scholarly journals A Metastructural Model of Mental Disorders and Pathological Personality Traits

2018 ◽  
Author(s):  
Aidan G.C. Wright ◽  
Leonard Simms

Background: Psychiatric comorbidity is extensive in both psychiatric settings and the general population. Such comorbidity challenges whether DSM-based mental disorders serve to effectively carve nature at its joints. In response, a substantial literature has emerged showing that a small number of broad dimensions—internalizing, externalizing, and psychoticism—can account for much of the observed covariation among common mental disorders. However, the location of personality disorders within this emerging metastructure has only recently been studied, and no studies have yet examined where pathological personality traits fit within such a broad metastructural framework.Methods: We conducted joint structural analyses of common mental disorders, personality disorders, and pathological personality traits in a sample of 628 current or recent psychiatric outpatients. Results: Bridging across the psychopathology and personality trait literatures, the results provide evidence for a robust five-factor metastructure of psychopathology, including broad domains of symptoms and features related to internalizing, disinhibition, psychoticism, antagonism, and detachment. Conclusions: These results reveal evidence for a psychopathology metastructure that (a) parsimoniously accounts for much of the observed covariation among common mental disorders, personality disorders, and related personality traits, and (b) provides an empirical basis for the organization and classification of mental disorder.

2015 ◽  
Vol 45 (11) ◽  
pp. 2309-2319 ◽  
Author(s):  
A. G. C. Wright ◽  
L. J. Simms

BackgroundPsychiatric co-morbidity is extensive in both psychiatric settings and the general population. Such co-morbidity challenges whether DSM-based mental disorders serve to effectively carve nature at its joints. In response, a substantial literature has emerged showing that a small number of broad dimensions – internalizing, externalizing and psychoticism – can account for much of the observed covariation among common mental disorders. However, the location of personality disorders within this emerging metastructure has only recently been studied, and no studies have yet examined where pathological personality traits fit within such a broad metastructural framework.MethodWe conducted joint structural analyses of common mental disorders, personality disorders and pathological personality traits in a sample of 628 current or recent psychiatric out-patients.ResultsBridging across the psychopathology and personality trait literatures, the results provide evidence for a robust five-factor metastructure of psychopathology, including broad domains of symptoms and features related to internalizing, disinhibition, psychoticism, antagonism and detachment.ConclusionsThese results reveal evidence for a psychopathology metastructure that (a) parsimoniously accounts for much of the observed covariation among common mental disorders, personality disorders and related personality traits, and (b) provides an empirical basis for the organization and classification of mental disorder.


Author(s):  
Marco Del Giudice

The chapter discusses the definition of mental disorder, reviews the biological explanations for vulnerability to disease, and presents a detailed taxonomy of undesirable conditions that may be regarded as disorders in a broad sense (whether or not they involve genuine dysfunctions). After detailing the main evolutionary and developmental processes that can lead to psychopathology, the chapter addresses some important questions about the structure and classification of disorders and the nature of psychiatric comorbidity. The chapter also considers the strengths and weaknesses of other emerging approaches: computational psychiatry, the network approach to psychopathology, the Research Domain Criteria (RDoC), and transdiagnostic models such as the Hierarchical Taxonomy of Psychopathology (HiTOP).


2017 ◽  
Vol 52 (5) ◽  
pp. 425-434 ◽  
Author(s):  
Bo Bach ◽  
Martin Sellbom ◽  
Mathias Skjernov ◽  
Erik Simonsen

