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Zhang L, Takahashi Y. Relationships between obsessive-compulsive disorder and the big five personality traits: A meta-analysis. J Psychiatr Res 2024; 177:11-23. [PMID: 38964090 DOI: 10.1016/j.jpsychires.2024.06.033] [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: 10/09/2023] [Revised: 05/31/2024] [Accepted: 06/24/2024] [Indexed: 07/06/2024]
Abstract
Although several studies have examined the relationships between obsessive-compulsive disorder (OCD) and the Big Five personality traits (i.e., neuroticism, extraversion, openness, agreeableness, and conscientiousness), the results have been inconsistent. Therefore, this meta-analysis comprehensively examined the relationships between OCD and these traits. In total, 23 studies (29 independent datasets) with 30,138 participants were analyzed. The pooled effect size was 0.34 (95% confidence interval [CI]: 0.28, 0.40) for neuroticism, -0.14 (95% CI: -0.18, -0.10) for extraversion, -0.04 (95% CI: -0.09, 0.02) for openness, -0.10 (95% CI: -0.16, -0.04) for agreeableness, and -0.03 (95% CI: -0.11, 0.05) for conscientiousness, indicating that OCD was associated with higher scores for neuroticism and lower scores for extraversion and agreeableness. Meta-regression and subgroup analyses indicated that heterogeneity was mainly due to differences in sample types and OCD measurement instruments. Sensitivity analysis showed that the results of the meta-analysis were robust. Overall, neuroticism was a maladaptive trait, whereas extraversion and agreeableness were adaptive traits for OCD. Although the results could be sample- and instrument-specific, our findings may inform preventions and interventions for OCD symptoms.
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Affiliation(s)
- Lei Zhang
- Graduate School of Education, Kyoto University, Kyoto, Japan
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2
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Vuijk R, Turner W, Zimmerman D, Walker H, Dandachi-FitzGerald B. Schema therapy in adults with autism spectrum disorder: A scoping review. Clin Psychol Psychother 2024. [PMID: 38214936 DOI: 10.1002/cpp.2949] [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: 10/24/2023] [Revised: 12/13/2023] [Accepted: 12/15/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND Schema therapy (ST) in adults with autism spectrum disorder (ASD) have gained increasing interest in clinical practice and research. However, to date, there has been no synthesis of the literature on ST as treatment for adults with ASD. Through a scoping review, we aim to summarize the emerging research and literature on ST for adults with ASD. METHODS A comprehensive literature search of three electronic databases was conducted using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Publications were included that examined ST in adults with ASD and non-clinical adults with autistic traits. RESULTS Systematic searches identified a total of 11 publications, all published since 2014, with the majority being conducted by Dutch and Japanese researchers. Of the 11 publications, 1 described an ST-informed social interaction training, 1 was an ST protocol, 2 described conceptual ST models, 2 were case examples, 2 examined early maladaptive schemas (EMSs) and 3 investigated the effectiveness of ST interventions. In summary, the theoretical exploration, practical examples of the application of ST and research findings with preliminary evidence of ST, EMSs and schema modes (SMs) in adults with ASD point towards the potential of ST for the treatment of adults with ASD. DISCUSSION The current scoping review highlights preliminary research findings and offers valuable suggestions for clinicians treating adults with ASD. This review underscores the need for development of and research in specialized ST protocols and programmes tailored to adults with ASD with chronic mental conditions, such as personality disorders (PDs).
