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Borderline personality disorder symptoms in individuals with eating disorder: Association with severity, psychological distress, and psychosocial function. 进食障碍患者的边缘性人格障碍症状:与严重程度、心理困扰和社会心理功能的关系
IF 2.7 3区 医学 Q1 Nursing Pub Date : 2023-05-01 DOI: 10.1002/pmh.1565
Prudence Vivarini, Zoe M Jenkins, David J Castle, Karen Gwee

We aimed to determine the prevalence of borderline personality disorder (BPD) symptoms in a sample of eating disorder (ED) outpatients and assess how BPD symptoms correlate with severity, distress, and function. A total of 119 individuals were assessed and divided into high BPD symptoms (H-BPD) and low BPD symptoms (L-BPD) using a cut-off score of seven on the McLean Screening for Borderline Personality Disorder (MSI-BPD). Groups were compared on ED diagnosis, age at ED onset, age at assessment, illness duration, body mass index (BMI), ED symptomatology, psychological distress, and psychosocial function. Correlation analyses were performed to assess the relationship between BPD symptoms and these variables. The 45.4% of the participants scored ≥7 on the MSI-BPD, indicating a diagnosis of BPD. There were no differences between the H-BPD (N = 54) and L-BPD (N = 65) groups on age at onset, age at assessment, duration of illness, BMI, or proportion of ED diagnosis. The H-BPD group reported significantly higher ED symptomatology, psychological distress, and poorer psychosocial functioning. MSI-BPD scores were positively associated with these variables. This study suggests a high prevalence of BPD symptoms within outpatients seeking ED treatment, and use of a brief screening instrument for BPD in this group may contribute to a greater understanding of the patient.

我们的目的是确定边缘性人格障碍(BPD)症状在进食障碍(ED)门诊患者样本中的患病率,并评估BPD症状与严重程度、痛苦和功能之间的关系。采用麦克林边缘型人格障碍筛查(MSI-BPD)的分值为7分,共对119人进行了评估,并将其分为高BPD症状(H-BPD)和低BPD症状(L-BPD)。各组患者在ED诊断、ED发病年龄、评估年龄、病程、体重指数(BMI)、ED症状、心理困扰和心理社会功能方面进行比较。进行相关分析以评估BPD症状与这些变量之间的关系。45.4%的参与者在MSI-BPD上得分≥7分,表明诊断为BPD。H-BPD组(N = 54)和L-BPD组(N = 65)在发病年龄、评估年龄、疾病持续时间、BMI或ED诊断比例方面没有差异。H-BPD组报告了明显更高的ED症状、心理困扰和更差的社会心理功能。MSI-BPD评分与这些变量呈正相关。本研究表明,在寻求ED治疗的门诊患者中,BPD症状的患病率很高,在这一群体中使用简短的BPD筛查工具可能有助于更好地了解患者。
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引用次数: 2
Normative data for the LPFS-BF 2.0 derived from the Danish general population and relationship with psychosocial impairment. LPFS-BF 2.0的标准数据来自丹麦普通人群及其与社会心理障碍的关系。
IF 2.7 3区 医学 Q1 Nursing Pub Date : 2023-05-01 DOI: 10.1002/pmh.1570
Laura C Weekers, Martin Sellbom, Joost Hutsebaut, Sebastian Simonsen, Bo Bach

The Level of Personality Functioning Scale-Brief Form 2.0 is a frequently used self-report inventory that may be used to screen for self- and interpersonal dysfunction according to the DSM-5 Alternative Model for Personality Disorders (AMPD) and the ICD-11 Classification of Personality Disorders. Nevertheless, reliable norms and cut-off scores to aid interpretation and clinical decision making are still lacking. The LPFS-BF and relevant impairment measures were administered to a sociodemographically stratisfied sample of 2,002 adults from the general Danish population of whom 713 individuals eventually delivered data for inclusion in the present study. The unidimensionality of the LPFS-BF scores was established using Confirmatory Factor Analysis (CFA). Item-Response Theory (IRT) analysis indicated satisfactory item functioning for all 12 items and suggested normative observed score thresholds at different latent severity levels. Meaningful associations were found between the LPFS-BF norm-based cut-off scores, quality of life, and social and occupational functioning. This study presented the first normative data for LPFS-BF, which specifically applies to Denmark but likely also other socioeconomically comparable Nordic and Western societies. These results allow for interpretation of LPFS-BF scores and clinical decision-making. Future research should corroborate these findings and compare them to scores obtained in other general population samples.

