Impaired Pavlovian conditioned inhibition in offenders with personality disorders

Certain types of violent offending are often accompanied by evidence of personality disorders (PDs), a range of heterogeneous conditions characterized by disinhibited behaviours that are generally described as impulsive. The tasks previously used to show impulsivity deficits experimentally (in borderline personality disorder, BPD) have required participants to inhibit previously rewarded responses. To date, no research has examined the inhibition of responding based on Pavlovian stimulus-stimulus contingencies, formally "conditioned inhibition" (CI), in PDs. The present study used a computer-based task to measure excitatory and inhibitory learning within the same CI procedure in offenders recruited from the "personality disorder" and the "dangerous and severe personality disorder" units of a high-security psychiatric hospital. These offenders showed a striking and statistically significant change in the expression of inhibitory learning in a highly controlled procedure: The contextual information provided by conditioned inhibitors had virtually no effect on their prepotent associations. Moreover, this difference was not obviously attributable to nonspecific cognitive or motivational factors. Impaired CI would reduce the ability to learn to control associative triggers and so could provide an explanation of some types of offending behaviour.     

Emotional reactivity and self-regulation in relation to personality disorders

Associations of both reactive and regulative temperamental features with personality disorders (PDs) are investigated in a sample of 162 normal controls and 89 psychiatric inpatients. Reactive and regulative temperamental features were assessed by means of the BIS/BAS Scales and the Attentional Control Scale. Dimensional PD scores were obtained by using the ADP-IV. All PDs were characterized by low levels of effortful control, cluster C PDs by high BIS and cluster B PDs by high BAS. For several PDs, BIS and effortful control interacted: BIS was only related to severe PD pathology if effortful control was low. Clinical implications of these findings are discussed.     

Beliefs in personality disorders: a test with the personality disorder belief questionnaire

The hypothesis that each personality disorder (PD) is characterized by a specific set of beliefs was tested in a sample of 643 subjects, including non-patient controls, axis-I and axis-II patients, diagnosed with SCID-I and -II interviews. Beliefs of six PDs (avoidant, dependent, obsessive-compulsive, paranoid, histrionic, borderline) were assessed with the Personality Disorder Belief Questionnaire (PDBQ). Factor analyses supported the existence of six hypothesized sets of beliefs. Structural equation modeling (SEM) supported the hypothesis that each PD is characterized by a specific set of beliefs. Path coefficients were however in the medium range, suggesting that PDs are not solely determined by beliefs. Nevertheless, empirically derived cutoff scores of the six belief subscales were reasonably successful in classifying subjects, percentages ranging form 51% to 83%. It appeared that there was a monotonical increase in scores on each belief subscale from non-patient controls, to patients without any PD, to patients with PDs (other than the pertinent PD), to patients with the pertinent PD. This suggests that PD-related beliefs are at least partly associated with (personality) psychopathology in general. Another explanation is that many patients' position on the underlying dimensions is not high enough to lead to a DSM PD diagnosis, but high enough to lead to an elevated belief score.     

Associations in Pavlovian conditioned inhibition

Two experiments with rat subjects used a variety of transfer tests to examine the associations learned when Pavlovian inhibition is established by an A+, AX− paradigm. Experiment 1 found in a conditioned suppression situation that inhibition conditioned to X with one exciter (A) readily transferred to another exciter (B) which had been paired with the same shock US. Transfer occurred even when the response to A had been extinguished prior to testing with B. However, X did not inhibit a general activity response produced by a B which had been subsequently paired with a food US. Experiment 2 employed a Pavlovian conditioning situation in which A and B, when separately paired with the same food US, evoked dissimilar responses. Nevertheless, an inhibitor trained in an A+, AX− paradigm successfully inhibited the different response evoked by B. However, such an X did not inhibit the behaviors acquired by A or B when they were subsequently paired with a shock US. The transfer of Pavlovian inhibition across conditioned stimuli and responses but not across unconditioned stimuli is consistent with the notion that a conditioned inhibitor acts to prevent activation of a US representation which would normally be activated by conditioned exciters.     

