Gender differences in alcohol dependence: personality variables, psychopathological profile and personality disorders

In this paper, gender differences in personality, psychopathology and personality disorders of alcohol-dependent patients are described. The sample consisted of 158 alcohol-dependent patients attending a psychiatric outpatient clinic (105 men and 55 women). All participants were assessed with various assessment tools related to personality (Impulsiveness Scale, Sensation Seeking Scale and STAI), psychopathology (SCL-90-R, BDI and Inadaptation Scale) and personality disorders (IPDE). There were no differences in personality variables, but the women had more anxiety and depressive symptoms and also more problems to adapt to everyday life than did the men. Personality disorders were not as prevalent as in the case of men, and the most frequent among women were obsessive-compulsive, dependent and histrionic personality disorders. Implications of this study for further research are commented on.     

Religious agency,identity, and communication: reflections on history and theory of religion

Abstract

This paper discusses the applicability of recent theories of religion to the problem of describing and explaining religious transformation in the period between the final Bronze Age and Late Antiquity. Instead of evolutionist and cognitive approaches, it proposes a model of religion that tries to analyze religion in terms of its making by starting from the individual's appropriation and creation of religious tradition. Religion is understood as a strategy to attribute agency to agents that do not appear immediately plausible. Recent scholarly discussions on human agency suggest categorizing human religious agency into the three subsets, namely: (1) acting religiously with regards to past, present, and future; (2) collective religious identity; and (3) religious communication. These subsets are shown to produce fruitful questions for research on historical sources. Against this backdrop, religion is explained as a precarious cultural resource articulated through the agency of individuals and allowing changed attributions of individual agency.     

Continuity of axes I and II: toward a unified model of personality, personality disorders, and clinical disorders

In the current standard psychiatric nomenclature, the DSM-IV-TR (APA, 2000), mental disorders are divided into two groups: Clinical Disorders (CDs) and Personality Disorders (PDs), and CD and PD diagnoses are recorded on two separate axes (Axes I and II, respectively). This article considers evidence regarding putative bases for distinguishing between CDs and PDs, and finds that these constructs are more similar than distinct. Links between the domains may be better understood by focusing on how personality connects CDs and PDs. This perspective underlines the need to work toward a more unified model of personality, PDs, and CDs in research and in future editions of the DSM.     

Transformations of identity: Referent location,agency, and levels of integration in the progress from potential self to existential identity

The study traces the genesis of existential despair and empty depression in personality disordered individuals to the impact of a premature definition of the self in terms of an other-centered referent. Three aspects of identity are discussed: self identity, role identity, and existential identity. Their respective potential contribution to self-integration is examined.     

Person, personality, self, and identity: a philosophically informed conceptual analysis

Who is the person, or self, associated with personality disorder and its treatment? How are we to account for a self conceptualized in terms of schemas and representations, that at the same time--as self--scrutinizes these schemas and representations (as in cognitive therapy for personality disorders)? Five approaches to personhood are examined: metaphysical, empirical, transcendental, hermeneutical, and phenomenological. An elementary sense of selfhood is tied to all one's experiences and activities; this sense of self is experientially irreducible and conceptually connected to a primordial form of self-relatedness. After examining these issues, I formulate four provisional conclusions: (a) the separation between person and roles (functions, personality features) is a modern fiction--persons are not neutral bearers of roles and functions; (b) the concept of personality in DSM-IV refers to nonhomogeneous behaviors such as feelings, moods, inclinations, temperaments, and habits, and these behaviors differ with respect to their distance to the core self; (c) there exists an enormous variety of ways of self-relating and this variety may affect the contents of the core self under certain circumstances; and (d) the concept of person may be primitive; that is, irreducible and referring to a background of unity and integrity.     

