Personality and Mental Health最新文献

{"title":"Mental Health and Personality Functioning of People With Probable Personality Disorder Who Have Coexisting Complex Post Traumatic Stress Disorder.","authors":"Sapphira McBride, Nia Goulden, Kirsten Barnicot, Kieron Corrigan, Sophie Shen, Serena Guillemard, Violet Effiom, Gemma Harrison, Lizwi Nyathi, Lyn Charles, Snehal P Pandya, Verity Leeson, Rachel Evans, Mike J Crawford","doi":"10.1002/pmh.70010","DOIUrl":"10.1002/pmh.70010","url":null,"abstract":"<p><p>This paper examines the prevalence and comorbidity of complex post-traumatic stress disorder (CPTSD) and borderline personality disorder (BPD) among individuals with probable personality disorder, using baseline data from the Structured Psychological Support clinical trial. The clinical characteristics and personality functioning of participants are summarised and compared between those meeting criteria for BPD, CPTSD, both or neither condition. Among 292 participants, 97% reported significant trauma exposure, and over half met the criteria for CPTSD. Those with CPTSD exhibited higher levels of social dysfunction and depression compared with those with BPD, despite both groups showing elevated emotion dysregulation and anxiety. Comorbidity of CPTSD and BPD was high, with 50% of the sample meeting criteria for both conditions. Participants with comorbid CPTSD and BPD displayed poorer baseline scores across all measures of mental health and functioning than those who met criteria for BPD alone. No statistically significant differences were found in suicidal behaviour or treatment-seeking between groups. There were no significant differences in International Classification of Diseases-11 personality trait domains between participants with CPTSD and BPD, but people with comorbid CPTSD and BPD displayed higher levels of trait negative affectivity than those with BPD alone. The findings highlight the need for trauma-informed assessments in clinical settings and a better understanding of the impact of CPTSD on treatment outcomes for people with personality disorder, including how existing treatments may need to be modified to better meet the needs of people with these highly comorbid conditions. TRIAL REGISTRATION: Current controlled trials ISRCTN13918289 (registered 11/11/2022).</p>","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":"19 1","pages":"e70010"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11842586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychotherapeutic Change in Intensive Day Treatment for Personality Disorders: A Single Case Study of Quantitative and Qualitative Change in Agency and Communion.","authors":"Silvia M Pol, Elke Brok, Gerben J Westerhof","doi":"10.1002/pmh.70007","DOIUrl":"10.1002/pmh.70007","url":null,"abstract":"<p><p>A better understanding of psychotherapeutic change is seen as essential for further development of treatment for personality disorders. The objective of this study is to describe the psychotherapeutic change process of a client with personality disorder to develop more insight in psychotherapeutic change processes. The change process was described quantitatively from ROM data and quantitatively and qualitatively from two narrative themes, agency and communion, described from the perspectives of client and treatment team. Reliable change analyses showed decrease in personality problems and increase in personality functioning and mental well-being. Content analyses from the client perspective showed positive changes in meaning, actual behavior change, and connection with others. The treatment team noticed growth in self-management ability and in connecting with own emotions and with others. These changes resulted in an increase in agency and communion. By mapping change processes through multiple sources and perspectives, the efficacy of psychotherapeutic treatment can be better understood.</p>","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":"19 1","pages":"e70007"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11815315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paraphilias, problematic sexual behaviours and personality disorder-To what extent are they linked?","authors":"Jessica Yakeley, Felicitas Rost, Heather Wood, Safia Abid","doi":"10.1002/pmh.1650","DOIUrl":"10.1002/pmh.1650","url":null,"abstract":"<p><strong>Background: </strong>Since DSM-III, mental disorders have been classified based on overt symptoms and behaviours rather than underlying psychological and personality processes.</p><p><strong>Aims: </strong>This study examines the occurrence of personality dysfunction in individuals with paraphilic disorders and problematic sexual behaviours.