根据DSM-5人格障碍替代模型(AMPD)和ICD-11人格障碍分类,人格功能水平量表-简表2.0是一种常用的自我报告清单,可用于筛选自我和人际功能障碍。然而,仍然缺乏可靠的标准和临界值来帮助解释和临床决策。LPFS-BF和相关损伤测量对来自丹麦普通人群的2002名成年人进行了社会人口统计学分层样本,其中713人最终提供了纳入本研究的数据。采用验证性因子分析(CFA)确定LPFS-BF评分的单维性。项目反应理论(IRT)分析表明,所有12个项目的项目功能都令人满意,并提出了不同潜在严重程度的规范观察得分阈值。在LPFS-BF基于规范的分值、生活质量、社会和职业功能之间发现了有意义的关联。这项研究提出了LPFS-BF的第一个规范性数据,它特别适用于丹麦,但可能也适用于其他社会经济可比较的北欧和西方社会。这些结果可以解释LPFS-BF评分和临床决策。未来的研究应证实这些发现,并将其与其他一般人群样本的得分进行比较。
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引用次数: 5
Are physical activity and nutrition linked to personality disorders? Health habits and personality disorders: A scoping review. 体育活动和营养与人格障碍有关吗?健康习惯与人格障碍:范围综述。
IF 2.7 3区 医学 Q1 Nursing Pub Date : 2023-05-01 DOI: 10.1002/pmh.1568
Samuel St-Amour, Félix-Antoine Bérubé, Lionel Cailhol, Catherine Le Corff

Individuals with personality disorders (PDs) have a decreased life expectancy compared with the general population in part due to physical illnesses. Many hypotheses have been suggested to explain those physical illnesses such as hormone imbalance, medication, lack of physical activity, and unhealthy diet. However, little is known about the relation between lifestyle and PDs. The purpose of this scoping review is to regroup the available information on this topic. We searched the literature up to February 2021 using four databases and found 21 articles analyzing the relation between lifestyle and PDs in observational studies including 153,081 participants from diverse populations going from general population to adults in psychiatric care. Most studies used measures of lifestyle as control variables or did not use lifestyle variables at all. Moreover, the instruments used to measure lifestyle variables lacked precision at best. Two studies demonstrated a relation between early malnutrition and further development of PDs, but those results may be influenced by confounding variables and cannot indicate a clear link between nutrition and personality disorder. The lack of solid evidence we observed is surprising, considering the multiple benefits individuals with PDs could get from a healthy lifestyle. More studies are needed to thoroughly analyze the impact of lifestyle on PDs and vice versa.

与一般人群相比,人格障碍(pd)患者的预期寿命较短,部分原因是身体疾病。人们提出了许多假说来解释这些身体疾病,如激素失衡、药物、缺乏体育活动和不健康的饮食。然而,人们对生活方式与pd之间的关系知之甚少。这个范围审查的目的是重新组合关于这个主题的可用信息。我们使用四个数据库检索了截至2021年2月的文献,并在观察性研究中发现了21篇分析生活方式与pd之间关系的文章,其中包括来自不同人群的153,081名参与者,从普通人群到精神科护理的成年人。大多数研究使用生活方式作为控制变量,或者根本不使用生活方式变量。此外,用于测量生活方式变量的仪器充其量也不够精确。两项研究表明,早期营养不良与pd的进一步发展之间存在联系,但这些结果可能受到混杂变量的影响,无法表明营养与人格障碍之间存在明确的联系。考虑到患有pd的人可以从健康的生活方式中获得多种好处,我们观察到的缺乏确凿证据令人惊讶。需要更多的研究来彻底分析生活方式对pd的影响,反之亦然。
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引用次数: 1
The joint hierarchical structure of psychopathology and dysfunctional personality domain indicators among community-dwelling adults. 社区成人精神病理与功能障碍人格领域指标的联合层次结构。
IF 2.7 3区 医学 Q1 Nursing Pub Date : 2023-02-01 DOI: 10.1002/pmh.1556
Antonella Somma, Robert F Krueger, Kristian E Markon, Giulia Gialdi, Claudia Frau, Andrea Fossati

