Are DSM-IV-TR Borderline Personality Disorder, ICD-10 Emotionally Unstable Personality Disorder, and CCMD-III Impulsive Personality Disorder Analogous Diagnostic Categories Across Psychiatric Nomenclatures?

This study examined the validity of the borderline construct which encompasses diagnostic criteria from the DSM-IV-TR Borderline Personality Disorder (BPD), ICD-10 Emotionally Unstable Personality Disorder (EUPD), and CCMD-III Impulsive Personality Disorder (IPD) in a sample of 1,419 Chinese psychiatric patients. Participants completed the Chinese Personality Disorder Inventory and the Chinese Personality Assessment Inventory-2 assessing various disordered personality features. Adequate internal consistency was found for the borderline construct (α = .83). Exploratory factor analysis revealed two components: (1) affective and cognitive disturbances, and (2) impulse dysregulation, which were replicated by confirmatory factor analysis. Item analysis indicated that the various borderline criteria displayed similar levels of diagnostic efficiency, which does not support the elimination of fear of abandonment and transient psychotic features from the EUPD and IPD criteria set. Findings of this study suggest that BPD, EUPD, and IPD may represent analogous diagnostic categories across classification systems.     

Is Gender Identity Disorder in Children a Mental Disorder?

Empirical studies were evaluated to determine whether Gender Identity Disorder (GID) in children meets the Diagnostic and Statistical Manual of Mental Disorders-4th Edition (DSM-IV, American Psychiatric Association, 1994) definitional criteria of mental disorder. Specifically, we examined whether GID in children is associated with (a) present distress; (b) present disability; (c) a significantly increased risk of suffering death, pain, disability, or an important loss of freedom; and if (d) GID represents dysfunction in the individual or is simply deviant behavior or a conflict between the individual and society. The evaluation indicates that children who experience a sense of inappropriateness in the culturally prescribed gender role of their sex but do not experience discomfort with their biological sex should not be considered to have GID. Because of flaws in the DSM-IV definition of mental disorder, and limitations of the current research base, there is insufficient evidence to make any conclusive statement regarding children who experience discomfort with their biological sex. The concluding recommendation is that, given current knowledge, the diagnostic category of GID in children in its current form should not appear in future editions of the DSM.     

Influence of Co‐Morbid Generalized Anxiety Disorder,Panic Disorder and Personality Disorders on the Outcome of Cognitive Behavioural Treatment of Obsessive‐Compulsive Disorder

This study examined co‐morbid generalized anxiety disorder and/or panic disorder and personality disorders as predictors of treatment outcomes in adult outpatients with obsessive‐compulsive disorder. The patients received exposure with response prevention (ERP) treatment with the addition of either elements of cognitive therapy (ERP+CT) or relaxation training (ERP+REL). It was hypothesized that the addition of cognitive interventions would yield better treatment outcomes for patients with co‐morbid generalized anxiety disorder and/or panic disorder. It was also hypothesized that patients with any personality disorder would show less treatment gains in both conditions. Using intention‐to‐treat criteria, patients with generalized anxiety disorder and/or panic disorder co‐morbidity showed less treatment gains at post‐treatment across both treatment conditions. This group showed significantly more treatment gains in the ERP+CT condition at the post‐treatment and the 12‐month follow‐up assessments compared with patients in the ERP+REL condition. However, this was not significant when comparing treatment completers. Patients with a co‐morbid Cluster A or B personality disorder showed significantly less treatment gains in both treatment conditions at the 12‐month follow‐up assessment. Among treatment completers, patients with a Cluster C personality disorder showed significantly better outcomes at the post‐treatment assessment in the ERP+REL treatment condition. These results, clinical implications, and the importance of further investigations are discussed.     

Borderline Personality Disorder and Posttraumatic Stress Disorder: Time for Integration?

The increasing prevalence of borderline personality disorder (BPD) and posttraumatic stress disorder (PTSD) diagnoses among women illustrates problems and limitations of the medical model system (Diagnostic and Statistical Manual of Mental Disorders, fourth edition; American Psychiatric Association, 1994). In particular, diagnoses of BPD continue the trend of overpathologizing women's issues and reinforcing a patriarchal system of diagnosis and treatment. A PTSD diagnosis, with similar criteria, is preferred for traumatized women because it portrays them in a more positive context. This article explores the overlapping relationship between BPD and PTSD and critiques how both are viewed within the mental health community. Previous research on BPD and PTSD is explored, as well as concerns and limitations regarding both diagnostic categories.     

