Personality Disturbance Research Articles

The importance of a correct and prompt diagnostic in a case of bacillar meningo-encephalitis

Introduction. Meningitis is the inflammation of the meninges and can be of infectious cause, the most common being viral, followed by bacterial, but which associates a more severe and rapid evolution, even when it is treated correctly and promptly. In infants and children tuberculous meningitis develops more frequently as a complication of progressive primary infection. Case presentation. A 12-year-old female patient presents to the emergency room with fronto-parietal headache, vomiting, vertigo and lumbar pain, which, despite treatment with oral cephalosporin, returns after 3 days, because the symptoms persist. She is admitted, her treatment is escalated, IV fluoroquinolones and acyclovir are added, along with corticotherapy and cerebral depletives, but within 48 hours the general condition worsens, associating severe headaches, neck stiffness and personality disturbances. Lumbar puncture detects high levels of leukocytes and proteins and low levels of glucose and chlorine, so the patient is transferred to an Intensive Care Unit, intubated and mechanically ventilated. MRI reveals meningoencephalitis with ponto-mesencephalic and cerebellar involvement, with biological minimal leukocytosis with neutrophilia and minimal inflammatory syndrome, the repeated lumbar puncture present the same pathological elements, but the PCR of CSF is positive for Mycobacterium tuberculosis and the diagnosis is of severe tuberculous meningoencephalitis. Under tuberculostatic treatment (isoniazid 5 mg/kg/day, rifampicin 10 mg/kg/day, ethambutol 20 mg/kg/day, pyrazinamide 30 mg/kg/day) associated with vitamin therapy (B1 and B6 – to prevent peripheral neuropathy induced by isoniazid), corticotherapy and cerebral depletives, after 5 days, the evolution was towards healing, which allowed extubation and later discharge, continuing the 7/7 tuberculostatic scheme for 30 days. A subsequent pulmonary assessment is necessary for conversion to 2/7 regime. Conclusions. Meningitis must be promptly and correctly diagnosed and treated, otherwise the evolution is serious, the patient may develop sequelae or even develop towards death. An important element is the anamnesis, because in the presents case, a member of the patient’s family has recently been hospitalized for a respiratory pathology for which he required oxygen therapy.

The Inventory of Personality Organization: A valid instrument to detect the severity of personality dysfunction.

In the eleventh revision of the International Classification of Diseases (ICD-11), the severity of personality dysfunction became the central dimension of personality disorder's (PDs) definition, besides the trait domain qualifiers. Personality functioning, also known as personality organization (PO), is becoming an increasingly important concept in administering, predicting, and measuring severity and nature of personality disturbance. Otto Kernberg and his team developed several tools to measure personality impairment. The Inventory of Personality Organization (IPO) is a self-report rating scale for the measurement of PO. Aim of this study was to identify severity groups according to the level of PO and to explore their validity. A clinical sample of 118 patients was recruited from a 4-weeks in-patient cognitive psychotherapy program. Beside the IPO, Structured Clinical Interview for the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders, (DSM-IV.) Axis I and II, Symptom Check List-90 (SCL-90), State-Trait Anger Expression Inventory and Dissociative Experience scale (DES). Two types of analyses were conducted: a person-centered (latent profile) analysis and various variable-centered tests to confirm the factor structure of IPO and calculate group differences. The three-factor (CFI = 0.990, TLI = 0.990, RMSEA = 0.022, SRMR = 0.089) and the five-factor (CFI = 0.995, TLI = 0.995, RMSEA = 0.014, SRMR = 0.090) models of the IPO was supported. Latent class analysis identified three subgroups of PO: "Well-integrated," "Moderately integrated," and "Disintegrated" classes. There were no significant differences between the three classes in the number of Axis 1 diagnoses (p = 0.354; η2 = 0.01). Group differences in the number of PDs, the number of PD symptoms as well as in the presence of borderline and depressive PD were significant (all p < 0.001; V = 0.35-0.42; η2 = 0.15-0.26). Persons with more severe PO problem level had higher rates of psychopathological symptoms, state and trait anger, and dissociative characteristics (all p < 0.001; η2 = 0.13-0.36). The IPO can be an appropriate instrument to measure the severity of personality disorganization and to classify participants along a continuum of severity in this regard. Our results present further evidence that the severity of personality dysfunction, the central dimension of the ICD-11 and the Alternative Model for PDs is detectable with an instrument, the IPO, that was initially developed to detect the disturbances in PO.

