Personality disorders最新文献

To gain social status, humans employ two strategies, rivalry and admiration-seeking, and these strategies are over-expressed in trait narcissism, according to the Narcissistic Admiration and Rivalry Concept (NARC) and the Status Pursuit in Narcissism (SPIN) model. Whether one engages in rivalry or admiration-seeking behaviors is thought to depend on the interaction between underlying traits and status-relevant social cues, with status threats encouraging rivalry and status-boosting experiences encouraging admiration-seeking. However, experimental studies of how traits and environment influence rivalry and admiration-seeking are lacking, and we do not know whether status-relevant cues selectively activate congruent traits (i.e., whether defeat primarily activates trait rivalry and victory, trait admiration-seeking). We used a rigged video game tournament with three randomized blocks with defeat manipulations of varying intensity, measuring behavioral rivalry (stealing points from opponents) and admiration-seeking (paying to boost rank in the tournament) in a sample of 434 undergraduates assessed for trait rivalry and trait admiration-seeking with the Narcissistic Admiration and Rivalry Questionnaire. We found trait-congruent main effects: behavioral rivalry scaled with trait rivalry and behavioral admiration-seeking with trait admiration-seeking. Exploratory analyses found modest support for trait × environment interactions wherein trait rivalry primarily increased status-pursuit behaviors following defeats and trait admiration-seeking following victories. However, these effects were not robust. These results support the NARC's two-dimensional conceptualization of narcissistic grandiosity. Future studies with greater within-subject power are needed to test the interactionist model of status pursuit. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Comments on an article by S. Sauer-Zavala et al. (see record 2022-23735-001), which presents BPD-Compass as a new intervention for borderline personality disorder (BPD). In this comment, the author says that BPD-Compass is described as comprehensive and short term. But, it is difficult to be both. As a short-term intervention, is the Compass proposed as a first-line treatment? If so, why are crises, self-harm, and suicidality, dominant issues in the early stages of most therapies, not addressed systematically? (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Cost of illness research has established that mental disorders lead to significant social burden and massive financial costs. A significant gap exists for the economic burden of many personality disorders, including psychopathic personality disorder (PPD). In the current study, we used a top-down prevalence-based cost of illness approach to estimate bounded crime cost estimates of PPD in the United States and Canada. Three key model parameters (PPD prevalence, relative offending rate of individuals with PPD, and national costs of crime for each country) were informed by existing literature. Sensitivity analyses and Monte Carlo simulations were conducted to provide bounded and central tendency estimates of crime costs, respectively. The estimated PPD-related costs of crime ranged from $245.50 billion to $1,591.57 billion (simulated means = $512.83 to $964.23 billion) in the United States and $12.14 billion to $53.00 billion (simulated means = $25.33 to $32.10 billion) in Canada. These results suggest that PPD may be associated with a substantial economic burden as a result of crime in North America. Recommendations are discussed regarding the burden-treatment discrepancy for PPD, as the development of future effective treatment for the disorder may decrease its costly burden on health and justice systems. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Comments on the article by S. Sauer-Zavala et al. (see record 2022-23735-001), which presents BPD-Compass as a new intervention for borderline personality disorder (BPD). Sauer-Zavala et al. have written a stimulating article that challenges fixed beliefs about the treatment of personality disorders and offers the first attempt to design a treatment according to the heuristic framework of the alternative model of personality disorders. This article presents several elements of the direction our field is developing to but may have underrated the importance of Criterion A in designing good-quality generic PD treatment. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Recidivism places a significant burden on society and efforts aimed at reducing cyclical criminal justice involvement are needed. This prospective study tested the utility of psychopathic traits in predicting general, felony, and substance-related rearrest in women following release from a correctional facility. The extent to which psychopathic traits offered incremental utility in predicting outcomes, above and beyond other established risk factors, including substance use disorder, was examined. Participants included 327 incarcerated adult women who completed comprehensive clinical and psychiatric assessments prior to release from correctional facilities. Psychopathic traits and lifetime substance use disorder were measured using the Hare Psychopathy Checklist-Revised (PCL-R) and Structured Clinical Interview for DSM-IV-TR Axis I Disorders, respectively. Results showed that general, felony, and substance-related rearrest following institutional release were associated with higher PCL-R Factor 2 scores, assessing lifestyle/behavioral and antisocial/developmental psychopathic traits. Additionally, when controlling for other risk factors associated with recidivism, including age at release, number of prior adult prison terms, and substance use disorder, higher PCL-R Factor 2 scores remained significantly associated with rearrest outcomes in women. Findings inform risk prediction and treatment efforts aimed at reducing recidivism in justice-involved women. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Comments on the article by S. Sauer-Zavala et al. (see record 2022-23735-001). Since its empirical debut in the early 1990s, dialectical behavior therapy (DBT) has amassed substantial support for treating individuals struggling with chronic suicidality, emotion dysregulation, impulsivity, and interpersonal distress. Today, it is known to be one of the most effective psychotherapies for complex mental health presentations, such as in borderline personality disorder (BPD). In this comment, the authors highlight strengths and limitations of one promising intervention, BPD Compass, as presented by Sauer-Zavala et al. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

