Personality disorder: a new global perspective

Personality disorder is now being accepted as an important condition in mainstream psychiatry across the world. Although it often remains unrecognized in ordinary practice, research studies have shown it is common, creates considerable morbidity, is associated with high costs to services and to society, and interferes, usually negatively, with progress in the treatment of other mental disorders. We now have evidence that personality disorder, as currently classified, affects around 6% of the world population, and the differences between countries show no consistent variation. We are also getting increasing evidence that some treatments, mainly psychological, are of value in this group of disorders. What is now needed is a new classification that is of greater value to clinicians, and the WPA Section on Personality Disorders is currently undertaking this task.     

An update on molecular genetic studies of human personality traits

Personality is a complex phenotype and people differ considerably when they are evaluated by self-report questionnaires. There is convincing evidence from twin studies that basic personality dimensions in men and women have a considerable genetic component. However, only recently have common genetic polymorphisms been associated with particular personality traits, especially the dopamine D4 receptor with novelty seeking and the serotonin transporter with anxiety-related traits or neuroticism. The current review examines progress in the past few years in molecular personality genetics and focuses on the reasons for difficulties in replicating first findings as well as the prospects for future studies in this area. The molecular genetic structure of human personality is worth studying both for its intrinsic interest in helping us to understand individual differences in human behaviour and the light it will shed on more complex behavioural disorders that are likely to partially share some common genetic variants.     

Personality,Attentional Biases towards Emotional Faces and Symptoms of Mental Disorders in an Adolescent Sample

Objective

To investigate the role of personality factors and attentional biases towards emotional faces, in establishing concurrent and prospective risk for mental disorder diagnosis in adolescence.

Method

Data were obtained as part of the IMAGEN study, conducted across 8 European sites, with a community sample of 2257 adolescents. At 14 years, participants completed an emotional variant of the dot-probe task, as well two personality measures, namely the Substance Use Risk Profile Scale and the revised NEO Personality Inventory. At 14 and 16 years, participants and their parents were interviewed to determine symptoms of mental disorders.

Results

Personality traits were general and specific risk indicators for mental disorders at 14 years. Increased specificity was obtained when investigating the likelihood of mental disorders over a 2-year period, with the Substance Use Risk Profile Scale showing incremental validity over the NEO Personality Inventory. Attentional biases to emotional faces did not characterise or predict mental disorders examined in the current sample.

Discussion

Personality traits can indicate concurrent and prospective risk for mental disorders in a community youth sample, and identify at-risk youth beyond the impact of baseline symptoms. This study does not support the hypothesis that attentional biases mediate the relationship between personality and psychopathology in a community sample. Task and sample characteristics that contribute to differing results among studies are discussed.     

Fear Conditioning Induced by Interpersonal Conflicts in Healthy Individuals

Psychophysiological markers have been focused to investigate the psychopathology of psychiatric disorders and personality subtypes. In order to understand neurobiological mechanisms underlying these conditions, fear-conditioning model has been widely used. However, simple aversive stimuli are too simplistic to understand mechanisms because most patients with psychiatric disorders are affected by social stressors. The objective of this study was to test the feasibility of a newly-designed conditioning experiment using a stimulus to cause interpersonal conflicts and examine associations between personality traits and response to that stimulus. Twenty-nine healthy individuals underwent the fear conditioning and extinction experiments in response to three types of stimuli: a simple aversive sound, disgusting pictures, and pictures of an actors’ face with unpleasant verbal messages that were designed to cause interpersonal conflicts. Conditioned response was quantified by the skin conductance response (SCR). Correlations between the SCR changes, and personality traits measured by the Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD) and Revised NEO Personality Inventory were explored. The interpersonal conflict stimulus resulted in successful conditioning, which was subsequently extinguished, in a similar manner as the other two stimuli. Moreover, a greater degree of conditioned response to the interpersonal conflict stimulus correlated with a higher ZAN-BPD total score. Fear conditioning and extinction can be successfully achieved, using interpersonal conflicts as a stimulus. Given that conditioned fear caused by the interpersonal conflicts is likely associated with borderline personality traits, this paradigm could contribute to further understanding of underlying mechanisms of interpersonal fear implicated in borderline personality disorder.     

