Homeless people: a review of personality disorders

Personality disorders in homeless people pose a challenge to the medical community and society, requiring specialized approaches for these super-difficult patients. The prevalence of personality disorders is higher in homeless populations than in the general population. However, there is a knowledge gap regarding personality disorders among people experiencing homelessness, and the implications of this lack of recognition are substantial. This paper provides a brief narrative review of personality disorders among homeless individuals. The primary importance and specificity of these disorders in this population remain unexplored. We searched PubMed and Web of Science databases in February and November 2023 using the keywords ‘homeless’ and ‘personality disorder’, and selected fifty-eight studies to be included in this literature review. The main themes of the results were personality disorders in homeless individuals and comorbid psychiatric disorders; risk factors and other psychological and behavioral data; clinical and intervention outcomes; and challenges linked to assessment, treatment, and intervention. The homeless population experiences significant diagnostic variability and the diagnosis of personality disorders is still evolving, contributing to difficulties in diagnosis, assessment, and treatment. A future challenge is to raise clinical awareness and optimize research knowledge, assessment, and intervention in personality disorders among homeless individuals with comorbid psychiatric disorders

A esquizofrenia e a demência no Teste de Apercepção Temática: Uma análise da angústia e da relação de objeto

Within the scope of Psychoanalytic Psychology, this study empirically draws on aspects of the classical discussion between the schizophrenia and the former denomination, dementia praecox. The aim of this research study is to explore a possible association between a specific psychic personality structure and the diagnoses of schizophrenia and dementia, in terms of angst and object relation patterns. The sample consisted of 58 female participants, 30 participants diagnosed with schizophrenia (M = 68.83 years of age, SD = 8.13) and 28 participants diagnosed with dementia (M = 83.36 years of age, SD = 7.51). The instruments used for psychological assessment were the projective test TAT (Murray, 1973; Shentoub, 1999) and the Manual for the Measurement of Symbiosis in Human Relationship (Summers, 1978). The fragmentation angst and the fusional object relation are associated with schizophrenia and, in turn, the abandonment angst and the anaclitic object relation with dementia. It was assumed that specific psychic personality structures were associated with the different diagnoses. In a continuum, the psychotic structure is connected with schizophrenia and, the borderline structure with dementia. The discussion highlights significant issues of this study. Some suggestions for further research have been proposed.Key words: dementia, schizophrenia, psychoanalytic psychology.Este estudo recupera empiricamente, por meio das lentes da psicologia psicanalítica, a discussão clássica entre a esquizofrenia e a antiga definição dementia praecox. O objeto de exploração é o da análise da possível associação entre uma estrutura de personalidade específica e os diagnósticos de esquizofrenia e demência, em termos da caracterização da angústia e da relação objetal. Amostra do estudo constituída por 58 participantes do sexo feminino, tendo 30 o diagnóstico de esquizofrenia (M = 68.83 anos de idade, DP = 8.13) e 28, o diagnóstico de demência (M = 83.36 anos de idade, DP = 7.51). Os instrumentos de avaliação psicológica utilizados são a prova projetiva TAT (Murray, 1973; Shentoub, 1999) e o Manual for the Measurement of Symbiosis in Human Relationship (Summers, 1978). A angústia de fragmentação e a relação de objeto fusional apresentam-se relacionadas com a esquizofrenia e, por seu turno, a angústia de abandono e a relação de objeto anaclítica, com a demência. Estruturas psíquicas de personalidade específicas parecem estar associadas com os diferentes diagnósticos. Num continuum, a estrutura psicótica surge associada à esquizofrenia, e a estrutura borderline, à demência. Discutem-se aspectos suscitados pelo estudo e propõem-se sugestões para futuras investigações.Palavras-chave: demência, esquizofrenia, psicologia psicanalítica

Alterações da personalidade na demência: Uma revisão

The present review aimed to analyze empirical studies that have investigated the personality changes in dementia, based on the Five Factor Model of Personality. We systematically reviewed empirical articles indexed in the following databases EBSCO/Web of Knowledge/Medline/Pubmed/SciELO/Scopus. Fifty-seven articles were included. The personality changes are evident in the early stages of dementia and could be an early clinical marker. A data appears to be generally transverse and unanimous, there is evidence of an increase in personality trait Neuroticism and a decrease in personality trait Consciousness. It is suggested the need for systematic investigations, in order to increase the sensitivity of early diagnosis and practical utility in terms of current clinical diagnosis in Alzheimer’s dementia, with the introduction of personality evaluation.Objetivou-se analisar estudos empíricos sobre as alterações da personalidade na Demência, através da avaliação dos traços baseada no Modelo dos Cinco Fatores da Personalidade. Procedeu-se a revisão da literatura indexada nas bases de dados EBSCO/Web of Knowledge/Medline/Pubmed/SciELO/Scopus. Foram incluídas 57 referências. As alterações da personalidade são evidentes nas fases iniciais da Demência e podem ser um marcador clínico precoce. Um dado parece ser transversal e geralmente unânime na literatura, evidencia-se um aumento na dimensão Neuroticismo e um decréscimo na dimensão Conscienciosidade. Sugere-se a necessidade de exploração sistemática, para que seja introduzida uma avaliação da personalidade, no diagnóstico de Demência de Alzheimer, de forma a aumentar a sensibilidade do diagnóstico precoce e com utilidade prática ao nível do diagnóstico clínico

