Psychometric Properties of the Persian Structured Clinical Interview for Personality Disorders of DSM-5-Personality Version (SCID-5-PD)

Background: The aim of this study was to investigate the psychometric properties of the Persian version of a structured clinical interview for personality disorders based on DSM-5 (R) (SCID-5-PD) in the population of patients with psychiatric disorders in Tehran.Method: The study population includes all outpatients and inpatients referred to three psychiatric centers in Tehran, including Iran Psychiatric Hospital, Rasoul Akram Hospital and Clinic of Behavioral Sciences and Mental Health (Tehran Psychiatric Institute). Inclusion criteria were age between 16 and 70 years, written Informed consent and the ability to understand and speak in Persian and no special physical problems that interfere with the interview process. Sampling in this study was done by Convenience sampling. In this study, in addition to the demographic questionnaire, the Persian version of SCID-5-PD was used. Finally, in order to evaluate the information, the methods of face and content validity and diagnostic validity, test-retest reliability and inter-rater reliability were used.Results: the diagnoses related to obsessive-compulsive personality disorder, paranoid, schizotypal, schizoid, histrionic, narcissistic, borderline and antisocial kappa were higher than 0.4 and the diagnoses related to avoidant personality disorder were dependent and in other certain disorders are below 0.4. Regarding borderline personality disorder with kappa 0.839, the highest agreement was reported between the two reports of the psychiatrist and the SCID interviewer. Also, the specificity results were mostly better than the sensitivity results, and in all diagnoses except obsessive-compulsive and paranoid personality disorder, the specificity was higher than 0.9 and in these two diagnoses, the specificity was higher than 0.85, which indicates the desired characteristic. SCID-5-PD. The sensitivity of all diagnoses except avoidant and dependent personality disorder was also reported to be higher than 0.8; But the susceptibility of avoidant and dependent personality disorder was 0.66. Also, the study of LR + / LR- ratio showed that this tool has the best diagnosis for histrionic, antisocial and schizotypal personality disorder. It is also suitable for other personality disorders except schizoid personality disorder and certain other disorders.Conclusion: According to the findings of the present study, SCID-5-PD can be used in psychiatric clinics and hospitals as a diagnostic tool. In general, this version is suitable for most diagnoses; but with regard to diagnoses of schizoid personality disorder and certain other disorders, this should be done with more caution.

Dimensions of Psychotic and Other Problems of Thought and Affect

A third broad domain of correlated dimensions of frequently serious psychological problems is termed psychotic and related problems of thought and affect in this book, for want of a better term. The adjective “psychotic” refers to beliefs and experiences that essentially all members of a society consider to be baseless or false. Many of the dimensions of problems described in this domain involve psychotic beliefs (delusions), perceptual experiences (hallucinations), and other cognitive disturbances that can be said to put the person “out of touch with reality.” In addition, they often involve emotions and atypical energy levels that can be markedly inconsistent with the situation. Cognition, emotion, and energy levels that are not consistent with reality can sometimes take a very serious toll on people, but recent research strongly suggests that each of these problems lies on a continuum and can be viewed in dimensional terms. The Diagnostic and Statistical Manual of Mental Disorders categorical diagnoses that correspond to high levels of these problems include schizophrenia, schizotypal personality disorder, schizoid personality disorder, bipolar disorder, conversion disorders, and dissociative disorders (derealization and depersonalization). In addition, recent research suggests that obsessive and compulsive problems, compulsive rigidity, and some eating problems share features with this domain. Autistic spectrum problems are discussed in this chapter on the basis of limited current evidence regarding their best placement.

Measuring Behavioral Inhibition and Behavioral Activation in Older Adults: Construct Validity of the Dutch BIS/BAS Scales

Research on the validity of the behavioral inhibition system/behavioral approach system (BIS/BAS) scales focused on adolescent, student and adult populations. This study is the first to examine the psychometric properties of the BIS/BAS scales in a community ( n = 368) and a clinical sample ( n = 160) of older adults. Exploratory structural equation modelling with target rotation to the Carver and White model supported the construct validity of the BIS/BAS scales. Internal consistencies of the scales were generally satisfactory. Female participants scored higher on BIS and BAS-Reward Responsiveness compared with males. The community-dwelling sample scored higher on BAS-Drive and BAS-Reward Responsiveness compared with the clinical sample. Concerning the nomological net, BIS was positively related to Anxiety, Depression, maladaptive coping strategies, Neuroticism and Cluster C personality disorders. BAS was positively related to Openness, Extraversion, Active Confronting and Cluster B personality disorders and negatively related to the schizoid personality disorder. The BIS/BAS Scales are a useful instrument for measuring Gray’s theory of personality in older adults.

