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1.
Purpose of Review
Impulsivity is a multifaceted construct and an important personality trait in various mental health conditions. Among personality disorders (PDs), especially cluster B PDs are affected. The aims of this review are to summarize the relevant findings of the past 3 years concerning impulsivity in cluster B PDs and to identify those subcomponents of self-reported impulsivity and experimentally measured impulse control that are most affected in these disorders.Recent Findings
All studies referred to antisocial (ASPD) or borderline PD (BPD), and none were found for narcissistic or histrionic PD. In ASPD as well as BPD, self-report scales primarily revealed heightened impulsivity compared to healthy controls. In experimental tasks, ASPD patients showed impairments in response inhibition, while fewer deficits were found in delay discounting. BPD patients showed specific impairments in delay discounting and proactive interference, while response inhibition was less affected. However, after inducing high levels of stress, deficits in response inhibition could also be observed in BPD patients. Furthermore, negative affect led to altered brain activation patterns in BPD patients during impulse control tasks, but no behavioral impairments were found.Summary
As proposed by the DSM-5 alternative model for personality disorders, heightened impulsivity is a core personality trait in BPD and ASPD, which is in line with current research findings. However, different components of experimentally measured impulse control are affected in BPD and ASPD, and impulsivity occurring in negative emotional states or increased distress seems to be specific for BPD. Future research could be focused on measures that assess impulsive behaviors on a momentary basis as this is a promising approach especially for further ecological validation and transfer into clinical practice.2.
Athanasios Apostolopoulos Ioannis Michopoulos Ioannis Zachos Emmanouil Rizos Georgios Tzeferakos Vasiliki Manthou Charalambos Papageorgiou Athanasios Douzenis 《Annals of general psychiatry》2018,17(1):35
Background
Personality disorders (PDs) have been associated with both violent crimes and homicides in many studies. The proportion of PDs among prisoners reaches up to 80%. For male prisoners, the most common PD in the literature is antisocial PD. The aim of this study was to investigate the association between PDs and violent crimes/homicides of male prisoners in Greece.Methods
A sample of 308 subjects was randomly selected from a population of 1300 male prisoners incarcerated in two Greek prisons, one urban and one rural. The presence of PDs was assessed using the Mini International Neuropsychiatric Interview (MINI) and the Personality Diagnostic Questionnaire-4 (PDQ-4). Using logistic regression models PD types and PD “Clusters” (independent variables) were associated with “violent/non-violent crimes” and “homicides/non homicides” (dependent variables).Results
“Cluster A” PDs (Paranoid, Schizoid, and Schizotypal) were diagnosed in 16.2%, “Cluster B” (Antisocial, Borderline, Histrionic, Narcissistic) in 66.9% and “Cluster C” (Obsessive–Compulsive, Dependent, Avoidant) in 2.9% of the studied population. Violent crimes and homicides were found significantly associated with “Cluster A” PDs (p?=?0.022, p?=?0.020). The odds ratio of committing violent crimes was 2.86 times higher for patients with “Cluster A” PDs than the ones without PDs. In addition, the odds ratio of committing homicides was 4.25 times higher for patients with “Cluster A” PDs. In separate analyses, the commitment of violent crimes as well as homicides, was significantly associated with Schizoid (p?=?0.043, p?=?0.020) and Schizotypal PD (p?=?0.017, p?=?0.030).Conclusions
The majority of prisoners was found to suffer from a PD, mainly the Antisocial “Cluster B”, but the commitment of violent crimes and homicides was significantly associated only with “Cluster A” PDs and specifically with Schizoid and Schizotypal PD.3.
4.
5.
Introduction
Common brain areas play a role in processing both personality and odor, while personality theory predicts that olfactory performance should vary according to personality traits. The Big Five model of personality is considered a gold standard measure but has yet to be directly applied in investigations linking personality and olfactory responses. Moreover, olfactory measures commonly used in personality studies are usually rudimentary sensory performance indices such as thresholds as opposed to higher-order perceptual and psychological metrics.Methods
This cross-sectional study examined the relationship between comprehensive measures of personality and perceptual responses to odors. Personality was measured using a comprehensive test of the Big Five model of personality, while olfactory responses included identification, pleasantness, perceived intensity, and familiarity. Odors were presented using the Sniffin’ Sticks test.Results
Small to moderate correlations were noted between aspects of personality and response to odor, even after controlling for participant (N = 74) characteristics such as age and gender. Regression analyses indicated that, overall, odor familiarity co-varies the most with aspects of personality.Conclusions and Implications
Responses to olfactory stimuli are moderated by specific personality dimensions. This finding is consistent with approach and avoidance motivational models of personality.6.
