1
|
de Francisco Carvalho L, Hauck Filho N, Pereira Gonçalves A, Pianowski G, Rocha L. Inventory of Interpersonal Problems-Personality Disorders: adaptation to Brazil and test of a bifactor model. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2023; 52:29-37. [PMID: 37085235 DOI: 10.1016/j.rcpeng.2021.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 03/23/2021] [Indexed: 04/23/2023]
Abstract
OBJECTIVE The Inventory of Interpersonal Problems-Personality Disorders (IIP-PD-47) has a controversial factor structure, as some studies have provided support for 5 correlated factors, and others have suggested the existence of a general second-order dimension. One approach of data modelling that reconciles multidimensionality and the existence of a general factor is the bifactor analysis. We used unrestricted exploratory-confirmatory bifactor modelling to validate the Brazilian version of the IIP-PD-47. METHODS The sample consisted of 1,091 subjects aged 18-64 years who answered the IIP-PD-47 and a collateral measure of pathological traits, the Dimensional Clinical Personality Inventory 2 (IDCP-2). RESULTS After testing many candidate models, our data were best represented by a bifactor model with one general factor and five specific uncorrelated factors. Nevertheless, a closer inspection of the discriminant validity of each IIP-PD-47 factor revealed strong support for the general factor and a factor capturing aggressive behaviours, but less support for the additional four specific factors. CONCLUSIONS The theoretical and practical implications of these findings are discussed, and some recommendations are offered about the need for controlling response styles when assessing PD traits via self-report inventories. Our findings indicate that the Brazilian version of IIP-PD has promising psychometric properties.
Collapse
Affiliation(s)
| | - Nelson Hauck Filho
- Department of Psychology, Universidade São Francisco, Campinas, Sao Paulo, Brazil
| | | | - Giselle Pianowski
- Department of Psychology, Universidade São Francisco, Campinas, Sao Paulo, Brazil
| | - Lia Rocha
- Department of Psychology, Universidade São Francisco, Campinas, Sao Paulo, Brazil
| |
Collapse
|
2
|
Toward Developing Clinical cut-off for the Grandiosity Scale of the Dimensional Clinical Personality Inventory 2. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2022; 51:293-300. [PMID: 36496224 DOI: 10.1016/j.rcpeng.2020.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 11/12/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The present study aims to establish a clinical cut-off for the Grandiosity dimension, using item-level evaluation procedures. METHODS Participants were 5,387 adults, including outpatients diagnosed with narcissistic personality disorder (NPD), outpatients diagnosed with other personality disorders, and adults from the community. We administered the self-reported Grandiosity scale from the Dimensional Clinical Personality Inventory 2 (IDCP-2). The equating procedure was applied to generate theta scores for participants who did not answer all items. RESULTS The Wright map revealed that outpatients scored high on the latent continuum of the Grandiosity scale. Group comparison showed large effect sizes for the mean difference between patients and non-patients. The ROC curve supports a cut off at a -0.45 score in theta standardisation, which yields a high sensitivity (91%) and moderate specificity (58%). Moreover, the PPP (71%) and NPP (79%) values suggest that the scale is able to identify NPD patients in 71% of cases, and people without NPD in 79% of cases. CONCLUSIONS The findings suggest the IDCP-2 Grandiosity scale is useful as an NPD screening tool. Possible clinical applications for the scale are described and the limitations of the study are discussed.
Collapse
|
3
|
Ruissen GR, Beauchamp MR, Puterman E, Zumbo BD, Rhodes RE, Hives BA, Sharpe BM, Vega J, Low CA, Wright AGC. Continuous-Time Modeling of the Bidirectional Relationship Between Incidental Affect and Physical Activity. Ann Behav Med 2022; 56:1284-1299. [PMID: 35802004 DOI: 10.1093/abm/kaac024] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Previous research suggests that there is a bidirectional relationship between incidental affect (i.e., how people feel in day-to-day life) and physical activity behavior. However, many inconsistencies exist in the body of work due to the lag interval between affect and physical activity measurements. PURPOSE Using a novel continuous-time analysis paradigm, we examined the temporal specificity underlying the dynamic relationship between positive and negative incidental affective states and moderate-to-vigorous physical activity (MVPA). METHODS A community sample of adults (n = 126, Mage = 27.71, 51.6% Male) completed a 14-day ambulatory assessment protocol measuring momentary positive and negative incidental affect six times a day while wearing a physical activity monitor (Fitbit). Hierarchical Bayesian continuous-time structural equation modeling was used to elucidate the underlying dynamics of the relationship between incidental affective states and MVPA. RESULTS Based on the continuous-time cross-effects, positive and negative incidental affect predicted subsequent MVPA. Furthermore, engaging in MVPA predicted subsequent positive and negative incidental affect. Incidental affective states had a greater relative influence on predicting subsequent MVPA compared to the reciprocal relationship. Analysis of the discrete-time coefficients suggests that cross-lagged effects increase as the time interval between measurements increase, peaking at about 8 h between measurement occasions before beginning to dissipate. CONCLUSIONS The results provide support for a recursive relationship between incidental affective states and MVPA, which is particularly strong at 7-9 hr time intervals. Future research designs should consider these medium-term dynamics, for both theory development and intervention.
Collapse
Affiliation(s)
- Geralyn R Ruissen
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - Mark R Beauchamp
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - Eli Puterman
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - Bruno D Zumbo
- Measurement, Evaluation, and Research Methodology Program, University of British Columbia, Vancouver, BC, Canada.,Institute of Applied Mathematics, University of British Columbia, Vancouver, BC, Canada
| | - Ryan E Rhodes
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| | - Benjamin A Hives
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - Brinkley M Sharpe
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Psychology, University of Georgia, Athens, GA, USA
| | - Julio Vega
- Mobile Sensing + Health Institute (MoSHI), University of Pittsburgh, Pittsburgh, PA, USA
| | - Carissa A Low
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA.,Mobile Sensing + Health Institute (MoSHI), University of Pittsburgh, Pittsburgh, PA, USA.,Department of Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Aidan G C Wright
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| |
Collapse
|
4
|
Yan R, Ringwald WR, Hernandez JV, Kehl M, Bae SW, Dey AK, Low C, Wright AGC, Doryab A. Exploratory Machine Learning Modeling of Adaptive and Maladaptive Personality Traits from Passively Sensed Behavior. FUTURE GENERATIONS COMPUTER SYSTEMS : FGCS 2022; 132:266-281. [PMID: 35342213 PMCID: PMC8951872 DOI: 10.1016/j.future.2022.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Continuous passive sensing of daily behavior from mobile devices has the potential to identify behavioral patterns associated with different aspects of human characteristics. This paper presents novel analytic approaches to extract and understand these behavioral patterns and their impact on predicting adaptive and maladaptive personality traits. Our machine learning analysis extends previous research by showing that both adaptive and maladaptive traits are associated with passively sensed behavior providing initial evidence for the utility of this type of data to study personality and its pathology. The analysis also suggests directions for future confirmatory studies into the underlying behavior patterns that link adaptive and maladaptive variants consistent with contemporary models of personality pathology.
Collapse
Affiliation(s)
- Runze Yan
- School of Engineering and Applied Science, University of Virginia, United States
| | | | - Julio Vega Hernandez
- Mobile Sensing + Health Institute, Center for Behavioral Health, Media, and Technology, University of Pittsburgh, United States
| | - Madeline Kehl
- Department of Psychology, University of Pittsburgh, United States
| | - Sang Won Bae
- School of Systems and Enterprises, Stevens Institute of Technology, United States
| | - Anind K Dey
- Information School, University of Washington, United States
| | - Carissa Low
- Mobile Sensing + Health Institute, Center for Behavioral Health, Media, and Technology, University of Pittsburgh, United States
| | - Aidan G C Wright
- Department of Psychology, University of Pittsburgh, United States
| | - Afsaneh Doryab
- School of Engineering and Applied Science, University of Virginia, United States
| |
Collapse
|
5
|
Sen P, Barnicot K, Podder P, Dasgupta I, Gormley M. Exploring the prevalence of personality disorder and the feasibility of using the SAPAS as a screening tool for personality disorder in an emergency department in India. MEDICINE, SCIENCE, AND THE LAW 2022; 62:8-16. [PMID: 34018857 DOI: 10.1177/00258024211011387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Personality disorders (PD) lead to frequent emergency department (ED) visits. Existing studies have evaluated high-risk ED populations in Western settings. PD screening tools, such as the Standardized Assessment of Personality - Abbreviated Scale (SAPAS), have thus far only been validated in Western populations. AIMS This study aimed to establish the screened prevalence of PD, and to evaluate the performance of the SAPAS as a screening tool within an ED setting in India. METHODS The study took place in the ED of a private multi-speciality hospital in Kolkata, India. All attendees were approached during two days per week over three months, except those who were medically unfit to participate. The SAPAS and the International Personality Disorder Examination (IPDE) were translated into Bengali and then used as screening tools for PD and as the reference standard for PD diagnosis. RESULTS Out of 120 ED attendees approached, 97 participated (48 men and 49 women), of whom 24% met the criteria for a diagnosis of PD. A cut-off score of 4 on the SAPAS provided the best trade-off between sensitivity and specificity for detecting PD. CONCLUSION The prevalence of PD was similar to Western samples, and the SAPAS showed promise for use in a non-Western setting.
