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1.
Int J Geriatr Psychiatry ; 39(4): e6084, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38558175

RESUMO

OBJECTIVE: Urinary incontinence (UI) is a common condition with a substantial negative impact on older adults' quality of life. This study examines whether individual differences in behavioral, cognitive, and emotional traits assessed by the five major dimensions of personality are related to the risk of concurrent and incident UI. METHODS: Participants were older women and men (N > 26,000) from the Midlife in the United States Survey, the Health and Retirement Study, and the English Longitudinal Study of Aging. In each cohort, personality traits (measured with the Midlife Development Inventory) and demographic (age, sex, education, and race), clinical (body mass index, diabetes, blood pressure), and behavioral (smoking) factors were assessed at baseline. UI was assessed at baseline and again 8-20 years later. Results for each cohort were combined in random-effect meta-analyses. RESULTS: Consistently across cohorts, higher neuroticism and lower conscientiousness were related to a higher risk of concurrent and incident UI. To a lesser extent, extraversion, openness, and agreeableness were also related to lower risk of concurrent and incident UI. BMI, diabetes, blood pressure, and smoking partially accounted for these associations. There was little evidence that age or sex moderated the associations. CONCLUSIONS: The present study provides novel, robust, and replicable evidence linking personality traits to UI. The higher vulnerability for UI for individuals who score higher on neuroticism and lower on conscientiousness is consistent with findings for other multifactorial geriatric syndromes. Personality traits can help identify individuals at risk and may help contextualize the clinical presentation of comorbid emotional, cognitive, and behavioral symptoms.


Assuntos
Diabetes Mellitus , Qualidade de Vida , Idoso , Feminino , Humanos , Masculino , Estudos Longitudinais , Neuroticismo , Personalidade , Transtornos da Personalidade/psicologia , Inventário de Personalidade , Estados Unidos/epidemiologia
2.
J Psychiatr Res ; 174: 245-253, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38670059

RESUMO

Adult attention deficit hyperactivity disorder (ADHD) is often associated with personality pathology. However, only few studies have been conducted on the link between ADHD and pathological narcissism (PN), with or without a diagnosis of narcissistic personality disorder (NPD). In order to fill this gap, PN and NPD were assessed in 164 subjects suffering from ADHD, with several other measures including ADHD severity, quality of life, depression, anxiety, impulsivity, and emotion dysregulation (ED). We found that a significant proportion of ADHD patients suffered from NPD, and that both narcissistic grandiosity and vulnerability were associated with ADHD hyperactivity and impulsivity symptoms, but not with inattentive symptoms. These two dimensions seemed to be negatively associated with well-being and positively associated with most of the other studied psychiatric dimensions except ED, the latter being only associated with vulnerability, even after adjustment on borderline symptoms. Overall, despite important limitations that limit the generalizability of our findings to the overall ADHD population (notably linked to selection bias), we believe that this exploratory study sheds light on the potential clinical relevance of narcissistic pathology in adult ADHD patients.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Narcisismo , Transtornos da Personalidade , Humanos , Adulto , Masculino , Feminino , Transtornos da Personalidade/epidemiologia , Estudos Retrospectivos , Escalas de Graduação Psiquiátrica , Adulto Jovem , Pessoa de Meia-Idade , Qualidade de Vida , Comportamento Impulsivo/fisiologia , Transtorno da Personalidade Narcisística
3.
Acta Psychol (Amst) ; 246: 104285, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38642453

RESUMO

The study's significance lies in the multitude of challenges facing individuals today, such as the COVID-19 pandemic, military conflicts like the war in Ukraine, and the escalating rates of cancer morbidity and mortality. These factors contribute to the onset of anxiety and depressive disorders, disrupting various aspects of individuals' mental functioning and social interactions. Addressing these disorders effectively necessitates a comprehensive approach, combining pharmacological interventions with psychotherapeutic strategies under the guidance of specialized professionals. In this regard, the study is aimed at identifying aspects and features of the development of psychological problems and personality disorders in the modern world filled with various stressors. The leading methods of studying this problem are analysis, synthesis, induction, deduction, comparison, experiment and systematisation of approaches that will help determine a wide range of mental disorders. Theoretical methods were used to analyze the literature and summarize theoretical material on anxiety and depressive disorders. Diagnostic methods were used to assess the psychological state of the study population. The study examines significant clinical syndromes and vegetative disorders that disrupt normal lifestyle, hinder daily activities, and impede professional growth. It evaluates the roles of psychologists, psychiatrists, and social workers in assisting individuals with anxiety disorders. It outlines preventive measures for anxiety and depression, while also delving into various types of anxiety disorders. The research proposes diverse methods to prevent emotional anxiety and instability. It underscores the importance of devising novel strategies for diagnosis and therapy, emphasizing a comprehensive approach involving psychotherapeutic support, medical intervention, and adaptive behavioral techniques. The findings of the study hold both practical and theoretical significance for professionals in psychology, psychiatry, psychoanalysis, and sociology who provide support for individuals with anxiety and depressive disorders. Furthermore, the insights provided may be pertinent to researchers and scholars investigating the psychological well-being of contemporary society amidst adverse external circumstances.