Super-latent inhibition of conditioned taste preference with a long retention interval

A long delay inserted between conditioning and test phases of a 3-stage Latent Inhibition (LI) procedure produces differential effects on LI depending on the delay context. Thus, enhanced LI has been obtained when the delay is spent in a context that is different from the remaining experimental contexts, but not when it is the same. The present paper examined the effect of delayed testing using a conditioned taste preference procedure. In Experiment 1, three groups received preexposure to either water, or almond, or citrus solutions. Subsequently, the animals were conditioned by pairing the almond and the citrus solutions with sucrose. In a two-bottle preference test conducted 1 day after conditioning, the preexposed flavored solutions were consumed less than the non-preexposed flavors (LI). Experiments 2 and 3 used the same basic procedure, but varied the retention interval duration (1 and 21 days) and the delay context, similar (Experiment 2) and different (Experiment 3) from that of the other stages of the experiments. LI was greater after the long than the short-retention interval when the context was different, thereby demonstrating super-LI. The results were explained by a time-induced context differentiation process.     

An empirical test of schema mode conceptualizations in personality disorders

Although the use of schema modes in schema-focused therapy (SFT) has been very popular since its introduction, Young's schema mode concept remained largely empirically untested. In order to provide insight into the mode conceptualization of personality disorders (PDs), the current study assessed the relationships between 14 schema modes and all PDs. Relationships between dimensional PD scores and self-reported mode scores were tested in a mixed study group of 489 participants, consisting of axis I and axis II patients, and non-patients. Psychopathology was assessed by means of the Structured Clinical Interview for DSM-IV axis I and axis II disorders (SCID I and SCID II) or the Structural Interview for DSM-IV Personality Disorders (SIDP-IV), and modes were assessed by the Schema Mode Inventory. Kendall's partial tau coefficients, controlling each PD-mode correlation for all other PD scores, indicated unique mode profiles for all PDs and corroborated most of the hypothesized PD-mode correlations, supporting the construct validity of the mode model. Nevertheless, the high number of correlations found for some PDs raises concerns about the specificity of the mode model. Implications for both research and therapy are discussed.     

Some determinants of latent inhibition in human predictive learning

The present experiments assessed the effects of different manipulations between cue preexposure and cue-outcome pairings on latent inhibition (LI) in a predictive learning task with human participants. To facilitate LI, preexposure and acquisition with the target cues took place while participants performed a secondary task. Presentation of neither the target cues nor the target outcome was anticipated based on the instructions. Experiment 1 demonstrated the LI effect in the new experimental preparation. Experiment 2 analyzed the impact on LI of different activities that participants performed during the interval between preexposure and acquisition. Experiment 3 assessed LI as a function of changes in the secondary task cues made between preexposure and acquisition, namely presenting novel cues and reversing the cue-outcome contingencies. All of the manipulations in Experiments 2 and 3 resulted in a decrease in LI. The attenuation of LI by these manipulations challenges most current theories of learning and is best accommodated by Conditioned Attention Theory (Lubow, Weiner, & Schnur, 1981).     

Latent inhibition and context change in psychometrically defined schizotypy

The disruption of latent inhibition within the schizophrenia spectrum has often been interpreted either as a result of increased attentional distractibility (attentional account) or as a result of deficient interference of past associations (associative account). The aim of the present investigation was to test competing predictions, as derived from the above theoretical accounts. In a visual search paradigm of latent inhibition, accuracy was examined as a function of prior experience with the target, and psychometrically defined schizotypy. In Experiment 1 (N=60), no context change was introduced. In accord with past evidence, latent inhibition was found to be intact in low-, but disrupted in high-schizotypy scorers, a result predicted both by attentional and associative accounts. In Experiment 2 (N=60), a context change was introduced. As predicted by past evidence, latent inhibition was disrupted in low-schizotypy scorers. However, latent inhibition was found to be intact in high-schizotypy scorers, a finding accommodated by attentional, but not associative accounts. Theoretical implications and alternative interpretations are also considered.     

Factor structure of the basic personality inventory with incarcerated offenders

The item and scale factor structure of the Basic Personality Inventory (BPI) was examined in a sample of 486 offenders incarcerated for violent and sexual crimes. Separate principal-component analyses of the items for each of the 11 clinical scales, critical item scale, and social desirability scale indicated a one-dimensional factor solution for all scales except Depression and Persecutory Ideation. The Depression scale's two factors were Hopelessness and Depressive Affect and the Persecutory Ideation scale's two factors were General Paranoia and Perception of External Control. Although the factors for these two scales may assist in interpretation, the correlations between the factors and the total score of their respective scale were high. Confirmatory factor analysis of the 220 items from the 11 clinical scales supported the factorial logic of the scoring key. Analysis of the 11 clinical scales resulted in two factors: General Psychopathology/Adjustment and Antisocial Orientation. The results suggest that all but two scales can be viewed as unidimensional thereby allowing for a straightforward clinical interpretation. These analyses support the internal structure of the BPI and lend credence to external validity work with forensic populations.     

