Depression in young patients with BPD is commonly related to autoagressive behaviours, including NSSI which varies in forms and is determined by high risk of suicide.
determine NSSI clinical psychopathological features in patients with depression and BPD in youth age.
clinical psychopathological interview. Sample N=98 males adolescents (age: 16-25) with: 1. Depression in BPD 2. Episodes of NSSI.
NSSI manifestation in patients with BPD more frequently occurred in subjectively significant situations, firstly in age of 14 to 16. Character of NSSI varied from light scratchers, hitting, to systematic self-cutting, burning and etc. Patients demonstrated clear age and PD specificity in their pathological traits – including instability of self-esteem and affective lability, narrowed life interests towards selective overvalued passions, even addictions (e.g. extreme sport, internet addiction). The very maximum of NSSI frequency and damage registered at age of 18 – 21, when affective liability turned into “affective storming” and first major depressive episodes developed. In terms of psychopathological nature of NSSI behaviors the most common types here were:
- Impulsive
- Demonstrative
- Addictive
- Self-torture-directed
More than 70 % of patients with MDD the time of NSSI reported suicidal ideation and activities, so NSSI in these cases could be described as suicide-integrated. As patients grew older (yet not mature), depressive episodes got shorter this relationship weakened – so NSSI obtained more of addictive character.
NSSI in depressed patients with BPD are very variable in character and nature, their development and relation to suicide is not linear, and requires further study.
Violence is particularly common in people with antisocial personality traits who misuse alcohol or drugs, or who have marked paranoid or sadistic traits. Organic personality disorder (OPD) is primarily characterized by change of premorbid behaviour due to an organic impairment or disease of the central nervous system.
Presenting a case of OPD after traumatic brain injury in a man with premorbid antisocial personality traits, reflecting about the aetiology of his aggressive ideation and its potential impact in a forensic evaluation.
Case report and review of literature.
A 65-year-old male was admitted to the inpatient unit with anxiety, depressed mood, suicidal and homicidal ideation and recent history of cannabinoids and benzodiazepines abuse.
He has been involved in a car accident about 25 years ago, with no history of clinical follow-up. Since then, he got in conflict with almost all of his direct family members and he confesses changes in his behaviour with memory issues and increase of impulsivity and frustration intolerance recognized by his family as prior to the accident, although in a minor degree.
Recent brain MRI (T2):
It is not clear whether the aggressive ideation of this patient is due to the OPD or to the premorbid antisocial traits exacerbated by the abuse of cannabinoids in the context of depression. The assessment of premorbid personality and a complete neuropsychological evaluation with follow-up after the accident would have been of uttermost importance for a forensic assessment, in order to assess his imputability.
Antisocial Personality Disorder (ASPD) is frequent in Bipolar Disorders (BDs) but the prevalence is controversial. Furthermore, ASPD, BD and psychopathy share some clinical manifestations poorly studied.
We aimed to evaluate the dimension “psychopathy” among BDs patients with and without comorbid ASPD.
Overall 111 BD patients answered personality and psychopathological questionnaires.Two-step cluster analysis were run to identify clusters based on PID-5 ASPD diagnosis (PID-5 ANALYSIS) and psychopathy variables (PPI-R ANALYSIS). Differences between clusters were analyzed through Chi-Quadro test and Anova as appropriate.
PID-5 ANALYSIS identified two clusters: Cluster 1 (ASPD +) identified 19 subjects with high scores in PID-5; Cluster 2 (ASPD -) included 92 BD patients. Slyness, antagonism and insensitivity were the most important predictors. The comparison showed higher means of mania, novelty seeking, impulsivity, Machiavellian egocentricity, Rebellions non conformity and Fearlessness together in Cluster 1 and higher scores in empathy quotient, self-directedness, cooperativeness and carefree non-planfulness in Cluster 2.
PPI-R ANALYSIS identified three clusters respectively: PSICOP-1 (28 subjects), PSICOP-2 (56 subjects), PSICOP-3 (27 subjects) with decreasing psychopathy severity. ASPD+ were over represented in PSICOP-1 cluster. Within PSICOP-1, ASPD+ subjects have lower EQ and C scores and higher ME scores than ASPD-.
Logistic regression showed that grandiosity (PID-5) was associated at a greater risk of psychopathy (p=,004)
ASPD results a frequent comorbidity in patients with BD. the psychopathic trait is highly frequent among BD patients without ASPD.
Psychopathy could be considered a characteristic dimension in DBs regardless of ASPD comorbidity.