Why some people do not get vaccinated against COVID-19: Social-cognitive determinants of vaccination behavior.

It is puzzling that a sizeable percentage of people refuse to get vaccinated against COVID-19. This study aimed to examine social psychological factors influencing their vaccine hesitancy. This longitudinal study traced a cohort of 2663 individuals in 25 countries from the time before COVID-19 vaccines became available (March 2020) to July 2021, when vaccination was widely available. Multilevel logistic regressions were used to examine determinants of actual COVID-19 vaccination behavior by July 2021, with country-level intercept as random effect. Of the 2663 participants, 2186 (82.1%) had been vaccinated by July 2021. Participants' attitude toward COVID-19 vaccines was the strongest predictor of both vaccination intention and subsequent vaccination behavior (p< .001). Perceived risk of getting infected and perceived personal disturbance of infection were also associated with higher likelihood of getting vaccinated (p< .001). However, religiosity, right-wing political orientation, conspiracy beliefs, and low trust in government regarding COVID-19 were negative predictors of vaccination intention and behavior (p< .05). Our findings highlight the importance of attitude toward COVID-19 vaccines and also suggest that certain life-long held convictions that predate the pandemic make people distrustful of their government and likely to accept conspiracy beliefs and therefore less likely to adopt the vaccination behavior.

User-Centered Design Methodologies for the Prototype Development of a Smart Harness and Related System to Provide Haptic Cues to Persons with Parkinson's Disease.

This paper describes the second part of the PASSO (Parkinson smart sensory cues for older users) project, which designs and tests an innovative haptic biofeedback system based on a wireless body sensor network using a smartphone and different smartwatches specifically designed to rehabilitate postural disturbances in persons with Parkinson's disease. According to the scientific literature on the use of smart devices to transmit sensory cues, vibrotactile feedback (particularly on the trunk) seems promising for improving people's gait and posture performance; they have been used in different environments and are well accepted by users. In the PASSO project, we designed and developed a wearable device and a related system to transmit vibrations to a person's body to improve posture and combat impairments like Pisa syndrome and camptocormia. Specifically, this paper describes the methodologies and strategies used to design, develop, and test wearable prototypes and the mHealth system. The results allowed a multidisciplinary comparison among the solutions, which led to prototypes with a high degree of usability, wearability, accessibility, and effectiveness. This mHealth system is now being used in pilot trials with subjects with Parkinson's disease to verify its feasibility among patients.

Reciprocal relationships between personality disorders and eating disorders in a prospective 17-year follow-up study.

This study aimed to report the presence of categorical and dimensional personality disorders (PD) in adults with longstanding eating disorders (ED) over a period of 17 years and to investigate whether changes in PD predict changes in ED symptoms or vice versa. In total, 62 of the 80 living patients (78% response rate) with anorexia nervosa (n=23), bulimia nervosa (n=25), or other specified feeding or ED (n=14) at baseline were evaluated during hospital treatment and at 1-year, 2-year, 5-year, and 17-year follow-up. PD were assessed using the Structured Clinical Interview for DSM-IV Axis II disorders, and the eating disorder examination (EDE) interview was used to assess ED. Data were analyzed using multilevel modeling. From baseline to the 17-year follow-up, the number of patients with any PD decreased significantly from 74.2% to 24.2%, and the total number of PD diagnoses declined from 80 to 22. Mean EDE score was significantly reduced from 4.2 (SD: 1.1) to 2.0 (SD: 1.6). There was a positive association between ED and PD where the initial level of either disorder was followed by similar levels of the other disorder throughout the entire follow-up period. High baseline levels of borderline PD predicted less decrease in ED symptoms. No significant within-person effects were found. Both ED and PD significantly declined over time. As the severity of either disorder seems to be associated with the other, thorough assessment and treatment that incorporates both the ED psychopathology and the personality disturbances are advisable. While personality disorders were highly prevalent in the sample of patients with longstanding eating disorders, both disorders were significantly reduced at the 17-year follow-up. The disorders are related in the sense that an initial high level of either disorder is associated with a high level of the other over time. A thorough assessment and attention to both illnesses are advisable in therapy. NCT03968705.