Childhood Gender Identity … Disorder? Developmental,Cultural, and Diagnostic Concerns

Childhood gender identity development is reviewed in the context of biological, environmental, cultural, and diagnostic factors. With the upcoming 5th revision of the Diagnostic and Statistical Manual of Mental Disorders, the authors offer a critical consideration of childhood gender identity disorder, along with proposed diagnostic changes. They argue that meaningful understanding of issues surrounding gender identity is necessary for a conscientious assessment and diagnostic process that does not pathologize human diversity.     

Correction to: Office Housework,Burnout, and Promotion: Does Gender Matter?

Journal of Business and Psychology - In the final version of the publication, the acknowledgement was missing. The data were supported by an ERC pilot grant, and they should be acknowledged.     

Does DSM-IV Asperger's Disorder Exist?

DSM-IV criteria for autistic and Asperger's disorders were applied to 157 children with clinical diagnoses of autism or Asperger's disorder. All children met the DSM-IV criteria for autistic disorder and none met criteria for Asperger's disorder, including those with normal intelligence and absence of early speech delay. The reason for this was that all children had social impairment and restricted and repetitive behavior and interests (required DSM-IV symptoms for both autistic and Asperger's disorders) and all had a DSM-IV communication impairment (which then qualified them for a diagnosis of autistic disorder and not Asperger's disorder). Communication problems exhibited by all children were impaired conversational speech or repetitive, stereotyped, or idiosyncratic speech (or both), which are DSM-IV criteria for autism. These findings are consistent with those of 5 other studies and indicate that a DSM-IV diagnosis of Asperger's disorder is unlikely or impossible.     

Is There Really Mental Disorder?

Proponents of the reality of mental disorder claim that mental disorder is ontologically real in the same sense that the variola virus and smallpox are ontologically real. The chief architect of the DSM-III revolution, Robert Spitzer (Zimmerman & Spitzer, 2005 Zimmerman , M. , & Spitzer , R. , L. ( 2005 ). Psychiatric classification . In B. J. Sadock & V. A. Sadock (Eds.), Comprehensive textbook of psychiatry (pp. 1003 – 1033 ). Philadelphia , PA : Lippincott, Williams, and Wilkins . [Google Scholar]), candidly admits that a diagnosis of primary mental disorder present must be arbitrary because the distress or social impairment under consideration could well be a normal-range reaction to stressful events. Based on Jerome Wakefield's harmful dysfunction thesis, Spitzer hopes that research in evolutionary psychology can solve the perennial “false positive” problem in psychiatric diagnosis. Interestingly, in 1988 Wakefield , J. ( 1988 ). Hermeneutics and empiricism . In S. B. Messer , L. A. Sass & R. L. Woolfolk (Eds.), Hermeneutics and psychological theory (pp. 131 – 150 ). New Brunswick , CT : Rutgers University Press . [Google Scholar] Wakefield argued that the study of meaning (i.e., human behavior and the products of human behavior, such as art and literature) could not be assimilated to empiricism (science), but evidently he subsequently changed his mind. The present paper sides with the 1988 Wakefield , J. ( 1988 ). Hermeneutics and empiricism . In S. B. Messer , L. A. Sass & R. L. Woolfolk (Eds.), Hermeneutics and psychological theory (pp. 131 – 150 ). New Brunswick , CT : Rutgers University Press . [Google Scholar] Wakefield. It is an illusion to hope that research in evolutionary psychology will reveal how people are supposed to react to stressful events and thereby rescue psychiatric diagnosis from the false positive problem. The identification of mental disorder will remain akin to the identification of pornography, i.e., a case of reification based on interpretation and moral reasoning. The fiction that mental disorder is real turns attention away from past and present conditions of living. This may serve some interests, but it is not likely to serve the patient's interests.     

Immigrant Families’ Perception of the Causes,First Manifestations,and Treatment of Autism Spectrum Disorder

Compared to families from their host country, families from immigrant backgrounds who have a child with autism spectrum disorder (ASD) tend to experience greater difficulties in accessing, using, and complying with intervention services for their child. This disparity may be partially accounted for by cultural differences in how families perceive the causes and symptoms of ASD as well as their treatment priorities. The present study sought to document these perceptions in immigrant families living in a Canadian city. Forty-five parents from Latin America, Africa, Western and Eastern Europe, the Caribbean, East Asia, and the Middle East participated in a semi-structured interview. These data were examined qualitatively through thematic analysis to first document all parents’ perceptions, then to contrast mothers’ and fathers’ responses, and finally to examine common themes as a function of country of origin. The most frequently mentioned causes of ASD were environmental factors such as vaccines and diet. Moreover, some participants did not know the cause of their child’s ASD. The majority of parents cited the absence of speech as one of the first symptoms noted in their child. Priorities for intervention varied: mothers tended to prioritize speech therapy, whereas fathers favored support in school. Taken as a whole, these findings highlight the need to implement informational programs for these families.     