People who suffer from personality disorders have a high comorbidity with mood disorder symptoms, as well as different risk behaviors. They also have high socio-medical impact and medical usage rate, both outpatient and in-patient.
propose updated and interdisciplinary methods of treatment in personality disorders
empirical and clinical experienceBibliographic review
Bearing in mind that there are no specific drugs approved for the treatment of these disorders, different treatment guidelines have been developed that include some possible courses of action. At this point, it is worth reflecting, deepening and understanding the psychosocial factors that surround the growth of these personalities in early stages; and in this way we can begin to weave a joint treatment that sustains and diminishes the discomfort and anguish of these patients. At the same time, it will be taken into consideration what characteristics and tools the reference professionals (psychiatrists, psychologists, nurses ...) must have in mind in order to adequately intervene with this type of suffering.
Bearing in mind that there are no specific drugs approved for the treatment of these disorders, different treatment guidelines have been developed that include some possible courses of action. At the same time, it will be taken into consideration what characteristics and tools the reference professionals (psychiatrists, psychologists, nurses ...) must have in mind in order to adequately intervene with this type of suffering.
Despite the complexity and chronicity of borderline personality disorder (BPD), pharmacological treatments that affect its specific deficits are still missing.
The aim of this work is to provide an integral overview of the role of oxytocin in BPD based on research studies available up to now.
A literature (‘medline’) review was performed using the keywords ‘oxytocin’ and ‘BPD’.
Many patients with BPD report experiences of childhood maltreatment and insecure attachment, which may have lasting effects on the brain (including oxytocinergic system) as indicated for example by reduced basal plasma oxytocin levels in female BPD patients. Also interpersonal dysfunction is central to BPD. Based on these findings, it has been discussed that BPD may be strongly related to dysregulations in the oxytocinergic system and that oxytocin may have the potency to ameliorate BPD symptomatology.
According to some studies, the intranasal application of oxytocin may be a useful therapeutic adjunct to psychotherapy.
Moreover, it is suggested that oxytocin may promote prosociality when social cues are interpreted as safe, however, in unsafe interpretation of the environment, oxytocin may promote more defensive emotions and behaviors.
Recent research suggests that a variety of individual factors may influence a person’s response to oxytocin as well as its endogenous release (including sex, hormonal status, (epi)genetic variations of the oxytocin system, attachment history).
There is substantial evidence suggesting that oxytocin has a critical role in BPD. However, larger prospective studies are needed to determine interactions of oxytocin with interpersonal functioning in BPD regarding individual patient´s factors.
The aim of this work is to study the big five personality traits among a sample of call center employees in the region of Rabat-Salé.
The aim of this work is to study the big five personality traits among a sample of call center employees in the region of Rabat-Salé.
The evaluation of the big five personality traits was accomplished by the Big Five Inventory.
The results show that 63.64% of our sample have an extraversion pole more dominant than introversion, while 36.36% of the participants have the introversion pole more dominant. 66.12% of our study subjects have Agreeableness character dominance, while 33.88% of the sample have disagreeableness dimension dominance.Almost a parity was registered between those whom have a dominance of the consciousness pole 50.41% and whom have a dominance of impulsivity pole 49.59%. A percentage of 74.38% of the participants have a dominance of neuroticism pole while 25.62% have a dominance of emotional stability dimension. 57.02% of the participants have a dominance of openness pole, while 42.98% have a dominance of the pole dogmatism.
Consequently, we can conclude that our sample is characterizedby a great extent of extraversion and agreeableness.Furthermore, this study has shed the light of the dominance of the neuroticism trait among this kind of population. However, because this study has covered only one region, it could be interesting to widen the inquiry area in a way to obtain deeper results.
Organic personality disorder (F07.0) as it is described in ICE-10 is characterized by a significant alteration of the habitual patterns of premorbid behaviour. The expression of emotions, needs, and impulses is particularly affected.
Identify the difficulties involved in approaching a patient with the aforementioned diagnosis and design a multidisciplinary treatment plan that addresses the different affected areas.
We present the case of a 33 year old male, with no previous history of Mental Health (MH). Consumer of alcohol and cannabis. He presents behavioral disorders after severe TBI (left frontotemporal epidural extraxial hemorrhage and probable diffuse axonal type III lesion with subarachnoid hemorrhage in convex grooves and silviana fissure) in December 2018, leading to family conflict and denunciation of gender violence. Previously outgoing, affective and impulsive personality.
Comprehensive approach in MH communitar y and interdisciplinary (neurology, neurosurgery and neurological rehabilitation) requiring hospitalization at 9 months with difficulties of containment of the mentioned behavioral alterations. It remains for 3 weeks until psychopathological stabilization.
Treatment plan: -Pharmacological adjustment. –Family psychoeducation - Reorganization of support system.
We observed a clinical improvement in the patient´s symptoms such a decreased number of agitation episodes. The final evaluation showed that the objectives formulated with the patient and his family were achieved.
The impact on the individual, family and social level of this diagnosis, as well as the therapeutic limitations and prognosis to chronicity, make necessary an specific and multidisciplinary intervention adapted to each individual case.
