Emerging as a Personality Disorder Service

Personality Disorder Services working along psychotherapeutic lines are gaining appeal with Health Care Commissioners following the publication of the NICE guidelines for Borderline & Antisocial Personality Disorders and the emerging successful application of psychoanalytically-derived approaches.

Establishing a new Personality Disorder Service is akin to constructing a ‘home’ within which the therapeutic work with patients can develop. As clinicians, we are required to question what facets are important to the development of this new home, and to further to endure the unfamiliar state of being ‘not at home’ while the identity of the service is established.

We address how this process parallels the task facing the patient as they struggle to establish their own identity. We also highlight some important tenets in the work of securing a robust identity for both the service and the patient suffering from a personality disorder.     

The Road to Creative Achievement: A Latent Variable Model of Ability and Personality Predictors

This study investigated the significance of different well‐established psychometric indicators of creativity for real‐life creative outcomes. Specifically, we tested the effects of creative potential, intelligence, and openness to experiences on everyday creative activities and actual creative achievement. Using a heterogeneous sample of 297 adults, we performed latent multiple regression analyses by means of structural equation modelling. We found openness to experiences and two independent indicators of creative potential, ideational originality and ideational fluency, to predict everyday creative activities. Creative activities, in turn, predicted actual creative achievement. Intelligence was found to predict creative achievement, but not creative activities. Moreover, intelligence moderated the effect of creative activities on creative achievement, suggesting that intelligence may play an important role in transforming creative activities into publically acknowledged creative achievements. This study supports the view of creativity as a multifaceted construct and provides an integrative model illustrating the potential interplay between its different facets. © 2013 The Authors. European Journal of Personality published by John Wiley & Sons Ltd on behalf of European Association of Personality Psychology.     

Teachers’ Beliefs of Creative Children

Teachers’ beliefs about characteristics of creative children do not always align with how creative children actually behave. Understanding these misaligned beliefs—defined as misconceptions—is important because teachers’ misconceptions can undermine efforts to foster children's creative development. This study aimed to identify teachers’ beliefs about the characteristics of creative children with an emphasis on their misconceptions about characteristics as either indicative or contraindicative of creative children. We analyzed responses of 136 teachers to 29 characteristics, indicating or contraindicating creative children, on Gough's (1979). Creative Personality Scale using the Rating Scale Model. Results revealed that teachers tended to have more misconceptions about characteristics contraindicative of creative children than characteristics indicative of creative children while teachers were able to accurately recognize certain characteristics when compared with explicit theories of creativity. In both the indicative and contraindicative characteristics, misconceptions appeared to increase if characteristics were desirable in the classroom. Teachers’ misconceptions may conceal creative potential in children who do not manage their undesirable characteristics in constructive ways. Findings provide practical implications to aid teachers and teacher educators in correcting misconceptions about the characteristics of creative children.     

A proposed adaptation of DC: 0‐3R for primary care,developmental research,and prevention of mental disorders

The development of the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC: 0‐3; Zero to Three: National Center for Clinical Infant Programs, 1994) has been an important step in the field of infant mental health. In this paper, we propose some additions to the existing classification system. These additions include the development of criteria for infant, toddler, and family strengths, and the development of criteria for symptomatology that represents risk for disorder, but not fully manifest disorder. These additions will give DC: 0‐3R greater potential for use in the primary health care of children, thereby increasing the system's utility in diagnosing and preventing infant mental health problems.     

Psychopathic Personality Traits as Protective Factors against the Development of Post-Traumatic Stress Disorder Symptoms in a Sample of National Guard Combat Veterans

Military personnel often experience post-traumatic stress symptoms following exposure to combat. Personality traits have been identified as possible protective and risk factors in the development of post-traumatic stress disorder (PTSD), and examination of the association between PTSD and personality characteristics provides further insight into this heterogeneous disorder. Psychopathy, frequently conceptualized as collection of pathological personality disturbances relating to deficits in emotionality, empathy, and inhibitory control, includes within its defining features components that may be adaptive in certain situations. In the current study, we sought to expand upon the literature related to personality and PTSD by exploring psychopathic traits as resiliency factors in a military sample. Specifically, facets of psychopathy were analyzed as moderators of the association between combat experience and symptoms of post-traumatic stress disorder within a sample of 292 combat-exposed National Guard and Reserve (NGR) service members. Results indicated that the relationship of combat exposure with PTSD decreased as rates of interpersonal-affective psychopathic traits increased. Impulsive-antisocial traits were also found to moderate the association between combat experience and PTSD, though interestingly there was a similar decrease in magnitude with higher levels of these traits. These findings suggest that particular components of psychopathy may serve as protective factors against the development of PTSD symptomatology within this population.     

