Personality disorders

2015 ◽  
Author(s):  
Sundeep Virdi ◽  
Robert L. Trestman
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Antisocial Personality Disorder ◽  
Borderline Personality ◽  
Narcissistic Personality Disorder ◽  
Correctional Staff ◽  
Mentally Disordered Offenders ◽  
Mentally Disordered ◽  
Paranoid Personality Disorder ◽  
Paranoid Personality

Personality disorders are highly prevalent and highly problematic in jails in prisons. Personality disorders, by definition, are associated with significant functional impairment of the affected individual and may negatively impact those around them. That impairment results from the way these individuals think and feel about themselves and others. Patients with personality disorder are often challenging to manage in the community. The difficulties associated with their care are accentuated in the confines and highly structured environments presented by jails and prisons. Inmates with personality disorders often require a disproportionate level of attention from correctional staff and their behavior can contribute to a dangerous environment inside a facility. Additionally, when compared to offenders with other psychiatric disorders or non-mentally disordered offenders, offenders with personality disorders have higher rates of violence, criminality, and recidivism. There are 4 personality disorders that are of particular clinical relevance to the correctional psychiatry setting: borderline personality disorder, antisocial personality disorder, narcissistic personality disorder, and paranoid personality disorder. Research also reflects that these disorders have the highest correctional prevalence rates among the personality disorders. For each of these four disorders, this chapter presents in turn a description and some management concerns and challenges, data on correctional prevalence, appropriate psychotherapy, and potential psychopharmacologic interventions.

Specific types of personality disorder

2012 ◽  
pp. 861-881 ◽  
Author(s):  
José Luis Carrasco ◽  
Dusica Lecic-Tosevski
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Personality Change ◽  
Obsessive Compulsive ◽  
Schizotypal Personality ◽  
General Medical Condition ◽  
Personality Changes ◽  
Paranoid Personality Disorder ◽  
Paranoid Personality ◽  
Cluster B Personality Disorders

This chapter begins by discussing the epidemiology, aetiology, clinical picture, course, differential diagnosis, and treatment of various Cluster A personality disorders (Paranoid personality disorder, paranoid personality disorder, schizotypal personality disorder), Cluster B personality disorders (antisocial personality disorder, borderline personality disorder (BPD), histrionic personality disorder, narcissistic personality disorder) and Cluster C personality disorders (avoidant personality disorder, dependent personality disorder (JLC), and obsessive–compulsive (anankastic) personality disorder). Other personality disorders (not included in DSM-IV) are also covered, including passive–aggressive (negativistic) personality disorder, self-defeating (masochistic) personality disorder, sadistic personality disorder, depressive personality disorder, and personality changes, including enduring personality changes after traumatic experiences and personality change due to a general medical condition (JLC).

scholarly journals Review of pharmacologic treatment in cluster A personality disorders

2016 ◽  
Vol 6 (2) ◽  
pp. 75-81 ◽  
Author(s):  
Jessa Koch ◽  
Taylor Modesitt ◽  
Melissa Palmer ◽  
Sarah Ward ◽  
Bobbie Martin ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Schizotypal Personality Disorder ◽  
Pharmacologic Treatment ◽  
Schizotypal Personality ◽  
Schizoid Personality ◽  
Schizoid Personality Disorder ◽  
Paranoid Personality Disorder ◽  
Paranoid Personality ◽  
Cluster A

Abstract Introduction: A personality disorder is a pervasive and enduring pattern of behaviors that impacts an individual's social, occupational, and overall functioning. Specifically, the cluster A personality disorders include paranoid personality disorder, schizoid personality disorder, and schizotypal personality disorder. Patients with cluster A personality disorders tend to be isolative and avoid relationships. The quality of life may also be reduced in these individuals, which provokes the question of how to treat patients with these personality disorders. The purpose of this review is to evaluate the current literature for pharmacologic treatments for the cluster A personality disorders. Methods: A Medline/PubMed and Ovid search was conducted to identify literature on the psychopharmacology of paranoid personality disorder, schizoid personality disorder, and schizotypal personality disorder. There were no exclusions in terms of time frame from article publication or country of publication, in order to provide a comprehensive analysis; however, only articles that contained information on the cluster A disorders were included. Results: Minimal evidence regarding pharmacotherapy in paranoid and schizoid personality disorders was found. Literature was available for pharmacologic treatment of schizotypal personality disorder. Studies evaluating the use of olanzapine, risperidone, haloperidol, fluoxetine, and thiothixene did yield beneficial results; however, treatment with such agents should be considered on a case-by-case basis. Discussion: Most of the literature analyzed in this review presented theoretical ideas of what may constitute the neurobiologic factors of personality and what treatments may address these aspects. Further research is needed to evaluate specific pharmacologic treatment in the cluster A personality disorders. At this time, treatment with pharmacologic agents is based on theory rather than evidence.

