Personality Syndrome Research Articles

A Comparison of Rapists and Sexual Murderers on Demographic and Selected Psychometric Measures

This study compared 58 sexual murderers and 112 rapists who were about to undergo treatment in prison for their sexual offending behavior. The two groups were compared on background, personality, offense, and victim characteristics. The sexual murderer group were less likely to have been involved in a relationship at the time of their index offense, generally attacked older victims, and had higher self-esteem. The rapist sample were found to have more violent previous convictions and scored higher on measures of historical deviance (nonsexual), paranoid suspicion, and resentment. No differences were found on the personality or clinical syndrome scales of the Millon Clinical Multiaxial Inventory-III. However, the rapist sample had significantly higher mean scores on the Paranoid Suspicion, Resentment, and Self-Esteem subscales of the Antisocial Personality Questionnaire. Future research should compare the two groups on dynamic or changeable factors to determine differential treatment needs.

Behavioral syndromes and the evolution of correlated behavior in zebrafish

Studies of “behavioral syndromes” in different populations and species of animals can be used to shed light on the underlying mechanisms of evolution. For example, some personality syndromes suggest the existence of an underlying hormonal link, whereas other relationships between boldness and aggression appear to be the result of similar selective pressures. Here, we used 1 wild-derived and 2 laboratory strains of zebrafish (Danio rerio) to examine relationships among 5 behavioral measures: shoaling, activity level, predator approaches, latency to feed after a disturbance, and biting to a mirror stimulus. We found evidence of an activity syndrome, as if underlying metabolic costs influence variation in multiple forms of behavior. Evidence for a relationship between boldness and aggression was also apparent but depended both on strain and which specific behavior patterns were identified as measures of “boldness.” Although some comparisons of laboratory and wild-derived strains were consistent with a domestication syndrome, others were not. Most observed relationships were relatively weak and occasionally inconsistent, arguing against strong underlying genetic linkages or pleiotropic effects relating any of the behavioral measures. Instead, it may be more important to study the details of selective context or the long-term impact of linkages between some, but not all, of a large set of genes influencing complex behavioral traits. We found profound differences among strains in most behavior patterns, but few sex differences. One strain (TM1) was consistently different from the others (SH and Nadia) being more social, more likely to approach predators, and taking less time to recover from disturbance than were the other 2 strains.

Independent Versus Substance-Induced Major Depressive Disorder in Substance-Dependent Patients

Clinicians frequently encounter patients presenting with both depression and substance abuse, and their diagnosis has been a source of controversy. The authors examined whether baseline and past diagnoses of DSM-IV primary (independent) or substance-induced depression or other psychiatric syndromes predict 1-year course of depression in substance-dependent patients. Inpatients with current DSM-IV major depressive disorder (MDD) and DSM-IV alcohol, cocaine, or opiate dependence (N = 110) were evaluated with the Psychiatric Research Interview for Substance and Mental Disorders (PRISM) and followed for 12 months after discharge. Logistic regression for repeated measures modeled the odds of MDD and depressed mood over time as a function of baseline diagnoses and past independent depression, controlling for demographics, substance use, and antidepressant treatment during the follow-up. Subject recruitment was conducted from July 25, 1995 to May 14, 1997. Over the 12 months, 88% of the patients experienced depressed mood for at least 1 week, and 57% experienced MDD. Depression during follow-up was equally likely among patients with current (baseline) DSM-IV independent or substance-induced MDD; in the latter group, past independent MDD increased the likelihood of MDD during the follow-up. Panic attacks, posttraumatic stress disorder (trend), borderline personality, and antisocial personality also significantly predicted depression during the follow-up. In substance-dependent patients, both DSM-IV primary and substance-induced MDD predict future depression, warranting consideration for specific treatment. The data suggest the importance of a careful psychiatric history that includes attention to past episodes of independent depression as well as anxiety and cluster B personality syndromes.

