Personality Disorder Dimensions Research Articles

The interpersonal dimension of borderline personality disorder: toward a neuropeptide model.

Borderline personality disorder is characterized by affective instability, impulsivity, identity diffusion, and interpersonal dysfunction. Perceived rejection and loss often serve as triggers to impulsive, suicidal, and self-injurious behavior, affective reactivity, and angry outbursts, suggesting that the attachment and affiliative system may be implicated in the disorder. Neuropeptides, including the opioids, oxytocin, and vasopressin, serve a crucial role in the regulation of affiliative behaviors and thus may be altered in borderline personality disorder. While clinical data are limited, the authors propose alternative neuropeptide models of borderline personality disorder and review relevant preclinical research supporting the role of altered neuropeptide function in this disorder in the hope of stimulating more basic research and the development of new treatment approaches.

Physical and Medical Dimensions of Borderline Personality Disorder and the Effect of Treatment

For many years, psychiatrists tended to view personality disorders as “psychological disorders” that were fundamentally different from “biological disorders,” such as schizophrenia or bipolar illness.<sup><a href="EditorPage.aspx?da=core&id=%7bA932AC25-CB6C-41F0-887A-1F74731AC343%7d&ed=FIELD17595849&vs&la=en&fld=%7b0B37FA8E-B2A6-4AE9-8E4F-53651D5CB226%7d&so=%2fsitecore%2fsystem%2fsettings%2fhtml+editor+profiles%2frich+text+healio&di=0&hdl=H17595923&us=sitecore%5cadmin&mo&pe=0#x00485718-20091123-01-bibr1">1</a></sup> In an era in which genetic and neuroimaging studies have enhanced our knowledge of the etiology and pathogenesis of Axis II conditions, psychiatry has evolved to a point where we now know that there are complex interactions between genes and environment, biology and psychology, and “mind” and “brain” that must be taken into account if we are to fully understand these disorders.

Physical and Medical Dimensions of Borderline Personality Disorder and the Effect of Treatment

Physical and Medical Dimensions of Borderline Personality Disorder and the Effect of Treatment

Emotional reactivity and self-regulation in relation to personality disorders

Associations of both reactive and regulative temperamental features with personality disorders (PDs) are investigated in a sample of 162 normal controls and 89 psychiatric inpatients. Reactive and regulative temperamental features were assessed by means of the BIS/BAS Scales and the Attentional Control Scale. Dimensional PD scores were obtained by using the ADP-IV. All PDs were characterized by low levels of effortful control, cluster C PDs by high BIS and cluster B PDs by high BAS. For several PDs, BIS and effortful control interacted: BIS was only related to severe PD pathology if effortful control was low. Clinical implications of these findings are discussed.

Pre‐treatment predictors and in‐treatment factors associated with change in avoidant and dependent personality disorder traits among patients with social phobia

We examined changes in avoidant and dependent personality disorder dimensions, and pre-treatment and in-treatment factors associated with such changes in 77 patients, randomized to medication-free residential cognitive (CT) or residential interpersonal therapy for social phobia. Personality disorders and personality dimensions according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) were assessed at pre-treatment and at one-year post-treatment. Both treatments were associated with a decrease in avoidant and dependent personality dimensions; dependent dimension decreased more in CT. Changes in cognitive factors predicted changes in both personality dimensions, whereas changes in symptoms or interpersonal factors did not. Change in the cognitive factor estimated cost was the most powerful predictor in the avoidant dimension, as it was the only predictor that remained significant in the forward regression analyses. Change in the cognitive factor estimated cost, and treatment were the most powerful predictors of change in the dependent dimension. Pre-treatment use of anxiolytics predicted larger changes in both PD dimensions.

The Age Distribution of Self-Reported Personality Disorder Traits in a Household Population

Stability over time is an essential criterion for the diagnosis of a personality disorder (PD) according to DSM-IV and ICD-10. However, both longitudinal and cross-sectional studies have demonstrated considerable changes of personality disorder traits during life-span, an observation which challenges this assumption. We measured self-reported DSM-IV personality disorder traits in a nationally representative community sample using a cross-sectional design. We investigated the association of dimensional PD scores with age. Our analyses confirmed a decreasing prevalence of personality disorder mean scores across age groups in the population, particularly Cluster B, with an increase in self-reported schizoid and obsessive-compulsive scores. Furthermore, specific interactions of demographic characteristics and age were identified. Analyses of transition points in the distribution of personality disorders across different age groups did not demonstrate increasing stability after age 30 as previously observed for normal personality traits. Significant changes occurred primarily after the third decade.

