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di Giacomo E, Andreini E, Lorusso O, Clerici M. The dark side of empathy in narcissistic personality disorder. Front Psychiatry 2023; 14:1074558. [PMID: 37065887 PMCID: PMC10097942 DOI: 10.3389/fpsyt.2023.1074558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 02/28/2023] [Indexed: 04/18/2023] Open
Abstract
Narcissistic personality disorder is characterized by self-absorption, grandiosity, exploitation of others and lack of empathy. People with that disorder may switch from an overt form, mainly with grandiosity, to a covert presentation, with fears, hypersensitivity and dependence from others. Empathy represents a key point in detecting people affected by narcissistic personality disorder because, even if it is described as reduced, it plays a fundamental role in exploitation and manipulation. A systematic search of Literature without any language or time restriction, was performed combining thesaurus and free-search indexing terms related to Narcissistic personality disorder and empathy and produced 531 results. Fifty-two papers that analyzed possible issues in the empathic attitude of people with narcissistic personality disorder were included in this narrative review. Empathy is the capability of understating and feeling others emotions. It is not a unitary construct and can be distinguished in cognitive and affective. It might be channeled into prosocial and antisocial behaviors. A crucial trait identified in narcissistic empathy is affective dissonance that is closely related to rivalry as part of the dark tetrad (narcissism, machiavellianism, psychopathy, and sadism). Subjects affected by narcissistic personality disorder show greater impairment in affective aspects while their cognitive part of empathy appears preserved. Saving at least the cognitive aspects of empathy may contribute to therapeutic improvement of affective aspects.
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Affiliation(s)
- Ester di Giacomo
- Department of Mental Health and Addiction, Health Care Trust–IRCCS San Gerardo Monza, Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Elena Andreini
- Department of Mental Health and Addiction, Health Care Trust–IRCCS San Gerardo Monza, Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Ottavia Lorusso
- Department of Mental Health and Addiction, Health Care Trust–IRCCS San Gerardo Monza, Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Massimo Clerici
- Department of Mental Health and Addiction, Health Care Trust–IRCCS San Gerardo Monza, Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
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The relationship between narcissism and empathy: A meta-analytic review. JOURNAL OF RESEARCH IN PERSONALITY 2023. [DOI: 10.1016/j.jrp.2022.104329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Mahmoudi E, Nakhostin-Ansari A, Ranjbar M, Memari AH. Are all types of empathy associated with lower aggression in athletes? A cross-sectional study on Iranian athletes. BMC Psychol 2022; 10:276. [PMID: 36419178 PMCID: PMC9682635 DOI: 10.1186/s40359-022-00985-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 11/11/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND This study aimed to evaluate the association between cognitive and affective empathy and aggression in a sample of Iranian athletes. METHODS We designed a cross-sectional study. The participants were selected by multistage random sampling among six colleges in Tehran, Iran's capital. We used the interpersonal reactivity index (IRI) to evaluate empathy, and Reactive Proactive Aggression Questionnaire, and the Buss-Perry aggression questionnaire to evaluate aggression. RESULTS In total, 492 athletes with a mean age of 27.42 years (SD = 7.72) participated in the study, of which 298 (60.6%) were male, and 194 (39.4%) were female. IRI's fantasy and personal distress subscales scores were positively associated with proactive and reactive aggression scores (p < 0.05). The score of the perspective-taking subscale of IRI was negatively associated with proactive and reactive aggression scores (p < 0.05). The score of the empathic concern subscale of IRI had a negative association with the proactive aggression score (p < 0.001). The score of the perspective-taking subscale of IRI had negative associations with all Buss-Perry aggression questionnaire subscales' scores (p < 0.05). The score of the personal distress subscale of IRI had positive associations with all Buss-Perry aggression questionnaire subscales' scores (p < 0.05), except with the verbal aggression subscale score. The score of the fantasy subscale of IRI was positively associated with the score of the hostility subscale of the Buss-Perry questionnaire (p = 0.001). CONCLUSION Perspective-taking is negatively associated with all kinds of aggression in athletes. Future studies can be conducted to determine the possible role of perspective-taking in preventive aggression, which can be a target for interventions. On the other hand, the score of the personal distress subscale of IRI is positively associated with all types of aggression scores, indicating that not all types of empathy inhibit aggression in athletes.