Swantje Matthies Miriam A. Schiele Christa Koentges Stefano Pini Christian Schmahl Katharina Domschke 《Current psychiatry reports》2018,20(10):83
Purpose of Review
In light of the apparent symptomatic resemblance of separation anxiety disorder (SAD) symptoms on the one hand and abandonment fears, anxiousness, and separation insecurity central to borderline personality disorder (BPD) on the other hand, a comprehensive overview of separation anxiety and related traits in BPD is provided.Recent Findings
Epidemiological, environmental, psychological, and neurobiological data connecting BPD to separation events, feelings of loneliness, insecure attachment styles, dimensional separation anxiety as well as SAD per se suggest a partly shared etiological pathway model underlying BPD and SAD. Differential diagnostic aspects and implications for treatment are discussed, highlighting separation anxiety as a promising transdiagnostic target for specific psychotherapeutic and pharmacological treatment approaches in BPD.Summary
This innovative angle on cross-disorder symptomatology might carry potential for novel preventive and therapeutic avenues in clinical practice by guiding the development of interventions specifically targeting separation anxiety and attachment-related issues in BPD.7.
Chiung M. Chen Young-Hee Yoon Thomas C. Harford Bridget F. Grant 《Social psychiatry and psychiatric epidemiology》2017,52(6):715-725
Background
Emerging confirmatory factor analytic (CFA) studies suggest that posttraumatic stress disorder (PTSD) as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is best characterized by seven factors, including re-experiencing, avoidance, negative affect, anhedonia, externalizing behaviors, and anxious and dysphoric arousal. The seven factors, however, have been found to be highly correlated, suggesting that one general factor may exist to explain the overall correlations among symptoms.Methods
Using data from the National Epidemiologic Survey on Alcohol and Related Conditions-III, a large, national survey of 36,309 U.S. adults ages 18 and older, this study proposed and tested an exploratory bifactor hybrid model for DSM-5 PTSD symptoms. The model posited one general and seven specific latent factors, whose associations with suicide attempts and mediating psychiatric disorders were used to validate the PTSD dimensionality.Results
The exploratory bifactor hybrid model fitted the data extremely well, outperforming the 7-factor CFA hybrid model and other competing CFA models. The general factor was found to be the single dominant latent trait that explained most of the common variance (~76%) and showed significant, positive associations with suicide attempts and mediating psychiatric disorders, offering support to the concurrent validity of the PTSD construct.Conclusions
The identification of the primary latent trait of PTSD confirms PTSD as an independent psychiatric disorder and helps define PTSD severity in clinical practice and for etiologic research. The accurate specification of PTSD factor structure has implications for treatment efforts and the prevention of suicidal behaviors.8.
Enrica Olivola Livia Brusa Camilla Rocchi Orazio Schillaci Claudio Liguori Rocco Cerroni Mariangela Pierantozzi Agostino Chiaravalloti Alessandro Stefani Fabrizio Stocchi 《Neurological sciences》2018,39(12):2169-2174
Background
Despite its negative impact on quality of life, fatigue in Parkinson’s disease (PD) remains an under-recognized issue and the underlying pathology is undetermined.Objective
To contribute at understanding the pathogenesis of fatigue in a naturalistic cohort of cognitively intact PD patients.Methods
In a Caucasian population of PD patients (n?=?27), we evaluated to what extent fatigue (quantified as PFS-16 score) is associated with PD duration and with autonomic dysfunction, studied by both MIBG scintigraphy and autonomic nervous system testing. The latter included the head-up tilt test, Valsalva maneuver, deep breathing, and handgrip tests.Results
PFS-16 score correlated with disease duration (R?=?0.57, p?=?0.002). Fatigue showed a clear correlation with deep breathing test (R?=???0.53, p?=?0.004) but not with the MIBG H/M ratios.Conclusions
Our data are consistent with a multifactorial pathogenesis of fatigue and with effects of dopamine depletion in PD-related fatigue; on the other hand, our findings do not support a role for sympathetic denervation in PD-related fatigue.9.
