Personality Disorder
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2021 ◽  
pp. 103985622110570
Heidari Parvaneh ◽  
Broadbear Jillian H ◽  
Cheney Lukas ◽  
Dharwadkar Nitin P ◽  
Rao Sathya

Objective The aim of this study was to investigate the well-being of people with severe borderline personality disorder (BPD) during the first wave of COVID-19 social restrictions. Method Clients of an outpatient specialist personality disorder clinic ( n = 77) were invited to the study. An online survey was conducted including a range of open-ended questions exploring well-being and the Coronavirus Anxiety Scale (CAS) which assesses ‘coronaphobia’. Qualitative data were analysed using inductive content analysis with NVivo software. CAS data were analysed descriptively using SPSS version 25. Results Thirty-six surveys were completed (48% response rate). Many participants experienced significant challenges to their overall well-being during lockdown although some reported improvements in psychosocial functioning. Three participants (8.3%) experienced clinically significant ‘coronaphobia’. Conclusion The self-reported physical and mental health of participants with BPD demonstrated resilience, suggesting that the capacity to maintain treatment via telehealth helped to mitigate many of the adverse aspects of social restrictions. This study was conducted during the first wave of social restrictions; subsequent studies will reveal longer-term effects of extended community lockdowns.

2021 ◽  
Vol 10 (23) ◽  
pp. 5622
Sophie A. Rameckers ◽  
Rogier E. J. Verhoef ◽  
Raoul P. P. P. Grasman ◽  
Wouter R. Cox ◽  
Arnold A. P. van Emmerik ◽  

We examined the effectiveness of psychotherapies for adult Borderline Personality Disorder (BPD) in a multilevel meta-analysis, including all trial types (PROSPERO ID: CRD42020111351). We tested several predictors, including trial- and outcome type (continuous or dichotomous), setting, BPD symptom domain and mean age. We included 87 studies (N = 5881) from searches between 2013 and 2019 in four databases. We controlled for differing treatment lengths and a logarithmic relationship between treatment duration and effectiveness. Sensitivity analyses were conducted by excluding outliers and by prioritizing total scale scores when both subscale and total scores were reported. Schema Therapy, Mentalization-Based Treatment and reduced Dialectical Behavior Therapy were associated with higher effect sizes than average, and treatment-as-usual with lower effect sizes. General severity and affective instability showed the strongest improvement, dissociation, anger, impulsivity and suicidality/self-injury the least. Treatment effectiveness decreased as the age of participants increased. Dichotomous outcomes were associated to larger effects, and analyses based on last observation carried forward to smaller effects. Compared to the average, the highest reductions were found for certain specialized psychotherapies. All BPD domains improved, though not equally. These findings have a high generalizability. However, causal conclusions cannot be drawn, although the design type did not influence the results.

E. M. Akhmetzyanova ◽  
I. A. Tregubenko

Introduction. There are speech disorders as one of the psychopathology diagnostics criteria in ICD and DSM. However, the linguistic component is not enough studied, so the study topic is actual. The use of text analysis allows to apply psycholinguistics approach to the objectification of thinking disorders. The objective of the study was aimed to detect psycholinguistics features of oral and written speech in patients with schizophrenia.Methods and materials. Participants were 29 schizophrenia patients, 20 patients with personality disorder and 25 healthy participants. Methods: expert assessment, anamnestic assessment, experimental-psychological (tests of thinking, collect memories), linguistic analysis, statistical analysis.Results. Oral speech of patients with schizophrenia is complex and volume, the writing speech is «factual», lexically varied and low communicative. In oral and writing speech of patients with schizophrenia, there are three text types correlated with thinking disorders. Texts of patients with schizophrenia are less volume, simpler in structure, describe more facts than thoughts and feelings, unlike patients with personality disorder and healthy participants.Conclusion. Texts of patients with schizophrenia, personality disorder and healthy participants are different in formal linguistics characteristics. Such characteristics of the speech of patients suffering from schizophrenia as a lot of impersonal sentences describing object attribute, complexly organized speech, emphasis on describing emotions and oneself using the pronoun «I» allow to suppose that the patient has thinking disorders: thinking distortion by formal and latent ways of object attributions, thinking purposefulness disorder, thinking «versatility».

