Comorbidity of DSM-IV Personality Disorders in unipolar and bipolar affective disorders: a comparative study

The aim of this study was to compare the prevalence of Personality Disorders assessed by Structured Clinical Interview for Axis-II in 155 inpatients diagnosed with Unipolar Disorder vs inpatients with Bipolar Disorder (39). The most frequent Axis II diagnoses among Unipolar inpatients were Borderline (31.6%), Dependent (25.2%), and Obsessive-Compulsive (14.2%) Personality Disorders. Among Bipolar inpatients, the most prevalent personality disorders were Borderline (41%), Narcissistic (20.5%), Dependent (12.8%), and Histrionic disorders (10.3%). Using chi squared analysis, few differences in distribution emerged between the two groups: Unipolar patients had more recurrent Obsessive-Compulsive Personality Disorder than Bipolar patients (chi(1)2=6.24, p<.005). Comorbid Narcissistic Personality Disorder was significantly more frequent in the Bipolar than in the Unipolar group (chi(1)2=6.34, P<.01). Considering the three clusters (DSM-IV classification), there was a significant difference between the groups, Cluster C (fearful, avoidant) diagnoses being more frequent in the Unipolar than in the Bipolar group (48.4% vs 20.5%, respectively). Cluster B (dramatic, emotionally erratic) diagnoses were found more frequently in patients with Bipolar Disorders (71.8% vs 45.2% in Unipolar patients, chi(2)2=10.1, p<.006). The differences in the distribution and prevalence of Personality Disorders between the two patient groups are discussed.     

Toward a model of self pathology underlying personality disorders: narratives, metacognition, interpersonal cycles and decision-making processes

If we want to explain the links between the various and heterogeneous elements--symptoms, dysfunctional forms of behavior and poor social functioning--making up personality disorders, we need model a self pathology that portrays dysfunctions, the links among them, and how their interactions maintain disorders over time. In our view, the most likely elements of self pathology are: a. problematic contents (thoughts and emotions)--experienced subjectively as states of mind and organized in the form of narratives; b. shortfalls in the ability, termed meta-cognition, to reflect on mental states, both of oneself and of others; c. pathogenic interpersonal schemas; and d. maladaptive decision-making processes. These elements get altered in the various personality disorders and interact to form typical pathological organizations. This article seeks to describe a model of self pathology in personality disorders and discuss its current scientific status based on a literature review that spans several disciplines. The model is illustrated with an example of how the pathogenic elements can interact to form personality disorder. Lastly, the limitations and advantages of the model are discussed.     

Is severe obesity a form of addiction? Rationale, clinical approach, and controlled clinical trial.

For many, obesity is just a problem of energy input and expenditure: more energy input than expenditure. However, the clinical practice and epidemiological data clearly show that weight control is more complex than expected by this simple equation. This is particularly true in morbid obesity, a form of severe obesity in which a person's Body Mass Index (BMI, kg/m(2)) is over 40. If we compare the definitions and diagnostic criteria for "dependence" and "addiction" with the situation of many severe obese subjects, it is apparent that they match very well. Further, different neurological studies confirm this similarity: both addiction and obesity patients have a deficiency of dopamine receptors. Nevertheless, when we compare many of the actual obesity treatments with the ones used in the area of addictions it is possible to find relevant differences: obesity treatments neither consider different levels of type and intensity of care, nor a multidimensional approach. To overcome these limitations, in this paper we propose a bio-psychosocial approach in which the genetic influence (lack of dopamine receptors) is matched by psychosocial issues (pressure for thinness and diet as main body image dissatisfaction treatment). Further, the paper outlines how this approach may influence the treatment options, by focusing both on the lessons coming from actual addiction treatment and the opportunities offered by virtual reality. Finally, the paper presents and discusses the outcome of a controlled trial, based on the proposed approach, including a 6-month follow-up (211 morbid obese females with a BMI of >40 and a documented history of failures.     

Which way is upright and normal? Haptic perception of letters above head level

In three experiments, the perception of the apparent orientation of block letters shown in various orientations above the subject’s head in the horizontal plane was examined. A block letter F with its front facing down toward the observer has two crossbars on its right side; the top is the part with the long crossbar, and the base has no bar. The experiments involved changing the locations of these parts with respect to the observer. In Experiment 1, the subjects using touch most often identified a letter as having its left and right sides in a normal orientation if the front of the block letter faced upwards away from the observer, with the bar on the right and the top of the letter farther from the subject than the letter’s base. In Experiment 2, the subjects judging visualuprightness favored positions in which the bars were on the right, the top of the block letter was near them, and the letter’s front faced downwards toward the observer. In Experiment 3, the subjects using touch most often assessed letters as being upright if the top of the letter was the farthest part and the bar was on the right. The results suggest that, when assessing orientation, subjects using touch favored positions that would be reached by a letter moving vertically upwards from table height, but subjects relying on vision favored positions reached by a letter moving in an arc centered on the subject’s head (on the eyes, in particular).     

