcomes are a few impacts of CSA. This study aims to discuss the CSA's impact on adulthood. Methods – The researcher used a total of 13 works of literature, articles, and journals that discuss CSA and its correlation with some mental health issues impact on an adult. Results – Adults with a history of CSA are more likely to suffer from early onset depression, borderline personality disorder, and suicidal tendencies than someone without a history, that is why emotional support seems very important to the CSA survivors. Discuss – As children are sexually abused, it may lead to a variety of difficulties with relationships in general, as well as a host of poor intimate relationship consequences such as adult sexual assault, intimate partner violence, and reduced happiness in romantic relationships. Conclusion – Childhood sexual abuse is still a major problem among children and has several psychological impacts on adulthood, and emotional support is one of the great therapies. Keywords: childhood, sexual, abuse.

Disentangling the shared and unique aspects of clinical and subclinical socially aversive traits relevant for interpersonal personality dysfunction.

Most socially and/or ethically aversive traits from clinical and broad personality research overlap to a large degree. For the latter, however, the association with interpersonal personality dysfunction (IPD) is understudied. Moreover, it is also unclear to what extent the associations of aversive traits with IPD are due to their shared versus unique aspects. We investigate these questions based on a theoretical framework that comprehensively describes the shared variance of all aversive traits. To this end, we concurrently measured 20 aversive traits from clinical and broad personality research together with their common core. Results from five studies (four of them preregistered, total N = 4,847) revealed that all aversive traits are associated with IPD and that most do so (only) due to their common core. Only three traits offered additional aspects beyond the common core relevant for IPD. The results inform debates about whether to include more traits in the Alternative Model for Personality Disorders. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Impact of Psychological Abuse, Physical Abuse, Sexual Abuse, and Neglect During Childhood on Criminal Behavior among Prisoners at Forensic Mental Health Department

Introduction: Childhood maltreatment, including physical, emotional, sexual abuse, and neglect, has been consistently linked to a higher likelihood of aggressive and criminal behaviour in adulthood. This phenomenon, often referred to as the "cycle of violence," perpetuates across generations. Furthermore, victimization during childhood can lead to a broad range of mental health problems, including personality disorders, psychosis, schizophrenia, and substance abuse. These issues are particularly prevalent among individuals within the forensic mental health system. Objectives: The study aims to evaluate the impact of psychological abuse, physical abuse, sexual abuse, and neglect during childhood on criminal behaviour among prisoners at forensic mental health department. Methods: A cross-sectional descriptive study was conducted to determine the impact of child abuse on criminal behaviour among prisoners in the Forensic Medicine Department. The study was during the period from December 19, 2022 to 15th of July 2024. The research has been carried out at Baghdad City's Al-Rashad Training Hospital. non-probability purposive sample procedures, this study sampling method relied on our judgment when identifying and selecting prisoners in the forensic medicine department, after their consent, who could provide the best information to achieve the objectives of the study. We choose purposive sampling because we want to focus in depth on relatively small samples (150) to get the most accurate results. a purposive sample of (110) prisoners was selected from Al-Rashad Training Hospital. Results: The findings indicate that prisoners having moderate to high level of psychological abuse during childhood among items. Prisoners having moderate to high level of physical abuse during childhood among items. The findings indicate that prisoners having moderate to high level of sexual abuse during childhood among items. The prisoners having moderate to high level of neglect during childhood among items. The prisoners have high level of criminal behaviour. There are significant relationships between (psychological, physical, sexual abuse) during childhood and criminal behaviour. Conclusions: Prisoners experience a moderate to high level of psychological abuse, physical abuse, and neglect during childhood, and the prisoners also experience a moderate to high level of sexual abuse during childhood.

The P300 and hierarchical dimensions of psychopathology.

