Does comorbid attention-deficit/hyperactivity disorder impact the clinical expression of pediatric obsessive-compulsive disorder?

What is the impact of attention-deficit/hyperactivity disorder (ADHD) on the phenotypic expression of pediatric obsessive-compulsive disorder (OCD). We examined phenotypic features, and functional and clinical correlates in youths with OCD, with and without comorbid ADHD, from a large sample of consecutively referred pediatric psychiatry patients. Although comorbid ADHD had no meaningful impact on the phenotypic expression or clinical correlates of OCD, it was associated with higher rates of compromised educational functioning compared with other OCD youths. Our findings suggest that the OCD phenotype runs true and is not impacted by comorbid ADHD in youths diagnosed with both OCD and ADHD. In such affected youths, both disorders contribute to morbid dysfunction and require treatment. More work is needed to determine whether OCD plus ADHD represents a developmentally and etiologically distinct form of the OCD syndrome.     

Histrionic personality disorder and antisocial personality disorder: sex-differentiated manifestations of psychopathy?

Little is known about the etiology of histrionic personality disorder (HPD) or its relation to other personality disorders. In this study, we examined whether HPD is etiologically related to psychopathy and more specifically whether HPD and antisocial personality disorder (ASPD) are sex-typed alternative manifestations of psychopathy. In addition, based on Newman's (1987) response modulation hypothesis of psychopathy, we examined the associations between psychopathic, HPD, and ASPD features and performance on laboratory measures of passive avoidance errors and interference effects. Seventy-five live theater actors completed self-report questionnaires and two laboratory measures of response modulation, and peers completed questionnaires concerning the participants' personality disorder features. The results provided weak and inconsistent support for the hypotheses that HPD is a female-typed variant of psychopathy and that ASPD is a male-typed variant of psychopathy. Contrary to previous findings, scores on response modulation tasks were not significantly related to psychopathy, or to either HPD or ASPD. The limitations of this study and possibilities for future research in this area are outlined.     

Should self-defeating personality disorder be revisited in the DSM?

Self-defeating personality disorder (SDPD) was proposed for consideration in the DSM-III-R, but was eventually removed from the manual because of the lack of evidence to support its validity. Yet, after DSM-IV was published, some studies suggested that SDPD may be a viable diagnosis. The purpose of this study was to evaluate SDPD's viability as a diagnostic category. Consequently, SDPD's internal consistency, comorbidity with other Axis I and II disorders, association with psychosocial impairment, and its ability to predict overall impairment in past, current, and global levels of functioning beyond other personality disorder symptomatology was assessed in 1,200 psychiatric evaluated with the Structured Clinical Interview for DSM-IV Personality (Pfohl, Blum, & Zimmerman, 1997). Cronbach's alpha for SDPD criteria was 0.61, and item-total correlations ranged between 0.22-0.38. There was substantial comorbidity of SDPD with depressive, avoidant, and borderline personality disorders, as well as major depression and anxiety disorders. The SDPD group did not significantly differ from psychiatric controls on multiple measures of psychosocial impairment, global functioning, and suicidality. SDPD did not meaningfully add to the prediction of impairment above and beyond other measures of Axis II pathology. It is concluded that the data do not support the reliability, validity, and utility of the SDPD diagnosis.     

Is personality disorder inherited? An overview of the evidence

Genetic factors appear to be of considerable importance in determining normal variation in personality. This is suggested by family, twin, and adoption studies as well as by indirect findings based on animal and psychophysiological studies. In contrast, there is consistent evidence that the contribution of shared family environment is minimal. Despite difficulties in defining personality disorder, it appears that many types of personality disorder, in particular schizotypal personality disorder and antisocial personality disorder/criminality, are also influenced genetically. The genetic transmission of normal personality traits and disorder is most easily explained by the contribution of multiple genes of small effect rather than by single-gene inheritance. Recent advances in molecular genetics have led to the localization of genes of minor effect for some traits. This raises the possibility of detecting a molecular basis of traits and disorders such as personality and personality disorder.Anita Thapar is supported by a Research Training Fellowship from the Medical Research Council.     

Is obsessive-compulsive disorder caused by a second-messenger imbalance?

Although the precise etiologic nature of obsessive-compulsive disorder (OCD), one of the most common psychiatric conditions, is unknown, several findings indicate involvement of the serotonin (5-HT) transporter. Apart from the specific effects of selective 5-HT reuptake inhibitors, other studies show decreased functionality of the platelet 5-HT transporter in OCD. In this report, the authors combine data from two independent studies of patients with OCD, showing both an increased activity of protein kinase type C (PKC) and a decreased activity of protein kinase type A (PKA). The authors propose a unifying hypothesis that OCD might be determined by an imbalance between PKC and PKA, with a prevalence of the former and, more generally, of the phosphoinositide over the cyclic adenosine monophosophate (cAMP) pathway. Should this hypothesis prove correct, the path would be open for new therapeutic interventions in the treatment of OCD.     

Who should rule? Does personality matter?