MRI findings and Axis I and II psychiatric disorders after traumatic brain injury: A 30-year retrospective follow-up study

We studied the association between psychiatric disorders and the presence and location of traumatic lesions on magnetic resonance imaging (MRI) in 58 patients, on average, 30 years after traumatic brain injury. Axis I psychiatric disorders that had begun after the injury were assessed with the Schedules for Clinical Assessment in Neuropsychiatry (version 2.1), and Axis II disorders with the Structured Clinical Interview for DSM-III-R Personality Disorders. A 1.5-Tesla MRI scanner was used. One-third of the subjects had traumatic lesions visible on MRI. Only three psychiatric disorders, that is, delusional disorder, dementia, and the disinhibited type of organic personality syndrome, were significantly more common in subjects with contusions. Concerning the location of contusions, organic personality syndrome and its disinhibited subtype were associated with frontal lesions, and major depression was, surprisingly, inversely associated with temporal lesions. These results, which should be interpreted with caution due to the limited size of the study group, suggest that the majority of psychiatric disorders after traumatic brain injury are not closely related to the specific location or even the presence of contusions detectable with post-acute MRI.

Alexithymia After Traumatic Brain Injury: Its Relation to Magnetic Resonance Imaging Findings and Psychiatric Disorders

People with traumatic brain injury (TBI) were studied to assess the prevalence of alexithymia and its relationship to magnetic resonance imaging (MRI) findings and psychiatric disorders. Fifty-four participants, 67% men, were evaluated after a median of 30 years since TBI. A control group was matched for age, gender, and severity of depression. Alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20). In patients with TBI, axis I psychiatric disorders were assessed with the Schedules for Clinical Assessment in Neuropsychiatry (SCAN, version 2.1), and axis II disorders with the Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II). MRI examinations were carried out with a 1.5 T MRI scanner. Alexithymia was significantly more common in patients with TBI than in controls (31.5% versus 14.8%; odds ratio 2.64, 95% confidence interval 1.03-6.80). None of the variables representing TBI, ie, severity of TBI or the presence, laterality, or location of contusions on MRI, was associated with the TAS-20 total scores. Several current axis I and II psychiatric disorders, particularly organic personality syndrome, were connected to higher TAS-20 scores. Alexithymia is common, along with psychiatric disorders, in patients with TBI. Both of them may reflect dysfunction of the injured brain. In clinical practice, alexithymic features should be taken into consideration in psychosocial rehabilitation after TBI.

A Simplistic Understanding of the Five-Factor Model

Back to table of contents Previous article Next article Letter to the EditorFull AccessA Simplistic Understanding of the Five-Factor ModelTHOMAS A. WIDIGER, Ph.D., , and TIMOTHY J. TRULL, Ph.D., THOMAS A. WIDIGERSearch for more papers by this author, Ph.D., Lexington, Ky., and TIMOTHY J. TRULLSearch for more papers by this author, Ph.D., Columbia, Mo.Published Online:1 Aug 2005https://doi.org/10.1176/appi.ajp.162.8.1550-aAboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To the Editor: Jonathan Shedler, Ph.D., and Drew Westen, Ph.D. (1), argued that the five-factor model “omits key clinical constructs and may not capture the complexity of personality syndromes seen in clinical practice” (p. 1743). To demonstrate this, they constructed an abbreviated measure of the five-factor model using a small subset (30%) of the 200 items contained within the Shedler-Weston Assessment Procedure (SWAP-200). It was a foregone conclusion that the results of a factor analysis of 30% of the SWAP-200 items would not correspond to a factor analysis of the entire SWAP-200. In addition, one should ask whether their SWAP-200 items provided an adequate assessment of the five-factor model. They never attempted to validate their five-factor model measure, and a visual inspection of the items indicates inaccurate representation of the five-factor model. Finally, it is highly unlikely that their small set of SWAP-200 items would provide anything close to a reasonably comprehensive assessment of the five-factor model. In sum, there was little reason to expect that an incomplete and inadequate assessment of the five-factor model with a subset of the SWAP-200 would account for the variance within the entire SWAP-200.Drs. Shedler and Westen suggested that the constructs assessed by the 12 SWAP-200 scales are outside of the realm of the five-factor model. They ignored many, many studies that indicated otherwise. For example, two other compelling dimensional models of personality disorder have been developed by Dr. Livesley (the Dimensional Assessment of Personality Pathology) and Dr. Clark (the Schedule for Nonadaptive and Adaptive Personality). A complete description of and references for these measures, as well as others, is provided by Widiger and Simonsen (2). The clinical constructs assessed by these scales include narcissism, identity problems, eccentric perceptions, affective lability, aggression, detachment, self-harm behaviors, and compulsivity that resemble closely the scales of the SWAP-200, and many studies have documented well that the constructs assessed by the Dimensional Assessment of Personality Pathology and the Schedule for Nonadaptive and Adaptive Personality are well within the realm of the five-factor model.Drs. Shedler and Westen (1) derogatorily characterized the five-factor model as providing a simplistic lay description of personality. What was simplistic was their characterization of the five-factor model. The five-factor model is a rich dimensional model of general personality structure that has been used successfully in many areas of science and practice, including (but not limited to) the study of temperament, gender differences, heritability, behavioral medicine, and aging. An integration of the DSM-IV personality disorder nomenclature with the five-factor model would go far in integrating DSM-IV with basic science research on personality structure (3). We regret that Drs. Shedler and Westen (1) argued instead for a distinct separation of our clinical understanding of personality disorders and basic science research on personality structure.