Assuntos
Transtornos de Ansiedade , COVID-19 , Transtorno Depressivo , Humanos , COVID-19/psicologia , Transtornos de Ansiedade/epidemiologia , Transtorno Depressivo/epidemiologia , Transtornos da Personalidade
4.
J Clin Psychol ; 80(5): 1177-1191, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38170437

RESUMO

The following case study provides a description of the transference-focused psychotherapy (TFP) treatment of a young man diagnosed with narcissistic personality disorder (NPD). TFP is an individual, psychodynamic therapy developed to treat a range of personality disorders. TFP is evidence-based for the treatment of borderline personality disorder and has been adapted for the treatment of NPD. This case illustrates the application of the strategies and techniques of TFP to treatment of NPD as well as challenges clinicians may face in arriving at timely diagnosis of the disorder. Although no specific treatment for NPD has been empirically validated, TFP utilizes the therapeutic techniques identified across modalities for successful treatment of pathological narcissism. This report describes how treatment interventions such as goal setting, developing a therapeutic alliance, using a treatment contract and addressing treatment interfering behaviors contributed to this patient's improvement in self-reflection, formation of healthier and more flexible ideas about self and other, increased self-agency, tolerance of normative disillusionments and increase in empathy.


Assuntos
Transtorno da Personalidade Borderline , Transtorno da Personalidade Narcisística , Masculino , Humanos , Transferência Psicológica , Psicoterapia/métodos , Transtorno da Personalidade Borderline/terapia , Transtornos da Personalidade/terapia
5.
Artigo em Inglês | LILACS, BDENF, COLNAL | ID: biblio-1553406

RESUMO

Introduction: Bariatric surgery has become an increasingly common procedure, especially for patients with morbid obesity who have obtained unsatisfactory results from conventional treatments. Objective: To evaluate the occurrence of behavioral patterns and personality disorders in patients in the preoperative period of bariatric surgery. Materials and methods: Cross-sectional study carried out with 146 patients from a medium-sized clinic, a reference in the execution of bariatric surgeries in the Midwest region of Minas Gerais, Brazil. Data collection was performed using the psychological instrument entitled Factorial Personality Battery. Descriptive analysis and data association were performed. Results: Half of the participants presented high or very high scores for greater propensity to develop depression and anxiety, showing a close relationship with personality disorders, especially with behavioral patterns of effort and dedication. Discussion: The patterns of effort and dedication behavior are protective factors in the postoperative period, taking into account the adaptations and new habits necessary for a good recovery and maintenance of weight loss. Conclusions: The dysfunctional patterns of behavior that stood out most are related to greater difficulty in perceiving the positive side and ease in perceiving the negative side, leading to a more intense experience of suffering, in addition to difficulty in making decisions and facing routine challenges. Screening behavioral patterns and personality disorders preoperatively is necessary for adequate patient monitoring and successful bariatric surgery.


