Differential social adjustment correlates of Axis I and Axis II psychopathology in anxiety and depressive disorders

1991 ◽  
Vol 6 (3) ◽  
pp. 127-130 ◽  
Author(s):  
M Mauri ◽  
N Sarno ◽  
A Armani ◽  
VM Rossi ◽  
S Zambotto ◽  
...  
Keyword(s):  
Personality Disorders ◽  
Social Adjustment ◽  
Depressive Disorders ◽  
Psychiatric Patients ◽  
Patient Treatment ◽  
Social Variables ◽  
Axis Ii ◽  
Need To Evaluate ◽  
Axis I ◽  
Axis Ii Psychopathology

SummaryThe interest in social adjustment of psychiatric patients has increased since potent therapeutic strategies have become available, allowing patient treatment within their natural social habitat. DSM III has formally recognized the need to evaluate social variables for each patient, introducing Axis V into its multiaxial system. This is of particular relevance for personality disorders where the main pathology is manifested within the social context. In this study, 94 patients with a DSM III-R diagnosis of Panic Disorder, Major Depression, and Generalized Anxiety Disorder have been evaluated with PDE (Personality Disorders Examination) to detect the presence of DSM III personality disorders, and with SAS (Social Adjustment Scale) to assess social adjustment. Results have shown that both Axis I and Axis II diagnoses affect social adjustment, though in a slightly different manner.

State of the Art “Personality Disorders”

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
S. Herpertz
Keyword(s):  
Personality Disorders ◽  
Psychiatric Patients ◽  
Maladaptive Behaviors ◽  
List Type ◽  
Axis Ii ◽  
Therapeutic Implications ◽  
High Prevalence ◽  
Axis I ◽  
Nature And Nurture ◽  
Specific Disorders

Personality disorders have high prevalence rates of approx. 8% in the general population and up to 40% among psychiatric patients. The increasing amount of empirical and experimental research within the last ten years challenges our concept of personality disorders (PDs) with the following most prominent findings:•Longitudinal studies indicate much less stability than expected.•The DSM classification system hypothesis of a fundamental difference between axis I and axis II disorders has not been empirically affirmed.•Some of the current categories of disorders cover highly heterogeneous individuals and have low therapeutic implications.•The detection of neurobiological underpinnings of personality dysfunctioning points to a close interaction between nature and nurture in etiology.•Psychotherapeutic approaches developed for specific disorders have been proven to be efficacious; they rather favour a limited focus on maladaptive behaviors and attitudes instead of targeting a fundamental change of personality structure.•There is no empirical basis for polypharmacy; classes of psychotropic agents act on a rather broad spectrum of symptoms with no convincing database to suggest the combination of several drugs with respect to different targets.

The dexamethasone suppression test and DSM-III-R diagnoses in suicide attempters

2003 ◽  
Vol 18 (7) ◽  
pp. 350-355 ◽  
Author(s):  
Åsa Westrin ◽  
Karin Frii ◽  
Lil Träskman-Bendz
Keyword(s):  
Personality Disorders ◽  
Stressful Events ◽  
Suicide Attempter ◽  
Axis Ii ◽  
Suppression Test ◽  
Axis I ◽  
Cortisol Levels ◽  
Low Cortisol ◽  
Hpa Axis Activity ◽  
Dexamethasone Suppression

AbstractPrevious research on hypothalamic-pituitary adrenal (HPA) axis-activity in suicide attempter research has shown conflicting outcomes. The design of the present study was to test the influence of personality disorders and concominant axis I diagnoses on the dexamethasone suppression diagnostic test by use of multiple regression analyses. The sample consisted of 184 patients with a recent suicide attempt and 42 healthy controls. As expected, the lowest pre- and postdexamethasone cortisol levels were found in patients with personality disorders axis II, cluster B as compared to the other patients. The results remained significant when analysed for covariance with DSM-III-R axis I diagnoses, age or sex. Whether these low cortisol levels are due to previous experience of extreme stressful events or long-lasting burden, or whether they may be a consequence of biogenetic or psychological predisposal of interest, remains to be elucidated. Axis I comorbidity needs to be further examined.

