The General Criteria for Personality Disorders Assessed by Interview: Do They Still Have a Role to Play?

2019 ◽  
Vol 33 (4) ◽  
pp. 515-S9
Author(s):  
Josep M. Peri ◽  
Ana Muñoz-Champel ◽  
Rafael Torrubia ◽  
Fernando Gutiérrez

On the path to developing dimensional models of personality disorder (PD), we are at risk of leaving key diagnostic aspects behind. The general criteria for PD may be important ones because they reflect the defining aspects of personality pathology: long duration, independence from psychopathological states, and harmfulness. We assessed these criteria by interview in a sample of 362 psychiatric outpatients after administering the Personality Diagnostic Questionnaire–4+. The result was a 42.5% fall in self-reported endorsements, due to misinterpretations (11.5%), short duration of traits or contamination by state psychopathology (9.8%), and traits being non-harmful (21.2%). However, not all personality traits and disorders underwent correction to the same extent, and ultimately, the interview did not improve the prediction of clinical variables. These findings raise doubts about the practical relevance of the general criteria for PD and support the role of self-report questionnaires for diagnostic purposes.

2014 ◽  
Vol 155 (40) ◽  
pp. 1584-1588
Author(s):  
András Láng

Introduction: Social and personality psychologists have described Machiavellianism as a pragmatic, callous-unemotional, exploitative and manipulative attitude towards others. Several former studies linked Machiavellian personality traits and interpersonal problems or personality dysfunction. Aim: The aim of this study was to reveal the connection between Machiavellianism and interpersonal problems that are characteristic of personality disorders. Method: 252 participants (146 females and 106 males, aged 32.46±5.39 years, mean±SD) filled out self-report measures of Machiavellianism and personality disorder related interpersonal problems. Results: There was a medium strength relationships between Machiavellianism and several interpersonal problems. Aggression and ambivalence proved to be significant predictors of Machiavellian personality traits. Conclusions: Results are discussed in relation to the patient–therapist bond. Orv. Hetil., 2014, 155(39), 1584–1588.


Author(s):  
Marta Moselli ◽  
Maria Pia Casini ◽  
Camilla Frattini ◽  
Riccardo Williams

AbstractThis work presents a review of research papers examining the role of emerging personality pathology in suicidal ideation and behaviours in adolescence. Initially, 226 studies were selected in line with PRISMA guidelines, and 33 articles were finally included in this review. The data show percentages of any personality disorder diagnosis ranging from 19.5 to 22.8% in suicide attempters, while in autopsy studies, the rate of personality disorder diagnosis varied between 29.6 and 42.1%. The overwhelming majority of the studies focus on the role of borderline personality disorder (BPD) in suicidal behaviours, also highlighting its predictive role at a longitudinal level. Furthermore, the literature review shows that personality traits supposed to underlie BPD, such as affective instability, impulsivity and identity diffusion, have specific predictive links with suicidal conduct. Other personality pathology dimensions, such as aggressiveness, sadism and perfectionism that are associated with other personality disorders, namely, antisocial and narcissistic personality disorders, have also shown a significant mediating role for suicidal risk. Overall, these results seem to parallel the role of personality pathology in predicting suicide in adulthood and point to the relevance of assessing the presence of emerging patterns of personality disorders for the clinical management of suicidal risk in adolescence.


2018 ◽  
Vol 24 (6) ◽  
pp. 830-839
Author(s):  
Francesco Oliva ◽  
Chiara Mangiapane ◽  
Gabriele Nibbio ◽  
Alberto Portigliatti Pomeri ◽  
Giuseppe Maina

Objective: To assess prevalence of personality traits and disorders according to Millon’s evolution-based model and to identify the most representative personality profiles among adult ADHD outpatients. Method: Personality traits and disorders were evaluated using the Millon Clinical Multiaxial Inventory–III (MCMI-III) and an exploratory factor analysis (EFA) in a consecutive sample of adult ADHD outpatients ( N = 70) diagnosed by the Adult ADHD Self-Report Scale–version 1.1 (ASRS-v1.1) and the Diagnostic Interview for ADHD in Adults (DIVA 2.0). Results: More than half of our sample (57.1%) showed at least one personality disorder (PD). The most prevalent PDs were paranoid, schizotypal and negativistic (18.6% for all three PDs), depressive (17.1%), and sadistic (11.4%). No patient had a borderline PD. The EFA identified three personality profiles (“sadistic-antisocial-negativistic,” “masochistic-depressive-dependent-avoidant,” and “antihistrionic-schizoid”). Conclusion: High prevalence of PDs among adult ADHD patients was confirmed. The personality profiles seemed to reflect the persistence of ADHD and related childhood comorbidities in adulthood.