High neuroticism indexes a risk factor to the development of any common mental disorders (Jeronimus et al., 2016). Equally, this personality trait has been associated with greater risk of HIV infection and poor adherence to antiretroviral therapy (ART) (Hutton and Treisman, 2017)
The aim of this study is to determine if neuroticism is associated with psychopathology in HIV patients.
85 HIV patients were assessed in an observational case-control study. Neuroticism and neurotic disorders (major depressive disorder (MDD), dysthymic disorder, panic disorder (PD), agoraphobia, social phobia, obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD) and generalized anxiety disorder (GAD)) were measured with NEO PI-R questionnaire and Mini-International Neuropsychiatric Interview v5.0.0, respectively.
A multivariate model (ANOVA lineal regression) was carried out with IBM SPSS v22.0. Variables included in the analysis were age, gender, economic status, educational level, alcohol dependence, other substances dependence (cannabis, cocaine, heroin), adherence to ART and the presence of neurotic disorders.
43.5% of HIV patients were diagnosed of any neurotic disorder (22.4% PD, 17.6% MDD, 17.6% agoraphobia, 9.4% social phobia, 5.9% GAD, 3.5% PTSD, 2.4% dysthymic disorder).
Neuroticism was significantly related to neurotic disorders (p=0.001; B=17.747; CI95%:7.742-27.753) and other substances dependence (p=0.030; B=11.670; CI95%:1.137-22.204).
High levels of neuroticism are associated with greater risk of neurotic disorders (PD, MDD and agoraphobia, mainly) and substances dependence in HIV patients. Early evaluation of this personality trait could identify an HIV patients profile at risk for psychiatric complications and/or poor adherence to ART.
DSM-V includes near-psychotic symptoms as new criteria in borderline personality disorder (BPD). This change makes more difficult the differential diagnosis between considering psychotic symptoms as part of the BPD or as part of a comorbid psychotic disorder.
Recognize the difficulty of the differential diagnosis in clinical practice between BPD and comorbid diagnosis of BPD with psychotic disorders, and how it could affect the patient’s outcome.
Patient’s data is obtained from medical history and psychiatric interviews carried out during her hospitalizations.
32 year-old female patient was admitted due to paranoid ideation, aggressiveness and increased consumption of cannabis. She has a medical history of four previous hospitalizations with diagnosis of BPD, psychotic episodes not specified and cannabis abuse. As she did not attend medical appointments, it has been impossible to carry out a longitudinal evaluation to reach a more precise diagnosis. Psychopathologically, during the hospitalizations the patient impresses of psychotic symptoms focused on persecutory ideation and ideas of reference, with massive borderline defense mechanisms (aggressiveness, frequent displays of anger, high impulsivity, low frustration tolerance, self-destructive behavior…).
Because of the psychotic symptoms, different diagnoses were considered. We believed BPD fitted more with the patient’s individual characteristics, although a comorbid substance-induced psychotic disorder or a psychotic disorder not otherwise specified (NOS) were also considered.
It is necessary to assess the difficulty of the differential diagnosis in these patients, and offer them specialized treatment depending on the diagnosis, as it could affect the patient’s outcome.
In the present work the new psychopathological models of clinical and psychopathological analysis of personality disorders will be analyzed, and integral approach models will be proposed
update about epidemiology, clinical criteria and diagnoses after personality disorders
interdisciplinary approach proposals
Bibliographic review.
DSM 5 and ICD 11 analysis
Interface with empirical evidence
The current clinical criteria about personality disorders show agreement with what is observed in the clinic.
The individualized approaches and without taking into account the context where the patient's symptoms develop are partial and do not favor the evolution and the favorable prognosis.
Therapeutic decisions must be made based on interdisciplinary models
In the axtuality, personality disorders can be evaluated clinically in an integral way, and from this the therapeutic proposals based on interdisciplinary models are the most accurate and effective
Introduction: Cloninger’s biopsychosocial model suggests the eight configuration types of temperament combining high or low score of Novelty Seeking (NS), Harm Avoidance (HA), or Reward Dependence (RD) temperament dimensions, and each type has different level of immaturity calculated as sum of Self-Directedness (SD) and Cooperativeness (CO) character dimensions.
Objectives: The aim of present study was to investigate whether the eight temperament types would exist and the immaturity level of eight temperament types could be replicated in Asian culture.
Methods: 527 Korean college students (195 males and 332 females) were recruited from the Busan metropolitan area, and their temperament types and immaturity levels were acquired by using Temperament and Character Inventory (TCI).
Results: The ratio of immature person varied from 4.2% of reliable/staid type (low NS, low HA, and high RD) to 74.6% of explosive/borderline type (high NS, high HA, and low RD) and showed the similarity of Western culture. However, the percent of adventurous/antisocial temperament type (high NS, low HA, and low RD) was found to be 23.5% unlike previous reports of 48% in Western culture.