Assuntos
Transtornos da Personalidade , Enfermagem Psiquiátrica , Comportamento , Cirurgia Bariátrica
6.
J Clin Psychol ; 80(4): 871-883, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37847856

RESUMO

Homework assignments, or specific tasks patients are asked to engage in or complete between sessions, are a controversial topic among psychoanalysts. While many argue these interventions contradict psychoanalytic principles, others believe they can help address problems and promote coping skills. We propose that homework can be a legitimate aspect of relational psychoanalysis when used in a way that is attuned to the patient's experience and that homework may be an important component of treating personality disorders (PD). We present the case of a man diagnosed with narcissistic PD. He often felt superior to and reported that he despised others, though the core self-image was of fragile. He embraced the role of the omnipotent caregiver, which came with boredom and anger and lack of satisfaction in his social life. The patient tried to control therapy, asserting that he could psychoanalyze himself. As a result, therapy was stalled and progress was limited. At this point, the therapist asked him to complete homework assignments that encouraged him to refrain from his compulsive caregiving to better understand what motivated this behavior. Through this process, the patient came to realize he acted out of avoidance, as he did not want to disclose his own vulnerabilities and flaws. At that point he was able to experience relationships while adopting different stances and finding new meanings. We argue that homework can be fully integrated into the relational psychoanalytic repertoire to improve self-reflection and foster change in patients with PD.


Assuntos
Psicanálise , Terapia Psicanalítica , Masculino , Humanos , Transtorno da Personalidade Narcisística , Transtornos da Personalidade/terapia , Autoimagem
8.
J Nerv Ment Dis ; 212(1): 4-11, 2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-37788338

RESUMO

ABSTRACT: Clinicians often encounter patients whose presentations are characterized by long lists of complaints about their biological, psychological, interpersonal, and social conditions. The problems on which the complaints are based are variably reality-based and variably modifiable. Some of these patients display chronic complaining as a core, distinguishing feature. Accordingly, the aims of this article are to consider excesses of chronic complaining as psychiatric phenomena, explore possible pathogenetic contributions, describe approaches for treating conditions marked by clinically pertinent chronic complaining, and suggest areas for future research. Based on clinical observations enhanced by selective narrative literature review, we delineate and differentiate four groups of patients: 1) situational complainers; 2) chronic complainers due to unidentified medical problems; 3) mood-induced chronic complainers; and 4) personality-driven pan-dimensional chronic complainers. The last-mentioned group consists of help-seeking versus help-rejecting subtypes, the latter including a subset we designate as malignant chronic complainers. Strategies for managing these patients begin with detailed assessment of all complaints, ascertaining reality-based contributions to the complaints, including those initiated by patients themselves. Management approaches use specific biopsychosocial techniques based on patient-centered particulars. Psychotherapeutic strategies center on compassionate, empathic witnessing. Specific tactics include attending to unresolved grief and trauma, behavioral activation, cognitive and narrative restructuring and reframing methods, mentalizing and imaginal approaches, and psychodynamic methods including attention to attachment issues and transference. Sources of countertransference reactions to these patients should be identified and can be addressed. The many questions raised by these patients' presentations merit further research.


Assuntos
Contratransferência , Transtornos da Personalidade , Humanos , Transtornos da Personalidade/terapia
9.
Health Psychol ; 43(3): 214-224, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38032613

RESUMO

OBJECTIVE: Personality traits have been regularly linked with all-cause mortality risk. However, what mechanisms may provide an indirect pathway from personality traits to mortality is unclear. We sought to systematically review the literature and provide an overview of the potential mechanisms that have been identified in the literature. METHOD: Five electronic databases (PubMed, Web of Science, CINAHL, PsycInfo, and PsycArticles) were searched from inception to January 27, 2023. From 611 studies initially identified, seven studies met the final inclusion criteria. These seven papers have a combined sample of 60,104 individuals (M = 8,585, SD = 14,600; range 957-44,094). RESULTS: These papers found that several variables, such as smoking, inflammation biomarkers, blood pressure, and sleep, mediated the relationship between various personality traits and mortality. There was considerable variation in the impact of results across cohorts, even when looking at similar variables, and notable differences in methodological approaches and reporting were discussed. CONCLUSIONS: This review identified a small pool of research looking at a range of indirect pathways (mediating variables). The review identified traits with well-established associations with mortality risk, such as neuroticism, do not have consistent findings in the mediation literature and a high level of variance in the degree to which mediators account for the personality-mortality relation between different cohorts. Despite these limitations, it is clear that examining indirect effects (mediation) has a crucial role to play in developing our understanding of the complex pathways that connect personality-mortality risk. We identify several avenues and considerations for future research. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Assuntos
Transtornos da Personalidade , Personalidade , Humanos , Neuroticismo , Sono
10.
J Clin Psychol ; 80(4): 795-808, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38009529

