Vulnerability of personality disorder during COVID-19 crises: a multicenter survey of mental and social distress among patients referred to treatment

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.

Download Full-text

Borderline Personality Disorder in Mom Predicts Teen's Social Problems

Pediatric News ◽

10.1016/s0031-398x(07)70141-8 ◽

2007 ◽

Vol 41 (3) ◽

pp. 2

Author(s):

SARAH PRESSMAN LOVINGER

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Social Problems ◽

Borderline Personality

Download Full-text

Professional Skills and Frame of Work Organization in Managing Borderline Personality Disorder: Shared Philosophy or Ambivalence - A Qualitative Study from the View of Caregivers

CrossRef Listing of Deleted DOIs ◽

10.1080/028393100300006843 ◽

2000 ◽

Vol 14 (4) ◽

pp. 245-252 ◽

Cited By ~ 3

Author(s):

Bodil Bergman ◽

Annsofi Eckerdal

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Qualitative Study ◽

Work Organization ◽

Borderline Personality ◽

Professional Skills

Download Full-text

Suicide Ideation and Attempt in a Community Cohort of Urban Aboriginal Youth: A Cross-Sectional Study

Crisis ◽

10.1027/0227-5910/a000187 ◽

2013 ◽

Vol 34 (4) ◽

pp. 251-261 ◽

Cited By ~ 17

Author(s):

Joanne N. Luke ◽

Ian P. Anderson ◽

Graham J. Gee ◽

Reg Thorpe ◽

Kevin G. Rowley ◽

...

Keyword(s):

Health Service ◽

Indigenous People ◽

Suicide Ideation ◽

Aboriginal Health ◽

Cross Sectional ◽

Data Set ◽

Indigenous Youth ◽

Aboriginal Youth ◽

Social Distress ◽

Suicide Behavior

Background: There has been increasing attention over the last decade on the issue of indigenous youth suicide. A number of studies have documented the high prevalence of suicide behavior and mortality in Australia and internationally. However, no studies have focused on documenting the correlates of suicide behavior for indigenous youth in Australia. Aims: To examine the prevalence of suicide ideation and attempt and the associated factors for a community 1 The term ”community” refers specifically to Koori people affiliated with the Victorian Aboriginal Health Service. cohort of Koori 2 The term ”Koori” refers to indigenous people from the south-eastern region of Australia, including Melbourne. The term ”Aboriginal” has been used when referring to indigenous people from Australia. The term ”indigenous” has been used throughout this article when referring to the first people of a nation within an international context. (Aboriginal) youth. Method: Data were obtained from the Victorian Aboriginal Health Service (VAHS) Young People’s Project (YPP), a community initiated cross-sectional data set. In 1997/1998, self-reported data were collected for 172 Koori youth aged 12–26 years living in Melbourne, Australia. The data were analyzed to assess the prevalence of current suicide ideation and lifetime suicide attempt. Principal components analysis (PCA) was used to identify closely associated social, emotional, behavioral, and cultural variables at baseline and Cox regression modeling was then used to identify associations between PCA components and suicide ideation and attempt. Results: Ideation and attempt were reported at 23.3% and 24.4%, respectively. PCA yielded five components: (1) emotional distress, (2) social distress A, (3) social distress B, (4) cultural connection, (5) behavioral. All were positively and independently associated with suicide ideation and attempt, while cultural connection showed a negative association. Conclusions: Suicide ideation and attempt were common in this cross-section of indigenous youth with an unfavorable profile for the emotional, social, cultural, and behavioral factors.

Download Full-text

Test-Retest Reliability of a Self-Report Questionnaire for DSM-IV and ICD-10 Personality Disorders

European Journal of Psychological Assessment ◽

10.1027//1015-5759.16.1.53 ◽

2000 ◽

Vol 16 (1) ◽

pp. 53-58 ◽

Cited By ~ 11

Author(s):

Hans Ottosson ◽

Martin Grann ◽

Gunnar Kullgren

Keyword(s):

Personality Disorder ◽

Anxiety Disorders ◽

Personality Disorders ◽

Clinical Sample ◽

Self Report ◽

Anxiety State ◽

Short Term ◽

Retest Reliability ◽

Axis I ◽

Test Retest Reliability

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.