Five‐year prospective study of personality disorders in adults with longstanding eating disorders

To (1) report the occurrence of personality disorders (PDs) in adults with eating disorders (EDs) during inpatient treatment, and at 1-, 2-, and 5-year follow-up, (2) compare the changes of PDs in anorexia nervosa (AN), bulimia nervosa (BN), and eating disorder not otherwise specified (EDNOS), and (3) investigate if recovered patients had lower frequency of PDs. Seventy-four patients with EDs were assessed with Structured Clinical Interview for DSM-IV Axis II disorders during inpatient treatment, and at 1-, 2-, and 5-year follow-up. During inpatient treatment, 58 patients (78%) had one or more PDs and this was reduced to 32 (43%) at 5-year follow-up. Dimensional PD scores changed significantly over time in both AN, BN, and EDNOS, but no significant differences emerged among the ED groups. Recovered patients had lower frequency of PDs (p < 0.01). The substantial 5-year follow-up reductions in the frequency of PDs in patients with EDs present an optimistic clinical scenario for treating patients with comorbid ED and PD.

Dimensionale Diagnostik mit dem Fragebogen zur Erfassung von DSM-IV-Persönlichkeitsstörungen (ADP-IV)

No AccessDimensionale Diagnostik mit dem Fragebogen zur Erfassung von DSM-IV-Persönlichkeitsstörungen (ADP-IV)Daniela Renn, Stefan Höfer, Gerhard Schüßler, Gerhard Rumpold, Ulrike Smrekar, Nicola Janecke, Stephan DoeringDaniela RennSearch for more papers by this author, Stefan HöferSearch for more papers by this author, Gerhard SchüßlerSearch for more papers by this author, Gerhard RumpoldSearch for more papers by this author, Ulrike SmrekarSearch for more papers by this author, Nicola JaneckeSearch for more papers by this author, Stephan DoeringSearch for more papers by this authorPublished Online:Apr 2014https://doi.org/10.13109/zptm.2008.54.3.212SectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinkedInRedditEmail About Previous article Next article FiguresReferencesRelatedDetailsCited byDie S3-Leitlinie Borderline-Persönlichkeitsstörungen1 March 2022 | PTT - Persönlichkeitsstörungen: Theorie und Therapie, Vol. 26, No. 1Gambling problems seldom come alone: prevalence and temporal relationships of mental health problems in casino excluders17 February 2019 | International Gambling Studies, Vol. 19, No. 3 Download book coverVolume 54Issue 3August 2008 ISSN: 1438-3608eISSN: 2196-8349HistoryPublished online:April 2014 PDF download

Sex-specific clinical correlates of hoarding in obsessive-compulsive disorder

Little is known about whether the clinical correlates of hoarding behavior are different in men and women with obsessive-compulsive disorder (OCD). In the current study, we evaluated the association of hoarding with categories of obsessions and compulsions, psychiatric disorders, personality dimensions, and other clinical characteristics separately in 151 men and 358 women with OCD who were examined during the OCD Collaborative Genetics Study. We found that, among men but not women, hoarding was associated with aggressive, sexual, and religious obsessions and checking compulsions. In men, hoarding was associated with generalized anxiety disorder and tics whereas, among women, hoarding was associated with social phobia, post-traumatic stress disorder, body dysmorphic disorder, nail biting, and skin picking. In women but not men, hoarding was associated with schizotypal and dependent personality disorder dimensions, and with low conscientiousness. These findings indicate that specific clinical correlates of hoarding in OCD are different in men and women and may reflect sex-specific differences in the course, expression, and/or etiology of hoarding behavior in OCD.

An empirical test of schema mode conceptualizations in personality disorders

Although the use of schema modes in schema-focused therapy (SFT) has been very popular since its introduction, Young's schema mode concept remained largely empirically untested. In order to provide insight into the mode conceptualization of personality disorders (PDs), the current study assessed the relationships between 14 schema modes and all PDs. Relationships between dimensional PD scores and self-reported mode scores were tested in a mixed study group of 489 participants, consisting of axis I and axis II patients, and non-patients. Psychopathology was assessed by means of the Structured Clinical Interview for DSM-IV axis I and axis II disorders (SCID I and SCID II) or the Structural Interview for DSM-IV Personality Disorders (SIDP-IV), and modes were assessed by the Schema Mode Inventory. Kendall's partial tau coefficients, controlling each PD–mode correlation for all other PD scores, indicated unique mode profiles for all PDs and corroborated most of the hypothesized PD–mode correlations, supporting the construct validity of the mode model. Nevertheless, the high number of correlations found for some PDs raises concerns about the specificity of the mode model. Implications for both research and therapy are discussed.

Severity Indices of Personality Problems (SIPP-118): Development, factor structure, reliability, and validity.

