Personality disorders related to schizophrenia]

Personality disorders related to schizophrenia were described since Kraepelin's works. According to the DMS III-R those disorders are gathered into the A cluster of personality disorders consisting in: schizotypal, schizoid and paranoid personality disorders. Schizotypal and paranoid personalities are biologically linked to schizophrenia and support the concept of "schizophrenia spectrum". Until now such a link is not found between schizoid personality and schizophrenia. Future research in the field of those personality disorders will bring a better knowledge in the pathogenesis of schizophrenia.     

Personality and psychopathology in schizophrenia: the association between personality traits and symptoms

Research has indicated that stable individual differences in personality exist among persons with schizophrenia, and that they likely predate the onset of illness. Little is known, however, about whether individual differences in personality are related to levels of psychopathology. This study tested the hypotheses that levels of Extroversion, Neuroticism, and Psychoticism are associated with symptomatology. Accordingly, measures of these dimensions of personality and of symptomatology were obtained simultaneously for 113 male subjects with schizophrenia or schizoaffective disorder. Next, subjects were characterized as having high or low levels on each personality dimension and their scores on the five components of the Positive Negative Syndrome Scale were compared using multivariate and univariate procedures. Results indicate that extroverted subjects had lower levels of Positive, Negative, and Emotional Discomfort symptoms, and higher levels of Excitement symptoms than introverted subjects. Subjects with higher levels of Neuroticism had higher levels of Positive and Emotional Discomfort symptoms than subjects with lower levels of Neuroticism. No differences in symptoms were found among subjects with higher versus lower levels of Psychoticism. Results suggest individual differences in personality are associated with psychopathology in schizophrenia and may help further explain the heterogeneity widely observed in this disorder.     

Personality traits,personality disorders,and migraine: a review

The personality trait of neuroticism has been associated with migraine, although research is needed to clarify potential moderators of this relationship and the extent to which neuroticism reflects a stable disposition or instead is a function of general somatic distress or situational influences. With the possible exception of harm avoidance, research has not consistently identified any other personality trait unique among migraineurs. Personality disorders have been researched less extensively, but existing data suggests that borderline personality disorder, in particular, is associated with increased negative impact of migraine, risk for medication overuse, and poor response to treatment that is likely of greater clinical importance than any personality trait per se.     

Personality traits,interpersonal problems and therapeutic alliance in early schizophrenia spectrum disorders

Background

The quality of the therapeutic alliance is associated with engagement in- and thus important to the outcome of- treatment in schizophrenia. In non-psychotic disorders, general personality traits and individual patterns of interpersonal problems have been linked to the formation and quality of the therapeutic alliance. The role of these factors in relation to therapeutic alliance has not previously been explored in schizophrenia spectrum disorders.

Aim

To investigate associations between personality traits, interpersonal problems and the quality of the therapeutic alliance in early schizophrenia spectrum disorders.

Methods

Demographic and clinical characteristics including Positive and Negative Syndrome Scale (PANSS) scores were assessed in 42 patients. Personality traits and interpersonal problems were assessed with the NEO Five factor Inventory (NEO-FFI) and the circumplex model of the Inventory of Interpersonal Problems (IIP-64C). Therapeutic alliance was measured with the Working Alliance Inventory – short form (WAI-S).

Results

Patient WAI-S scores were predicted by IIP-64C Submissive/Hostile interpersonal problems, age and PANSS excitative symptoms. Therapist WAI-S scores were predicted by NEO-FFI Agreeableness and the PANSS insight item.

Conclusion

Core traits of personality and dimensions of interpersonal problems are associated with both patients' and therapists' perceptions of the quality of the working alliance.     