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Affiliation(s)
- Elham Mahmoudi
- grid.411705.60000 0001 0166 0922Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amin Nakhostin-Ansari
- grid.411705.60000 0001 0166 0922Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran ,grid.411746.10000 0004 4911 7066Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Ranjbar
- grid.411705.60000 0001 0166 0922Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran ,grid.46072.370000 0004 0612 7950Department of Psychology, University of Tehran, Tehran, Iran
| | - Amir Hossein Memari
- grid.411705.60000 0001 0166 0922Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
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Eddy CM. Self-serving social strategies: A systematic review of social cognition in narcissism. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01661-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AbstractNarcissistic Personality Disorder is characterised by inflated self-importance, an excessive need for admiration, and a lack of empathy. The interpersonal difficulties associated with narcissistic personality may be becoming more widespread given its increasing prevalence within the general population. This systematic review investigated the relationship between narcissistic personality traits and social cognition (i.e. theory of mind; emotion recognition; empathy; emotional intelligence) in clinical and non-clinical samples. Cognitive empathy (i.e. perspective taking) appears unlikely to be impaired, while affective empathy (relating to another’s emotion state) may be reduced in association with narcissism. Those with grandiose narcissism rate their empathic skills more highly than those with vulnerable narcissism, but concurrent administration of objective measures is rare, limiting insight into the validity of self-ratings. Rather than deficits in aspects of social cognition, the overall pattern could reflect motivation, or advantageous use of social cognitive skills to serve the self. Indeed, interpersonal strategies associated with narcissism (e.g. deception; manipulation) suggest the application of understanding another’s beliefs or desires in the context of low empathy. Further research should seek to explore performance on a wider range of emotion recognition and theory of mind tasks, and whether characteristics such as excessive jealousy and paranoia could reflect hyper-mentalizing.
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Palmieri A, Meconi F, Vallesi A, Capizzi M, Pick E, Marcato S, Kleinbub JR, Sorarù G, Sessa P. Enhanced Neural Empathic Responses in Patients with Spino-Bulbar Muscular Atrophy: An Electrophysiological Study. Brain Sci 2020; 11:E16. [PMID: 33374355 PMCID: PMC7824338 DOI: 10.3390/brainsci11010016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/16/2020] [Accepted: 12/21/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Spino-bulbar muscular atrophy is a rare genetic X-linked disease caused by testosterone insensitivity. An inverse correlation has been described between testosterone levels and empathic responses. The present study explored the profile of neural empathic responding in spino-bulbar muscular atrophy patients. METHODS Eighteen patients with spino-bulbar muscular atrophy and eighteen healthy male controls were enrolled in the study. Their event-related potentials were recorded during an "Empathy Task" designed to distinguish neural responses linked with experience-sharing (early response) and mentalizing (late response) components of empathy. The task involved the presentation of contextual information (painful vs. neutral sentences) and facial expressions (painful vs. neutral). An explicit dispositional empathy-related questionnaire was also administered to all participants, who were screened via neuropsychological battery tests that did not reveal potential cognitive deficits. Due to electrophysiological artefacts, data from 12 patients and 17 controls were finally included in the analyses. RESULTS Although patients and controls did not differ in terms of dispositional, explicit empathic self-ratings, notably conservative event-related potentials analyses (i.e., spatio-temporal permutation cluster analyses) showed a significantly greater experience-sharing neural response in patients compared to healthy controls in the Empathy-task when both contextual information and facial expressions were painful. CONCLUSION The present study contributes to the characterization of the psychological profile of patients with spino-bulbar muscular atrophy, highlighting the peculiarities in enhanced neural responses underlying empathic reactions.
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Affiliation(s)
- Arianna Palmieri
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, Piazza Capitaniato, 35139 Padova, Italy; (A.P.); (E.P.); (S.M.); (J.R.K.)
- Padova Neuroscience Centre (PNC), University of Padova, Via Giuseppe Orus, 35131 Padova, Italy
| | - Federica Meconi
- School of Psychology, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK;
| | - Antonino Vallesi
- Department of Neurosciences (DNS) & Padova Neuroscience Centre, University of Padova, Via Giustiniani, 35128 Padova, Italy; (A.V.); (G.S.)