Prejudice in person memory: Self‐threat biases memories of stigmatized group members

The present research investigated whether self‐threat biases memory via retrieval‐induced forgetting. Results show that people under self‐threat whose goal is to restore their self‐worth by making prejudicial judgments that deprecate others are more likely to exhibit an enhanced RIF effect for positive items and a reduced RIF for negative items ascribed to a stereotyped target (i.e., homosexual). Overall, the present findings are consistent with the view that motivation can affect the magnitude of RIF effects in person memory and that, in turn, they can serve as mechanisms for justifying desired conclusions.     

Evaluating Three Models of Intimate Relationships

The purpose of this study was to evaluate three models of intimate relationships: attachment, elementary pragmatic, and selfhood. These models were evaluated with three instruments respectively constructed to evaluate the validity of each model. One convenience group of functioning individuals and three experimental groups of inpatients and outpatients were administered the three instruments. All three instruments showed relatively high internal consistency and discriminated among the four groups. Significant correlations were found among the measure of attachment with measures of the pragmatic elementary and selfhood models. These correlations indicate that all three instruments were measuring similar aspects of intimate relationships. Clinical and preventive implications and applications of these models are briefly discussed.     

The relationship between maladaptive personality functioning and problematic technology use in adolescence: A cluster analysis approach

In the last two decades, scientific research has explored the problematic use of internet, videogames and mobile phones. However, there is still little consistent knowledge regarding the co-occurrence of problematic technology use and the role of maladaptive personality characteristics in adolescence. The present study aimed to investigate adolescents' styles of technology use with a cluster analysis approach focusing on personality functioning. The sample comprised 408 Italian adolescents (46.3% males) aged 11 to 18 years (M _age = 13.80; SD = 2.08). Data were collected using the Internet Addiction Test, the Videogame Dependency Scale, the Test of Mobile-Phone Dependence Brief Form and the Personality Inventory for DSM5 Brief Form. Results provided a four-cluster solution based on the co-occurrence of problematic technology use. The four clusters were labeled as follows: cluster 1: “Above average internet and mobile-phone use”; cluster 2: “Below average technology use”; cluster 3: “Above average videogame use”; and cluster 4: “Problematic technology use.” Analyses on demographic variables (e.g., gender and age) demonstrated significant differences between the four groups. Adolescents with high levels of problematic technology use reported greater overall personality dysfunction than the other three groups. This finding supported our hypothesis on maladaptive personality functioning in adolescents at risk for addiction. Finally, the Antagonism domain played a specific role in differentiating the severity of adolescents' involvement in technology use. Further studies are needed to confirm our findings and to plan preventive interventions as well as therapeutic treatments.     

Factor Uniqueness of the Structural Parafac Model

Psychometrika - Factor analysis is a well-known method for describing the covariance structure among a set of manifest variables through a limited number of unobserved factors. When the observed...     

Parietal versus temporal lobe components in spatial cognition: Setting the mid‐point of a horizontal line

Recent anatomo‐clinical correlation studies have extended to the superior temporal gyrus, the right hemisphere lesion sites associated with the left unilateral spatial neglect, in addition to the traditional posterior‐inferior‐parietal localization of the responsible lesion (supramarginal gyrus, at the temporo‐parietal junction). The study aimed at teasing apart, by means of repetitive transcranial magnetic stimulation (rTMS), the contribution of the inferior parietal lobule (angular gyrus versus supramarginal gyrus) and of the superior temporal gyrus of the right hemisphere, in making judgments about the mid‐point of a horizontal line, a widely used task for detecting and investigating spatial neglect. rTMS trains at 25 Hz frequency were delivered over the inferior parietal lobule (angular gyrus and supramarginal gyrus), the superior temporal gyrus and the anterior parietal lobe of the right hemisphere, in 10 neurologically unimpaired participants, performing a line bisection judgment task. rTMS of the inferior parietal lobule at the level of the supramarginal gyrus brought about a rightward error in the bisection judgment, ipsilateral to the side of the rTMS, with stimulation over the other sites being ineffective. The neural correlates of computing the mid‐point of a horizontal segment include the right supramarginal gyrus in the inferior parietal lobule and do not extend to the angular gyrus and the superior temporal gyrus. These rTMS data in unimpaired subjects constrain the evidence from lesion studies in brain‐damaged patients, emphasizing the major role of a subset of relevant regions.