Download Full-text

Suicidal Behavior in Patients with Adjustment Disorders

Crisis ◽

10.1027//0227-5910.22.3.125 ◽

2001 ◽

Vol 22 (3) ◽

pp. 125-131 ◽

Cited By ~ 34

Author(s):

Ludmila Kryzhanovskaya ◽

Randolph Canterbury

Keyword(s):

Personality Disorder ◽

Suicidal Behavior ◽

Suicide Attempts ◽

Adjustment Disorder ◽

Adjustment Disorders ◽

Involuntary Hospitalization ◽

Axis Ii ◽

The Past ◽

Substance Abuse Disorders ◽

Axis I

Summary: This retrospective study characterizes the suicidal behavior in 119 patients with Axis I adjustment disorders as assessed by psychiatrists at the University of Virginia Hospital. Results indicated that 72 patients (60.5%) had documented suicide attempts in the past, 96% had been suicidal during their admission to the hospital, and 50% had attempted suicide before their hospitalization. The most commonly used method of suicide attempts was overdosing. Of the sample group with suicide attempts in the past, 67% had Axis II diagnoses of borderline personality disorder and antisocial personality disorder. Adjustment disorder diagnosis in patients with the suicide attempts was associated with a high level of suicidality at admission, involuntary hospitalization and substance-abuse disorders. Axis II diagnoses in patients with adjustment disorders constituted risk factors for further suicidal behavior. Additional future prospective studies with reliability checks on diagnosis of adjustment disorders and suicidal behavior are needed.

Download Full-text

Emotion-Oriented Coping Style Predicts Self-Harm in Response to Acute Psychiatric Hospitalization

Crisis ◽

10.1027/0227-5910/a000713 ◽

2020 ◽

pp. 1-7

Author(s):

Jacqueline M. Frei ◽

Vladimir Sazhin ◽

Melissa Fick ◽

Keong Yap

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Psychiatric Hospitalization ◽

Coping Styles ◽

Psychiatric Inpatients ◽

Borderline Personality ◽

Self Report ◽

Therapeutic Interventions ◽

Coping Behaviors ◽

Self Harm

Abstract. Psychiatric hospitalization can cause significant distress for patients. Research has shown that to cope with the stress, patients sometimes resort to self-harm. Given the paucity of research on self-harm among psychiatric inpatients, a better understanding of transdiagnostic processes as predictors of self-harm during psychiatric hospitalization is needed. The current study examined whether coping styles predicted self-harm after controlling for commonly associated factors, such as age, gender, and borderline personality disorder. Participants were 72 patients (mean age = 39.32 years, SD = 12.29, 64% male) admitted for inpatient treatment at a public psychiatric hospital in Sydney, Australia. Participants completed self-report measures of coping styles and ward-specific coping behaviors, including self-harm, in relation to coping with the stress of acute hospitalization. Results showed that younger age, diagnosis of borderline personality disorder, and higher emotion-oriented coping were associated with self-harm. After controlling for age and borderline personality disorder, higher levels of emotion-oriented coping were found to be a significant predictor of self-harm. Findings were partially consistent with hypotheses; emotion-oriented but not avoidance-oriented coping significantly predicted self-harm. This finding may help to identify and provide psychiatric inpatients who are at risk of self-harm with appropriate therapeutic interventions.

Download Full-text

Diagnostic Concordance Between Categorical and Dimensional Instruments to Assess Personality Disorder in Chronic Fatigue Syndrome

European Journal of Psychological Assessment ◽

10.1027/1015-5759/a000281 ◽

2017 ◽

Vol 33 (3) ◽

pp. 158-165

Author(s):

Natalia Calvo ◽

Naia Sáez-Francàs ◽

Sergi Valero ◽

Jesús Castro-Marrero ◽

José Alegre Martín ◽

...

Keyword(s):

Personality Disorder ◽

Chronic Fatigue Syndrome ◽

Personality Assessment ◽

Chronic Fatigue ◽

Specific Pattern ◽

Harm Avoidance ◽

Assessment Instrument ◽

Compulsive Disorder ◽

Fatigue Syndrome ◽

Self Transcendence

Abstract. The study examines the relationship between a categorical and a dimensional personality assessment instrument in patients with Chronic Fatigue Syndrome (CFS). A total of 162 CFS patients were included in the study (91.4% women; mean age 47.5 years). All subjects completed the Spanish versions of the Personality Diagnostic Questionnaire-4+ (PDQ-4+) and the Temperament and Character Inventory-Revised (TCI-R). Results: 78 (48.1%) of the patients presented a Personality Disorder (PD), the most frequent being Cluster C, specifically Obsessive-compulsive disorder, followed by Avoidant disorder. PDs showed a specific pattern of correlation with temperament scales. All PD clusters correlated positively with Harm Avoidance and Self-Transcendence, and negatively with Reward Dependence, Self-Directedness, and Cooperativeness. In a logistic regression analysis, Self-Directedness and Cooperativeness predicted PD presence. The findings are consistent with previous studies in non-CFS samples and suggest that the combination of the Temperament and Character dimensions (low Self-Directedness and Cooperativeness and high Harm Avoidance and Self-Transcendence) correlates with PD severity, and that Self-Directedness and Cooperativeness are associated with PD presence in CFS patients. The integration of these two perspectives expands the current comprehension of personality pathology in CFS patients.

Download Full-text