Creative potential, creative achievement, and personal growth

We tested the idea that young people who have creative potential (are complex and unconventional) increase in intrapsychic awareness as they mature but often have difficulty with psychosocial growth, especially the development of a cohesive identity; and that for some women commitment to creative work solves the problem of psychosocial integration and leads to creative achievement. In a longitudinal sample of 109 women, these ideas were supported: Creative potential and creative achievement were both associated with intrapsychic growth but only creative achievement was associated with psychosocial growth. Regression analyses showed that the development of a cohesive identity from early to middle adulthood added to and interacted with creative potential in the prediction of creative achievement.     

Fluid insight moderates the relationship between psychoticism and crystallized intelligence

To elucidate potential relationships between personality and intelligence it is necessary to move beyond the ad hoc reporting of correlation coefficients and focus instead on testing deductions from well-established theories. To this end the present paper references Eysenck’s (1995) theoretical work linking the dimension of psychoticism to both psychosis and creative genius. Drawing on this theory it was argued that the relationship between psychoticism and crystallized ability will be conditional on the level of fluid intelligence. Participants (N = 100) completed the Eysenck Personality Questionnaire-Revised (EPQ-R) and the Kaufman Brief Intelligence Test (K-BIT). Moderated multiple regression revealed a significant interaction effect. Crystallized ability (K-BIT vocabulary) was negatively related to psychoticism at low levels of fluid ability (K-BIT matrices) and positively related to psychoticism at high levels of fluid ability. These findings highlight the potential importance of psychoticism within GfGc investment theory.     

On Vandervert et al. “Working Memory,Cerebellum, and Creativity”

Four measures of self-determination (SD) were correlated with two measures of trait creativity. In Study 1, subjects high on the Creative Personality Scale (Gough, 1979) and the Problem-Solving/Creativity scale (Marsh &; O'Neill, 1984) were found to strive for self-determined reasons, to strive toward greater SD, and to evidence higher SD in measures of both motivational orientation and self-concept. Study 2 replicated most of these findings and also showed that creative subjects perceived their parents to be more autonomy supportive. Results are interpreted in terms of a general disposition to be self-determining that may help attune creative people to deeper cognitive resources and capacities within themselves.     

Frequency of borderline personality disorder among psychiatric outpatients in Shanghai

The objective of this study was to investigate the frequency, clinical characteristics, and comorbidity of borderline personality disorder (BPD) among psychiatric outpatients in two clinics at Shanghai Mental Health Center. A cross-sectional investigation was conducted. From 3,075 outpatients screened using the Personality Diagnostic Questionnaire-IV+, 2,284 patients positive for a personality disorder were assessed using the Structured Clinical Interview for DSM-IV Personality Disorders. The frequency of BPD among the psychiatric outpatients was 5.8%, with a frequency of 3.5% among males and 7.5% among females (p < .01). BPD was found to have extensive comorbidity with Axis I and II disorders. This study proves that BPD does occur in China. The detected frequency among outpatients is lower than that reported in North America.     

Predicting dimensions of personality disorder from domains and facets of the Five-Factor Model

We compared the utility of several trait models for describing personality disorder in a heterogeneous clinical sample (N = 94). Participants completed the Schedule for Nonadaptive and Adaptive Personality (SNAP; Clark, 1993b), a self-report measure that assesses traits relevant to personality disorder, and two measures of the Five-Factor Model: the Revised NEO Personality Inventory (NEO-PI-R; Costa and McCrae, 1992) and the Big Five Inventory (BFI; John, Donahue, & Kentle, 1991). Regression analyses indicated substantial overlap between the SNAP scales and the NEO-PI-R facets. In addition, use of the NEO-PI-R facets afforded substantial improvement over the Five-Factor Model domains in predicting interview-based ratings of DSM-IV personality disorder (American Psychiatric Association, 1994), such that the NEO facets and the SNAP scales demonstrated roughly equivalent levels of predictive power. Results support assessment of the full range of NEO-PI-R facets over the Five-Factor Model domains for both research and clinical use.     

The Significance of the Emergence of Language and Symbol in the Development of the Young Infant

In this paper I have suggested that the mother–child dyad is the foundation for integrity between the psychic self and the physical self, and the capacity of these to relate to the external environment. I have also argued that the development of language and symbol are creative agents in the development of consciousness in the young infant, and that the emergence of language and symbol are an expression of the opening of a potential space which allows differentiation from the mother and facilitates the infant’s ability to distinguish fantasy from fact and self from other. Sharn Waldron is a psychotherapist residing and working in Suffolk, England and is a registered member with the UKCP through the Forum for Independent Psychotherapists. She has contributed numerous papers for international psychotherapeutic journals, is a contributor to Pear’s Cyclopedia and writes freelance for Penguin and the National Health Service in the United Kingdom.     

