Personality Disturbance Research Articles

Prevalence of aggressive challenging behaviours in intellectual disability and its relationship to personality status: Jamaican study

Both the classification of personality disorder in intellectual disability (ID) and its identification in practice are deemed to be difficult. A simpler approach to classification and its relationship to challenging behaviours were tested in an adult Jamaican population with ID. The study was carried out in Kingston, Jamaica, as part of a programme of field trials to determine the utility of the proposed revision of personality disorders in the 11th Revision of the International Classification of Diseases (ICD-11), in a population of adults with ID living with their families or in supported care homes. Thirty-eight people with borderline (n = 5), mild (n = 16), moderate (n = 14) and severe (n = 3) ID were assessed at face-to-face interview and with relatives or staff using the provisional criteria for severity of personality disorder and its associated domain traits, and challenging behaviour was assessed using the Problem Behaviour Check List (PBCL) (a 5-point, 7-item scale). Using the severity scale 18 patients (47%) had no personality disorder, 7 (18%) had personality difficulty, 9 (24%) had mild personality disorder, and 4 (11%) had moderate personality disorder. None of the sample had severe personality disorder in which there is high risk of harm to self or others. Of the four major trait domains, provisionally named anankastic, detached, emotional and dissocial, three were evenly distributed in those with personality disturbance with the antagonistic (antisocial) trait less commonly shown (6 only). Scores on the PBCL were higher in those with increasing severity of personality disorder (P = 0.03) and those in the antagonistic personality trait domain had the highest PCL scores. Despite previous difficulties in assessing personality disorder in intellectual difficulties the ICD-11 classification was easy to administer in practice in this population, and the higher problem behaviour scores in those with greater severity of personality disturbance support its construct validity.

Rasgos patológicos de personalidad y metabolitos cerebrales como predictores de no abstinencia en adictos con trastornos de personalidad

Differences in pathological personality traits and disturbances in brain metabolites between non consumers, abstinent and non abstinent consumers were assessed. Participants (n=113) aged between 18-45 years with personality disorder (PD) were diagnosed with clinical interview and scales for depression, anxiety, impulsivity and dimensions of personality pathology. Brain metabolites were analyzed with magnetic resonance spectroscopy. Data were analyzed with ANOVA and multiple comparisons. Abstinent and non-abstinent differentiated from non-consumers in emotional deregulation, inhibition, and restricted expression; abstinent and non-abstinent differentiated from each other in self-aggression, dissocial behaviour, conduct disorder, stimulus seeking and intimacy problems. N-Acetyl Aspartate and creatine values were lower between non-abstinent in prefrontal, anterior cingulate cortex, cerebellar vermis and superior corona radiata. For abstinent, choline levels were greater in cerebellar vermis and n-acetyl aspartate were lower in dorso-lateral prefrontal and anterior cingulated cortex and insula. Regarding personality traits, insecure attachment, narcissism, lability, self-aggression and anxiety characterize consumers and abstinent, while suspiciousness, rejection and character hardness are found in consumers (non-abstinent and abstinent). Compulsive traits, unplanned body impulsiveness and lack of control in emotional regulation predominated in non-abstinent and participants with co-morbidities. Detachment and inhibition predominate in alcohol abuse disorder and narcissistic traits in substance abuse.

Impact of clinical severity on outcomes of mentalisation-based treatment for borderline personality disorder

Evidence of remission from borderline personality disorder (BPD) without specialised treatment is accumulating. To establish whether specialised treatments are indicated for patients with clinically severe disorder. The impact of clinical severity on outcomes of a randomised controlled trial of mentalisation-based treatment (MBT) was contrasted with structured clinical management (SCM). Severity indicators were defined as severity of comorbid psychiatric syndromes, severity of BPD, severity of personality disturbance and severity of symptom distress. Logistic regressions were used to predict the likelihood of recovery at 18 months, and mixed-effects regression analysis was applied to examine the association of severity and rates of improvement across time in the two treatment groups. None of the severity criteria predicted outcome at the end of treatment on logistic regression. However, testing the significance of distribution of cases of recovery v. non-recovery suggested that multiple Axis II diagnoses and symptom distress influenced outcomes. Borderline personality disorder with significant Axis II comorbidity is a possible but uncertain indicator for specialist treatment. Patients whose only personality disorder diagnosis is BPD do equally well with SCM. Prospective studies are needed.