Collapse
Affiliation(s)
- Piyal Sen
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
- Elysium Healthcare, UK
| | - Kirsten Barnicot
- Centre for Psychiatry, Imperial College London, UK
- Central and North West London NHS Foundation Trust, UK
| | | | - Indraneel Dasgupta
- Department of Emergency Medicine, Peerless Hospital and B.K. Roy Research Centre, India
- Royal College of Emergency Medicine, UK
| | | |
Collapse
|
6
|
Vize CE, Ringwald WR, Edershile EA, Wright AGC. Antagonism in Daily Life: An Exploratory Ecological Momentary Assessment Study. Clin Psychol Sci 2022; 10:90-108. [PMID: 35402088 PMCID: PMC8992688 DOI: 10.1177/21677026211013507] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Abstract
Interpersonal Antagonism is one of the major domains of maladaptive personality. Structural-based investigations of Antagonism have generally been consistent in highlighting the more specific antagonistic traits (e.g., manipulativeness, callousness) that underlie the broader domain. However, less work has attempted to merge structural and functional accounts of Antagonism to assess how specific antagonistic traits manifest in daily life. This exploratory study examined how Antagonism and its specific features relate to outcomes assessed using ecological momentary assessment (EMA) methods. Across four independent EMA samples (N range=297-396; total N = 1,365; observations per outcome=5,419-17,735), we investigated how antagonistic traits related to theoretically relevant, EMA-based outcomes (e.g., affect, empathy, coldness-warmth in interpersonal interactions). Results showed robust findings across samples and operationalizations of Antagonism (e.g., Antagonism's relation with negative affect), along with more mixed results (e.g., Antagonism's relation with different measures of empathy). We discuss future research directions for structural and functional accounts of Antagonism.
Collapse
|
7
|
Sperry SH, Sharpe BM, Wright AGC. Momentary dynamics of emotion-based impulsivity: Exploring associations with dispositional measures of externalizing and internalizing psychopathology. JOURNAL OF ABNORMAL PSYCHOLOGY 2021; 130:815-828. [PMID: 34843288 PMCID: PMC8634794 DOI: 10.1037/abn0000720] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Emotion-based impulsivity has emerged as an important transdiagnostic risk factor for both internalizing and externalizing psychopathology. However, it is unclear how this dynamic process unfolds within individuals. We measured urgency within-persons as the momentary association between impulsivity and contemporaneous negative and positive affect in 4 ecological momentary assessment samples (N = 233[16,202 observations]; N = 302[11,360]; N = 311[17,517]; N = 291[20,297]) that span clinical, community, and student populations. Based on reflexive responding to emotion (RRE) and urgency frameworks, we hypothesized a) that significant individual differences in the dynamic association between affect and impulsivity would emerge, and b) that individual differences in positive and negative urgency pathways would be associated with externalizing and internalizing psychopathology. Within-person associations between negative affect and impulsivity consistently emerged; however, the association between positive affect and impulsivity was inconsistent across samples. Although average effects were small, significant individual differences existed in both urgency pathways. Consistent with prior studies, within-person urgency pathways were unassociated with global or dispositional measures of impulsivity. Contrary to expectation, within-person urgency was also unassociated with between-person measures of either internalizing or externalizing psychopathology. Yet, robust associations were seen between the same measures and average levels of momentary impulsivity and negative affect. We discuss results in terms of their relevance to both urgency and RRE frameworks and propose future directions to help disentangle emotion-based impulsivity and psychopathology in the moment. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Collapse
Affiliation(s)
- Sarah H Sperry
- Department of Psychology, University of Illinois at Urbana-Champaign
| | - Brinkley M Sharpe
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center
| | | |
Collapse
|
8
|
Pilkonis PA, Johnston KL, Dodds NE. Validation of the Three-Item Screener for Personality Disorders From the Inventory of Interpersonal Problems (IIP-3). J Pers Disord 2021; 35:750-763. [PMID: 33779285 DOI: 10.1521/pedi_2020_34_499] [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] [Indexed: 11/20/2022]
Abstract
We previously developed a three-item screener for identifying respondents with any personality disorder (PD) using the Inventory of Interpersonal Problems (IIP). The current goal was to examine the convergent validity of the IIP-3 with other PD screeners and diagnostic tools and to investigate its relationship to measures of adult attachment and emotion regulation. The sample consisted of participants from five studies (total N = 852), with data from collateral informants available for a subsample (N = 353). Despite its brevity, the IIP-3 showed moderate to strong relationships with other longer PD screeners, with PD symptom scores from the Structured Interview for DSM-IV Personality (SIDP-IV), and with a global rating of PD severity. It was most sensitive to the stylistic aspects of PD typical of the traditional DSM cluster B (dramatic, expressive) PDs. These results emerged with data from both participants and informants, although correlations using informant data were generally smaller.
Collapse
Affiliation(s)
- Paul A Pilkonis
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Kelly L Johnston
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Nathan E Dodds
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| |
Collapse
|
9
|
de Francisco Carvalho L, Hauck Filho N, Pereira Gonçalves A, Pianowski G, Rocha L. Inventory of Interpersonal Problems-Personality Disorders: adaptation to Brazil and test of a bifactor model. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2021; 52:S0034-7450(21)00071-8. [PMID: 34049685 DOI: 10.1016/j.rcp.2021.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 03/23/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The Inventory of Interpersonal Problems-Personality Disorders (IIP-PD-47) has a controversial factor structure, as some studies have provided support for 5 correlated factors, and others have suggested the existence of a general second-order dimension. One approach of data modelling that reconciles multidimensionality and the existence of a general factor is the bifactor analysis. We used unrestricted exploratory-confirmatory bifactor modelling to validate the Brazilian version of the IIP-PD-47. METHODS The sample consisted of 1,091 subjects aged 18-64 years who answered the IIP-PD-47 and a collateral measure of pathological traits, the Dimensional Clinical Personality Inventory 2 (IDCP-2). RESULTS After testing many candidate models, our data were best represented by a bifactor model with one general factor and five specific uncorrelated factors. Nevertheless, a closer inspection of the discriminant validity of each IIP-PD-47 factor revealed strong support for the general factor and a factor capturing aggressive behaviours, but less support for the additional four specific factors. CONCLUSIONS The theoretical and practical implications of these findings are discussed, and some recommendations are offered about the need for controlling response styles when assessing PD traits via self-report inventories. Our findings indicate that the Brazilian version of IIP-PD has promising psychometric properties.
Collapse
Affiliation(s)
| | - Nelson Hauck Filho
- Department of Psychology, Universidade São Francisco, Campinas, Sao Paulo, Brazil
| | | | - Giselle Pianowski
- Department of Psychology, Universidade São Francisco, Campinas, Sao Paulo, Brazil
| | - Lia Rocha
- Department of Psychology, Universidade São Francisco, Campinas, Sao Paulo, Brazil
| |
Collapse
|
10
|
Romirowsky A, Zweig R, Glick Baker L, Sirey JA. The Relationship Between Maladaptive Personality and Social Role Impairment in Depressed Older Adults in Primary Care. Clin Gerontol 2021; 44:192-205. [PMID: 30362909 PMCID: PMC6486454 DOI: 10.1080/07317115.2018.1536687] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Objective: Personality pathology is associated with impaired social functioning in adults, though further evidence is needed to examine the individual contributions of personality traits and processes to social functioning in depressed older adults. This study is a secondary analysis examining the relationship between maladaptive personality traits and processes and social role impairment in depressed older adults in primary care. Methods: Participants (N = 56) were 77% female and ranged in age between 55-89 (M = 66.82, SD = 8.75). Personality pathology was measured by maladaptive traits (NEO-FFI) and processes (Inventory of Interpersonal Problems; IIP-PD-15). Individual variable as well as combined predictive models of social role impairment were examined. Results: Higher neuroticism (β = 0.30, p < .05), lower agreeableness (β = -0.35 p < .001) and higher IIP-PD-15 (β = 0.28, p < .01) scores predicted greater impairment in social role functioning. A combined predictive model of neuroticism and IIP-PD-15 scores predicted unique variance in social role impairment (R2 = .71). Conclusion: These results link select personality traits and interpersonal processes to social role impairment, suggesting that these are indicators of personality pathology in older adults. Clinical Implications: These findings lend preliminary support for clinical screening of personality pathology in depressed older adults utilizing both personality trait and process measures.
Collapse
Affiliation(s)
| | - Richard Zweig
- Ferkauf Graduate School of Psychology, Yeshiva University
| | | | | |
Collapse
|
11
|
Carvalho LDF, Sette CP, Costa ARL. Toward Developing Clinical cut-off for the Grandiosity Scale of the Dimensional Clinical Personality Inventory 2. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2021; 51:S0034-7450(20)30130-X. [PMID: 33735010 DOI: 10.1016/j.rcp.2020.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 08/14/2020] [Accepted: 11/12/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE The present study aims to establish a clinical cut-off for the Grandiosity dimension, using item-level evaluation procedures. METHODS Participants were 5,387 adults, including outpatients diagnosed with narcissistic personality disorder (NPD), outpatients diagnosed with other personality disorders, and adults from the community. We administered the self-reported Grandiosity scale from the Dimensional Clinical Personality Inventory 2 (IDCP-2). The equating procedure was applied to generate theta scores for participants who did not answer all items. RESULTS The Wright map revealed that outpatients scored high on the latent continuum of the Grandiosity scale. Group comparison showed large effect sizes for the mean difference between patients and non-patients. The ROC curve supports a cut off at a -0.45 score in theta standardisation, which yields a high sensitivity (91%) and moderate specificity (58%). Moreover, the PPP (71%) and NPP (79%) values suggest that the scale is able to identify NPD patients in 71% of cases, and people without NPD in 79% of cases. CONCLUSIONS The findings suggest the IDCP-2 Grandiosity scale is useful as an NPD screening tool. Possible clinical applications for the scale are described and the limitations of the study are discussed.
