Personality disorders at the crossroads

Personality disorders are now at a crossroads with respect to theory, research, and conceptualization. In this article, we review relevant and current issues within the personality disorder field. After reviewing changes in the conception of personality disorders across the past half century (1952 to 2002), we focus on the issue of continuity versus discontinuity methodologies for assessing personality, interactionism, treatments, resolved and unresolved issues, and future directions. The issue of continuity versus discontinuity is a theme in this article. We conclude that the evidence is in favor of a reapprochment between a categorical classification system and a dimensional system and we also outline the difficulties in achieving this change.     

Changing views about personality disorders: Comment about the prospective studies CIC, CLPS, and MSAD

Three large-scale prospective studies (Children in the Community Study [CIC; Cohen, Crawford, Johnson, & Kasen, this issue], Collaborative Longitudinal Personality Disorders Study [CLPS; Skodol et al., this issue], and the McLean Study of Adult Development [MSAD; Zanarini, Frankenburg, Hennen, Reich, & Silk, this issue]) are discussed with respect to the following issues: shared and complementary features of the study designs, evidence for stable and changing personality disorder features, methodological issues (reliability, stability, and invariance), the relationship between Axis I and II disorders, and dimensional versus categorical representations of personality disorders.     

Combating intimate partner violence in Africa: Opportunities and challenges in five African countries

Recent research results emerging from Africa show a worrying situation regarding the levels of intimate partner violence (IPV) in various countries in the continent — levels that are quite high and place great financial burden on individuals and governments. This paper explores the magnitude, nature, and risk factors of IPV in five African countries, namely, Morocco, Nigeria, Namibia, Uganda, and Tanzania. The focus of the paper is to explore issues of IPV in these countries by considering the opportunities in each country that could assist in the prevention of violence, and also to identify inherent challenges that may pose threats to efforts in reducing the high IPV prevalence. As there are only limited studies on IPV in developing countries, new insights provided by this paper would afford relevant stakeholders a better understanding of the issue.     

Toward a Social Psychology of Aging

The articles in this special issue highlight how social psychology can further the understanding of aging. One goal of this special issue is to generate more interest in aging as an area of study for social psychologists. A second goal is to challenge readers to think about how their research interconnects with issues in aging. A third goal is to demonstrate how social psychological processes have direct applications to real-world issues that face people as they age. This introduction to the special issue provides additional examples of how social psychology can contribute to a better understanding of aging.     

A manifesto for the new MCDA era

The following manifesto has been prepared by five prominent workers in the field of MCDA. We are currently preparing a special issue on the issues that they raise (see Call for Papers on p. 128). We invite you to contribute to the debate in that issue, either in the form of a paper or a letter to the Editor.     

Schlafstörung – Symptom der Depression?

Sleep disorders are an interdisciplinary health issue. Among western industrialized countries, many people suffer from poor quality of sleep. Especially, psychiatric patients have a high prevalence of sleep disorders. The treatment of sleep disorders should follow a detailed sleep history and polysomnographic work-up, which is often not possible in daily work. Thus, patients with sleep disorders are often not treated accurately. Mobile inhospital polysomnography is an attractive alternative that allows tests to be performed already during normal hospitalization on any ward. The following case report shows that the diagnostic work-up of sleep disorders can significantly affect further treatment decisions.     

Insiders and outsiders: Levels of collaboration in research partnerships across resource divides

With increasing recognition of the health and psychosocial challenges in developing countries, more research in these countries is essential. Research collaborations between wealthier and less wealthy countries are, however, complex. A partnership model has been proposed which emphasizes the importance of mutually respectful and beneficial relationships in international research. Using an example of a mother‐infant intervention project in South Africa we describe the elements of an equitable partnership model of research. An issue which has been overlooked, however, is the reality of power differentials within the poorer countries themselves. We show that there are many intersecting levels of relationships within intercountry research, and suggest that power dynamics within countries deserves equal attention as international issues. Based on our experiences, we present some tentative guidelines for international research which builds long‐term capacity and recognizes the importance of multiple levels of analysis and interaction.     

The temporal dimension of national identification: An empirical investigation in South Korea and Australia

We argue that national identification can be framed temporally, such that people may differently identify with their nation's past or present. Further, we argue that temporal national identification has important consequences for attitudes towards social changes. Within this new theoretical framing, we tested the empirical separability and predictive utility of past national identification and present national identification in South Korea and Australia. Results showed that, in both countries, past and present national identifications are correlated but empirically distinct constructs, which independently contribute to general national identification. Past and present national identifications were also shown to be grounded in distinct notions of national continuity. Most importantly, in both countries, present national identification positively predicted favourable attitudes towards social changes and globalization, whereas past national identification negatively predicted these attitudes. These findings suggest that temporally framed national identification is an important construct in the domain of social identification and in research on social changes and globalization.     