RESUMO

Pathological narcissism is a personality constellation comprising distorted self-image, maladaptive self-esteem regulation, and difficulties in intimate relationships. Patients with elevated pathological narcissism may not necessarily meet criteria for narcissistic personality disorder, and may seek treatment for a range of mental health concerns across various clinical settings. An understanding of key principles of control-mastery theory (CMT) can help clinicians understand the specific goals and challenges of the individual patient with pathological narcissism, and can illuminate ways in which the patient may work in psychotherapy. This paper outlines how patients with pathological narcissism may engage in testing of their pathogenic beliefs, and how therapists can respond in ways that facilitate the patient's sense of safety and foster psychological work. The role of the therapist's attitude is highlighted as a means for countering pathogenic beliefs associated with pathological narcissism. Clinical material from a single case of time-limited supportive psychotherapy will be used to illustrate these principles and associated therapeutic processes. Insights from CMT regarding pathogenic beliefs and the patient's plan for addressing them can help to explain how therapy works or does not work for patients with pathological narcissism.


Assuntos
Narcisismo , Transtorno da Personalidade Narcisística , Humanos , Psicoterapia/métodos , Transtornos da Personalidade/terapia , Transtornos da Personalidade/psicologia , Autoimagem
11.
Soc Psychiatry Psychiatr Epidemiol ; 59(3): 475-492, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37932472

RESUMO

PURPOSE: The importance of sociality in psychology and psychotherapy is quite undisputed; however, this construct risks being underestimated in psychiatric nosography. The aim of the review was to assess the relevance of sociality in DSM 5 criteria. METHOD: Sociality-laden criteria of 192 selected DSM categories have been identified through a textual grid. Second, the criteria have been classified into 6 categories, i.e., (1) Affiliation and Attachment (AA), (2) Social Communication (SC), (3) Perception and Understanding of Others (PUO), (4) Culture, (5) Clinical Significance Criterion (CSC) (6), and No Specific Construct (NSC). RESULTS: 13% of all mental disorders mention AA in their criteria. 8.8% of all mental disorders mention SC; 8.8% of all mental disorders mention PUO in their criteria. 15% of all mental disorders mention culture in their criteria (exclusively ex negativo though). 40% of mental disorders mention non-specific sociality (NSC) in their criteria. CSC is mentioned in 85% of mental disorders. Personality disorders have the highest "concentration" of sociality mentions throughout the DSM categories. CONCLUSIONS: The overall results suggest that DSM criteria offer a confused account of sociality. We believe that the descriptive approach is the underlying reason. We suggest that in the long run a theory-laden approach to sociality, informed by evolutionary insights about motivations, could be of help.


Assuntos
Transtornos da Personalidade , Comportamento Social , Humanos , Relações Interpessoais , Manual Diagnóstico e Estatístico de Transtornos Mentais
12.
J Clin Psychol ; 80(4): 776-794, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37965788

RESUMO

In order to effectively treat individuals suffering from Narcissistic Personality Disorder (NPD), it is crucial to establish therapeutic goals and identify tasks to achieve them. However, this is a challenging process with NPD patients because they often struggle to find meaningful goals beyond the pursuit of status. Moreover, in order to change Furthermore, to promote change, they must confront painful emotions such as shame, guilt, or fear, which they habitually try to avoid. Additionally, they face difficulties in forming a positive perception of their therapists and cooperating towards mutually agreed-upon goals and tasks. As a consequence, NPD patients ask for change but hardly engage themselves in the work necessary to achieve it. Therapists therefore need to pay the uttermost attention to drafting, negotiating and continuously updating a reasonable and realistic therapeutic contract. In this paper we describe the story of a man in his thirties with NPD who was ridden with depression, guilt, envy and anger and did not find ways to pursue the healthy and adaptive behaviors he would need to pursue in order to leave a richer social life. The therapist overcame ruptures in the therapeutic alliance and then involved the patient in a process where they set the steps to follow, making sure the patient was convinced they made sense. After a contract was reached progress became possible. Implications for the role of the therapeutic contract in NPD treatment are discussed.


