Structured Clinical Interview For DSM-IV Axis II Research Articles

Personality Pathology and Functional Impairment in Patients With Hypochondriasis.

Research indicates substantial co-occurance of personality pathology and hypochondriasis, which both involve significant psychosocial impairment. This study sought to investigate the role of personality pathology for explaining functional impairment in patients with hypochondriasis, while accounting for the influence of health anxiety severity. Patients diagnosed with hypochondriasis (N=84; 60% women) were administered interview- and self-report instruments for personality pathology, health anxiety severity, and functional impairment (general, social, and physical): The Structured Clinical Interview for DSM-IV Axis II (SCID-II), the Personality Inventory for DSM-5 (PID-5), the Short Health Anxiety Inventory (SHAI), the 36-item Short Form health survey (SF-36), and the Global Assessment of Functioning (GAF). Hierarchical regression analyses were performed with boot-strapping (1000 samples). Findings overall showed that personality pathology incrementally explained functional impairment over the influence of health anxiety severity. More specifically, findings revealed that the incremental effect of PID-5 trait dimensions was substantially larger than the SCID-II personality disorder criterion-count. Functional impairment was specifically associated with SCID-II symptoms of Avoidant Personality disorder and dependent personality disorder as well as PID-5 trait domains of negative affectivity, detachment, and psychoticism. The findings highlight the potential significance of personality pathology for understanding and clinical management of functional impairment in patients with hypochondriasis. The personality features that best explained functional impairment were avoidant personality disorder and dependent personality disorder and, in particular, DSM-5 and the International Classification of Diseases, 11th revision personality trait domains of negative affectivity, detachment, and psychoticism.

Exploring the Presence of Personality Disorders in a Sample of Psychiatric Inpatients

Objective: The study sought to explore the presence and determine the prevalence of personality disorders and their psychiatric comorbidities in a Slovakian psychiatric inpatient sample. Secondary goals were to describe the demographic determinants of personality disorders and to compare the prevalences of the particular personality disorders over the past two decades. Methods: This was a retrospective chart review study of psychiatric inpatients admitted to the 1st Department of Psychiatry, University Hospital of Louis Pasteur in Kosice, Slovakia during the years 2016-2017 who met the inclusion criteria and underwent psychological examination using the Structured Clinical Interview for DSM-IV Axis II (SCID-II). Results: Personality disorder was diagnosed in 146 (76%) of the 192 enrolled inpatients. The most prevalent were borderline (37.7%), obsessive-compulsive (15.8%), dependent (10.3%), and narcissistic (10.3%) personality disorder. Cluster B comprised 80 subjects (58%), followed by Cluster C with 50 subjects (36.2%) and Cluster A with 8 subjects (5.8%). The most common psychiatric comorbidities were code F40-F48 Neurotic, stress-related and somatoform disorders (27.6%), followed by F10-F19 Mental and behavioral disorders due to psychoactive substance use (24.6%), and F30-F39 Mood (affective) disorders (23.9%). The prevalence of Cluster C increased, whereas Cluster A prevalence decreased over the past two decades. There was an increase in the prevalence of borderline and obsessive-compulsive personality disorder; the schizoid and the other personality disorders prevalences considerably decreased. Conclusion: The findings of high prevalence of personality disorders highlight the need for interviewing psychiatric inpatients for both personality disorders and psychiatric disorders in order to optimize their treatment.

Co-Morbidity of DSM-IV Personality Disorder in Major Depressive Disorder Among Psychiatric Outpatients in China: A Further Analysis of an Epidemiologic Survey in a Clinical Population.