</p><p><strong>Method: </strong>The Shedler-Westen Assessment Procedure (SWAP-200), a clinician-rated assessment measure of personality disorders, was administered in a sample of 303 patients referred to a specialist forensic psychotherapy clinic. Sixty-six percent (N = 200) of the sample were diagnosable with traits of one or more DSM-5 personality disorders, and 35% (N = 106) were diagnosable with categorical DSM-5 personality disorders. When an alternative set of empirically derived personality diagnoses was examined, 94% (N = 285) had significant traits of the personality syndromes, and 62% (N = 188) of the sample met criteria for categorical diagnoses.</p><p><strong>Conclusions: </strong>Paraphilic fantasies and behaviours may be linked to underlying personality pathology, suggesting implications for assessment and treatment.</p>","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":"19 1","pages":"e1650"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Narcissistic personality disorder and emotion regulation in psychiatric inpatients.","authors":"Ryan P Smith, John M Bouras, Christopher Frazier, Katrina A Rufino, Michelle A Patriquin","doi":"10.1002/pmh.1645","DOIUrl":"10.1002/pmh.1645","url":null,"abstract":"<p><strong>Background: </strong>Emotional regulation difficulties in those with narcissistic personality disorder can cause problematic social and occupational functioning and inhibit treatment. Identifying which aspects of emotion regulation difficulties narcissistic personality disorder (NPD) patients have can help inform treatment. Adult psychiatric inpatients (N = 108) were assessed on measures of emotion regulation. Propensity score matching (PSM) was utilized to match inpatients with a diagnosis of NPD (n = 54) to psychiatric peers on several criteria. An analysis of variance compared groups at admission and discharge. A moderation analysis was used to explore the effects of neuroticism across the treatment for NPD, and cut scores were used to explore the effect of neuroticism on NPD patients at admission and discharge. NPD patients demonstrated more difficulties with impulse control, engaging in goal-directed behaviours, clarity of emotions, emotional regulation strategies, and experiential avoidance at admission. NPD patients experienced difficulties with impulse control and acceptance of emotional responses at discharge. They were also more likely to end treatment before their peers. Neuroticism was a moderating factor in treatment of patients with NPD, with high neuroticism aligning with greater gains across treatment; however, high neuroticism NPD patients continued to report more difficulties with experiential avoidance and strategies for emotional regulation.</p><p><strong>Limitations: </strong>Use of self-report measures, reliance on DSM criteria for NPD diagnoses, and the generalizability to non-inpatient populations.</p><p><strong>Conclusions: </strong>NPD patients benefit from treatment but continue to struggle with aspects of emotion regulation. Addressing these aspects may help NPD patients receive more benefits from treatment.</p>","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":"19 1","pages":"e1645"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender differences in treatment effectiveness for borderline personality disorder.","authors":"Xinyu Qian, Michelle L Townsend, Brin F S Grenyer","doi":"10.1002/pmh.1642","DOIUrl":"10.1002/pmh.1642","url":null,"abstract":"<p><p>Borderline personality disorder (BPD) is a psychological disorder that is diagnosed predominantly in females yet is equally as prevalent in males. Many empirical research studies on the treatment of BPD have been conducted with only female participants. We aimed to investigate the impact of current treatments for BPD on men compared to women. Using data from a larger ongoing longitudinal study, we matched 48 males with 48 females in treatment on age, overall functioning and psychological distress at intake and then accessed their progress in treatment after 12 months. Controlling for the initial scores at baseline, analysis of covariance (ANCOVA) analysis found significant differences in outcome measures at 12-months follow-up. Females had significantly greater improvements in BPD severity and greater improvements in internalizing symptoms such as chronic feelings of emptiness. Females also reported significantly greater satisfaction and ratings of health at follow-up. These findings suggest that current treatment as usual for BPD could be more effective for women compared to men. Results from the study highlight the need for future studies to investigate the experience of males in current BPD treatment and to identify potential areas for modification to better cater to this population.