2019 ◽  
Author(s):  
Randi Breivik ◽  
Theresa Wilberg ◽  
Julie Evensen ◽  
Jan Ivar Røssberg ◽  
Hanne Sofie Dahl ◽  
...  

Abstract Background The Feeling Word Checklist (FWC) is a self-report questionnaire designed to measure therapists’ countertransference (CT) feelings. The primary aim of the study was to evaluate the psychometric properties of a brief version of the Feeling Word Checklist comprising twelve feeling words (FWC-12). The second aim was to validate the factor structure by examining the associations between the FWC-12 factors, patients’ personality pathology and therapeutic alliance (TA). Methods Therapists at 13 different outpatient units within the Norwegian Network of Personality Disorders completed the FWC-12 every 6 months during the course of treating a patient with a personality disorder (PD), over a period of up to 2.5 years. A large sample of patients with personality pathology participated in the study. The data were analysed with exploratory (EFA) and confirmatory (CFA) factor analysis. Internal consistency was estimated using Cronbach’s alpha. The Structured Clinical Interview for DSM-IV – Axis II (SCID II) and Mini International Neuropsychiatric Interview (MINI) were used as diagnostic instruments, and patient-rated TA was assessed using the Working Alliance Inventory (WAI-SR). Results Factor analyses revealed three clinically meaningful factors: Inadequate, Idealised and Confident. These factors had acceptable psychometric properties. Most notably, a number of borderline PD criteria correlated positively with the factors Inadequate and Idealised, and negatively with the factor Confident. All the factors correlated significantly with at least one of the WAI-SR subscales. Conclusions The FWC-12 measures three clinically meaningful aspects of therapists’ CT feelings. This brief version of the FWC seems satisfactory for use in further research and in clinical contexts. Keywords: Countertransference, Feeling Word Checklist, factor analysis, personality disorder, psychometrics


2020 ◽  
Author(s):  
Randi Breivik ◽  
Theresa Wilberg ◽  
Julie Evensen ◽  
Jan Ivar Røssberg ◽  
Hanne Sofie Dahl ◽  
...  

Abstract Background The Feeling Word Checklist (FWC) is a self-report questionnaire designed to measure therapists’ countertransference (CT) feelings. The primary aim of the study was to evaluate the psychometric properties of a brief version of the Feeling Word Checklist (FWC-BV) comprising 12 feeling words. The second aim was to validate the factor structure by examining the associations between the FWC-BV factors, patients’ personality pathology and therapeutic alliance (TA). Methods Therapists at 13 different outpatient units within the Norwegian Network of Personality Disorders completed the FWC-BV every 6 months during the course of treating a patient with a personality disorder (PD), over a period of 2.5 years. A large sample of patients (N=2425) with personality pathology participated in the study. The data were analysed with exploratory (EFA) and confirmatory (CFA) factor analysis. Internal consistency was estimated using Mc Donald’s coefficient Omega (ωt). The Structured Clinical Interview for DSM-IV – Axis II (SCID II) and Mini International Neuropsychiatric Interview (MINI) were used as diagnostic instruments, and patient-rated TA was assessed using the Working Alliance Inventory (WAI-SR). Results Factor analyses revealed three clinically meaningful factors: Inadequate, Idealised and Confident. These factors had acceptable psychometric properties. Most notably, a number of borderline PD criteria correlated positively with the factors Inadequate and Idealised, and negatively with the factor Confident. All the factors correlated significantly with at least one of the WAI-SR subscales Conclusions The FWC-BV measures three clinically meaningful aspects of therapists’ CT feelings. This brief version of the FWC seems satisfactory for use in further research and in clinical contexts. Keywords: Countertransference, Feeling Word Checklist, factor analysis, personality disorder, psychometrics


2000 ◽  
Vol 16 (1) ◽  
pp. 53-58 ◽  
Author(s):  
Hans Ottosson ◽  
Martin Grann ◽  
Gunnar Kullgren

Summary: Short-term stability or test-retest reliability of self-reported personality traits is likely to be biased if the respondent is affected by a depressive or anxiety state. However, in some studies, DSM-oriented self-reported instruments have proved to be reasonably stable in the short term, regardless of co-occurring depressive or anxiety disorders. In the present study, we examined the short-term test-retest reliability of a new self-report questionnaire for personality disorder diagnosis (DIP-Q) on a clinical sample of 30 individuals, having either a depressive, an anxiety, or no axis-I disorder. Test-retest scorings from subjects with depressive disorders were mostly unstable, with a significant change in fulfilled criteria between entry and retest for three out of ten personality disorders: borderline, avoidant and obsessive-compulsive personality disorder. Scorings from subjects with anxiety disorders were unstable only for cluster C and dependent personality disorder items. In the absence of co-morbid depressive or anxiety disorders, mean dimensional scores of DIP-Q showed no significant differences between entry and retest. Overall, the effect from state on trait scorings was moderate, and it is concluded that test-retest reliability for DIP-Q is acceptable.