Personality traits and disorders in obsessive-compulsives

The Personality Diagnostic Questionnaire (PDQ) was completed by significant others for 26 obsessive-compulsive disorder (OCD) patients. Personality traits and diagnoses were scored. Profiles indicated that only one patient met criteria for compulsive personality, whereas one quarter to one third of the sample met criteria for avoidant, histrionic, schizotypal, and dependent personality disorders. High mean percentages on traits scores were found for avoidant and dependent traits, as well as for passive-aggressive and compulsive ones. Patients with more personality traits provoked more negative familial reactions and were less socially adjusted, but they did not have more OCD symptoms at pretest. Personality diagnoses did not predict behavioral treatment outcome. High dependent personality trait scores were related to better post-test gains, whereas passive-aggressive ones were associated with poorer long-term benefits. Results are discussed in light of recent reports of personality disorder in OCD and in other anxiety disorder patients. Methodological concerns are delineated.     

Premorbid personality disorders in schizophrenia

Premorbid personality disorders (PD) were studied retrospectively in 40 schizophrenic patients by interviewing the parents and patients who were reliable with the SCID-II. 85% of the patients had premorbid PDs. The most frequent premorbid PDs were: avoidant PD (32. 5%), schizoid PD (27.5%), paranoid PD (20%), dependent PD (20%) and schizotypal PD (12.5%). In most of the patients, two or more PDs could be diagnosed simultaneously (47.5%), comorbilidity of the premorbid PDs in schizophrenia being the most common one. The most frequent combination was avoidant-schizoid-schizotypal PD.     

Personality and personality disorders in chronic pain

Personality characteristics and disorders have long been noted in the chronic pain population. Clinicians and researchers alike will attest to the high rates of personality difficulties encountered in these individuals. Historically, it has been found that certain personality styles such as hypochondriasis and hysteria are common in chronic pain suffers. In addition, the prevalence of personality disorders (PDs) is significantly greater in the pain population than in the general population or in medical or psychiatric populations. A diathesis-stress model has been suggested to account for this finding and is discussed in this article, with implications for both treatment and research.     

Personality, personality disorders and depression

Personality is one of most frequently investigated fields in depression research and, despite changes in research paradigms, has not lost its relevance. Numerous results concerning the conceptualization of conspicuous personality traits, their aetiopathogenetic significance, and their effect on treatment and course have contributed to a better understanding of depression. Genetics and neurobiology provide new incentives for research in this field. We present an overview of aspects relevant to personality research in depression including personality types, personality traits, temperament factors, and personality disorders. Especially results on personality factors' effect on treatment and course of depression, integrating these results with different personality models in depression, and their consequences to treatment and further research of personality traits in depression are discussed.     

Gender differences in personality traits and disorders

Personality disorders differ in prevalence by gender. The most striking findings concern antisocial personality disorder, which is more common in men, and borderline personality disorder, which is more common in women. These differences are not artifacts, but reflect gender differences in the personality traits that underlie Axis II diagnoses.     

Diagnosing personality disorders in recent-onset schizophrenia

The present study aimed to determine the prevalence of personality disorders (PDs) and personality disorder traits in 40 recent-onset schizophrenic patients, to establish the degree of concordance between the Structured Interview for DSM-III Personality Disorders (SIDP) and the Million Multiaxial Clinical Inventory (MCMI-I), and to examine the interrater reliabilities for the diagnosis of SIDP disorders and traits. During their recovery phase, patients underwent the SIDP and completed the MCMI-I, a self-report inventory. Results showed that 57% of all patients had PDs according to the SIDP. The most common PDs were antisocial, borderline, and schizotypal, whereas the most common according to the MCMI-I were dependent, narcissistic, and avoidant. Both instruments indicated that multiple PD diagnoses were common. Paranoid and schizotypal traits were found to be ubiquitous across instruments. The level of agreements between the two instruments was poor on diagnostic assignment but better when trait scores were considered.     