E. Zirek Burcu Ersoz Huseyinsinoglu Z. Tufekcioglu B. Bilgic H. Hanagasi 《Neurological sciences》2018,39(12):2151-2157
Background
There is evidence that cognitive load has a negative effect on the gait of patients with Parkinson’s disease (PD). However, it is not clear which type of cognitive activities are more likely to affect dual-task abilities in this patient group.Aims
To compare the cognitive dual-task abilities in patients with PD and control subjects and to analyze the effect of different cognitive activities on the walking ability of patients with PD.Methods
The Hoehn and Yahr scale, the Freezing of Gait Questionnaire (FOGQ), Montreal Cognitive Assessment (MoCA), and the Functional Reach Test were used to include and exclude the patients. The Timed Up and Go (TUG) test was applied under single and dual-task conditions.Results
The completion time of TUG was found to be increased in the PD group compared with the healthy controls under single- and dual-task conditions (p?<?0.05). The completion time of TUG was significantly increased in dual-task conditions with complex attention activity (serial subtractions test) compared with other dual-task conditions in patients with PD (p?<?0.001).Discussion
The gait performance of both healthy subjects and patients with PD was impaired with cognitive activity during walking, and patients with PD showed more impairment under different cognitive dual tasks. Among the other cognitive tasks, the ‘serial sevens’ test, a measure of complex attention, significantly increased the completion time of TUG.Conclusions
While assessing the dual-task ability of patients with early-stage PD, tasks that increase the demand for complex attention seem to be more sensitive to showing impaired dual-task ability.10.
Ruth Howard Thanos Karatzias Kevin Power Adam Mahoney 《Social psychiatry and psychiatric epidemiology》2017,52(1):21-25
Purpose
Despite empirical evidence suggesting complex associations between psychological trauma, substance misuse, and violent offending, there is a dearth of research investigating these associations in the female prison population.Methods
A cross-sectional, interview-format questionnaire study was undertaken with a sample of 89 female prisoners. History of traumatic events, DSM-5 PTSD, drug use, and offending behaviour were assessed.Results
Traumatic experiences had occurred in 97.8 % of the sample, while 60.5 % met criteria for a PTSD diagnosis. The majority of the sample (70.8 %) reported using illicit drugs, and 59.6 % had committed at least one violent offence. History of drug use was significantly correlated with trauma, PTSD status, and violent offending. A mediation analysis identified an indirect effect of PTSD symptoms on the relationship between history of drug use and violent offending.Conclusions
The result of our mediation analysis further highlights the importance of addressing PTSD symptoms and substance misuse, among female offenders, to help prevent violent offending.11.
Purpose of Review
This review aims to give an overview on the current literature on sex differences in personality disorders and to highlight the potential of dimensional approaches.Recent Findings
Empirical findings on sex differences in personality disorders are inconsistent and appear to be highly dependent on study settings. Current studies have mainly focused on borderline and antisocial personality disorder and the question whether these are sex-specific representations of a common substrate. In general, sexes differ in the manifestation of personality disorders as well as in comorbidities. Criticism of the established categorical model led to an additional dimensional model of personality disorders in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.Summary
Investigations on sex differences in personality disorders are sparse and mainly limited to antisocial and borderline personality disorder. The introduction of a dimensional model offers the chance to re-think the construct of “personality disorder” and thereby also opens the possibility for a better understanding of sex differences.12.
Anne Schienle Axel Wolf Peter Valentin Tomazic Rottraut Ille 《Chemosensory perception》2018,11(2):72-76
Introduction
Olfactory dysfunction can have a negative impact on emotional well-being. The aim of the present study was to examine associations between olfactory deficits and two affective personality characteristics (trait anxiety/trait depression).Methods
A questionnaire study was conducted with a total of 116 participants (33 classified as anosmic, 40 as hyposmic, and 39 as normosmic). All participants gave self-reports on two facets of trait depression (dysthymia, euthymia) and trait anxiety (arousal, worrying). Due to the fact that in all three groups, trait depression and anxiety were substantially correlated, analyses of covariance were conducted.Results
After controlling for trait depression, anosmic and hyposmic patients showed lower trait arousal compared to normosmic controls (partial η 2?=?.05). After controlling for trait anxiety, patients scored higher on dysthymia (partial η 2?=?.06).Conclusions
This study underlines the importance of statistically isolating specific associations between each of these affective personality characteristics and olfactory dysfunction.Implications
The present findings suggest that olfactory dysfunction can have opposite effects on facets of trait depression and trait anxiety.13.
