Anxiété et personnalité: études catégorielle et dimensionnelle de leur association et facteurs de vulnérabilité

Anxiety disorders often appear in patients with particular personality traits, and in some cases with actual personality disorders. This clinical observation may question the respective interactions between personality and anxiety disorders: Is it possible to evaluate the personality of patients with severe anxiety disorders reliably? What is the real co-morbidity between personality disorders and anxiety disorders? Are there psychopathological and etiological links between these two disorders? Studies relying on categorical approaches of personality suggest that about 40-60% of anxious patients fulfill the diagnostic criteria of at least one personality disorder. The most frequent diagnoses belong to the cluster C of the DSM-IV axis II classification, with a majority having avoidant and dependent personalities, but without any real specificity according to the types of anxiety disorders. On the other hand, dimensional studies have shown that anxiety disorders are often associated with avoidant personality traits, with very deviant scores in some cases, even after treatment of the anxiety disorder. These works support the existence of some temperament traits, underlined by psychobiological, stable, and inheritable dimensions, which may constitute early vulnerability factors for anxiety disorders in both children and adults.     

Names,numbers and indentations: a guide to post-Linnaean taxonomy

The vast majority of biological taxonomists use the Linnaean system when constructing classifications. Taxa are assigned Linnaean ranks and taxon names are devised according to the Linnaean rules of nomenclature. Unfortunately, the Linnaean system has become theoretically outdated. Moreover, its continued use causes a number of practical problems. This paper begins by sketching the ontological and practical problems facing the Linnaean system. Those problems are sufficiently pressing that alternative systems of classification should be investigated. A number of proposals for an alternative system are introduced and evaluated. The best aspects of those proposals are brought together to form a post-Linnaean system, and a comparison of the Linnaean and post-Linnaean systems is conducted. The final section of this paper considers not only the theoretical reasons for replacing the Linnaean system, but also the practical feasibility of adopting an alternative system.     

Stems,nodes, crown clades,and rank‐free lists: is Linnaeus dead?

Recent radical proposals to overhaul the methods of biological classification are reviewed. The proposals of phylogenetic nomenclature are to translate cladistic phylogenies directly into classifications, and to define taxon names in terms of clades. The method has a number of radical consequences for biologists: taxon names must depend rigidly on the particular cladogram favoured at the moment, familiar names may be reassigned to unfamiliar groupings, Linnaean category terms (e.g. phylum, order, family) are abandoned, and the Linnaean binomen (e.g. Homo sapiens) is abandoned. The tenets of phylogenetic nomenclature have gained strong support among some vocal theoreticians, and rigid principles for legislative control of clade names and definitions have been outlined in the PhyloCode. The consequences of this semantic maelstrom have not been worked out. In pratice, phylogenetic nomenclature will bc disastrous, promoting confusion and instability, and it should be abandoned. It is based on a fundamental misunderstanding of the difference between a phylogeny (which is real) and a classification (which is utilitarian). Under the new view, classifications are identical to phlylogenies, and so the proponents of phylogenetic nomenclature will end up abandoning classifications altogether.     

The etiology of personality function: the University of British Columbia Twin Project.

The UBC Twin Project is an on-going study of personality and personality disorder that has collected personality data on approximately 1000 adult volunteer twin pairs. The primary purpose of the study is to develop and validate measures of the major forms of personality disorder as a quantitative alternative to the classificatory system first proposed by the DSM-III using the standard methods of personality and behavioural genetics research. To date, the study has explored the univariate and multivariate relationships between the major personality and personality disorder inventories, and their relationships to other psychopathologies including the mood and anxiety disorders and key psychological variables, such as cognitive ability, attachment and attitudes. The results have several implications for personality and personality disorders, most notably a rationalized diagnostic/nosological system to enhanced measurement instruments that index and reflect the influence of specific genetic and environmental influences.     

