Development of Dementia, Including Assessment and Interventions

Adults with Down syndrome show premature aging with a high risk of developing dementia, specifically Alzheimer’s disease. Dementia in people with Down syndrome develops in addition to pre-existing intellectual disability, which poses difficulties in its diagnosis. Determining baseline function and conducting regular assessments are essential to detecting cognitive and functional decline. Comorbid conditions such as epilepsy and depression may also affect dementia presentation. As there is little evidence for effective pharmacological treatment of dementia in adults with Down syndrome, the identification of novel treatment targets is vital. In addition, a better understanding of the time course of the development of dementia will aid in better detection and monitoring of individuals showing early signs of cognitive decline. Early dementia-related changes may include prominent declines in behavior, personality disturbance, and early impairments in memory. Advances in neuroimaging and biomarker detection will further assist in understanding the time course of dementia development in people with Down syndrome.

Diagnostic Moderators of the Risk-Recidivism Relationship for Offenders with Mental Illness

Recent research suggests that early onset of criminality is a potential marker for a subgroup of offenders with mental illness (OMI) for whom general risk/need factors are more relevant. The present study examines whether the presence of certain psychiatric diagnostic categories (i.e., Psychotic Disorders, Mood Disorders, Personality Disorders, Substance use Disorders) moderates the prediction of arrest outcomes using Level of Service Inventory-Revised (LSI-R) total scores in an archival sample of N = 179 OMI probationers. Moderator analyses demonstrated that LSI-R total scores predicted arrest outcomes significantly better for those with a diagnosis of Personality Disorder using path and survival analytic methods. Hierarchical regressions using LSI-R subscales as predictors revealed lower pro-criminal Attitudes for Mood Disordered participants, while more severe Criminal History and Family/Marital problems characterized those diagnosed with Personality Disorders. This study adds to the developing literature on subgroups of OMI for whom general risk/need factors are particularly important and highlights personality disturbance as another potential characterizing feature.

Acquired Personality Disturbances After Meningioma Resection Are Strongly Associated With Impaired Quality of Life

BACKGROUND Some patients experience long-term declines in quality of life following meningioma resection, but associated factors are not well understood. OBJECTIVE To investigate whether long-term declines in quality of life (specifically impaired adaptive functioning) after meningioma resection are associated with specific personality disturbances that often develop with lesions in ventromedial prefrontal cortex (vmPFC). METHODS We studied 38 patients who underwent resection of meningioma, 18 of whom had vmPFC lesions and 20 with lesions elsewhere (non-vmPFC). A total of 30 personality characteristics were rated by spouse or family, and a neuropsychologist blindly rated adaptive functioning an average of 3.8 yr postresection. Relevant personality disturbance was defined by a priori process: the presence of “conjoint personality disturbance” required specific disturbances in at least 2 of 4 types of disturbance: executive disorders, disturbed social behavior, emotional dysregulation, and hypoemotionality. RESULTS Fourteen patients had impaired adaptive functioning: 12 had vmPFC lesions and 2 had non-vmPFC lesions. Fourteen patients had conjoint personality disturbance, and 12 of them had impaired adaptive functioning. By contrast, among the 24 patients who did not have conjoint personality disturbance, only 2 had impaired adaptive functioning. Mediation analysis showed that the association between vmPFC lesions and impaired adaptive functioning was mediated by the negative impact of acquired personality disturbance on adaptive functioning. CONCLUSION Anterior skull base meningiomas plus resection surgery may result in specific personality disturbances that are highly associated with impaired adaptive functioning at long-term follow-up. These patients may benefit from early counseling regarding potential personality changes and their implications for adaptive functioning.

Sense of Self: Its Place in Personality Disturbance, Psychopathology, and Normal Experience

Sense of self (SOS) is a cornerstone of psychological inquiry and therapy and is a defining feature of a range of psychological conditions including borderline personality disorder, yet it is poorly understood. SOS is that continuous experience of being a complete and authentic person who feels in control of their own activities. It is a part of normal development of the self and, when weakened by trauma or developmental neglect, is a vulnerability for developing many different disorders, including depression and dissociative, personality, and eating disorders. This review aims to provide a working definition and description of SOS and to summarize its transdiagnostic role in contributing to psychological disorders. To achieve this aim, the article encompasses and unites the literature from various theoretical domains including developmental psychology, identity theory, cognitive psychology, personality disorders, and psychodynamic theories. Implications are raised for psychological therapy and research into psychopathology and its underpinnings.

Rhodiola rosea Improves Lifespan, Locomotion, and Neurodegeneration in a Drosophila melanogaster Model of Huntington’s Disease

Huntington’s disease (HD) is a dominant, late-onset disease characterized by choreiform movements, cognitive decline, and personality disturbance. It is caused by a polyglutamine repeat expansion in the Huntington’s disease gene encoding for the Huntingtin protein (Htt) which functions as a scaffold for selective macroautophagy. Mutant Htt (mHtt) disrupts vesicle trafficking and prevents autophagosome fusion with lysosomes, thus deregulating autophagy in neuronal cells, leading to cell death. Autophagy has been described as a therapeutic target for HD, owing to the key role Htt plays in the cellular process. Rhodiola rosea, a plant extract used in traditional medicine in Europe and Asia, has been shown to attenuate aging in the fly and other model species. It has also been shown to inhibit the mTOR pathway and induce autophagy in bladder cancer cell lines. We hypothesized that R. rosea, by inducing autophagy, may improve the phenotype of a Huntington’s disease model of the fly. Flies expressing HttQ93 which exhibit decreased lifespan, impaired locomotion, and increased neurodegeneration were supplemented with R. rosea extract, and assays testing lifespan, locomotion, and pseudopupil degeneration provided quantitative measures of improvement. Based on our observations, R. rosea may be further evaluated as a potential therapy for Huntington’s disease.

A Developmental Perspective on the Stability and Change of Psychopathic Personality Traits Across the Adolescence–Adulthood Transition

The stability of psychopathic personality disturbance (PPD) has important theoretical implications for developmental criminology and population heterogeneity perspective assertions that psychopathy is a key measure of criminal propensity. Data from the Pathways to Desistance Study ( n = 1,354) were used to examine short-, moderate-, and long-term reliable change in symptoms of PPD measured via the Youth Psychopathic Traits Inventory (YPI). Youth scoring highest on the YPI at the baseline assessment were most likely to experience reliable decreases in test scores. Binomial regression analyses showed that a reliable decrease in YPI test score was associated with decreased odds of endorsing additional offenses. Findings contrasted the adolescent “fledgling” psychopathy perspective and indicated that individuals scoring high on the YPI are the group most likely to experience reliable decreases in test scores, especially over a longer follow-up period.