Collapse
|
12
|
Pilkonis PA, Lawrence SM, Johnston KL, Dodds NE. Screening for Personality Disorders: A Three-Item Screener From the Inventory of Interpersonal Problems (IIP-3). J Pers Disord 2019; 33:832-845. [PMID: 30650003 DOI: 10.1521/pedi_2019_33_369] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
To encourage screening for personality disorders (PDs), we developed (in previous work) self-report scales for PDs using the Inventory of Interpersonal Problems (IIP). The combined score from three of the scales-inter-personal sensitivity, interpersonal ambivalence, and aggression-requiring 15 items (IIP-15) did the best job of distinguishing between respondents with any versus no PD. The goals for the present work were (a) to cross-validate the IIP-15 by examining its performance using receiver operating characteristics (ROC) analyses in a new sample (N = 410), and (b) to investigate the utility of a brief three-item variant (IIP-3). The present results again documented the good operating characteristics of the IIP-15. Sensitivity, specificity, and positive and negative predictive values were all above. 70. The operating characteristics of the IIP-3 were nearly as good despite its brevity and support its use as an initial screen for PDs.
Collapse
Affiliation(s)
- Paul A Pilkonis
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Suzanne M Lawrence
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Kelly L Johnston
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Nathan E Dodds
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| |
Collapse
|
13
|
Zhang K, Szanto K, Clark L, Dombrovski AY. Behavioral empathy failures and suicidal behavior. Behav Res Ther 2019; 120:103329. [PMID: 30477905 PMCID: PMC6497579 DOI: 10.1016/j.brat.2018.10.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 09/16/2018] [Accepted: 10/31/2018] [Indexed: 12/11/2022]
Abstract
Impaired decision-making has recently gained recognition as a component of the suicidal diathesis. Yet, although precipitants and particularly deterrents to suicidal behavior are often interpersonal, little is known about social decision-making in suicidal individuals. This study employed a novel version of the Ultimatum Game to investigate how empathy moderates responses to social conflict in 149 older adults, comprising groups of suicide attempters (n = 49), suicide ideators (n = 32), non-suicidal depressed controls (n = 33), and a non-psychiatric control group (n = 35). Participants acted as responder to a series of single-shot financial offers that varied in fairness. Some offers were paired with social context information on the proposer, designed to evoke either empathy or punishment. Offer acceptance was sensitive to Fairness and Social Context, such that participants accepted more offers in the empathy condition and fewer offers in the punishment condition. A Group * Context interaction was observed, wherein the suicide attempters adjusted their acceptance rates less in the empathy condition than the non-psychiatric controls. Thus, older adults with a history of suicide attempt were less influenced by empathy scenarios, indicating that a failure to integrate others' emotions into decisions may undermine social deterrents to suicide.
Collapse
Affiliation(s)
- Ke Zhang
- Centre for Gambling Research at UBC, Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Katalin Szanto
- Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, PA, USA
| | - Luke Clark
- Centre for Gambling Research at UBC, Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Alexandre Y Dombrovski
- Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, PA, USA.
| |
Collapse
|
14
|
Carvalho L, Costa A, Otoni F, Junqueira P. Obsessive–compulsive personality disorder screening cut-off for the Conscientiousness dimension of the Dimensional Clinical Personality Inventory 2. THE EUROPEAN JOURNAL OF PSYCHIATRY 2019. [DOI: 10.1016/j.ejpsy.2019.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
|
15
|
Beeney J, Lazarus S, Hallquist M, Stepp S, Wright A, Scott L, Giertych R, Pilkonis P. Detecting the Presence of a Personality Disorder Using Interpersonal and Self-Dysfunction. J Pers Disord 2019; 33:229-248. [PMID: 29505391 PMCID: PMC6123313 DOI: 10.1521/pedi_2018_32_345] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Calls have increased to place interpersonal and self-disturbance as defining features of personality disorders (PDs). Findings from a methodologically diverse set of studies suggest that a common factor undergirds all PDs. The nature of this core of PDs, however, is not clear. In the current study, interviews were completed for DSM-IV PD diagnosis and interpersonal dysfunction independently with 272 individuals (PD = 191, no-PD = 91). Specifically, we evaluated interpersonal dysfunction across social domains. In addition, we empirically assessed the structure of self-dysfunction in PDs. We found dysfunction in work and romantic domains, and unstable identity uniquely predicted variance in the presence of a PD. Using receiver operating characteristic analysis, we found that the interpersonal dysfunction and self-dysfunction scales each predicted PDs with high accuracy. In combination, the scales resulted in excellent sensitivity (.90) and specificity (.88). The results support interpersonal and self-dysfunction as general factors of PD.
Collapse
Affiliation(s)
- J.E. Beeney
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | - S.A. Lazarus
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | | | - S.D. Stepp
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | | | - L.N. Scott
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | - R.A. Giertych
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | - P.A. Pilkonis
- Department of Psychiatry, University of Pittsburgh School of Medicine
| |
Collapse
|
16
|
Abstract
ABSTRACTObjectives:To understand pathways to suicide by investigating the association between personality and suicidal motivations in mid- and late-life attempts. DESIGN In a two-study approach, we measured different components of suicidal motivations using an existing self-report investigating reasons for suicide and a semi-qualitative assessment of motivational states preceding attempts. SETTING Inpatient and outpatient psychiatric services in Pittsburgh, PA. PARTICIPANTS Study 1 (n = 50, mean age at attempt = 60.4) was a smaller sample of suicide attempters included in Study 2 (n = 69, mean age at attempt = 60.9). Non-psychiatric healthy controls (n = 50, mean age = 67.1) were used as benchmarks for dispositional measures. MEASUREMENTS Motives for suicide were measured by the Reasons for Attempting Suicide Questionnaire (RASQ). Participants' written descriptions of the thoughts and feelings preceding their attempt captured motivational states. Measures of personality for both studies included assessments of impulsivity, five-factor model, interpersonal dysfunction, and borderline traits. RESULTS In study 1, escape/self-punishment motives on the RASQ were associated with multiple attempts and borderline pathology, while interpersonal motives were less frequently endorsed and associated with poorly planned attempts. In study 2, experiences of defeat (i.e. powerlessness, poor coping to threats to autonomy/status) were more frequently endorsed by men and associated with disagreeableness. CONCLUSIONS Study 1 revealed that attempters high in dysfunctional psychopathology were more likely to report self-oriented escape motives for suicide, while study 2 identified a putative pathway to suicide in men involving antagonism and the experience of defeat.
Collapse
Affiliation(s)
- Maria Alessi
- Western Psychiatric Institute & Clinic at the University of
Pittsburgh Medical Center, 100 N. Bellefield Ave, Pittsburgh, PA 15213, USA
| | - Katalin Szanto
- Western Psychiatric Institute & Clinic at the University of
Pittsburgh Medical Center, 100 N. Bellefield Ave, Pittsburgh, PA 15213, USA
| | - Alexandre Dombrovski
- Western Psychiatric Institute & Clinic at the University of
Pittsburgh Medical Center, 100 N. Bellefield Ave, Pittsburgh, PA 15213, USA
| |
Collapse
|
17
|
Selvik SG, Hummelen B, Romild U, Langbehn DR, Pedersen G. The Iowa Personality Disorder Screen: A validation study in a psychiatric population that receives long-term group psychotherapy for personality related problems. Personal Ment Health 2018; 12:229-240. [PMID: 29722177 DOI: 10.1002/pmh.1418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 02/14/2018] [Accepted: 02/18/2018] [Indexed: 11/07/2022]
Abstract
Personality disorder (PD) is common among psychiatric patients, and diagnosing such disorders is of great importance for the choice of treatment. Diagnosing PD is a demanding and time-consuming process. The utilities of several PD screening instruments have been studied in different populations, but not in a population who receives long-term group psychotherapy. In the current study, we investigate the predictive properties of the Iowa Personality Disorder Screen (IPDS) in a sample of 694 psychiatric outpatients with and without PD who were admitted for psychodynamic long-term group therapy from 2012 to 2014. The definitive, reference diagnoses were defined according to the SCID-II, by which 484 patients (68%) warranted a PD diagnosis. The IPDS correctly classified 67.4 percent of all participants. Sensitivity (0.75) and specificity (0.51) were lower than in previous validation studies of IPDS. We discuss possible explanations related to the general concept of PD and, more specifically, to our study sample. Because of the weaker predictive properties of IPDS, we advise caution in use of the IPDS in similar clinical settings. Copyright © 2018 John Wiley & Sons, Ltd.
Collapse
Affiliation(s)
- S G Selvik
- Department for Mental Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Psychiatric Hospital Namsos, Helse Nord-Trøndelag, Namsos, Norway
| | - B Hummelen
- Department of Research and Development, Division of Mental Health and Addiction, Oslo University Hospital, Norway
| | | | - D R Langbehn
- Department of Psychiatry, University of Iowa Health Care, USA
| | - G Pedersen
- Department of Personality Psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, Norway.,NORMENT, Institute of Clinical Medicine, University of Oslo, Norway
| |
Collapse
|
18
|
Carvalho LDF, Lima Costa AR. Clinical cut-off point for the Distrust dimension of the Dimensional Clinical Personality Inventory 2 (IDCP-2). Scand J Psychol 2018; 59:560-566. [PMID: 29992580 DOI: 10.1111/sjop.12465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Accepted: 04/25/2018] [Indexed: 11/29/2022]
Abstract
The Clinical Dimensional Personality Inventory 2 (IDCP-2) is a 206-item self-report tool developed for the assessment of 12 dimensions (divided into 47 factors) of personality pathology. One of the scales comprising the instrument, the Distrust scale, is intended to provide psychometric information on traits closely related to the Paranoid Personality Disorder (PPD). In the present research, we used the Item Response Theory and the Receiver Operating Characteristic curve analysis to establish a clinical meaningful cutoff for the Distrust scale. Participants were 1,679 adults, among outpatients diagnosed with PPD, outpatients diagnosed with other PDs, and adults from the community. The Wright map revealed that outpatients were located at the very high levels on the latent continuum of the Distrust scale, with a very large effect size for the mean difference between patients and non-patients. The ROC curve supported a cutoff at -1.00 score in theta standardization which yielded 0.87 of sensitivity and 0.54 of specificity. Findings from the present investigation suggest the IDCP-2 Distrust scale is useful as a screening tool of the core features of the PPD. We address potential clinical applications for the instrument and discuss limitations from the present study.