Explorando a psicogénese da demência na sua relação com a esquizofrenia: Proposta psicodinâmica dum continuum estrutural

A possível existência de um continuum entre uma estrutura psíquica de personalidade específica e os diagnósticos de esquizofrenia e demência é o objecto de exploração desta investigação. A amostra do estudo é constituída por 58 participantes do sexo feminino, tendo 30 participantes o diagnóstico de esquizofrenia (M=68.83 anos, DP=8.13) e 28 participantes o diagnóstico de demência (M=83.36 anos, DP=7.51). Os instrumentos de avaliação psicológica utilizados são a prova projectiva TAT (Murray, 1973; Shentoub, 1999), o Manual for the Measurement of Symbiosis in Human Relationship (Summers, 1978) e escalas do Ego Function Assessment (Bellak, 1989). A angústia de fragmentação e a relação de objecto fusional apresentam-se relacionadas com a esquizofrenia e, por seu turno, a angústia de abandono e a relação de objecto anaclítica com a demência. Diferentes estruturas de personalidade parecem estar relacionadas com os diferentes diagnósticos, sendo que a estrutura psicótica surge associada à esquizofrenia e a estrutura borderline à demência. Discutem-se aspectos suscitados pelo estudo e propõem-se sugestões para futuras investigações.The aim of this research is to explore the possible association and continuum between a specific psychic structure of personality and the diagnoses of schizophrenia and dementia. The sample consisted of 58 female participants, 30 participants diagnosed with schizophrenia (M=68.83 years of age, SD=8.13) and 28 participants diagnosed with dementia (M=83.36 years of age, SD=7.51). The projective test TAT (Murray, 1973; Shentoub, 1999), the Manual for the Measurement of Symbiosis in Human Relationship (Summers, 1978) and the scales of the Ego Function Assessment (Bellak, 1989) were used for the psychological assessment. The fragmentation anguish and the fusional object relation were associated with schizophrenia and the abandonic anguish and the anaclitic object relation were associated with dementia. It was assumed that specific psychic structures of personality were associated with the different diagnoses, the psychotic structure connected with schizophrenia and the borderline structure with dementia. The discussion points out significant issues of this study. Some suggestions for further research are proposed.info:eu-repo/semantics/publishedVersio

Explorando a psicogénese da demência na sua relação com a esquizofrenia: Proposta psicodinâmica dum continuum estrutural

A possível existência de um continuum entre uma estrutura psíquica de personalidade específica e os diagnósticos de esquizofrenia e demência é o objecto de exploração desta investigação.A amostra do estudo é constituída por 58 participantes do sexo feminino, tendo 30 participantes o diagnóstico de esquizofrenia (M=68.83 anos, DP=8.13) e 28 participantes o diagnóstico de demência (M=83.36 anos, DP=7.51). Os instrumentos de avaliação psicológica utilizados são a prova projectiva TAT (Murray, 1973; Shentoub, 1999), o Manual for the Measurement of Symbiosis in Human Relationship (Summers, 1978) e escalas do Ego Function Assessment (Bellak, 1989).A angústia de fragmentação e a relação de objecto fusional apresentam-se relacionadas com a esquizofrenia e, por seu turno, a angústia de abandono e a relação de objecto anaclítica com a demência. Diferentes estruturas de personalidade parecem estar relacionadas com os diferentes diagnósticos, sendo que a estrutura psicótica surge associada à esquizofrenia e a estrutura borderline à demência. Discutem-se aspectos suscitados pelo estudo e propõem-se sugestões para futuras investigações

Predicting relatedness and self-definition depressive experiences in aging women based on personality traits: A preliminary study

As part of the research relating personality and depression, this study seeks to predict depressive experiences in aging women according to Sidney Blatt’s perspective based on the Five-Factor Model of Personality. The NEO-Five Factor Inventory and the Depressive Experiences Questionnaire were administered. The domains Neuroticism, Agreeableness, and Conscientiousness predicted self-criticism, explaining 68% of the variance; the domains Neuroticism and Extraversion predicted dependency, explaining 62% of the variance. The subfactors Neediness and Connectedness were differently related to personality traits. These findings are relevant to the research relating personality and anaclitic / introjective depressive experiences in late adulthood