Borderline personality disorder

BORDERLINE PERSONALITY DISORDER is a chronic psychiatric disorder characterized by marked impulsivity, instability of mood and interpersonal relationships, and suicidal behaviour that can complicate medical care. Identifying this diagnosis is important for treatment planning. Although the cause of borderline personality disorder is uncertain, most patients improve with time. There is an evidence base for treatment using both psychotherapy and psychopharmacology. The clinical challenge centres on managing chronic suicidality.CaseColleen, a 22-year old student, is seen for a psychiatric assessment after presenting to the emergency department because of taking an overdose of acetaminophen pills. Although the immediate precipitant to her suicide attempt was a break-up with her boyfriend, she has a history of multiple suicide attempts since the age of 14. Colleen reports that she has daily mood swings, from depression to intense anger, and that she often cuts herself on the wrists and arms to relieve dysphoria. When stressed, she experiences feelings of unreality, sometimes hearing a voice telling her to kill herself. Colleen has had highly problematic relationships with men, falling quickly in and out of love and feeling that her life depends on them, even when they have behaved abusively toward her. What is the appropriate diagnosis and management of this patient?Personality disorders constitute a major group in the classification of mental disorders. According to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR),¹ these conditions are defined by maladaptive personality characteristics beginning early in life that have consistent and serious effects on functioning. Borderline personality disorder (BPD) is frequently seen in clinical practice.² Characterized by emotional turmoil and chronic suicidality (suicide ideation and attempts), this type of personality disorder presents some of the most difficult and troubling problems in all of psychiatry.     

支气管哮喘患者心理特征研究进展

支气管哮喘是全球范围内影响巨大的慢性气道炎症性呼吸道疾病,近年来随着空气污染的加剧和吸烟人数的增多,其发病率呈逐年上升的趋势,引起医学界越来越多的关注。支气管哮喘是由遗传因素、生物因素、心理因素等多种发病因素综合影响所致,随着研究的深入,有关心理因素对支气管哮喘的作用取得了重大的进展,其中支气管哮喘患者存在明显的人格特征和情绪障碍,并且患者特有的人格特征以及情绪障碍会对患者的病情和生活质量产生一定的影响。鉴于此,本文就支气管哮喘患者的性格特征、情绪特征以及其对疾病的影响进行简要阐述,以供临床参考。     

Putative miRNAs for the diagnosis of dyslexia,dyspraxia, and specific language impairment

Disorders of human communication abilities can be classified into speech and language disorders. Speech disorders (e.g., dyspraxia) affect the sound generation and sequencing, while language disorders (e.g., dyslexia and specific language impairment, or SLI) are deficits in the encoding and decoding of language according to its rules (reading, spelling, grammar). The diagnosis of such disorders is often complicated, especially when a patient presents more than one disorder at the same time. The present review focuses on these challenges. We have combined data available from the literature with an in silico approach in an attempt to identify putative miRNAs that may have a key role in dyspraxia, dyslexia and SLI. We suggest the use of new miRNAs, which could have an important impact on the three diseases. Further, we relate those miRNAs to the axon guidance pathway and discuss possible interactions and the role of likely deregulated proteins. In addition, we describe potential differences in expressional deregulation and its role in the improvement of diagnosis. We encourage experimental investigations to test the data obtained in silico.     

Lessons learned in developing community mental health care in North America

This paper summarizes the findings for North America of the WPA Task Force on Steps, Obstacles and Mistakes to Avoid in the Implementation of Community Mental Health Care. Community mental health has evolved over five decades in the United States and Canada. The United States has led the world in innovation and spending, but provide variable quality of care; Canada has steadily developed a more uniform public health system for less cost. Lessons learned from North America include: team-based approaches and other evidence-based practices, when implemented with high fidelity, can improve outcomes in routine mental health care settings; recovery ideology and peer support enhance care, though they have not been studied rigorously; effective community-based care for people with serious mental disorders is expensive.     

Evaluation of selected personality features in patients with various clinical forms of bronchial asthma]

Psychological factors are of importance in the onset and clinical course of the bronchial asthma. Marked emotional disorders are seen in patients with atypical asthma. This study aimed at evaluating selected personality features in patients with various clinical forms of the bronchial asthma. Statistical analysis included 91 asthmatic patients and 30 healthy individuals being a control group. Selected personality features were evaluated with three psychological tests: Eysenck Personality Inventory, Minnesota Multiphasic Personality Inventory, and Cattel's Self cognition Chart. The obtained results have shown that the index of psychopathologies is higher in patients with non-atopic bronchial asthma than in patients with atopic asthma. Therefore, psychotherapy of asthmatic patients, especially with non-atopic form of the disease, should emphasize disturbances of experienced feelings in such patients.     