Collapse
|
19
|
Carvalho LDF, Pianowski G, Reis AM. Development and Diagnostic Accuracy of the Screening of the Dimensional Clinical Personality Inventory. PSICOLOGIA: CIÊNCIA E PROFISSÃO 2017. [DOI: 10.1590/1982-3703003082016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract: The assessment of personality disorders assumes unquestioned clinical relevance when considering the prevalence rates in the general population. Tests assessing the typical pathological traits of these disorders has been adapted to and developed in Brazil. However, there is a gap in the country of screening tools for personality disorders. Screening tools are designed to allow a fast and informative application on the likelihood of a positive diagnosis, where the consequence should be conveyed to a diagnostic assessment. Using as a base the Dimensional Clinical Personality Inventory (IDCP), developed at the national level, the objective of this research was to develop a screening tool for personality disorders, as well as investigate its diagnostic accuracy. The study included 1,196 people, aging between 18 and 73 years (M = 26.32, SD = 8.69), and 64.1% female. The sample was divided into clinical and non-clinical group. We used an empirical approach based on criteria for selection of items similar to those adopted in the development of Minnesota Multiphasic Personality Inventory was used (MMPI). The logistic regression analysis and also the calculation of Cohen's d indicated the items that best discriminate against people with personality disorders and those without this diagnosis. We achieved a final set of 15 items with satisfactory sensitivity and specificity for screening test. We discusses the strengths and limitations of screening version of the IDCP and guidelines for further study.
Collapse
|
20
|
Vanyukov PM, Szanto K, Hallquist M, Moitra M, Dombrovski AY. Perceived burdensomeness is associated with low-lethality suicide attempts, dysfunctional interpersonal style, and younger rather than older age. Int J Geriatr Psychiatry 2017; 32:788-797. [PMID: 27298114 PMCID: PMC5156588 DOI: 10.1002/gps.4526] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 05/13/2016] [Accepted: 05/18/2016] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Perceived burdensomeness is thought to contribute to suicide risk. However, suicidal behavior is clinically and psychologically heterogeneous. Does a high level of perceived burdensomeness differentiate medically serious suicidal acts, most closely resembling death by suicide, from less serious ones? How is perceived burdensomeness related to dysfunctional personality dimensions implicated in suicide? We sought to answer these questions in a cross-sectional, case-control study of adults, aged 42 years or older (n = 165). METHODS Participants were suicidal depressed with history of high-lethality and low-lethality attempts, depressed with serious suicidal ideation, depressed non-suicidal, and psychiatrically healthy controls. Following detailed clinical characterization, we assessed perceived burdensomeness, the Big Five, impulsivity, and anger rumination. RESULTS Low-lethality attempters reported the highest levels of perceived burdensomeness, followed by ideators, high-lethality attempters, non-suicidal depressed, and healthy controls. Group differences were robust to confounders, including demographics, severity of depression, and physical illness burden. In suicide attempters, perceived burdensomeness scaled positively with neuroticism, impulsivity, and anger and negatively with extraversion, conscientiousness, and age. CONCLUSIONS Our findings suggest that perceived burdensomeness is most prominent in a subgroup of younger individuals with lower-lethality suicide attempts and a dysfunctional interpersonal style. Older adults with high-lethality attempts are surprisingly more resilient to the feelings of burdensomeness. Copyright © 2016 John Wiley & Sons, Ltd.
Collapse
Affiliation(s)
- Polina M Vanyukov
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA, USA
| | - Katalin Szanto
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA, USA
| | - Michael Hallquist
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA, USA
| | - Modhurima Moitra
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA, USA
| | - Alexandre Y Dombrovski
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA, USA
| |
Collapse
|
21
|
Carvalho LDF. External validity study of a personality disorders screening test in a community sample. ARCH CLIN PSYCHIAT 2017. [DOI: 10.1590/0101-60830000000115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
|
22
|
An Empirical Study of Personality Disorders Among Treatment-Seeking Problem Gamblers. J Gambl Stud 2016; 32:1079-1100. [DOI: 10.1007/s10899-016-9600-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
23
|
Fossati A, Somma A, Borroni S, Maffei C, Markon KE, Krueger RF. A Head-to-Head Comparison of the Personality Inventory for DSM-5 (PID-5) With the Personality Diagnostic Questionnaire-4 (PDQ-4) in Predicting the General Level of Personality Pathology Among Community Dwelling Subjects. J Pers Disord 2016; 30:82-94. [PMID: 26828108 DOI: 10.1521/pedi_2015_29_184] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In order to evaluate if measures of DSM-5 Alternative PD Model domains predicted interview-based scores of general personality pathology when compared to self-report measures of DSM-IV Axis II/DSM-5 Section II PD criteria, 300 Italian community adults were administered the Iowa Personality Disorder Screen (IPDS) interview, the Personality Inventory for DSM-5 (PID-5), and the Personality Diagnostic Questionnaire-4+ (PDQ-4+). Multiple regression analyses showed that the five PID-5 domain scales collectively explained an adequate rate of the variance of the IPDS interview total score. This result was slightly lower than the amount of variance in the IPDS total score explained by the 10 PDQ-4+ scales. The PID-5 traits scales performed better than the PDQ-4+, although the difference was marginal. Hierarchical regression analyses revealed that the PID-5 domain and trait scales provided a moderate, but significant increase in the prediction of the general level of personality pathology above and beyond the PDQ-4+ scales.
Collapse
Affiliation(s)
- Andrea Fossati
- LUMSA University, Rome, and San Raffaele Hospital, Milan, Italy
| | - Antonella Somma
- LUMSA University, Rome, and San Raffaele Hospital, Milan, Italy
| | | | | | | | | |
Collapse
|
24
|
Fok MLY, Seegobin S, Frissa S, Hatch SL, Hotopf M, Hayes RD, Moran P. Validation of the standardised assessment of personality--abbreviated scale in a general population sample. Personal Ment Health 2015; 9:250-7. [PMID: 26314385 PMCID: PMC4950006 DOI: 10.1002/pmh.1307] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Revised: 07/19/2015] [Accepted: 07/26/2015] [Indexed: 11/10/2022]
Abstract
BACKGROUND Personality disorder (PD) is associated with important health outcomes in the general population. However, the length of diagnostic interviews poses a significant barrier to obtaining large scale, population-based data on PD. A brief screen for the identification of people at high risk of PD in the general population could be extremely valuable for both clinicians and researchers. AIM We set out to validate the Standardised Assessment of Personality - Abbreviated Scale (SAPAS), in a general population sample, using the Structured Clinical Interviews for DSM-IV Personality Disorders (SCID-II) as a gold standard. METHOD One hundred and ten randomly selected, community-dwelling adults were administered the SAPAS screening interview. The SCID-II was subsequently administered by a clinical interviewer blind to the initial SAPAS score. Receiver operating characteristic analysis was used to assess the discriminatory performance of the SAPAS, relative to the SCID-II. RESULTS Area under the curve for the SAPAS was 0.70 (95% CI = 0.60 to 0.80; p < 0.001), indicating moderate overall discriminatory accuracy. A cut point score of 4 on the SAPAS correctly classified 58% of participants. At this cut point, the sensitivity and specificity were 0.69 and 0.53 respectively. CONCLUSION The SAPAS operates less efficiently as a screen in general population samples and is probably most usefully applied in clinical populations.
Collapse
Affiliation(s)
- Marcella Lei-Yee Fok
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Seth Seegobin
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Souci Frissa
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Stephani L Hatch
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Matthew Hotopf
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Richard D Hayes
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Paul Moran
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| |
Collapse
|
25
|
Gillard ND, Rogers R. Denial of risk: The effects of positive impression management on risk assessments for psychopathic and nonpsychopathic offenders. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2015; 42-43:106-113. [PMID: 26493092 DOI: 10.1016/j.ijlp.2015.08.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Risk assessments for offenders often combine past records with current clinical findings from observations, interviews, and test data. Conclusions based on these risk assessments are highly consequential, sometimes resulting in increased criminal sentences or prolonged hospitalization. Therefore, many offenders are motivated to intentionally minimize risk factors and their negative consequences. Positive impression management (PIM) is especially likely to occur in offenders with high psychopathic traits because goal-directed deception is reflected in several of psychopathy's core traits of the disorder, such as manipulativeness, glibness, and superficial charm. However, this connection appears to be based on the conceptual understanding of psychopathy, and has rarely been examined empirically for either frequency of or success at deception. The current study examined the ability of a jail sample to intentionally minimize risk factors and related criminal attributes using a repeated measures, simulation design. In general, offenders were able to effectively use PIM to lower scores on the HCR-20 and the Self-Appraisal Questionnaire (SAQ), while the Psychological Inventory of Criminal Thinking Styles (PICTS), as a measure of cognitive styles, was more resistant to such minimization. Psychopathic traits, especially high Factor 1 scores (i.e., affective/interpersonal), were associated with greater PIM. Important differences in the willingness and ability to use deception were found based on the (a) mode of administration (i.e., interview vs. self-report) and (b) level of psychopathy as measured by the Psychopathy Checklist - Revised (PCL-R). The important implications of this research are discussed for risk assessment procedures regarding likely areas of deception and its detection. The current research also informs the growing literature on the connection between psychopathic traits and deception.