Objective: The five personality disorder trait domains in the proposed International Classification of Diseases, 11th edition and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition are comparable in terms of Negative Affectivity, Detachment, Antagonism/Dissociality and Disinhibition. However, the International Classification of Diseases, 11th edition model includes a separate domain of Anankastia, whereas the Diagnostic and Statistical Manual of Mental Disorders, 5th edition model includes an additional domain of Psychoticism. This study examined associations of International Classification of Diseases, 11th edition and Diagnostic and Statistical Manual of Mental Disorders, 5th edition trait domains, simultaneously, with categorical personality disorders. Method: Psychiatric outpatients ( N = 226) were administered the Structured Clinical Interview for DSM-IV Axis II Personality Disorders Interview and the Personality Inventory for DSM-5. International Classification of Diseases, 11th edition and Diagnostic and Statistical Manual of Mental Disorders, 5th edition trait domain scores were obtained using pertinent scoring algorithms for the Personality Inventory for DSM-5. Associations between categorical personality disorders and trait domains were examined using correlation and multiple regression analyses. Results: Both the International Classification of Diseases, 11th edition and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition domain models showed relevant continuity with categorical personality disorders and captured a substantial amount of their information. As expected, the International Classification of Diseases, 11th edition model was superior in capturing obsessive–compulsive personality disorder, whereas the Diagnostic and Statistical Manual of Mental Disorders, 5th edition model was superior in capturing schizotypal personality disorder. Conclusion: These preliminary findings suggest that little information is ‘lost’ in a transition to trait domain models and potentially adds to narrowing the gap between Diagnostic and Statistical Manual of Mental Disorders, 5th edition and the proposed International Classification of Diseases, 11th edition model. Accordingly, the International Classification of Diseases, 11th edition and Diagnostic and Statistical Manual of Mental Disorders, 5th edition domain models may be used to delineate one another as well as features of familiar categorical personality disorder types. A preliminary category-to-domain ‘cross walk’ is provided in the article.


2007 ◽  
Vol 191 (2) ◽  
pp. 158-163 ◽  
Author(s):  
David L. Fone ◽  
Frank Dunstan ◽  
Ann John ◽  
Keith Lloyd

BackgroundThe relationship between the Mental Illness Needs Index (MINI) and the common mental disorders is not known.AimsTo investigate associations between the small-area MINI score and common mental disorder at individual level.MethodMental health status was measured using the Mental Health Inventory of the Short Form 36 instrument (SF-36). Data from the Caerphilly Health and Social Needs population survey were analysed in multilevel models of 10 653 individuals aged 18–74 years nested within the 2001 UK census geographies of 110 lower super output areas and 33 wards.ResultsThe MINI score was significantly associated with common mental disorder after adjusting for individual risk factors. This association was stronger at the smaller spatial scale of the lower super output area and for individuals who were permanently sick or disabled.ConclusionsThe MINI is potentially useful for small-area needs assessment and service planning for common mental disorder in community settings.


BJPsych Open ◽  
2016 ◽  
Vol 2 (1) ◽  
pp. 18-24 ◽  
Author(s):  
Sebastião Viola ◽  
Joanna Moncrieff

BackgroundThere is international concern about the levels of sickness and disability benefits, with mental disorders known to account for a large proportion of claims.AimsTo examine trends in sickness and disability benefits awarded for mental disorders in the UK.MethodThe researchers analysed UK Government data from 1995 to 2014.ResultsMental disorders have become the most common cause of receiving benefits, with the number of claimants rising by 103% from 1995 to 1.1 million in 2014. Claimants with other conditions fell by 35%. In 2014, 47% of claims were attributed to a mental disorder. The number of long-term claimants (claiming over 5 years) with mental disorders increased by 87% from 2000 to 2011. Two-thirds of mental disorder claimants were classified as having a depressive or anxiety disorder.ConclusionsCommon mental disorders may involve greater morbidity and social costs than usually recognised. Availability of suitable employment, as well as individual support, may be necessary to reduce benefit levels.