Conclusions: Asian people are regarded as more collectivistic and less individualistic and therefore, those with adventurous/antisocial temperament type tend to behave more conformative to social norms, resulting in less maladaptive and immature character. Both universal and distinctive properties of temperament types considering the importance of sociocultural contexts were discussed for the future research.
From the earliest descriptions of schizophrenia, changes in personality were seen as a fundamental part of the natural history of the disorder. Nevertheless, the relationship of personality pathology and schizophrenia is a topic generally lacking research. This is of particular interest considering that the basis of the treatment of schizophrenia and personality disorders is of a different nature.
The authors will present an historical review of the concept of “borderline”, focusing on its initial affinity to classical conceptions of schizophrenia. This revision will expose areas of potential conceptual confusion, especially with the progressive broadening of the boundaries of the schizophrenia spectrum.
The authors’ searched the databases Pubmed, PsycInfo and Google Scholar, applying the search terms borderline personality and borderline schizophrenia. Reviews were preferred and arborized research followed. Two authors independently selected the abstracts to be included.
There is large psychiatric literature on various “borderline” conditions. The ways in which this term is used are often contradictory and obscure, even within the same theoretical backgrounds. Standard manual diagnostic criteria may be too narrow compared with the psychodynamic understanding of the concept, whereas the latter may be too broad to adapt to the notion of prodromal stages of schizophrenia.
Patients with schizophrenia benefit with the early introduction of anti-psychotic therapy, but these earlier stages may be harder to differentiate from phenomena frequently observed in patients with borderline personality. Conceptual consensus regarding the concept of “borderline” is yet to be achieved.
Delusional disorder is a low prevalence disease. Both its diagnosis and its treatment are difficult and its chronic course tends to worsen with age.
To make a differential diagnosis and to treat the delusional disorder through the clinical case of a patient who was admitted into hospital due to a psychotic episode.
Firstly tacking acount into the age, an organic origin of the case is dismissed making electroencephalofram, CT and lumbar puncture as a result of a positive reagin test. Once discarded the organic origin of the symptomatolohy, antipsychotic treatment is initiated. Subsequently, a psychobiographical screening is conducted.
After initiating the antipsychotic treatment, the patient’s productive psychotic symptoms stopped and delusion was encapsulated. Therefore, its influence on the patient’s emotional state and daily life was reduced.
A proper differential diagnosis of the delusional disorder is necessary. Paliperidone palmitate may be a useful treatment for patients suffering from this disease and experiencing psychotic symptoms.
Fromm (1964) first used the term “malignant narcissism” (MN) to describe a severe mental disorder. Kernberg (1984) later introduced the concept of MN to psychoanalytic literature. Very little has been written about MN since his contribution.
To create psychosocial consciousness of the consequences of MN and suggest its inclusion among Personality Disorders (PD) in psychiatric manuals and guidelines.
Case Report
(In Results)
A female 34-years-old patient, G, victim of her mother, E, a MN who used the judicial system and family against her. MN-E manipulated G's ex-husband to stone and to whip her as stated in the Bible, fueling his rage with lies. Social services and the juvenile court intervened, judging G as a negligent mother for being victim of gender-based violence, and stigmatizing her as “crazy” for consulting a psychiatrist to deal with said conflict. MN-E continued dehumanizing G, who finally lost custody of her children since 2015. Over time, driven by her envy towards her daughter meaningful life, MN-E was given possession of her grand-children. Due to unresolved hatred and need for admiration, MN-E brainwashed the infants memories, persuading them G was not their real mother. At last, to preserve the minds of the minors, psychologists and the juvenile court agreed G could never get in touch with her children. G developed a chronic PTSD and is currently being medicated for MDD.
MN is definitely “the quintessence of evil” (Fromm, 1964). Features outlined are a core narcissistic PD, antisocial behavior, ego-syntonic sadism and a paranoid orientation.
Previous studies reported that the precursors of obsessive compulsive personality disorder (OCPD) may be seen in adolescence. Although adolescents with OCPD features such as achievement striving, ambition, order, and self-control may be seen as succesful individuals, the early intervention on these symptoms may prevent the development of more challenging OCPD characteristics and comorbid psychiatric conditions.
The aim of this study is to evaluate of the effectivity of therapeutic intervention focusing on infliated self-responsibility, overly moralistic self evaluation, self-critism and guilt in three adolescents with obssessive compulsive personality characteristics and to present the detailed interviews of the sessions.
Three female adolescents between the ages of 15 and 17 were followed until 8 to 16 weeks. The sessions were planned as two times a week. One of the adolescent had performance anxiety, the second one had impulse control disorder, and the third one had unspecified eating disorder.
Both OCPD characteristics and comorbid conditions were improved at the end of therapeutic intervention.
