Adult ADHD and emerging models of maladaptive personality: a meta-analytic review

BACKGROUND

ADHD is a highly consequential disorder that is estimated to affect 2.5% of the adult population. Emerging models of psychopathology posit that disorders like ADHD can be usefully situated within general models of individual differences in personality, such as those recently implemented in the DSM and ICD for the diagnosis of personality disorder. Previous research and systematic reviews have linked adult ADHD to the personality traits Conscientious Inhibition and Negative Emotionality. However, there have been some inconsistencies in the literature and research embedding ADHD-personality connections in the DSM-5 and ICD-11 personality disorder models has been limited. The goal of this paper was to systematically review associations between adult ADHD and personality traits, organized within a maladaptive five factor framework.

METHOD

A comprehensive literature search yielded 13 papers whose effects were meta-analyzed.

RESULTS

Results supported associations between ADHD and low Conscientious Inhibition and high Negative Emotionality. However, interesting patterns of variability were observed, potentially related to issues such as instrumentation and facet variation.

CONCLUSION

Results support the clinical application of personality assessment for suggesting risk for ADHD symptoms, and point to important directions for further research.

Borderline personality disorder diagnosis in a new key

BACKGROUND

Conceptualizations of personality disorders (PD) are increasingly moving towards dimensional approaches. The definition and assessment of borderline personality disorder (BPD) in regard to changes in nosology are of great importance to theory and practice as well as consumers. We studied empirical connections between the traditional DSM-5 diagnostic criteria for BPD and Criteria A and B of the Alternative Model for Personality Disorders (AMPD).

METHOD

Raters of varied professional backgrounds possessing substantial knowledge of PDs (N = 20) characterized BPD criteria with the four domains of the Level of Personality Functioning Scale (LPFS) and 25 pathological personality trait facets. Mean AMPD values of each BPD criterion were used to support a nosological cross-walk of the individual BPD criteria and study various combinations of BPD criteria in their AMPD translation. The grand mean AMPD profile generated from the experts was compared to published BPD prototypes that used AMPD trait ratings and the DSM-5-III hybrid categorical-dimensional algorithm for BPD. Divergent comparisons with DSM-5-III algorithms for other PDs and other published PD prototypes were also examined.

RESULTS

Inter-rater reliability analyses showed generally robust agreement. The AMPD profile for BPD criteria rated by individual BPD criteria was not isomorphic with whole-person ratings of BPD, although they were highly correlated. Various AMPD profiles for BPD were generated from theoretically relevant but differing configurations of BPD criteria. These AMPD profiles were highly correlated and showed meaningful divergence from non-BPD DSM-5-III algorithms and other PD prototypes.

CONCLUSIONS

Results show that traditional DSM BPD diagnosis reflects a common core of PD severity, largely composed of LPFS and the pathological traits of anxiousness, depressively, emotional lability, and impulsivity. Results confirm the traditional DSM criterion-based BPD diagnosis can be reliably cross-walked with the full AMPD scheme, and both approaches share substantial construct overlap. This relative equivalence suggests the vast clinical and research literatures associated with BPD may be brought forward with DSM-5-III diagnosis of BPD.

New class of dynamics in concentrated polymer gels

We show that concentrated poly(methyl methacrylate) solution exhibits a new class of coupled dynamics, which can be regarded as an intermediate between the collective diffusion of solutions and the structural relaxations of glasses. This class of dynamics have a relaxation rate that is directly proportional to the wave vector. The transition from diffusive to coupled collective dynamics occurs at smaller length scales with increasing polymer concentration and decreasing temperature. The experimental observations can be understood by considering the contributions from physical cross-links interconnected by stiff polymer segments.

Influence of chain length on the alpha-beta bifurcation in oligomeric glass formers

A series of oligo(propylene glycol) dimethyl ethers has been investigated using dielectric spectroscopy in order to relate features of the glass transition dynamics to the number of monomer units N in the chain. The results show that (i) when scaled with the glass transition temperature, the beta relaxations systematically become faster for larger N whereas the alpha relaxations display nearly identical temperature evolutions, i.e., the alpha-beta bifurcation shifts towards shorter times for larger N, (ii) the bifurcation scenario displays a crossover in behavior at N approximately 10 monomer units, signaling the transition from oligomeric to polymeric behavior, and (iii) the beta relaxation has a cooperative nature.

Power laws in polymer solution dynamics

The dynamical screening length xi(h) in semidilute to highly concentrated polymer solutions of poly(methyl methacrylate) in propylene carbonate has been examined using photon correlation spectroscopy and pulsed field gradient nuclear magnetic resonance. A crossover between different concentration dependent regimes, xi(h) approximately phi(-alpha), where alpha is found to be approximately 0.5, approximately 1, and approximately 2, is observed when the local viscosity is taken into account. Here phi is the volume fraction of polymer in the solution. Well-defined crossovers between alpha=0.5 and alpha=1 corresponding to a transition from a marginal solvent to a theta solvent behavior have been predicted to occur due to the reduction of excluded-volume effects between the spatially correlated polymer segments with increasing polymer volume fraction. However, a clear experimental validation of the crossover has never been presented before. The third regime (alpha approximately 2) is observed in the highly concentrated region where the static screening length is comparable to the persistence length of the polymer. The observation indicates that the rigid rod model previously used to describe concentrated solutions is an oversimplification valid only in the very high concentration limit. The obtained results at high concentrations are discussed in the frame of a simple physical model where segments at the persistence length scale are treated as flexible rodlike segments.

Chain-length-dependent relaxation scenarios in an oligomeric glass-forming system: from merged to well-separated alpha and beta loss peaks

We have studied the relaxation dynamics of a homologous series of propylene glycol based dimethyl ethers in the supercooled regime by means of broadband dielectric spectroscopy. The system is chosen in order to minimize changes of the intermolecular interactions with varying molecular weight, M. A gradual transformation from a scenario of well-separated to one of merged alpha and beta loss peaks was observed with decreasing M. The results give strong evidence for the currently debated excess wing being due to an underlying beta relaxation. The study suggests that the main difference between glass formers with and without excess wings is the relaxation time at the merging temperature.

Is profound peripheral insulin resistance in patients with pancreatic cancer caused by a tumor-associated factor?

Diabetes in patients with pancreatic cancer occurs in 70% to 80% of the patients and is characterized by high plasma levels of insulin. In type II diabetes that is not associated with pancreatic cancer, peripheral insulin resistance and impaired muscle glycogen synthesis are major pathogenic factors. We investigated peripheral insulin sensitivity in patients with pancreatic cancer before and after tumor removal. The effects of pancreatic tumor extracts on glycogen synthesis in skeletal muscle in vitro and the tumor content of pancreatic islet hormones were also investigated. Marked peripheral insulin resistance was found in the patients with pancreatic cancer and was more pronounced in the diabetic patients than in the nondiabetic patients. Insulin sensitivity was not correlated with weight loss, tumor size, or bilirubin levels but improved after surgery. Tumor extracts from diabetic patients with pancreatic cancer caused a marked reduction of glycogen synthesis in skeletal muscle in vitro. All tumors contained islet hormones but not in concentrations sufficient to explain the effect on glycogen synthesis. These findings indicate that a diabetogenic factor associated with pancreatic adenocarcinomas could be involved in the development of the profound peripheral insulin resistance and thereby could contribute to the high incidence of diabetes observed in patients with pancreatic cancer.