Caregiver burden in recent-onset schizophrenia and spectrum disorders: the influence of symptoms and personality traits

Earlier studies that used two symptom dimensions indicate that the caregiver burden for patients with schizophrenia is significantly determined by their negative symptoms. The purpose of this study is to examine the relationship between symptom severity in recent-onset schizophrenia and caregiver burden in a more differentiated way (i.e., five-symptom dimensions). Based on previous research, which shows that patients' personality traits influence the course of schizophrenia, we theorize that personality traits could also influence caregiver burden. So far, this hypothesis has never been studied. Therefore, the second purpose of this study is to examine whether patients' personality traits would contribute to caregiver burden. The results of this study showed that the disorganization symptom component was the predicting variable of the subscales supervision, tension, urging, distress, and the overall amount of caregiver burden in a linear regression analysis. Personality traits of patients played no substantial role in caregiver burden. These findings suggest that psychoeducational programs should address the severity of disorganization symptoms to reduce caregiver burden in the early phase of schizophrenia.     

Personality traits predict current and future functioning comparably for individuals with major depressive and personality disorders

Axes I and II were separated in DSM-III to encourage the consideration of the influence of both personality and psychopathology on patient behavior, on the assumption that an understanding of personality would increment syndromal diagnosis in treatment decisions. However, in practice the distinction between Axis I and Axis II is less clear. The current report investigates one aspect on which Axis I and Axis II might be expected to differ, that being the the significance of normative personality traits as an influence on functional status. In this study, the contribution of normative personality traits to functioning is presented for 2 groups of patients, one with major depression and a second with personality disorders. The data suggest that personality traits are significant and equally relevant predictors of functioning for both groups. The utility of assessing personality traits for individuals with both Axis I and II disorders is thus supported.     

Comorbid personality traits in schizophrenia: prevalence and clinical characteristics

Accumulating evidence suggests high rates of personality disorder (PD) in schizophrenia (Sz), and as such, the implications of PD in this context are beginning to be studied more thoroughly. We examined clinical, cognitive and experiential (i.e., reported childhood adversity) correlates of aberrant personality traits in schizophrenia and healthy controls (HC) as measured by the International Personality Disorder Examination Questionnaire (IPDEQ). Participants were 549 individuals with schizophrenia or schizoaffective disorder, and 572 healthy adults recruited to the Australian Schizophrenia Research Bank (ASRB). Schizophrenia participants were significantly more likely than healthy controls to screen positive for personality disorder across all ICD-10 subtypes, and there was substantial overlap between clusters, with ～33% of Sz participants screening positive for all 3 personality disorder clusters. Among both Sz and HC groups, cluster B personality characteristics were significantly associated with increased suicidal behaviours, lower cognitive performance, and the experience of childhood adversity. In addition, Cluster C personality features were associated with higher overall ratings of affective blunting in schizophrenia, and Cluster A personality features were associated with childhood 'loss' in HC participants only. The cumulative effects of screening positive for more than one personality disorder in Sz was associated with higher likelihood of suicidal behaviour, earlier age of onset of Sz, and poorer cognitive functioning. The results suggest that abnormal co-occurrence of personality traits across DSM-IV clusters is evident in a significant proportion of individuals with schizophrenia, and that these personality features impact significantly on clinical and cognitive characteristics of Sz.     

精神分裂症患者一级亲属人格特征的研究

目的 探讨精神分裂症患者一级亲属的人格特征.方法 采用分裂型人格问卷(SPQ)及三维人格问卷(TPQ)评定181例精神分裂症患者一级亲属(高危组)、321名正常对照个体(对照组)的人格特征.结果 高危组sPQ阴性分裂型人格维度评分[(9.80±7.05)分]高于对照组[(8.42±5.87)分],差异有统计学意义(P＜0.05).高危组在TPQ寻求新奇维度评分[(15.60±5.62)分]、奖赏依赖维度评分[(17.41 ±1.13)分]与对照组[(14.20±2.83)分,(18.22±3.26)分]的差异均有统计学意义(P均＜0.01).高危组的阴性分裂型人格维度分数与寻求新奇维度、奖赏依赖维度分数显著相关(r=0.17和-0.23).结论 精神分裂症患者一级亲属具有阴性分裂型维度、寻求新奇维度、奖赏依赖维度的人格特征.     