Prevalence, Correlates, and Comorbidity of DSM-IV Antisocial Personality Syndromes and Alcohol and Specific Drug Use Disorders in the United States

The purpose of this study was to provide nationally representative data on the prevalence, sociodemographic correlates, and comorbidity of antisocial syndromes across alcohol and 8 specific drug use disorders, including sedative, tranquilizer, opiate, stimulant, hallucinogen, cannabis, cocaine, and inhalant/solvent abuse and dependence. This study is based on a nationally representative sample of adults. Lifetime prevalences of antisocial syndromes were estimated and logistic regression analyses were used to examine associations between antisocial syndromes and sociodemographic characteristics and substance use disorders. Diagnoses were made according to the criteria of the DSM-IV using the National Institute on Alcohol Abuse and Alcoholism Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV Version. The lifetime prevalences of antisocial personality disorder (APD), conduct disorder, and adult antisocial behavior were 3.6%, 1.1%, and 12.3%, respectively. Prevalences of alcohol use disorders and drug use disorders were 30.3% and 10.3%, respectively. In general, men and individuals who were younger, widowed/separated/divorced, of lower socioeconomic status, and living in urban areas or in the West were more likely to have antisocial syndromes. Native Americans were more likely and Asians and Hispanics were less likely to have APD and adult antisocial behavior. Virtually all of the associations between APD and adult antisocial behavior and specific substance use disorders were positive and statistically significant (p < .05). Significant associations between conduct disorder and substance use disorders were concentrated among women. Comorbidity of specific substance disorders with antisocial syndromes is very common in the U.S. population. Further work in many directions is indicated by the results of this study, including the factors that give rise to the associations and the treatment and prevention implications of these conditions when comorbid.

Y a-t-il un lien entre hypnotisabilité et psychopathologie ?