2021 ◽  
Vol 49 (2) ◽  
pp. 339-360
Author(s):  
Monica Carsky

The clinical and technical difficulties presented by patients with personality disorders are well documented. This article focuses on the challenges faced by therapists when managing their emotional reactions, that is, their countertransferences, to patients with personality disorders. While leaving room for therapists' unique and idiosyncratic countertransferences to the patient with personality pathology, Kernberg emphasized the role of a more general form of countertransference, one reflective largely of the patient's conflicts and defenses, in the treatments of personality disordered individuals. Here, the nature of the patient's internal and external functioning can be seen to lead to similar reactions among different therapists, opening the possibility of utilizing countertransference to better understand the patient's difficulties. In transference-focused psychotherapy (TFP), countertransferences arising in the patient–therapist interaction are first identified and contained by the therapist and then utilized to clarify and explore how the patient's internal object relations are being enacted in the clinical process. This article describes this process and how TFP therapists work with their countertransference to help illuminate the patient's split representational world, paving the way for interpretation and integration.


2016 ◽  
Vol 33 (S1) ◽  
pp. S506-S506
Author(s):  
S. Neves ◽  
J. Tudela

IntroductionMental illness develops and is inseparable from the sociocultural context. The Disturbances may exhibit different symptoms in different cultures. In personality disorders, there is a pathological expansion of normal traits that often demonstrate a sociocultural change. The quality of life of these patients can improve with certain treatments, which appears to be relevant to be achieved.MethodSearch on Pubmed and Medline for original research or review articles published in English or Portuguese in the last 10 years. It used a combination of terms: “personality”, “treatment”, “personality disorder”, “borderline”, “antissocial”, “pharmacotherapy”, and other named personality disorders.Objectives/AimSearch the evidence base and the new perspectives for the effective treatment of personality disorders.ResultsThe same personality traits may be adaptive or non-adaptive in different contexts. So, without changing these characteristics, patients can learn to use them more effectively. In other words, although the therapy did not change the personality traits, it can be modified in the way they affect the behavioral expression.ConclusionsPsychological or psychosocial intervention is recommended as the primary treatment for borderline personality disorder and pharmacotherapy is only advised as an adjunctive treatment. The amount of research about the underlying, abnormal, psychological or biological processes leading to the manifestation of a disordered personality is increasing, which could lead to more effective interventions.Disclosure of interestThe authors have not supplied their declaration of competing interest.


1998 ◽  
Vol 43 (2) ◽  
pp. 148-153 ◽  
Author(s):  
Joel Paris

Objective: To examine the relationship between trauma in childhood and personality disorders in adulthood. Method: A review of the literature was conducted. Results: The reported associations between trauma and personality pathology are illuminated by the following research findings: 1) personality is heritable; 2) only a minority of patients with severe personality disorders report childhood trauma; and 3) children are generally resilient, and traumatic experiences do not consistently lead to psychopathology. Conclusions: The role of trauma in the personality disorders is best understood in the context of gene–environment interactions.


2014 ◽  
Author(s):  
Yosefa A. Ehrlich ◽  
Amir Garakani ◽  
Stephanie R Pavlos ◽  
Larry Siever

Personality can be defined as an organizational system of self that shapes the manner in which a person interacts with his or her environment. Personality traits develop in adolescence or early adulthood and are thought to be shaped by early childhood experiences and enduring throughout a lifetime. Personality traits that prevent an individual from being able to function in society or that cause significant distress are diagnosed as personality disorders. A thorough history is needed to rule out other psychiatric and medical disorders. This chapter reviews the diagnostic criteria, differential diagnosis, comorbidity, prevalence, etiology (including genetics and neurobiology), prognosis, and treatment of paranoid, schizoid, schizotypal, borderline, antisocial, narcissistic, histrionic, avoidant, obsessive-compulsive, and dependent personality disorders. A discussion of the relevance of personality disorders to primary care practices and approaches to managing such patients is also included. Tables describe the diagnostic criteria of each personality disorder. Figures illustrate the prevalence of personality disorders in the general and psychiatric populations; schizotypal personality disorder in the community, general population, and clinical population; childhood trauma in individuals with personality disorder; and comorbid disorders in individuals with borderline personality disorder. A model of brain processing in borderline personality disorder is also featured. This chapter contains 5 highly rendered figures, 10 tables, 230 references, and 5 MCQs.


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