Social identity and personality processes: Non‐Aboriginal Australian identity and Neuroticism

There are ongoing debates both in personality psychology and social psychology on the causes and consequences of personality stability and change. Recent work on social roles suggests that as people change roles (e.g. employee to manager), different experiences and demands are internalised into one's self‐concept shaping identity and personality. In this paper, the emphasis moves beyond ‘roles’ to other group memberships (e.g. ethnicity) in shaping one's self‐view and self‐rated personality (e.g. Neuroticism). The results of two experiments demonstrated that the salience of a particular group membership (as a Non‐Aboriginal Australian) did significantly impact on Neuroticism. Such findings suggest that social identity processes may offer a hitherto neglected avenue for helping to explain personality (dis)continuity. Implications of these findings for both fields are discussed. Copyright © 2012 John Wiley & Sons, Ltd.     

Temperament, personality, and developmental psychopathology as childhood antecedents of personality disorders

To contribute to the case for a dimensional conceptualization of psychopathology in general and maladaptive personality or personality disorders in particular, the present paper reviews the evidence for a dimensional representation of childhood temperament and personality. The review of temperament and variable-centered as well as person-centered approaches to childhood personality leads us to propose five broadband dimensions that capture individual differences in children and adolescents: extraversion, emotional stability, agreeableness, conscientiousness, and openness/intellect. Our analysis of the CBCL (Achenbach, 1991) and the DIPSI (currently under development at Ghent University), two dimensional models for childhood psychopathology, suggests two common broadband factors, internalizing and externalizing. The relations between the dimensional representation of childhood temperament/personality and psychopathology are documented with data from general population and clinical samples of children and adolescents. The article concludes with a proposal on how the higher-order dimensions emerging from studies of adaptive and maladaptive individual differences in childhood could be integrated in a common dimensional model.     

Forced migration, adolescence, and identity formation

Adolescence is a complex biopsychosocial phenomenon. All the inner-subjective changes in adolescents take place within the context of a specific social environment, which offers the necessary ideological setting that adolescents must confront in the course of their identity formation. Forced migration creates conditions under which the adolescent Ego may be traumatized more easily, resulting in the development of defensive mechanisms, which may interfere with the natural process of identity formation. The aim of this paper is to investigate how a traumatic situation such as forced migration may affect the mechanisms of identity formation in adolescence. For this purpose, clinical material, consisting of two cases of psychoanalytical psychotherapy of adolescents who were forced to immigrate to Greece, is presented and discussed in a psychoanalytical theoretical framework, along with the historical-sociological background.Dimitris C. Anagnostopoulos, M.D., is a child psychiatrist and psychoanalyst, Child and Adolescent Psychiatric Unit, Community Mental Health Center, Psychiatric Department, Medical School, University of Athens, Athens, Greece.Maria Vlassopoulos, Ph.D., is at the Child and Adolescent Psychiatric Unit, Community Mental Health Center, Psychiatric Department, Medical School, University of Athens, Athens, Greece.Helen Lazaratou, M.D., is at the Child and Adolescent Psychiatric Unit, Community Mental Health Center, Psychiatric Department, Medical School, University of Athens, Athens, Greece.     

The dynamics of personality and identity in adolescence

The present paper summarizes some of the key findings on the dynamics of personality and identity in adolescence by the author's research group. With regard to personality, we found evidence for a maturation process in which girls were ahead of boys. Being ahead or lagging behind with regard to this maturation process was found to be associated with internalizing and externalizing problems, respectively. We further identified which specific traits were associated with problem behaviour, and showed that these associations are bidirectional. With regard to identity, we showed that short-term fluctuations affect subsequent levels of identity dimensions. In addition, we uncovered a commitment–reconsideration dynamic that operates on a day-to-day level.     

Discrepancy between explicit judgement of agency and implicit feeling of agency: Implications for sense of agency and its disorders

The sense of agency refers to the feeling of authorship that “I am the one who is controlling external events through my own action”. A distinction between explicit judgement of agency and implicit feeling of agency has been proposed theoretically. However, there has not been sufficient experimental evidence to support this distinction. We have assessed separate explicit and implicit agency measures in the same population and investigated their relationships. Intentional binding task was employed as an implicit measure and self-other attribution task as an explicit measure, which are known to reflect clinical symptoms of disorders in the sense of agency. The results of the implicit measure and explicit measure were not correlated, suggesting dissociation of the explicit judgement of agency and the implicit feeling of agency.     