This article describes a series of studies involving 2,730 participants on the development and validity testing of the Severity Indices of Personality Problems (SIPP), a self-report questionnaire covering important core components of (mal)adaptive personality functioning. Results show that the 16 facets constituted homogeneous item clusters (i.e., unidimensional and internally consistent parcels) that fit well into 5 clinically interpretable, higher order domains: self-control, identity integration, relational capacities, social concordance, and responsibility. These domains appeared to have good concurrent validity across various populations, good convergent validity in terms of associations with interview ratings of the severity of personality pathology, and good discriminant validity in terms of associations with trait-based personality disorder dimensions. Furthermore, results suggest that the domain scores are stable over a time interval of 14-21 days in a student sample but are sensitive to change over a 2-year follow-up interval in a treated patient population. Taken together, the final instrument, the SIPP-118, provides a set of 5 reliable, valid, and efficient indices of the core components of (mal)adaptive personality functioning.

Personality Disorders in a Cross-Cultural Perspective: Impact of Culture and Migration on Diagnosis and Etiological Aspects

The diagnosis of personality disorders is highly dependent on how a society views certain behavior. Self concept, adaptation and social context are important aspects of the cultural dimensions of personality disorders. However, the relevance and implications of the influence of sociocultural factors are seen differently. Accordingly, there are very distinct conceptional, nosological and diagnostic approaches for classifying personality dispositions and personality disorders in a cross-cultural perspective. The present paper describes the social and cultural context of migration from an European perspective. A review of the literature on mental health risk in immigrants is given, and special focus is placed on the impact of culture on the development of personality in general and on the emergence and manifestation versus prevention of personality disorders in specific. Due to globalization and migration processes clinicians and therapists are increasingly called upon to assess the level of personality functioning, not only in patients from different ethnic backgrounds, but also in traumatized refugees and migrants. Multiple social and cultural factors have an influence on each level of the diagnostic and therapeutic process. In addition to thorough background knowledge concerning trauma, migration and culture specific issues, cultural sensitivity and cultural competence are requisite for clinicians and therapists.

Dimensions of DSM-IV Personality Disorders and Life-Success

This study examined associations between dimensional representations of DSM-IV personality disorders and life-success in a community sample of 304 men at age 48. Measures included a standardized social interview and the SCID-II for assessment of personality disorders. The identified indicators of life-success were factor-analyzed resulting in two moderately correlated components representing "status and wealth" and "successful intimate relationships." Avoidant, obsessivecompulsive, and narcissistic dimensional scores were positively associated with "status and wealth." Inverse relationships were found between dependent, schizotypal, schizoid, and adult antisocial personality disorder dimensions and this domain of life-success. Avoidant, schizoid, and borderline personality disorder dimensions were negatively associated with "successful intimate relationships." The findings suggest that although most personality disorders are associated with impaired psychosocial functioning and life-failure, some personality disorder traits (even if considered as pathological) can contribute positively to one important aspect of life-success: status and wealth.

The relationship between the five-factor model and latent Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition personality disorder dimensions

This study compared the latent structure of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition personality disorders (PDs) with the 5-factor model (FFM) of general personality dimensions. The subjects in the study were 742 community-residing individuals who participated in the Hopkins Epidemiology of Personality Disorders Study. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition PD traits were assessed by psychologists using the International Personality Disorder Examination, and PD dimensions were derived previously using dichotomous factor analysis. The Revised NEO Personality Inventory, a measure of the FFM, was administered to all subjects. The relationship between the 2 sets of personality-related constructs was examined using a construct validity framework and also using Pearson correlation coefficients, multiple linear regression models, and spline regression models. The 5 PD factors each exhibited small to moderate correlations with several NEO dimensions; together, the NEO domain and facet scores explained a fifth to a third of the variance in PD dimensions. Examples of nonlinear relationships between the personality dimensions were identified. There is a modest correspondence between the PD dimensions and FFM traits, and the traits of FFM only partially explain the variance of the PDs. Dimensional measures of general personality may be a suitable alternative to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Whether additional maladaptive traits would better define the domain of PDs remains an important objective for future research.

Family Environment and Adult Attachment as Predictors of Psychopathology and Personality Dysfunction Among Inpatient Abuse Survivors

The current study explored the role of early family environment and adult attachment style in explaining long-term outcomes among child abuse survivors. Adult patients (N = 80) in a trauma treatment program were assessed for clinical diagnosis and administered a multiscale questionnaire. Hierarchical regression analyses were significant for dissociative identity disorder (DID), substance abuse, anxiety disorder, posttraumatic stress, somatization, and six personality disorder dimensions. Adult attachment styles were significant predictors of most outcome variables. Of particular note was the strong contribution of attachment avoidance to DID. Five family environment scales (Independence, Organization, Control, Conflict, Expressiveness) also contributed to various psychopathological outcomes. Evidence emerged supporting a mediating role for attachment style in the link between family independence and five personality disorder dimensions.

