scholarly journals The genetic epidemiology of personality disorders

2010 ◽  
Vol 12 (1) ◽  
pp. 103-114 ◽  

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.

2016 ◽  
Vol 209 (4) ◽  
pp. 319-326 ◽  
Author(s):  
Yongsheng Tong ◽  
Michael R. Phillips ◽  
Kenneth R. Conner

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.


1999 ◽  
Vol 174 (6) ◽  
pp. 530-538 ◽  
Author(s):  
Jeremy Coid

BackgroundElucidation of aetiological processes leading to development of Axis II disorders is important in category validation and could lead to new treatments.AimsTo establish aetiological associations between Axis II disorders and specific risk factors.MethodMale and female subjects (n=260) in maximum security hospitals and prisons were interviewed to determine DSM-III Axis II and lifetime Axis I diagnoses. Aetiological risk factors were obtained at interview and from case files. Independent statistical associations were established by logistic regression.ResultsAxis II categories were divided into four groups: (a) disorders of character development, secondary to an adverse early environment: antisocial, self-defeating and paranoid; (b) disorders of temperament, secondary to constitutional aetiology: avoidant, dependent, schizoid and schizotypal; (c) a ‘mixed’ disorder of constitutional and environmental aetiology: borderline; and (d) aetiological associations not established: narcissistic, histrionic, compulsive and passive-aggressive.ConclusionsThe study validates several Axis II categories but challenges the inclusion of others within Axis II of DSM-IV, in particular schizoid, schizotypal, avoidant and borderline personality disorders. The findings have implications for future treatment interventions.


2001 ◽  
Vol 178 (S41) ◽  
pp. s128-s133 ◽  
Author(s):  
Nick Craddock ◽  
Ian Jones

BackgroundA robust body of evidence from family, twin and adoption studies demonstrates the importance of genes in the pathogenesis of bipolar disorder. Recent advances in molecular genetics have made it possible to identify these susceptibility genes.AimsTo present an overview for clinical psychiatrists.MethodReview of current molecular genetics approaches and emerging findings.ResultsOccasional families may exist in which a single gene plays a major role in determining susceptibility, but the majority of bipolar disorder involves more complex genetic mechanisms such as the interaction of multiple genes and environmental factors. Molecular genetic positional and candidate gene approaches are being used for the genetic dissection of bipolar disorder. No gene has yet been identified but promising findings are emerging. Regions of interest include chromosomes 4p16, 12q23–q24, 16p13, 21q22, and Xq24–q26. Candidate gene association studies are in progress but no robust positive findings have yet emerged.ConclusionIt is almost certain that over the next few years the identification of bipolar susceptiblity genes will have a major impact on our understanding of disease pathophysiology. This is likely to lead to major improvements and treatment in patient care, but will also raise important ethical issues.


2003 ◽  
Vol 18 (7) ◽  
pp. 350-355 ◽  
Author(s):  
Åsa Westrin ◽  
Karin Frii ◽  
Lil Träskman-Bendz

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.


Author(s):  
Susan C. South ◽  
Ted Reichborn-Kjennerud ◽  
Nicholas R. Eaton ◽  
Robert F. Krueger

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.


2012 ◽  
Vol 43 (8) ◽  
pp. 1673-1683 ◽  
Author(s):  
K. M. Keyes ◽  
N. R. Eaton ◽  
R. F. Krueger ◽  
A. E. Skodol ◽  
M. M. Wall ◽  
...  

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.


2004 ◽  
Vol 113 (2) ◽  
pp. 301-301 ◽  
Author(s):  
Shirley Yen ◽  
Tracie Shea ◽  
Maria Pagano ◽  
Charles A. Sanislow ◽  
Carlos M. Grilo ◽  
...  

2007 ◽  
Vol 38 (1) ◽  
pp. 135-146 ◽  
Author(s):  
J. Hill ◽  
P. Pilkonis ◽  
J. Morse ◽  
U. Feske ◽  
S. Reynolds ◽  
...  

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.


2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Dragana Duišin ◽  
Borjanka Batinić ◽  
Jasmina Barišić ◽  
Miroslav L. Djordjevic ◽  
Svetlana Vujović ◽  
...  

Background.Investigations in the field of gender identity disorder (GID) have been mostly related to psychiatric comorbidity and severe psychiatric disorders, but have focused less on personality and personality disorders (PDs).Aims.The aim of the study was to assess the presence of PDs in persons with GID as compared to cisgendered (a cisgender person is a person who is content to remain the gender they were assigned at birth) heterosexuals, as well as to biological sex.Methods.The study sample consisted of 30 persons with GID and 30 cisgendered heterosexuals from the general population. The assessment of PDs was conducted by application of the self-administered Structured Clinical Interview for DSM-IV Axis II PDs (SCID-II).Results.Persons with GID compared to cisgender heterosexuals have higher presence of PDs, particularly Paranoid PD, avoidant PDs, and comorbid PDs. In addition, MtF (transwomen are people assigned male at birth who identify as women) persons are characterized by a more severe psychopathological profile.Conclusions.Assessment of PDs in persons with GID is of great importance as it comprises a key part of personalized treatment plan tailoring, as well as a prognostic factor for sex-reassignment surgery (SRS) outcome.


2008 ◽  
Vol 103 (1) ◽  
pp. 173-188
Author(s):  
Tali Nachshoni ◽  
Yehuda Abramovitch ◽  
Vladimir Lerner ◽  
Miriam Assael-Amir ◽  
Moshe Kotler ◽  
...  

There is limited information on mental health of psychologists and social workers despite their rendering mental health services, so their subjective perception of mental disorder was explored via a self-evaluation survey in which they self-diagnosed the presence of DSM-IV disorders within themselves. The sample of 128 professionals included 63 psychologists and 65 social workers. The presence of Axis I traits was reported by 81.2%, the three most frequent traits being mood, obsessive-compulsive disorder, and eating disorder. Axis II traits were reported by 73.4% of subjects, the three most frequent conditions being narcissistic, avoidant, and obsessive-compulsive personality traits. While a high percentage of subjects reported the presence of either an Axis I or Axis II disorder, the average severity reported was low. More psychologists reported on mood, social phobia, and eating problems than social workers, while the latter reported more on psychotic problems. Psychologists reported more Axis II traits, especially paranoid, narcissistic, and avoidant subtypes. More women than men reported eating problems, while more men reported schizoid and avoidant personality traits. In conclusion, manifestations of subthreshold psychiatric conditions were prominently reported. These findings suggest encouraging mental health care professionals to explore treatment for problems if present.


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