Decision-making deficits in normal elderly persons associated with executive personality disturbances

The problems that some community-dwelling elderly persons develop in real-world decision-making may have disastrous consequences for their health and financial well-being. Investigations across the adult life span have identified personality as an important individual differences variable that is related to decision-making ability. The aim of this study was to investigate the relationship between personality characteristics, as rated by an informant, and complex decision-making performance among elderly persons. It was hypothesized that deficits in decision-making would be associated with personality characteristics reflecting weak executive functioning (Lack of Planning, Poor Judgment, Lack of Persistence, Perseveration, Lack of Initiative, Impulsivity, and Indecisiveness). Fifty-eight elderly persons participated. Their health and cognitive status were deemed intact via comprehensive neuropsychological evaluation. The Iowa Scales of Personality, completed by an informant, was used to assess personality characteristics, and the Iowa Gambling Task, completed by the participant, was used to assess complex decision-making abilities. Longstanding disturbances in executive personality characteristics were found to be associated with poor decision-making, and these disturbances remained predictive of poor decision-making even after taking into consideration demographic, neuropsychological, and mood factors. Acquired personality disturbances did not add significantly to prediction after longstanding disturbances were taken into account. Disturbances in other dimensions of personality were not significantly associated with poor decision-making. Our study suggests that attentiveness to the personality correlates of difficulties with aspects of executive functioning over the adult years could enhance the ability to identify older individuals at risk for problems with real-world decision-making.

The Clustering of Psychiatric Disorders in High-Risk Gambling Populations

The aims of this study were to examine the associations between psychiatric disorders and pathological gambling (PG) and the clustering of psychiatric disorders in high risk gambler populations. The sample comprised 140 regular gamblers who were recruited from the general public. A variety of self- report and semi structured questionnaires was administered, including the Mini International Neuropsychiatric Interview, The Personality Diagnostic Questionnaire-4th Edition, NORC DSM-IV Screen for Gambling Problems Self- administered and Problem Gambling Severity Index. Axis I and Axis II psychiatric disorders and personality disturbances were found to be more prevalent amongst pathological gamblers than other gamblers with the strongest differences observed for mood and anxiety-related disorders. Almost two-thirds of pathological gamblers reported both an anxiety or mood disorder in conjunction with another type of disorder. These differences between the gambling groups existed even after controlling for gender. The results highlight the high rates of co-morbidity in pathological gamblers in the community and the extent to which anxiety and mood disorders co-existing with other forms of pathology. These results highlight the significant challenges facing treatment services in the treatment of PG and the extent to which this should be treated as the primary disorder.

What is Essential Tremor?

Classic essential tremor is a clinical syndrome of action tremor in the upper limbs (at least 95 % of patients) and less commonly the head, face/jaw, voice, tongue, trunk, and lower limbs, in the absence of other neurologic signs. However, the longstanding notion that essential tremor is a monosymptomatic tremor disorder is being challenged by a growing literature describing associated disturbances of tandem walking, personality, mood, hearing, and cognition. There is also epidemiologic, pathologic, and genetic evidence that essential tremor is pathophysiologically heterogeneous. Misdiagnosis of essential tremor is common because clinicians frequently overlook other neurologic signs and because action tremor in the hands is caused by many conditions, including dystonia, Parkinson disease, and drug-induced tremor. Thus, essential tremor is nothing more than a syndrome of idiopathic tremulousness, and the challenge for researchers and clinicians is to find specific etiologies of this syndrome.

A questionnaire-wide association study of personality and mortality: The Vietnam Experience Study