The Hierarchical Taxonomy of Psychopathology (HiTOP) framework offers the potential to better understand how neurobiological mechanisms relate to psychopathology. The P300 is an event-related potential component that indexes attention, stimulus evaluation, and categorization. A blunted P300 has been associated with psychiatric disorders across externalizing, internalizing, and thought disorder domains. However, there has been little research investigating whether the P300 is related to higher-order dimensions of psychopathology. In a sample of 225 adults aged 18-35 years (Mage = 23.09, SD = 3.83, 82.2% female) who were oversampled for psychopathology, the present study examined the associations between the P300 and both psychopathology spectra and a general factor. Participants completed multiple experimental tasks, while electroencephalography was recorded to measure the P300 elicited by auditory, tactile, and visual stimuli. Participants also completed the self-report Comprehensive Assessment of Traits Relevant to Personality Disorder to assess pathological personality dimensions. We used structural equation modeling to examine the relationship between a latent P300 factor and both psychopathology spectra (negative emotionality, detachment, psychoticism, disinhibition, and antagonism) and a general factor. The results indicated that the P300 was inversely related to the general factor. Further analyses revealed no relationships between the P300 and any individual spectrum when accounting for the general factor. Overall, the present study indicates that the P300 is associated with the general factor of psychopathology, which might explain its association with multiple categorical disorders. The study also demonstrates the potential importance of neuroscience-informed dimensional systems to understand clinical phenomena. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Psychological Impact of Childhood Trauma on Adolescents: A Scoping Review

Violence experienced in childhood will lead to a period of crisis when a person is in adolescence. The crisis period that arises is unique to adolescence. Some adolescents become increasingly experiencing crises or problems when in childhood they experience an unpleasant event or even trauma. Traumatic experiences in childhood will have their own impact on adolescents. Objektive: This study aims to get a clear picture of the psychological impact of childhood trauma on adolescents. Methods: Researchers use the scoping review method. The literature search was conducted using the search keywords "adolescents" AND "psychological" AND "childhood" AND "trauma". The databases used were Sciencedirect, Scopus, and Pubmed. Inclusion criteria were articles reviewed from publications within the last 5 years (2019-2023), articles that were in English, quantitative and/or qualitative research with a study population of former adolescents who experienced childhood trauma, and the full article was accessible. Stepwise screening was conducted and documented according to the PRISMA flowchart. Results: Based on identification, there were 463 articles from search engines from sciencedirect, scopus, and pubmed. The final results obtained were 6 articles that fit the criteria after going through the selection process. Childhood trauma has psychological effects that can arise such as the impact of mental distress at risk of suicide, the impact of suicide, psychosis (mental disorders), psychiatric disorders in offspring, borderline personality disorder and the impact on internet addiction. Researchers used the PEO (population, exposure, outcome) question format to find related research articles. Conclusion: Based on the analysis of the 6 literatures that have been reviewed, it can be concluded that the incidence of childhood trauma in adolescents will have a psychological impact.

Subtypes of borderline personality features in adolescence: Insights from cross-lagged panel network analysis.

Borderline personality disorder (BPD) is a complex and severe psychiatric condition characterized by emotional, self-image, behavior, and relational instability. While adult BPD heterogeneity has been extensively studied, the phenomenological borderline personality features (BPFs) in adolescence remain uninvestigated. This study aimed to explore the potentially dynamic causal relationships between BPFs in adolescence and identify the subtypes through cross-lagged panel network (CLPN) analysis. Two independent Chinese adolescent samples were followed over 18 months (N₁ = 1,056, M1age = 15.37, SD1 = 1.86) and 6 months (N₂ = 723, M2age = 16.84, SD₂ = 0.48) to track BPFs. CLPN modeling was employed to investigate the stability, potential causal relations, and subtypes of adolescent BPFs. The results revealed a relatively stable overall adolescent BPF network structure with some subtle changes over time. Impulsivity emerged as the BPF with the highest out-expected influence, indicating its predictive role for other BPFs. A strong reciprocal causal relationship was observed between impulsivity and affective instability. Based on the CLPN estimation, two distinct BPFs subgroups were spontaneously clustered: externalized-dysregulation subtype (impulsivity, affective instability, and self-harm/suicide) and introjective-disturbance subtype (identity disturbance, chronic emptiness, and stress-related dissociation). The present study tentatively explores a potential typology for adolescent BPF based on these two clusters, which possibly have different pathological mechanisms, and moreover offer insights into the essential construct and clinical intervention of adolescent BPD. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Existential Reflection: Borderline Personality Disorder (BPD) Caused by Excessive Existentialism in 'A Streetcar Named Desire'