- Brain Imaging & Neural Dynamics Research Group, IRCCS San Camillo Hospital, 30126 Venice, Italy
| | | | - Emanuele Pick
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, Piazza Capitaniato, 35139 Padova, Italy; (A.P.); (E.P.); (S.M.); (J.R.K.)
| | - Sonia Marcato
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, Piazza Capitaniato, 35139 Padova, Italy; (A.P.); (E.P.); (S.M.); (J.R.K.)
| | - Johann R. Kleinbub
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, Piazza Capitaniato, 35139 Padova, Italy; (A.P.); (E.P.); (S.M.); (J.R.K.)
| | - Gianni Sorarù
- Department of Neurosciences (DNS) & Padova Neuroscience Centre, University of Padova, Via Giustiniani, 35128 Padova, Italy; (A.V.); (G.S.)
| | - Paola Sessa
- Padova Neuroscience Centre (PNC), University of Padova, Via Giuseppe Orus, 35131 Padova, Italy
- Department of Developmental and Socialization Psychology (DPSS), University of Padova, Via Venezia, 35131 Padova, Italy
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Urbonaviciute G, Hepper EG. When is narcissism associated with low empathy? A meta-analytic review. JOURNAL OF RESEARCH IN PERSONALITY 2020. [DOI: 10.1016/j.jrp.2020.104036] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Borderline personality disorder, metacognition and psychotherapy. J Affect Disord 2020; 276:1095-1101. [PMID: 32777647 DOI: 10.1016/j.jad.2020.07.117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/08/2020] [Accepted: 07/22/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Deficits in the ability to think about own mental states and that of others (mindreading) are seen as key aspects of borderline personality disorder (BPD), which could sustain BPD symptoms. Interestingly, some studies showed that in BPD patients metacognition is selectively compromised and could improve during treatments. However, empirical findings are inconsistent, and it is debatable whether BPD presents a specific profile of mindreading impairments that could improve during treatments. METHODS We performed a bibliographic research on PubMed , Google Scholar and Scopus of all studies investigating a) the metacognitive functioning in the BPD patients and b) the link between psychotherapy, metacognition improvement and BPD symptomatology. A total of 11 studies met our inclusion criteria and considered metacognition following the definition proposed by Semerari. RESULTS Overall, the results suggest that BPD metacognitive profile mainly includes difficulties in metacognitive sub-domains of integration, differentiation and mastery. The type of treatment most appropriate to improve metacognitive abilities and reduce symptoms seemed to be a long term treatment and specifically focused on metacognitive deficits. LIMITATIONS Lack of a control group, small sample sizes and heterogeneity in terms of gender, age, comorbidities and other ongoing treatments are the key limits of the original studies reviewed. CONCLUSIONS The results sustain the hypothesis of a selective and specific metacognitive impairment in BPD patients that could improve during treatments together with their symptomatology. However, more studies are needed to further investigate the role of metacognition in the effectiveness of treatments.
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Bilotta E, Carcione A, Fera T, Moroni F, Nicolò G, Pedone R, Pellecchia G, Semerari A, Colle L. Symptom severity and mindreading in narcissistic personality disorder. PLoS One 2018; 13:e0201216. [PMID: 30110368 PMCID: PMC6093639 DOI: 10.1371/journal.pone.0201216] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 07/11/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Grandiose narcissism has been associated with poor ability to understand one's own mental states and the mental states of others. In particular, two manifestations of Narcissistic Personality Disorder (NPD) can be explained by poor mindreading abilities: absence of symptomatic subjective distress and lack of empathy. METHODS We conducted two studies to investigate the relationships between mindreading capacity, symptomatic subjective distress and narcissistic personality. In the first study (N = 246), we compared mindreading capacities and symptomatic distress in three outpatient samples: narcissistic patients (NPD); patients with other Personality Disorders (PD); patients without PD. In the second study (N = 1357), we explored the relationships between symptomatic distress, mindreading and specific NPD criteria. RESULTS In the first study, the NPD patients showed poorer mindreading than the patients without PD and comparable to patients with other PDs. Symptomatic subjective distress in the narcissistic group was less severe than in the other PDs group and comparable to the group without PDs. However, no relationship emerged between mindreading and symptomatic subjective distress. In the second study, taking the clinical sample as a whole, symptomatic distress appeared negatively linked to grandiosity traits, while mindreading scores were negatively linked to empathy. CONCLUSIONS NPD showed specific mindreading impairments. However, mindreading capacity did not appear to be directly connected with subjective distress, but did appear to be connected with specific aspects of narcissistic pathology.