Convergence of clinically derived diagnoses and parent checklists among inpatient children

The extent to which parent rating scales differentiated children according to DSM III diagnoses was examined. A total of 113 psychiatric inpatient boys (ages 6–11) were rated by their mothers or maternal figures on the Child Behavior Checklist (CBCL) and the Behavior Problem Checklist (BPC). Children with DSM III diagnoses of conduct disorder or depression were compared to children without these diagnoses. Externalizing and internalizing scales of the parent checklists and additional measures of child aggression and depression differentiated children according to major diagnoses. The use of parent checklists to classify children indicated a high level of sensitivity for both CBCL and BPC scales for diagnosing conduct disorder and depression. However, specificity of the subscales, particularly for the CBCL, was relatively low, indicating a high rate of false positives. The need for further work that extends the range of diagnosis, that examines subtypes of disorders, and that increases the specificity of the measures for diagnostic purposes is discussed.Completion of this project was supported by a Research Scientist Development Award (MH00353) and a grant (MH35408) from the National Institute of Mental Health, and by a Clinical Research Center Grant for the Study of Affective Disorders (5 P50 MH30915) from the National Institute of Mental Health. The authors are grateful to Elaine Meyer, Karen Esveldt-Dawson, Antoinette Rodgers, and the clinical research team and staff of the Child Psychiatric Treatment Service.     

Association between substance use disorders and self- and other-directed aggression: An integrated model approach

Our study's objective is to determine whether substance use disorders’ association with aggression differs according to the type of substance and/or the form of aggression, within the same population. We used data from the National Survey on Drug Use and Health across 2008–2014, with a pooled sample of 270,227 adult respondents. We used regression models to estimate the odds ratios for those having alcohol and/or drug use disorder(s) perpetrating (a) each form of aggression compared with no aggression and (b) other-directed compared with self-directed aggression. Alcohol use disorder alone and drug use disorder(s) alone were both associated with significantly increased odds of committing self-directed, other-directed, and combined aggression. Individuals with drug use disorder(s) alone were more likely to commit other-directed than self-directed aggression (adjusted odds ratio = 1.46, 95% CI = 1.04–2.05). Individuals with alcohol use disorder alone were not likely to commit one over the other (adjusted odds ratio = 1.20, 95% CI = 0.90–1.61). In conclusion, the integrated model of aggression based on the stress–diathesis model is a relevant framework to study risk factors for aggression. Further research is needed to identify longitudinal predictors of directionality of aggression.     

Probing Linear and Nonlinear Relations Among Schizotypy,Hypomania, Cognitive Inhibition,and Creativity

This study explored the relationship between schizotypy, hypomania, and indicators of creativity in 152 adult undergraduate students. We were interested in exploring a possible inverted U-shaped relationship between mental illness and creativity where moderate (vs. high or low) amounts of pathology are associated with facilitating creative responses. An indicator of cognitive inhibition derived from Stroop mismatch reaction times was also evaluated as a potential moderating factor between symptomatology and levels of creativity. College students (n = 152) were recruited from an introductory psychology class and completed a series of questionnaires (Schizotypal Personality Questionnaire-BR; Hypomania Checklist-32; Creative Achievement Questionnaire) and experimental tasks (color Stroop task; Wallach-Kogan Creativity Test) with a research assistant in a controlled environment. Polynomial regression results suggested that creative accomplishments were predicted by levels of disorganized schizotypy, but negatively associated with levels of interpersonal schizotypy. Scores on two divergent thinking indices were predicted by levels of disorganized schizotypy, yet surprisingly negatively associated with scores of hypomania. Although the relationship between disorganized symptoms and creative processes was not anticipated, these results may reflect certain nonconforming characteristics (e.g., tendency to wander off the topic in conversations) associated with this symptom domain. Although there was no definitive evidence supporting an inverted-U relationship between symptom severity and creativity within our sample, several linear relationships emerged suggesting that cognitive inhibition acted as a moderator variable for originality in those with higher levels of interpersonal schizotypy. Limitations and recommendations for future research are discussed.     