Assuntos
Transtorno da Personalidade Narcisística , Transtornos da Personalidade , Masculino , Humanos , Transtornos da Personalidade/terapia , Transtornos da Personalidade/psicologia , Narcisismo , Emoções , Culpa
13.
Acta Psychiatr Scand ; 149(3): 195-206, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38145901

RESUMO

BACKGROUND: Knowledge of the association between parental personality disorders and mental disorders in children is limited. To examine the association between parental personality disorders and the risk of mental disorders in offspring. METHODS: We linked Danish health registers to create a cohort of children born from January 1, 1995, to December 31, 2016. Children were followed until their 18th birthday, diagnosis set, emigration, death, or December 31, 2016. Parental personality disorders according to the International Classification of Diseases (ICD) Eighth or 10th Revision. Poisson regression analyses were used to estimate the incidence risk ratio (IRR) and cumulative incidence of ICD 10th mental disorders in offspring (age 0-17). RESULTS: The study cohort included 1,406,965 children. For girls, maternal or paternal personality disorder (MPD/PPD) was associated with mental disorders: MPD girls (IRR, 2.74; 95% CI, 2.59-2.89) and PPD girls (IRR, 2.10; 95% CI, 1.94-2.27). Likewise, the risk was increased for both MPD boys (IRR, 2.44; 95% CI, 2.33-2.56) and PPD boys (IRR, 2.04; 95% CI, 1.91-2.18). For girls and boys combined, exposure to two parents with a personality disorder was associated with the highest risk (IRR, 3.69; 95% CI, 3.15-4.33). At age 18, the cumulative incidence of any mental disorder in children of one or two parents with a personality disorder was 34.1% (95% CI, 33.0-35.1), which was twice the cumulative incidence of mental disorders in nonexposed children (15.2% [95% CI, 15.1-15.3]). CONCLUSION: Children of parents with a personality disorder were at a 2 to 3.5 times higher risk of mental disorders compared with nonexposed offspring. Possible mechanisms of transmission of mental disorders from parent to child involve genetic, environmental, and gene-environment pathways. More research into these mechanisms and research into preventive interventions is warranted.


Assuntos
Transtornos Mentais , Transtornos da Personalidade , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estudos de Coortes , Dinamarca/epidemiologia , Pai , Transtornos Mentais/epidemiologia , Pais , Fatores de Risco
14.
Acta neurol. colomb ; 39(4)dic. 2023.
Artigo em Espanhol | LILACS | ID: biblio-1533511

RESUMO

Introducción: El síndrome de Balint es un trastorno neurológico infrecuente, de etiología diversa, cuya presentación incluye la triada clásica de: simultagnosia, ataxia óptica y apraxia oculomotora, síntomas secundarios asociados a lesiones parieto-occipitales, con pronóstico variable según la etiología que se encuentre. A continuación, se reporta un caso secundario a una trombosis de senos venosos. Presentación del caso: Mujer de 66 años que ingresa a urgencias por cefalea aguda asociada a síntomas neurológicos progresivos con compromiso visual. Presentó tensión arterial elevada, simultagnosia, ataxia óptica y apraxia oculomotora. Los estudios imagenológicos reportaron hemorragia subaracnoidea por trombosis de seno sigmoideo izquierdo, por lo que se inició anticoagulación, antihipertensivo, con adecuada evolución del cuadro clínico. Discusión: A pesar de que el síndrome de Balint es un trastorno poco común, de etiología diversa, con escasos reportes a escala global, el caso comentado concordó con las características descritas en la literatura. El abordaje de la paciente en su atención inicial permitió la sospecha diagnóstica oportuna y la indicación de ayudas diagnósticas imagenológicas pertinentes. Tales ayudas soportaron un manejo temprano y la adecuada evolución y resolución del cuadro, en el contexto de la asociación del síndrome a una trombosis de senos venosos cerebrales (una etiología infrecuente). Conclusión: Mediante una historia clínica completa y minuciosa, junto a un adecuado examen neurológico, es posible hacer un acercamiento diagnóstico temprano que permita generar la sospecha del síndrome de Balint y la solicitud temprana de imágenes diagnósticas que orienten en el estudio de su etiología y manejo oportuno, con mejores desenlaces en el paciente.


