Personality traits and disorders in childhood. Clinical evaluation and diagnosis

Objective: aim of the paper is to examine the controversial issue of personality traits and disorders in childhood. Method: a literature review of clinical and research data was performed, and a conceptual synthesis was proposed. Results: although there are still few longitudinal studies able to clarify the evolution of personality traits from childhood to adulthood, a growing number of studies confirmed emerging personality patterns in childhood and the need for early intervention and prevention. after a discussion of clinical and research data on continuity vs discontinuity in personality disorders, we propose a conceptual synthesis of emerging personality patterns in childhood, conjugating both top-down (theoretical) and bottom-up (research) perspectives. Conclusions: the literature review showed that a deeper understanding of personality and mental functioning in childhood is still required and that emerging personality patterns and disorders need specific assessment and empirical derived classication that takes into account the developmental perspectiv

Identity development in adolescents with mental problems

Background: In the revision of the Diagnostic and Statistical Manual (DSM-5), "Identity" is an essential diagnostic criterion for personality disorders (self-related personality functioning) in the alternative approach to the diagnosis of personality disorders in Section III of DSM-5. Integrating a broad range of established identity concepts, AIDA (Assessment of Identity Development in Adolescence) is a new questionnaire to assess pathology-related identity development in healthy and disturbed adolescents aged 12 to 18 years. Aim of the present study is to investigate differences in identity development between adolescents with different psychiatric diagnoses. Methods: Participants were 86 adolescent psychiatric in- and outpatients aged 12 to 18 years. The test set includes the questionnaire AIDA and two semi-structured psychiatric interviews (SCID-II, K-DIPS). The patients were assigned to three diagnostic groups (personality disorders, internalizing disorders, externalizing disorders). Differences were analyzed by multivariate analysis of variance MANOVA. Results: In line with our hypotheses, patients with personality disorders showed the highest scores in all AIDA scales with T>70. Patients with externalizing disorders showed scores in an average range compared to population norms, while patients with internalizing disorders lay in between with scores around T=60. The AIDA total score was highly significant between the groups with a remarkable effect size of f= 0.44. Conclusion: Impairment of identity development differs between adolescent patients with different forms of mental disorders. The AIDA questionnaire is able to discriminate between these groups. This may help to improve assessment and treatment of adolescents with severe psychiatric problems

Practitioner review: Borderline personality disorder in adolescence: Recent conceptualization, intervention, and implications for clinical practice

The past decade has seen an unprecedented increase in research activity on personality disorders in adolescents. The increase in research activity, in addition to major nosological systems legitimizing the diagnosis of borderline personality disorder (BPD) in adolescents, highlights the need to communicate new research on adolescent personality problems to practitioners. In this review, we provide up-to-date information on the phenomenology, prevalence, associated clinical problems, etiology, and intervention for BPD in adolescents. Our aim is to provide a clinically useful practitioner review and to dispel long-held myths about the validity, diagnostic utility, and treatability of personality disorders in adolescents

Is Criminal Sentencing Influenced by Type of Disorder?

Differences in sentencing due to disorder and gender were examined. Four scenarios were randomly presented for each disorder type. Participants indicated the sentence length for each scenario and whether they would parole the individual. Men with personality disorders received longer sentences while women with psychotic or neurological disorders received longer sentences. Perpetrators with personality disorders were less likely to be paroled than those with a psychotic or neurological disorder. Parole decisions about psychotic women were made faster than any other condition

Antecedents of personality disorder in childhood and adolescence: toward an integrative developmental model

Antecedents of personality disorder in childhood and adolescence have been a neglected area in official taxonomies of mental disorders such as the International Classification of Diseases or the different editions of the Diagnostic and Statistical Manual of Mental Disorders. An evolving research field, however, underscores the importance of antecedents for understanding psychopathology and personality pathology in adulthood. The current article summarizes the history, updates reviews, and incorporates new research findings into an integrative scheme for conceptualizing personality pathology in childhood and adolescence. Implications of this model for assessment, future research, and intervention are discussed

Genome-wide analyses for personality traits identify six genomic loci and show correlations with psychiatric disorders

Personality is influenced by genetic and environmental factors1 and associated with mental health. However, the underlying genetic determinants are largely unknown. We identified six genetic loci, including five novel loci2,3, significantly associated with personality traits in a meta-analysis of genome-wide association studies (N = 123,132–260,861). Of these genomewide significant loci, extraversion was associated with variants in WSCD2 and near PCDH15, and neuroticism with variants on chromosome 8p23.1 and in L3MBTL2. We performed a principal component analysis to extract major dimensions underlying genetic variations among five personality traits and six psychiatric disorders (N = 5,422–18,759). The first genetic dimension separated personality traits and psychiatric disorders, except that neuroticism and openness to experience were clustered with the disorders. High genetic correlations were found between extraversion and attention-deficit– hyperactivity disorder (ADHD) and between openness and schizophrenia and bipolar disorder. The second genetic dimension was closely aligned with extraversion–introversion and grouped neuroticism with internalizing psychopathology (e.g., depression or anxiety)

To what extent does severity of loneliness vary among different mental health diagnostic groups: A cross-sectional study.