Correction to: The varieties of impartiality,or, would an egalitarian endorse the veil?

Philosophical Studies - The citations of Figures 1, 2, 3 and 4 were placed after the figures in the original publication of the article. However, they should be placed prior the placement...     

Assessment of DSM–5 Personality Disorder

The purpose of this article is to present an approach to defining, identifying, and assessing personality disorders, including the links between these definitions and personality assessment, with a particular reference to the proposed revisions to the personality disorders section of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM–5]; American Psychiatric Association, 2013 American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Routledge.[Crossref] , [Google Scholar]). The article discusses measures of maladaptive variants of the Five-factor model (FFM) that are coordinated with both the traditional personality disorder syndromes as well as the DSM–5 dimensional trait model. Discussed as well is the assessment of the more psychodynamically oriented deficits in sense of self and interpersonal relatedness that are also included within the hybrid model proposed for DSM–5.     

Is 'Normal Grief' a Mental Disorder?

I argue that grief (including 'normal grief') is a mental disorder. I discuss the main concepts involved briefly, and state the prima facie case in favour of the view that grief is a disorder. I consider objections that grief is not a disorder because (a) it is a normal response; (b) it is more healthy than failing to grieve; (c) it involves cognitive good; (d) it is a rational response; (e) it ought not to be medicalized or treated; (f ) it has a 'distinct sustaining cause'. Each objection is flawed, and I conclude that there is a strong case for regarding even 'normal' grief as a disorder. Alternatively, the arguments in this paper may be taken as attacking 'orthodoxrsquo; definitions of mental health (e.g., in DSM 4th edn) by providing an extended discussion of one particular counter-example.     

Can Attention Deficit Hyperactivity Disorder and Fetal Alcohol Spectrum Disorder be differentiated by motor and balance deficits?

There is an ongoing debate regarding the diagnostic overlap between Attention Deficit Hyperactivity Disorder (ADHD) and Fetal Alcohol Spectrum Disorder (FASD). Differential diagnosis is important because of treatment implications. Children aged 7–10 years (47 ADHD, 30 FASD, 39 controls) participated. The Movement Assessment Battery for Children (M-ABC) and the Clinical Observations of Motor and Postural Skills (COMPS) were used. Force plate and electromyography data were collected during static balance and balance perturbation. On the M-ABC both children with ADHD and FASD had more motor problems than controls. The ADHD-Combined and the ADHD-Predominantly Inattentive subgroups were similarly affected in their fine motor skills. On the COMPS, the majority of children in both groups performed in the normal range, but for those children clinically affected, it was the children with ADHD who were more likely to be severely impaired. The children with ADHD were characterized by early onset latencies of the tibialis anterior muscles and increased amplitudes of the gastrocnemius muscles. Difficulty scaling muscle force reflecting medial cerebellar involvement may be the key problem in ADHD. Cerebellar involvement in the postural instability in FASD awaits further study.     

Troubled or Traumatized Youth? The Relations Between Psychopathy,Violence Exposure,Posttraumatic Stress Disorder,and Antisocial Behavior Among Juvenile Offenders

The current study examined how psychopathy, exposure to violence, and posttraumatic stress disorder (PTSD) are associated with antisocial behavior among 1,354 serious delinquent adolescents from the Pathways to Desistance study. Results showed that psychopathy, violence exposure, and PTSD are independently linked to self-reported involvement of delinquency, even after controlling for respondents’ demographic characteristics. However, the effect of PTSD on antisocial behavior was small. Differential associations were observed between the 2 factors of psychopathy, interpersonal/affective and social deviance, and PTSD symptoms. Specifically, the effect of social deviance characteristics on delinquency was above and beyond that of interpersonal/affective features. In addition, exposure to violence as a victim or witness were uniquely associated with increased delinquent behavior. Findings clarified the relations among psychopathy, violence exposure, PTSD, and antisocial behavior, and highlighted the differential links between psychopathy factors and delinquency.     

Oil,Crime, and Disorder: A Methodological Examination of the Oil Boom’s Impact in North Dakota

This article examines the impact the oil boom has had on crime and disorder in North Dakota. Particular attention is paid to the methods used to analyze these impacts. Several quantitative analyses, including t-tests and regressions, were performed and critiqued. Overall, few significant relationships were found that could link the oil boom to increases in crime and disorder. In addition, this article introduces location quotients as an alternative method to examine crime and disorder in boomtown settings. The results suggest that the impact of the boom was localized in that different counties experienced differential crime and disorder impacts.