Existential Reflection: Borderline Personality Disorder (BPD) Caused by Excessive Existentialism in 'A Streetcar Named Desire'

Sex differences in insomnia and hypersomnia complaints during major depressive episode: Results from a national sample

BackgroundSex differences in sleep disturbances during major depressive episodes (MDE) have been suggested. This study compares the prevalence, sociodemographic characteristics, and psychiatric comorbidity associated with sleep complaints specific to each sex among adults with MDE. These findings are crucial for precise diagnosis, personalized treatment, and improved clinical outcomes. MethodsIn a large nationally representative prospective survey, we used multi-adjusted logistic regression models including sociodemographic characteristics, psychiatric comorbidity, and depression severity to examine whether associations differ between men and women. ResultsAmong women, 93.3 % reported at least one type of sleep complaints (i.e., trouble falling asleep, early morning awakening or hypersomnia) while 91.0 % of men did, with respectively 78.3 % and 77.2 % of insomnia complaints, and 46.2 % and 41.3 % of hypersomnia complaints. Women with sleep complaints were more likely to be black, with lower individual incomes, have histrionic personality disorder or a specific phobia. Conversely, men with sleep complaints were more likely to have a lifetime diagnosis of mania spectrum disorder, generalized anxiety disorder, drug use disorder, as well as dependent and schizotypal personality disorders. Surprisingly, being “never married” has emerged as a protective factor against sleep complaints in women, while posing as a risk factor in men compared to other marital statuses. Differences and specificities were also noted concerning subtypes of insomnia and hypersomnia complaints. LimitationsThe cross-sectional design means the associations found do not imply causality. ConclusionsThese findings provide insights into the complex relationship between sleep and depression in men and women, highlighting the need for personalized interventions.

Chronotype, sleep quality, impulsivity and aggression in patients with borderline personality disorder and healthy controls

ABSTRACT Impulsivity, aggression, and suicide are the major clinical symptoms of borderline personality disorder (BPD). Although previous studies indicated poor sleep quality and its relationship with clinical symptoms in patients with BPD, chronotype, an important sleep parameter, was not investigated in these patients. This study aimed to analyze chronotype and its relationship with clinical symptoms in patients with BPD. Participants in this study consisted of 68 BPD patients and 65 healthy controls. Subjective sleep characteristics, impulsivity, aggression, suicide probability, and chronotype were assessed using the Pittsburgh Sleep Quality Index (PSQI), Barratt Impulsivity Scale, Buss-Perry Aggression Scale (BPAQ), Suicide Probability Scale, and Morningness – Eveningness Questionnaire, respectively. PSQI total and subscale scores subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, and daytime drowsiness were significantly higher in the BPD group (p < 0.001). There was a positive correlation between the PSQI total score and the BPAQ total score (r = 0.268, p = 0.027). The rate of evening type was significantly higher in the control group (p = 0.004). Suicide attempts and the subscale of suicide probability hopelessness, suicidal ideation, and negative self-evaluation scores were significantly higher in evening type BPD patients. (p = 0.017, p = 0.009, p = 0.001, p = 0.047). Sleep quality is associated with aggression, and the eveningness chronotype is associated with suicide. It may be useful to focus on sleep problems in treating BPD patients.

Antisocial Personality Disorder as an Associated Precursor to the Development of Substance Use Disorder among Substance Users and Non Substance Users in Federal Neuropsychiatric Hospital, Kaduna, Nigeria

Antisocial Personality Disorder as an Associated Precursor to the Development of Substance Use Disorder among Substance Users and Non Substance Users in Federal Neuropsychiatric Hospital, Kaduna, Nigeria