To examine the hierarchical structure of psychopathology and dysfunctional personality domains, 2416 Italian community-dwelling adult volunteers were administered a set of psychometrically sound psychopathology measures and the Personality Inventory for DSM-5 Brief Form+ (PID-5-BF+). Parallel analysis, minimum average partial, and very simple structure results suggested that 1-6 principal components (PCs) should be retained. Goldberg's bass-ackwards model of the joint psychopathology measure and PID-5-BF+ ipsatized domain scale correlation matrix evidenced a hierarchical structure that was consistent with the working model proposed by the Hierarchical Taxonomy of Psychopathology (HiTOP) consortium. Hierarchical agglomerative cluster analysis around latent variables of the psychopathology indicators and PID-5-BF+ domain scales recovered four latent dimensions, which were akin to the corresponding bass-ackwards components and nicely reproduced the HiTOP Internalizing, Externalizing, Thought Disorder, and Eating Pathology dimensions.

为了研究精神病理和功能障碍人格域的层次结构,我们对2416名意大利社区成年志愿者进行了一套心理测量学上健全的精神病理测量和人格量表(DSM-5 Brief Form+, PID-5-BF+)。平行分析、最小平均偏分和非常简单的结构结果表明,应保留1-6个主成分(PCs)。Goldberg的联合精神病理学测量和PID-5-BF+ ipsatized域量表相关矩阵的bass- backward模型证明了一个层次结构,与hiop (hierarchical Taxonomy of psychopathology)联盟提出的工作模型一致。围绕精神病理指标潜变量和PID-5-BF+域量表的分层聚类分析,恢复了四个潜维度,这些潜维度与相应的后向分量相似,并很好地再现了HiTOP内化、外化、思维障碍和饮食病理维度。
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引用次数: 0
Relationship of DRD5 and MAO-B VNTR polymorphisms with paranoid and antisocial personality disorders in polydrug users.
IF 2.7 3区 医学 Q1 Nursing Pub Date : 2023-02-01 DOI: 10.1002/pmh.1563
Marcelo O'Higgins, Ana Benito, Matías Real-López, Isis Gil-Miravet, Enrique Ochoa, Gonzalo Haro

Although multiple studies have shown the role genetics plays in personality disorders and in addictions, few have studied the genetic aspects of their comorbidity. Here, we carried out a cross-sectional study in a sample comprising 303 Caucasian polydrug-consuming patients. The presence of personality disorders was evaluated using the International Personality Disorder Examination, and genes related to dopamine, serotonin and monoamine oxidase (MAO) were genotyped. A significant relationship was observed between the bp 279 DRD5 variable number of tandem repeat (VNTR) polymorphism and paranoid personality disorder OR 95 % CI = 2.186 1.074 ; 4.449 ; p = 0.006 . The bp 182 OR 95 % CI = 0.407 0.178 ; 0.931 ; p = 0.033 and bp 184 OR 95 % CI = 0.391 0.188 ; 0.813 ; p = 0.012 alleles of the MAOB VNTR were also associated with antisocial personality disorder. Among patients with addictions, paranoid personality disorder should also be considered in addition to the importance of antisocial and borderline personality disorders. The higher frequency of the bp 279 DRD5 VNTR allele found in patients with paranoid personality disorder, as well as the associations between alleles of the MAOB VNTR and antisocial personality disorder, support the monoaminergic bases of these personality disorders, especially when dealing with patients with addictions.