‘Moral Taint’ or Ethical Responsibility? Unethical Information and the Problem of HIV Clinical Trials in Developing Countries

Clinical trials in developing countries are often beset by ethical problems that would be considered unresolvable in countries like Australia and the U.S. Nevertheless, such trials continue to go ahead throughout Asia, Africa and South America, and are often conducted in ways that could be considered to be unethical. In this article I discuss two issues, focussing on an HIV preventative trial of a vaginal gel, the Nonoxynol 9 phase three trial being held in Kenya. The first of these is what makes such a trial unethical given that it has approval from the WHO and seemingly conforms with acceptable standards of consent. The second issue involves using material from such trials, if we accept that they were conducted unethically.     

Advancing a clinical transport psychology

This article argues that mental disorders are a dimension so far largely overlooked in studies of transport behaviour and mobility consumption, even though they may to a considerable degree affect how we understand, value, and use different transport modes. Mental disorders include anxiety-, mood-, substance abuse-, and personality disorders, each of which affects only up to a few per cent of the population in industrialised countries. On an aggregated basis, however, mental illnesses influence large parts of the population. Based on an exploratory research approach, this article discusses how mental disorders affect, and are affected by, mobility consumption, also identifying social, political and/or institutional mechanisms that contribute to or validate mental disorders. It is argued that without a better understanding of these interrelationships, mobility consumption and -growth cannot be fully understood. Results are consequently of relevance for transport planning, the prevention of accidents, as well as the design of interventions to develop more sustainable transport systems.     

Introduction to the special issue on personality assessment in the DSM-5

The DSM-5 is poised to dramatically reshape the way clinicians and researchers assess personality by reconfiguring the conceptualization of DSM-IV personality disorders. This special issue brings together leading scholars in personality pathology, including members of the DSM-5 Personality and Personality Pathology Work Group, as well as personality assessors operating from a variety of theoretical perspectives, to describe various facets of these changes and their potential impacts and in some cases to propose alternative solutions. As we describe in this brief introductory article, the articles in this special issue highlight several important and controversial issues in the transition to DSM-5 personality assessment.     

Personality disorder and antisocial deviance: comments on the debate on the structure of the psychopathy checklist-revised

The recent debate on the structure of the Psychopathy Checklist-Revised (PCL-R: Hare, 1991; 2003) has been presented primarily as a statistical issue, but underlying it are longstanding conceptual issues about the relationship of personality concepts to deviant behavior and of psychopathy to criminality and personality disorder. I discuss these issues in this paper. The antisocial items of the PCL-R seem to reflect a propensity to commit crimes that has long been of interest to criminology. This disposition overlaps with, but differs conceptually from personality dispositions, but these surface dispositions do not provide a causal account of criminality. I present data that indicate that the core personality characteristics of psychopathy are more closely related to narcissistic and histrionic personality disorders than to antisocial personality disorder. Overemphasis on involvement in crime has obscured the nature of psychopathy as a disorder of personality characterised by interpersonally harmful behavior that need not necessarily take criminal form.     

Portrayals of Global Health Worker Migration in Canadian Print News Media: Domestic Concerns vs. Global Awareness

The global migration of physicians and nurses has implications for health human resources in both source and recipient countries. Of particular concern to academics and policy experts is the “brain drain” of health professionals from under-resourced nations to developed countries, which promote immigration of physicians and nurses to solve their own health worker shortages. How does the general public in these destination countries understand and respond to concerns over migration and immigration of health professionals? This understanding is likely to be influenced in large part by how the issues are portrayed in the news media. News media treatment of this issue was explored by surveying news articles; newspaper columns/editorials; and op-ed pieces; and letters to the editor published in four prominent Canadian newspapers between May 2004 and January 2009, a time frame that included two federal elections in which physician immigration was highlighted as a political issue. Despite the prominence among academics of concern over the brain drain of physicians and nurses from developing countries to Canada and other Western nations, this issue received little attention in print news media discussions, which focused on domestic physician shortages and the role of international medical graduates in filling Canadian needs. While recent federal elections brought concerns about immigrant physicians into the political spotlight in Canada, they did so by focusing on Canadians' health care provision needs to the exclusion of promoting a broader, global awareness that the immigration of health professionals to developed nations such as Canada exacerbates global health disparities.     

Moral Arguments in the Debate over Nanotechnologies: Are We Talking Past Each Other?

How are we to understand the fact that the philosophical debate over nanotechnologies has been reduced to a clash of seemingly preprogrammed arguments and counterarguments that paralyzes all rational discussion of the ultimate ethical question of social acceptability in matters of nanotechnological development? With this issue as its starting point, the study reported on here, intended to further comprehension of the issues rather than provide a cause-and-effect explanation, seeks to achieve a rational grasp of what is being said through the appeals made to this or that principle in the range of arguments put forward in publications on the subject. We present the results of the study’s analyses in two parts. In the first, we lay out the seven categories of argument that emerged from an analysis of the literature: the arguments based on nature, dignity, the good life, utility, equity, autonomy, and rights. In the second part, we present the background moral stances that support each category of argument. Identifying the different categories of argument and the moral stance that underlies each category will enable a better grasp of the reasons for the multiplicity of the arguments that figure in discussions of the acceptability of nanotechnologies and will ultimately contribute to overcoming the tendency towards talking past each other that all too often disfigures the exchange. Clarifying the implications of the moral arguments deployed in the debate over nanotechnologies may make it possible to reduce the confusion observable in these exchanges and contribute to a better grasp of the reasons for their current unproductiveness.     