Introduction: It is common that personality disorder (PD) co-occurs with major depressive disorder (MDD). In the current literature, there is a dearth of information on the co-occurrence of PD and MDD among Chinese population. Materials and Methods: 609 individuals were randomly sampled from outpatients diagnosed as MDD in Shanghai Mental Health Center. Co-morbidity of PDs was assessed using the Personality Diagnostic Questionnaire Fourth Edition Plus (PDQ-4+) and eligible subjects were interviewed with the Structured Clinical Interview for DSM-IV Axis II (SCID-II). The score of PDQ-4+ and the rate of SCID-II PD between subjects diagnosed with MDD and those with anxiety disorders (AD) were compared. Results: Two hundred fifty-eight outpatients (42.36%) with MDD were recognized to possess at least one criterion of diagnosis for PD, according to the DSM-IV. The most prevalent PD was depressive PD (14.61%), followed by avoidant (11.49%) and borderline (11.49%) PD. Cluster C PDs (anxious and panic PD) were the most common PD types (12.12%) when compared to other clusters. Compared to patients with AD, individuals with MDD were significantly more likely to have paranoid PD (6.6% vs. 3.3%, p = 0.011), borderline PD (11.5% vs. 3.7%, p = 0.000), passive-aggressive PD (5.6% vs. 2.4%, p = 0.007), and depressive PD (14.6% vs. 7.8%, p = 0.000). Discussion: The finding indicates that there is a high prevalence of PD among patients with MDD. More significant co-morbidity rates of PDs in MDD have been found when compared with AD. Further studies for the longitudinal impact of the PD-MDD co-morbidity are in need.

Patologiczna Wielka Piątka: próba zbudowania pomostu pomiędzy psychiatryczną klasyfikacją zaburzeń a cechowym modelem osobowości zdrowej

The fifth edition of the DSM diagnostic manual has presented a hybrid system of personality disorder diagnosis, which integrates categorical and dimensional approach to diagnosis, building a kind of bridge between psychiatric classifications of disorders and psychological research on the structure of normal personality. The key element of this system is a new dimensional model of pathological personality traits. This article presents the results of the empirical verification of this model in Poland. The participants in the study were 754 individuals from the nonclinical population, aged 16–86 (M = 36.45, SD = 16.65), including 52% women. Normal personality traits were measured by means of the Revised NEO Personality Inventory (NEO-PI-R), and pathological personality traits – by means of the Personality Inventory for DSM-5 (PID-5); the risk of personality disorders was determined on the basis of SCID-II (Structured Clinical Interview for DSM-IV Axis II) questionnaire scores. The obtained results proved to be consistent with the expectations: (1) on the level of the five broad traits, the pathological DSM-5 model strongly corresponds to the Five-Factor Model of normal personality; (2) the DSM-5 model predicts the categories of disorders better than the Five-Factor Model does.

Patologiczna Wielka Piątka: próba zbudowania pomostu pomiędzy psychiatryczną klasyfikacją zaburzeń a cechowym modelem osobowości zdrowej

The fifth edition of the DSM diagnostic manual has presented a hybrid system of personality disorder diagnosis, which integrates categorical and dimensional approach to diagnosis, building a kind of bridge between psychiatric classifications of disorders and psychological research on the structure of normal personality. The key element of this system is a new dimensional model of pathological personality traits. This article presents the results of the empirical verification of this model in Poland. The participants in the study were 754 individuals from the nonclinical population, aged 16–86 (M = 36.45, SD = 16.65), including 52% women. Normal personality traits were measured by means of the Revised NEO Personality Inventory (NEO-PI-R), and pathological personality traits – by means of the Personality Inventory for DSM-5 (PID-5); the risk of personality disorders was determined on the basis of SCID-II (Structured Clinical Interview for DSM-IV Axis II) questionnaire scores. The obtained results proved to be consistent with the expectations: (1) on the level of the five broad traits, the pathological DSM-5 model strongly corresponds to the Five-Factor Model of normal personality; (2) the DSM-5 model predicts the categories of disorders better than the Five-Factor Model does.

Personality traits and personality disorders in gender dysphoria

Investigations in the field of gender dysphoria (GD) have been mostly related to psychiatric comorbidity and severe psychiatric disorders, but have focused less on personality traits and personality disorders (PDs).We aimed to assess personality and the presence of PDs in a sample of 25 persons with GD attending the Psychiatric Clinic or the Department of Endocrinology of the University of Cagliari requesting sex reassignment therapy. They were assessed through the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and the Structured Clinical Interview for DSM-IV Axis II (SCID-II).The sample consisted of 14 MtF and 11 FtM, with a mean age of 29.6 ± 9.5. Overall, 39.1% of the sample met the criteria for at least one PD, more frequently cluster-B PD (21.7%). MtF met a higher number of SCID-II criteria than FtM, especially regarding histrionic personality traits (P = 0.001). A total of 20 persons (9 MtF and 11 FtM) completed the MMPI-2. Mean T scores did not differ from the general population, except for the Psychopathic Deviate (Pd) scale (mean T = 66.2 ± 11.2). The Masculinity-Femininity (Mf) scale was slightly increased, and its score reduced after correction for perceived sex (P = 0.037). MtF scored significantly higher at the Family Problems (FAM) scale (P = 0.052) and lower at the Social Discomfort (SOD) scale (P = 0.005) compared to FtM.The high prevalence of PDs confirms that this kind of assessment in GD is of great importance, as a key part of personalized treatment plan tailoring. The high scores on the Pd scale suggest misidentification with societal standards.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The influence of personality disorder on outcome in adolescent self-harm.

