scholarly journals Comparing the magnitude of improvement for patients with and without personality disorders in open-ended psychotherapy

2020 ◽  
Author(s):  
Magnus Nordmo ◽  
Jon T. Monsen ◽  
Per Andreas Høglend ◽  
Ole Andre Solbakken
Keyword(s):  
Mental Illness ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Treatment Outcomes ◽  
Symptomatic Improvement ◽  
Personality Pathology ◽  
Individual Needs ◽  
Diagnostic Changes

Psychotherapy tends to produce meaningful and sustained positive changes for individuals suffering from a mental illness. A salient distinction can be made between patients with a Personality Disorder (PD) and those without. There is some evidence that patients with PD have poorer treatment outcomes, but the majority of these studies are from time-limited interventions that might be less suited for patients with PD. In contrast, the present study provided open-ended psychotherapy to a sample of patients (N = 370), half of which had at least one PD before treatment. The therapists received instruction to organize their treatments in cooperation with patients so that therapy was tailored to each patient’s individual needs and characteristics. The results revealed that patients with a PD demonstrated equal symptomatic improvement and greater interpersonal improvement compared to patients without a PD. Similarly, observer-rated diagnostic changes were equivalent across the two groups. Both groups demonstrated enduring improvements when assessed at a two-and-half-year follow-up. The degree of personality pathology was positively related to the magnitude of change, i.e. patients with more severe personality problems demonstrated greater gains in the open-ended treatment format.

Behavior and Molecular Genetics of Personality Disorders

2012 ◽  
pp. 142-165
Author(s):  
Susan C. South ◽  
Ted Reichborn-Kjennerud ◽  
Nicholas R. Eaton ◽  
Robert F. Krueger
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Molecular Genetics ◽  
Behavior Genetics ◽  
Association Studies ◽  
Molecular Genetic ◽  
Genetic Research ◽  
Twin Studies ◽  
Personality Pathology ◽  
Genome Wide Association Studies

The purpose of this chapter is to provide an overview of the behavior and molecular genetics of personality disorder. We begin with a thorough review of findings from the field of behavior genetics of personality pathology, including univariate twin studies, multivariate twin studies, and new models of gene–environment interplay. We then discuss the molecular genetics of personality pathology, including a consideration of candidate gene analysis, linkage analysis, and genome-wide association studies. We focus in particular on research concerning antisocial personality disorder (including antisociality and aggression), borderline personality disorder, schizotypal personality disorder, Cluster B and C personality disorders, and normal personality traits. We then provide a discussion of challenges and future directions with respect to behavior and molecular genetic research. We conclude the chapter with a discussion of the implications of this research for the forthcoming fifth edition of the American Psychiatric Association’s diagnostic manual.

COGNITIVE BEHAVIOUR THERAPY AND ASSERTION TRAINING GROUPS FOR PATIENTS WITH DEPRESSION AND COMORBID PERSONALITY DISORDERS

2000 ◽  
Vol 28 (1) ◽  
pp. 71-85 ◽  
Author(s):  
Jillian Ball ◽  
Brian Kearney ◽  
Kay Wilhelm ◽  
Jodie Dewhurst-Savellis ◽  
Belinda Barton
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Depressive Symptomatology ◽  
Therapy Group ◽  
Self Report ◽  
Cognitive Behaviour ◽  
Long Term Follow Up ◽  
Assertion Training

Longitudinal evaluations were conducted on 61 adults who were referred to a Mood Disorders Unit with a history of depression (all index episodes reached criteria for DSM-III-R major depression or dysthymia) and who had completed a cognitive behavioural therapy group either on its own or in combination with an assertion training group. Assessment of personality was made using DSM-III-R Axis II personality disorder categories. These categories were aggregated to form three groups: (i) no personality disorder; (ii) Cluster B (dramatic-erratic); and (iii) Cluster C (anxious-fearful), and were used to identify responsiveness to treatment and outcome at long-term follow-up. A battery of self-report measures were administered pretreatment, posttreatment and at long-term follow-up (1–3 years later). Both groups showed significant improvements in mean scores during treatment and these gains were maintained over the follow-up period. However, improvement in those patients without personality disorders was greater at posttreatment and at long-term follow-up, both in level of depressive symptomatology and proportion of cases meeting criteria for recovery. The treatment implications of these results are discussed.