Psychological well-being: its relation to work personality, vocational identity, and career thoughts

The authors examined the impact of the 6 dimensions of psychological well-being on participants' career thoughts, vocational identity, and developmental work personality. Undergraduates (N = 91) completed 4 measures: (a) C. D. Ryff's (1989, 1995) Scales of Psychological Well-Being (SPWB), (b) J. P. Sampson, G. W. Peterson, J. G. Lenz, R. C. Reardon, and D. E. Saunders's (1996) Career Thoughts Inventory (CTI), (c) the Vocational Identity (VI) subscale of J. L. Holland, D. C. Daiger, and G. Power's (1980) My Vocational Situation, and (d) D. R. Strauser and J. M. Keim's (2002) Developmental Work Personality Scale (DWPS). The authors then conducted multiple regression analyses to examine the relations between psychological well-being and the 3 career variables. Results indicated the following: (a) Psychological well-being accounted for a significant portion of the variance in all 3 career variables; (b) scores on the Purpose in Life subscale of the SPWB made a unique contribution to scores on the Commitment Anxiety subscale of the CTI (CTI-CA) and to VI; (c) scores on the Personal Growth subscale of the SPWB made a unique contribution to CTI-CA scores; and (d) scores on the Self-Acceptance and Environmental Mastery subscales of the SPWB each made a unique contribution to DWPS scores.     

Major depression, double depression and personality disorders

Personality disorders are much more common among depressive patients than among normal people. Until now, little research has been conducted into the prevalence of personality disorders among patients with both major depression and dysthymia (double depression). The subject of this study is whether depressive patients with dysthymia have more personality disorders than those with no dysthymia. The Vragenlijst voor Kenmerken van de Persoonlijkheid (a Dutch self-report based on the International Personality Disorder Examination) was completed for 211 outpatients with major depression. Approximately 60% of the patients suffer from one or more personality disorders. Depressive patients with dysthymia differ little from the patients without dysthymia, but patients with dysthymia have more cluster A disorders and are more avoidant. Depressive patients without dysthymia do not differ from the patients with dysthymia in terms of symptoms. Depressive patients with personality disorders have significantly more symptoms than the patients without these disorders. There is no interaction between dysthymia and personality disorder.     

DSM-5 personality traits and DSM-IV personality disorders

Two issues pertinent to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) proposal for personality pathology, the recovery of DSM-IV personality disorders (PDs) by proposed DSM-5 traits and the validity of the proposed DSM-5 hybrid model, which incorporates both personality pathology symptoms and maladaptive traits, were evaluated in a large undergraduate sample (N = 808). Proposed DSM-5 traits as assessed with the Personality Inventory for DSM-5 explained a substantial proportion of variance in DSM-IV PDs as assessed with the Personality Diagnostic Questionnaire-4+, and trait indicators of the 6 proposed DSM-5 PDs were mostly specific to those disorders with some exceptions. Regression analyses support the DSM-5 hybrid model in that pathological traits, and an indicator of general personality pathology severity provided incremental information about PDs. Findings are discussed in the context of broader issues around the proposed DSM-5 model of personality disorders.     

Addicted patients with personality disorders: traits, schemas, and presenting problems

We evaluated the association of Structure Clinical Interview for the DSM-IV Axis II (SCID-II) severity and personality traits, early maladaptive schemas, and presenting symptoms in 41 methadone-maintained patients meeting criteria for either antisocial, borderline, avoidant, or depressive personality disorder. Correlational analyses indicated that the severity of each personality disorder was associated with a unique profile of presenting problems and underlying traits and schemas. The evaluation of multiple psychological indicators appears to be a useful method for case conceptualization and planning interventions within a promising individual therapy model that focuses both on substance abuse and psychiatric symptoms and maladaptive schemas and coping styles.     