The effectiveness of cognitive behavioral therapy were reported in adult patients with OCPD. However, the studies with young population is still limited. We present clinical features of three adolescent female with OCPD characteristics and the improvement of symptoms and comorbid conditions in the course of therapeutic process. The self-criticism and guilt were the essential parts focused on in the improvement effect of the therapeutic process.
Patients with borderline personnality disorder (BPD) occupy an important place among patients admitted for suicidal attempt.
Preventing recurrence of suicide attempts in this specific population, by controlling its risk factors, is an important public health issue.
The purpose of this study was to determine the risk factors of the recurrence of suicidal attempt in BPD patients consulting the emergency unit.
It's a retrospective study about 30 cases. All subjects included in the study had been diagnosed with BPD according to DSM V criteria. Moreover, they all consulted the emergency psychiatric unit after, at least, one suicide attempt. The exclusion criteria were the presence of cognitive, bipolar or psychotic disorders. Patients were divided into two groups: with and without recurrence of suicide attempt.
Socio-demographic informations was collected. The gravity of depressive disorders was assessed with the Hamilton Depression Rating Scale (HDRS).
Among the thirty patients included in the study, 66% patients were re-admitted to the emergency unit for one or several suicide attempt . The recurrence of the suicide attempt was significantly higher in unemployed patients, in patients with family history of suicide and in patients who consume cannabis. Interestingly, living with parents who are not separated seems to be a protective factor (OR = 0.3). Furthermore, recurrence and intensity (HDRS) of the major depressive episode did not differ statistically in patients with or without SB recurrence.
Identifying patients at risk of recurrence of suicidal act, represents an essential step in secondary prevention.
The study of the individual's self-image is an important task. We will consider the features of the self-concept of such a category of people as “downshifters” who have abandoned the traditional concept of “career”. These people are characterized by a higher level of global self-relation. Downshifter - this is the person who would rather speak up for his own personality than against. It seems that the downshifter challenges society and begins to rebel, showing with his whole way of life that he is independent of the external frames of the social discourse and constantly proving his individual peculiarity with non-standard self-presentation strategies.
The hypothesis about differences between substantial characteristics of downshifters’ and not-downshifters’ self-concept has been checked.
In quantitative and qualitative study (N = 153 ) open data analysis (correlation and Spirmen criteria) and semi-structured interviews were carried out.
The empirical study allowed to show the existence of a significant relationship between the tendency to downshift and the peculiarities of the Self-concept for the cognitive and affective components of the Self-concept and its absence for the behavioral component of a person's ideas about himself.
Persons prone to downshifting have more pronounced indicators such as global self-esteem, self-esteem, self-sympathy, expected attitude from others, self-confidence, self-interest and self-acceptance in the affective component of the self-concept. Persons prone to downshifting have a less pronounced indicator of self-incrimination. Persons prone to downshifting have a less pronounced goal setting.
The 42-item version of Ryff’s Psychological Well-being (PWB) scales (environmental mastery, personal growth, purpose in life, and self-acceptance) with 6 items and response style is one of the most widely used survey instruments. Although there is an Arabic version of (PWB), it is not identical to the original version in terms of the number of items and response.
To evaluate the psychometric properties of the Arabic adaptation, a 42-item version of Ryff’s (PWB) scales and its factorial structure in an undergraduate sample.
The participants were 1133 first year undergraduate Kuwaitis: 522 males and 611 females, mean age = 20.90 ± 2.04. The Arabic versions of (PWB) scales (Ryff, 1989) were administered to participants. The internal consistency reliability, factor structure, and convergent validity of the Ryff’s (PWB) scales with Oxford Happiness Inventory (OHI), Life Orientation Test (LOT-R, Adult Hope Scale (AHS), Satisfaction With Life Scale (SWLS) were assessed as well as divergent validity of the Ryff’s (PWB) with Beck Depression Inventory-II (BDI-II).
Internal consistency was satisfactory for the PWB (Cronbach’s alpha =0.88). The results revealed significant gender differences in Environmental Mastery with a favor for males and in Personal Growth a favor with females. Principal component analyses (PCA) showed that a PWB six -component solution explains %62.89 of the total variance. The PWB correlates with OHI (r=.56) SWLS (r=.56), LOT-R (r=0.58) AHS (r=.48) and BDI-II (r=-56).
The PWB provides satisfactory validation, and thus it can be recommended as a measure of Psychological Well-being among Arab samples.
Antisocial personality disorder has great negative impact on the affected individuals, their loved ones, and society. Its diagnostic characteristics included in DSM 5 are highly conroversial, as the category might be too heterogeneous and with considerable overlap with other constructs. Although often used interchangeably, the diagnostic constructs of psychopathy and antisocial personality disorder are distinct.