Broadening the diagnosis of bipolar disorder: benefits vs. risks

There is considerable debate over whether bipolar and related disorders that share common signs and symptoms, but are currently defined as distinct clinical entities in DSM-IV and ICD-10, may be better characterized as falling within a more broadly defined "bipolar spectrum". With a spectrum view in mind, the possibility of broadening the diagnosis of bipolar disorder has been proposed. This paper discusses some of the rationale for an expanded diagnostic scheme from both clinical and research perspectives in light of potential drawbacks. The ultimate goal of broadening the diagnosis of bipolar disorder is to help identify a common etiopathogenesis for these conditions to better guide treatment. To help achieve this goal, bipolar researchers have increasingly expanded their patient populations to identify objective biological or endophenotypic markers that transcend phenomenological observation. Although this approach has and will likely continue to produce beneficial results, the upcoming DSM-IV and ICD-10 revisions will place increasing scrutiny on psychiatry's diagnostic classification systems and pressure to re-evaluate our conceptions of bipolar disorder. However, until research findings can provide consistent and converging evidence as to the validity of a broader diagnostic conception, clinical expansion to a dimensional bipolar spectrum should be considered with caution.     

Event-related potentials in schizotypal personality disorder and schizophrenia

The article analyzes event-related potentials in the Go/NoGo test of patients with schizophrenia and schizotypal personality disorder in relation to healthy subjects. Differences identified in the group of patients with schizophrenia are consistent with previous studies and indicate disruption in processes associated with different stages of visual information processing and executive functions. Specific features of brain activity in patients with schizotypal personality disorder were significantly less pronounced and presumably pointed to changes in the processes of attention redistribution and action monitoring. The results agree well with the clinical symptoms of schizophrenia and schizotypal personality disorder, so that this technique can be considered a possible additional diagnostic criterion for these disorders.     

Personality disorders in the elderly: diagnostic aspects

This article describes the usefulness of the DSM personality disorders. In conclusion the presence of personality disorders during a lifetime is not always an enduring pattern of (the same) conduct disorders. Despite this, the DSM describes a static course of mainly interpersonal behaviour. Next to this, the utility of the DSM-Axis-II assessment and general personality assessment in relation to older adults will be discussed. In general these instruments are not very suitable for the assessment of the disposition and gravity of personality disorders in the elderly. It is proposed to develop specific profiles with regard to personality disorders in the elderly by applying the Delphi-technique on existing personality assessment. A Delphi panel of experts in the field of personality pathology in older adults can be asked to mention a certain personality disorder and describe this on a certain personality selfreport list, like the shortened version of the TCI.     

Diagnosis and classification of disorders specifically associated with stress: proposals for ICD‐11

The diagnostic concepts of post‐traumatic stress disorder (PTSD) and other disorders specifically associated with stress have been intensively discussed among neuro‐ and social scientists, clinicians, epidemiologists, public health planners and humanitarian aid workers around the world. PTSD and adjustment disorder are among the most widely used diagnoses in mental health care worldwide. This paper describes proposals that aim to maximize clinical utility for the classification and grouping of disorders specifically associated with stress in the forthcoming 11th revision of the International Classification of Diseases (ICD‐11). Proposals include a narrower concept for PTSD that does not allow the diagnosis to be made based entirely on non‐specific symptoms; a new complex PTSD category that comprises three clusters of intra‐ and interpersonal symptoms in addition to core PTSD symptoms; a new diagnosis of prolonged grief disorder, used to describe patients that undergo an intensely painful, disabling, and abnormally persistent response to bereavement; a major revision of “adjustment disorder” involving increased specification of symptoms; and a conceptualization of “acute stress reaction” as a normal phenomenon that still may require clinical intervention. These proposals were developed with specific considerations given to clinical utility and global applicability in both low‐ and high‐income countries.     

Transdiagnostic dimensions of psychosis in the Bipolar‐Schizophrenia Network on Intermediate Phenotypes (B‐SNIP)