Janet and Charcot both regarded hypnotic states as an indicator of psychopathology – either a general indicator (Janet) or an indicator of hysteria in particular (Charcot). If susceptibility to hypnosis is currently viewed as a normal disposition, the question why patients with hysteria who were hospitalised at the Salpêtrière were so easy to hypnotise was ignored for almost a century on account of Charcot's discreditation, to be resuscitated in the 1980s in the course of investigations on the characteristics of very easily hypnotisable persons. Personalities of this type exhibit a non-pathological syndrome characterised by a reliance on fantasy, which manifests itself in the major role played by the imaginary in their daily lives. Such people inhabit a world in which fantasy and the imagination occupy a central place, and notably tend to compensate for their often unsatisfying affective lives and disappointments by constructing a parallel world. They are also markedly prone to acquiring psychosomatic disorders, which are largely the product of their imagination.The origins of the very easily hypnotisable personality lie in childhood, and take root in one of two ways. The first involves the very early familiarisation of the child with games requiring an exercise of the imagination, as a result of a parent encouraging this type of activity. The second is characterised by a defensive reaction against a hostile environment, commonly involving childhood abuse, where the child resorts to flights of fantasy as the only means of escaping from his powerlessness. These studies therefore tend to indicate that there is an indirect link between hypnosis and psychopathological troubles of a hysterical nature, which rests on a common feature : fantasy. The shared characteristic of the very easily hypnotisable personality and persons presenting psychopathological problems would be their exercise of the imagination, which the former rely on in responding to hypnotic suggestion, the latter in producing pathological symptoms. If the presence of problems of a hysterical type or of multiple personality syndrome very likely signifies a high susceptibility to hypnosis, the inverse does not hold: The majority of highly imaginative and very easily hypnotisable subjects do not exhibit any psychological problems. The fact that Charcot and Janet regarded susceptibility to hypnosis as a pathological phenomenon is therefore apparently explained by the nature of their clientele, which consisted exclusively of patients with psychological problems, notably cases of major hysteria. This population proved to be particularly easy to hypnotize and represented the pathological facet of a wider, pathologically normal population.

Dimensions of Personality Pathology: An Alternative to the Five-Factor Model

OBJECTIVE: Researchers have advocated replacing the DSM-IV classification of personality disorders with an alternative diagnostic system based on the five-factor model. This study evaluates the clinical comprehensiveness of the five-factor model and addresses the broader question of how many factors, and which factors, are necessary to understand personality pathology. METHOD: A national sample of 530 psychiatrists and clinical psychologists used the Shedler-Westen Assessment Procedure (SWAP-200) to provide detailed psychological descriptions of patients with personality disorder diagnoses. The SWAP-200 is a 200-item instrument designed to capture the richness and complexity of clinical observations while also providing quantifiable data for research. We used factor analysis to identify dimensions of personality relevant to understanding personality pathology. RESULTS: The five-factor structure replicated in a content-restricted subset of 60 SWAP-200 items. However, factor analysis of the full SWAP-200 yielded a conceptually richer factor solution that did not resemble the five-factor model. The analysis identified 12 clinically relevant personality dimensions labeled psychological health, psychopathy, hostility, narcissism, emotional dysregulation, dysphoria, schizoid orientation, obsessionality, thought disorder, oedipal conflict (histrionic sexualization), dissociation, and sexual conflict. CONCLUSIONS: The five-factor model represents a sound distillation of the personality constructs used by laypersons. However, it omits key clinical constructs and may not capture the complexity of personality syndromes seen in clinical practice. The SWAP-200 factors may provide a framework for studying personality pathology that is both empirically grounded and clinically relevant.

Personality and disease: correlations of multiple trait scores with various illnesses.

Correlations between personality measures and self-reported data on health status were examined in a sample of 5133 men and women, aged between 40 and 65. A wider range of diseases was studied than is typical. Small but theoretically meaningful correlations with personality were found for some diseases. Personality syndromes of Emotional Lability, Type A Behaviour, Behavioural Control, Locus of Control over Diseases and Psychoticism were distinguished factorially. Emotional Lability appeared to be the most robust predictor of general disease vulnerability. Some small but significant associations between specific illnesses and Type A and Behavioural Control were also found.

Time perception, impulsivity, emotionality, and personality in self-harming borderline personality disorder patients.

To investigate how time perception may contribute to the symptoms of self-harming Borderline Personality Disorder (BPD) patients, 19 self-harming BPD inpatients and 39 normal controls were given measures of time perception, impulsivity, personality, emotion, and BPD characteristics. A test sensitive to orbitofrontal cortex (OFC) function ("Frontal" Behavior Questionnaire) was also administered, as the OFC has been associated with impulsivity and time perception. BPD patients produced less time than controls, and this correlated with impulsiveness and other characteristics commonly associated with BPD. BPD patients were also less conscientious, extraverted, and open to experience, as well as more impulsive (self-report and behaviorally), emotional, neurotic, and reported more BPD characteristics, compared to controls. The results suggest that some of these core characteristics of BPD may be on a continuum with the normal population and, impulsivity in particular, may be related to time perception deficits (i.e., a faster subjective sense of time). Finally, BPD patients scored higher on the Frontal Behavior Questionnaire, suggesting that some symptoms of the BPD syndrome may be related to problems associated with the OFC. A control spatial working memory task (SWM) revealed that SWM deficits could not explain any of the BPD patients' poor performance. While impulsivity was correlated with time perception across all participants, emotionality, introversion, and lack of openness to experience were not. This suggests that different symptoms of the borderline personality syndrome may be separable, and therefore, related to different cognitive deficits, and potentially to different brain systems. This may have important implications for treatment strategies for BPD.