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Affiliation(s)
- Richard Vuijk
- Sarr Autism Rotterdam (Parnassia Psychiatric Institute), Rotterdam, The Netherlands
| | - Wesley Turner
- Minds & Hearts, Stones Corner, Queensland, Australia
- University of Queensland, Brisbane, Queensland, Australia
| | - David Zimmerman
- Minds & Hearts, Stones Corner, Queensland, Australia
- University of Queensland, Brisbane, Queensland, Australia
| | - Hugh Walker
- Minds & Hearts, Stones Corner, Queensland, Australia
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3
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Broglia G, Nisticò V, Di Paolo B, Faggioli R, Bertani A, Gambini O, Demartini B. Traits of narcissistic vulnerability in adults with autism spectrum disorders without intellectual disabilities. Autism Res 2024; 17:138-147. [PMID: 37983956 DOI: 10.1002/aur.3065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 10/30/2023] [Indexed: 11/22/2023]
Abstract
The relationship between Autism Spectrum Disorders (ASD) and Narcissistic Personality Disorder (NPD), considering the dimensions of narcissistic grandiosity and vulnerability, represents an important differential diagnosis and potential ground of comorbidity, since both conditions show high grades of pervasiveness, a life-long course, ego-syntonic traits, and difficulties in building up and sustaining interpersonal relationships Although the co-diagnosis rates, according to the categorical criteria in use, are limited (0%-6.4%), it is common to encounter diagnostic doubts in clinical practice. Here we investigated the dimensions of narcissistic vulnerability and grandiosity in a sample of 87 adults diagnosed with ASD without intellectual disabilities through the administration of the Pathological Narcissism Inventory-52 Items (PNI-52). The mean scores of our sample were compared with the normative distribution available in the literature, and we found that individuals with ASD scored significantly higher than neurotypical controls at the Total Score and at the Vulnerable Narcissism subscale, but not at the Grandiose Narcissism subscales. Demographic features did not influence these results. Vulnerable narcissism was significantly associated with the "Ritvo Autism and Asperger Diagnostic Scale - Revised" subscale Social Relatedness. These findings could potentially be indicative of a greater comorbidity rate between the two disorders with respect to the one reported to date, possibly because DSM-5 criteria are mainly focused on the grandiose dimension. Potential explanatory links between ASD phenomenology and vulnerable narcissism, such as the personality dimension of neuroticism, are discussed, together with the possible role of narcissistic vulnerability in mediating internalizing symptoms (e.g., anxiety, depression) in individuals with ASD.
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Affiliation(s)
- Giovanni Broglia
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy
| | - Veronica Nisticò
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy
- "Aldo Ravelli" Research Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Milan, Italy
- Dipartimento di Psicologia, Università degli Studi di Milano-Bicocca, Milan, Italy
| | - Bianca Di Paolo
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy
| | - Raffaella Faggioli
- Unità di Psichiatria 52, Dipartimento Salute Mentale e Dipendenze, Presidio San Paolo, ASST Santi Paolo e Carlo, Milan, Italy
| | - Angelo Bertani
- Centro Giovani "Ettore Ponti", Dipartimento Salute Mentale e Dipendenze, ASST Santi Paolo e Carlo, Milan, Italy
| | - Orsola Gambini
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy
- "Aldo Ravelli" Research Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Milan, Italy
- Unità di Psichiatria 52, Dipartimento Salute Mentale e Dipendenze, Presidio San Paolo, ASST Santi Paolo e Carlo, Milan, Italy
| | - Benedetta Demartini
- "Aldo Ravelli" Research Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Milan, Italy
- Unità di Psichiatria 52, Dipartimento Salute Mentale e Dipendenze, Presidio San Paolo, ASST Santi Paolo e Carlo, Milan, Italy
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4
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Cho A, Wood JJ, Ferrer E, Rosenau K, Storch EA, Kendall PC. Empirically-identified subgroups of children with autism spectrum disorder and their response to two types of cognitive behavioral therapy. Dev Psychopathol 2023; 35:1188-1202. [PMID: 34866567 DOI: 10.1017/s0954579421001115] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Autism spectrum disorder (ASD) is heterogeneous and likely entails distinct phenotypes with varying etiologies. Identifying these subgroups may contribute to hypotheses about differential treatment responses. The present study aimed to discern subgroups among children with ASD and anxiety in context of the five-factor model of personality (FFM) and evaluate treatment response differences to two cognitive-behavioral therapy treatments. The present study is a secondary data analysis of children with ASD and anxiety (N=202; ages 7-13; 20.8% female) in a cognitive behavioral therapy (CBT) randomized controlled trial (Wood et al., 2020). Subgroups were identified via latent profile analysis of parent-reported FFM data. Treatment groups included standard-of-practice CBT (CC), designed for children with anxiety, and adapted CBT (BIACA), designed for children with ASD and comorbid anxiety. Five subgroups with distinct profiles were extracted. Analysis of covariance revealed CBT response was contingent on subgroup membership. Two subgroups responded better to BIACA on the primary outcome measure and a third responded better to BIACA on a peer-social adaptation measure, while a fourth subgroup responded better to CC on a school-related adaptation measure. These findings suggest that the FFM may be useful in empirically identifying subgroups of children with ASD, which could inform intervention selection decisions for children with ASD and anxiety.