ObjectiveWe examined the association between the Minnesota Multiphasic Personality Inventory (MMPI) and all-cause mortality in 4462 middle-aged Vietnam-era veterans. MethodsWe split the study population into half-samples. In each half, we used proportional hazards (Cox) regression to test the 550 MMPI items' associations with mortality over 15years. In all participants, we subjected significant (p<.01) items in both halves to principal-components analysis (PCA). We used Cox regression to test whether these components predicted mortality when controlling for other predictors (demographics, cognitive ability, health behaviors, and mental/physical health). ResultsEighty-nine items were associated with mortality in both half-samples. PCA revealed Neuroticism/Negative Affectivity, Somatic Complaints, Psychotic/Paranoia, and Antisocial components, and a higher-order component, Personal Disturbance. Individually, Neuroticism/Negative Affectivity (HR=1.55; 95% CI=1.39, 1.72), Somatic Complaints (HR=1.66; 95% CI=1.52, 1.80), Psychotic/Paranoid (HR=1.44; 95% CI=1.32, 1.57), Antisocial (HR=1.79; 95% CI=1.59, 2.01), and Personal Disturbance (HR=1.74; 95% CI=1.58, 1.91) were associated with risk. Including covariates attenuated these associations (28.4 to 54.5%), though they were still significant. After entering Personal Disturbance into models with each component, Neuroticism/Negative Affectivity and Somatic Complaints were significant, although Neuroticism/Negative Affectivity's were now protective (HR=0.73; 95% CI=0.58, 0.92). When the four components were entered together with or without covariates, Somatic Complaints and Antisocial were significant risk factors. ConclusionsSomatic Complaints and Personal Disturbance are associated with increased mortality risk. Other components' effects varied as a function of variables in the model.

Treatment issues for personality disorders in epilepsy

This article supports a view that certain personality disturbances in epilepsy should be viewed as associated with the cerebral abnormalities that also lead to seizures. Herein I discuss two main variants: that related to temporal lobe epilepsy and that associated with juvenile myoclonic epilepsy. In view of its controversial nature, I also comment on the link between aggression and epilepsy. Recommendations for treatment include psychological and social therapies with further advice about the use of antiepileptic drugs (AEDs) and psychotropic medications in these conditions.

Autism as the clinical core marker in schizophrenia

In his paper published in the June 2012 issue of World Psychiatry, J. Parnas focuses on the fundamental disturbance in patients before the onset of schizophrenic illness 1. He refers to the ICD-8, in which a personality disturbance was considered to be the clinical core marker of schizophrenia. In the ICD-9, this concept was retained including a disturbance of the will (inertia and negativism). In his editorial in the same issue 2, M. Maj calls for follow-up studies on Parnas' Gestalt approach in order to capture the basis of schizophrenia. This dialog immediately brought to my mind the work of another Danish psychiatrist, E. Dein (1922–1975). In the 1950s, Dein performed follow-up studies in patients within the spectrum of schizophrenia 3. He defined autism as “a permanent and socially perceptible deviation as to the interpersonal relations of the individual, characterized by a pervasive tendency to keep an abnormal distance to other people, to adopt a passive attitude and to be emotionally indifferent” 4. He found that 109 of 142 patients with chronic schizophrenia had autism before the onset of their illness, compared to only one of 52 patients with episodic schizophreniform (probably schizoaffective) states 3. The results obtained by Dein confirmed Kraepelin's observation that autism is a clinical core marker of schizophrenia. The Gestalt approach proposed by J. Parnas is a major contribution in this respect. During our validation study on depression and mania scales 5, Dein told me that the most severe case of contact disturbance he had ever observed was in a patient with manic-depressive illness. In that illness, however, the disturbance does not appear outside acute episodes, in contrast to schizophrenia, where it represents a personality trait 4. In his editorial, M. Maj also makes some remarks on the practical problems of Parnas' model. Among these is that the core Gestalt is possibly very reliable in the hands of super experts, but dangerously volatile in ordinary clinical practice 2. In this respect, Dein's words 4 echo Maj's concerns: “It is true that the ability of psychiatrists to perceive subtle shades in contact varies considerably, and perhaps a natural wish to establish contact may lure many psychiatrists into overestimating their rapport with the patient. It is at any rate inexpedient if a criterion so decisive for the diagnosis as autism must depend too much on the individuality of the psychiatrist, and it really may become a problem if the amount of his experience and competence comes to play a dominant role in clinical discussion”. Dein also states that “when evaluating possible autism… one should… try to close one's eyes to other symptoms, as for instance disturbances of thinking, transitivistic phenomena, delusions or hallucinations; these symptoms are sometimes so suggestive of the diagnosis of schizophrenia that one may be prejudiced in favour of the presence of autism” 4. When making an attempt to close the eyes of psychiatrists of the DSM-IV era to Schneider's first-rank symptoms in order to focus on the key feature of schizophrenia, Maj 6 has previously concluded that the concept of autism, as revisited by Parnas 7, deserves attention. We believe that this element should be explicitly introduced in the current debate in the journal.

