Journal of Personality Disorders最新文献

Psychopathy is a personality disorder characterized by affective-interpersonal features and an impulsive-antisocial lifestyle. Psychopathy commonly co-occurs with other forms of psychopathology, but current understanding of how behavioral features of psychopathy co-occur with, or are distinct from, other mental health problems is limited. In this study, we analysed data from a large sample of young adults to study the relationship between different facets of psychopathic traits and general psychopathology ("p"). Data were collected between 2010 and 2016 and included 1,324 U.S. undergraduate students (M_age = 19.7 years; 57% female). Linear regression models revealed that the antisocial facet of psychopathy was distinct from p, while the lifestyle facet was correlated with p and externalizing behavior. Interpersonal and affective facets were correlated with internalizing behaviors. Collectively, these findings suggest that psychopathic traits of severe, premeditated antisocial behavior are distinct from general psychopathology, whereas impulsive and uninhibited lifestyle traits are a shared feature of psychopathology.

The degree to which schizoid and avoidant personality styles represent unique variants of interpersonal detachment remains controversial. This study contrasted core traits associated with schizoid versus avoidant personalities in a mixed-sex sample of 221 community adults, using the five traits that comprise the Alternative Model for Personality Disorders (AMPD). The International Personality Disorders Examination Screening Questionnaire was used to assess schizoid and avoidant personality traits; the Personality Inventory for DSM-5 was used to assess negative affectivity, detachment, antagonism, disinhibition, and psychoticism. As expected, schizoid and avoidant scores were both positively associated with AMPD detachment scores (rs were .68 and .57, respectively). Regression analyses confirmed that, in addition to detachment, high levels of negative affectivity and low levels of disinhibition were uniquely predictive of avoidant personality traits, whereas low levels of antagonism were uniquely predictive of schizoid personality traits. The present findings support the distinctiveness of these two contrasting expressions of detachment.

This study describes the 8-year course of physical and psychosocial impairment in middle-aged patients with borderline personality disorder (BPD) and other personality disorders (OPD). This study also compares BPD subgroups (recovered vs. nonrecovered) and explores predictors of physical impairment. Patients (N = 282) were assessed as part of the McLean Study of Adult Development. Physical and psychosocial impairments were assessed using the 36-Item Short-Form Health Survey. Patients with BPD reported significantly more impairment than OPD patients across all domains. Nonrecovered BPD patients reported significantly more impairment than their recovered counterparts. Three medical conditions (osteoarthritis, chronic fatigue syndrome, and obesity) and two symptomatic disorders (mood disorder and posttraumatic stress disorder) were significant multivariate predictors of physical impairment in BPD patients. These results suggest that BPD patients experience serious functioning impairment that persists over time and that physical functioning impairments reported by these patients are strongly related to certain physical and psychiatric health conditions.

The phenomenological differences in auditory hallucinations between schizophrenia and borderline personality disorder (BPD) are unclear in the existing literature, in part due to underpowered studies and heterogeneous research populations that do not represent those in the acute clinical setting. This study addresses this by using patient records to compare auditory hallucinations at the point of clinical psychiatric assessment for 341 unique patients, 165 with BPD and 176 with schizophrenia. Patients with BPD were found to have more subjectively distressing and objectively negative hallucinations, as well as more command hallucinations. Furthermore, they possessed more insight and were less likely to incorporate hallucinations into delusions. These results support the hypothesis that, while descriptively similar, auditory hallucinations are interpreted differently between the two groups. This study also supports that electronic records of patient assessments are a feasible way to assess large numbers of reports of auditory hallucinations.