Collapse
Affiliation(s)
- Nathan D Gillard
- Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX 76203-5017, United States
| | - Richard Rogers
- Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX 76203-5017, United States.
| |
Collapse
|
26
|
Vanyukov PM, Szanto K, Siegle GJ, Hallquist MN, Reynolds CF, Aizenstein HJ, Dombrovski AY. Impulsive traits and unplanned suicide attempts predict exaggerated prefrontal response to angry faces in the elderly. Am J Geriatr Psychiatry 2015; 23:829-39. [PMID: 25529800 PMCID: PMC4528975 DOI: 10.1016/j.jagp.2014.10.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 10/14/2014] [Accepted: 10/16/2014] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Abnormal responses to social stimuli are seen in people vulnerable to suicidal behavior, indicating possible disruptions in the neural circuitry mediating the interpretation of socioemotional cues. These disruptions have not been empirically related to psychological and cognitive pathways to suicide. In the present study of older suicide attempters, we examined neural responses to emotional faces and their relationship to impulsivity, one of the components of the suicidal diathesis. METHODS Using functional magnetic resonance imaging, we recorded neurohemodynamic responses to angry faces in a carefully characterized sample of 18 depressed elderly with history of suicide attempts, 13 depressed nonsuicidal patients, and 18 healthy individuals, all aged 60+. Impulsivity was assessed with the Social Problem Solving Inventory Impulsivity/Carelessness Style subscale and Barratt Impulsiveness Scale. The Suicide Intent Scale planning subscale was used to describe the degree of planning associated with the most lethal attempt. RESULTS Depression and history of attempted suicide were not associated with neural responses to angry faces, failing to replicate earlier studies. Higher impulsivity, however, predicted exaggerated responses to angry faces in fronto-opercular and dorsomedial prefrontal cortex (pcorr <0.05). Poorly planned suicide attempts also predicted increased fronto-opercular responses. Results were robust to effects of medication exposure, comorbid anxiety and addiction, severity of depression, burden of physical illness, and possible brain injury from suicide attempts. CONCLUSION Impulsive traits and history of unplanned suicide attempts partly explain the heterogeneity in neural responses to angry faces in depressed elderly. Displays of social emotion command excessive cortical processing in impulsive suicide attempters.
Collapse
|
27
|
Beitel M, Peters S, Savant JD, Cutter CJ, Cecero JJ, Barry DT. The psychometric properties of the iowa personality disorder screen in methadone-maintained patients: an initial investigation. J Pers Disord 2015; 29:131-44. [PMID: 23398100 PMCID: PMC3659190 DOI: 10.1521/pedi_2013_27_081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The psychometric properties of the Iowa Personality Disorder Screen (IPDS) were examined in 150 methadone-maintained patients who completed measures of demographic, psychopathology, substance use, pain, and methadone maintenance treatment (MMT) characteristics. An exploratory factor analysis revealed a two-factor solution that explained 45% of the scale variance. The first factor captured internalizing tendencies, such as inhibition and hypersensitivity to others. The second factor comprised externalizing tendencies, such as impulsivity and insensitivity to others. The IPDS item subsets, derived factors, and the total score were significantly related to race/ethnicity but not sex. The effects of race/ethnicity were controlled statistically when the IPDS was compared to other measures of psychopathology, self-reported substance use, pain variables, and MMT characteristics. In general, the IPDS appears to be reliable and valid for use with methadone-maintained patients. The two-factor structure found in this study may have clinical utility and merits further investigation in other MMT samples.
Collapse
Affiliation(s)
- Mark Beitel
- Yale University School of Medicine, New Haven, CT,APT Foundation Pain Treatment Services, New Haven, CT
| | - Skye Peters
- APT Foundation Pain Treatment Services, New Haven, CT
| | | | - Christopher J. Cutter
- Yale University School of Medicine, New Haven, CT,APT Foundation Pain Treatment Services, New Haven, CT
| | | | - Declan T. Barry
- Yale University School of Medicine, New Haven, CT,APT Foundation Pain Treatment Services, New Haven, CT
| |
Collapse
|
28
|
Láng A. Machiavellianism and personality disorder: their relationship in the mirror of interpersonal attitudes. Orv Hetil 2014; 155:1584-8. [DOI: 10.1556/oh.2014.30004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Introduction: Social and personality psychologists have described Machiavellianism as a pragmatic, callous-unemotional, exploitative and manipulative attitude towards others. Several former studies linked Machiavellian personality traits and interpersonal problems or personality dysfunction. Aim: The aim of this study was to reveal the connection between Machiavellianism and interpersonal problems that are characteristic of personality disorders. Method: 252 participants (146 females and 106 males, aged 32.46±5.39 years, mean±SD) filled out self-report measures of Machiavellianism and personality disorder related interpersonal problems. Results: There was a medium strength relationships between Machiavellianism and several interpersonal problems. Aggression and ambivalence proved to be significant predictors of Machiavellian personality traits. Conclusions: Results are discussed in relation to the patient–therapist bond. Orv. Hetil., 2014, 155(39), 1584–1588.
Collapse
Affiliation(s)
- András Láng
- Pécsi Tudományegyetem, Bölcsészettudományi Kar Pszichológia Intézet Pécs Ifjúság útja 6. 7624
| |
Collapse
|
29
|
Neither too much, nor too little. The dilemma of identifying personality disorders in adolescents patients with self-reports. Psychiatry Res 2014; 215:683-6. [PMID: 24398066 DOI: 10.1016/j.psychres.2013.12.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Revised: 08/19/2013] [Accepted: 12/15/2013] [Indexed: 11/24/2022]
Abstract
The study aimed to compare methods of identification of Personality Disorders (PD) in adolescent patients with psychiatric disorders. A sample of 120 Spanish adolescents with clinical disorders was assessed using the International Personality Disorder Examination (IPDE) interview, its Screening Questionnaires (IPDE-SQ) comprising the ICD-10 and DSM-IV modules, and also the Temperament Character Inventory (TCI) to identify risk of PD. The IPDE-SQ identified a risk of PD around 92-97% of the sample; 61.7% when adjusting the stricter cut-off points. The TCI showed a PD risk of 20%, whereas the prevalence of PD identified by the IPDE clinical interview was around 36-38%. The differences between the IPDE, IPDE-SQ and TCI were significant, and a low agreement among instruments was obtained. Large discrepancy between self-report instruments in identifying PD with regard to the clinical interview raises several questions concerning the use of these instruments in clinical settings on adolescents with psychiatric disorders.
Collapse
|
30
|
Szanto K, Clark L, Hallquist M, Vanyukov P, Crockett M, Dombrovski AY. The cost of social punishment and high-lethality suicide attempts in the second half of life. Psychol Aging 2014; 29:84-94. [PMID: 24660798 PMCID: PMC4051315 DOI: 10.1037/a0035339] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Age-related cognitive changes may contribute to impairments in making complex social decisions. Interpersonal conflict is a key factor behind suicidal behavior in old age, with suicidal motivations ranging from escape to revenge. Such conflicts may prove catastrophic for people prone to suicide, in part because of their tendency to make disadvantageous decisions. Yet, little is known about social decision making in older suicidal individuals. We assessed economic bargaining behavior using the Ultimatum Game, where players decide whether to accept or punish (reject) unfair monetary offers from another player. Our sample included depressed older adults with a history of high-medical-lethality suicide attempts, low-medical-lethality suicide attempts, nonsuicidal depressed older adults, and those with no psychiatric history who served as control groups. Participants in all groups punished their counterparts in response to unfair offers. However, low-lethality attempters, nonsuicidal depressed, and nonpsychiatric controls punished less as the cost of punishment increased, accepting more unfair offers as the stakes grew large. High-lethality attempters did not adjust their choices based on stake magnitude, punishing unfair offers without regard to the cost. Two thirds of the difference between the high-lethality attempters and nonpsychiatric controls was explained by individual differences in fairness judgments: the comparison group judged offer fairness as a joint function of inequality and magnitude, whereas the high-lethality attempter participants judged offer fairness on the basis of inequality. In real life, high-lethality attempters' relative insensitivity to the cost of retaliation may lead to uncompromising, catastrophic responses to conflict.
Collapse
Affiliation(s)
| | - Luke Clark
- Department of Psychology, University of Cambridge
| | | | | | | | | |
Collapse
|
31
|
Hallquist MN, Wright AGC. Mixture modeling methods for the assessment of normal and abnormal personality, part I: cross-sectional models. J Pers Assess 2013; 96:256-68. [PMID: 24134433 DOI: 10.1080/00223891.2013.845201] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Over the past 75 years, the study of personality and personality disorders has been informed considerably by an impressive array of psychometric instruments. Many of these tests draw on the perspective that personality features can be conceptualized in terms of latent traits that vary dimensionally across the population. A purely trait-oriented approach to personality, however, might overlook heterogeneity that is related to similarities among subgroups of people. This article describes how factor mixture modeling (FMM), which incorporates both categories and dimensions, can be used to represent person-oriented and trait-oriented variability in the latent structure of personality. We provide an overview of different forms of FMM that vary in the degree to which they emphasize trait- versus person-oriented variability. We also provide practical guidelines for applying FMM to personality data, and we illustrate model fitting and interpretation using an empirical analysis of general personality dysfunction.
Collapse
|
32
|
Hentschel AG, John Livesley W. Differentiating normal and disordered personality using the General Assessment of Personality Disorder (GAPD). Personal Ment Health 2013; 7:133-42. [PMID: 24343939 DOI: 10.1002/pmh.1218] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Criteria to differentiate personality disorder from extremes of normal personality variations are important given growing interest in dimensional classification because an extreme level of a personality dimension does not necessarily indicate disorder. The DSM-5 proposed classification of personality disorder offers a definition of general personality disorder based on chronic interpersonal and self/identity pathology. The ability of this approach to differentiate personality disorder from other mental disorders was evaluated using a self-report questionnaire, the General Assessment of Personality Disorder (GAPD). This measure was administered to a sample of psychiatric patients (N = 149) from different clinical sub-sites. Patients were divided into personality disordered and non-personality disordered groups on the basis of the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II). The results showed a hit rate of 82% correct identified patients and a good accuracy of the predicted model. There was a substantial agreement between SCID-II interview and GAPD personality disorder diagnoses. The GAPD appears to predict personality disorder in general, which provides support of the DSM-5 general diagnostic criteria of personality disorder.