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Affiliation(s)
- Anchuen Cho
- University of California, Los Angeles, 405 Hilgard Ave., 3132A Moore Hall, Los Angeles, CA90095, USA
| | - Jeffrey J Wood
- University of California, Los Angeles, 405 Hilgard Ave., 3132A Moore Hall, Los Angeles, CA90095, USA
| | - Emilio Ferrer
- University of California, Davis, 1 Shields Ave., 135 Young Hall, Davis, CA95616, USA
| | - Kashia Rosenau
- University of California, Los Angeles, 405 Hilgard Ave., 3132A Moore Hall, Los Angeles, CA90095, USA
| | - Eric A Storch
- Baylor College of Medicine, 7200 Cambridge St, Houston, TX77030, USA
| | - Philip C Kendall
- Temple University, 1701 North 13th St., Weiss Hall, Philadelphia, PA19122, USA
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5
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van den Heuvel BB, Dekker JJM, Daniëls M, Van HL, Peen J, Bosmans J, Arntz A, Huibers MJH. G-FORCE: the effectiveness of group psychotherapy for Cluster-C personality disorders: protocol of a pragmatic RCT comparing psychodynamic and two forms of schema group therapy. Trials 2023; 24:300. [PMID: 37120550 PMCID: PMC10149026 DOI: 10.1186/s13063-023-07309-w] [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: 03/19/2022] [Accepted: 04/11/2023] [Indexed: 05/01/2023] Open
Abstract
BACKGROUND Cluster-C personality disorders (PDs), characterized by a high level of fear and anxiety, are related to high levels of distress, societal dysfunctioning and chronicity of various mental health disorders. Evidence for the optimal treatment is extremely scarce. Nevertheless, the need to treat these patients is eminent. In clinical practice, group therapy is one of the frequently offered approaches, with two important frameworks: schema therapy and psychodynamic therapy. These two frameworks suggest different mechanisms of change, but until now, this has not yet been explored. The purpose of the present G-FORCE trial is to find evidence on the differential (cost)effectiveness of two forms of schema group therapy and psychodynamic group therapy in the routine clinical setting of an outpatient clinic and to investigate the underlying working mechanisms and predictors of outcome of these therapies. METHODS In this mono-centre pragmatic randomized clinical trial, 290 patients with Cluster-C PDs or other specified PD with predominantly Cluster-C traits, will be randomized to one of three treatment conditions: group schema therapy for Cluster-C (GST-C, 1 year), schema-focused group therapy (SFGT, 1.5 year) or psychodynamic group therapy (PG, 2 years). Randomization will be pre-stratified on the type of PD. Change in severity of PD (APD-IV) over 24 months will be the primary outcome measure. Secondary outcome measures are personality functioning, psychiatric symptoms and quality of life. Potential predictors and mediators are selected and measured repeatedly. Also, a cost-effectiveness study will be performed, primarily based on a societal perspective, using both clinical effects and quality-adjusted life years. The time-points of assessment are at baseline, start of treatment and after 1, 3, 6, 9, 12, 18, 24 and 36 months. DISCUSSION This study is designed to evaluate the effectiveness and cost-effectiveness of three formats of group psychotherapy for Cluster-C PDs. Additionally, predictors, procedure and process variables are analysed to investigate the working mechanisms of the therapies. This is the first large RCT on group therapy for Cluster-C PDs and will contribute improving the care of this neglected patient group. The absence of a control group can be considered as a limitation. TRIAL REGISTRATION CCMO, NL72826.029.20 . Registered on 31 August 2020, first participant included on 18 October 2020.
