Changing views about personality disorders: Comment about the prospective studies CIC, CLPS, and MSAD

Three large-scale prospective studies (Children in the Community Study [CIC; Cohen, Crawford, Johnson, & Kasen, this issue], Collaborative Longitudinal Personality Disorders Study [CLPS; Skodol et al., this issue], and the McLean Study of Adult Development [MSAD; Zanarini, Frankenburg, Hennen, Reich, & Silk, this issue]) are discussed with respect to the following issues: shared and complementary features of the study designs, evidence for stable and changing personality disorder features, methodological issues (reliability, stability, and invariance), the relationship between Axis I and II disorders, and dimensional versus categorical representations of personality disorders.     

Dimensional assessment of personality pathology in female and male juvenile delinquents

A developmental perspective implies similar personality pathology dimensions for adolescents and adults. The present study examined the applicability of a dimensional approach in incarcerated delinquent female and male juveniles using the Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ). A sample of detained adolescents (n = 146) was compared to adolescent students (n = 98) and a healthy control group of adults (n = 82). Additionally, psychopathology was assessed in the incarcerated juveniles using the Youth Self Report (YSR). Analyses of variance revealed higher scores on personality disorder traits for juveniles compared to adult controls; the highest scores were observed in criminal juveniles. Hypothesized relationships could be confirmed within the criminal sample between the DAPP factor Emotional Dysregulation and the YSR Internalization syndrome scale, and between the DAPP factor Dissocial Behavior and the YSR Externalization syndrome scale. Moreover, gender differences in the criminal sample are discussed. Results indicate that the DAPP-BQ can assess personality disorder traits in delinquent and nondetained juveniles with sufficient group and criterion validity.     

Aktuelle Entwicklungslinien in der Pers?nlichkeitsforschung im Jugendalter

Personality disorders in juveniles are still a controversially discussed topic. The aim of this paper is to describe the recent trend in personality research in adolescence and to outline perspectives in research and assessment. Recent study results have pointed out that personality disorders in juveniles can be reliably assessed with diagnostic instruments that have been developed for adults. At the same time there is a lack of specific instruments that can represent the characteristics during adolescence and that can differentiate personality disorders from youth crises. As some personality disorder dimensions also describe unstable developmental criteria we will focus separately on this differential diagnosis and meaning of stable versus transient personality characteristics in youth. The prevalence of personality disorders seems to be higher in adolescence than in adulthood. The stability, however, is comparable in adolescence and adulthood. Psychopathy as a subtype of the antisocial personality disorder ?C that can also be assessed in juveniles ?C will be discussed regarding its core and behavioral dimensions as well as primary and secondary subtypes. Furthermore, we discuss forensic issues when assessing personality disorders with respect to criminal responsibility. Overall we can show that more diagnostic longitudinal studies are essential in order to clarify under which conditions personality disorders develop, which factors influence its course and which interventions can change them.     

Creativity in Medical Education: The Value of Having Medical Students Make Stuff

What is the value of having medical students engage in creative production as part of their learning? Creating something new requires medical students to take risks and even to fail--something they tend to be neither accustomed to nor comfortable with doing. “Making stuff” can help students prepare for such failures in a controlled environment that doesn’t threaten their professional identities. Furthermore, doing so can facilitate students becoming resilient and creative problem-solvers who strive to find new ways to address vexing questions. Though creating something new can be fun, this is not the main outcome of interest. Rather, the principle reason we recommend devoting precious curricular time to creative endeavors is because it helps medical students become better doctors.     

Hospice Comics: Representations of Patient and Family Experience of Illness and Death in Graphic Novels

Non-fiction graphic novels about illness and death created by patients and their loved ones have much to teach all readers. However, the bond of empathy made possible in the comic form may have special lessons for healthcare providers who read these texts and are open to the insights they provide.