尽管多项研究表明遗传学在人格障碍和成瘾中起着重要作用,但很少有人研究其共病的遗传方面。在这里,我们对包括303名服用多种药物的高加索患者的样本进行了横断面研究。bp 279 DRD5可变数串联重复序列(VNTR)多态性与偏执型人格障碍有显著相关OR 95% CI = 2.186 1.074;4.449;P = 0.006。bp 182 OR 95% CI = 0.407 0.178;0.931;p = 0.033, bp = 184 OR 95% CI = 0.391 0.188;0.813;p = 0.012 MAOB VNTR等位基因也与反社会人格障碍相关。在成瘾患者中,除了反社会和边缘型人格障碍的重要性外,还应考虑偏执型人格障碍。在偏执型人格障碍患者中发现的bp 279 DRD5 VNTR等位基因的较高频率,以及MAOB VNTR等位基因与反社会人格障碍之间的关联,支持了这些人格障碍的单胺能基础,特别是在处理成瘾患者时。
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引用次数: 0
Investigating general and specific psychopathology factors with nuance-level personality traits. 研究一般和特殊的精神病理因素与细微差别水平的人格特质。
IF 2.7 3区 医学 Q1 Nursing Pub Date : 2023-02-01 DOI: 10.1002/pmh.1561
Yuzhan Hang, Lydia Gabriela Speyer, Liina Haring, Aja Louise Murray, René Mõttus

Mental health disorders share substantial variance, prompting researchers to develop structural models that can capture both generalised psychopathology risk and disorder/symptom-specific variation. This study investigated the associations of the general and specific psychopathology factors with multiple personality trait hierarchy levels: broad domains, their facets and nuances (N = 1839 Estonian adults). A bi-factor model with a general 'p' factor and specific factors for internalising problems, thought disorders and substance use best represented psychopathology structure. Although traits' predictive accuracy varied across psychopathology factors, nuances (the lowest level personality units) provided higher predictive accuracy and higher discriminant validity than domains. For example, traits related to high vulnerability, depression and immoderation and low friendliness and achievement striving were most strongly associated with the p factor. Nuances may prove useful for predicting and understanding general and specific psychopathology forms.

精神健康障碍有很大的差异,促使研究人员开发结构模型,既可以捕捉一般的精神病理风险,也可以捕捉疾病/症状特异性的变化。本研究调查了一般和特殊的精神病理因素与多重人格特质层次水平的关系:广泛的领域,他们的方面和细微差别(N = 1839爱沙尼亚成年人)。一个双因素模型,具有一般的“p”因素和内化问题、思维障碍和物质使用的特定因素,最能代表精神病理结构。虽然特质的预测准确度在不同的精神病理因素中存在差异,但细微差别(最低层次的人格单位)比领域提供了更高的预测准确度和判别效度。例如,与高脆弱性、抑郁和不节制以及低友善和追求成就相关的特征与p因素的关系最为密切。细微差别可能有助于预测和理解一般和特定的精神病理形式。
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引用次数: 1
The role of clinical and Personological features in predicting high lethality suicide attempts: A study among mood disorder patients. 临床和人格特征在预测高致命性自杀企图中的作用:一项情绪障碍患者的研究。
IF 2.7 3区 医学 Q1 Nursing Pub Date : 2023-02-01 DOI: 10.1002/pmh.1546
Serena Borroni, Linda Franchini, Silvia Brioschi, Giulia Vassena, Elisabetta Masci, Chiara Franzoni, Giulia Ruotolo, Cristina Colombo, Andrea Fossati

Suicidal attempts (SA) represent heterogeneous behaviours ranging in their seriousness from fatal and near-fatal (high-lethality) cases to those that do not require medical attention (low lethality). These considerations stress the need to identify high-risk individuals for high lethality SA in order to target suicide preventive interventions. The present study aims at evaluating the role of sociodemographic and clinical variables and examining personality pathological features in predicting high lethality SA. The sample was composed by 94 patients who were consecutively admitted to the Mood Disorders Unit of the San Raffaele Turro Hospital in Milan. The results of binary logistic regression analyses showed that previous SA and current suicide ideation play a role in predicting serious SA. Considering the DSM-5 personality dysfunctional domains assessed by the Personality Inventory for DSM-5, our logistic regression analyses suggested that high lethality SA was associated with Detachment PID-5 domain. Finally, binary hierarchical regression analysis showed that Detachment domain remained a significant predictor of serious SA over and above the effect of previous SA and suicide ideation. As a whole, our results highlight the importance of a multidimensional approach to develop adequate assessment, effective treatments and prevention of high lethality SA risk.