Risk for suicidal behaviour in personality disorders

While it is well known that depression, substance dependence, and schizophrenia are strongly associated with suicide, personality disorder also confers a significant risk, but has been consistently understudied. Borderline personality disorder has been consistently associated with suicide risk; additionally, antisocial personality disorder, and avoidant personality disorder have also been found to have a significant risk but has received little research attention. Research also hints at the possibility that schizoid personality disorder and narcissistic personality disorder could increase the risk for suicide as well. Importantly, stressful life events, such as those involving interpersonal distress and loss, confer a significant risk for those with personality disorders, possibly due to poor coping strategies. Reliable instruments with good psychometric properties need to be established that are sensitive to detecting axis II personality disorders. This text reviews the literature on risk factors and treatment approaches to suicidal behaviour in personality disorders.

Temperament and character of patients with alcohol toxicity during COVID -19 pandemic

Background Corona virus pandemic acts as a stressor or trauma that affects both physical health and mental health. People exhibited various reactive behaviors to confront with this stressful situation. Alcohol consumption for coping motive was one of the most common techniques. Personality factors evidently influence alcohol consumption, since they are associated with drinking motives. The main purpose of this study is to investigate the correlation between temperament and character and alcohol abuse. Methods This cross-section study was conducted on 135 alcohol toxicity patients admitted to emergency room in March 2020 and 255 participants who were randomly selected from public in Shiraz. The questionnaire consisted of TCI (Temperament and character inventory) and several questions about COVID-19 pandemic. It was completed by a trained interviewer using the matched answer technique. Demographic factors were also self-reported. Results Among the participants, 216 were males (55.4%) and 174 females (44.6%). The mean age of the participants was 32.88 ± 13.49 years. Alcohol toxicity was mostly observed among the young males (male/female ratio was 6.45). Mean scores of novelty seeking, harm avoidant, and self-transcendent were higher in the alcohol toxicity group than normal population (P < 0.01). Mean scores of reward dependent, cooperativeness, and self-directedness were higher in normal population than the alcohol toxicity group (P < 0.001). The mean score of persistence was not significant in both group (P = 0.718). Conclusion Novelty-seeking and self-transcendence scores were higher and reward-dependency score was lower among the alcohol abusers and cooperativeness and self-directedness scores were lower among the alcohol abusers. Higher novelty-seeking was correlated with higher impulsiveness, exploratory excitability, extravagance, and disorderliness, which are included in Cluster B personality disorders and associated with alcohol and drug involvement. Lower self-directedness and lower cooperativeness indicate the higher likelihood of personality disorders. Cluster A personality disorder symptoms (in particular, schizoid personality disorder symptoms) are correlated with low reward-dependence scores.

Gender Identity Disorder Arising as a Part of Nonpsychotic Forms of Endogenous Diseases and Personality Disorders (Clinical and Psychopathological Aspects)

Purpose: psychopathological differentiation of gender identity disorder (GID) that occurs as part of depressive episode; creating a typology for developing diagnostic and prognostic criteria. Material and methods: 63 patients (46 women and 17 men) who applied to the FSBRI MHRC from 2016 to 2019 were examined by a clinical psychopathological method. All patients were diagnosed with a depression being part of schizotypal disorder or histrionic personality disorder or mixed histrionic and schizoid personality disorder. Results: Clinical and psychopathological analysis of gender identity disorder occurring as a part of depressive episode showed its heterogeneity, varying severity, as well as a diverse relationship with other psychopathological disorders, which required an in-depth and detailed study. We have identified the following typological varieties: type 1 — GID as a part of depersonalization disorders, type 2 — GID as a part of dysmorphophobic disorders, type 3 — GID as a part of histrionic disorders. Conclusions: The obtained results give us the opportunity to suggest that the diagnosis of the disease, in which the gender identity disorder is detected, can help predict its further course and possible outcomes.