If an Entrepreneur Founded the DSM-5 Alternative Model of Personality Disorder: When Axis II Meets Disruptive Innovation

Personality disorder (PD) researchers proposed a highly innovative “paradigm-shifting” revamp for the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5; APA, 2013). Yet, ten years later, Widiger and Hines (this issue) summarize a developmental process plagued by disagreement and stagnation, with little evidence of the field having reaped the desired benefits of this diagnostic revolution. In this commentary, we draw on principles from entrepreneurial creation, operation, and success—positioning the personality disorder scientists in the role of “disruptive innovator”—and summarize key principles from the entrepreneurial process that may be relevant in understanding the challenges and failures of the personality disorder revolution to date.

Methodology of hydrogen embrittlement study of long-term operated natural gas distribution pipeline steels caused by hydrogen transport

A methodology of experimental research on hydrogen embrittlement of pipe carbon steels due to the transportation of hydrogen or its mixture with natural gas by a long-term operated gas distribution network is presented. The importance of comparative assessments of the steel in the as-received and operated states basing on the properties that characterize plasticity, resistance to brittle fracture and hydrogen assisted cracking is accentuated. Two main methodological peculiarities are pointed out, (i) testing specimens should be cut out in the transverse direction relative to the pipe axis; (ii) strength and plasticity characteristics should be determined using flat tensile specimens with the smallest possible thickness of the working part. The determination of hydrogen concentration in metal, metallographic and fractographic analyses have been supplemented the study. The effectiveness of the proposed methodology has been illustrated by the example of the steel research after its 52-year operation.

Personality and Illness

A personality disorder (PD) is defined in the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5) as “an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment.” DSM-5 has revised the PDs to individual disorders. They no longer are reported in Axis II; DSM-5, unlike previous editions, does not use the axis system.

Cognitive Conflicts in Functional Gastrointestinal Disorders

The importance of psychological factors in functional gastrointestinal disorders (FGID) is well-stablished in the literature; however, cognitive factors have hardly been researched and, in particular, cognitive conflicts have not been explored for these disorders. The aim of this study is to compare the cognitive and symptomatic characteristics of a group of 66 FGID patients (33 diagnosed with irritable bowel syndrome and 33 with functional dyspepsia) with a control group of participants without FGID or psychopathological symptoms. Both groups were matched by sex and age. The evaluation of the clinical sample was carried out following the criteria of the DSM-IV-TR. The SCL 90-R, and also the Repertory Grid for the identification of cognitive conflicts (implicative dilemmas) and self-ideal discrepancy, were administered to both the clinical sample and the control group. Results showed that 85% of FGID patients met the criteria for one axis I disorder of the DSM-IV-TR, mainly anxiety and somatization disorders. Regarding axis II, 23% presented at least one personality disorder, the most common ones being those of avoidance and dependence. Regarding axis IV, the patients reported a higher number of problems relative to the primary support group. FGID patients showed greater symptoms compared to the control group on various SCL 90-R scales. On the other hand, FGID patients presented more implicative dilemmas than healthy controls, as well as lower self-esteem. No significant differences were observed depending on the type of FGID (irritable bowel syndrome or functional dyspepsia).

Understanding perceived social support among women with personality disorder clusters

Objective: This study aimed to understand perceived social support (PSS) among women with personality disorder (PD). We also investigated potential differences in PSS according to PD clusters (clusters A, B, C). Methods: Women ( n = 718) from the Geelong Osteoporosis Study completed the Multidimensional Scale of Perceived Social Support (MPSS) and Structured Clinical Interview for DSM-IV Axis II Disorders. Multivariable regression and analyses of covariance were employed, controlling for psychiatric and sociodemographic confounders. Results: After age-adjustment, PD (any) and the PD clusters were negatively associated with PSS across all subscales. Bonferroni-adjusted pairwise comparisons revealed lower: significant other PSS for cluster A; family PSS for cluster C, friend PSS for clusters B and C; and total PSS for clusters B and C. Conclusion: Aspects of PSS were predominantly lower among women with cluster B and C PDs.

Comorbidity within Axis-II Disorders: The Unending Issues

Personality Disorders have since the 19th century been known and established as psychiatric diagnosis, yet till date, issues of definition still remain unresolved. With a prevalence of 10-15% of the general population, and it’s associated extreme disruption in the lives of the patients and the communities, it is still not a principle focus of treatment. It’s assessment and diagnosis have been restricted to clinical settings and drug treatment and rehabilitation centres. A study in a Nigerian prison community has revealed a comorbidity prevalence rate of 70% with substance use disorder, a 25% comorbidity prevalence within the personality disorders and a strong association between personality disorders and criminality.

Borderline Personality Disorder with Paranoid Features

This paper aims to evaluate the current and dynamic profile of a 19-year-old with Borderline Personality Disorder (BPD) with paranoid features. The case allows us to detect how the symptoms associated with BPD evolve on a background of poor management of potentially stressful events. There is a Borderline personality structure with obvious paranoid features, which pushes the patient into dysfunctional behaviors, aggressive acts and suicidal tendencies, the patient's instability, chaotic sexuality, addictive and self-harming behavior being observed. There are elements specific to an antisocial personality with narcissistic notes, which highlight impulsive and manipulative tendencies, accompanied by recurrent conflicts and delinquency. The clinical picture of axis II pathology is highlighted, an accentuated aspect being represented by the deficient defense mechanisms, which prevent the integration of the events in an adequate way. Considering the patient's self-destructive behaviors, impulsiveness, and multiple addictions, in the absence of appropriate treatment, psychotherapy, and/or pharmacological treatment, several future complications may occur, including risks of future problems with the law, self-destructive behaviors, and suicide attempts.