Collapse
Affiliation(s)
- Annett G Hentschel
- SKH Grossschweidnitz, Psychiatrische Institutsambulanz, 02943, Weisswasser, Germany
| | | |
Collapse
|
33
|
Zimmermann J, Benecke C, Hörz S, Rentrop M, Peham D, Bock A, Wallner T, Schauenburg H, Frommer J, Huber D, Clarkin JF, Dammann G. Validierung einer deutschsprachigen 16-Item-Version des Inventars der Persönlichkeitsorganisation (IPO-16). DIAGNOSTICA 2013. [DOI: 10.1026/0012-1924/a000076] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
In diesem Artikel wird eine deutschsprachige Kurzskala des Inventars der Persönlichkeitsorganisation (IPO-16) vorgestellt und in drei klinischen Stichproben mit insgesamt 1300 Personen validiert. Das IPO ist ein international verbreitetes Selbsteinschätzungsinstrument, das in mehreren Versionen vorliegt und zur Erfassung von struktureller Beeinträchtigung in den Bereichen Identität, Abwehr und Realitätsprüfung eingesetzt wird. Die Kurzskala basiert auf 16 versionsübergreifenden IPO-Items und misst den Schweregrad der strukturellen Beeinträchtigung. In den Studien konnte gezeigt werden, dass das IPO-16 (1) intern konsistent ist, (2) eine modellkonforme Faktorenstruktur hat, (3) eine sehr hohe Überlappung zur IPO-Vollversion aufweist, (4) in der Selbsteinschätzung über konvergente und diskriminante Validität verfügt, (5) den Schweregrad der Persönlichkeitsstörung aus Expertensicht unabhängig vom aktuellen Leidensdruck vorhersagt und (6) eine diagnostische Effizienz erreicht, die mit anderen Screening-Instrumenten im Bereich der Persönlichkeitsstörungsdiagnostik vergleichbar ist. Mit dem IPO-16 liegt für den deutschsprachigen Raum erstmals ein ökonomisches und gut validiertes Selbsteinschätzungsinstrument zur Erfassung von struktureller Beeinträchtigung vor.
Collapse
|
34
|
Ogrodniczuk JS, Sochting I, Piper WE, Joyce AS. A naturalistic study of alexithymia among psychiatric outpatients treated in an integrated group therapy program. Psychol Psychother 2012; 85:278-91. [PMID: 22903919 DOI: 10.1111/j.2044-8341.2011.02032.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Alexithymia is common among psychiatric outpatients and can complicate treatment. There has been little research into whether alexithymia can be modified by psychological intervention, and whether change in alexithymia is related to other areas of improvement. The purpose of the present study was to examine whether participation in an integrated group therapy program could effect change in alexithymia, and whether such change is related to improvement in interpersonal functioning. DESIGN AND METHODS Sixty-eight consecutively admitted psychiatric outpatients to a comprehensive group therapy program were evaluated at baseline, post-therapy, and 3-month follow-up using the Toronto Alexithymia Scale 20, the Beck Depression Inventory, and the Inventory of Interpersonal Problems-28. Associations among variables were evaluated with correlations and among group comparisons with t test, ANOVA, chi-square tests, and logistic regression. Change in alexithymia was examined using repeated measures ANOVA, controlling for change in depressive symptoms. RESULTS Alexithymia, particularly difficulty identifying feelings, decreased significantly during the treatment period. Post-therapy levels of alexithymia were maintained during the 3 months following treatment completion. Changes in alexithymia were significantly associated with changes in interpersonal problems, both during therapy and during the follow-up period. CONCLUSIONS The results of our study suggest that a comprehensive, integrated group therapy program can affect change in alexithymia, and that such change can be maintained once therapy is completed. Also, modifying alexithymia may contribute to improvement in interpersonal functioning.
Collapse
Affiliation(s)
- John S Ogrodniczuk
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
| | | | | | | |
Collapse
|
35
|
Kongerslev M, Moran P, Bo S, Simonsen E. Screening for personality disorder in incarcerated adolescent boys: preliminary validation of an adolescent version of the standardised assessment of personality - abbreviated scale (SAPAS-AV). BMC Psychiatry 2012; 12:94. [PMID: 22846474 PMCID: PMC3507652 DOI: 10.1186/1471-244x-12-94] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Accepted: 07/24/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Personality disorder (PD) is associated with significant functional impairment and an elevated risk of violent and suicidal behaviour. The prevalence of PD in populations of young offenders is likely to be high. However, because the assessment of PD is time-consuming, it is not routinely assessed in this population. A brief screen for the identification of young people who might warrant further detailed assessment of PD could be particularly valuable for clinicians and researchers working in juvenile justice settings. METHOD We adapted a rapid screen for the identification of PD in adults (Standardised Assessment of Personality - Abbreviated Scale; SAPAS) for use with adolescents and then carried out a study of the reliability and validity of the adapted instrument in a sample of 80 adolescent boys in secure institutions. Participants were administered the screen and shortly after an established diagnostic interview for DSM-IV PDs. Nine days later the screen was readministered. RESULTS A score of 3 or more on the screening interview correctly identified the presence of DSM-IV PD in 86% of participants, yielding a sensitivity and specificity of 0.87 and 0.86 respectively. Internal consistency was modest but comparable to the original instrument. 9-days test-retest reliability for the total score was excellent. Convergent validity correlations with the total number of PD criteria were large. CONCLUSION This study provides preliminary evidence of the validity, reliability, and usefulness of the screen in secure institutions for adolescent male offenders. It can be used in juvenile offender institutions with limited resources, as a brief, acceptable, staff-administered routine screen to identify individuals in need of further assessment of PD or by researchers conducting epidemiological surveys.
Collapse
Affiliation(s)
- Mickey Kongerslev
- Department of Child and Adolescent Psychiatry, Region Zealand, Roskilde, Denmark
- Psychiatric Research Unit, Region Zealand, Toftebakken 9, 4000, Roskilde, Denmark
| | - Paul Moran
- King’s College London, Health Services & Population Research Department, Institute of Psychiatry, London, United Kingdom
| | - Sune Bo
- Psychiatric Research Unit, Region Zealand, Toftebakken 9, 4000, Roskilde, Denmark
| | - Erik Simonsen
- Psychiatric Research Unit, Region Zealand, Toftebakken 9, 4000, Roskilde, Denmark
| |
Collapse
|
36
|
Szanto K, Dombrovski AY, Sahakian BJ, Mulsant BH, Houck PR, Reynolds CF, Clark L. Social emotion recognition, social functioning, and attempted suicide in late-life depression. Am J Geriatr Psychiatry 2012; 20:257-65. [PMID: 22354116 PMCID: PMC3286029 DOI: 10.1097/jgp.0b013e31820eea0c] [Citation(s) in RCA: 116] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES : Lack of feeling connected and poor social problem solving have been described in suicide attempters. However, cognitive substrates of this apparent social impairment in suicide attempters remain unknown. One possible deficit, the inability to recognize others' complex emotional states has been observed not only in disorders characterized by prominent social deficits (autism-spectrum disorders and frontotemporal dementia) but also in depression and normal aging. This study assessed the relationship between social emotion recognition, problem solving, social functioning, and attempted suicide in late-life depression. DESIGN, PARTICIPANTS, MEASUREMENTS : There were 90 participants: 24 older depressed suicide attempters, 38 nonsuicidal depressed elders, and 28 comparison subjects with no psychiatric history. We compared performance on the Reading the Mind in the Eyes test and measures of social networks, social support, social problem solving, and chronic interpersonal difficulties in these three groups. RESULTS : Suicide attempters committed significantly more errors in social emotion recognition and showed poorer global cognitive performance than elders with no psychiatric history. Attempters had restricted social networks: they were less likely to talk to their children, had fewer close friends, and did not engage in volunteer activities, compared to nonsuicidal depressed elders and those with no psychiatric history. They also reported a pattern of struggle against others and hostility in relationships, felt a lack of social support, perceived social problems as impossible to resolve, and displayed a careless/impulsive approach to problems. CONCLUSIONS : Suicide attempts in depressed elders were associated with poor social problem solving, constricted social networks, and disruptive interpersonal relationships. Impaired social emotion recognition in the suicide attempter group was related.