PERTURBAÇÕES DA PERSONALIDADE COMO EXPRESSÃO DIMENSIONAL DA PERSONALIDADE EM MULHERES IDOSAS

Esta investigação visa compreender e enquadrar as perturbações do eixo II (DSM-IV), à luz de uma polaridade dimensional no desenvolvimento da personalidade - o relacionamento (dependência) versus a auto-definição (auto-criticismo) - proposta por Sidney Blatt (1990, 2008), em mulheres na idade adulta avançada, autónomas e inseridas na comunidade. Participaram 102 mulheres (M = 72,07 anos de idade, DP = 7,04). Os instrumentos de avaliação utilizados foram a versão Portuguesa (Henriques-Calado & Duarte-Silva, 2009) do Personality Diagnostic Questionnaire (PDQ-4+; Hyler, 1994), e a versão Portuguesa (Campos, 2000, 2009) do Questionário de Experiências Depressivas (Blatt, D’Afflitti, & Quinlan, 1976, 1979). As escalas de perturbação da personalidade histriónica (β = 0,34), dependente (β = 0,26), e obsessivo-compulsiva (β = 0,39) associam-se significativamente com o relacionamento (escala de dependência do QED), explicando 50% da variância, e as escalas de perturbação da personalidade narcísica (β = 0,34), borderline (β = 0,25), e evitante (β = 0,29) associam-se significativamente com a dimensão da auto-definição (escala de auto-criticismo do QED), explicando 63% da variância. Os resultados são consistentes e estão de acordo com as conceptualizações teóricas que na atualidade alargam o campo da psicopatologia, valorizando uma abordagem de cariz interpessoal e dimensional da personalidade

Cross-cultural Study of the Personality Inventory for the DSM-5 (PID-5) across the Portuguese and the United Arab Emirates (UAE) Community and Clinical Populations

Aims: The present paper focused on compare the PID-5 mean score levels across two matched community and clinical samples of Portugal and the UAE. Background: The generalizability and universality of the Alternative Model of Personality Disorders has been thoroughly studied through the Personality Inventory for DSM-5 (PID-5) across countries and languages. However, studies comparing Western and Middle Eastern countries are still limited, in particular those who assess the PID-5 measurement invariance. Objectives: We examined measurement invariance of the PID-5 scales across matched Emirati and Portuguese clinical and nonclinical groups, as well as compare and contrast the PID-5 mean score levels across both countries and samples. Methods: The Arabic and the Portuguese versions of the PID-5 was administered to Emirati community participants (N = 300, 80% women and 20% men, Mage = 27.95) which were matched with Portuguese community participants (N = 300, 80.3% women and 19.7% men, Mage = 28.96), as well as clinical participants of the UAE (N = 150, 61.3% women and 38.7% men, Mage = 31.29) and Portugal (N = 150, 52% men and 48% women, Mage = 44.97). We examined measurement invariance through an unrestricted Factor Analysis based program, and mean scores levels were compared and analyzed. Results: Our findings supported the PID-5 measurement invariance across the Emirati and Portuguese clinical samples pointing to the universality and generalizability of the Alternative Model of Personality Disorders. The Emirati psychiatric sample exhibited somehow higher results than the Portuguese psychiatric participants, albeit the small effect size for most of the PID-5 scales. Conclusion: Further research is needed to examine the applicability of the PID-5 across non-clinical representative samples of Portugal and the UAE, and other Middle Eastern countries

The utility of ICD-11 and DSM-5 traits for differentiating patients with personality disorders from other clinical groups

Copyright © 2021 Pires, Henriques-Calado, Sousa Ferreira, Bach, Paulino, Gama Marques, Ribeiro Moreira, Grácio and Gonçalves. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.The ICD-11 Classification of Personality Disorders delineates five trait domain qualifiers (i.e., negative affectivity, detachment, dissociality, disinhibition, and anankastia), whereas the DSM-5 Alternative Model of Personality Disorders also delineates a separate domain of psychoticism. These six combined traits not only characterize individual stylistic features, but also the severity of their maladaptive expressions. It was, therefore, the aim of this study to investigate the utility of ICD-11 and DSM-5 trait domains to differentiate patients with personality disorders (PD) from patients with other mental disorders (non-PD). The Personality Inventory for DSM-5 Brief Form Plus (PID5BF+M) was administered to a sample of patients diagnosed with a personality disorder (N = 124, M age = 42.21, 42.7% females) along with a sample of patients diagnosed with other mental disorders (N = 335, M age = 44.83, 46.6% females). Group differences were explored using the independent sample t test or the Mann-Whitney U test for independent samples, and discriminant factor analysis was used to maximize group differences for each trait domain and facet score. The PD group showed significantly higher scores for the total PID5BF+M composite score, for the trait domains of negative affectivity, antagonism/dissociality, and disinhibition and for the trait facets of emotional lability, manipulativeness, deceitfulness, and impulsivity. The trait domains of disinhibition, negative affectivity, and antagonism/dissociality as well as the trait facets of impulsivity, deceitfulness, emotional lability, and manipulativeness were the best discriminators between PD and non-PD patients. The global PID5BF+M composite score was also one of the best discriminators supporting its potential as a global severity index for detecting personality dysfunction. Finally, high scores in three or more of the 18 PID5BF+M facets suggested the possible presence of a PD diagnosis. Despite some limitations, our findings suggest that the ICD-11 and DSM-5 traits have the potential to specifically describe the stylistic features that characterize individuals with PD, including the severity of their maladaptive expressions.This research was financially supported by the Fundação para a Ciência e a Tecnologia [Foundation for Science and Technology] through the Research Center for Psychological Science, CICPSI (UIDP/04527/2020) and the Business Research Unit, BRU-IUL (UIDB/00315/2020).info:eu-repo/semantics/publishedVersio