Response: Personality disorder is here to stay across the lifespan - a response to Commentaries on the May 2022 Debate.

The classification of personality disorder is in a state of flux. Revision is necessary, overdue, and is provided by the new ICD-11 classification. To explain the advantages of the new classification system and why 'borderlne' is a redundant term. To summarise positive and negative views about its implications, especially in young people. Review of recent literature and developments. Personality disturbance is ubiquitous and changes across the life span. The data are unequivocal. As personality disturbance is so common in childhood and adolescence it should be recognised and acknowledged at this time even though it is very likely to change. The stigma surrounding personality disorder can be countered by science and courage.

Association between Sleep Disturbances at Subacute Stage of Mild Traumatic Brain Injury and Long-Term Outcomes.

Mild (mTBI) traumatic brain injury (TBI) accounts for the majority of all TBI cases. Evidence has suggested that patients with mTBI can suffer from long-lasting cognitive deficits, persistent symptoms, and decreased quality of life. Sleep disorders are commonly observed after TBI, with the prevalence rate of sleep disturbances in persons with TBI being much higher than that in the general population. Poor sleep quality can impair cognitive functions in the general population. This effect of sleep disturbances may impede the recovery processes in the population with TBI. The objective of this study is to add to our understanding of the relationship between self-reported sleep problems and other post-concussion symptoms and look at the association between early sleep problems and long-term outcomes in mTBI. Post-concussion symptoms, neurocognitive functions, level of global outcomes, and rating of satisfaction of life were assessed in 64 patients with mTBI. The results revealed that the presence of sleep disturbances co-occur with an increased level of overall post-concussion symptoms at the subacute stage of mTBI, particularly with symptoms including poor concentration, memory problems, and irritability. In addition, sleep disturbance at the subacute stage is associated with persistent poor concentration and memory problems, as well as worse neurocognitive function, slower overall recovery, and lower satisfactory of life at the long term. Our findings suggest that sleep disturbance can be a prognostic factor of long-term outcomes after mTBI. Early interventions to improve sleep quality can have potential benefits to facilitate the recovery process from mTBI.

Adaptive and maladaptive perfectionism of graduating medical students

IntroductionPerfectionism, as a multiform trait of character, plays an important role in the formation of motivation of achievements in socially significant activity. Adaptive perfectionism, together with the desire to achieve recognition in one’s professional community and insure the emotional stability. Maladaptive (neurotic) perfectionism is directed towards the achievement of excessively high (non-relevant) standards of activity, a constant anxiety, internal stress and lack of self-confidenceObjectivesTo pinpoint the types of perfectionism that graduating medical students at Medical University experience, those who, during all the years of study, showed high academic resultsMethodsForty-nine graduating medical students volunteered to take part in the study, their average mark being not lower than 4.75 (maximum was 5). Their average age was 22.41±0.75. The following scales measured the level of expressiveness of perfectionism: A.A. Zolotareva, Hewitt and Flett, I.I. GrachevaResultsThe results of the study undertaken showed two distinct groups. Students of the first group (79.6%) aimed at high internal standards in their study that would make them very well prepared professionally for their future work as doctors. They consciously accepted the common rules and norms of their society. Students of the other group (20.4%), consciously and subconsciously, estimate their high academic results as a good way of overcoming personal disturbances. They have excessive non-realistic demands towards self and othersConclusionsThe results of our study make it possible for us to suppose that medical students of the second group will experience quite a lot of difficulties in their future professional activityDisclosureNo significant relationships.

