A Transdiagnostic Comparison of Emotion Dysregulation in Schizophrenia and Cluster B Personality Disorders

Author(s):  
Christina Evangeline Newhill ◽  
Yan Yuan ◽  
Jessica Wojtalik ◽  
Shaun Eack
1999 ◽  
Vol 4 (6) ◽  
pp. 5-6

Abstract Personality disorders are enduring patterns of inner experience and behavior that deviate markedly from those expected by the individual's culture; these inflexible and pervasive patterns reflect issues with cognition, affectivity, interpersonal functioning and impulse control, and lead to clinically significant distress or impairment in social, occupational, or other important areas of functioning. The AMA Guides to the Evaluation of Permanent Impairment, Fourth Edition, defines two specific personality disorders, in addition to an eleventh condition, Personality Disorder Not Otherwise Specified. Cluster A personality disorders include paranoid, schizoid, and schizotypal personalities; of these, Paranoid Personality Disorder probably is most common in the legal arena. Cluster B personality disorders include antisocial, borderline, histrionic, and narcissistic personality. Such people may suffer from frantic efforts to avoid perceived abandonment, patterns of unstable and intense interpersonal relationships, an identity disturbance, and impulsivity. Legal issues that involve individuals with cluster B personality disorders often involve determination of causation of the person's problems, assessment of claims of harassment, and assessment of the person's fitness for employment. Cluster C personality disorders include avoidant, dependent, and obsessive-compulsive personality. Two case histories illustrate some of the complexities of assessing impairment in workers with personality disorders, including drug abuse, hospitalizations, and inpatient and outpatient psychotherapy.


2017 ◽  
Vol 38 (4) ◽  
pp. 203-210 ◽  
Author(s):  
Christopher M. Lootens ◽  
Christopher D. Robertson ◽  
John T. Mitchell ◽  
Nathan A. Kimbrel ◽  
Natalie E. Hundt ◽  
...  

Abstract. The goal of the present investigation was to expand the literature on impulsivity and Cluster B personality disorders (PDs) by conceptualizing impulsivity in a multidimensional manner. Two separate undergraduate samples (n = 223; n = 204) completed measures of impulsivity and Cluster B dimensions. Impulsivity was indeed predictive of Cluster B dimensions and, importantly, each PD scale exhibited a unique impulsivity profile. Findings for borderline PD scores were highly consistent across samples and strongly and positively associated with urgency and lack of perseverance, as expected. Findings for the other PD dimensions also exhibited a fair amount of consistency. Implications of these findings for diagnostic classification and treatment are discussed.


2010 ◽  
Vol 196 (5) ◽  
pp. 396-403 ◽  
Author(s):  
Djøra I. Soeteman ◽  
Roel Verheul ◽  
Jos Delimon ◽  
Anke M. M. A. Meerman ◽  
Ellen van den Eijnden ◽  
...  

BackgroundRecommendations on current clinical guidelines are informed by limited economic evidence.AimsA formal economic evaluation of three modalities of psychotherapy for patients with cluster B personality disorders.MethodA probabilistic decision-analytic model to assess the cost-effectiveness of out-patient, day hospital and in-patient psychotherapy over 5 years in terms of cost per recovered patient-year and cost per quality-adjusted life-year (QALY). Analyses were conducted from both societal and payer perspectives.ResultsFrom the societal perspective, the most cost-effective choice switched from out-patient to day hospital psychotherapy at a threshold of €12 274 per recovered patient-year; and from day hospital to in-patient psychotherapy at €113 298. In terms of cost per QALY, the optimal strategy changed at €56 325 and €286 493 per QALY respectively. From the payer perspective, the switch points were at €9895 and €155 797 per recovered patient-year, and €43 427 and €561 188 per QALY.ConclusionsOut-patient psychotherapy and day hospital psychotherapy are the optimal treatments for patients with cluster B personality disorders in terms of cost per recovered patient-year and cost per QALY.