Sex differences in the original thinking of preschool and elementary school children

Abstract:

The purpose of this study was to assess the development of sex differences in the creative potential of preschool and early elementary school children. Preschool, first‐, and third‐grade children (N = 188) received the Multidimensional Stimulus Fluency Measure (MSFM). The MSFM assesses creative potential in terms of popular and original responses (ideational fluency). Comparisons of the three groups of children indicated that sex differences emerged throughout early elementary school. No sex differences were found within the preschool sample; but by third‐grade, boys were found to score significantly higher than girls on both popular and original responses. These findings were discussed with regard to evaluation, conformity, assimilative strategies, and the environmental factors which might affect creative potential.     

Creating Through Deviancy or Adjustment? The Link between Personality Profile Normativeness and Creativity

Does deviancy or adjustment predict creativity? To address this question, we tested the association between personality profile normativeness (similarity between one's personality profile and the average profile—a proxy for the deviancy–adjustment continuum) and creativity across four different samples (total N = 348 768). We used a wide range of creativity measures, including self‐reported, informant‐reported, behavioural, and occupational creativity, as well as several essential statistical controls (i.e., demographics, socio‐economic background, intelligence, and life satisfaction). Furthermore, we employed both cross‐sectional and longitudinal designs, including samples of college students and representative adult populations. We found that people who had more normative personality profiles were more creative. However, this association only held within modality (i.e. when both personality and creativity were either self‐reported or informant‐reported). We did not find robust associations between personality profile normativeness and laboratory‐based behavioural measures of creativity, occupational creativity, or creative achievements. We discuss alternative explanations for the observed adjustment–creativity link, specifically, implicit theories of creativity and person perception biases (halo effects). Notably, the findings did not support the idea that deviancy breeds creativity, suggesting that the famed ‘mad genius’ hypothesis might not hold among the general population. © 2019 European Association of Personality Psychology     

Identity and Creativity

Emerging adulthood is a period for exploration of identity aspects including occupational identity, and creative activity may contribute to or result from this exploration. Grounded in several conceptions of identity, particularly that of Erik Erikson, this research tested the prediction that identity processes predict creativity. In 2 studies (N = 250), university students completed measures of identity (Berzonsky's Identity Styles Inventory; Cheek's Aspects of Identity Questionnaire), plus creative potential (Creative Personality Scale), accomplishments (behavior checklist and open-ended listing), and products (drawings, stories). In keeping with prediction, these findings demonstrated that those who are information-seeking in style and emphasize their personal identity have the greatest potential creativity and evidence the greatest number of creative accomplishments in their young lives, whereas those emphasizing normative or collective identities evidenced fewer accomplishments. These identity variables contributed over and above the effects of gender and verbal ability. Results fit well with past findings in the creativity literature but represent a new direction for identity research and theory.     

Death in Hospital: The Place of Religion in the Care of the Patient

The reflections in this article are based on my experience over the past ten years as hospital chaplain of a large district general hospital within the UK National Health Service. I realize the limitations of this experience, but I hope that I may achieve some insights that have a wider application. I attempt to bring my hospital experience into a creative relationship with other aspects of my life, which include a commitment to Christian–Muslim dialogue, and a background of life and work in the Middle East, where I worked for the Anglican Church in Lebanon and Syria from 1973 until 1982.     

3~4岁幼儿创造性人格与气质的交叉滞后分析

以幼儿创造性人格倾向教师评定问卷、儿童气质教师评定问卷作为研究工具,对287名3岁和4岁组幼儿进行为期一年的追踪研究,考察幼儿气质与创造性人格的发展变化情况,以及幼儿气质与其创造性人格之间的关系。结果发现：随着时间的发展,幼儿气质对其创造性人格有显著影响。幼儿的情绪性、活动性、反应性及专注性均能够显著正向预测其创造性人格,而幼儿的社会抑制性则能够显著负向预测其创造性人格。     

The nature (and nurture) of personality disorders

Personality disorders have a long history in the literature but a short scientific history. The point prevalence of personality disorders is 10%, but the lifetime prevalence is probably 30–40%. Genetic factors contribute to around 40–50% of the variation in the development of personality disorders. The effect of shared environment is very small or non‐existent. Some researchers have tried to promote gene‐environment interaction. However, in reality, the studies investigated gene‐situation interaction, as the “environment” may in reality be partly of a genetic nature. Thus, we are dealing with an unknown part of gene‐gene interaction. Gene‐experience (not gene‐environment) correlations are the rule in human life. Personality disorders co‐occur (are comorbid) with symptom disorders (Axis I) and correlate with common personality dimensions. Possibly, the concept of personality disorder could merge with dysfunctional personality types. But it is likely that the concept will survive on its own.