To perform an updated literature review on the characteristics of the antisocial personality disorder, psychopathy, and the relationship between both constructs.
A comprehensive review of literature was performed. A search of PubMed and EMBASE databases using the keywords 'antisocial personality disorder' and 'psychopathy' yielded 256 articles for a more detailed reading of the full texts. This reading finally produced 17 relevant articles for inclusion. Most of the articles were excluded due to the lack of relevance to the present review.
The diagnostic criteria for antisocial personality disorder under DSM 5 are primarily behavior based, in contrast to the construct of psychopathy, with also includes affective and interpersonal traits. There is substantial debate in literature whether both entities reflect different subsets of individuals under the same entity or differ more substantially.
The criteria for antisocial personality disorder captures many of the deviant or abnormal behaviors associated with psychopathy, but does not include most interpersonal or affective traits included under the psychopathy definition. Further research must be carried on to discern if psychopathy represents a specific subtype of antisocial personality disorder or if it represents an entirely different entity.
The traffic jam is a worldwide problem. It causes environmental, economic damage, and harms the psychological health of a person, for example, provokes stress disorders. The study was supported by the RFBR and the Government of Moscow #19-313-70005.
To study the influence of chronic stress and chronic fatigue on drivers’ behaviour.
The experiment involved 24 participants (average age 19.3 years, 12 men/12 women). Measures: Questionnaire "Acute and chronic stress" (Leonova A.B.); Questionnaire "Assessment of the degree of chronic fatigue" (Leonova A.B.); Questionnaire on visual fatigue (Leonova A.B.); Cognitive load Test (Bourdon B.); BPAQ (Enikolopov S.N.).
The experiment consisted of three 15-minute series that simulated a situation of traffic jam on a computer. The subject has the task: to press the button when changing the brake light of the going ahead machine. Diagnostic scheme includes 4 stages: before the experiment and after 1, 2, 3 series.
Based on cluster analysis two different groups of drivers revealed according to the index of chronic stress and index of chronic fatigue. The 1 group manifests reduced attention and increased chronic fatigue. The 2 group marked enhanced attention and decreased chronic fatigue. Significant differences between groups on the scales attention, acute and chronic stress, aggression, visual fatigues were found.
Drivers of the first group, unlike the second, with high levels of chronic stress and fatigue, significantly characterized by high score aggression, acute stress, visual fatigue, and low attention. These drivers are more likely to commit offences and get into accidents. Now the research is continuing.
There are a lot of quite difference options of dysregulation in personality disorder and they are associated with the level of personal disharmony and the degree of complexity of the situation of choice. Personality disorders are includes the lack of stable semantic formations, prognostic abilities, emotional experience, motivational simplicity, the discrepancy between the ideal goal and the real ways of achieving it.
Refinement of the possibilities of using psychological diagnostic methods of personality traits and regulation of behavior
Clinical and psychopathological method, psychological method
Accused persons with personality disorders tend to be impulsive; they have difficulties of emotional control, immediate stress response, a lack of rational analysis of situational conditions, the prevalence of unconscious response models in conflict situations. The basic beliefs of the accused with personality disorders include instability of self-esteem, rigidity of assessments. So it was found that these features are associated with an increased risk of committing rash acts, including aggressive and criminal nature.
In view of the type of crime committed, the following were found. Persons who have committed crimes against sexual integrity are more flexible in matters of interpersonal relations than groups of persons who have committed murder and serious harm to health, and crimes related to the illegal acquisition, storage, transportation, manufacture, processing of drugs.
Thus, it was found that psychological methods for diagnosing decision-making features and personal characteristics are a promising direction in creating a comprehensive diagnostic system for forensic psychiatric assessment of personality disorders.
The Lawyer is one of the most stressful job because of responsibility, multitasking and uncertainty. They must clearly understand the case, be able to defend interest in the tribunal.
To study the correlation between chronic stress, anxiety and coping strategies among lawyers to further create a program to increase work efficiency.
Participants were 35 lawyers (22 men and 13 women) from the Civil service. They fulfilled 3 standardized questionnaires: Managerial stress survey — MSS (Leonova A.B), 16 PF (Kapustina A.N.), Strategic Approach to Coping Scale — SACS (Hobfoll S.E.).
It was found the high scores of the Depression and Anxiety. The Chronic stress positively correlates with coping - aggressive actions (r=0,684; p=0,0001), and inversely correlates with the self-control (r=-0,607; p=0,0001). Chronic stress and all sub-scales are negatively associated with emotional stability (r=-0,713; p=0,0001). With increased anxiety, lawyers are more likely to use impulsive actions (r=0,471; p=0,0001), and aggressive actions (r=0,602; p=0,0001).