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Affiliation(s)
| | | | - M Daniëls
- Arkin Mental Health Care, Amsterdam, the Netherlands
| | | | - Jaap Peen
- Arkin Mental Health Care, Amsterdam, the Netherlands
| | - Judith Bosmans
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Arnoud Arntz
- Universiteit Van Amsterdam, Amsterdam, the Netherlands
| | - Marcus J H Huibers
- Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands
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Daniëls M, Van HL, van den Heuvel B, Dekker JJM, Peen J, Bosmans J, Arntz A, Huibers MJH. Individual psychotherapy for cluster-C personality disorders: protocol of a pragmatic RCT comparing short-term psychodynamic supportive psychotherapy, affect phobia therapy and schema therapy (I-FORCE). Trials 2023; 24:260. [PMID: 37020251 PMCID: PMC10077625 DOI: 10.1186/s13063-023-07136-z] [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: 03/21/2022] [Accepted: 02/04/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND Cluster-C personality disorders (PDs) are highly prevalent in clinical practice and are associated with unfavourable outcome and chronicity of all common mental health disorders (e.g. depression and anxiety disorders). Although several forms of individual psychotherapy are commonly offered in clinical practice for this population, evidence for differential effectiveness of different forms of psychotherapy is lacking. Also, very little is known about the underlying working mechanisms of these psychotherapies. Finding evidence on the differential (cost)-effectiveness for this group of patients and the working mechanisms of change is important to improve the quality of care for this vulnerable group of patients. OBJECTIVE In this study, we will compare the differential (cost)-effectiveness of three individual psychotherapies: short-term psychodynamic supportive psychotherapy (SPSP), affect phobia therapy (APT) and schema therapy (ST). Although these psychotherapies are commonly used in clinical practice, evidence for the Cluster-C PDs is limited. Additionally, we will investigate predictive factors, non-specific and therapy-specific mediators. METHODS This is a mono-centre randomized clinical trial with three parallel groups: (1) SPSP, (2) APT, (3) ST. Randomization on patient level will be pre-stratified according to type of PD. The total study population to be included consists of 264 patients with Cluster-C PDs or other specified PD with mainly Cluster-C traits, aged 18-65 years, seeking treatment at NPI, a Dutch mental health care institute specialized in PDs. SPSP, APT and ST (50 sessions per treatment) are offered twice a week in sessions of 50 min for the first 4 to 5 months. After that, session frequency decreases to once a week. All treatments have a maximum duration of 1 year. Change in the severity of the PD (ADP-IV) will be the primary outcome measure. Secondary outcome measures are personality functioning, psychiatric symptoms and quality of life. Several potential mediators, predictors and moderators of outcome are also assessed. The effectiveness study is complemented with a cost-effectiveness/utility study, using both clinical effects and quality-adjusted life-years, and primarily based on a societal approach. Assessments will take place at baseline, start of treatment and at 1, 3, 6, 9, 12, 18, 24 and 36 months. DISCUSSION This is the first study comparing psychodynamic treatment to schema therapy for Cluster-C PDs. The naturalistic design enhances the clinical validity of the outcome. A limitation is the lack of a control group for ethical reasons. TRIAL REGISTRATION NL72823.029.20 [Registry ID: CCMO]. Registered on 31 August 2020. First participant included on 23 October 2020.