心理学对和谐社会的贡献

心理学在现代社会中具有满足社会需求的任务。多数国家都有这种社会需求,使得心理学成为真正意义上的跨国界学科。心理学确实能够提供解决问题的一般方法,但在面对某个国家的具体国情时则需要特殊的处理方法。在不同体制国家里所做的研究并不一定完全适用于其他国家,这意味着对一个国家里提出的心理学问题,还必须在本国内做进一步的基础研究。每个国家都需要这种心理学的本土化过程。本文提供一些研究案例,其研究成果既是有意义的,但还需要进一步研究。如何为和谐社会做贡献,作者提出了一个研究框架     

Cluster A Personality Symptomatology in Youth

There is an increasing recognition of the importance of studying the childhood antecedents of adult personality disorders as well as personality disorders themselves within childhood and adolescence. This has been a long neglected area of research. The two papers within this special issue of Journal of Psychopathology and Behavioral Assessment by Esterberg et al. (2010) and De Clercq et al. (2010) make significant strides toward addressing this delinquent focus of investigation. This commentary addresses three issues stimulated by these two particular studies: the distinction between personality and other mental disorders, dimensional models of classification, and openness to experience.     

Bioethics and Pastoral Concern: Some Possible New Directions in Pastoral Theology

This special issue of the journal is comprised of papers given at a conference in May 2011 at the University of Texas Health Science Center at Houston on the theme of “Social Justice and the Health Professions.” This article offers the following rationale for this special issue in particular and for pastoral theologians to contribute to bioethics in general: (1) two contemporary theological thinkers in bioethics, Karen Lebacqz and Lisa Cahill, argue that theological discussions of justice broaden and deepen discussions of justice in mainstream bioethics—thus the focus on social justice provides an area for interdisciplinary and intersectional work; (2) pastoral theologians have not, to a great extent, contributed to discussions of religion and bioethics—this has been the territory of theological ethicists, especially during the 1970s; (3) one influential pastoral theologian, Bonnie Miller-McLemore, has called for (a) a broader concern for health in pastoral theology beyond psychological health and (b) more disciplinary approaches within pastoral theology beyond psychology so as to attend to “the living human web”; and (4) one way to advance the theological contributions in bioethics is by inviting pastoral theologians to focus on matters of social justice (an established area of intersection) as identified by health professionals, thus providing (a) new areas for inquiry and (b) new theological perspectives in bioethics. This article also suggests that pastoral theologians can contribute to bioethics by focusing on both “macro” issues (issues relating to structures and groups) and “micro” issues (issues relating to persons and experiences) as a way of pursuing the topic of justice in bioethics. The bulk of this article focuses on “macro” issues, but, in closing, the author articulates how he has been addressing “micro” issues in his own work. The author argues that both of these approaches—“macro” and “micro”—are legitimate ways for pastoral theologians to express pastoral concerns in bioethics.     

We Are the World—and They Are Not: Prototypicality for the World Community,Legitimacy, and Responses to Global Inequality

The relation between developed and developing countries is characterized by inequalities that sometimes hinder actions against worldwide problems. The current research presents an intergroup approach, based on the ingroup projection model, towards an analysis of psychological processes that perpetuate global inequality on a social group level. Precisely, we argue that people from developed countries perceive their group as more prototypical for the world population than they perceive people from developing countries. These perceptions of ingroup prototypicality should in turn relate to legitimacy beliefs and predict unfavorable behavioral intentions towards developing countries. We present two studies that corroborate our hypotheses: In Study 1, participants from a developed country perceived their ingroup as more prototypical for the superordinate group (i.e., world population) than the outgroup (i.e., developing countries), which in turn was related to beliefs that global inequality is legitimate. This finding was replicated in Study 2, and the predicted effect of ingroup prototypicality on behavioral intentions was mediated by legitimacy beliefs. These findings demonstrate that intergroup processes can contribute to perpetuating global inequality.     

Psychosomatic disorders: the canalization of mind into matter

Psychosomatic disorders represent a therapeutic conundrum. Despite compelling evidence to suggest the integrity of mind and body, humans are famously prone to experiencing them as separate. This paper explores the scientific challenges posed by psychosomatic disorders and how changing cultural notions contribute to their perplexing presentations. Excerpts of cases from patients with chronic pelvic pain, chronic fatigue, and a factitious disorder are presented as examples of the challenges that these patients pose in analysis. An explanatory model of mind/body interaction based on early maternal-infant interactions and the placebo response complex is proposed as the basis for how psychosomatic pathologies may develop. Finally, therapeutic approaches to the psychological treatment of patients with psychosomatic issues are considered.     

In Search for the Many Faces of Community Resilience Among LGBT Individuals

Many countries (e.g., Egypt, Russia, and Uganda) have very draconian laws against LGBT individuals. Despite facing such adversity or hostility many LGBT individuals do strive and maintain their sense of self‐worth. How do they do it? The collection of papers in this special issue attempts to provide some answers to this question. I will attempt to analyze two overlapping issues in these papers, and how they might inform LGBT research using a resilience lens.