The validity of the classification of non‐affective and affective psychoses as distinct entities has been disputed, but, despite calls for alternative approaches to defining psychosis syndromes, there is a dearth of empirical efforts to identify transdiagnostic phenotypes of psychosis. We aimed to investigate the validity and utility of general and specific symptom dimensions of psychosis cutting across schizophrenia, schizoaffective disorder and bipolar I disorder with psychosis. Multidimensional item‐response modeling was conducted on symptom ratings of the Positive and Negative Syndrome Scale, Young Mania Rating Scale, and Montgomery‐Åsberg Depression Rating Scale in the multicentre Bipolar‐Schizophrenia Network on Intermediate Phenotypes (B‐SNIP) consortium, which included 933 patients with a diagnosis of schizophrenia (N=397), schizoaffective disorder (N=224), or bipolar I disorder with psychosis (N=312). A bifactor model with one general symptom dimension, two distinct dimensions of non‐affective and affective psychosis, and five specific symptom dimensions of positive, negative, disorganized, manic and depressive symptoms provided the best model fit. There was further evidence on the utility of symptom dimensions for predicting B‐SNIP psychosis biotypes with greater accuracy than categorical DSM diagnoses. General, positive, negative and disorganized symptom dimension scores were higher in African American vs. Caucasian patients. Symptom dimensions accurately classified patients into categorical DSM diagnoses. This study provides evidence on the validity and utility of transdiagnostic symptom dimensions of psychosis that transcend traditional diagnostic boundaries of psychotic disorders. Findings further show promising avenues for research at the interface of dimensional psychopathological phenotypes and basic neurobiological dimensions of psychopathology.     

Developments in social terminology: semantic battles in a conceptual war

The problems posed by the evolution of the diverse forms of animal sociality are among the most important and fascinating in evolutionary biology. The conceptual and terminological framework guiding studies of social evolution has been based on a particular insect model, namely, that of highly derived family-structured societies. Virtually all other social systems have been categorized as 'less social' relative to these societies. Recently, the ambiguities and constraints inherent in this hierarchical classification have led to numerous proposals to amend social terminology. What is the best framework for studying social evolution? Should the traditional classification be expanded, narrowed or abandoned altogether? In an important respect, most recent proposals present the same wine in a different bottle by retaining and recasting key terms of the traditional social-evolutionary classification.     

Affective Disorders among Patients with Borderline Personality Disorder

Background

The high co-occurrence between borderline personality disorder and affective disorders has led many to believe that borderline personality disorder should be considered as part of an affective spectrum. The aim of the present study was to examine whether the prevalence of affective disorders are higher for patients with borderline personality disorder than for patients with other personality disorders.

Methods

In a national cross-sectional study of patients receiving mental health treatment in Norway (N = 36 773), we determined whether psychiatric outpatients with borderline personality disorder (N = 1 043) had a higher prevalence of affective disorder in general, and whether they had an increased prevalence of depression, bipolar disorder or dysthymia specifically. They were compared to patients with paranoid, schizoid, dissocial, histrionic, obsessive-compulsive, avoidant, dependent, or unspecified personality disorder, as well as an aggregated group of patients with personality disorders other than the borderline type (N = 2 636). Odds ratios were computed for the borderline personality disorder group comparing it to the mixed sample of other personality disorders. Diagnostic assessments were conducted in routine clinical practice.

Results

More subjects with borderline personality disorder suffered from unipolar than bipolar disorders. Nevertheless, borderline personality disorder had a lower rate of depression and dysthymia than several other personality disorder groups, whereas the rate of bipolar disorder tended to be higher. Odds ratios showed 34% lower risk for unipolar depression, 70% lower risk for dysthymia and 66% higher risk for bipolar disorder in patients with borderline personality disorder compared to the aggregated group of other personality disorders.

Conclusions

The results suggest that borderline personality disorder has a stronger association with affective disorders in the bipolar spectrum than disorders in the unipolar spectrum. This association may reflect an etiological relationship or diagnostic overlapping criteria.     

Long-term repeatability and stability of three personality traits in meadow voles

Consistency of animal personality traits is expected. Mounting evidence suggests that animal personalities will change with time and major life events. Research into this phenomenon is often limited to span only short periods of time in the animals’ life or have few measures across their life. We measured Exploration, Activity and Boldness of litters of meadow voles, Microtus pennsylvanicus, in a pair of novel object tests six times over a year, representing a large proportion of the lifespan of the vole. Our null hypothesis was that the personality traits would not change, and our first alternative hypothesis was that personality traits would change equally for all individuals as they aged. Neither was supported. The data support our third hypothesis that traits would change and change unequally. Activity and Boldness were consistent across time. However, Exploratory behaviour increased with the vole's age. The supported models show that personality traits change consistently for related individuals, but the litters differ in their change with age. This suggests that meadow vole life history affects how personality traits develop, but not necessarily their magnitudes. We also tested the repeatability of traits across the testing intervals. We discovered that the repeatability of these three personality traits varied across time, depending on the trait. Activity was repeatable equally across ages. Exploration became more repeatable and Boldness became less so. Thus, personality traits may be more malleable than supposed, especially over long periods of time.     