0138 Exploring the influencing factors of sleep disturbance and work well-being among shift-work nurses in Taiwan

Abstract Introduction Job-related stress and sleep disturbances are common problems among registered nurses (RNs). At present, more than half of the nursing staff in Taiwan have the intention to leave, so this is a problem that cannot be ignored. This cross-sectional correlational research based on Job Demands-Resources Model aimed to explore the influencing factors of work well-being from sleep and job crafting perspective. Methods A total of 220 (13.3% was male) shift-work RNs (mean age= 30.6, SD= 6.5), were recruited from seven intensive care units of a teaching hospital in central Taiwan. All nurses completed a battery questionnaires measuring their job-related stress, sleep disturbances, fatigue severity, self-efficacy, job crafting, and work well-being. In addition, a 7-day sleep diary were collected to estimate their total sleep time (TST). Results Majority of the RNs reported poor sleep quality (61.5%), insufficient sleep quantity (62.8%), and poor daytime functioning (49.5%). According to the sleep diary, their average TST (464 minutes, SD= 91.7) was close to what they needed to feel refreshed (472 minutes, SD= 87.5); however, more than three-quarters of them experienced clinically significant fatigue before bedtime (92.3%) and after waking up (72.7%). Job-related stress was measured by the Copenhagen Psychosocial Questionnaire II, the top three stressors were from value at work level, interpersonal relations and leadership, and work organization. Sleep disturbances was correlated with poor work well-being. After controlling for personal factors (age, gender, and years in nursing) and sleep disturbances, self-efficacy, job-related stress, and job crafting explained 49.8% of work well-being; work organization, value at work level, and job crafting are the significant predictors. Conclusion Most RNs in this study reported sleep disturbances and severe fatigue, which had a negative impact on their work well-being. Job-related stress contributed to sleep disturbances, and calls for further study on job-crafting and shift work coping. Support (If Any) Changhua Christian Hospital,Taichung, Taiwan

The recording of personality strengths: An analysis of the impact of positive personality features on the long-term outcome of common mental disorders.

Although personality strengths are assessed frequently in occupational and managerial settings and in children, they have been less used in studies of personality disorder. The aim of this study is to examine the impact of a measure of personality strengths derived from the comprehensive version of the Personality Assessment Schedule (CPAS) (i.e., positive and reinforcing traits) on clinical symptoms and functioning. Eighty‐nine patients with anxiety and depression seen at the 30‐year follow‐up point in a cohort study (Nottingham Study of Neurotic Disorder) were administered the Comprehensive version of the PAS (CPAS). A factor analysis of the results determined the main groupings and their impact on long‐term outcomes as well as their association with change of outcomes over 30 years. Five positive factors (strengths), forceful considerateness, emotional toughness, cautiousness, independence and discernment accounted for 67.2% of the variance using both Varimax and Promax rotations. Low positive scores were strongly associated with suicide attempts, moderate/severe personality disorder, cothymia (mixed anxiety‐depression), greater symptomatology and poor social function. High scores were protective of serious pathology and particularly effective in inhibiting suicidal behaviour. The promotion of personality strengths may be of value in preventing suicidal behaviour and helping pro‐social change in those with personality disturbance.

The role of symptoms of psychopathy in persistent violence over the criminal career into full adulthood

Purpose: The extant criminal career literature supports the assertion that risk factors for violent and non-violent offending are the same. However, such studies have not examined the role of psychopathic personality disturbance (PPD) in the development of persistent violence across the life course. A situational action theory perspective was used to help illustrate the utility of PPD in explaining persistent violent offending. Methods: Convictions for violent offense and non-violent offenses were measured for Canadian male (n = 262) and female (n = 64) offenders at each year between ages 12 and 28. Semi-parametric group-based modeling was used to identify joint trajectories of violent and non-violent offending. Symptoms of adolescent PPD and other criminogenic risk factors were also measured. Results: Through the joint trajectory model, five violent and five non-violent trajectories were identified. PPD emerged as a strong predictor of membership in the trajectory associated with chronic violent offending but lower levels of non-violent offending. Conclusions: Contrary to earlier criminal career research, the most persistent violent offenders were not also involved in the highest rate of general offending. Theories that help explain why individuals are involved in persistent violence are needed. Incorporating PPD into such a theoretical framework appears necessary.

Family, personal, parental correlates and behavior disturbances in school-aged boys with attention-deficit/hyperactivity disorder (ADHD): a cross-sectional study