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Affiliation(s)
- Elena Bilotta
- Third Center of Cognitive Psychotherapy, Rome, Italy
| | | | - Teresa Fera
- Third Center of Cognitive Psychotherapy, Rome, Italy
| | - Fabio Moroni
- Third Center of Cognitive Psychotherapy, Rome, Italy
| | | | - Roberto Pedone
- Third Center of Cognitive Psychotherapy, Rome, Italy
- Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | | | | | - Livia Colle
- Third Center of Cognitive Psychotherapy, Rome, Italy
- Department of Psychology, Center of Cognitive Science, University of Turin, Turin, Italy
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Abstract
Avoidant personality disorder (AVPD) is a relatively common disorder that is associated with significant distress, impairment, and disability. It is a chronic disorder with an early age at onset and a lifelong impact. Yet it is underrecognized and poorly studied. Little is known regarding the most effective treatment. The impetus for research into this condition has waxed and waned, possibly due to concerns regarding its distinctiveness from other disorders, especially social anxiety disorder (SAD), schizoid personality disorder, and dependent personality disorder. The prevailing paradigm subscribes to the "severity continuum hypothesis", in which AVPD is viewed essentially as a severe variant of SAD. However, areas of discontinuity have been described, and there is support for retaining AVPD as a distinct diagnostic category. Recent research has focused on the phenomenology of AVPD, factors of possible etiological significance such as early parenting experiences, attachment style, temperament, and cognitive processing. Self-concept, avoidant behavior, early attachments, and attachment style may represent points of difference from SAD that also have relevance to treatment. Additional areas of research not focused specifically on AVPD, including the literature on social cognition as it relates to attachment and personality style, report findings that are promising for future research aimed at better delineating AVPD and informing treatment.
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Affiliation(s)
- Lisa Lampe
- Discipline of Psychiatry, University of Newcastle, Newcastle, NSW, Australia
| | - Gin S Malhi
- Discipline of Psychiatry, University of Sydney, Sydney, NSW, Australia
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Avoidant personality disorder as a social anxiety phenotype: risk factors, associations and treatment. Curr Opin Psychiatry 2016; 29:64-9. [PMID: 26651009 DOI: 10.1097/yco.0000000000000211] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW This article identifies research trends and synthesizes information from recent studies of avoidant personality disorder (AVPD). RECENT FINDINGS AVPD and social anxiety disorder (SAD) share genetic vulnerability, but may have distinct environmental risk factors that shape qualitative differences. Negative self-concept, shame proneness, and interpersonal hypersensitivity are characteristic of AVPD and may be predisposed to by heritable traits of high negative affectivity and low positive affectivity, and experiences of neglectful or emotionless parents. The interpersonal difficulties of AVPD may be associated with both anxious and avoidant attachment. Most individuals with AVPD do not also meet criteria for SAD. SUMMARY Integrative treatments incorporating cognitive behavioral strategies effective in SAD but also targeting shame aversion and avoidance may be most helpful for AVPD. Therapy adapted to both anxious attachment, associated with heightened interpersonal sensitivity and distress, and avoidant attachment, associated with experiential avoidance, may be optimal, though this is yet to be tested. Effective treatment of AVPD may enhance the outcome of comorbid conditions. More research is needed which compares three social anxiety groups (SAD alone, AVPD alone, and SAD plus AVPD) to further explore these disorders which are highly related, but which may have differences that are clinically relevant for individuals.
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Psychopathy, narcissism, and borderline personality: A critical test of the affective empathy-impairment hypothesis. PERSONALITY AND INDIVIDUAL DIFFERENCES 2015. [DOI: 10.1016/j.paid.2015.05.036] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Chrysikou EG, Thompson WJ. Assessing Cognitive and Affective Empathy Through the Interpersonal Reactivity Index: An Argument Against a Two-Factor Model. Assessment 2015; 23:769-777. [PMID: 26253573 DOI: 10.1177/1073191115599055] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
One aspect of higher order social cognition is empathy, a psychological construct comprising a cognitive (recognizing emotions) and an affective (responding to emotions) component. The complex nature of empathy complicates the accurate measurement of these components. The most widely used measure of empathy is the Interpersonal Reactivity Index (IRI). However, the factor structure of the IRI as it is predominantly used in the psychological literature differs from Davis's original four-factor model in that it arbitrarily combines the subscales to form two factors: cognitive and affective empathy. This two-factor model of the IRI, although popular, has yet to be examined for psychometric support. In the current study, we examine, for the first time, the validity of this alternative model. A confirmatory factor analysis showed poor model fit for this two-factor structure. Additional analyses offered support for the original four-factor model, as well as a hierarchical model for the scale. In line with previous findings, females scored higher on the IRI than males. Our findings indicate that the IRI, as it is currently used in the literature, does not accurately measure cognitive and affective empathy and highlight the advantages of using the original four-factor structure of the scale for empathy assessments.