Prince Liev Nikoláievitch Míchkin ("The Idiot", Fiódor Dostoevsky) and the interictal personality syndrome of temporal lobe epilepsy

Russian romancist Fiódor Dostoevsky's composition, besides its extraordinary literary value, has a special importance for neurologists and epileptologists. The writer, who suffered of epilepsy, transmitted in his texts the epileptic's universe and how the patient is perceived by the society. His novels had great influence on how epilepsy is perceived by western culture. The romance "The Idiot" has as protagonist Prince Liev Nikoláievitch Míchkin, a epileptic with remarkable personality. Considering the propose made by Geschwind-Waxman (1975) of a interictal personality syndrome in temporal lobe epilepsy, this article intends to discuss the behavioral alterations in epileptic patient, from Míchkin, the main character in Fiódor Dostoevsky's "The Idiot".

Saccadic eye movements, schizotypy, and the role of neuroticism

We investigated the relationships of anti- and prosaccades with psychometric schizotypy. One aim was to estimate the role of negative emotionality and general psychopathology (i.e. neuroticism) in this relationship. 115 non-clinical volunteers underwent infrared oculographic assessment of antisaccades and prosaccades. Schizotypy was assessed with the Personality Syndrome Questionnaire (PSQ-80), the Rust Inventory of Schizotypal Cognitions (RISC), and Eysenck Personality Questionnaire-Revised (EPQ-R) Psychoticism. Higher positive schizotypy scores predicted increased antisaccade errors (RISC) and greater prosaccade spatial error (PSQ-80 Unreality). Greater thought disorder (PSQ-80 Activity) predicted shorter prosaccade latencies. EPQ-R Neuroticism was substantially correlated with schizotypy but was not related to saccadic measures and did not account for their relationship with schizotypy. We conclude that saccadic performance patterns in schizotypy are not due to negative emotionality or general psychopathology, but specific to schizophrenia spectrum signs and symptoms.

Saccadic eye movements, schizotypy, and the role of neuroticism

We investigated the relationships of anti- and prosaccades with psychometric schizotypy. One aim was to estimate the role of negative emotionality and general psychopathology (i.e. neuroticism) in this relationship. 115 non-clinical volunteers underwent infrared oculographic assessment of antisaccades and prosaccades. Schizotypy was assessed with the Personality Syndrome Questionnaire (PSQ-80), the Rust Inventory of Schizotypal Cognitions (RISC), and Eysenck Personality Questionnaire-Revised (EPQ-R) Psychoticism. Higher positive schizotypy scores predicted increased antisaccade errors (RISC) and greater prosaccade spatial error (PSQ-80 Unreality). Greater thought disorder (PSQ-80 Activity) predicted shorter prosaccade latencies. EPQ-R Neuroticism was substantially correlated with schizotypy but was not related to saccadic measures and did not account for their relationship with schizotypy. We conclude that saccadic performance patterns in schizotypy are not due to negative emotionality or general psychopathology, but specific to schizophrenia spectrum signs and symptoms.