Collapse
Affiliation(s)
- Katalin Szanto
- Western Psychiatric Institute and Clinic, Department of Psychiatry, University of Pittsburgh School of Medicine, Pennsylvania 15213, USA.
| | | | | | | | | | | | | |
Collapse
|
37
|
Rauber R, Hefti S, In-Albon T, Schmid M. Wie psychisch belastet fühlen sich Jugendliche mit selbstverletzendem Verhalten? KINDHEIT UND ENTWICKLUNG 2012. [DOI: 10.1026/0942-5403/a000067] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
In den letzten Jahren wurden zahlreiche Prävalenzstudien zum selbstverletzenden Verhalten bei Heranwachsenden in unterschiedlichen Ländern veröffentlicht. Aus der Schweiz liegen jedoch keine belastbaren Zahlen vor. Kritisch ist bei der Vielzahl der Studien anzumerken, dass sich diese oft auf ein „einfaches“ Feststellen der Prävalenz beschränken und kaum Hinweise für eine effektive Frühintervention geben. Im Rahmen einer epidemiologischen Fragebogenuntersuchung im Kanton Basel-Stadt wurden 447 Schüler (M = 14.95 Jahre, SD = 0.74, 52 % männlich) untersucht. Neben der Erfassung der Form und Art der Selbstverletzung wurde auch die psychische Belastung der Schüler erfasst. Es sollte überprüft werden, wie viele Selbstverletzer sich im Screening für psychische Störungen (SPS-J) als psychisch belastet beschreiben. 61 (13.6 %) Jugendliche gaben an, sich bereits mindestens einmal selbstverletzt zu haben. 29 (6.4 %) haben sich im letzten Monat selbst verletzt, 4 davon häufiger als viermal. Die Ergebnisse bestätigten die hohen Prävalenzraten für selbstverletzendes Verhalten. Interessant ist, dass Selbstverletzer im Schnitt zwar wesentlich höhere Werte im SPS-J erzielten, sich aber bei weitem nicht alle als psychisch auffällig beschrieben (18 von 61 selbstverletzenden Jugendlichen erzielten unauffällige Werte). Für eine effektivere Identifikation sollten daher Fragen zum selbstverletzenden Verhalten in psychopathologische Screeningfragebögen integriert werden, um diese Symptomatik adäquat abbilden zu können. Die Ergebnisse und die hohen Prävalenzen legen nahe, dass verschiedene Subgruppen von Selbstverletzern existieren, die passgenaue Hilfen für ihre Symptomatik benötigen.
Collapse
Affiliation(s)
- Rachel Rauber
- Kinder- und Jugendpsychiatrische Klinik der UPK Basel
- Kinder- und Jugendpsychiatrische Dienste St. Gallen
| | | | - Tina In-Albon
- Fakultät für Psychologie der Universität Basel, Abteilung Klinische Psychologie und Psychotherapie
| | - Marc Schmid
- Kinder- und Jugendpsychiatrische Klinik der UPK Basel
| |
Collapse
|
38
|
Ubbiali A, Chiorri C, Donati D. The Italian version of the Inventory of Interpersonal Problems Personality Disorders Scales (IIP-47): psychometric properties and clinical usefulness as a screening measure. J Pers Disord 2011; 25:528-41. [PMID: 21838567 DOI: 10.1521/pedi.2011.25.4.528] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The Inventory of Interpersonal Problems-47 (IIP-47) is a brief and valid self-report measure for screening Personality Disorders (PDs). This study examined internal consistency, factor structure, criterion validity, temporal stability, and operating characteristics of the Italian version of the IIP-47 in two independent samples: PD subjects (n = 120) and nonclinical subjects (n = 475). Alpha coefficients ranged from .70 to .90. Multiple-Group Confirmatory Factor Analyses showed that the five-correlated-factor model reported in literature had the highest measurement invariance across the two groups. Criterion validity was supported by correlations among IIP-47 scale scores and scores on established measures of personality dimensions and pathology. Test-retest indices ranged from .71 to .95. PD subjects scored significantly higher than nonclinical subjects on all IIP-47 scales and cut-off scores for different levels of specificity and sensibility are reported. It is concluded that the psychometric properties of the original IIP-47 were preserved in its Italian version.
Collapse
|
39
|
Schöttke H, Lange J, Imholz M, Wiedl KH. Entwicklung eines Screening-Verfahrens zur Diagnostik von Persönlichkeitsstörungen: Das Persönlichkeitsstörungs-Screening – Kurzform (PSS-K). VERHALTENSTHERAPIE 2011. [DOI: 10.1159/000329747] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
40
|
de Reus RJM, van den Berg JF, Emmelkamp PMG. Personality Diagnostic Questionnaire 4+ is not Useful as a Screener in Clinical Practice. Clin Psychol Psychother 2011; 20:49-54. [DOI: 10.1002/cpp.766] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2010] [Revised: 05/20/2011] [Accepted: 05/23/2011] [Indexed: 11/08/2022]
|
41
|
Olssøn I, Sørebø Ø, Dahl AA. A cross-sectional testing of The Iowa Personality Disorder Screen in a psychiatric outpatient setting. BMC Psychiatry 2011; 11:105. [PMID: 21711506 PMCID: PMC3151206 DOI: 10.1186/1471-244x-11-105] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Accepted: 06/28/2011] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patients suspected of personality disorders (PDs) by general practitioners are frequently referred to psychiatric outpatient clinics (POCs). In that setting an effective screening instrument for PDs would be helpful due to resource constraints. This study evaluates the properties of The Iowa Personality Disorder Screen (IPDS) as a screening instrument for PDs at a POC. METHODS In a cross-sectional design 145 patients filled in the IPDS and were examined with the SCID-II interview as reference. Various case-findings properties were tested, interference of socio-demographic and other psychopathology were investigated by logistic regression and relationships of the IPDS and the concept of PDs were studied by a latent variable path analysis. RESULTS We found that socio-demographic and psychopathological factors hardly disturbed the IPDS as screening instrument. With a cut-off ≥4 the 11 items IPDS version had sensitivity 0.77 and specificity 0.71. A brief 5 items version showed sensitivity 0.82 and specificity 0.74 with cut-off ≥ 2. With exception for one item, the IPDS variables loaded adequately on their respective first order variables, and the five first order variables loaded in general adequately on their second order variable. CONCLUSION Our results support the IPDS as a useful screening instrument for PDs present or absent in the POC setting.
Collapse
Affiliation(s)
- Ingrid Olssøn
- Department of Psychiatry, Innlandet Hospital Trust, N-2318 Hamar, Norway.
| | - Øystein Sørebø
- Schools of Business and Social Sciences, Buskerud University College, N-3511 Hønefoss, Norway
| | - Alv A Dahl
- Department of Oncology, Oslo University Hospital and University of Oslo, N-0310 Oslo, Norway
| |
Collapse
|
42
|
Dahl AA, Dahl CF. Are there gender differences in impairment associated with high social anxiety? A community-based study. J Anxiety Disord 2010; 24:487-93. [PMID: 20378310 DOI: 10.1016/j.janxdis.2010.03.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2009] [Revised: 03/09/2010] [Accepted: 03/10/2010] [Indexed: 11/25/2022]
Abstract
This comparative, cross-sectional community-based study examines sex differences in associations between various types of impairment and high level of social phobia/anxiety symptoms (SPAS) in adults aged 30, 40, and 45 years and their controls. Men with high SPAS had higher rates of non-paired relationships, alcohol problems, low intake of fruit/vegetables, risk for future fatal cardiac events, but lower rate for low annual income than women. The pattern of differences in impairment variables cases and controls did not show sex differences. Stepwise multivariate logistic regression analysis showed that the socio-demographic and lifestyle impairment steps made significant contributions to the model which explained 41.6% of the variance. The individual variables significant at the last step were lower level of education, more smokers, less alcohol problems and lower risk of fatal cardiac events in women compared to men. In conclusion, few significant sex differences concerning impairment were observed in individuals with high SPAS.
Collapse
Affiliation(s)
- Alv A Dahl
- Department of Clinical Cancer Research, The Norwegian Radium Hospital, Oslo University Hospital, Montebello, N-310 Oslo, Norway.
| | | |
Collapse
|
43
|
Abstract
BACKGROUND Social networks may protect depressed elders against suicidal behavior. However, conflict in important relationships may undermine the sense of social support, potentially negating the protective effects. Thus, we investigated the role of chronic interpersonal difficulties and perceived social support in depressed elders with and without suicidal thoughts and attempts. METHODS 106 individuals aged 60 years and older participated in this cross-sectional, case-control study. They were placed in three groups: suicidal depressed, non-suicidal depressed and non-depressed. Following a detailed clinical characterization, we assessed perceived social support (Interpersonal Support Evaluation List), and chronic interpersonal difficulties (Inventory of Interpersonal Problems). Using general linear models, we explored the relationship between suicidal thoughts/attempts, social support, and chronic interpersonal difficulties. We also examined whether lower perceived social support explained the relationship between chronic interpersonal difficulties and suicidal thoughts/attempts. RESULTS Suicidal depressed elders reported the lowest levels of perceived social support (belonging, tangible support, and self-esteem) and higher levels of chronic interpersonal difficulties (struggle against others and interpersonal hostility), compared to both non-suicidal depressed and non-depressed elders. The relationship between chronic interpersonal difficulties and suicidal behavior was partially explained by low perceived social support. CONCLUSIONS The experience of strong affects, interpersonal struggle, and hostility in relationships may undermine the sense of social support in depressed elders, possibly leading them to contemplate or attempt suicide. Depressed elders with a history of interpersonal difficulties need to be carefully monitored for suicidal behavior.
Collapse
|
44
|
Falk Dahl CA, Dahl AA. Lifestyle and social network in individuals with high level of social phobia/anxiety symptoms: a community-based study. Soc Psychiatry Psychiatr Epidemiol 2010; 45:309-17. [PMID: 19468662 DOI: 10.1007/s00127-009-0069-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2008] [Accepted: 05/10/2009] [Indexed: 11/29/2022]
Abstract
AIM To study the lifestyle issues and social network in a community-based sample of individuals with a high level of social phobia/anxiety symptoms (SPAS) compared to controls, and to explore the factors that were most strongly associated with unhealthy lifestyle and a small social network. METHODS The MINI-SPIN test was administered in The Oslo Health Study (HUBRO), and the scores used to identify persons with a high level of SPAS. The SPAS group consisted of 446 individuals aged 30, 40 or 45 years defined by MINI-SPIN score > or =8. We randomly selected five controls for each case among those with a MINI-SPIN score of 0-7 (N = 2,230). Information was collected with questionnaires, physical measurements and blood samples. RESULTS The SPAS group showed significantly higher prevalence of unhealthy lifestyle than controls, which did not hold up in multivariate analyses. The SPAS group showed significantly more alcohol problems and higher future risk of coronary heart disease among females, but not in males. Low level of physical activity in general, and in spare time, was significantly associated with the SPAS group. Small social network was significantly more common in the SPAS group and that result held up in multivariate analysis. In that analysis not being in paired relationship and mental comorbidity were also significantly associated with a small social network. CONCLUSION Unhealthy lifestyle and a small social network places younger adults with SPAS under considerable risk for the development of future morbidity. This risk calls for counseling by general practitioners in such individuals.