BackgroundTo evaluate the relationship among family, personal, parental correlates, and behavioral disturbances in boys with attention-deficit/hyperactivity disorder (ADHD).MethodsWe performed a hospital-based cross-sectional study. School-aged boys who first visited the hospital between 2000 and 2011 with ADHD were identified. Through medical records review, demographic information, family characteristics, personal characteristics, parental characteristics, and the Child Behavior Checklist (CBCL) collected during the first outpatient visit were retrieved. A T-score higher than 63 in the internalizing or externalizing subscale of the CBCL indicated severe behavioral disturbances in each domain. Multivariable logistic regression was used to evaluate the relationship between the correlates and behavioral disturbances. Eligible patients were further classified into groups without behavioral disturbance, with either only severe internalizing or only severe externalizing behaviors, or with both behaviors. Multivariable ordinal logistic regression was used to investigate the association between the correlates and the number of types of behavioral disturbances.ResultsA total of 1855 boys with ADHD were included. In the multivariable logistic regression, family factors, including being first-born, living in a family not with both parents, and family history of mental disorder, were associated with severe internalizing and externalizing behaviors. Personal factors, including prenatal complications, perinatal complications, and medical and psychiatric comorbidities, were associated with severe internalizing behaviors, but only prenatal complications and medical comorbidities were associated with severe externalizing behaviors. Parental factors were only associated with severe externalizing behaviors. A higher paternal education level had a protective effect, but younger motherhood increased the risk. In ordinal logistic regression, these factors were also associated with more types of behavioral disturbances.ConclusionsMultiple factors are related to behavioral disturbances in ADHD. Our study reported the association among family, personal, parental factors, severe internalizing behavior, severe externalizing behavior, and number of behavioral disturbances in boys with ADHD. However, the impacts differed as the behavior phenotypes varied. Further research is needed to better understand the heterogeneity of ADHD behavior.

Worsening sleep quality across the lifespan and persistent sleep disturbances in persons with opioid use disorder.

Individuals with opioid use disorder (OUD) may experience worsening sleep quality over time, and a subset of individuals may have sleep disturbances that precede opioid use and do not resolve following abstinence. The purpose of the present study was to (1) collect retrospective reports of sleep across the lifespan and (2) identify characteristics associated with persistent sleep disturbance and changes in sleep quality in persons with OUD. Adults with OUD (n = 154) completed a cross-sectional study assessing current and past sleep disturbance, opioid use history, and chronic pain. Repeated-measures analysis of variance was used to examine changes in retrospectively reported sleep quality, and whether changes varied by screening positive for insomnia and/or chronic pain. Multivariate linear regression analyses were used to identify additional correlates of persistent sleep disturbance. Participants reported that their sleep quality declined over their lifespan. Changes in reported sleep over time varied based on whether the individual screened positive for co-occurring insomnia and/or chronic pain. In regression analyses, female sex (β = 0.16, P = .042), a greater number of treatment episodes (β = 0.20, P = .024), and positive screens for chronic pain (β = 0.19, P = .018) and insomnia (β=0.22, P = .013) were associated with self-reported persistent sleep disturbance. Only a portion of participants who screened positive for sleep disorders had received a formal diagnosis. OUD treatment providers should routinely screen for co-occurring sleep disturbance and chronic pain. Interventions that treat co-occurring OUD, sleep disturbance, and chronic pain are needed. Ellis JD, Mayo JL, Gamaldo CE, Finan PH, Huhn AS. Worsening sleep quality across the lifespan and persistent sleep disturbances in persons with opioid use disorder. J Clin Sleep Med. 2022;18(2):587-595.

Adverse Childhood Experiences, Personality, and Crime: Distinct Associations among a High-Risk Sample of Institutionalized Youth.

Despite high rates of adverse childhood experiences (ACEs) and personality-related disturbances among delinquent juveniles, associations among ACEs, youth personality, and juvenile crime involvement are still unclear. High-risk samples of institutionalized youth are in specific need of a comprehensive assessment of ACEs and personality features in order to broaden the current knowledge on the occurrence and persistence of juvenile crime and to derive implications for prevention and intervention. We examined a heterogeneous high-risk sample of 342 adolescents (35.1% females, 64.9% males) aged between 12 and 18 years (M = 15.74, SD = 1.61 years) living in child-welfare or juvenile justice institutions regarding cumulative ACEs, psychopathic traits, temperament, and clinical personality disorder ratings, and criminal involvement before and up to 10 years after assessment. We found considerable rates of ACEs, although cumulative ACEs did not predict future crime. Latent Profile Analysis based on dimensional measures of psychopathy, temperament, and personality disorders derived six distinct personality profiles, which were differently related to ACEs, personality disturbances, clinical psychopathology, and future delinquency. A socially difficult personality profile was associated with increased risk of future crime, whereas avoidant personality traits appeared protective. Findings indicate that the role of ACEs in the prediction of juvenile delinquency is still not sufficiently clear and that relying on single personality traits alone is insufficient in the explanation of juvenile crime.