The discriminant validity of paranoid personality disorder has been recently questioned, and paranoid presentations are now conceived of as transdiagnostic features of personality disorders (PDs). However, empirical results are inconsistent. This study investigated the link between subclinical personality disorders (except paranoid PD) and paranoid presentations, exploring how the severity of personality functioning affects this relationship. Nonclinical participants (N = 270, females: n = 194; 71.9%) completed self-report measures of the constructs of interest. In multiple regression analyses, subclinical borderline PD was primarily related to a wide range of paranoid presentations. Moreover, the severity of personality functioning increased the strength of the association between subclinical BPD and severe paranoid presentations. Results suggest that, when exploring unique contributions, paranoid presentations are especially associated with subclinical forms of BPD and highlight the importance of considering personality dysfunction severity. Additionally, the findings demonstrate that paranoid presentations are a relatively transdiagnostic dimension.

Alexithymia is an important transdiagnostic risk factor for many psychopathologies. To explore its relevance for personality disorders, we examined the association between alexithymia and maladaptive personality traits, as conceptualized within the DSM-5-TR Alternative Model for Personality Disorders (i.e., negative affect, detachment, antagonism, disinhibition, psychoticism). Participants (N = 651) completed a battery of psychometric questionnaires. Regressions revealed that alexithymia facets accounted for a significant 15% of the variance in negative affect, 22% in detachment, 11% in antagonism, 18% in disinhibition, and 25% in psychoticism. Latent profile analysis showed that profiles with more severe personality pathology were generally characterized by more severe levels of alexithymia. Overall, our data highlight that alexithymia is important in understanding personality dysfunction. All facets of alexithymia, across both positive and negative emotions, are linked to each maladaptive personality trait. The assessment and targeting of alexithymia may therefore be of high relevance for the treatment of personality pathology.

Borderline personality disorder (BPD) is frequently understood as a diagnosis applicable mainly to women, despite population studies suggesting similar prevalence between men and women. The scarce available information suggests that compared to women, men may face additional gender-related barriers to diagnosis and treatment when attempting to engage with support and treatment for BPD-related difficulties. The current study presents a qualitative in-depth exploration of the help-seeking and diagnosis experiences of four men with BPD. Using Interpretive Phenomenological Analysis, three themes were generated: (1) "There's just no help out there": barriers to treatment; (2) self-understanding and insight; and (3) the importance of emotional and psychological connection with health care professionals and close family and friends. Having a greater understanding of male-specific experiences of BPD could improve the helpseeking journeys of men with BPD through early identification, accurate and timely diagnosis, to relevant and effective treatment and support.

While research has shown that the prevalence of ADHD in the general population has increased over time, there have been no studies focused on ADHD prevalence in patients with borderline personality disorder (BPD). This study compares two cohorts of adults with rigorously diagnosed BPD recruited nearly three decades apart (1992 vs. 2020). Participants from the 1992 McLean Study of Adult Development (MSAD) (N = 290) and the 2020 Flourishing study (N = 147) were assessed for ADHD using DSM-III-R and DSM-5 criteria respectively. Compared to MSAD subjects, the prevalence of ADHD among Flourishing subjects was significantly higher overall, and in female (but not male) subjects. This increased prevalence, which is likely due to the broadening of the DSM criteria over time, highlights what many observers believe to be a problematic expansion of the diagnostic criteria for ADHD that may have decoupled this criteria set from capturing a neurodevelopmental disorder that typically begins in childhood.

While existing literature suggests that posttraumatic stress disorder (PTSD) is frequently undetected in routine clinical practice, the detection rate of PTSD in patients with a personality disorder (PD) has not been investigated. This study examined the point prevalence of PTSD and frequency of trauma-focused treatment in 204 outpatients with a PD. Data were derived from electronic patient files. Compared to the mean weighted prevalence of PTSD in the literature, the Mini International Neuropsychiatric Interview Plus (MINI-Plus) found lower rates of PTSD for the entire sample (29.2%), but not separately for patients with borderline PD (BPD; 33.3%) and patients with other PDs (26.9%). In addition, PTSD diagnoses following intake were less prevalent for PD patients overall (18.6%), BPD patients (27%), and patients with other PDs (13.8%). The present study provides preliminary evidence that PTSD might be underdiagnosed and consequently unmanaged in PD patients in clinical practice, suggesting that the recognition of PTSD among patients with PD needs improvement.