Finding words for feelings: The relationship between personality disorders and alexithymia

This study examined whether personality disorders (PDs) are associated with alexithymic features at varying levels of comorbid psychopathology distress. 167 psychiatric outpatients completed the Toronto Alexithymia Scale (TAS) and the General Severity Index (GSI) of the SCL90-revised. Bootstrapping analyses were performed to test whether the PD/alexithymia relationship was moderated by psychopathology distress (GSI). The overall number of PD criteria was associated with cognitive aspects of alexithymia (i.e., Externally Oriented Thinking, EOT) only at low/moderate levels of distress. Borderline criteria predicted EOT only when distress was low, while avoidant and dependent criteria were independently related with EOT. No association was found between other PDs and alexithymia facets. Thus, within clinical samples the alexithymia/PD association is mainly explained by comorbid psychopathology; however, individuals with avoidant, dependent and borderline features might have a specific difficulty with focusing on internal reality, even when their current symptom distress is low.     

Interpersonal perception and personality disorders: Utilization of a thin slice approach

Study 1 expands upon previous research by looking at the ability of untrained raters to detect pathological traits within a normal population of college students. In Study 1, 30-s video clips of 81 target persons were shown to 42 raters. Ratings of traits of personality disorders made by thin slice raters reliably predicted scores on the personality pathology measures obtained from the targets themselves and from close peers. Study 2 is a preliminary examination of how pathological rater traits impacts thin slice accuracy. In Study 2, peer and self-report data were examined regarding 87 thin slice raters. Raters who exhibited traits of narcissistic personality disorder were significantly less accurate in making personality predictions regarding targets. Three clusters of personality items were identified based on rater characteristics related to accuracy in predicting behavior.     

A psycho-ethical approach to personality disorders: The role of volitionality

The rupture between psychology and ethics has led to an oversimplification of the study of personality disorders (PD). We claim that an integrated view could enrich and widen the study of PD. This article is an attempt to reconceptualize PD from a psycho-ethical perspective, which includes the dimension of volitionality, to clarify how moral decisions can undermine psychological capacities and contribute, to a greater or lesser degree, to a progressive depersonalization. It is proposed that behaviors with a strong similarity with types of classical vicious character can be categorized into different typical PDs. Using the contributions of theorists who have described types of cognitive biases, in light of virtue epistemology and the underling motivation, we present an understanding of how vicious cognition develops, which is a step in the crystallization of vicious character. This approach, also, offers a distinction between disharmonic and fragmented personality that allows establishing different levels of severity from the psychological and ethical perspective.     

Personality disorder cognitions in the eating disorders

The eating disorders are frequently found to be comorbid with Axis II cluster B and C personality disorders. It is important to identify the personality-level cognitions that typify these disorders. This study of a clinical group examines the personality disorder cognitions in the eating disorders. The cognitions that were most relevant to the eating disorder pathology were those relating to avoidant and obsessive-compulsive personality disorder. Other personality disorder cognitions were associated with comorbid psychopathology in largely clinically meaningful ways. These findings extend our understanding of the comorbidity of eating disorders and personality pathology, suggesting that some cases need to be assessed and formulated with such cognitions in mind. Treatment strategies are required that address both the eating and the personality pathology, while considering the impact of these cognitions on the therapeutic relationship.     

Comments concerning Iverach, et al., Screening for personality disorders among adults seeking speech treatment for stuttering [J. Fluency Disorders 34 (2009) 173-186

Iverach, Jones, O’Brian, Block, Lincoln, and Harrison (2009) indicate the high co-occurrence of one or more Personality Disorders (PD) for adults who stutter. The findings of Iverach et al. argue against many years of research and the experiences of skilled clinicians who have considered the relationship between stuttering and anxiety/negative affectivity. The results of Iverach et al. are questioned based on several methodological issues.Educational objectives: 1. To explain why the unusually high occurrence of personality disorders (PD) for individuals who stutter found by Iverach et al. (2009) may be questionable based on methodological approach. 2. To explain the heightened levels of anxiety experienced by many individuals who stutter as a natural and reasonable response to a chronic and serious problem such as stuttering. 3. To debate the potential for the inaccurate diagnosis of Axis II Personality Disorders to unnecessarily stigmatize individuals who stutter.     