Relationships between treatments received in the Nottingham Study of Neurotic Disorder over 30 years and personality status.

We compared the drug treatments and health service contacts of anxious and depressed patients separated by personality disturbance in 200 patients over 30 years. Contact details with health professionals at 5, 12 and 30 years were recorded and analysed by multilevel models at all time points. Over 30 years, patients with dependent and anankastic personality disturbance and cothymia (the general neurotic syndrome) were 2.27 times more likely to receive selective serotonin reuptake inhibitors (SSRIs) and new antidepressants (95% confidence interval [CI]: 1.22-4.24), particularly paroxetine, and were 1.6 weeks (95% CI: 1.2-2.3) longer on the drug than those without the syndrome. Similar results with SSRIs and new antidepressants in patients with personality disorder fell short of significance after adjusting for age, sex and DSM status. Most patients had a DSM diagnosis at follow-up points, and these had increased psychological treatment, psychiatric admissions, multiple drugs, SSRIs and new antidepressants. At later follow-up, most drug treatments decreased apart from psychological treatment, SSRIs and new antidepressants, and baseline personality disorder had little impact on treatment histories compared with others. We conclude that the (Galenic) general neurotic syndrome is associated with greater use of treatments in the long term, showing that combined personality and symptomatic pathology overcomes that of personality disorder alone.

Dynamics of psychovegetative syndrome in patients during the period of rehabilitation after coronary bypass

The study was to investigate the role of moderate and severe anxiety in development of psychovegetative syndrome after coronary artery bypass graft (CABG), to describe the nature and direction of resulting autonomic dysfunction and to study possibilities of anti-ancient therapy. We studied 33 patients (19 - in the main group, 14 - in the comparison group) on average 13 days after CABG and in dynamics in the process of early postoperative rehabilitation. A point assessment of the psychological and autonomic spheres, and sleep quality was made. Indicators of vegetative tone and vegetative regulation were studied, in particular, temporal and spectral indicators of heart rate variability. In addition to basic therapy for ischemic heart disease (IHD), the patients in main group were received therapy with alimemazine. In most cases, after CABG, moderate situational and personal anxiety and sleep disturbances were recorded in combination with autonomic dysregulation with a predominance of sympathetic influences from the autonomic nervous system (ANS). Adding to the basic therapy of IHD among patients of the main group of the drug with a mild anti-anxiety effect, allowed for 2 weeks to significantly reduce the level of anxiety and correct the existing autonomic disorders. This study found that patients with an increased level of anxiety after CABG are characterized by the formation of a psychovegetative syndrome with a predominance of sympathetic activity. The using anti-anxiety drugs can reduce the severity of anxiety and autonomic dysfunction, which can probably become a factor contributing to the successful rehabilitation of patients after CABG in the early and late postoperative periods, and the prevention of progression of IHD.

Lesions in different prefrontal sectors are associated with different types of acquired personality disturbances

“Frontal lobe syndrome” is a term often used to describe a diverse array of personality disturbances following frontal lobe damage. This study's guiding premise was that greater neuroanatomical specificity could be achieved by evaluating specific types of personality disturbances following acquired frontal lobe lesions. We hypothesized that three acquired personality disturbances would be associated with lesion involvement of distinct sectors of the prefrontal cortex (PFC): 1) emotional-social disturbance and ventromedial PFC, 2) hypoemotional disturbance and dorsomedial PFC, and 3) dysexecutive and dorsolateral PFC. In addition, we hypothesized that distressed personality disturbance would not be associated with focal PFC lesions in any sector. Each hypothesis was pre-registered and tested in 182 participants with adult-onset, chronic, focal brain lesions studied with an observational, cross-sectional design. Pre- and postmorbid personality was assessed by informant-rating with the Iowa Scales of Personality Change, completed by a spouse or family member. Two complementary analytic approaches were employed: 1) a hypothesis-driven region-of-interest (ROI) regression analysis examining the associations of lesions in specific PFC sectors with acquired personality disturbances; 2) a data-driven multivariate lesion-behavior mapping analysis, which was not limited to pre-specified regions. Each hypothesis received some support: (i) Emotional/social personality disturbance was most strongly associated with ventromedial PFC lesions in both statistical approaches. (ii) Hypoemotional disturbance was associated with dorsomedial PFC lesions in the ROI analyses, without any significant lesion-symptom mapping associations. (iii) Dysexecutive personality disturbance was associated with bilateral dorsolateral PFC lesions and ventromedial PFC lesions; lesion-symptom mapping showed maximal association of executive dysfunction with damage of the right middle frontal gyrus within the dorsolateral PFC. (iv) Distressed personality disturbance was not associated with lesions in any PFC sector. Altogether, the findings can be interpreted to indicate that damage to different prefrontal sectors may disrupt different anatomical-functional systems and result in distinct personality disturbances.