Personality Variation in Little Brown Bats

Animal personality or temperament refers to individual differences in behaviour that are repeatable over time and across contexts. Personality has been linked to life-history traits, energetic traits and fitness, with implications for the evolution of behaviour. Personality has been quantified for a range of taxa (e.g., fish, songbirds, small mammals) but, so far, there has been little work on personality in bats, despite their diversity and potential as a model taxon for comparative studies. We used a novel environment test to quantify personality in little brown bats (Myotis lucifugus) and assess the short-term repeatability of a range of behaviours. We tested the hypothesis that development influences values of personality traits and predicted that trait values associated with activity would increase between newly volant, pre-weaning young-of-the-year (YOY) and more mature, self-sufficient YOY. We identified personality dimensions that were consistent with past studies of other taxa and found that these traits were repeatable over a 24-hour period. Consistent with our prediction, older YOY captured at a fall swarming site prior to hibernation had higher activity scores than younger YOY bats captured at a maternity colony, suggesting that personality traits vary as development progresses in YOY bats. Thus, we found evidence of short-term consistency of personality within individuals but with the potential for temporal flexibility of traits, depending on age.     

The Relationship between Personality Dimensions and Resiliency to Environmental Stress in Orange-Winged Amazon Parrots (Amazona amazonica), as Indicated by the Development of Abnormal Behaviors

Parrots are popular companion animals, but are frequently relinquished because of behavioral problems, including abnormal repetitive behaviors like feather damaging behavior and stereotypy. In addition to contributing to pet relinquishment, these behaviors are important as potential indicators of diminished psychological well-being. While abnormal behaviors are common in captive animals, their presence and/or severity varies between animals of the same species that are experiencing the same environmental conditions. Personality differences could contribute to this observed individual variation, as they are known risk factors for stress sensitivity and affective disorders in humans. The goal of this study was to assess the relationship between personality and the development and severity of abnormal behaviors in captive-bred orange-winged Amazon parrots (Amazona amazonica). We monitored between-individual behavioral differences in enrichment-reared parrots of known personality types before, during, and after enrichment deprivation. We predicted that parrots with higher scores for neurotic-like personality traits would be more susceptible to enrichment deprivation and develop more abnormal behaviors. Our results partially supported this hypothesis, but also showed that distinct personality dimensions were related to different forms of abnormal behavior. While neuroticism-like traits were linked to feather damaging behavior, extraversion-like traits were negatively related to stereotypic behavior. More extraverted birds showed resiliency to environmental stress, developing fewer stereotypies during enrichment deprivation and showing lower levels of these behaviors following re-enrichment. Our data, together with the results of the few studies conducted on other species, suggest that, as in humans, certain personality types render individual animals more susceptible or resilient to environmental stress. Further, this susceptibility/resiliency can have a long-term effect on behavior, as evidenced by behavioral changes that persisted despite re-enrichment. Ours is the first study evaluating the relationship between personality dimensions, environment, and abnormal behaviors in an avian species.     

Genetic variation in the hypothalamic-pituitary-adrenocortical axis regulatory factor, T-box 19, and the angry/hostility personality trait

Neurotic personality traits are important factors in several psychiatric disorders and suicidal behavior. Here, we have investigated the existence of potential relationships between neurotic personality traits and genetic variation. Non-suicidal parents derived from trios (suicide attempter and both parents) and non-suicidal volunteers, examined by the Neuroticism, Extraversion and Openness (NEO) Personality Inventory - Revised (NEO PI-R), were divided into screening and replication samples. The screening sample (n= 127) was used to select potential relationships between neurotic personality traits and genetic variation among 130 single nucleotide polymorphisms (SNPs). Screening (analysis of variance) with regard to the personality dimension neuroticism indicated potential relationships at three different loci. More detailed analysis of these three SNPs at NEO PI-R facet level indicated four potential relationships. T-test analysis in the replication sample (n= 617) was used to retest the relationships indicated during screening. One of those relationships was confirmed in the replication sample (P= 0.0052; Bonferroni correction), indicating that genetic variation at the human T-box 19 (TBX19) locus is related to the personality trait angry/hostility. Furthermore, using analysis of haplotypes among trios by transmission disequilibrium test and its extension, the family-based association test, overtransmission of a haplotype GAC at the TBX19 locus was associated with increased angry/hostility scores among suicide attempters (P= 0.009; Bonferroni correction). This is to our knowledge the first report on the association of the angry hostility personality trait with genetic variation at the TBX19 locus, an important regulator of the hypothalamic-pituitary-adrenocortical axis.     