In our article, "How much does that cost? Examining the economic costs of crime in North America attributable to people with psychopathic personality disorder" (Gatner et al., 2023, pp. 391-400), we estimated that psychopathic personality disorder (PPD) was associated with substantial crime costs, using a top-down approach of national costs in the United States and Canada. Verona and Joyner (2023) raised several concerns about our findings. Although we think some of their points help to map directions for future research, we disagree with others they raised related to the conceptualization of PPD, the problem of undetected crimes, and their concerns with putative national comparisons. We strongly welcome debate about the societal impacts of PPD in the hope that it spurs increased attention and innovation regarding the treatment and management of PPD. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Different psychotherapeutic approaches demonstrated their efficacy but the possible neurobiological mechanism underlying the effect of psychotherapy in borderline personality disorder (BPD) patients is poorly investigated. We assessed the effects of metacognitive interpersonal therapy (MIT) on BPD features and other dimensions compared to structured clinical management (SCM). We also assessed changes in amygdala activation by viewing emotional pictures after psychotherapy. One hundred forty-one patients were referred and 78 BPD outpatients were included and randomized to MIT or SCM. Primary outcome was emotional dysregulation assessed with the Difficulties in Emotion Regulation Scale (DERS). We also assessed BPD symptomatology, number of PD criteria, metacognitive abilities, state-psychopathology, depression, impulsiveness, interpersonal functioning, and alexithymia. A subset of 60 patients underwent functional magnetic resonance imaging before and after 1 year of psychotherapy to assess amygdala activation by viewing standardized emotional pictures (secondary outcome). DERS scores decreased in both groups (time effect p < .001). The Cohen's d effect size for change (baseline posttreatment) on DERS was very large (d = 0.84) in MIT, and large (d = 0.76) in SCM. Both groups significantly improved in depressive symptoms, state-psychopathology, alexithymia, and interpersonal functioning. MIT showed larger effect on metacognitive functions than SCM (Time × Group p < .001). Both interventions showed a significant effect on BPD symptomatology although SCM group showed a larger decrease. On the contrary, MIT group showed larger decrease in impulsivity and number of PD criteria. Interestingly, both MIT and SCM modulated amygdala activation in BPD patients. MIT is a valid and effective psychotherapy for BPD with an impact on amygdala activation. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

In their crime cost estimation, Gatner et al. (2022) conclude that psychopathic personality disorder (PPD) is associated with billions of dollars of crime costs in the United States (US) and Canada. Gatner et al.'s analysis goes far in putting a cost estimate to PPD, when the burden of psychopathy for the criminal justice system has been unspecified for years. Nonetheless, in the present commentary, we identify two broad problems with their analyses that motivate caution in the interpretation of the findings and their potential applicability: (a) the conceptualization of psychopathy that formed the bases for estimates of PPD, and (b) the assumptions underlying crime cost estimates made by Gatner et al. The questionable assumptions and diminished focus on the criminal justice context in the US versus Canada limit the extent to which these estimates can produce useful policy implications and may instead perpetuate misconceptions of crime and PPD. (PsycInfo Database Record (c) 2023 APA, all rights reserved).