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Affiliation(s)
| | | | | | - Jack J M Dekker
- Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands
| | - Jaap Peen
- Arkin Mental Health Care, Amsterdam, The Netherlands
| | - Judith Bosmans
- Department of Health Sciences, Faculty of Science, VU University Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Arnoud Arntz
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Marcus J H Huibers
- Arkin Mental Health Care, Amsterdam, The Netherlands
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
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7
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Gillett G, Leeves L, Patel A, Prisecaru A, Spain D, Happé F. The prevalence of autism spectrum disorder traits and diagnosis in adults and young people with personality disorders: A systematic review. Aust N Z J Psychiatry 2023; 57:181-196. [PMID: 35986511 PMCID: PMC9896258 DOI: 10.1177/00048674221114603] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Autism spectrum disorders and personality disorders are spectrum conditions with shared clinical features. Despite similarities, previous attempts to synthesise literature on co-existing prevalence and shared traits have employed a unidirectional focus, assessing personality characteristics of individuals with an autism spectrum disorder diagnosis. Here, we assess the prevalence of autism spectrum disorder diagnosis and/or traits among persons diagnosed with a personality disorder. METHODS We systematically reviewed the English-language literature following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, according to a pre-registered protocol (PROSPERO: CRD 42021264106). Peer-reviewed quantitative studies reporting the prevalence of autism spectrum disorder diagnosis or traits in persons with an established personality disorder diagnosis were included. Studies were critically appraised using the Appraisal tool for Cross-Sectional Studies. RESULTS Fifteen studies were identified, including 72,902 participants (median: 48, interquartile range: 30-77). Diagnoses included borderline, schizotypal and obsessive-compulsive personality disorders, and cohorts with unspecified personality disorder diagnoses. There was significant heterogeneity in diagnostic methodology and assessment tools used. We identified preliminary evidence of an increased prevalence of co-existing autism spectrum disorder diagnosis and traits among those diagnosed with a personality disorder, although significant limitations of the literature were identified. CONCLUSION Our research suggests clinicians should consider conducting a careful developmental assessment when assessing service-users with possible or confirmed personality disorder. Future research directions may include larger studies featuring clinical control groups, an exploration of shared and differentiating behavioural-cognitive features of the two conditions, and investigation into potentially shared aetiological factors. Research investigating demographic factors that may contribute to potential diagnostic overshadowing would also be welcomed.
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Affiliation(s)
- George Gillett
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK,George Gillett, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, 16 De Crespigny Park, London SE5 8AB, UK.
| | | | | | | | - Debbie Spain
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Francesca Happé
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
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8
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Vuijk R, Deen M, Geurts HM, Arntz A. Schema therapy for personality disorders in autistic adults: Results of a multiple case series study. Clin Psychol Psychother 2022; 30:458-472. [PMID: 36522138 DOI: 10.1002/cpp.2817] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 11/16/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND To our knowledge, treatment of personality disorder (PD) comorbidity in autistic adults is understudied and is still in its infancy. We investigated the effectiveness of schema therapy (ST) for autistic adults with PD. METHOD A multiple case series design with 12 adults (aged 19-62 years) was used with baseline, exploration, ST (with cognitive behavioural and experiential techniques) and follow-up conditions. Participants rated dysfunctional core beliefs (primary outcome) weekly during baseline and treatment and monthly during follow-up. Schema modes, general mental health symptoms, social responsiveness, PD traits and common Axis-I mental disorders were assessed. RESULTS Mixed model analyses indicated significant effects of ST with medium to large effect sizes for dysfunctional core beliefs, functional schema modes, PD traits, general mental health symptoms and social responsiveness. Results remained stable during follow-up. CONCLUSION The results of this study indicate that ST might be effective in decreasing dysfunctional core beliefs, PD traits and general mental health symptoms and in increasing functional schema modes and social responsiveness. Improvements persisted over time. ST seems effective in treating PD in autistic individuals.
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Affiliation(s)
- Richard Vuijk
- Sarr Autism Rotterdam (Parnassia Psychiatric Institute), Rotterdam, The Netherlands
| | - Mathijs Deen
- Parnassia Psychiatric Institute, The Hague, The Netherlands.,Institute of Psychology, Methodology and Statistics Unit, Leiden University, Leiden, The Netherlands
| | - Hilde M Geurts
- University of Amsterdam, Amsterdam, The Netherlands.,Leo Kanner Huis (Youz; Parnassia Psychiatric Institute), Amsterdam, The Netherlands
| | - Arnoud Arntz
- University of Amsterdam, Amsterdam, The Netherlands
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9
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Langwerden RJ, van der Heijden PT, Soons PH, Derksen JJ, Vuijk R, Egger JI. An Exploratory Study of MMPI-2-RF Personality and Psychopathology Profiles of Adults with Autism Spectrum Disorder without Intellectual Disability. CLINICAL NEUROPSYCHIATRY 2022; 19:335-346. [PMID: 36340276 PMCID: PMC9597642 DOI: 10.36131/cnfioritieditore20220509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE More empirical research is needed to disentangle the phenotypes of autism spectrum disorder (ASD) and cluster C personality symptomatology (CCPD), as both show similarities in their clinical presentation. We explored personality and psychopathology dimensions as conceptualized in contemporary dimensional taxonomies (i.e., hierarchical taxonomy of psychopathology; HiTOP) in adults with ASD without intellectual disability operationalized by the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF). METHOD Applying secondary analytic processes using clinical data, we cross-examined the MMPI-2-RF profiles of adults with ASD (n = 28) compared to adults with Cluster C personality disorders (CCPD; n = 28) and a control group (n = 28) by conducting nonparametric tests and assessing effect sizes. RESULTS The profiles of the ASD and CCPD groups evidenced to be similar, and both average clinical profiles diverged from the average control group profiles by elevated levels of demoralization, internalizing, and somatization symptomatology. There were small differences between the average profiles of adults with ASD and adults with CCPD. Additional research using dimensional measures of psychopathology could elucidate the dimensional phenotypes of ASD and CCPD. CONCLUSIONS Based on the results in this study, the MMPI-2-RF may not meaningfully discriminate between the two clinical presentations, with the exception of various externalizing scales.