scholarly journals Case Report: The Association Between Chromosomal Anomalies and Cluster A Personality Disorders: The Case of Two Siblings With 16p11.2 Deletion and a Review of the Literature

2021 ◽  
Vol 12 ◽  
Author(s):  
Cecilia Maria Esposito ◽  
Paolo Enrico ◽  
Domenico Sciortino ◽  
Elisabetta Caletti ◽  
Giulia Bruna Marchetti ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Psychotic Disorders ◽  
Chromosomal Rearrangements ◽  
Epidemiologic Studies ◽  
Deletion Syndrome ◽  
Chromosomal Anomalies ◽  
Paranoid Personality Disorder ◽  
Paranoid Personality ◽  
Cluster A

Although several studies have shown the correlation between chromosomal rearrangements and the risk of developing psychotic disorders, such as schizophrenia, little attention has been given to identifying the genetic basis of pre-disposing personality so far. In this regard, a limited but significant number of studies seem to indicate an association between chromosomal anomalies and cluster A personality disorders (CAPD). Starting from the clinical description of two brothers affected by familial 16p11 deletion syndrome (OMIM #611913), both sharing cluster A and C personality traits, the aim of the present study is to critically review the literature regarding the correlation between chromosomal rearrangements and CAPD. A bibliographic search on PubMed has been conducted, and eight studies were finally included in our review. Most of the studies highlight the presence of schizotypal personality disorder in the 22q11.2 deletion syndrome, whose evolutionary course toward psychotic pictures is well-known. One study also identified a paranoid personality disorder in a patient with a deletion on chromosome 7q21.3. No studies have so far identified the presence of paranoid personality disorder in 16p11 deletion, as in the case of the two siblings we report, while its association with psychosis and autism is already known. Although further epidemiologic studies on broader populations are indicated, our observations might pave the way for the definition of new diagnostic subgroups of CAPD and psychotic disorders, in order to implement the clinical management of such complex conditions.

scholarly journals The role of personality disorder in ‘difficult to reach’ patients with depression: Findings from the ODIN study

2007 ◽  
Vol 22 (3) ◽  
pp. 153-159 ◽  
Author(s):  
Brendan D. Kelly ◽  
Patricia Casey ◽  
Graham Dunn ◽  
Jose Luis Ayuso-Mateos ◽  
Christopher Dowrick
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Psychological Treatment ◽  
Comorbid Diagnosis ◽  
Schizoid Personality Disorder ◽  
Paranoid Personality Disorder ◽  
Paranoid Personality ◽  
Study Sites ◽  
Specific Disorders

AbstractIndividuals with personality disorders (especially paranoid personality disorder) tend to be reluctant to engage in treatment. This paper aimed to elucidate the role of personality disorder in predicting engagement with psychological treatment for depression. The Outcomes of Depression International Network (ODIN) involves six urban and three rural study sites throughout Europe at which cases of depression were identified through a two-stage community survey. One patient in seven who was offered psychological treatment for depression had a comorbid diagnosis of personality disorder (most commonly paranoid personality disorder). Forty-five percent of patients who were offered psychological treatment for depression did not complete treatment. The odds of completion were higher for patients with a comorbid diagnosis of personality disorder, especially paranoid, anxious or dependent personality disorder. The relatively low number of cases with some specific personality disorders (e.g. schizoid personality disorder) limited the study's power to reach conclusions about these specific disorders. This study focused on a community-based sample which may lead to apparently lower rates of engagement when compared to studies based on treatment-seeking populations. Episodes of depression in the context of personality disorder may represent a valuable opportunity to engage with patients who might otherwise resist engagement.

The Antisocial Personality Questionnaire: An Inventory for Assessing Personality Deviation in Offender Populations1 * An earlier version of this paper was presented at the Fifth European Conference on Law and Psychology, Budapest, Hungary, August 1995.