SKOMPUTERYZOWANA LINGWISTYKA I PSYCHOLOGIA POKONUJĄC OGRANICZENIA POLIGRAFU

We developed an auxiliary tool, named “Software Human Reliability Estimator” (SHRE), which in certain cases can replace the polygraph. The polygraph is not always effective in measuring the reliability of a witness. For instance, the polygraph is ineffective when the witness believes that the testimony is the truth even when in reality it is not. In such cases, an alternative objective test is required. Another disadvantage of the polygraph test lies in the lack of discreetness owing to the requirement that the witness must agree to undergo a polygraph test. In addition, the polygraph test cannot be performed in real time because of its cumbersome and bulky nature. These drawbacks have motivated the search for alternatives to the polygraph. Herein, we suggest a methodology accompanied by a corresponding software package that overcomes the mentioned shortcomings of the polygraph. The methodology is based on a computer-assisted cognitive behavioral therapy methodology (CBT) (Burns 1999). CBT was originally developed for psychological treatment and can be used to characterize personalities. This methodology can also be used to find the individual’s personality disturbances and to evaluate the reliability of a witness. The CBT methodology assumes that the cognitive thoughts of a human are expressed in his language. In the literature, about ten categories of thoughts are determined, and so called distorted thoughts, indicate a behavioral deviation. Based on the above assumption, it is possible to map thoughts, including distorted thoughts and analyze them methodically with the help of linguistic tools. These tools should be able to scan the mapping and discover distorted thoughts as classified by the CBT method. We will use extreme situations as examples to illustrate distorted thoughts. The mentioned situations will refer to time description (always, never), location (everywhere, nowhere), quantity (everything, nothing, nobody), possibility (must, forced, incapable) etc. These types of expressions leave no doubt as to their meanings. The linguistic analysis is performed at two levels: semantic and syntactic. The first stage is the semantic analysis. Here, the vocabulary of the sentence is analyzed. The known linguistic term, quantitative-semantics, is given a special significance since it enables a pre-ranking of the nouns, adjectives, adverbs beyond their regular usage. Quantitative semantics analysis searches especially for superlatives such as “never”, which indicate an extreme case. This analysis is supported in the first stage by using an expression named “distinguished”. In order to find distinguished expressions it is recommended to use in the second stage of the analysis a methodology borrowed from formal-languages, a field in computer sciences. This analysis is supposed to strengthen or eliminate the indications found in the first analysis stage, the semantic analysis.

Effectiveness of Structured Teaching Program on Knowledge Regarding Epilepsy in Children among school teachers.

Childhood is a unique phase of human development. Children are the important feature of every society and also a future of a nation.Though epilepsy is a symptom primarily of a neurological disorder it has a great extent psychiatric and psychological involvement. Epilepsy may cause personality disturbance, depression, poor academic ability, poor self confidence, learning difficulties. The aim of the study was to assess the knowledge regarding epilepsy in children among school teachers before and after the Structured Teaching Programme (STP). The data were generated by using structured questionnaire, Simple random sampling technique was adopted to select 50 subjects based on the sample frame and every 2 nd sample was selected for the study. STP was developed in regard to knowledge on epilepsy in children. The data obtained from the study subjects were analyzed and interpreted in term of the objectives and hypothesis of the study. Descriptive and inferential statistics were used for data analysis; the level was set at 0.05 levels. The mean post test score 36.10 was higher than the mean pre test score 25.38. The computedt value 23.321, indicated that there was a significant difference between pre test and post test knowledge score. The findings identified that there was no significant association between pre test knowledge score of teachers and the selected personal variables, which shows the knowledge of school teachers was independent of selected personal variables. This study revealed that the knowledge of teachers regarding epilepsy in children was inadequate and was increased after the administration of STP. Thus the research hypothesis was accepted.

