Personality and Mental Health最新文献

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.

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 $\left(\text{OR}\left(95\%\mathrm{CI}\right)=2.186\left(1.074;4.449\right);p=0.006\right)$ . The bp 182 $\left(\text{OR}\left(95\%\mathrm{CI}\right)=0.407\left(0.178;0.931\right);p=0.033\right)$ and bp 184 $\left(\text{OR}\left(95\%\mathrm{CI}\right)=0.391\left(0.188;0.813\right);p=0.012\right)$ 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.

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.

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.

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.

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.

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.

Psychodynamic therapy effectively reduces symptomatology by focusing on underlying (unconscious) processes instead of symptoms. Nevertheless, the exact interrelationship between psychodynamic constructs and psychopathology remains unclear. This study uses network analysis to explore these associations. We computed a cross-sectional partial correlation network between psychodynamic constructs (i.e., personality functioning, interpersonal relations, and active and passive modes of intrapsychic conflicts according to the Operationalized Psychodynamic Diagnostics [OPD] system) and psychopathology (i.e., depression and somatization) in a naturalistic sample of 341 adults registering for psychodynamic outpatient therapy. We estimated node centrality, node predictability, and bridge symptoms and used community detection analysis. Bootstrap methods were applied to assess network stability. Psychodynamic constructs and psychopathology resulted in separate but connected clusters. Personality functioning emerged as the most influential node in the network and was bridging the clusters. The network was found to be highly stable, allowing reliable interpretations. The results offer important insights on how psychodynamic constructs relate to psychopathology, which can be used to inform treatment approaches. The findings suggest that personality functioning may be an important intervention target. However, future research is needed to include a broader range of diagnoses. In addition, longitudinal studies may clarify the direction of causality.

Mild traumatic brain injury (mTBI) poses risk to the neurocognitive, emotional, and financial well-being of affected individuals. While aggression and impulsivity have been examined in relation to mTBI, little work has been done to evaluate the relationship between history of mTBI and personality disorder (PD). The authors examined the associations between history of mTBI and PD in a control group without history of mTBI (N = 1189) and individuals with history of mTBI (N = 267). Results demonstrated that any PD diagnosis is a significant risk factor for mTBI (p < 0.001). Cluster B diagnoses, particularly borderline and antisocial PD, were independently significant risk factors for mTBI. These data suggest a role for screening for a history of mTBI in patients with PDs and associated traits.

Borderline personality disorder (BPD) diagnosis in adolescents is a relatively recent concept and a fast-emerging research area. Regarded by some as controversial, it is important for research to provide greater understanding of differing perspectives and their impact on the use of this diagnosis. Perspectives of 13 clinicians (therapists, psychiatrists and mental health nurses) were explored, to provide a contemporary understanding of perceptions and use of BPD diagnosis within child and adolescent mental health services in England. A particular focus was to explore dilemmas faced by clinicians and how these dilemmas were negotiated. This research took a qualitative, social constructionist approach to explore the in-depth views and experiences of each participant. Interviews were analysed using thematic analysis, to seek out patterns and commonalities across these clinical perspectives. Three overarching themes were generated: 'Who holds the power?', 'Dilemmas within the multidisciplinary team (MDT)' and 'The weightiness of making this decision'. Professional opinions of an adolescent BPD diagnosis are influenced by dominant and less dominant mental health discourses, including the impact of power, and availability of resources within the service context. The role of meaningful collaboration with young people, clinical implications and directions for future research are discussed.