How Different Medical School Selection Processes Call upon Different Personality Characteristics

Background

Research indicates that certain personality traits relate to performance in the medical profession. Yet, personality testing during selection seems ineffective. In this study, we examine the extent to which different medical school selection processes call upon desirable personality characteristics in applicants.

Methods

1019 of all 1055 students who entered the Dutch Bachelor of Medicine at University of Groningen, the Netherlands in 2009, 2010 and 2011 were included in this study. Students were admitted based on either top pre-university grades (n = 139), acceptance in a voluntary multifaceted selection process (n = 286), or lottery weighted for pre-university GPA. Within the lottery group, we distinguished between students who had not participated (n = 284) and students who were initially rejected (n = 310) in the voluntary selection process. Two months after admission, personality was assessed with the NEO-FFI, a measure of the five factor model of personality. We performed ANCOVA modelling with gender as a covariate to examine personality differences between the four groups.

Results

The multifaceted selection group scored higher on extraversion than all other groups(p<0.01), higher on conscientiousness than both lottery-admitted groups(p<0.01), and lower on neuroticism than the lottery-admitted group that had not participated in the voluntary selection process. The latter group scored lower on conscientiousness than all other groups(p<0.05) and lower on agreeableness than the multifaceted selection group and the top pre-university group(p<0.01).

Conclusions

Differences between the four admission groups, though statistically significant, were relatively small. Personality scores in the group admitted through the voluntary multifaceted selection process seemed most fit for the medical profession. Personality scores in the lottery-admitted group that had not participated in this process seemed least fit for the medical profession. It seems that in order to select applicants with suitable personalities, an admission process that calls upon desirable personality characteristics is beneficial.     

Comparison of Subjective Well-Being and Personality Assessments in the Clouded Leopard (Neofelis nebulosa), Snow Leopard (Panthera uncia), and African Lion (Panthera leo)

The study of subjective well-being in nonhuman animals is growing in the field of psychology, but there are still only a few published studies and the focus is on primates. To consider whether the construct of subjective well-being could be found in another mammal, this study aimed to assess subjective well-being in felids and to examine its association with personality. Personality is one of the strongest and most consistent predictors of well-being in humans. This relationship could have important implications for other species, because personality has also been shown to affect health outcomes including stress, morbidity, and mortality. As in previous studies in nonhuman animals, the study results revealed that subjective well-being was related to agreeableness/openness and neuroticism in clouded leopards, neuroticism in snow leopards, and impulsiveness and neuroticism in African lions. The implications of these results for health outcomes and the welfare of animals in captivity are discussed. More research on any direct links among personality, subjective well-being, and these outcomes is important to advancing this field and adding another tool for improving captive animals' lives.     

Therapies and therapeutic approaches in Congenital Disorders of Glycosylation

Inborn errors in glycoconjugate biosynthesis termed ‘Congenital Disorders of Glycosylation’ (CDG) comprise a rapidly expanding group of metabolic diseases in man. Up till now more than 60 different inherited disorders in N- and O-glycosylation pathways have been identified. They affect the biosynthesis of glycan moieties linked to proteins as well as lipids. Due to failures in protein glycosylation, CDG patients suffer from multi systemic disorders, which mostly present with severe psychomotor and mental retardations, muscular impairment, ataxia, failure to thrive and developmental delay. Although improved biochemical and genetic investigations led to identification of a variety of new molecular defects in glycoconjugate biosynthesis, effective therapies for most types of the CDG are so far not available. Therefore, intensive investigations on treatment options for this group of diseases have been carried out in recent years.     