1998 ◽  
Vol 173 (1) ◽  
pp. 11-53 ◽  
Author(s):  
Clare Harris ◽  
Brian Barraclough

BackgroundWe describe the increased risk of premature death from natural and from unnatural causes for the common mental disorders.MethodWith a Medline search (1966–1995) we found 152 English language reports on the mortality of mental disorder which met our inclusion criteria. From these reports, covering 27 mental disorder categories and eight treatment categories, we calculated standardised mortality ratios (SMRs) and 95% confidence intervals (CIs) for all causes of death, all natural causes and all unnatural causes; and for most, SMRs for suicide, other violent causes and specific natural causes.ResultsHighest risks of premature death, from both natural and unnatural causes, are for substance abuse and eating disorders. Risk of death from unnatural causes is especially high for the functional disorders, particularly schizophrenia and major depression. Deaths from natural causes are markedly increased for organic mental disorders, mental retardation and epilepsy.ConclusionAll mental disorders have an increased risk of premature death.


2020 ◽  
Author(s):  
Nicholas R Eaton ◽  
Susan Carol South ◽  
Robert Krueger

An overview of different models of mental disorder comorbidity and an early review of the transdiagnostic factor model of comorbidity (e.g., internalizing-externalizing).


2020 ◽  
Author(s):  
Kefyalew Dagne Gizachew ◽  
Gashaw Andargie Biks ◽  
Abate Dargie Wubetu

Abstract Introduction: The high prevalence of antenatal mental disorders in Sub-Saharan African countries is poorly understood. Pregnancy and childbirth are gaining recognition as significant risk factors for the development and exacerbation of mental health problems. In low- and lower-middle income countries about one in six pregnant women are experiencing antenatal common mental disorders (CMD). Objective: To assess prevalence and associated factors of common mental disorders (CMD) among pregnant women in Debre Berhan town, North Showa Zone, Amhara region, Ethiopia, 2016. Methods: Community based cross-sectional study was employed among 569 participants. Data was collected using face-to-face interviews with Amharic version of Self Reporting Questionnaire (SRQ-20) from seven selected kebeles. Kebeles were selected by simple random sampling and individuals were selected using cluster sampling. Crude and adjusted OR was analyzed using bivariate and multivariable logistic regression analysis and the level of significance for association was determined with 95% CI and at P- value < 0.05. Result: A total 557 study participants were completed the interview and the prevalence of antenatal common mental disorder was found to be 45.2%. Loss of loved one (AOR = 1.97; 95% CI: 1.19–3.27), history of chronic medical illness (AOR = 6.57; 95% CI: 2.17–19.94), unwanted pregnancy (AOR = 2.13; 95% CI: 1.15–3.95), nulliparity (AOR = 8.71; 95% CI: 1.58–47.94), one or less ANC consultations (AOR = 0.22; 95% CI: 0.08–0.64), two-three ANC consultations (AOR = 0.30; 95% CI: 0.11–0.83) and current obstetric complications (AOR = 4.45; 95% CI: 2.21–8.99) were important factors significantly associated with antenatal common mental disorder. Conclusion: The prevalence of antenatal common mental disorder (CMD) was high in this study that shows antenatal CMD is significant public health issue that requires a great emphasis. So, early screening and intervention for antenatal CMD should be integrated in primary health care and antenatal care service settings.


Author(s):  
Sally-Ann Cooper

Mental disorders are common in people with intellectual disability, with a reported point prevalence of 36% in children and young people (including challenging behaviours), and 40.9% in adults (or 28.3% excluding challenging behaviours). People with intellectual disability experience all types of mental disorders, some more commonly than the general population, e.g. autism, attention-deficit hyperactivity disorder, schizophrenia, bipolar affective disorder, and dementia. Challenging behaviours are also common, and have no clear general population equivalent. Multi-morbidity of mental and physical disorders is typical. Mental disorder assessments are complex due to multi-morbidity and polypharmacy, in addition to impairments in communication, understanding, vision, and hearing, and the need to work with family and paid carers as well as the person with intellectual disability. Mental disorder classificatory systems have been developed for people with intellectual disability, in view of under-reporting when using general population manuals: DC-LD was designed to complement ICD-10, and DM-ID 2 to interpret DSM-5.


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