Purpose
The main purpose of this review was to critically evaluate the literature on psychotherapies for borderline personality disorder (BPD) published over the past 5 years to identify the progress with remaining challenges and to determine priority areas for future research.Method
A systematic review of the literature over the last 5 years was undertaken.Results
The review yielded 184 relevant abstracts, and after applying inclusion criteria, 16 articles were fully reviewed based on the articles’ implications for future research and/or clinical practice.Conclusion
Our review indicated that patients with various severities benefited from psychotherapy; more intensive therapies were not significantly superior to less intensive therapies; enhancing emotion regulation processes and fostering more coherent self-identity were important mechanisms of change; therapies had been extended to patients with BPD and posttraumatic stress disorder; and more research was needed to be directed at functional outcomes.14.
Keren Lehavot Simon B. Goldberg Jessica A. Chen Jodie G. Katon Joseph E. Glass John C. Fortney Tracy L. Simpson Paula P. Schnurr 《Social psychiatry and psychiatric epidemiology》2018,53(9):943-953
Objectives
To examine factors that account for women veterans’ higher prevalence of past-year DSM-5 posttraumatic stress disorder (PTSD) compared to women civilians and men veterans.Methods
Cross-sectional analyses of the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III). Face-to-face interviews with 379 women veterans, 20,007 women civilians, and 2740 men veterans were conducted. Trauma type (child abuse, interpersonal violence, combat or war zone, and other), number of trauma types, past-year stressful life events, current social support, and DSM-5 PTSD were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-5. Generalized linear models were used that accounted for the complex survey design.Results
Women veterans had a higher unadjusted prevalence of past-year PTSD (11.40%) compared to their civilian (5.96%) and male (5.19%) counterparts. Individual predictor models indicated that the difference between women veterans’ and civilians’ prevalence of PTSD was attenuated when adjusting for number of trauma types, whereas the difference between men and women veterans was attenuated when adjusting for child abuse, interpersonal violence, and stressful life events. Nonetheless, while full adjustment in a multiple predictor model accounted for the difference in PTSD between women veterans and civilians, gender differences between men and women veterans remained.Conclusions
Number of trauma types, type of trauma, and social factors may together help explain women veterans’ higher PTSD prevalence compared to women civilians, but do not fully account for differences between men and women veterans. Results highlight a need to explore additional explanatory factors and evaluate associations with longitudinal data.15.
Mike Arnhold Yanina Dening Michaël Chopin Esteban Arévalo Mathias Schwarz Heinz Reichmann Gabriele Gille Richard H. W. Funk Francisco Pan-Montojo 《Clinical autonomic research》2016,26(3):211-222
Introduction
Involvement of the peripheral nervous system (PNS) is relatively common in Parkinson’s disease (PD) patients. PNS alterations appear early in the course of the disease and are responsible for some of the non-motor symptoms observed in PD patients. In previous studies, we have shown that environmental toxins can trigger the disease by acting on the enteric nervous system.Material and methods
Here, we analyzed the effect of mitochondrial Complex I inhibition on sympathetic neuritis in vivo and sympathetic neurons in vitro. Combining in vivo imaging and protein expression profiling.Results
we found that rotenone, a widely used mitochondrial Complex I inhibitor decreases the density of sympathetic neurites innervating the gut in vivo, while in vitro, it induces the redistribution of intracellular alpha-synuclein and neurite degeneration. Interestingly, sympathetic neurons are much more resistant to rotenone exposure than mesencephalic dopaminergic neurons.Conclusion
Altogether, these results suggest that enteric sympathetic denervation could be an initial pre-motor alteration in PD progression that could be used as an early biomarker of the disease.16.
S. Döpfmer M. C. Münchmeyer T. Natschke W. Herrmann F. Holzinger R. Burian A. Berghöfer C. Heintze 《Der Nervenarzt》2018,89(1):64-70
Background
The aim of this study was to compare the approach of general practitioners (GP) and outpatient specialists for psychiatry, neurology or psychosomatic medicine to patients with somatically unexplained complaints.Methods
Qualitative interviews were conducted with general practitioners in Berlin and with outpatient specialists. Interviews were analyzed by qualitative content analysis.Results
Both GPs and specialists rarely used structured diagnostic instruments. Guidelines are seen and used with reservation throughout the different specialties. Similar to the GPs, most of the specialists surveyed in this study had reservations against the necessity of a precise coding according to the International Classification of Diseases (ICD).Conclusion
In outpatient care the concern for the individual patient is the connecting element between different medical specialties. This results in a differential diagnostic and therapeutic approach that is not automatically in line with guidelines. The development of common concepts in ambulatory care might help to meet the demands of this complex group of patients with somatically unexplained complaints.17.