The integration of agency and communion in moral personality: Evidence of enlightened self-interest

Agency and communion are fundamental human motives, often conceptualized as being in tension. This study examines the notion that moral exemplars overcome this tension and adaptively integrate these 2 motives within their personality. Participants were 25 moral exemplars-recipients of a national award for extraordinary volunteerism-and 25 demographically matched comparison participants. Each participant responded to a life review interview and provided a list of personal strivings, which were coded for themes of agency and communion; interviews were also coded for the relationship between agency and communion. Results consistently indicated that exemplars not only had both more agency and communion than did comparison participants but were also more likely to integrate these themes within their personality. Consistent with our claim that enlightened self-interest is driving this phenomenon, this effect was evident only when agency and communion were conceptualized in terms of promoting interests (of the self and others, respectively) and not in terms of psychological distance (from others) and only when the interaction was observed with a person approach and not with the traditional variable approach. After providing a conceptual replication of these results using different measures elicited in different contexts and relying on different coding procedures, we addressed and dismissed various alternative explanations, including chance co-occurrence and generalized complexity. These results provide the first reliable evidence of the integration of motives of agency and communion in moral personality.     

Gender role and personality disorders

Many researchers have hypothesized relationships between personality disorders and gender role (i.e., masculinity and femininity). However, research has not addressed if people who are masculine or feminine more often meet the criteria for personality disorders. The present study examined whether college students (N = 665, 60% women) higher in masculinity or femininity more often exhibited features of the 10 DSM-IV personality disorders. Feminine men exhibited more features of all the personality disorders except antisocial. Dependent traits were associated with higher femininity and lower masculinity. Antisocial traits were associated with masculinity. Both men and women who typically behaved consistent with their gender had more narcissistic and histrionic features, whereas participants who typically behaved unlike their gender had more features of the Cluster A personality disorders.     

Authority conflicts and personality disorders

We investigated personality disorders (PDs) of young men with chronic authority conflicts using the Millon Clinical Multiaxial Inventory-I (MCMI-I; Millon, 1983). PDs occurred considerably more often in the young men with chronic authority conflicts (62%) compared with a clinical control group of young men with acute authority conflicts (39%). The prevalence of PDs in a normal control group was considerably lower (11%). The passive-aggressive PD is over-represented among young men with chronic authority conflicts; there is hardly any antisocial PD. Millon's conceptualization of these disorders could have influenced these results. The high prevalence of passive-aggressive PDs complicates a good psychotherapeutic outcome in young men with chronic authority conflicts. Our results underscore the clinical utility of the controversial PAPD diagnosis.     

Borderline personality disorder,complex trauma,and problems with self and identity: A social-communicative approach

Borderline personality disorder (BPD) is a relatively highly prevalent psychiatric disorder that is associated with very high personal and socioeconomic costs. This paper provides a state-of-the-art review of the relationship between complex trauma and key features of BPD, with a focus on problems with self-coherence and self-continuity. We first review evidence for the high prevalence of complex trauma in BPD patients. This is followed by a discussion of emerging knowledge concerning the biobehavioral mechanisms involved in problems related to self and identity in BPD. We emphasize three biobehavioral systems that are affected by complex trauma and are centrally implicated in identify diffusion in BPD: the attachment system, mentalizing or social cognition, and the capacity for epistemic trust—that is, an openness to the reception of social communication that is personally relevant and of generalizable significance. We formulate a new approach to personality and severe personality disorders, and to problems with self and identity in these disorders, rooted in a social-communicative understanding of the foundations of selfhood. We also discuss how extant evidence-based treatments address the above-mentioned biobehavioral systems involved in identity diffusion in BPD and related disorders, and the supporting evidence. We close the paper with recommendations for future research.