It is revealed that lawyers have a high level of anxiety and depression, which may be related to their specific activities which are work in the Arbitral tribunal. Anxiety and depression are associated with low emotional stability, low self-control, and aggressive actions. With a high level of chronic stress, lawyers can make mistakes in their activities, which can lead to negative results. These findings will help create programs to improve functional states.
Los cuadros de agitación psicomotriz en los trastornos de la personalidad representan un desafío clínico de importancia en la actualidad debido a su forma de prresentación y a los riesgos que trasunta en los pacientes, sus familiares y tambien los profesionales de salud
En este ensayo Se proponen herramientas de abordaje Interdisciplinarios en la Urgencia en Salud mental de los cuadros graves agudos de los trastornos de la personalidad.
Tipificar cuadros Agudos en los trastornos de la personalidad en términos sindromáticos
Analizar las herramientas disponibles en la acrualidad para el abordaje de estos cuadros
definir criterios legales a la hira de la incursión terapéutica
Proponer terapéutica en términos de presición, de manera interdisciplinaria
Trabajo clínico, observación, recopilación de datos estadísticos y análisis de conclusiones en Guardia de Urgencias y Emergencias en Salud Mental interdisciplinaria.
Se logro mediante protocolo de actuación especifica reducir lo disruptivo de la presentación aguda en términos de impulsividad, desorganización cognitivo conductual, ansiedad y temerosidad y riesgo de suicidio en los cuadros agudos en los trastornos de la personalidad}
Se disminuyó el número de internaciones
Se deben configurar herramientas psicofarnacológicas y de laboratorio de presición.
Los trastornos de la personalidad configuran un desafío clínico, diagnóstico y pronóstico cuando se presentan cuadros agudos de urgencias o emergencias.
Se pueden desarrollar protocolos de actuación inter y trasdisciplinarias para obtener presición diagnóstica y terapéutica.
Several risk factors are involved in the phenomenon of School Refusal (SR). It might be useful to focus on emerging personality features in order to more accurately identify psychopathological characteristics of those individuals. Indeed, personality features and SR still remain an unsolved issue.
The aim of this study is to investigate differences about psychiatric symptoms and brain primary emotional systems between SR and non-SR adolescents in a clinical sample.
The sample included 50 help-seeking adolescents, 24% (12) SR, referred to the clinic for Anxiety and Mood Disorders in Adolescence (Psychiatric Department of Sant’Andrea Hospital, Rome). Subjects met criteria for DSM-5 diagnoses. Only 12% (6) did not meet criteria for psychiatric disorders. The sample was evaluated with the Affective Neuroscience Personality Scale (ANPS), with Hamilton Rating Scale For Anxiety (HAM-A) and Depression (HAM-D). SR was evaluated using a brief, ad-hoc interview, according to scientific licterature. Z-Test for independent samples was conducted to compare the means of each variable of the two groups (SR vs Non-SR).
There was a significant difference between SR and non-SR about the emotional system of FEAR. Moreover, SR showed more anxius and depressive symptomathology compared to non-SR.
SR help-seeking adolescents showed more anxious and mood symptoms. SR described themselves with higher propensity to worry and anticipate negative outcomes for the future, ruminate and feel tense if compared to non-SR. This is a stable personality feature at the basis of this phenomenon: it could be useful to better understand the symptomatic patterns and clinical conditions of those adolescents.
We intend to approach this interference from a personological dimensional perspective.
We intend to approach this interference from a personological dimensional perspective.
We assessed the personality of the studied patients – diagnosed with pathological gambling – from a dimensional perspective by means of DECAS personality inventory elaborated according to the Big Five Factors dimensional model. We observed the relations between the values of the personality dimensions and the types of pathological gambling, respectively their clinical and evolutional characteristics.
We have determined that the personality dimensions condition both the clinical symptomatology and the integration in the therapeutic strategy of the subjects. To that effect, the values of the dimension Conscientiousness have the most obvious predictive role.
The delineation of the dimensional profile and its integration in the diagnostic and therapeutic approach, possible also in the absence of a categorical diagnosis of personality disorder, allows a personalized version and a more accurate one to approach the phenomenon.
This dimensional approach of gambling needs further and more comprehensive studies and confirmations.
Villaverde’s day hospital for adults is an intensive psychotherapeutic treatment center for patients with severe mental disorder. It is an intensive multidisciplinary treatment center focused mainly in group therapy, with a therapeutic community approach.
We receive adult patients (from 18 to 65 years old) with severe mental disorder from the southern area of Madrid. We are a nonspecific center, so our patients are not referred by diagnosis. They are usually chronic patients with little improvement with previous ambulatory treatment.
Even without being an specific center, we have observed differences in the profile of patients referred to our center, so we wanted to study the proportion of patients with different diagnoses.
We made a qualitative analysis of the diagnostic profile of patients admitted to our center during 2018 and 2019.