1999 ◽  
Vol 15 (1) ◽  
pp. 14-24 ◽  
Author(s):  
Ronald Blackburn ◽  
Diane Fawcett
Keyword(s):  
Personality Disorder ◽  
Social Withdrawal ◽  
Self Control ◽  
Self Report ◽  
Criminal Career ◽  
Big Five Personality ◽  
Personality Questionnaire ◽  
Antisocial Personality ◽  
Mentally Disordered Offenders ◽  
Mentally Disordered

Summary: The development is described of the Antisocial Personality Questionnaire (APQ), a short multitrait, self-report inventory that measures intrapersonal and interpersonal dispositions of relevance to antisocial populations. Scales were generated through factor analysis of an item pool adapted from the MMPI, Buss-Durkee Hostility Inventory, and a self-report scale of Psychopathy, using samples of male mentally disordered offenders (N = 499) and male volunteer nonoffenders (N = 238). Eight factors extracted were identified as Self-Control, Self-Esteem, Avoidance, Paranoid Suspicion, Resentment, Aggression, Deviance, and Extraversion. Short scales constructed to measure these have satisfactory reliability (α), and correlations with measures of personality disorder, observer ratings of interpersonal style, and criminal career data support their construct validity. Scale intercorrelations yield two higher-order dimensions of hostile impulsivity and social withdrawal that reflect orientations towards others and the self, respectively. The APQ provides comprehensive coverage of the deviant traits implicated in personality disorder and antisocial behavior, and appears to tap three of the Big Five personality dimensions (Neuroticism, Extraversion and Agreeableness). The questionnaire has satisfactory psychometric properties and can aid research and intervention with offenders.

scholarly journals Oxytocin Receptor Gene, Childhood Maltreatment and Borderline Personality Disorder Features among Male Inmates in China

2020 ◽  
Author(s):  
Min Zhang ◽  
Na Liu ◽  
Haocheng Chen ◽  
Ning Zhang
Keyword(s):  
Sexual Abuse ◽  
Borderline Personality Disorder ◽  
High Risk ◽  
Personality Disorder ◽  
Antisocial Personality Disorder ◽  
Childhood Maltreatment ◽  
Oxytocin Receptor ◽  
Borderline Personality ◽  
Antisocial Personality ◽  
Male Inmates

Abstract Background: Borderline personality disorder (BPD) is caused by a variety of biological and environmental factors. Accumulating evidence suggests that childhood maltreatment is a risk environmental factor in the development of BPD, but research on the genetic pathology of BPD is still in its early stages, and very little is known about the oxytocin receptor (OXTR) gene. The purpose of this study is to further explore the interactive effects between OXTR gene polymorphisms and childhood maltreatment on BPD risk. Methods: Among the 1804 male inmates, 765 inmates who had BPD or antisocial personality disorder (ASPD) or highly impulsive or violent crime were considered as high-risk inmates and included in this study. Childhood maltreatment, BPD, antisocial personality disorder (ASPD) and impulsivity were measured by self-reported questionnaires. Peripheral venous blood was collected for the genotype test. Results: Analyses revealed that the BP group (inmates with BPD features) had higher rs53576 AA genotype frequency and rs237987 AA genotype frequency than the non-BP group, while the statistical significances were lost after Bonferroni correction. Total childhood maltreatment score, emotional abuse and neglect could positively predict BPD risk. Among the high-risk samples, rs53576 GG genotype carriers had higher BPD scores at higher levels of physical abuse and sexual abuse and had lower BPD scores at lower levels of physical abuse and sexual abuse. Conclusions: The findings suggest that the interaction between OXTR gene variations and childhood maltreatment is an important mechanism for the development of BPD. The moderating role of the OXTR gene provides evidence for gene plasticity.

scholarly journals Proportion of Psychiatry Outpatients with Borderline Personality and Associated Clinical Syndromes using the Millon Clinical Multiaxial Inventory-III: A Retrospective Study

2021 ◽  
Author(s):  
Shaunak Ajit Ajinkya ◽  
Pranita Shantanu Sharma ◽  
Aparna Ramakrishnan
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Mental Health Professionals ◽  
Borderline Personality ◽  
Personality Types ◽  
Care Hospital ◽  
Millon Clinical Multiaxial Inventory ◽  
Clinical Syndromes ◽  
Thought Disorders