The study of leadership and personality has a long and controversial history. A review of trends and empirical research on relations between personality characteristics and leadership is presented. It is concluded that fragmentation and a narrow focus have been characteristic of most empirical research on leadership personality. The total space encompassing leadership issues has been compartmentalized into subareas such as leader traits, behaviour styles, and the situational view. It is argued that leadership is a multifaceted phenomenon that cannot be captured by focusing on a small number of variables. A holistic approach attempting to cover a range of traits so as to discern more complex trait patterns in relation to kinds of leader behaviour in different organizational settings is needed to gain an in-depth insight into the complexity of leader behaviour and leader effectiveness. Fragmentation of individual functioning needs to be reduced. Research should also focus on the dynamics of the relationship between leader characteristics and leader behaviour in different social settings. © 1997 John Wiley & Sons, Ltd.     

Does personality matter in exercise participation?

This research extends previous work by demonstrating how the relationships between social cognition and exercise are influenced by different personality types. The theory of planned behaviour forms the basis of our theoretical model, and the Big Five personality framework was used to determine personality types. Data were collected from a quota sample of 512 Malaysian adults. The results suggest that an individual's personality can prevent him or her from exercising. For example, an extrovert is likely to be driven by affect and self‐confidence in their capability to exercise, and thus are more likely to participate in exercise. Those who are more conscientious (and less neurotic) feel more in control and thus possess a greater ability to exercise in comparison with their less conscientious and more neurotic counterparts. Our findings demonstrate the importance of considering personality factors in exercise research and caution us about underestimating the relationship between perceived control, attitude and its potential behavioural outcomes that could lead to a misinterpretation of its true impact. Our core contribution lies in identifying the underlying causes of social cognition differences in a moderating capacity, which has potential to yield important theoretical and practical implications. This study sets the ground for social marketers to improve their understanding of exercise behaviour and, in turn, consumer welfare. Ultimately, they could be in a better position to develop effective health intervention and educational programmes. Copyright © 2013 John Wiley & Sons, Ltd.     

Does personality disorder co-morbidity impact treatment outcome for patients with major depression? A multi-level analysis

In literature, there exists disagreement regarding the impact of comorbid personality disorder(s) (PD[s]) on treatment outcome for patients with major depressive disorder (MDD). The aim of this paper was to investigate whether statistical heterogeneity and inter-dependency are potential moderators of the effect of co-morbid PDs on outcome for patients with MDD. Clinician-rated MADRS scores and DSM-IV Axis II personality disorder diagnoses were obtained from 562 outpatients with MDD who received 6 months of combined psycho- and pharmacotherapy. Single-level regression showed significantly worse treatment outcome among patients with co-morbid PD, as compared to patients with no PD. After controlling for statistical heterogeneity and interdependency, treatment outcome was no longer significantly worse for patients with co-morbid PD. In conclusion, heteroscedasticity and inter-dependency should be considered as potentially compelling explanations for inconsistencies in findings on treatment outcome for depressed patients with co-morbid PDs.     

Does multicultural personality moderate the relationship between cross-group friendship and allophilia?

ABSTRACT

Contact research has well documented the beneficial effects of cross-group interactions in general, and friendship potential in particular, in promoting positive attitudes toward outgroups. Yet, most of the studies to date have mainly focused on reducing negative attitudes and prejudice. Extending emerging attempts in social and psychological research to understand positive outgroup orientations, the present study aimed to investigate the relationship between cross-group friendship and allophilia (i.e., positive outgroup attitudes) in a sample of 406 American undergraduates. The study also examined whether individual differences in multicultural personality play a moderating role in this relationship. Findings revealed that cross-group friendship was positively associated with allophilia, and that the relationship was stronger for individuals who scored low on open-mindedness and high on social initiative. The present study highlights the important role of multicultural personality in the linkage between close cross-group interactions and positive outgroup attitudes.     

Is avoidant personality disorder more than just social avoidance?

Although social avoidance is a defining feature of avoidant personality disorder (APD), some theorists posit that APD is characterized by a broader pattern of avoidance that extends beyond social situations. This paper describes a series of four studies that examined the different types of nonsocial avoidance hypothesized to characterize APD in three undergraduate student samples and a clinical sample of adults with APD. Overall, the findings revealed low to moderate associations between APD and emotional and novelty avoidance, as well as avoidance of various nonsocial events. The results provide support for contemporary models of APD.     

Frontal lobe dysfunctions in borderline personality disorder? Neuropsychological findings

This study aims to determine whether specific neuropsychological performance impairments in borderline patients can be objectified and whether these findings indicate frontal dysfunctions. Twenty-three patients with borderline personality disorder and 23 normal controls were examined using a neuropsychological test battery to assess intelligence, attentiveness, proneness to interference, learning and memory, as well as planning and problem solving. All subjects filled out standardized questionnaires to assess aggressiveness and impulsiveness in the context of these cognitive performance areas. The neuropsychological test results of the borderline patients were comparable to those of the controls. Although there were no indications of frontal dysfunction of cognitive information processing, inverse correlations were found between the severity of borderline-related personality traits regarding impulsiveness and various areas of cognitive performance. Borderline personality patients show no indications of frontal cognitive dysfunction. Further research is needed to clarify the relationship between impulsiveness and cognitive information processing in borderline personality disorder, including a dimensional approach to personality and personality disorder.     