Personality disorders and traits in patients with body dysmorphic disorder

Individuals with body dysmorphic disorder (BDD) have been postulated to have schizoid, narcissistic, and obsessional personality traits and to be sensitive, introverted, perfectionistic, and insecure. However, data on personality traits and disorders in BDD are limited. This study assessed 148 subjects with BDD, 26 of whom participated in a fluvoxamine treatment study; 74 subjects were assessed for personality disorders with the Structured Clinical Interview for DSMIII-R Personality Disorders (SCID-II), 100 subjects completed the NEO-Five Factor Inventory (NEO-FFI), and 51 subjects completed the Rathus Assertiveness Scale. Forty-two subjects (57%) had one or more personality disorders, with avoidant personality disorder (43%) being most common, followed by dependent (15%), obsessive-compulsive (14%), and paranoid (14%) personality disorders. On the NEO-FFI, the mean scores were in the very high range for neuroticism, the low range for extraversion and conscientiousness, the low-average range for agreeableness, and the average range for openness to experience. On the Rathus Assertiveness Scale, the mean score was -17.1 +/- 32.0 for women and -17.0 +/- 32.3 for men. Among fluvoxamine responders, the number of personality disorders significantly decreased between the study baseline and endpoint. These findings suggest that the rate of personality disorders in BDD is relatively high, with avoidant personality disorder being most common. The high neuroticism scores and low extraversion scores are consistent with this finding.     

Predicting domain-specific insight of schizophrenia patients from symptomatology, multiple neurocognitive functions, and personality related traits

This study examines the contribution of various neurocognitive functions, clinical characteristics, and personality traits to the prediction of three insight dimensions. Clinically stable schizophrenia patients (n=107) residing in the community were evaluated using the Positive and Negative Syndrome Scale, the Scale for the Assessment of Unawareness of Mental Disorder, and a comprehensive battery of instruments to measure personality related variables and neurocognitive functioning. Step-wise multivariate regression analysis indicates significant association of variability in insight dimensions with neurocognitive functioning (20-41%), personality related traits (8-18% temperament factors, 4-7% self-constructs, 10-14% coping styles), severity of symptoms (about 7%), illness duration (6%), and education (about 5%). Poor insight was attributed to impairment in visual and movement skills, sustained attention, executive functions, intensity of autistic preoccupations and positive symptoms, as well as increased novelty seeking behavior, task and emotion oriented coping styles, better self-esteem, self-efficacy, and higher education. Better awareness was related to better performance of neurocognitive tasks, reward dependence behavior, avoidant coping style, and longer illness duration. Aside from common indicators for the various insight dimensions, we defined specific indicators for each insight dimension. Thus, insight dimensions in schizophrenia patients residing in the community were attributed to neurocognitive and personality related factors rather than to psychopathological symptoms. The findings enable better understanding of the multifactorial nature of insight and highlight targets for more effective intervention and rehabilitation.     

Personality traits in schizophrenia: comparison with a community sample

The objective of this study was to compare personality trait profiles in patients with schizophrenia and healthy controls. Male outpatients with schizophrenia (N = 24) and a male nonpsychiatric community sample (N = 46) completed the NEO-FFI personality questionnaire. Multivariate analyses were used to compare mean scale scores and scale profiles for each group. The overall personality profile of clinically stable patients with schizophrenia differed significantly from that of a community sample. On individual scales, patients scored significantly higher on neuroticism and significantly lower on conscientiousness. These results confirm and extend those of previous studies that used normative data for comparison and a much longer version of the same personality questionnaire. Prospective studies of populations at risk are needed to determine whether group differences reflect a premorbid diathesis for schizophrenia or a secondary effect of serious mental illness.