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Rössler W, Ajdacic-Gross V, Müller M, Rodgers S, Kawohl W, Haker H, Hengartner MP. Association between processing speed and subclinical psychotic symptoms in the general population: focusing on sex differences. Schizophr Res 2015; 166:316-21. [PMID: 26070411 DOI: 10.1016/j.schres.2015.05.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2014] [Revised: 04/29/2015] [Accepted: 05/13/2015] [Indexed: 11/18/2022]
Abstract
Evidence is growing that persons along the schizophrenia spectrum, i.e., those who also display subclinical psychotic symptoms, exhibit deficits across a broad range of neuropsychological domains. Because sex differences in the association between cognitive deficits and psychosis have thus far been mostly neglected, we believe that ours is the first study specifically focused upon those differences when examining the relationship between subclinical psychosis and processing speed. Using a sample of 213 persons from the general population from Zurich, Switzerland, psychotic symptoms were assessed with three different questionnaires including the Schizotypal Personality Questionnaire, an adaptation of the Structured Interview for Assessing Perceptual Anomalies, and the Paranoia Checklist. Processing speed was assessed with the WAIS digit-symbol coding test. Two higher-order psychosis domains were factor-analytically derived from the various psychosis subscales and then subjected to a series of linear regression analyses. The results demonstrate that in both men and women associations between subclinical psychosis domains and processing speed were weak to moderate (β ranging from -0.18 to -0.27; all p<0.05). However, we found no sex-differences in the interrelation of subclinical psychosis and processing speed (ΔR(2)<0.005; p>0.30). In conclusion, it appears that sex differences in psychosis manifest themselves only at the high end of the continuum (full-blown schizophrenia) and not across the sub-threshold range. The small magnitude of the effects reported herein conforms to the etiopathology of the disorder. Since schizophrenia and related disorders from the spectrum are assumed to be multifactorial diseases, it follows that many etiological components of small effect are involved.
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Affiliation(s)
- Wulf Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland; Institute of Psychiatry, Laboratory of Neuroscience (LIM 27), University of Sao Paulo, Brazil; Zurich Program for Sustainable Development of Mental Health Services, Zurich, Switzerland.
| | - Vladeta Ajdacic-Gross
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland; Zurich Program for Sustainable Development of Mental Health Services, Zurich, Switzerland
| | - Mario Müller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland; Zurich Program for Sustainable Development of Mental Health Services, Zurich, Switzerland
| | - Stephanie Rodgers
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland; Zurich Program for Sustainable Development of Mental Health Services, Zurich, Switzerland
| | - Wolfram Kawohl
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - Helene Haker
- Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich & ETH Zurich, Switzerland
| | - Michael P Hengartner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland; Zurich Program for Sustainable Development of Mental Health Services, Zurich, Switzerland; Department of Applied Psychology, Zurich University of Applied Sciences (ZHAW), Zurich, Switzerland
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Personality Disorders and Mindreading: Specific Impairments in Patients With Borderline Personality Disorder Compared to Other PDs. J Nerv Ment Dis 2015; 203:626-31. [PMID: 26153890 DOI: 10.1097/nmd.0000000000000339] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The capacity of understanding mental states is a complex function which involves several components. Single components can be selectively impaired in specific clinical populations. It has been suggested that impairments in mindreading are central for borderline personality disorder (BPD). However, empirical findings are inconsistent, and it is debatable whether BPD presents a specific profile of mindreading impairments. The aim of this study is to compare BPD and other PDs in mindreading. Seventy-two patients with BPD and 125 patients with other PD diagnoses were assessed using the Metacognition Assessment Interview. BPD showed difficulties in two mindreading functions, differentiation and integration, even when the severity of psychopathology was controlled. These results suggest a specific mindreading impairment in BPD and a strong relationship between these impairments and the severity of psychopathology.