scholarly journals The genetic epidemiology of personality disorders

2010 ◽  
Vol 12 (1) ◽  
pp. 103-114 ◽  
Keyword(s):  
Personality Disorders ◽  
Genetic Factors ◽  
Association Studies ◽  
Molecular Genetic ◽  
Cluster Structure ◽  
Epidemiologic Studies ◽  
Axis Ii ◽  
Candidate Gene Association ◽  
Axis I ◽  
Dsm Iv

Genetic epidemiologic studies indicate that all ten personality disorders (PDs) classified on the DSM-IV axis II are modestly to moderately heritable. Shared environmental and nonadditive genetic factors are of minor or no importance. No sex differences have been identified, Multivariate studies suggest that the extensive comorbidity between the PDs can be explained by three common genetic and environmental risk factors. The genetic factors do not reflect the DSM-IV cluster structure, but rather: i) broad vulnerability to PD pathology or negative emotionality; ii) high impulsivity/low agreeableness; and iii) introversion. Common genetic and environmental liability factors contribute to comorbidity between pairs or clusters of axis I and axis II disorders. Molecular genetic studies of PDs, mostly candidate gene association studies, indicate that genes linked to neurotransmitter pathways, especially in the serotonergic and dopaminergic systems, are involved. Future studies, using newer methods like genome-wide association, might take advantage of the use of endophenotypes.

scholarly journals Thought disorder in the meta-structure of psychopathology

2012 ◽  
Vol 43 (8) ◽  
pp. 1673-1683 ◽  
Author(s):  
K. M. Keyes ◽  
N. R. Eaton ◽  
R. F. Krueger ◽  
A. E. Skodol ◽  
M. M. Wall ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
General Population ◽  
Personality Disorders ◽  
Thought Disorder ◽  
Patient Treatment ◽  
Treatment Needs ◽  
Co Morbidity ◽  
The Us ◽  
Axis I ◽  
Dsm Iv

BackgroundDimensional models of co-morbidity have the potential to improve the conceptualization of mental disorders in research and clinical work, yet little is known about how relatively uncommon disorders may fit with more common disorders. The present study estimated the meta-structure of psychopathology in the US general population focusing on the placement of five under-studied disorders sharing features of thought disorder: paranoid, schizoid, avoidant and schizotypal personality disorders, and manic episodes as well as bipolar disorder.MethodData were drawn from the National Epidemiologic Survey on Alcohol and Related Conditions, a face-to-face interview of 34 653 non-institutionalized adults in the US general population. The meta-structure of 16 DSM-IV Axis I and Axis II psychiatric disorders, as assessed by the Alcohol Use Disorder and Associated Disabilities Interview Schedule DSM-IV version (AUDADIS-IV), was examined using exploratory and confirmatory factor analysis.ResultsWe document an empirically derived thought disorder factor that is a subdomain of the internalizing dimension, characterized by schizoid, paranoid, schizotypal and avoidant personality disorders as well as manic episodes. Manic episodes exhibit notable associations with both the distress subdomain of the internalizing dimension as well as the thought disorder subdomain. The structure was replicated for bipolar disorder (I or II) in place of manic episodes.ConclusionsAs our understanding of psychopathological meta-structure expands, incorporation of disorders characterized by detachment and psychoticism grows increasingly important. Disorders characterized by detachment and psychoticism may be well conceptualized, organized and measured as a subdimension of the internalizing spectrum of disorders. Manic episodes and bipolar disorder exhibit substantial co-morbidity across both distress and thought disorder domains of the internalizing dimension. Clinically, these results underscore the potential utility of conceptualizing patient treatment needs using an approach targeting psychopathological systems underlying meta-structural classification rubrics.