Tailored Music Listening to Improve Sleep in Older Adults With Dementia: A Randomized Clinical Trial

Sleep disturbances in persons living with dementia (PLWD) contribute to reduced well-being. Music has shown promise to improve sleep among older adults, but there is limited evidence of music interventions improving sleep specifically in PLWD. The purpose of this wait-list RCT was to examine the i) feasibility; ii) acceptability and iii) preliminary efficacy of tailored music listening intervention in community-dwelling PLWD and their caregivers (dyads). Thirty consented dyads out of 33 (91%) completed the RCT. Tailored music for sleep was feasible based on screening (26%), enrollment (89%), and recruitment (3 dyads/month) rates. The intervention was found acceptable, as evidenced by post-intervention interviews. Compared to controls, PLWD in the intervention group reported greater global sleep quality improvement post-intervention (PSQI mean change -0.08 vs -1.65; p=0.06). The results from this feasibility RCT have informed the development of a music mobile application that will be tested in a future clinical trial.

Psychopathy in women: insights from neuroscience and ways forward for research.

Psychopathy is a severe form of personality disturbance, resulting in a detrimental impact on individuals, healthcare systems, and society as a whole. Until relatively recently, most research in psychopathy has focused on male samples, not least because of its link with criminal behavior and the large proportion of violent crime committed by men. However, psychopathy in women also leads to considerable problems at an individual and societal level, including substance misuse, poor treatment outcomes, and contribution to ever-increasing numbers of female prisoners. Despite this, due to relative neglect, most research into adult female psychopathy is underpowered and outdated. We argue that the field needs revitalizing, with a focus on the developmental nature of the condition and neurocognitive research. Recent work international consortia into conduct disorder in female youth-a precursor of psychopathy in female adults-gives cause for optimism. Here, we outline key strategies for enriching research in this important field with contemporary approaches to other psychiatric conditions.

Differences in Sleep Disorders between HIV-Infected Persons and Matched Controls with Sleep Problems: A Matched-Cohort Study Based on Laboratory and Survey Data.

Objectives: Sleep disturbances are prevalent problems among human immunodeficiency virus (HIV)-infected persons. The recognition of comorbid sleep disorders in patients with HIV is currently hampered by limited knowledge of sleep-related symptoms, sleep architecture, and types of sleep disorders in this population. We aimed to compare the differences in sleep-related symptoms and polysomnography-based sleep disorders between HIV-infected persons and controls. Methods: The study evaluated 170 men with a Pittsburgh sleep quality index scores greater than 5, including 44 HIV-infected men and 126 male controls who were frequency-matched by sex, age (±3.0 years) and BMI (±3.0 kg/m2). For all participants, an overnight sleep study using a Somte V1 monitor was conducted. Differences in sleep-related symptoms and sleep disorders between HIV-infected patients and controls were examined using t-tests or chi-square tests. Results: HIV-infected persons with sleep disturbances more often had psychological disturbances (72.7% vs. 40.5%, p < 0.001) and suspected rapid eye movement behavior disorder (25.0% vs. 4.8%, p < 0.01) than controls. Sleep-disordered breathing was less common in HIV-infected persons than in controls (56.8% vs. 87.3%, p < 0.001). The mean percentage of rapid eye movement sleep was higher among HIV-infected patients than among controls (20.6% vs. 16.6%, p < 0.001). Nocturia was more common in HIV-infected persons than in controls (40.9% vs. 22.2%, p = 0.02). Conclusions: Psychological disturbances and sleep-disordered breathing can be possible explanations of sleep disturbances in HIV-infected persons in whom sleep-disordered breathing is notable. Further studies are warranted to examine the underlying factors of rapid eye movement behavior disorder among HIV-infected persons with sleep disturbances.