Little is currently known about the presence and impact of personality disorder in adolescents who self-harm. To evaluate personality disorder in repeated self-harm in adolescence and its impact on self-harm psychopathology and adaptation outcomes over 1 year. A clinical referral sample (n = 366) of adolescents presenting with repeated self-harm aged 12-17 years, as part of a randomised controlled trial (Assessment of Treatment in Suicidal Teenagers study, ASSIST). Personality disorder was assessed using the Structured Clinical Interview for DSM-IV Axis II (SCID-II). One-year outcomes included frequency and severity of repeat self-harm, self-reported suicidality, mood and functional impairment. About 60% of the referred adolescents showed one or more forms of personality disorder. Personality disorder was associated with significantly greater severity of self-harm, overall psychopathology and impairment. There was a complex association with treatment adherence. Personality disorder predicted worse 1-year outcomes in relation to self-harm frequency and severity, as well as impairment, suicidality and depressive symptoms. Personality disorder can be reliably measured in adolescence and showed high prevalence in this clinical self-harm sample. Controlling for other variables, it showed a strong independent association with self-harm severity at referral and predicted adherence to treatment and clinical outcomes (independent of treatment) over 1 year. Consideration of personality disorder diagnosis is indicated in the assessment and management of adolescents who repeatedly self-harm.

Screening schizotypal personality disorder for detection of clinical high risk of psychosis in Chinese mental health services

Schizotypal personality disorder (SPD) is viewed as a marker of prodromal psychosis. However, information regarding genetic risk (e.g. SPD) is often overlooked in the identification process. This study assessed whether SPD screening questionnaire help the prodromal psychosis (also widely applied “clinical high risk” (CHR) for clinical sample) detection in Chinese mental health service. This work also examined whether SPD had higher frequency in genetic risk population and CHR subjects. Two wave studies concerning the SPD identification was used for analysis. Wave 1 survey: 3075 subjects were assessed by Personality Diagnostic Questionnaire for SPD (PDQ-SPD) and Structured Clinical Interview for DSM-IV Axis II (SCID-II). Wave 2 survey: 2113 subjects screened with the prodromal questionnaire -brief version (PQ-B), PDQ-SPD, and interviewed by Structured Interview for Prodromal Symptoms (SIPS). Subjects with family history of mental disorders or with psychosis reported significantly higher scores in SPD. Receiver operating characteristic curves suggested that PDQ-SPD had moderate sensitivity and specificity for identifying CHR subjects. There was significant higher on SPD features in subjects with early stage (Course less than 1 year) of psychosis. Identifying SPD may be useful in early detection of psychosis especially in detecting the genetic risk syndromes and can be integrated with existing prodromal screen tools to improve its efficiency.

EPA-0746 – Mood instability and psychosis: analyses of british national survey data

Background We used British national survey data to test specific hypotheses that mood instability 1) is associated with psychosis and individual psychotic phenomena, 2) predicts the later emergence of auditory hallucinations and paranoid ideation, and 3) mediates the link between child sexual abuse and psychosis. Methods We analysed data from the 2000 and 2007 UK national surveys of psychiatric morbidity (N=8580 and 7403 respectively). The 2000 survey included an 18-month follow-up of a subsample (N=2406). Mood instability was assessed from the Structured Clinical Interview for DSMIV Axis II (SCID-II) questionnaire. Our dependent variables comprised auditory hallucinations, paranoid ideation, the presence of psychosis overall, and a 15-item paranoia scale Results Mood Instability was strongly associated in cross-sectional analyses with psychosis (2000 OR: 7.5; 95% CI: I 4.1–13.8; 2007: OR 21.4; CI 9.7–41.2), paranoid ideation (2000: OR: 4.7; CI 4.1–5.4; 2007: OR 5.7; CI 4.9–6.7), auditory hallucinations (2000: OR: 3.4; CI 2.6–4.4; 2007: OR 3.5; CI 2.7–4.7) and paranoia total score (2000: Coefficient: 3.6;CI 3.3–3.9), remaining so after adjustment for current mood state. Baseline mood instability significantly predicted 18-month inceptions of paranoid ideation (OR: 2.3;CI 1.6–3.3) and of auditory hallucinations (OR: 2.6;CI 1.5–4.4). Finally it mediated a third of the total association of child sexual abuse with psychosis and persecutory ideation, and a quarter of that with auditory hallucinations. Conclusions Mood instability is a prominent feature of psychotic experience, and may have a role in its genesis. Targeting mood instability could lead to innovative treatments for psychosis.