自杀企图是一种不同的行为,其严重程度从致命和接近致命(高致死率)到不需要医疗照顾(低致死率)不等。这些考虑强调需要确定高致死率SA的高危个体,以便有针对性地进行自杀预防干预。本研究旨在评估社会人口学和临床变量的作用,并检验人格病理特征在预测高致死率SA中的作用。样本由94名连续入住米兰圣拉斐尔图罗医院情绪障碍病房的患者组成。二元logistic回归分析结果显示,既往SA和当前自杀意念对严重SA有预测作用。考虑到DSM-5人格量表评估的人格功能障碍域,我们的逻辑回归分析表明,高致死率SA与分离性人格障碍域相关。最后,二元层次回归分析显示,分离域仍然是严重SA的显著预测因子,高于既往SA和自杀意念的影响。总的来说,我们的结果强调了多维方法的重要性,以制定适当的评估,有效的治疗和预防高致命性SA风险。
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引用次数: 2
Systems Training for Emotional Predictability and Problem Solving for borderline personality disorder: A systematic review. 边缘型人格障碍情绪可预见性和问题解决的系统训练:系统综述。
IF 2.7 3区 医学 Q1 Nursing Pub Date : 2023-02-01 DOI: 10.1002/pmh.1558
Erol Ekiz, Sebastiaan P J van Alphen, Machteld A Ouwens, Jamie Van de Paar, Arjan C Videler

Systems Training for Emotional Predictability and Problem Solving (STEPPS) is a group treatment program for patients with borderline personality disorder (BPD). The program was intended to be highly accessible, both for patients and therapists. During STEPPS, patients are taught emotion regulation and behavior management skills. This systematic review synthesizes the current empirical status of STEPPS, focusing on research designs, quality of studies, target groups, protocols, and outcome. We selected 20 studies, with three randomized controlled trials. Patients with BPD, subthreshold BPD, and patients with BPD and comorbid antisocial personality disorder were investigated. One study was conducted in adolescents. There were no studies in older adults. Results demonstrated STEPPS to be associated with reduced BPD symptoms, improved quality of life, decreased depressive symptoms, and decreased negative affectivity. Mixed results were found for impulsivity and suicidal behaviors. STEPPS has both been studied as an add-on therapy to patients' ongoing treatment, and, with the addition of individual STEPPS sessions, as a stand-alone treatment. High attrition rates were found in patients attending STEPPS, complicating the generalizability of the results. Although the evidence for STEPPS is promising, further research is needed before firm conclusions can be drawn. Recommendations for future research are discussed.

情绪可预见性和问题解决系统训练(STEPPS)是一个针对边缘型人格障碍(BPD)患者的团体治疗项目。该项目旨在为患者和治疗师提供高度可访问性。在STEPPS期间,患者学习情绪调节和行为管理技能。本系统综述综合了STEPPS目前的实证状况,重点关注研究设计、研究质量、目标群体、方案和结果。我们选择了20项研究,其中包括3项随机对照试验。对BPD患者、阈下BPD患者、BPD合并反社会人格障碍患者进行调查。一项研究是在青少年中进行的。没有针对老年人的研究。结果表明,STEPPS与BPD症状减轻、生活质量改善、抑郁症状减轻和负面情绪减少有关。冲动和自杀行为的结果喜忧参半。STEPPS既被研究作为患者正在进行的治疗的附加疗法,也被研究作为单独的STEPPS治疗。在参加STEPPS的患者中发现高流失率,使结果的普遍性复杂化。尽管STEPPS的证据很有希望,但在得出确切的结论之前,还需要进一步的研究。并对今后的研究提出了建议。
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引用次数: 0
Influence of personality profile in patients with drug-resistant epilepsy on quality of life following surgical treatment: A 1-year follow-up study. 耐药癫痫患者人格特征对手术后生活质量的影响:1年随访研究
IF 2.7 3区 医学 Q1 Nursing Pub Date : 2023-02-01 DOI: 10.1002/pmh.1564
Elena Iurina, Eva Bailles, Mar Carreño, Antonio Donaire, Jordi Rumià, Teresa Boget, Núria Bargalló, Xavier Setoain, Pedro Roldan, Estefanía Conde-Blanco, María Centeno, Luis Pintor