</p>","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":"19 1","pages":"e1642"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meaning in Life as an Outcome of Inpatient or Day-Hospital Psychotherapy for Personality Disorder.","authors":"Angelien Steen, Arjan W Braam, Adriaan W Hoogendoorn, Han Berghuis, Gerrit Glas","doi":"10.1002/pmh.70001","DOIUrl":"10.1002/pmh.70001","url":null,"abstract":"<p><p>Psychotherapy may contribute to the experience of meaning in life. This study investigated meaning in life among patients with personality disorders during inpatient or day-hospital psychotherapy. Meaning in life was approached from two conceptual perspectives: personality functioning with an emphasis on self-direction and existential psychology. We investigated changes in the sense of meaning in life and accounted for changes in depressive symptoms and identity and interpersonal pathology. Using pre-post measures, Livesley's General Assessment of Personality Disorder, especially, the Lack-of-Meaning-Purpose-and-Direction subscale and Steger's Meaning-in-Life Presence subscale were administered to 75 patients with personality disorders during inpatient or day-hospital psychotherapy for 8-12 months. Regression models showed that levels of the lack and presence of meaning decreased and increased during treatment, respectively, controlled for changes in depressive symptoms. Decreased identity pathology was significantly associated with changes in the lack or presence of meaning. Meaning in life may act as an outcome variable in intensive psychotherapy for personality disorders. The development of identity and self-direction may restore or create the ability to give life meaning.</p>","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":"19 1","pages":"e70001"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience of childhood adversity and maladaptive personality traits: Magnitude and specificity of the association in a clinical sample of adult outpatients.","authors":"Valeria Deiana, Federico Suprani, Pasquale Paribello, Andrea Mura, Carlo Arzedi, Mario Garzilli, Laura Arru, Mirko Manchia, Bernardo Carpiniello, Federica Pinna","doi":"10.1002/pmh.1643","DOIUrl":"10.1002/pmh.1643","url":null,"abstract":"<p><p>The relationship between the experience of childhood adversity (CA) and the development of personality disorders (PDs) has been well documented. The dimensional PD alternative model (AMPD) has been introduced in nosography in 2013, and so far it is been used for CA research mostly on non-clinical samples. We included in our study 137 psychiatric outpatients who were screened for history of maternal antipathy (MA), paternal antipathy (PA), maternal neglect (MN), paternal neglect (PN), maternal physical abuse (MPA), paternal physical abuse (PPA) and sexual abuse (SA) using the Childhood Experience of Care and Abuse Questionnaire (CECA.Q) and underwent personality assessment using the Personality Inventory for DSM-5. Applying CECA.Q cut-off scores, rates of participants reporting CA were as follows: 14.6% MA; 13.9% PA; 13.1% MN; 10.2% PN; 25.5% MPA; 24.8% PPA; and 22.6% SA. In multivariate regression models, accounting for age, gender and exposure to other types of CA, exposure to MA was associated with increased negative affect, detachment, disinhibition and psychoticism; exposure to PA with increased disinhibition; and exposure to SA with increased antagonism, disinhibition and psychoticism. All effect sizes were small, except for a moderate effect of SA on psychoticism. Results pointed to a small but specific and independent effect of MA on most maladaptive personality traits; a possible specific role of the paternal figure for externalizing traits; and a moderate effect of SA on psychoticism. The cumulative exposure to multiple CAs significantly predicted all maladaptive personality traits, with much larger effect sizes compared to those calculated for single CAs. CA explained the higher proportion of variance for antagonism and psychoticism. In conclusion, exposure to specific forms of childhood abuse was associated with specific maladaptive traits in psychiatric outpatients, even if the effect of cumulative multiple CAs was larger.</p>","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":"19 1","pages":"e1643"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishing the relationship between history of childhood trauma and personality disorder using the ICD-11 classification system.","authors":"Jordan Lock, Min Yang, Peter Tyrer","doi":"10.1002/pmh.1648","DOIUrl":"10.1002/pmh.1648","url":null,"abstract":"<p><p>The temporal relationship between childhood trauma and personality status using the ICD-11 classification was examined in 75 adults (65%F) aged between 19 and 72 selected by constrained procedure to ensure the full range of personality disturbance. Trauma history was assessed using the Childhood Traumatic Events Scale, past and recent versions and personality status using scales to assess the severity and domains of the ICD-11 system, PDS-ICD-11 and PAQ-11. The PDS-ICD-11 findings showed 52 (59.3%) had some personality disturbance with 17 (22.7%) having moderate or severe personality disorder. There was a significant association between childhood sexual trauma and ICD-11 personality severity (p = 0.005) and a lessened association with recent trauma (p = 0.02). Apart from the borderline composite score, the PAQ-11 negative affectivity domain was significantly associated with childhood sexual trauma (p = 0.003), but other domains were not linked. The Anankastia domain was significantly associated with early major physical illness (p = 0.012), and physical illness both in early life (p = 0.005) and recent exposure (p = 0.024) were associated with personality disorder. Other forms of childhood abuse and illness or injury in childhood did not differ with regard to later personality disorder. The results confirm a significant but not overwhelming relationship between childhood sexual trauma and severity of ICD-11 personality disturbance in adult life that is greater than for other classes of trauma.