Integrating scientific guidance into marine spatial planning

Marine spatial planning (MSP), whereby areas of the ocean are zoned for different uses, has great potential to reduce or eliminate conflicts between competing management goals, but only if strategically applied. The recent literature overwhelmingly agrees that including stakeholders in these planning processes is critical to success; but, given the countless alternative ways even simple spatial regulations can be configured, how likely is it that a stakeholder-driven process will generate plans that deliver on the promise of MSP? Here, we use a spatially explicit, dynamic bioeconomic model to show that stakeholder-generated plans are doomed to fail in the absence of strong scientific guidance. While strategically placed spatial regulations can improve outcomes remarkably, the vast majority of possible plans fail to achieve this potential. Surprisingly, existing scientific rules of thumb do little to improve outcomes. Here, we develop an alternative approach in which models are used to identify efficient plans, which are then modified by stakeholders. Even if stakeholders alter these initial proposals considerably, results hugely outperform plans guided by scientific rules of thumb. Our results underscore the importance of spatially explicit dynamic models for the management of marine resources and illustrate how such models can be harmoniously integrated into a stakeholder-driven MSP process.     

Combining predictors for classification using the area under the receiver operating characteristic curve

No single biomarker for cancer is considered adequately sensitive and specific for cancer screening. It is expected that the results of multiple markers will need to be combined in order to yield adequately accurate classification. Typically, the objective function that is optimized for combining markers is the likelihood function. In this article, we consider an alternative objective function-the area under the empirical receiver operating characteristic curve (AUC). We note that it yields consistent estimates of parameters in a generalized linear model for the risk score but does not require specifying the link function. Like logistic regression, it yields consistent estimation with case-control or cohort data. Simulation studies suggest that AUC-based classification scores have performance comparable with logistic likelihood-based scores when the logistic regression model holds. Analysis of data from a proteomics biomarker study shows that performance can be far superior to logistic regression derived scores when the logistic regression model does not hold. Model fitting by maximizing the AUC rather than the likelihood should be considered when the goal is to derive a marker combination score for classification or prediction.     

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.     

Topological consideration in the theory of replication of DNA

Summary An obvious difficulty of the Watson-Crick model of DNA is that the intertwining of the strands would seem to hinder their separation during replication. The nature of the difficulty is here made precise and is called the alignment problem. It is shown that the swivelase theory, found in current textbooks and thought to overcome the difficulty, does not in fact do so. The various conceivable solutions of the alignment problem are considered and rejected, leading to the conclusion that chromosomal DNA is not double-helical. An alternative model of DNA is discussed. In addition a topological classification of DNA denaturation processes is given, and an alternative interpretation of the gel electrophoresis experiments on circular duplex DNA is suggested.     

景观性格评价在国土空间规划和管控中的应用

自然特征、景观格局、自然与人文资源和现有开发导向等因素,共同决定了景观空间内部不同的本底特征,即景观性格。通过对多类型资源的叠加,生成对区域空间景观性格的综合评价结果,一方面可以作为国土空间用途管制所涉及问题的评价依据,另一方面可以具体指导国土空间风貌控制问题,从而弥补现有国土空间规划编制过程对景观资源禀赋及本底特色的忽视。对现有景观性格评价方法进行了梳理,基于此构建景观性格评价在国土空间规划中应用的过程步骤,并以黑龙江省伊春市为例进行景观性格评价实践,形成景观性格分区、景观性格分级及景观性格描述等成果,指导伊春市国土空间规划风貌控制、功能区划分及发展定位。景观性格评价有利于发掘利用空间自身优势,与现有国土空间规划评估体系形成互补,共同指导规划的编制过程。