Natural killer and natural killer T-like cells in splenectomised patients

ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Grywalska E, Markowicz J, Siwicka D, et al. Natural killer and natural killer T-like cells in splenectomised patients. Central European Journal of Immunology. 2013;38(3):372-379. doi:10.5114/ceji.2013.37759. APA Grywalska, E., Markowicz, J., Siwicka, D., Pasiarski, M., Surdacka, A., & Grafka, A. et al. (2013). Natural killer and natural killer T-like cells in splenectomised patients. Central European Journal of Immunology, 38(3), 372-379. https://doi.org/10.5114/ceji.2013.37759 Chicago Grywalska, Ewelina, Justyna Markowicz, Dorota Siwicka, Marcin Pasiarski, Agata Surdacka, Agnieszka Grafka, and Agnieszka Malec et al. 2013. "Natural killer and natural killer T-like cells in splenectomised patients". Central European Journal of Immunology 38 (3): 372-379. doi:10.5114/ceji.2013.37759. Harvard Grywalska, E., Markowicz, J., Siwicka, D., Pasiarski, M., Surdacka, A., Grafka, A., Malec, A., Bilski, M., Roman, T., and Roliński, J. (2013). Natural killer and natural killer T-like cells in splenectomised patients. Central European Journal of Immunology, 38(3), pp.372-379. https://doi.org/10.5114/ceji.2013.37759 MLA Grywalska, Ewelina et al. "Natural killer and natural killer T-like cells in splenectomised patients." Central European Journal of Immunology, vol. 38, no. 3, 2013, pp. 372-379. doi:10.5114/ceji.2013.37759. Vancouver Grywalska E, Markowicz J, Siwicka D, Pasiarski M, Surdacka A, Grafka A et al. Natural killer and natural killer T-like cells in splenectomised patients. Central European Journal of Immunology. 2013;38(3):372-379. doi:10.5114/ceji.2013.37759.

German translation, cross-cultural adaptation and validation of the whiplash disability questionnaire.

BackgroundThe Australian Whiplash Disability Questionnaire (WDQ) was cross-culturally translated, adapted, and tested for validity to be used in German-speaking patients. The self-administered questionnaire evaluates actual pain intensity, problems in personal care, role performance, sleep disturbances, tiredness, social and leisure activities, emotional and concentration impairments with 13 questions rated on an 11-point rating scale from zero to ten.MethodsIn a first part, the Australian-based WDQ was forward and backward translated. In a consensus conference with all translators and health care professionals, who were experts in the treatment of patients with a whiplash associated disorder (WAD), formulations were refined. Original authors were contacted for clarification and approval of the forward-backward translated version. The German version (WDQ-G) was evaluated for comprehensiveness and clarity in a pre-study patient survey by a random sample of German-speaking patients after WAD and four healthy twelve to thirteen year old teenagers.In a second part, the WDQ-G was evaluated in a patient validation study including patients affected by a WAD. Inpatients had to complete the WDQ-G, the North American Spine Society questionnaire (NASS cervical pain), and the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) at entry in the rehabilitation centre.ResultsIn the pre-study patient survey (response rate 31%) patients rated clarity for title 9.6 ± 0.9, instruction 9.3 ± 1.4 and questions 9.6 ± 0.7, and comprehensiveness for title 9.6 ± 0.7, instruction 9.3 ± 1.4 and questions 9.8 ± 0.4. Time needed to fill in was 13.7 ± 9.0 minutes.In total, 70 patients (47 females, age = 43.4 ± 12.5 years, time since injury: 1.5 ± 2.6 years) were included in the validation study. WDQ-G total score was 74.0 ± 21.3 points (range between 15 and 117 points). Time needed to fill in was 6.7 ± 3.4 minutes with data from 22 patients. Internal consistency was confirmed with Cronbachs’s α = 0.89. Concurrent validity showed a highly significant correlation with subscale pain and disability (NASS) at r = 0.74 and subscale pain (SF-36) at r = 0.71.ConclusionsThe officially translated and adapted WDQ-G can be used in German-speaking patients affected by a WAD to evaluate patients’ impairments in different domains. The WDQ-G is a self-administered outcome measure showing a high internal consistency and good concurrent validity.

Caregiver burden and nonachievement of healthy lifestyle behaviors among family caregivers of cardiovascular disease patients.