</p>","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":"19 1","pages":"e1648"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The societal costs of avoidant personality disorder.","authors":"Carl-Aksel Sveen, Geir Pedersen, Theresa Wilberg, Elfrida Hartveit Kvarstein","doi":"10.1002/pmh.1644","DOIUrl":"10.1002/pmh.1644","url":null,"abstract":"<p><p>The study aims to estimate the societal costs of avoidant personality disorder (AvPD). Cross-sectional data on AvPD patients during 2017-2020 were retrieved from the quality register of the Norwegian Network for Personality Disorders. Cost estimations were based on a bottom-up approach, using a structured interview covering the 6-month period prior to initial assessment. Unit costs were retrieved from public records. The human capital approach was used to calculate productivity losses. Diagnoses were determined according to DSM-5 by semi-structured diagnostic interviews (SCID-5-PD). Mean societal costs were €19,378 for the total group (N = 410). The subgroup with a single diagnosis (n = 270) incurred €18,818, whereas the subgroup with at least one comorbid PD (n = 140) incurred €20,458. The difference between the two subgroups was not statistically significant. The largest cost component was productivity loss (69%), whereas health service costs constituted 31%. The main contributors to societal costs from the health service cost components were inpatient treatment (18%) and individual outpatient treatment (11%). In conclusion, societal costs for AvPD patients were high, on the same level as borderline PD, schizotypal PD, and schizophrenia, and higher than anxiety disorders, depression, and rheumatoid arthritis. In the future, development of effective AvPD treatment programs enhancing personality functioning and workforce participation is important in order reduce the cost of illness.</p>","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":"19 1","pages":"e1644"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11582018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The incremental validity of level of personality functioning over borderline personality features in associations with early adolescent social reward processing.","authors":"Kiran Boone, Dara Babinski, Autumn Kujawa, Samantha Pegg, Carla Sharp","doi":"10.1002/pmh.70000","DOIUrl":"10.1002/pmh.70000","url":null,"abstract":"<p><p>More work is needed to establish the validity of the Alternative Model of Personality Disorders (AMPD) in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Acceptance of the AMPD as the primary model of personality disorder requires identifying neurocognitive validators of AMPD-defined personality functioning and demonstrating superiority of the AMPD over the traditional categorical model of personality disorder. It is also important to establish the utility of the AMPD in a developmental context given evidence that personality disorder emerges in adolescence. We assessed the incremental validity of AMPD-defined level of personality functioning (LPF) versus borderline personality features (BPF) in explaining alterations in neural processing of social acceptance feedback in early adolescent girls. One hundred nine girls (M_age = 12.21, SD = 1.21; N = 79 with a psychiatric history) completed a computerized peer interaction task to elicit neural response to social acceptance feedback via electroencephalogram (EEG). Subjects or caregivers reported adolescent psychopathology. In hierarchical regressions controlling for neural response to social rejection and internalizing and externalizing symptoms, LPF incremented BPF and all other covariates in predicting response to social acceptance, but BPF did not. Higher LPF impairment was associated with enhanced reactivity to social acceptance (St.b = 0.274, p = 0.018). LPF appears to provide additional information about neural response to social reward in early adolescence beyond that provided by borderline personality features. These findings add to an emerging literature demonstrating the validity and superiority of the AMPD and help build the rationale for moving toward the AMPD as the primary model of personality disorder classification.</p>","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":"19 1","pages":"e70000"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}