Mood instability and psychosis: analyses of British national survey data.

Background: We used British national survey data to test specific hypotheses that mood instability (1) is associated with psychosis and individual psychotic phenomena, (2) predicts the later emergence of auditory hallucinations and paranoid ideation, and (3) mediates the link between child sexual abuse and psychosis. Methods: We analyzed data from the 2000 and 2007 UK national surveys of psychiatric morbidity (N = 8580 and 7403, respectively). The 2000 survey included an 18-month follow-up of a subsample (N = 2406). Mood instability was assessed from the Structured Clinical Interview for DSM-IV Axis II (SCID-II) questionnaire. Our dependent variables comprised auditory hallucinations, paranoid ideation, the presence of psychosis overall, and a 15-item paranoia scale. Results: Mood instability was strongly associated in cross-sectional analyses with psychosis (2000: OR: 7.5; 95% CI: I 4.1–13.8; 2007: OR: 21.4; CI: 9.7–41.2), paranoid ideation (2000: OR: 4.7; CI: 4.1–5.4; 2007: OR: 5.7; CI: 4.9–6.7), auditory hallucinations (2000: OR: 3.4; CI: 2.6–4.4; 2007: OR 3.5; CI: 2.7–4.7), and paranoia total score (2000: Coefficient: 3.6; CI: 3.3–3.9), remaining so after adjustment for current mood state. Baseline mood instability significantly predicted 18-month inceptions of paranoid ideation (OR: 2.3; CI: 1.6–3.3) and of auditory hallucinations (OR: 2.6; CI: 1.5–4.4). Finally, it mediated a third of the total association of child sexual abuse with psychosis and persecutory ideation and a quarter of that with auditory hallucinations. Conclusions: Mood instability is a prominent feature of psychotic experience and may have a role in its genesis. Targeting mood instability could lead to innovative treatments for psychosis.

Pretreatment outcome indicators in an eating disorder outpatient group: The effects of self-esteem, personality disorders and dissociation

ObjectiveThe prognosis for eating disorders (ED) is unsatisfactory, and the literature about outcome indicators is controversial. The present study evaluates the roles of self-esteem, personality disorders (PD), and dissociation as outcome predictors. MethodFifty-seven ED outpatients were recruited from a population beginning a Cognitive Behavioral Therapy-Enhanced (CBT-E) treatment. All patients received the Structured Clinical Interview for DSM-IV Axis I (SCID-I), the Structured Clinical Interview for DSM-IV Axis II (SCID-II), and completed the Eating Disorder Examination Questionnaire (EDE-Q), the Dissociation Questionnaire (DIS-Q), and the Rosenberg Self-Esteem Scale (RSES). One month after the end of treatment, recovery was evaluated as meeting the DSM-IV criteria for EDs. ResultsA small group of patients recovered (42.2%). Low self-esteem and dissociation results correlated with a negative outcome. DiscussionDissociation may be an important moderator of psychotherapy and treatment success, as already suggested by previous studies on non-eating-related disorders.

The correlation and difference of childhood traumatic experiences in personality disorders