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Hengartner MP, von Wyl A, Tanis T, Halmi W, Galynker I, Cohen LJ. Severity of personality disorders and domains of general personality dysfunction related to attachment. Personal Ment Health 2015; 9:195-207. [PMID: 26033749 DOI: 10.1002/pmh.1297] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 02/27/2015] [Accepted: 04/29/2015] [Indexed: 02/02/2023]
Abstract
This is the first study to link attachment to both severity of total DSM-IV personality disorder (PD) traits and domains of general personality dysfunction, using a sample of 72 inpatients from New York City. We assessed a measure of global PD severity and the core domains of personality functioning using the severity indices of personality problems (SIPP-118). Attachment was measured with the experience in close relationships-revised (ECR-R) and the relationship style questionnaire (RSQ). Global PD severity correlated most strongly with attachment anxiety (r = 0.65). Regression of the SIPP-118 domains on attachment produced models that accounted for a substantial proportion of variance in those scales (R(2) ranging from 28.2 to 54.2%). SIPP-118 relational capacities were the strongest predictor of ECR-R avoidance (β = -0.88) and anxiety (β = -0.58), as well as RSQ secure (β = 0.53) and fearful (β = -0.65). In conclusion, insecure attachment strongly related to the severity of global PD traits and specifically to relational capacities, which are a higher-order domain of general personality dysfunction. These findings provide further evidence that interpersonal problems are at the core of PDs and that attachment could constitute an important mediator of the social dysfunction in persons with personality pathology.
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Affiliation(s)
- Michael P Hengartner
- School of Applied Psychology, Zurich University of Applied Sciences (ZHAW), Zurich, Switzerland
| | - Agnes von Wyl
- School of Applied Psychology, Zurich University of Applied Sciences (ZHAW), Zurich, Switzerland
| | - Thachell Tanis
- Icahn School of Medicine, Mount Sinai Beth Israel Medical Center, New York City, NY, USA
| | | | - Igor Galynker
- Icahn School of Medicine, Mount Sinai Beth Israel Medical Center, New York City, NY, USA
| | - Lisa J Cohen
- Icahn School of Medicine, Mount Sinai Beth Israel Medical Center, New York City, NY, USA
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Schmitt A, Falkai P. Historical aspects of Mozart's mental health and diagnostic insights of ADHD and personality disorders. Eur Arch Psychiatry Clin Neurosci 2014; 264:363-5. [PMID: 24880638 DOI: 10.1007/s00406-014-0507-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Andrea Schmitt
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Nußbaumstr. 7, 80336, Munich, Germany,
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Can protective factors moderate the detrimental effects of child maltreatment on personality functioning? J Psychiatr Res 2013; 47:1180-6. [PMID: 23743134 DOI: 10.1016/j.jpsychires.2013.05.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Revised: 04/23/2013] [Accepted: 05/08/2013] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of this study was to examine whether, and if so, to what extent, education and coping strategies may reduce the detrimental effects of childhood maltreatment on personality functioning. METHODS We assessed dimensional trait-scores of all 10 DSM-IV personality disorders (PDs), childhood maltreatment, education and three coping styles in 511 subjects of the general population of Zurich, Switzerland, using data from the ZInEP Epidemiology Survey. RESULTS Childhood maltreatment was associated with all 10 PDs. Low education was related to antisocial, borderline and histrionic PD. Low emotion-focused coping was associated with paranoid, schizoid, borderline, avoidant, and obsessive-compulsive PD. Low problem-focused coping was related to schizoid PD and high problem-focused coping to histrionic PD. High dysfunctional coping was significantly related to all 10 PD dimensions. Obsessive-compulsive trait scores were significantly lower in maltreated subjects with high emotion-focused coping. Antisocial, borderline and narcissistic trait scores were significantly higher in maltreated subjects with high dysfunctional coping. CONCLUSION Education and adaptive coping may have a protective effect on PD symptomatology. Promotion of adaptive coping and suppression of dysfunctional coping may additionally reduce PD symptoms specifically in maltreated subjects. Those findings have important clinical implications. Longitudinal research is needed to address questions of causality and to evaluate potential effects of treatment and intervention.
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