scholarly journals Psychiatric, demographic and personality characteristics of elderly sex offenders

2002 ◽  
Vol 32 (2) ◽  
pp. 219-226 ◽  
Author(s):  
S. FAZEL ◽  
T. HOPE ◽  
I. O’DONNELL ◽  
R. JACOBY
Keyword(s):  
Mental Illness ◽  
Personality Disorder ◽  
Sex Offenders ◽  
Personality Traits ◽  
Personality Disorders ◽  
Psychiatric Morbidity ◽  
The Elderly ◽  
Personality Factors ◽  
Obsessive Compulsive ◽  
Dsm Iv

Background. Psychiatric disorders are purported to play a role in the aetiology of violent crime, but evidence for their role in sexual offending is less clear. The authors investigated the prevalence of psychiatric morbidity and personality disorders in elderly incarcerated sex offenders compared with elderly non-sex offenders.Method. One hundred and one sex offenders and 102 non-sex offenders aged over 59 years were interviewed using standardized semi-structured interviews for psychiatric illness (the Geriatric Mental State) and the personality disorder (Structured Clinical Interview for DSM-IV personality disorders). Data on demographic, offence and victim characteristics were collected.Results. Six per cent of the elderly sex offenders had a psychotic illness, 7% a DSM-IV major depressive episode and 33% a personality disorder; and 1% had dementia. These prevalence figures were not different from the elderly non-sex offenders interviewed in this study. Differences emerged at the level of personality traits with sex offenders having more schizoid, obsessive–compulsive, and avoidant traits, and fewer antisocial traits compared with non-sex offenders.Conclusions. Elderly sex offenders and non-sex-offenders have similar prevalence rates of mental illness. However, elderly sex offenders have increased schizoid, obsessive–compulsive, and avoidant personality traits, supporting the view that sex offending in the elderly is associated more with personality factors than mental illness or organic brain disease.

Psychodynamic Models of Personality Disorders

2012 ◽  
pp. 344-371
Author(s):  
Peter Fonagy ◽  
Patrick Luyten
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Empirical Research ◽  
Personality Pathology ◽  
Diagnosis And Treatment

This chapter provides an overview of psychodynamic approaches to personality pathology and their core assumptions, and it reviews empirical research supporting these approaches. It also includes a review of contemporary psychodynamic approaches to classification, diagnosis, and treatment of personality disorders. Finally, a summary of findings concerning the effectiveness of psychodynamic treatments for personality disorder is provided.

scholarly journals Stability of early-phase primary psychotic disorders with concurrent substance use and substance-induced psychosis

2007 ◽  
Vol 190 (2) ◽  
pp. 105-111 ◽  
Author(s):  
Carol L. M. Caton ◽  
Deborah S. Hasin ◽  
Patrick E. Shrout ◽  
Robert E. Drake ◽  
Boanerges Domínguez ◽  
...  
Keyword(s):  
Mental Illness ◽  
Substance Use ◽  
Early Phase ◽  
Psychotic Disorders ◽  
History Of ◽  
Dsm Iv ◽  
The Stability ◽  
Primary Substance ◽  
Diagnostic Changes

BackgroundThe stability of the diagnostic distinction between a substance-induced psychosis and a primary psychotic disorder co-occurring with substance use is not established.AimsTo describe DSM – IV diagnostic changes over 1 year and determine the predictive validity of baseline indicators of the substance-induced psychosis v. primary psychosis distinction.MethodWe conducted a 1-year follow-up study of 319 psychiatric emergency department admissions with diagnoses of early-phase psychosis and substance use comorbidity.ResultsOf those with a baseline DSM—IV diagnosis of substance-induced psychosis, 25% had a diagnosis of primary psychosis at follow-up. These patients had poorer premorbid functioning, less insight into psychosis and greater family mental illness than patients with a stable diagnosis of substance-induced psychosis. Reclassifying change cases to primary psychoses on follow-up, key baseline predictors of the primary/substance-induced distinction at 1 year also included greater family history of mental illness in the primary psychosis group.ConclusionsFurther study of substance-induced psychoses should employ neuroscientific and behavioural approaches. Study findings can guide more accurate diagnoses at first treatment.