2021 ◽  
Vol 36 (6) ◽  
pp. 1132-1132
Author(s):  
D'anna Sydow ◽  
Daniel Amen ◽  
Kristen Willeumier ◽  
Brittny Arias ◽  
Charles J Golden ◽  
...  

Abstract Objective To identify regional cerebral blood flow (rCBF) differences between individuals with DSM-IV diagnosis of Cluster B Personality Disorders (PDB) and healthy controls. Method Healthy controls (n = 81, Mage = 41.9, 53.0% female, 42.0% Caucasian) and persons diagnosed by psychiatric examination with PDB (n=, Mage = 34.12, 71.5% female, 69.8% Caucasian) were selected from a deidentified adult clinical outpatient database. Those with comorbid diagnoses were included. Significant differences (alpha = 0.005) were found for age [t(195) = −3.62], gender [χ2(2) = 7.1], and race [χ2(12) = 23.82] between groups. Mean age [t(523) = 2.09, p = 0.037) and gender [t(532) = −2.653, p = 0.008] different significantly between groups. No significant mean difference was found for education [t(523) = 0.832, p = 0.406]. Results Significant rCBF differences were noted in the cerebellum [left:F(1,192) = 10.5; right:F(1,192) = 4.6], limbic system [left:F(1,192) = 7.8; right:F(1,192) = 5.0], and basal ganglia [left:F(1,192) = 12.3; right:F(1,192) = 6.7]. Group means comparisons indicated higher perfusion in the cerebellum for the PDB group. Lower perfusion was found in the limbic system and basal ganglia in the PDB group. Conclusion Results observed in this study are concurrent with previous literature. PDB demonstrates higher activity in the cerebellum which contains inhibitory neurotransmitters, like Purkinje cells. The increased blood flow to cerebellar circuits may be related to the explicit self-recognition of negative emotion reported in PDB. Hypoperfusion found in the limbic system could be linked to impaired emotional responses. Apathy experienced in PDB may be accounted for by the low perfusion in the highly dopaminergic pathway in the basal ganglia. Further research should assess how different comorbidities with PDB affect perfusion.


Author(s):  
Raffaele Popolo ◽  
Angus MacBeth ◽  
Stefano Brunello ◽  
Flaviano Canfora ◽  
Ercan Ozdemir ◽  
...  

Patients with personality disorders (PDs) other than borderline, with prominent features of social inhibition and over-regulation of emotions, are in need of specialized treatments. Individuals present with poor metacognition, that is the capacity to understand mental states and use psychological knowledge for the sake of purposeful problem solving; and are guided by maladaptive interpersonal schemas. We developed a short-term group intervention, Metacognitive Interpersonal Therapy in Groups (MIT-G), incorporating psychoeducational and experiential elements, to help these individuals become more aware of their drives when interacting with others; and to help them adopt more flexible behaviors via improvements in metacognition. We present results of an effectiveness study, evaluating whether we could replicate the initial positive results of our first pilot randomized controlled trial. Seventeen young adults outpatients with personality disorders were included in the 16 session program. Effect sizes were calculated for change from baseline to treatment end for the primary outcome, symptoms and functioning (Clinical Outcomes in Routine Evaluation Outcome Measure) and then for one putative mechanism of change – metacognition. Emotional dysregulation and alexithymia were also assessed. Qualitative evaluations of the acceptability and subjective impact of the treatment were also performed. MIT-G was acceptable to participants. There were medium to large magnitude changes from pre- to post- treatment on wellbeing, emotion dysregulation, alexithymia and metacognition. These gains were maintained at follow-up. There was evidence of clinically significant change on key variables. MIT-G appears acceptable to patients, as evidenced by the absence of drop-out from treatment. In light of the positive outcomes of this study and the expanding evidence base, MIT-G is a candidate for dissemination and investigations in larger trials as a possible effective intervention for PDs characterized by tendencies to overcontrol.


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