To determine whether caregiver burdens are associated with lifestyle behaviors 1 year following the hospitalization of a family member with cardiovascular disease (CVD). Prospective follow-up study of National Heart Lung and Blood Institute sponsored Family Intervention Trial for Heart Health participants. Hospital-based recruitment/baseline visit with 1-year follow-up. Family members of hospitalized CVD patients (N = 423; 67% female; 36% racial/ethnic minority; mean age 49 years). Systematic evaluation at 1 year to determine heart-healthy diet (defined as <10% kcal from saturated fat; Block 98 Food Frequency Questionnaire) and physical activity (defined as ≥4 d/wk; Behavioral Risk Factor Surveillance System Survey) behaviors and caregiver burdens (five domains: employment, financial, physical, social, and time; Caregiver Strain Questionnaire). Logistic regression adjusted for covariates. Heart-healthy diet was less frequent among caregivers citing feeling overwhelmed (odds ratio [OR] = .50; 95% confidence interval [CI] = .26-.97), sleep disturbance (OR = .51; 95% CI = .27-.96), financial strain (OR = .41; 95% CI = .20-.86), upsetting behavior (OR = .48; 95% CI = .25-.92), and/or time demands (OR = .47; 95% CI = .26-.85) as burdens. Physical activity was less frequent among caregivers reporting financial strain (OR = .32; 95% CI = .13-.81) or upsetting patient behavior (OR = .33; 95% CI = .15-.76) as burdens. The most commonly cited caregiver burdens included changes in personal plans (39%), time demands (38%), and sleep disturbance (30%). Caregiver burdens were associated with nonachievement of heart-healthy diet and physical activity behaviors among family caregivers 1 year after patient discharge. When developing heart-health promotion interventions, caregiver burden should be considered as a possible barrier to prevention among family members of CVD patients.

The Management of Narcissistic Vulnerability: Three Case Studies Guided by Stephen Mitchell's Integrated Treatment Model

The psychological literature pertaining to the treatment of the patient with a narcissistic personality disturbance is dominated by the divergent theories of Otto Kernberg and Heinz Kohut. In this context, Stephen Mitchell’s theory of narcissistic illusion, which integrates Kernberg’s view of narcissism as a defensive phenomenon and Kohut’s view of narcissism as a growth-enhancing opportunity, is first reviewed. The current study then seeks to assess, through the application of Mitchell’s integrated treatment model to three long-term psychotherapy cases, the efficacy of Mitchell’s model. Efficacy is assessed through (a) a comparison of pre-treatment and post-treatment scores on two standardized, self-report measures, Raskin and Terry's Narcissistic Personality Inventory and the Millon Clinical Multiaxial Inventory-III; (b) DSM diagnostic appraisals before and after therapy; and (c) behavioral comparisons indicating initial psychopathology versus improvement over the course of therapy. In interpreting the findings of the case studies, I argue that the goal of treatment of patients with a narcissistic personality disturbance is to help them (a) acknowledge their narcissistic orientation, and (b) ultimately understand the function of their narcissistic illusion. I conclude that Mitchell’s theory successfully guides the clinician to such an outcome. The strengths and limitations of Mitchell’s model are critically reviewed. Finally, adjunctive interventions to aid the clinician in the management of the patient’s ongoing narcissistic vulnerability are proposed.

A Personal Perspective on the Treatment of Three Cases of Narcissistic Vulnerability

ABSTRACT This article is a response to the commentaries of Nancy McWilliams (2012) and Kenneth Levy (2012) concerning my treatment of three patients—Alex, Brian, and Candace—whose presenting difficulties included a narcissistic personality disturbance and who were treated using Mitchell's (1988) integrated treatment model. In addition to responding to particular points raised by McWilliams' more "artistic" and Levy's more "scientific" perspectives, I provide a more personal context and view of my experience in providing therapy to these three patients.

Features of diagnostic cognitive impairment for faces of genesial age

The diseases accompanying with development cognitive of a dysfunction, represent a major medical and social problem. It is conditioned on the one hand by high abundance of the given kind of a pathology, and on the other hand by considerable costs of treatment and after treatment ill. There is enough often cognitive of disturbance meet for young faces. The development of disturbance of maximum crustal functions is in this case conditioned by contagions, endocrine disturbance, craniocerebral traumas and series of other morbid conditions. Overseen at cognitive disturbance the personal and behavioral disturbance are capable to render negative influencing on a genesial function, pregnancy and its outcomes. Large percent cognitive of disturbance overseen for young, falls into to the so-called potentially reversible forms, that allows to hope for a favorable outcome of management of such patients at the correctly planned therapy and tactics of an after treatment. One of key aspects is the valuable well-timed diagnostic cognitive of disturbance. Now in diagnostic looking up the considerable role is allocated to methods functional neuroimaging. One of such methods is functional magnetic-resonant tomography. The research, conducted by us, has allowed to determine specific zones, accountable for implementation of visual storage and reproduction. The obtained data can be utilised in complex diagnostic cognitive of disturbance, in particular on up to dementia of stage for faces of genesial age

The genetics and neuropathology of frontotemporal lobar degeneration.