Personality heterogeneity in adolescents with disruptive behavior disorders

We first confirmed adolescents diagnosed with disruptive behavior disorders (oppositional defiant, conduct disorder; n = 158) had lower constraint and higher negative emotionality, and greater psychiatric comorbidity and psychosocial dysfunction, relative to adolescents without (n = 755), in a population-based sample enriched for externalizing psychopathology (mean age = 17.90 years; 52% female). We then explored whether different personality types, defined by patterns of personality identified via latent profile analysis, were differently associated with clinical features in adolescents with a disruptive behavior disorder diagnosis. Four distinct personality types (“disinhibited,” “high distress,” “low distress,” “positive”) were meaningfully different from one another. Results highlight personality heterogeneity as a means of identifying individuals at greatest risk for the most deleterious forms of externalizing psychopathology.     

Enhanced latent inhibition in context aversion conditioning

In four experiments, we investigated the effect of giving rats exposure to a distinctive environmental context before a phase of training in which an injection of LiCl was paired with that context. The results of Experiments 1 and 2 were consistent with the possibility that such preexposure served to retard subsequent conditioning to the context (i.e., produced a latent inhibition effect). Experiments 3 and 4 demonstrated that allowing the rats to consume a novel-flavored solution during preexposure enhanced the latent inhibition effect. The relevance of these findings both for theories of latent inhibition and for the use of preexposure as a clinical intervention for the reduction of conditioned nausea in humans is considered.     

Impaired self-reflection in psychiatric disorders among adults: A proposal for the existence of a network of semi independent functions

Self-reflection plays a key role in healthy human adaptation. Self-reflection might involve different capacities which may be impaired to different degrees relatively independently of one another. Variation in abilities for different forms of self-reflection are commonly seen as key aspects of many adult mental disorders. Yet little has been written about whether there are different kinds of deficits in self-reflection found in mental illness, how those deficits should be distinguished from one another and how to characterize the extent to which they are interrelated. We review clinical and experimental literature and suggest four different forms of deficits in self-reflection: (a) sense of ownership of one’s own thoughts and actions, (b) emotional awareness, (c) distinction between fantasy and reality and (d) the integration of a range of different views of oneself and others. We propose how these different impairments in self-reflection are linked with one another.     

Disparities in the moral intuitions of criminal offenders: The role of psychopathy

The present study examined whether and in what ways psychopathy is associated with abnormal moral intuitions among criminal offenders. Using Haidt et al.’s Moral Foundations Questionnaire, 222 adult male offenders assessed for clinical psychopathy reported their degree of support for five moral domains: Harm Prevention, Fairness, Respect for Authority, Ingroup Loyalty, and Purity/Sanctity. As predicted, psychopathy total score explained a substantial proportion of the variance in reduced support for Harm Prevention and Fairness, but not the other domains. These results confirm that psychopathy entails a discrete set of moral abnormalities and suggest that these abnormalities could potentially help to explain the characteristic antisocial behavior of individuals with psychopathy.     

Past experience influences the processing of stimulus compounds in human Pavlovian conditioning

In two human skin conductance conditioning experiments we investigated whether processing of stimulus compounds can be influenced by past experience. Participants were either pre-trained with a discrimination problem that could be solved elementally (A+, B−, AB+, C− in Experiment 1 and A+, AB+, C−, CB− in Experiment 2) or one that required a configural solution (AB+, BC−, CD+, DA− in Experiment 1 and A−, AB+, C+, CB− in Experiment 2). After pre-training, participants were shown an EX+, FX− discrimination. Subsequently, responding to individual components (E and F) was tested. After elemental pre-training, participants showed larger responses to the component from the previously reinforced compound (E) than to the component from the nonreinforced compound (F) whereas no such difference was found after configural pre-training. This means that the kind of pre-training influenced whether the later discrimination problem was processed elementally or configurally. The results indicate that organisms can flexibly process stimulus compounds in different ways.