We found that, even without a focus on an specific disorder, 88% of our patients had a main diagnosis of personality disorder, with a big gap compared to other diagnoses (6,8% psychotic disorders, 8,8% bipolar disorder, 9,8% OCD). In addition to this, the vast majority of patients undergoing treatment at our center have comorbidity, with 97% of patients with two or more psychiatric diagnoses.
Our findings could be explained by two main reasons. On the one hand, the difficult management of patients with these disorders on an outpatient setting and, on the other, the few specific resources that exist in our community for the treatment of patients with personality disorder.
BPD is comorbid with a number of mental disorders such as Alcohol or other substance abuse, Anxiety disorders, Eating disorders, Bipolar disorder, Post-traumatic stress disorder (PTSD), Attention-deficit/hyperactivity disorder (ADHD) and others.
It is well known that BPD is a significant predictor of outcome for comorbid disorders, in most cases worsening prognosis. The effects of comorbid diseases on the manifestations and course of BPD have not been practically studied. Although it can be assumed that both the disease itself and the treatment obtained in connection with the treatment can change the course and severity of the manifestation of comorbid BPD.
Methods: psychopathological, C-SSRS, ZAN-BPD Scales.
Materials – 30 men with BPD comorbid with alcohol dependence , 10 men with BPD without alcohol dependence were observed.
The frequency of occurrence and distinctive features: suicidal ideation, self- injurious acts, suicidal attempts, suicidal gestures, suicidal fantasies, suicidal threats in the groups of subjects were studied. It was found that suicidal thoughts, suicidal fantasies were much less common in BPD patients with alcohol dependence. The suicidal attempts, suicidal gestures, suicidal threats in the groups met equally often. Self- injurious acts and suicidal attempts became more brutal when alcohol abuse had became alcohol dependence. At the same time, the cognitive and emotional problems in BPD patients with alcohol dependence were somewhat smoothed out. Interpersonal problems are aggravated.
Conclusions: сomorbid alcohol dependence has multidirectional affects on BPD traits. One manifestation of which is the change in the pattern of suicidal/self harm behaviour of patient with BPD.
At the Mental Health Centre of Forlì, we have introduced a multidisciplinary working group, a complex psychodiagnostic evaluation, a therapeutic contract and a wide range of evidence based treatments for patients who suffered by severe personality disorders and their families. Specifically we speak about a group psychotherapy based on the principles of W. Bion and on techniques of MBT method (Fonagy and Bateman).
This study aims to verify the effectiveness of this specific group treatment in reducing symptoms and in increasing retention in treatment measured by some outcomes (drop-out, hospital-admissions, accesses to emergency medical treatments and pharmacotherapy).
During the year 2018 we recruited 15 patients with severe Personality disorders of cluster B (valuated with SCID-II) defined severe by at least one of the criteria of the Region guide lines. We have considered hospital admissions in the previous 12-month period and during the full course of treatment (one year).
of the 15, patients were primarily females (9), males were 6, the mean age was 43 yrs, only 5 also had individual not specific psychotherapy. Psychiatric comorbidities are most with Bipolar Disorder (80%). We have noted a drastic reduction of hospital admissions and emergency visits at Emergency Aid and at Mental Health Centre. These outcomes are more substantial for patients who received additionally individual psychotherapy
This approach is effectiveness in reducing drop out, the number and duration of hospital admissions, emergency visits and less number of drug prescription. We think that this is more specific and personalized treatment for these very complicated patients
Experiencing negative life events as Childhood Trauma (CT) would lead to individual differences in reaction and perception of stress. Neuroticism and low Conscientiousness have been linked to worse physical and mental health-related behaviors. However, the association between different types of CT with personality traits has been poorly characterized in healthy adults.
To examine the relationship between CT with personality traits in healthy adults.
Fifty-nine participants (Mean age = 28.1, SD = 7.1 years old, Male = 49%) completed the Childhood Trauma Questionnaire (CTQ), the Childhood Experience of Care and Abuse Questionnaire (CECA), and the Five-Factor NEO Personality Inventory-Revised (NEO-PI-R).
Emotional Abuse and Neglect, Physical Neglect, Bullying exposure and witnessing Parental Violence were positively related to Neuroticism (r = .40, p = .002; r = .33, p = .01; r = .29, p = .028; r = .26, p = .045, r = .39, p = .002) and negatively to Extraversion (r = -.32, p = .013, r = -.32, p = .015; r = .33, p = -.012; r = .31, p = .016; r = -.47, p = .000). Physical Abuse and Emotional Neglect were negatively related to Openness (r = -.29, p = .025; r = -.31, p = .017). All types of CT were negatively related to Agreeablenees. Conscientiouness was also negatively related to all types of CT, except for witnessing Parental Violence (n.s.) and Bullying (r = .26, p = .46).
Trauma exposure during childhood seems to be associated with maladaptive personality traits development in healthy adults.