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Affiliation(s)
- Robbert J. Langwerden
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, The Netherlands, Community-Based Research Institute, Florida International University, Miami, FL, USA,Corresponding Author Robbert J. Langwerden 11200 SW 8th Street, Miami, FL 33199, USA E-mail: robbert.langwerden@ donders.ru.nl Phone: (+1) 305 348 5388
| | - Paul T. van der Heijden
- Behavioural Science Institute, Radboud University Nijmegen, The Netherlands, Reinier van Arkel Mental Health Institute, ’s Hertogenbosch, The Netherlands
| | | | - Jan J.L. Derksen
- Behavioural Science Institute, Radboud University Nijmegen, The Netherlands, Faculty of Psychology and Educational Sciences, Department of Clinical and Life Span Psychology, Vrije Universiteit Brussel, Belgium
| | - Richard Vuijk
- Sarr Autism Rotterdam, Parnassia Psychiatric Institute, Rotterdam, The Netherlands
| | - Jos I.M. Egger
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, The Netherlands, Vincent van Gogh Centres of Excellence for Neuropsychiatry, Venray, The Netherlands, Stevig Specialized and Forensic Care for People with Intellectual Disabilities, Dichterbij, Oostrum, The Netherlands
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An Explorative Study of Atypical Social Interaction Styles in Adult Men with Autism Spectrum Disorder, Men with Personality Disorders and Men from the General Population. J Autism Dev Disord 2022; 53:2297-2305. [PMID: 35298755 DOI: 10.1007/s10803-022-05521-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2022] [Indexed: 10/18/2022]
Abstract
Different atypical social interaction styles (SISs) were defined and tested in children and adolescents with autism spectrum disorder (ASD). Whether these styles can also be distinguished in adults with ASD has not yet been explored. In men with ASD, men with personality disorder (PD), and men from the general population (N = 90), aged 18-65 years, we tested which SISs can be distinguished and how they relate to the presence of PD traits. We found a significant distinction in allocation to atypical SISs between the three groups. This study shows the presence of atypical SISs in adults with ASD, and complements previous SIS findings in children and adolescents with ASD.Trial registration The Netherlands National Trial Register NTR6391. Registered 04 May 2017.
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11
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Rinaldi C, Attanasio M, Valenti M, Mazza M, Keller R. Autism spectrum disorder and personality disorders: Comorbidity and differential diagnosis. World J Psychiatry 2021; 11:1366-1386. [PMID: 35070783 PMCID: PMC8717043 DOI: 10.5498/wjp.v11.i12.1366] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 05/26/2021] [Accepted: 11/24/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Differential diagnosis, comorbidities and overlaps with other psychiatric disorders are common among adults with autism spectrum disorder (ASD), but clinical assessments often omit screening for personality disorders (PD), which are especially common in individuals with high-functioning ASD where there is less need for support. AIM To summarize the research findings on PD in adults with ASD and without intellectual disability, focusing on comorbidity and differential diagnosis. METHODS PubMed searches were performed using the key words "Asperger's Syndrome", "Autism", "Personality", "Personality disorder" and "comorbidity" in order to identify relevant articles published in English. Grey literature was identified through searching Google Scholar. The literature reviews and reference sections of selected papers were also examined for additional potential studies. The search was restricted to studies published up to April 2020. This review is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method. RESULTS The search found 22 studies carried out on ASD adults without intellectual disability that met the inclusion criteria: 16 evaluated personality profiles or PD in ASD (comorbidity), five compared ASD and PD (differential diagnosis) and one performed both tasks. There were significant differences in the methodological approaches, including the ASD diagnostic instruments and personality measures. Cluster A and cluster C PD are the most frequent co-occurring PD, but overlapping features should be considered. Data on differential diagnosis were only found with cluster A and cluster B PD. CONCLUSION ASD in high-functioning adults is associated with a distinct personality profile even if variability exists. Further studies are needed to explore the complex relationship between ASD and PD.