Introduction: Balint Syndrome is a rare neurological disorder with multiple etiologies. The physical signs include a classic triad (simultagnosia, optic ataxia, and oculomotor apraxia). These symptoms are associated with parieto-occipital lesions, and the prognosis depends on the etiology. This article reports a case secondary to venous sinus thrombosis. Presentation of the case: A 66-year-old woman presented to the emergency room with acute headache associated with progressive neurological symptoms and visual impairment. She had high blood pressure, simultanagnosia, optic ataxia, and oculomotor apraxia. Imaging studies revealed subarachnoid hemorrhage due to thrombosis of the left sigmoid sinus, for which anticoagulation and antihypertensive therapy were started. The patient had a favorable clinical outcome. Discussion: Although Balint syndrome is a rare disorder of diverse etiology with few clinical cases reported globally, the case discussed here was consistent with the characteristics described in the literature. The patient's initial assessment allowed for timely diagnostic suspicion and appropriate imaging studies, which supported early management and the appropriate evolution and resolution of the condition, given the association of the syndrome with an uncommon cause as cerebral venous sinus thrombosis. Conclusion: A complete and thorough medical history, along with a proper neurological exam, can lead to an early diagnostic approach that raises suspicion of Balint's syndrome and prompts timely imaging studies to guide the investigation of its etiology and management, ultimately leading to better outcomes for the patient.


Assuntos
Transtornos da Personalidade , Transtornos da Visão , Trombose Venosa , Agnosia , Síndrome , Exame Neurológico
15.
J Psychiatr Res ; 168: 30-37, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37875035

RESUMO

BACKGROUND: Personality traits have been associated with cognitive functioning and risk of cognitive decline. Fewer studies have investigated how personality facets are associated with cognition in large cohorts with a prospective design. METHODS: The association between eight personality facets and cognition (speed measures reflecting psychomotor speed and visual attention; hit rate measures reflecting visual learning and working memory) was analyzed in middle-aged adults from the Lifelines cohort (N = 79911; age 43 ± 11 years). RESULTS: High hostility, high vulnerability, low excitement seeking, and low competence were associated with worse cognitive performance on all tasks. Impulsivity-related facets had weak and differential associations, with self-discipline negatively associated with accuracy and deliberation negatively associated with speed. These associations remained largely unchanged when accounting for lifestyle factors (smoking, alcohol consumption, physical activity). The associations with cognition were stronger in older people for impulsiveness, deliberation, and hostility, while stronger in younger people for excitement seeking, self-discipline, and vulnerability. CONCLUSION: In a large population-based sample with a broad age range, the associations of personality facets with cognitive functioning had small effect sizes, were independent of lifestyle factors, and varied with age and among facets within the same personality domain. These findings highlight the importance of developmental stages and facet-level research in personality-cognition associations.


Assuntos
Disfunção Cognitiva , Personalidade , Adulto , Pessoa de Meia-Idade , Humanos , Idoso , Estudos de Coortes , Transtornos da Personalidade , Cognição
16.
Clin Psychol Psychother ; 30(6): 1215-1233, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37727949

RESUMO

Recent diagnostic developments suggest that paranoia is a transdiagnostic characteristic common to several personality disorders rather than a personality disorder per se. Nonetheless, empirical literature fails to provide comprehensive and univocal findings on whether and how paranoid presentations relate to different personality disorders. In the present scoping review, we map the empirical literature on paranoid presentations in personality disorders, considering the entire spectrum of paranoid manifestations (i.e., the paranoia hierarchy). In selecting original quantitative studies on paranoid presentations in personality-disordered patients, we screened 4,433 records in PsycArticles, PsycInfo and PUBMED. We eventually included 47 eligible studies in the review. Our synthesis indicates consistent empirical evidence of a wide range of paranoid presentations in Paranoid, Schizotypal and Borderline personality disorders. Conversely, little empirical literature exists on paranoid presentations in other personality disorders. Preliminary findings suggest broad-severity paranoid presentations, ranging from milder to severe forms, in Paranoid, Schizotypal and Borderline personality disorders. There is also some evidence of milder forms of paranoia in Avoidant, Antisocial and Narcissistic personality disorders. Conversely, there is poor evidence of paranoid presentations in Schizoid, Histrionic, Dependent or Obsessive-compulsive personality disorders. Research gaps and recommendations for improving empirical research on paranoid presentations in personality disorders are discussed.