Personality,Metabolic Rate and Aerobic Capacity

Personality traits and cardiorespiratory fitness in older adults are reliable predictors of health and longevity. We examined the association between personality traits and energy expenditure at rest (basal metabolic rate) and during normal and maximal sustained walking. Personality traits and oxygen (VO₂) consumption were assessed in 642 participants from the Baltimore Longitudinal Study of Aging. Results indicate that personality traits were mostly unrelated to resting metabolic rate and energy expenditure at normal walking pace. However, those who scored lower on neuroticism (r =  −0.12) and higher on extraversion (r = 0.11), openness (r = 0.13), and conscientiousness (r = 0.09) had significantly higher energy expenditure at peak walking pace. In addition to greater aerobic capacity, individuals with a more resilient personality profile walked faster and were more efficient in that they required less energy per meter walked. The associations between personality and energy expenditure were not moderated by age or sex, but were in part explained by the proportion of fat mass. In conclusion, differences in personality may matter the most during more challenging activities that require cardiorespiratory fitness. These findings suggest potential pathways that link personality to health outcomes, such as obesity and longevity.     

Horse personality: Variation between breeds

Anecdotal evidence from horse owners and handlers suggests the existence of breed typical behaviour and personality in horses. This is further supported by current research on heritability of personality characteristics in a range of species. The Horse Personality Questionnaire (HPQ) is a 25-item rating method that has previously been shown to be reliable for the assessment of personality in horses. Principal component analysis on HPQ data has identified six underlying personality components in horses. These are Dominance, Anxiousness, Excitability, Protection, Sociability and Inquisitiveness. Using the HPQ a survey of 1223 horses of eight different breeds was completed. Data were analysed to explore any differences in personality between breeds across the six personality components. Breed differences in personality were identified, and it was noted that variability between breeds varied between personality components. Anxiousness and Excitability showed the most variation between breeds, whilst Dominance and Protection showed the least variance. The results identified breed typical personalities that were comparable to results from previous studies as well as anecdotal evidence provided by the popular equine literature. The results are discussed in terms of the potential selection pressures that may have resulted in these differences.     

Validation of a Preclinical Drug Screening Platform for Pharmacoresistant Epilepsy

The successful identification of promising investigational therapies for the treatment of epilepsy can be credited to the use of numerous animal models of seizure and epilepsy for over 80 years. In this time, the maximal electroshock test in mice and rats, the subcutaneous pentylenetetrazol test in mice and rats, and more recently the 6 Hz assay in mice, have been utilized as primary models of electrically or chemically-evoked seizures in neurologically intact rodents. In addition, rodent kindling models, in which chronic network hyperexcitability has developed, have been used to identify new agents. It is clear that this traditional screening approach has greatly expanded the number of marketed drugs available to manage the symptomatic seizures associated with epilepsy. In spite of the numerous antiseizure drugs (ASDs) on the market today, the fact remains that nearly 30% of patients are resistant to these currently available medications. To address this unmet medical need, the National Institute of Neurological Disorders and Stroke (NINDS) Epilepsy Therapy Screening Program (ETSP) revised its approach to the early evaluation of investigational agents for the treatment of epilepsy in 2015 to include a focus on preclinical approaches to model pharmacoresistant seizures. This present report highlights the in vivo and in vitro findings associated with the initial pharmacological validation of this testing approach using a number of mechanistically diverse, commercially available antiseizure drugs, as well as several probe compounds that are of potential mechanistic interest to the clinical management of epilepsy.     

Subjective assessment of chimpanzee (<Emphasis Type="Italic">Pan troglodytes</Emphasis>) personality: reliability and stability of trait ratings

A 46-item rating scale was used to obtain personality ratings from 75 captive chimpanzees (Pan troglodytes) from 7 zoological parks. Factor analysis revealed five personality dimensions similar to those found in previous research on primate personality: Agreeableness, Dominance, Neuroticism, Extraversion and Intellect. There were significant sex and age differences in ratings on these dimensions, with males rated more highly on Dominance and older chimpanzees rated as more agreeable but less extraverted than younger chimpanzees. Interobserver agreement for most individual trait items was high, but tended to be less reliable for trait terms expressing more subtle social or cognitive abilities. Personality ratings for one zoo were found to be largely stable across a 3-year period, but highlighted the effects of environmental factors on the expression of personality in captive chimpanzees.