Are personality disorder criteria ethnically biased? A card-sort analysis

On the basis of methodology used in previous research on sex criterion bias, this study examined ethnicity criterion bias of personality disorders (PDs) defined in the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., Rev.) and included examination of sex as well as ethnicity. A card-sort analysis using undergraduate college students as sorters indicated that criteria for all of the PDs were applied disproportionately by ethnicity, resulting in particular ethnic groups receiving diagnoses for specific PDs. Criteria were sorted systematically such that diagnoses of antisocial and paranoid PDs were assigned to African Americans, schizoid PD was assigned to Asian Americans, and schizotypal PD was assigned to Native Americans. All other PDs were assigned to European Americans, whereas none of the criteria were sorted resulting in any PD diagnosis being applied to Latinos. Implications for clinicians, methodological considerations, and recommendations for future research are discussed.     

Where's the beef? Putting personality back into personality assessment

This article attempts to demonstrate the value of using a psychoanalytic theory of personality for psychological testing. This approach has more clinical utility than a solely research-based one. It recasts test data into conceptually related constructs that have internal consistency to each other and are directly relevant to psychotherapeutic treatment. Such theoretical recasting serves an organizing function, an integrative function, a clarification function, and a predictive function for the clinical inference process. Furthermore, a psychoanalytically oriented approach to testing allows for the expansion in sources of data that one considers in the testing situation. Five different sources of data emerge from the testing situation once one refocuses on theoretical constructs rather than test signs. These include test scores, test content, the patient-examiner interaction, patient behavior, and examiner countertransference.     

Why is visual search superior in autism spectrum disorder?

This study investigated the possibility that enhanced memory for rejected distractor locations underlies the superior visual search skills exhibited by individuals with autism spectrum disorder (ASD). We compared the performance of 21 children with ASD and 21 age‐ and IQ‐matched typically developing (TD) children in a standard static search task and a dynamic search task, in which targets and distractors randomly changed locations every 500 ms, precluding the use of memory in search. Children with ASD exhibited overall faster reaction time (RT) relative to TD children, and showed no disruption in search efficiency in the dynamic condition, discounting the possibility that memory for rejected distractors augments their visual search abilities. Analyses of RT x set size functions showed no group differences in slopes but lower intercepts for the ASD group in both static and dynamic search, suggesting that the ASD advantage derived from non‐search processes, such as an enhanced ability to discriminate between targets and distractors at the locus of attention. Eye‐movement analyses revealed that the ASD and TD groups were similar in the number and spatial distribution of fixations across the search array, but that fixation duration was significantly shorter among children with ASD. Lower intercepts in static search were related to increased symptom severity in children with ASD. In summary, ASD search superiority did not derive from differences in the manner in which individuals with ASD deployed their attention while searching, but from anomalously enhanced perception of stimulus features, which was in turn positively associated with autism symptom severity.     

Does switching between strategies within the same task involve a cost?

In two experiments, participants had to switch regularly between two cognitive strategies of a different complexity in the context of a numerosity judgement task. Expt 1 comprised bivalent stimuli (i.e. allowing the application of the two strategies), whereas Expt 2 involved univalent stimuli (i.e. allowing the application of only one strategy). Both experiments revealed that switching between strategies entailed a cognitive cost that was reflected in longer response times on switch compared to non‐switch trials but not in reduced accuracy. The size of this switch cost did not differ as a function of strategy complexity but tended to diminish as a strategy became more appropriate for solving a particular problem. We discuss the extent to which current theories of task switching can account for these findings.     

Does intergroup contact affect personality? A longitudinal study on the bidirectional relationship between intergroup contact and personality traits

We conducted a longitudinal study to test whether, in addition to being predicted by personality, intergroup contact is longitudinally associated with personality traits. Participants were 388 majority (Italian) and 109 minority (immigrant) first‐year high school students. Results revealed a bidirectional relationship between contact and personality: Quality of contact was longitudinally associated with greater agreeableness and openness to experience, whereas agreeableness and openness to experience were longitudinal predictors of contact quality. An unexpected negative longitudinal association also emerged between quantity of contact and agreeableness. These effects were not moderated by group of belonging (majority vs. minority). Our findings highlight the importance of integrating research on intergroup contact with research on personality.     

Is hospitalization useful for suicidal patients with borderline personality disorder?

This article examines the value of hospitalization for chronically suicidal patients with borderline personality disorder (BPD). One in 10 of these patients will eventually complete suicide. However, this outcome is not readily predictable. Hospitalization is of unproven value for suicide prevention and can often produce negative effects. Day treatment is an evidence-based alternative to full admission. Chronic suicidality can best be managed in an outpatient setting.