"Axis I and Axis II disorders as predictors of prospective suicide attempts: Findings from the Collaborative Longitudinal Personality Disorders Study": Correction to Yen et al (2003).

2004 ◽  
Vol 113 (2) ◽  
pp. 301-301 ◽  
Author(s):  
Shirley Yen ◽  
Tracie Shea ◽  
Maria Pagano ◽  
Charles A. Sanislow ◽  
Carlos M. Grilo ◽  
...  
Keyword(s):  
Personality Disorders ◽  
Suicide Attempts ◽  
Axis Ii ◽  
Axis I

scholarly journals DSM-IV Axis II personality disorders and suicide and attempted suicide in China

2016 ◽  
Vol 209 (4) ◽  
pp. 319-326 ◽  
Author(s):  
Yongsheng Tong ◽  
Michael R. Phillips ◽  
Kenneth R. Conner
Keyword(s):  
Personality Disorders ◽  
Suicidal Behaviour ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Control Group ◽  
Axis Ii ◽  
Clinical Interviews ◽  
Increased Risk ◽  
Axis I ◽  
Dsm Iv

BackgroundThere are meagre data on Axis II personality disorders and suicidal behaviour in China.AimsTo describe the prevalence of Axis II personality disorders in suicides and suicide attempts in China and to estimate risk for these outcomes associated with personality disorders.MethodPeople who died by suicide (n = 151), people who attempted suicide (n = 118) and living community controls (n = 140) were randomly sampled from four Chinese counties and studied using the Structured Clinical Interviews for DSM-IV-TR Axis I Disorders (SCID-I) and Axis II Personality Disorders (SCID-II). We also determined the prevalence of subthreshold versions of ten DSM-IV personality disorders.ResultsAxis II personality disorders were present in 7% of the suicide group, 6% of the suicide attempt group and 1% of the control group. Threshold and subthreshold personality disorders had adjusted odds ratios (point estimates) in the range of 2.7–8.0 for suicide and for suicide attempts.ConclusionsAxis II personality disorders may confer increased risk for suicidal behaviour in China, but their low prevalence in the community and among people with suicidal behaviour suggests that other personality constructs such as select dimensional traits may be a more fruitful avenue for understanding and preventing suicide in China.

scholarly journals Social domain dysfunction and disorganization in borderline personality disorder

2007 ◽  
Vol 38 (1) ◽  
pp. 135-146 ◽  
Author(s):  
J. Hill ◽  
P. Pilkonis ◽  
J. Morse ◽  
U. Feske ◽  
S. Reynolds ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Romantic Relationship ◽  
Fold Increase ◽  
Standardized Assessments ◽  
Social Dysfunction ◽  
Social Domain ◽  
Axis Ii ◽  
Axis I ◽  
Social Domains

BackgroundSocial dysfunction in personality disorder is commonly ascribed to abnormal temperamental traits but may also reflect deficits in social processing. In this study, we examined whether borderline and avoidant personality disorders (BPD, APD) may be differentiated by deficits in different social domains and whether disorganization of social domain functioning uniquely characterizes BPD.MethodPatients were recruited from psychiatric clinics in Pittsburgh, USA, to provide a sample with BPD, APD and a no-personality disorder (no-PD) comparison group. Standardized assessments of Axis I and Axis II disorders and social domain dysfunction were conducted, including a new scale of ‘domain disorganization’ (DD).ResultsPervasive social dysfunction was associated with a 16-fold increase in the odds of an Axis II disorder. Both APD and BPD were associated with elevated social dysfunction. Romantic relationship dysfunction was associated specifically with BPD symptoms and diagnosis. DD was associated specifically with a categorical BPD diagnosis and with a dimensional BPD symptom count.ConclusionsA focus on the inherently interpersonal properties of personality disorders suggests specific mechanisms (within and across interpersonal domains) that may help to account for the origins and maintenance of some disorders. In particular, BPD reflects disturbances in romantic relationships, consistent with a role for attachment processes, and in the organization of functioning across social domains.

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