Introduction: Personality disorders are a group of behavioural patterns associated with significant personal and socio-occupational disturbances. Numerous studies have demonstrated borderline personality to be one of the most common personality disorders. It’s less often diagnosed with just a clinical assessment. Aim: To examine the proportion of patients with Borderline Personality Disorder (BPD), and its associated personality types and clinical syndromes, using the Millon Clinical Multiaxial Inventory version-III (MCMI-III). Materials and Methods: A retrospective observational study was carried out on 450 adult patients who attended the psychiatry outpatient department of an urban tertiary care hospital. They had been administered the MCMI-III, a self-rating questionnaire commonly used to provide information on personality types and associated clinical syndromes. Statistical Package for the Social Sciences (IBM SPSS, Windows) version 20.0 was used for statistical analyses. Data was expressed in terms of actual number, mean and percentages. Chi-Square or Fisher’s-exact test, as appropriate, was used for categorical data to test for associations. Odds ratio was estimated to measure strength of the association. Results: Borderline was the most common personality type comprising nearly half (46.63%) of the study population. 25.5% had borderline traits while 21.1% had Borderline Personality Disorder (BPD). BPD was significantly higher in females (p<0.001), younger age group below the age of 40 years (p<0.001) and unmarried persons (p<0.001). It was comorbid most with Anxiety (90.91%; OR=4.05; p<0.001), Major Depression (85.23%; OR=18.39; p<0.001), Post Traumatic Stress Disorder (PTSD) (46.59%; OR=6.30; p<0.001) and Thought disorders (56.82%; OR=18.15; p<0.001). Alcohol (22.73%; OR=3.54; p<0.001) and Drug dependence (13.64%; OR=11.52; p<0.001) were also seen significantly higher in patients with BPD. Personality types significantly comorbid with BPD were Sadistic, Depressive, Masochistic, Negativistic, Schizotypal, Avoidant, Dependent, Antisocial and Paranoid types, with odds being most for Sadistic personality (OR=9.44). Conclusion: It is recommended that mental health professionals and clinicians should start to look for underlying symptoms of BPD in patients of anxiety and mood syndromes. If found these patients should be directed for psychotherapy as early as possible. The MCMI psychological test would be an important contribution to this area, given the need for systematic, quick, and objective testing methods that facilitate the diagnosis.

scholarly journals The person behind the label: co-production as a tool in teaching about borderline personality disorder

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S122-S122
Author(s):  
Nyakomi Adwok ◽  
Sharon Nightingale
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Mental Health Professionals ◽  
Service User ◽  
Borderline Personality ◽  
Junior Doctors ◽  
Service Users ◽  
Teaching Session ◽  
Negative Attitudes

AimsThe overarching aim of the session was to address and reduce stigma around Borderline Personality Disorder among doctors. The three main objectives were:To increase empathy and understanding around Borderline Personality Disorder by exposing junior doctors to service user perspectives outside a clinical setting;To address knowledge gaps identified by junior doctors in a self-reported questionnaire disseminated prior to the teaching session;To offer junior doctors a basic psychological framework to base their assessment and formulation of service users with personality disorders.Background‘Borderline Personality Disorder: The Person Behind the Label’ was the title of the first co-produced teaching session in the Leeds and York Partnership Foundation Trust (LYPFT). Prior to the teaching session, an online questionnaire was sent out to trainees. The results highlighted three key issues:Negative attitudes towards service users with personality disorders;Poor subjective knowledge of the psychological models of personality disorders;Perception among trainees that they do not receive adequate training to deal with the challenges service users with personality disorders present.MethodA teaching session was co-produced by a team of two service users, a principal clinical psychologist within the Leeds Personality Disorder Network (PDN) and a core Psychiatry trainee. It was delivered in a 75 minute session to 40 attendees consisting of both trainee doctors and consultants.ResultFeedback was collected immediately after the session through the use of anonymous feedback forms. The response to the training was overwhelmingly positive with all 28 respondents rating the session as 4/5 or 5/5 on a satisfaction scale ranging from 1 (poor) to excellent (5). Key themes from the feedback included appreciation for the service user perspective and teaching on psychological theory. The fourth question in the questionnaire: “How will this teaching impact your work?” produced the highest number of responses (25/28) and provided evidence that the above listed objectives of the session were met.ConclusionCo-produced teaching has great potential to address negative attitudes around highly stigmatised conditions by bridging the gap that often exists between service users and mental health professionals.

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