Jeffrey Guina Matthew Baker Kelly Stinson Jon Maust Joseph Coles Pamela Broderick 《Current psychiatry reports》2017,19(10):66
Purpose of Review
Since 1980, posttraumatic stress (PTS) disorder has been controversial because of its origin as a social construct, its discriminating trauma definition, and the Procrustean array of symptoms/clusters chosen for inclusion/exclusion. This review summarizes the history of trauma-related nosology and proposed changes, within current categorical models (trauma definitions, symptoms/clusters, subtypes/specifiers, disorders) and new models.Recent Findings
Considering that trauma is a risk factor for virtually all mental disorders (particularly depressive, anxiety, dissociative, personality), the multi-finality of trauma (some survivors are resilient, and some develop PTS and/or non-PTS symptoms), and the various symptoms that trauma survivors express (mood, cognitive, perceptual, somatic), it is difficult to classify PTS.Summary
Because the human mind best comprehends categories, reliable classification generally necessitates using a categorical nosology but PTS defies categories (internalizing and/or externalizing, fear-based and/or numbing symptoms), the authors conclude that PTS—like DSM-5’s panic attacks specifier—is currently best conceptualized as a specifier for other mental disorders.18.
Gemma Lombardi Cristina Polito Valentina Berti Camilla Ferrari Giulia Lucidi Silvia Bagnoli Irene Piaceri Benedetta Nacmias Alberto Pupi Sandro Sorbi 《Neurological sciences》2018,39(7):1203-1210
Background
An early differentiation between Alzheimer’s Disease (AD) and other dementias is crucial for an adequate patients’ management, albeit it may result difficult for the occurrence of “atypical presentations.” Current diagnostic criteria recognize the importance of biomarkers for AD diagnosis, but still an optimal diagnostic work-up isn’t available.Objective
Evaluate the utility and reproducibility of biomarkers and propose an “optimal” diagnostic work-up in atypical dementia.Methods
(1) a retrospective selection of “atypical dementia cases”; (2) a repetition of diagnostic assessment by two neurologists following two different diagnostic work-ups, each consisting of multiple steps; (3) a comparison between diagnostic accuracy and confidence reached at each step by both neurologists and evaluation of the inter-rater agreement.Results
In AD, regardless of the undertaken diagnostic work-up, a significant gain in accuracy was reached by both neurologists after the second step, whereas in frontotemporal dementia (FTD), adding subsequent steps was not always sufficient to increase significantly the baseline accuracy. A relevant increment in diagnostic confidence was detectable after studying pathophysiological markers in AD, and after assessing brain metabolism in FTD. The inter-rater agreement was higher at the second step for the AD group when the pathophysiological markers were available and for the FTD group when the results of FDG-PET were accessible.Conclusions
In atypical cases of dementia, biomarkers significantly raise diagnostic accuracy, confidence, and agreement. This study introduces a proof of diagnostic work-up that combines imaging and CSF biomarkers and suggests distinct ways to proceed on the basis of a greater diagnostic likelihood.19.
Background
The 10-m walk test (10MWT) is a widely used measure of gait speed in Parkinson’s disease (PD). However, it is unclear if different standardizations of its conduct impact test results.Aim of the study
We examined the clinical significance of two aspects of the standardization of the 10MWT in mild PD: static vs. dynamic start, and a single vs. repeated trials. Implications for fall prediction were also explored.Methods
151 people with PD (mean age and PD duration, 68 and 4 years, respectively) completed the 10MWT in comfortable gait speed with static and dynamic start (two trials each), and gait speed (m/s) was recorded. Participants then registered all prospective falls for 6 months.Results
Absolute mean differences between outcomes from the various test conditions ranged between 0.016 and 0.040 m/s (effect sizes, 0.06–0.14) with high levels of agreement (intra-class correlation coefficients, 0.932–0.987) and small standard errors of measurement (0.032–0.076 m/s). Receiver operating characteristic curves showed similar discriminate abilities for prediction of future falls across conditions (areas under curves, 0.70–0.73). Cut-off points were estimated at 1.1–1.2 m/s.Conclusions
Different 10MWT standardizations yield very similar results, suggesting that there is no practical need for an acceleration distance or repeated trials when conducting this test in mild PD.20.
Jennifer J. Thomas Elizabeth A. Lawson Nadia Micali Madhusmita Misra Thilo Deckersbach Kamryn T. Eddy 《Current psychiatry reports》2017,19(8):54