scholarly journals The effect of concurrent mental illness on tuberculosis treatment outcomes at Butabika National Referral Mental Hospital – Uganda

2019 ◽  
Author(s):  
Derrick Kimuli ◽  
Etwom Alfred ◽  
Nicholas Sebuliba Kirirabwa ◽  
Racheal Tibyonza ◽  
Daniel Ayen Okello ◽  
...  
Keyword(s):  
Mental Illness ◽  
Treatment Outcomes ◽  
Mental Hospital ◽  
Quality Care ◽  
Psychosocial Assessment ◽  
Hiv Positive ◽  
Targeted Interventions ◽  
Tb Treatment ◽  
The Impact

Abstract Background The renaissance of tuberculosis (TB) through certain groups of the population including patients with mental illness has been observed for the last 30 years. However, literature on treatment outcomes of patients with mental illness is still scarce. The following research examines the impact of concurrent mental health illness on TB treatment outcomes in Butabika National Referral Mental Hospital. Methods A retrospective analysis of data for registered TB patients with and without mental-illness for the period July 2013 to December 2015. Data was extracted for age, sex, human immunodeficiency virus (HIV) serostatus and Directly Observed Treatment (DOT) status, TB classification and history of TB treatment. For HIV co-infected patients, data on Co-trimoxazole preventative therapy (CPT) and anti-retroviral therapy (ART) uptake was collected. Treatment outcomes of patients with and without mental illness were analyzed. Results A total of 325 records were analyzed, of which 105 (32%) patients were found to have had mental illness. Of the patients with mental illness, 61 (58%) were HIV positive while of those without mental illness, 134 (61%) were HIV positive. Patients with mental illness were less likely to complete treatment (adj. OR 0.3, 95% CI 0.2 - 0.5, p = 0.000) more likely to die, (adj. OR 2.3, 95% CI 1.2 – 4.3, p = 0.01) and more likely to get lost to follow up during treatment (adj. OR 2.8, 95% CI 1.3 – 6.0, p = 0.005) compared to those without mental illness. Conclusion Mental illness is associated with unfavorable outcomes of TB treatment. We recommend targeted interventions for patient follow up at this hospital and further studies to guide improvement in the quality care in this patient population. We also recommend psychosocial assessment and counselling for all patients on TB treatment as practice to improve treatment outcomes for all TB patients in Kampala.

scholarly journals Suicidality and Personality Pathology in Adolescence: A Systematic Review

2021 ◽  
Author(s):  
Marta Moselli ◽  
Maria Pia Casini ◽  
Camilla Frattini ◽  
Riccardo Williams
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Borderline Personality ◽  
Personality Pathology ◽  
Suicidal Risk ◽  
Research Papers ◽  
Mediating Role ◽  
Identity Diffusion ◽  
Predictive Role

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.

Personality problems and disorders

2017 ◽  
Author(s):  
Tom Burns ◽  
Mike Firn
Keyword(s):  
Mental Illness ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Borderline Personality ◽  
Team Work ◽  
Dimensional Approach ◽  
Outreach Workers ◽  
Dsm V ◽  
Icd 10

This chapter deals with the controversial issue of personality disorder, whether these are meaningful diagnoses and, if so, how they affect management. The classification is entirely pragmatic: the definitions and classification in both ICD-10 and DSM-V are outlined along with proposals to abandon categories in favour of a dimensional approach. The issue of treatability is explored, but we conclude that ignoring personality and personality disorders is not a viable alternative for outreach workers. Most of the chapter deals with the management of dissocial personality disorder (usually in men) and borderline personality disorder (usually in women). Specific psychotherapies are not dealt with here; the focus is on how to use team work to manage individuals with severe mental illness and disorders of personality.

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