The objectives of this study are to determine the influence of personality profile in patients with drug-resistant epilepsy on quality of life (QoL) after surgical treatment and compare the results with a non-surgical control group at the 1-year follow-up. We conducted a prospective, comparative, controlled study, including 70 patients suffering from drug-resistant epilepsy. Demographic, psychiatric, neurological, and psychological data were recorded at the baseline and at the 1-year follow-up. Assessment of personality dimensions was performed using the NEO-FFI-R questionnaire; severity of anxiety and depression were assessed by the Hospital Anxiety and Depression Scale (HADS), and QoL was evaluated using the QOLIE-31. At the 1-year follow-up, comparing the control and the surgical groups, we detected differences in scores of most items of QoL, which were higher in those patients who had undergone surgery. High levels of Conscientiousness and Openness to experience at the baseline in patients who underwent surgery predicted better post-surgical outcomes in the QoL scores, whereas high neurotic patients showed worse QoL results. Postoperative changes in QoL in patients were associated with the personality profile at the baseline. QoL measures significantly improved in the surgical group compared with the non-surgical group but were not associated with baseline or postoperative seizure frequency at 1 year.

本研究的目的是确定人格特征对耐药癫痫患者手术治疗后生活质量的影响,并与非手术对照组进行1年随访。我们进行了一项前瞻性,比较,对照研究,包括70例耐药癫痫患者。在基线和1年随访时记录人口统计学、精神病学、神经学和心理学数据。采用NEO-FFI-R问卷进行人格维度评估;采用医院焦虑抑郁量表(HADS)评估焦虑和抑郁的严重程度,采用QOLIE-31评估生活质量。在1年的随访中,对照组与手术组比较,我们发现大多数项目的生活质量得分存在差异,手术组患者的生活质量得分更高。接受手术的患者在基线时的高水平尽责性和开放性预示着更好的术后生活质量评分结果,而高神经质患者的生活质量结果较差。患者术后生活质量的变化与基线时的人格特征相关。与非手术组相比,手术组的生活质量显著改善,但与基线或术后1年的癫痫发作频率无关。
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引用次数: 1
Stability of resilience in times of the COVID-19 pandemic. 2019冠状病毒病大流行时期的韧性稳定性。
IF 2.7 3区 医学 Q1 Nursing Pub Date : 2023-02-01 DOI: 10.1002/pmh.1560
Sophie Köhne, Veronika Engert, Jenny Rosendahl

There is disagreement among researchers regarding the conceptualization of resilience as a dynamic state or stable trait. Aiming to shed light on the state-versus-trait debate, we explored the stability and construct validity of four of the most frequently utilized state or trait resilience scales in a longitudinal assessment. Additionally, we examined the predictive validity of these scales. Our study was conducted before and during the COVID-19 pandemic, which served as collectively experienced adversity. Correlations among the resilience scales and among resilience scales and Big Five personality traits were strong. All except one scale showed high test-retest correlations. Experience of an additional critical life event during the pandemic led to an increase in resilience. Other than in cross-sectional studies, associations between resilience and psychological distress were weak, because personality and baseline psychological distress were controlled for. Nevertheless, next to personality, resilience explained additional variance in distress change. Our results show relatively high stability of resilience overall. Yet, they also confirm dynamic resilience features, suggesting that resilience change occurs with significant adversity, leading to improved adaptation. To gauge the true association between resilience and mental health, baseline levels of these variables as well as personality traits should be considered.

对于心理弹性是一种动态状态还是一种稳定的特征,研究者之间存在分歧。为了阐明状态与特质的争论,我们探讨了纵向评估中最常用的四种状态或特质弹性量表的稳定性和结构效度。此外,我们检验了这些量表的预测效度。我们的研究是在COVID-19大流行之前和期间进行的,这是集体经历的逆境。心理弹性量表之间、心理弹性量表与大五人格特质之间的相关性均较强。除一个量表外,其余量表均表现出较高的重测相关性。在大流行期间又经历了一次重大生活事件,从而增强了复原力。与横断面研究不同,复原力和心理困扰之间的联系很弱,因为人格和基线心理困扰是被控制的。然而,除了性格之外,恢复力解释了痛苦变化的额外差异。我们的研究结果表明,弹性总体上具有较高的稳定性。然而,他们也证实了动态弹性特征,表明弹性变化发生在显著的逆境中,导致适应能力的提高。为了衡量弹性和心理健康之间的真正联系,应该考虑这些变量的基线水平以及人格特征。
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引用次数: 0
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Personality and Mental Health
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