An Overview of Issues Related to Categorical and Dimensional Models of Personality Disorder Assessment

Despite long-standing efforts to improve the current diagnostic system for Axis II, problems remain with the categorical conceptualization of personality disorders (PDs). Due in part to these problems, interest has developed in dimensional models of PD classification. In this article, we discuss four issues relevant to categorical vs. dimensional assessment of PDs: (a) problems with self-reports in PD patients, (b) methodological issues in behavioral and clinician assessment of PDs, (c) challenges that arise when dimensional models are applied to patient and nonpatient samples, and (d) clinical implications of categorical and dimensional PD models. We suggest that researchers and clinicians address these concerns to avoid implementing a new PD assessment model that—although different from the current system—would otherwise remain fraught with difficulties.

Decision making as measured with the Iowa Gambling Task in patients with borderline personality disorder

Affective instability is a core dimension of borderline personality disorder. The somatic marker hypothesis suggests that emotions play a crucial role in decision making. In this preliminary study, decision making was assessed in individuals with borderline personality disorder. Patients with borderline personality disorder (n = 20) and healthy comparison subjects (n = 15) were tested with the Iowa Gambling Task (IGT). The patients showed less advantageous choices on the IGT than did the healthy comparison subjects. The results could not be explained by indicators of general cognitive function or by symptoms of depression. These findings demonstrate that deficits in decision making in borderline personality disorder may manifest themselves in an ecologically valid neuropsychological test. Future studies should address whether those deficits are related to the behavioral characteristics of affective dysregulation and/or impulsivity, to the proposed dysfunctions and reduced volume of the orbitofrontal cortex and/or the amygdala, and to other neuropsychological functions.

Insecure attachment and personality disorder: a twin study of adults

This study used 239 twin pairs from a volunteer community sample to investigate how anxious and avoidant attachment are related to personality disorder (PD). Factor analysis showed that self‐reported anxious attachment and 11 PD scales from the Dimensional Assessment of Personality Problems loaded onto one factor (emotional dysregulation), and avoidant attachment and four PD scales loaded onto a second factor (inhibitedness). Biometric models indicated that 40% of the variance in anxious attachment was heritable, and 63% of its association with corresponding PD dimensions was attributable to common genetic effects. Avoidant attachment was influenced by the shared environment instead of genes. Correlations between avoidance and corresponding PD dimensions were attributable to experiences in the nonshared environment that influenced both variables. Copyright © 2006 John Wiley &amp; Sons, Ltd.

Underlying dimensions of ICD-10 personality disorders: Risk factors, childhood antecedents, and adverse outcomes in adulthood

Previous studies have identified specific underlying dimensions of personality disorders with remarkable consistency. This study aimed to replicate the factor structure of personality disorders using ICD-10 dimensional scores from a sample of 366 male offenders. Factor analysis yielded three factors. Factor 1 demonstrated dissocial, paranoid, histrionic, and impulsive personality traits. Factor 2 reflected borderline, anxious, and avoidant PD symptoms. Factor 3 showed high loadings on schizoid PD traits and an inverse relation to anankastic personality. The factor structure was identical to a recent study using ICD-10 personality disorder scores and showed strong similarities to previous studies using DSM-III personality disorder dimensions. Factor 1 was substantially correlated with the psychopathy total score. Elevated scores on this factor were associated with adverse childhood experiences, early behavioural problems (conduct/hyperkinetic disorder), co-morbid substance abuse in adulthood, an earlier start of criminal career, and a higher number of sentences/offences. No risk factors or childhood antecedents could be identified for Factor 2. However, this factor was distinctively characterised by co-morbid affective and neurotic mental disorders in adulthood. Factor 3 was negatively associated with measures of cognitive functioning. The findings suggest specific pathways, courses, and outcomes of the identified personality disorder dimensions.

Personality disorders in a cross-cultural perspective

Background and aims:The diagnosis of personality disorders is highly dependent on how a society views certain behaviour. Self concept, adaptation and social context are important aspects to the cultural dimensions of personality disorders. However, the relevance and implications of the influence of sociocultural factors are seen differently. Accordingly there are very distinct conceptional, nosological and diagnostic approaches to classify personality dispositions and personality disorders in a cross-cultural perspective.Methods:The paper describes the social, demographical and political context of migration in Europe and tries to indicate the needs and mental health problems of immigrants. A review of the literature concerning mental health risk in immigrants is carried out. Special focus lies on the impact of cultural concerning the emergence and manifestation versus prevention of personality disorders. The work also faces the problems of health policy towards immigrants and the access to mental health care services for immigrants in Europe.Results and Conclusions:Due to globalization and migration processes clinicians and therapists are increasingly asked to evaluate and differentiate the level of personality functioning not only in patients from different cultures and ethnic groups but also in traumatized refugees and migrants. Multiple social and cultural factors have influence on each level of the diagnostic and therapeutic process. Apart from a high back ground knowledge concerning trauma, migration and culture specific issues, such skills as cultural sensitivity and cultural competence are requirements for clinicians and therapists.