Collapse
|
45
|
Germans S, Van Heck GL, Langbehn DR, Hodiamont PP. The Iowa Personality Disorder Screen. EUROPEAN JOURNAL OF PSYCHOLOGICAL ASSESSMENT 2010. [DOI: 10.1027/1015-5759/a000003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The internal consistency, test-retest reliability, and predictive validity of the Iowa Personality Disorder Screen (IPDS) as a screening instrument for personality disorders (PDs) were studied in 195 Dutch psychiatric outpatients, using the SCID-II as the gold standard. All patients completed a self-administered version of the IPDS. Internal consistency was moderate (0.64), and the test-retest reliability was good (0.87). According to the SCID-II, 97 patients (50%) had at least one personality disorder (PD). The IPDS correctly classified 81.0 percent of all participants in the category PD present/absent. The sensitivity and specificity were 77% and 88%, respectively. Positive and negative predictive values were 83% and 79%. Test-retest reliability after a 2-week interval was 0.87. These results are comparable with those reported in earlier studies with respect to the interview version of the IPDS and more promising than previously reported results obtained with a self-report version of the IPDS. Therefore, it is concluded that a self-report version of the IPDS may be useful as a screening measure for determining the presence/absence of PD in a population of psychiatric outpatients.
Collapse
Affiliation(s)
- Sara Germans
- Department of Psychiatry, Helse Nord-Trøndelag HF, Hospital Namsos, Norway
| | - Guus L. Van Heck
- Department of Medical Psychology, CoRPS – Centre of Research on Psychology in Somatic diseases, Tilburg University, The Netherlands
| | | | - Paul P.G. Hodiamont
- Department of Developmental, Clinical and Cross-Cultural Psychology, Tilburg University, The Netherlands
| |
Collapse
|
46
|
Barry DT, Beitel M, Garnet B, Joshi D, Rosenblum A, Schottenfeld RS. Relations among psychopathology, substance use, and physical pain experiences in methadone-maintained patients. J Clin Psychiatry 2009; 70:1213-8. [PMID: 19607760 PMCID: PMC2760669 DOI: 10.4088/jcp.08m04367] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2008] [Accepted: 10/31/2008] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Differences in psychiatric distress and substance use (licit and illicit) were examined in methadone maintenance treatment (MMT) patients with a variety of pain experiences. METHOD Parametric and nonparametric statistical tests were performed on data obtained from 150 patients currently enrolled in MMT. Assessments were carried out at the 3 opioid agonist treatment programs operated by the APT Foundation, New Haven, Connecticut. Participants were recruited between March 2007 and March 2008. RESULTS In comparison to MMT patients reporting no pain in the previous week, those with chronic severe pain (CSP) (ie, pain lasting at least 6 months with moderate to severe pain intensity or significant pain interference) exhibited significantly higher (P < .01) levels of depression, anxiety, somatization, overall psychiatric distress, and personality disorder criteria but reported comparable rates of substance use. A third group, ie, non-CSP MMT patients reporting some pain in the past week, differed significantly (P < .05) from the other 2 pain groups on somatization and global psychiatric distress but reported comparable rates of substance use. CONCLUSIONS Pain-related differences in psychiatric problems exist in MMT patients and may have implications for program planning and outreach efforts.
Collapse
Affiliation(s)
| | - Mark Beitel
- Yale University School of Medicine, New Haven, CT
| | | | | | - Andrew Rosenblum
- Institute for Treatment and Services Research, National Development and Research Institutes, Inc., New York, NY
| | | |
Collapse
|
47
|
Kamarck TW, Haskett RF, Muldoon M, Flory JD, Anderson B, Bies R, Pollock B, Manuck SB. Citalopram intervention for hostility: results of a randomized clinical trial. J Consult Clin Psychol 2009; 77:174-88. [PMID: 19170463 DOI: 10.1037/a0014394] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Hostility is associated with an increased risk for cardiovascular disease (CVD). Because central serotonin may modulate aggression, we might expect selective serotonin reuptake inhibitors (SSRIs) to be effective in reducing hostility. Such effects have never been examined in individuals scoring high on hostility who are otherwise free from major Axis I psychopathology according to criteria in the Diagnostic and Statistical Manual of Mental Disorders (4th ed., Text Revision; American Psychiatric Association, 2000). A total of 159 participants (ages 30?50 years, 50% female) scoring high on 2 measures of hostility and with no current major Axis I diagnosis were randomly assigned to 2 months of citalopram (40 mg, fixed-flexible dose) or placebo. Adherence was assessed by electronic measurement and by drug exposure assessment. Treated participants showed larger reductions in state anger (Condition x Time; p = .01), hostile affect (p = 02), and, among women only, physical and verbal aggression (p = .005) relative to placebo controls. Treatment was also associated with relative increases in perceived social support (p = .04). The findings have implications for understanding the central nervous system correlates of hostility, its associations with other psychosocial risk factors for CVD, and, potentially, the design of effective interventions.
Collapse
Affiliation(s)
- Thomas W Kamarck
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA.
| | | | | | | | | | | | | | | |
Collapse
|
48
|
Personality problems are considerably associated with somatic morbidity and health care utilisation. Eur Psychiatry 2009; 24:442-9. [PMID: 19540726 DOI: 10.1016/j.eurpsy.2009.05.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2009] [Revised: 04/27/2009] [Accepted: 05/08/2009] [Indexed: 01/23/2023] Open
Abstract
PURPOSE To explore the associations between the presence of personality problems and somatic morbidity and health care utilisation. METHODS The Iowa Personality Disorder Screen was administered in order to identify persons with personality problems in a Norwegian population survey (the Oslo Health Study - HUBRO). Cases consisted of 369 individuals, 30, 40 and 45 years of age with personality problems matched on age and gender with five controls each. Data on somatic morbidity and health care utilisation were collected by questionnaires. RESULTS The cases more frequently reported persistent muscular pain, asthma, fibromyalgia and alcohol problems than the controls. They also more often used nonprescribed analgesics and antidepressants. The cases more frequently had consulted a general practitioner (GP) in the last 12 months, less frequently got referral to somatic specialist care and were less satisfied with their last visit to a GP. CONCLUSION In this population based study, personality problems in young adults based on DSM-IV personality disorder criteria were associated with increased occurrence of somatic morbidity and primary health care utilisation. The relevance for GP to take personality problems into account during consultations is underlined and a method for doing so is suggested.
Collapse
|
49
|
Psychometric characteristic of the Italian version of the Temperament and Character Inventory--revised, personality, psychopathology, and attachment styles. Compr Psychiatry 2008; 49:514-22. [PMID: 18702939 DOI: 10.1016/j.comppsych.2007.11.002] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2007] [Revised: 11/21/2007] [Accepted: 11/28/2007] [Indexed: 11/21/2022] Open
Abstract
In this article, we described the psychometric characteristics of the revised version of the Cloninger's personality Temperament and Character Inventory (TCI-R), Italian translation. Two independent samples, which were composed of 355 and 385 nonclinical mother-language Italian subjects, respectively, completed the TCI-R. A further sample of psychiatric outpatients was compared with community samples. We analyzed the internal consistency of each dimension, the test-retest reliability and the factorial structure of the questionnaire. Furthermore, we explored the potential association between personality, psychopathologic indicators (evaluated by the Symptom Checklist-90), behavior dyscontrol measures, and adaptive and maladaptive interpersonal styles. As a whole, the internal consistency of the TCI-R scales was adequate, although some differences in Cronbach alpha values were observed between the 2 samples in some TCI-R subfacets. The factorial structure was consistent with the original hypothesis of Cloninger and test-retest showed a good stability of the scores over the time. Normal data for the Italian population were also calculated. Furthermore, the character dimensions of self-directedness and cooperativeness were related with some psychopathologic domains in our sample and negatively with impulsiveness, anger, and hostility. Novelty seeking was associated with impulsiveness, whereas harm avoidance was associated with anger and hostility. On the contrary, persistence and reward dependence were inversely correlated with such traits. Harm avoidance, reward dependence, self-directedness, and cooperativeness were strongly related with measures of attachment. Finally, significant differences were observed in both temperament and character traits between community subjects and psychiatric outpatients. In the present study, the validity of the Italian translation of the TCI-R is therefore supported. Personality features are also confirmed as risk factors for specific psychopathologic domains, impulsivity, anger, and hostility. Furthermore, we found attachment styles of nonclinical subjects correlated with personality features.
Collapse
|
50
|
Abstract
PURPOSE OF REVIEW Borderline personality disorder is the most widely researched single personality disorder, and much research activity continues. This review covers empirical literature on diagnosis, classification and treatment of borderline personality disorder published during 2006 and 2007. Several of the issues that concern borderline personality disorder also concern personality disorders in general, and so the review is broadened in the diagnostic section to include the latter. RECENT FINDINGS Integration of categorical and dimensional approaches to personality disorders is actively being sought for inclusion in the next revision of the psychiatric classifications. Although there are few new studies on pharmacotherapy for borderline personality disorder, many new findings on psychotherapy have been reported. They indicate that a variety of treatment modalities can influence borderline personality disorder, but the role of spontaneous improvement over time and established prognostic factors have not received sufficient attention. New modalities of psychotherapy have been tested by less stringent designs. SUMMARY Research into classification, diagnosis and psychotherapy of borderline personality disorder is flourishing, but research activity in pharmacotherapy is limited.
Collapse
|