RESUMEN
OBJECTIVE: It is commonly believed that some features of borderline personality disorder (BPD) improve as individuals reach their late 30s and 40s. This study examined age-related change in borderline criteria and functional impairment, testing the hypothesis that older age would be associated with relatively more improvement than younger age. METHOD: A total of 216 male and female participants with BPD were followed prospectively with yearly assessments over 6 years. RESULTS: Participants showed similar rates of improvement in borderline features regardless of age. A significant age by study year interaction showed functioning in older subjects to reverse direction and begin to decline in the latter part of the follow-up, in contrast to younger subjects who maintained or continued improvement over the 6 years. Despite the decline, functioning for the older subjects was comparable with or slightly better at year 6 than at year 1. CONCLUSION: Improvement in borderline features is not specific to the late 30s and 40s. There may be a reversal of improvement in functioning in some borderline patients in this older-age range.
Asunto(s)
Envejecimiento/psicología , Trastorno de Personalidad Limítrofe/diagnóstico , Trastorno de Personalidad Limítrofe/psicología , Adolescente , Adulto , Factores de Edad , Femenino , Estudios de Seguimiento , Humanos , Entrevista Psicológica/métodos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Prospectivos , Índice de Severidad de la Enfermedad , Factores Socioeconómicos , Adulto JovenRESUMEN
Identification of factors that increase risk for PTSD in military personnel following deployments is critical to early intervention and prevention. The study tested hypothesized main and moderating risk factors for PTSD in National Guard/Reserve members deployed to Iraq or Afghanistan. Members of the National Guard/Reserves (n=238) completed diagnostic interviews and measures of risk factors at a post-deployment assessment conducted an average of four and a half months following return from deployment. Hierarchical multivariate logistic regression analyses were used to test hypotheses. Higher levels of combat exposure, life and family concerns during deployment, and post-deployment social support independently predicted PTSD. Life/family concerns during deployment and perceived adequacy of training and preparation were significant moderators of the association between combat exposure and PTSD. Among those with higher levels of both combat exposure and life and family stress, 27% had PTSD in contrast to 3% of those with high exposure but lower levels of such stress during deployment. In addition to combat exposure, life and family stress during deployment is a particularly important predictor of PTSD. The findings highlight the importance of identifying and addressing such stress.
Asunto(s)
Trastornos de Combate/complicaciones , Personal Militar/psicología , Trastornos por Estrés Postraumático/diagnóstico , Guerra , Adulto , Campaña Afgana 2001- , Trastornos de Combate/diagnóstico , Trastornos de Combate/epidemiología , Trastornos de Combate/psicología , Femenino , Humanos , Guerra de Irak 2003-2011 , Modelos Logísticos , Masculino , Personal Militar/clasificación , Personal Militar/estadística & datos numéricos , Prevalencia , Factores de Riesgo , Índice de Severidad de la Enfermedad , Apoyo Social , Trastornos por Estrés Postraumático/epidemiología , Trastornos por Estrés Postraumático/psicología , Estados Unidos/epidemiología , Adulto JovenRESUMEN
OBJECTIVE: Comorbidity among personality disorders is widely considered problematic. The validity of one proposed solution, diagnostic hierarchies, was investigated in the current study with respect to borderline, schizotypal, avoidant, and obsessive-compulsive personality disorders. METHOD: One approach used discriminant functions, derived from multiple psycho-social domains, that were used to classify comorbid individuals from the Collaborative Longitudinal Personality Disorder study (CLPS) to explore the possibility of hierarchical precedence of one personality disorder over another. A second approach examined the incremental increase in R(2)-value in predicting functioning and personality provided by each diagnosis over each other diagnosis. RESULTS: Obsessive-compulsive personality disorder was consistently subordinate to other diagnoses, whereas other indications of hierarchical relationships were domain-specific. CONCLUSION: Results indicate minimal support for an over-arching hierarchical pattern among studied personality disorders, and suggest the inclusion of all relevant diagnoses in clinical practice.
Asunto(s)
Trastorno de Personalidad Limítrofe/diagnóstico , Trastorno de Personalidad Compulsiva/diagnóstico , Trastornos de la Personalidad/diagnóstico , Trastorno de la Personalidad Esquizotípica/diagnóstico , Adolescente , Adulto , Trastorno de Personalidad Limítrofe/epidemiología , Trastorno de Personalidad Limítrofe/psicología , Comorbilidad , Trastorno de Personalidad Compulsiva/epidemiología , Trastorno de Personalidad Compulsiva/psicología , Análisis Discriminante , Femenino , Humanos , Entrevista Psicológica , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Trastornos de la Personalidad/epidemiología , Trastornos de la Personalidad/psicología , Inventario de Personalidad , Valor Predictivo de las Pruebas , Pruebas Psicológicas , Reproducibilidad de los Resultados , Trastorno de la Personalidad Esquizotípica/epidemiología , Trastorno de la Personalidad Esquizotípica/psicología , Autorrevelación , Índice de Severidad de la EnfermedadRESUMEN
OBJECTIVE: Existing evidence from anxiety disorder research indicates that social phobics (SP) with avoidant personality disorder (AVPD) experience more anxiety and show more impairment than patients with SP alone. The purpose of this study was to examine whether in patients diagnosed with AVPD, the co-occurrence of SP adds to its severity. We hypothesized that the addition of SP will not add to the severity of AVPD alone. METHOD: Two groups of patients (AVPD=224; AVPD/SP=101) were compared at baseline and 2 years later on multiple demographic and clinical variables. RESULTS: Patients with AVPD and an additional diagnosis of SP differed little from patients with AVPD alone. CONCLUSION: These findings suggest that AVPD and SP may be alternative conceptualizations of the same disorder.