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Affiliation(s)
- Camilla Rinaldi
- Adult Autism Center, Department of Mental Health, ASL Città di Torino, Turin 10138, Italy
| | - Margherita Attanasio
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, L’Aquila 67100, Italy
- Regional Centre for Autism, Abruzzo Region Health System, L’Aquila 67100, Italy
| | - Marco Valenti
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, L’Aquila 67100, Italy
- Regional Centre for Autism, Abruzzo Region Health System, L’Aquila 67100, Italy
| | - Monica Mazza
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, L’Aquila 67100, Italy
- Regional Centre for Autism, Abruzzo Region Health System, L’Aquila 67100, Italy
| | - Roberto Keller
- Adult Autism Center, Department of Mental Health, ASL Città di Torino, Turin 10138, Italy
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12
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Vuijk R, Deen M, Arntz A, Geurts HM. First Psychometric Properties of the Dutch Interview for Diagnostic Assessment of Autism Spectrum Disorder in Adult Males Without Intellectual Disability. J Autism Dev Disord 2021; 52:3523-3535. [PMID: 34409554 DOI: 10.1007/s10803-021-05225-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2021] [Indexed: 12/28/2022]
Abstract
For autism spectrum disorder (ASD) in adults there are several diagnostic instruments available with a need for consideration of the psychometric properties. This study aimed to conduct a first psychometric evaluation of a new diagnostic ASD instrument, the NIDA (Dutch Interview for Diagnostic assessment of ASD in adults) in 90 adult males without intellectual disability (age 18-65 years) in the Netherlands: 30 with ASD, 30 with a Personality Disorder and 30 nonpatient controls. The interrater agreement ranged from 0.79 to 1.00, the convergent validity including sensitivity and specificity ranged from 0.76 to 1.00, and we observed an adequate concurrent criterion-related validity. These promising findings can serve as foundation for future psychometric NIDA studies in a more diverse population. TRIAL REGISTRATION: The Netherlands National Trial Register NTR6391. Registered 04 May 2017.
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Affiliation(s)
- Richard Vuijk
- Sarr Autism Rotterdam (Parnassia Psychiatric Institute), Dynamostraat 18, 3083 AK, Rotterdam, The Netherlands.
| | - Mathijs Deen
- Parnassia Psychiatric Institute, Kiwistraat 32, 2552 DH, The Hague, The Netherlands.,Institute of Psychology, Methodology and Statistics Unit, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands
| | - Arnoud Arntz
- University of Amsterdam, Postbus 15933, 1001 NK, Amsterdam, The Netherlands
| | - Hilde M Geurts
- University of Amsterdam, Postbus 15933, 1001 NK, Amsterdam, The Netherlands.,Dr. Leo Kanner Huis, Youz, Parnassia Psychiatric Institute, Derkinderenstraat 10-18, 1062 DB, Amsterdam, The Netherlands
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McDonald TAM. The broader autism phenotype constellations-disability matrix paradigm: Theoretical model for autism and the broader autism phenotype. Med Hypotheses 2021; 146:110456. [PMID: 33412500 PMCID: PMC8216083 DOI: 10.1016/j.mehy.2020.110456] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 12/09/2020] [Indexed: 12/27/2022]
Abstract
The prevalence of autism has increased dramatically over the last 60 years, and the cause of this increase is unclear. In this paradigm-shift paper, I propose an explanatory paradigm for the cause of autism and its increased prevalence in the general population. I also discuss how social and historical contexts may have influenced the evolution and manifestation of specific traits in the autism population. These traits expand the characterization of the broader autism phenotype to include a constellation of socially valued traits, termed Broader Autism Phenotype Constellations (BAPCO). The frequency of these traits may have increased due to assortative mating opportunities that occurred alongside social changes in education and occupational opportunities over the last 100 years. I propose that assortative mating can lead to both positive and negative developmental consequences affecting social and language development. I also propose that BAPCO traits, which are not intrinsically disabilities, could interact with co-occurring conditions in a new model called the BAPCO-Disability Matrix Paradigm (BAPCO-DMAP). In this paradigm, autism is located at the intersection of BAPCO traits and at least one co-occurring condition. These proposed models support the need to create a more comprehensive definition of autism that includes constellations of BAPCO traits. The BAPCO-DMAP paves the way to testable predictions of autism prevalence and provides a framework to better understand the foundational traits of autism. Finally, this paradigm radically redefines the broader autism phenotype with characteristics that can inform therapy and child development.