2021 ◽  
Vol 12 ◽  
Carolin Steuwe ◽  
Michaela Berg ◽  
Thomas Beblo ◽  
Martin Driessen

Background: Comorbid Posttraumatic Stress Disorder (PTSD) increases the already high symptom burden of patients with Borderline Personality Disorder (BPD). As the gold standard for BPD treatment, Dialectical Behavior Therapy (DBT), does not focus on PTSD, other treatment approaches are needed. Narrative Exposure Therapy (NET) was designed to address multiple traumatic events and may be especially useful in this patient group. The aim of the present study was to determine the efficacy of NET compared to DBT based treatment (DBT-bt) in a randomized controlled trial.Methods: Female patients (n = 60) with BPD and comorbid PTSD were randomized to either a 10-week residential NET or DBT-bt. The primary outcome was change in PTSD severity as assessed by the Clinician Administered PTSD Scale (CAPS). Mixed linear models as well as reliable change, remission, and response rates were used to compare improvement across treatment groups.Results: Mixed linear model showed that patients in both treatments improved significantly over time across all outcome measures. This improvement was not more pronounced in NET (no significant time × type of treatment effect). However, NET resulted in a higher remission rate as compared to DBT-bt. PTSD remission was accompanied by BPD remission in all cases.Conclusions: This study shows the value of trauma-focused therapy in patients with BPD and PTSD for recovery in both disorders. To shorten the duration of both illnesses as much as possible, future studies should focus on the factors predicting treatment success and enabling patients to benefit from trauma-focused treatment as soon as possible.Trial, identifier: NCT02517723.

2021 ◽  
Vol 12 ◽  
Mark H. Waugh ◽  
Abby L. Mulay ◽  
E. Bailey Crittenden ◽  
Gina Rossi

The Minnesota Multiphasic Personality Inventory (MMPI) instruments are frequently used to assess personality and psychopathology. Recent publications of personality disorder (PD) spectra scales for dimensionalized PD syndromes with MMPI instruments may advance PD assessment. To this end, we examined MMPI-Second Edition (2) and MMPI-2-Restructured Form (-RF) PD Spectra scales within the lens of a contemporary dimensional model of PDs, the alternative model for personality disorders (AMPD). The core dimension of PD, Criterion A of the AMPD or level of personality functioning (LPF), was characterized quantitatively within the PD Spectra scales. By sequentially factor analyzing the scales of the Severity Indices of Personality Problems (SIPP-118) to a common general factor of PD, an index of LPF external to the MMPI item pool was established. This LPF dimension was strongly represented across most PD Spectra scales. LPF variances within the PD Spectra scales were deconstructed using measures of general demoralization (RCdemoralization) and maladaptive personality traits indexed by the Personality Psychopathology-5 (PSY-5). Nuanced LPF and PD Spectra scale relationships were discerned. Dimensionalized Antisocial PD, Borderline PD, Dependent PD, and Paranoid PD showed meaningful association with LPF after demoralization, and maladaptive trait variances were removed. The examination of the MMPI-3 item pool reveals that the existing PD Spectra scale item sets are largely carried forward in the new edition of the MMPI. This suggests PD Spectra scale correlates, including LPF relationships, may be discernable in the newest edition of the MMPI, pending future study.

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Carmel Proctor ◽  
Sakib Rahman

“Severe domestic squalor” or Diogenes syndrome is characterised by extreme self-neglect of environment, health, and hygiene, excessive hoarding, squalor, social withdrawal, and a distinct lack of concern or shame regarding one’s living condition. This report presents a case of a 51-year-old male admitted to the hospital psychiatric ward following the police removing him from his home. Police officers attended the man’s home following the alarm being raised by his stepfather that he had not been seen or heard from in 3 weeks. His home was covered in several feet of rubbish, rotting food, and debris and smelled intensely of rotting mould, urine, and faeces. He was found lying nude on top of garbage with a rug over him. Diogenes syndrome is highly comorbid with psychiatric and somatic disorders, including depression, obsessive-compulsive disorder, personality disorder, and stress. This case report provides a rare opportunity to better understand the distinction of Diogenes syndrome from the closely related condition hoarding disorder. Furthermore, creating an agreed-upon constellation of symptoms representative of Diogenes is essential to creating a formal Diagnostic and Statistical Manual of Mental Disorders (DSM) entry, which would facilitate the much-needed development of assessment measures to enable accurate diagnosis and treatment.

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