Loneliness is a common and debilitating problem in individuals with mental health disorders. However, our knowledge on severity of loneliness in different mental health diagnostic groups and factors associated with loneliness is poor, thus limiting the ability to target and improve loneliness interventions. The current study investigated the association between diagnoses and loneliness and explored whether psychological and social factors were related to loneliness. This study employed a cross-sectional design using data from a completed study which developed a measure of social inclusion. It included 192 participants from secondary, specialist mental health services with a primary diagnosis of psychotic disorders (n = 106), common mental disorders (n = 49), or personality disorders (n = 37). The study explored differences in loneliness between these broad diagnostic groups, and the relationship to loneliness of: affective symptoms, social isolation, perceived discrimination, and internalized stigma. The study adhered to the STROBE checklist for observational research. People with common mental disorders (MD = 3.94, CI = 2.15 to 5.72, P < 0.001) and people with personality disorders (MD = 4.96, CI = 2.88 to 7.05, P < 0.001) reported higher levels of loneliness compared to people with psychosis. These differences remained significant after adjustment for all psychological and social variables. Perceived discrimination and internalized stigma were also independently associated with loneliness and substantially contributed to a final explanatory model. The severity of loneliness varies between different mental health diagnostic groups. Both people with common mental disorders and personality disorders reported higher levels of loneliness than people with psychosis. Addressing perceived mental health discrimination and stigma may help to reduce loneliness

Learning Disabilities and Serious Crime – Sex Offences

This review paper follows on from two previous reviews of the literature with regard to, firstly, learning disability and murder and, secondly, learning disability and arson. This paper, in turn, examines the relationship, if any, between learning disability and sexual offence. The approach taken in all these papers involves the concept of Disruptive Behaviour Disorder as being the group of behaviour and personality disorders most involved in the aetiology of these criminal and anti-social behaviours. Disruptive behaviour disorders (Read 2007) comprise: Oppositional Defiant Disorder Conduct Disorder Anti-social Personality Disorder Intermittent Explosive Disorder (DSM IVR 2001) The common characteristics of these disorders comprise aggression, irritability, over-activity, high arousal, and repetitive behaviour

Economic Evaluation of Psychotherapy for Personality Disorders: burden of disease, cost-effectiveness, and the value of further research and active implementation

Personality disorders are among the most common mental disorders in the general population1,2 and mental healthcare settings3,4 with reported prevalence rates of 13.4 and 45.5 percent, respectively. Personality traits are pervasive and enduring patterns of the ways individuals perceive, relate to, think about, and behave within their environment. When these traits become inflexible and maladaptive they constitute personality disorders. The general diagnostic criteria for personality disorders according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth edition, Text Revision (DSM-IV-TR) of the American Psychiatric Association5 are presented in Table 1.1. Personality disorders can be categorized into three clusters. Cluster A contains the odd or eccentric disorders, including paranoid, schizoid, and schizotypal personality disorder; cluster B covers the dramatic, emotional or erratic disorders, including borderline, antisocial, histrionic, and narcissistic personality disorder; and cluster C consists of the anxious or fearful disorders, including avoidant, dependent, and obsessive-compulsive personality disorder

Medication overuse headache, addiction and personality pathology: a controlled study by SWAP-200

Background: Medication Overuse Headache (MOH) is a type of chronic headache, whose mechanisms are still unknown. Some empirical investigations examining the addiction-like behaviors and processes, as well as personality characteristics underlying MOH development, reached contrasting findings. This study aimed at detecting personality and its disorders (PDs) in MOH patients, with a specific attention to the features of addiction. Methods: Eighty-eight MOH patients have been compared with two clinical populations including 99 patients with Substance Use Disorder (SUD) and 91 with PDs using the Shedler-Westen Assessment Procedure-200 (SWAP-200). MANCOVAs were performed to evaluate personality differences among MOH, SUD and PD groups, controlling for age and gender. Results: MOH patients showed lower traits of the SWAP-200’s clusters A and B disorders than SUD and PD patients, whom presented more severe levels of personality impairment. No differences in the SWAP-200’s cluster C have been found, indicating common personality features in these populations. At levels of specific PDs, MOH patients presented higher obsessive and dysphoric traits, as well as better overall psychological functioning than SUD and PD patients. Conclusions: The study supported the presence of a specific pattern of personality in MOH patients including obsessive (perfectionist) and dysphoric characteristics, as well as good enough psychological resources. No similarities with drug addicted and personality-disordered patients were found. Practitioners’ careful understanding of the personality of MOH patients may be useful to provide more effective treatment strategies and patient-tailored intervention programs