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Hooks E, Dale BA, Hernandez Finch ME. Profile analysis of the Personality Assessment Inventory‐Adolescent (PAI‐A) for individuals with autism spectrum disorder. PSYCHOLOGY IN THE SCHOOLS 2020. [DOI: 10.1002/pits.22453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Elizabeth Hooks
- Critical Care Unit for Behavioral Supports Behavioral Dimensions, Inc. Minnesota USA
| | - Brittany A. Dale
- Department of Special Education Ball State University Muncie Indiana USA
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Vuijk R, de Nijs PF, Deen M, Vitale S, Simons-Sprong M, Hengeveld MW. Temperament and character in men with autism spectrum disorder: A reanalysis of scores on the Temperament and Character Inventory by individual case matching. Contemp Clin Trials Commun 2018; 12:55-59. [PMID: 30259003 PMCID: PMC6151855 DOI: 10.1016/j.conctc.2018.09.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 09/12/2018] [Accepted: 09/17/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Interest in autism spectrum disorders (ASD) in adulthood is increasing. Although a person may be diagnosed with ASD, the diagnosis reveals little about the individual's temperament, character, and personality. Also, relatively little is known about the personality of adults with ASD. METHOD A reanalysis of scores on the Temperament and Character Inventory (TCI) administered to a group of 66 normally intelligent men aged 18-63 years, diagnosed with ASD, by individual case matching to a comparison group of 66 men from the general population drawn from the TCI manual. RESULTS Compared to the comparison group, men with ASD scored significantly higher on the scale for Harm Avoidance, and lower on Novelty Seeking, Reward Dependence, Self-Directedness, and Cooperativeness. CONCLUSIONS In this study the score pattern for temperament and character found in men with ASD by individual case matching confirms and strengthens earlier general group matching findings emerging from our 2012 study and from studies from Sweden and the Netherlands.
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Affiliation(s)
- Richard Vuijk
- Sarr Expertise Center for Autism, Parnassia Groep, Bavo Europoort, Oudedijk 76, 3062 AG, Rotterdam, the Netherlands
| | - Pieter F.A. de Nijs
- Erasmus MC, Sophia Children's Hospital, Department of Child and Adolescent Psychiatry/Psychology, Wytemaweg 80, 3015 CN, Rotterdam, the Netherlands
| | - Mathijs Deen
- Parnassia Psychiatric Institute, Kiwistraat 32, 2552 DH, The Hague, the Netherlands
- Institute of Psychology, Methodology and Statistics Unit, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, the Netherlands
| | - Salvatore Vitale
- Erasmus MC, Department of Psychiatry, 's Gravendijkwal 230, 3015 CE, Rotterdam, the Netherlands
| | - Mirjam Simons-Sprong
- Sarr Expertise Center for Autism, Parnassia Groep, Bavo Europoort, Oudedijk 76, 3062 AG, Rotterdam, the Netherlands
| | - Michiel W. Hengeveld
- Erasmus MC, Department of Psychiatry, 's Gravendijkwal 230, 3015 CE, Rotterdam, the Netherlands
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