Frontotemporal lobar degeneration (FTLD) is a heterogeneous group of disorders characterized by disturbances of behavior and personality and different types of language impairment with or without concomitant features of motor neuron disease or parkinsonism. FTLD is characterized by atrophy of the frontal and anterior temporal brain lobes. Detailed neuropathological studies have elicited proteinopathies defined by inclusions of hyperphosphorylated microtubule-associated protein tau, TAR DNA-binding protein TDP-43, fused-in-sarcoma or yet unidentified proteins in affected brain regions. Rather than the type of proteinopathy, the site of neurodegeneration correlates relatively well with the clinical presentation of FTLD. Molecular genetic studies identified five disease genes, of which the gene encoding the tau protein (MAPT), the growth factor precursor gene granulin (GRN), and C9orf72 with unknown function are most frequently mutated. Rare mutations were also identified in the genes encoding valosin-containing protein (VCP) and charged multivesicular body protein 2B (CHMP2B). These genes are good markers to distinguish underlying neuropathological phenotypes. Due to the complex landscape of FTLD diseases, combined characterization of clinical, imaging, biological and genetic biomarkers is essential to establish a detailed diagnosis. Although major progress has been made in FTLD research in recent years, further studies are needed to completely map out and correlate the clinical, pathological and genetic entities, and to understand the underlying disease mechanisms. In this review, we summarize the current state of the rapidly progressing field of genetic, neuropathological and clinical research of this intriguing condition.

Is hyperemesis gravidarum associated with mood, anxiety and personality disorders: a case–control study

ObjectiveIntractable nausea and vomiting, known as hyperemesis gravidarum (HG), are relatively common medical problems among pregnant women. Although there are some studies based on psychiatric symptom scales, the relationship between HG and psychiatric disorders, particularly anxiety and personality disorders, is unclear. In this study, we aimed to investigate whether there is a difference among women with and without HG with respect to frequency of mood, anxiety and personality disorders. MethodsThe study sample was composed of 52 patients with HG and 90 control pregnant women. Mood and anxiety disorders were ascertained by means of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Personality disorders were assessed with the Structured Clinical Interview for DSM, Revised Third Edition, Personality Disorders (SCID-II). ResultsThe prevalence of any mood disorder and any anxiety disorder in women with HG was 15.4% and 36.5%, respectively. In addition, 19 (36.5%) of the patients with HG had at least one personality disorder. According to reports collected from the participants in the study, most of the mood or anxiety disorders occurred before the pregnancy in women with HG. The prevalence of major depression, generalized anxiety disorder, avoidant personality disorder and obsessive–compulsive personality disorder was significantly higher in women with HG compared to the control subjects. ConclusionsThe results of the present study suggest that mood and anxiety disorders, and personality disturbances are frequently observed among women with HG and that there is a potential relationship between these psychiatric disorders and HG during pregnancy.

Clinical Phenomenology of Childhood Abuse–Related Complex PTSD in a Population of Female Patients: Patterns of Personality Disturbance

Objective: Complex posttraumatic stress disorder (PTSD) involves a variety of personality disturbances presumed to result from repeated interpersonal trauma such as child abuse. As Complex PTSD patients are a heterogeneous population, we searched for clinically relevant personality-based subtypes. Method: This study used a cluster analysis of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), Axis II features within a sample of 71 female outpatients with systematically assessed child abuse–related Complex PTSD. Results: Two main subtypes were found: adaptive and nonadaptive. The latter was further differentiated into withdrawn, alienated, suffering, and aggressive subtypes, characterized by different levels of introversion and disinhibition. Among the nonadaptive subtypes, the severity of Complex PTSD symptoms was lowest in the withdrawn (introverted only) subtype. The subtypes differed in their level of dissociation and depression but did not differ regarding PTSD symptoms, trauma history, or parental bonding characteristics. Conclusion: Confirming earlier findings, our study found personality-based Complex PTSD subtypes, which could implicate differential treatment needs and results.