Behavioural disturbances following Japanese B encephalitis

Clinically, Japanese B encephalitis (JBE) is often overlooked as its occurrence in Western countries is rare. However, its neurological, cognitive and psychiatric sequelae constitute a major public health problem in the Far East where JBE is endemic. European and American subjects may however experience the JBE when returning from a Far East journey. In such cases, misdiagnosis is frequent because of the unawareness of psychiatrists and physicians. The present review, therefore, documents the behavioural and cognitive sequelae of JBE. This reactivates the debate concerning the vaccination against the virus all the more that the literature enlightens the importance of the vaccination for those who undertake frequent and extensive tourist excursions to the Orient but still discusses it for occasional travellers. Following is a case-report of a young western European post-graduate student who has contracted JBE by experiencing an acute febrile delirium during an unusual short stay in South East Asia. Pyramidal syndrome, Parkinsonism and amnesia were the prominent acute deficits. Whereas these faded in great part during convalescence, emotional and behavioural instability associated with affective involvement, obsessive–compulsive symptoms and cognitive impairments appeared. A partial recovery was however obtained with neuroleptics, lithium and following electro-convulsive therapy. Organic personality syndrome was persistent and thereafter constituted the main sequelae syndrome. Hypersomnia and several enuretic episodes persisted.

Natal dispersal and personalities in great tits (Parus major).

Dispersal is a major determinant of the dynamics and genetic structure of populations, and its consequences depend not only on average dispersal rates and distances, but also on the characteristics of dispersing and philopatric individuals. We investigated whether natal dispersal correlated with a predisposed behavioural trait: exploratory behaviour in novel environments. Wild great tits were caught in their natural habitat, tested the following morning in the laboratory using an open field test and released at the capture site. Natal dispersal correlated positively with parental and individual exploratory behaviour, using three independent datasets. First, fast-exploring parents had offspring that dispersed furthest. Second, immigrants were faster explorers than locally born birds. Third, post-fledging movements, comprising a major proportion of the variation in natal dispersal distances, were greater for fast females than for slow females. These findings suggest that parental behaviour influenced offspring natal dispersal either via parental behaviour per se (e.g. via post-fledging care) or by affecting the phenotype of their offspring (e.g. via their genes). Because this personality trait has a genetic basis, our results imply that genotypes differ in their dispersal distances. Therefore, the described patterns have profound consequences for the genetic composition of populations.

Textbook of Clinical Neuropsychiatry

Textbook of Clinical Neuropsychiatry

Becoming as Sick as They

Abstract Mental illness invariably has an impact on the spouse of a mentally ill partner; in Al-Anon it has become proverbial, “If you live with them long enough, you will become as sick as they are.” This article compares three different types of illness in their impact on spouses: alcoholism, the borderline personality syndrome, and the obsessive-compulsive disorder. The intent of the article is to sharpen the counselor's differentiation between characteristic responses of these spouses, so that care giving is more effective. Suggestions for treatment are made in that pastoral counselors may well be the professional group most likely to work with such spouses. The prevention of a sick outcome within the relationship is a distinctive pastoral opportunity.

The Incremental Validity of Passive-Aggressive Personality Symptoms Rivals or Exceeds That of Other Personality Symptoms in Suicidal Outpatients

We examined the incremental validity of passive-aggressive and other personality symptoms, by determining personality syndromes' ability to account for unique variance in distress and impairment as indexed by several Axis I-related symptoms. Two hundred fifty young adults, referred for suicidal behavior or ideation, completed the Millon Clinical Multiaxial Inventory (Millon, 1983) as well as several other symptom measures. The personality syndromes varied considerably in their ability to account for unique variance in Axis I-related symptoms. Several syndromes, including schizoid, schizotypal, and compulsive symptoms, showed relatively low incremental validity, whereas the incremental validity of passive-aggressive symptoms exceeded all others. The criterion of incremental validity represents an inclusive and persuasive means to evaluate personality disorder validity. On this criterion, passive-aggressive symptoms display high validity, and passive-aggressive personality disorder, in some form, may deserve inclusion on Axis II of future editions of Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association).

Relación entre estrategias de afrontamiento, síndromes clínicos y trastornos de personalidad en pacientes esquizofrénicos crónicos

The aim of this paper has been to study whether coping styles in schizophrenics are related to personality syndromes and disorders as measured Millon Multiaxial Clinical Inventory (MCMI-II) and the characteristic profile of chronic schizophrenics on this test. Results show an important relationship between negative coping strategies (emotion and avoidance) and those subscales with high scores and also between task-centered coping strategies and low psychopathology.