Objective To explore the relationship between childhood traumatic experiences and personali-ty disorders. Methods 1511 clients were sampled randomly from Shanghai Psychological Counseling Center. Per-sonality Diagnostic Questionnaire (PDQ+4) was administered to 1402 clients to screen personality disorders. Childhood Trauma Questionnaire(CTQ) and Blind semi-structure interviews using Structured Clinical Interview for DSM-Ⅳ Axis Ⅱ (SCID-Ⅱ) were conducted to screened subjects whose PDQ + 4 test was defined as positive. Re-suits Correlation analysis revealed that the total score of CTQ had a strong association with all the of personality disorders. Using partial correlations,the significant relationships between Cluster-B personality disorders and all the CTQ factors except physical neglect were demonstrated. Emotional abuse positively correlate with Ciuster-A per-sonality disorders(r=0.139, P<0.001 ), Cluster-C could be related to none of the early life experiences. Using Kruskal Wallis test,all the groups of subjects had significantly difference in emotional abuse,physical abuse,sexual abuse,physical neglect(P<0.01). Stepwise regression analysis showed that emotional abuse,emotional neglect en-tered the regression equation of Cluster-A and Cluster-B of personality disorders,standardized regression coefficient was 0.135 and 0.119(Cluster-A) ,0. 200 and 0. 084(Cluster-B) ,emotional neglect entered the regression equa-tion of Cluster-C of personality disorders, standardized regression coefficient was 0.077 and 0.141 (Cluster-C). Conclusion Childhood traumatic experiences might contribute to individuals susceptibility to personality disor-ders. The effect of the Cluster-B personality disorders are the most obviously. Childhood traumatic experiences in 3 clusters of personality disorders are different. Key words: Personality disorders; Childhood traumatic experiences; Client; Abuse; Neglect

Asociación entre características de personalidad y consumo de cigarrillo en adultos de Bucaramanga (Colombia)

&lt;p style="text-align: justify;"&gt;Esta investigación tuvo como objetivo determinar la asociación entre rasgos de personalidad y consumo diario de cigarrillo en adultos de la población general de Bucaramanga (Colombia). Para ello se realizó un estudio transversal poblacional con una muestra probabilística de adultos entre dieciocho y sesenta y cinco años. Las características de personalidad se establecieron con el cuestionario de autoinforme de la Entrevista Clínica Estructurada para Diagnósticos DSM-IV del Eje II (SCID-II) y se utilizó regresión logística para controlar factores de confusión. En el estudio participaron 2.496 adultos con una edad promedio de treinta y ocho años (DE = 13,5), la escolaridad promedio fue 9,2 años (DE = 4,1), 69,7% eran mujeres, 58,1% estaban casados, 49,1% tenían un empleo y 67,8% vivían estrato socioeconómico medio. Quienes reportaron consumo diario de cigarrillo durante el último mes fueron considerados como fumadores actuales y ellos representaron el 10% de la población. Se encontró que las características marcadas antisociales y límites de personalidad están independiente y modestamente asociadas al consumo actual de cigarrillo. Sin embargo, se considera que las características de personalidad se deben tener en cuenta en los programas de prevención.&lt;/p&gt;&lt;p style="text-align: justify;"&gt;&lt;strong&gt;Palabras clave: &lt;/strong&gt;personalidad, tabaquismo, adultos, estudio transversal.&lt;/p&gt;

Personality Disorders and Pathological Gambling: Comorbidity and Treatment Dropout Predictors

This study describes the personality disorders (PDs) among French-speaking Canadian gamblers seeking cognitive and behavioural treatment (CBT) in an external setting. One hundred pathological gamblers were assessed with the Structured Clinical Interview for DSM-IV Axis II (SCID-II) in four different treatment centres for problem gambling. Sixty-four per cent had at least one comorbid PD according to the semi-structured interview based on the DSM-IV. The most common PDs were represented in clusters B and C. The presence of a comorbid cluster B was a significant predictor of treatment dropout. This characteristic seems to reduce the chances of recovery for some pathological gamblers. The implications for clinical practice and research are discussed.

Developing a rating scale for projected stories.

The Six-part Story Method (6PSM) is a projective tool in wide use by dramatherapists in the UK, USA and Israel (Lahad & Ayalon, 1993). In contrast to projective tests used by psychotherapists and psychologists, the 6PSM has never been the subject of any validation or reliability studies. This study reports on the identification of scale items to describe the manifest content of six-part stories. In all, 26 statements with acceptable inter-rater reliability have been identified. These statements were used to rate stories produced by clinicians (N = 24) mainstream community mental health patients (N = 21) and patients with a borderline personality disorder (N = 19). Some features that were expected to be indicators of an author with a BPD diagnosis proved to be as common in stories from other authors. However, a scale of eight items was identified that differentiated well between authors with a BPD diagnosis and others, with adequate test-retest and inter-rater reliability. Concurrent validity was tested against the Structured Clinical Interview for DSM-IV Axis II (SCID-II), the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM) and the Inventory of Interpersonal Problems--Short Form (IIP-32).