Assuntos
Transtorno da Personalidade Borderline , Transtorno Obsessivo-Compulsivo , Humanos , Transtornos da Personalidade/diagnóstico , Transtorno da Personalidade Borderline/diagnóstico , Transtorno da Personalidade Borderline/epidemiologia , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno da Personalidade Narcisística
17.
J Pers Disord ; 37(3): 285-303, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-37367822

RESUMO

Narcissistic personality disorder is a heterogeneous and complex pathology which manifests itself very differently in individuals. The aim of the present study was to analyze differences and similarities in morality and sensitivity to feelings of guilt among grandiose narcissism (GN), vulnerable narcissism (VN), and malignant self-regard (MSR). We expected that MSR and VN would be most sensitive to deontological and altruistic guilt, and that MSR and VN would have higher levels of moral standards than GN. A nonclinical sample of 752 participants was evaluated. Results showed a significant association among MSR, VN, and GN. According to our hypothesis, GN turned out to be the one with the lowest association values to guilt measures. Our results demonstrated that MSR is strongly associated with all types of guilt, GN is associated with a substantial lack of guilt, and VN is associated with deontological guilt and self-hate, but not altruistic guilt. Results confirm the relevance of considering and understanding guilt when differentiating GN, VN, and MSR.


Assuntos
Narcisismo , Transtornos da Personalidade , Humanos , Transtornos do Humor , Emoções , Culpa
18.
Subj. procesos cogn ; 27(1): 1-26, jun. 05, 2023.
Artigo em Português | LILACS, UNISALUD, BINACIS | ID: biblio-1437788

RESUMO

Este artigo pretende verificar a quantidade de pesquisas publicadas no mundo nos últimos cinco anos e sua predição para com o comportamento humano. Foram encontrados 75 artigos nas bases de dados Scielo, Medline e Lilacs, a través de uma busca utilizando descritores em português e na língua inglesa no Portal Periódicos.capes. Os resultados apontaramque os estudos encontrados tiveram relação aos transtornos da personalidade, referindode forma direta a comportamentos relacionados aos esquemas desadaptativos como preditores dos transtornos da personalidade. Outros temas considerados foram o suicídio, o divórcio, a violência conjugal, patologias orgânicas e/ou dor crônica, a parentalidade,comportamentos erráticos, saúde e validação de escalas. Conclui-se que esta revisão tem sua importância na análise criteriosa dos estudos sobre os EIDs e sua relação com a personalidade, já que a teoria cognitiva traz a priori que os comportamentos disfuncionais estão relacionados com os Esquemas Iniciais Desadaptativos AU


Este artículo tiene como objetivo verificar la cantidad de investigaciones publicadas en el mundo en los últimos cinco años y su predicción para el comportamiento humano. Se encontraron un total de 75 artículos en las bases de datos Scielo, Medline y Lilacs, a través de una búsqueda con descriptores en portugués e inglés en el Portal Periódicos.capes. Los resultados mostraron que los estudios encontrados estaban relacionados con los trastornos de personalidad, refiriéndose directamente a conductas relacionadas con esquemas desadaptativos como predictores de trastornos de personalidad. Otros temas considerados fueron suicidio, divorcio, violencia conyugal, patologías orgánicas y/o dolor crónico, crianza, comportamiento errático, salud y validación de escalas. Se concluye que esta revisión es importante en el análisis cuidadoso de los estudios sobre las EID y su relación con la personalidad, ya que la teoría cognitiva muestra a priori que las conductas disfuncionales están relacionadas con los Esquemas Desadaptativos Iniciales AU


This article aims to verify the amount of research published in the world in the last five years and its prediction for human behavior. A total of 75 articles were found in the Scielo, Medline and Lilacs databases, through a search using descriptors in Portuguese and English on the Portal Periódicos.capes. The results showed that the studies found were related topersonality disorders, referring directly to behaviors related to maladaptive schemas as predictors of personality disorders. Other topics considered were suicide, divorce, marital violence, organic pathologies and/or chronic pain, parenting, erratic behavior, health and validation of scales. It is concluded that this review is important in the careful analysis of studies on EIDs and their relationship with personality, since the cognitive theory shows a priori that dysfunctional behaviors arerelated to Initial Maladaptive Schemas AU


Assuntos
Humanos , Masculino , Feminino , Transtornos da Personalidade/psicologia , Suicídio , Transtornos de Adaptação/psicologia , Comportamento Problema/psicologia , Terapia Cognitivo-Comportamental , Experiências Adversas da Infância
19.
J Nerv Ment Dis ; 211(6): 460-466, 2023 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-37252882

RESUMO

ABSTRACT: Kernberg and McWilliams have spawned differing conceptualizations of the relationship between depressive and masochistic (self-defeating) personalities. Kernberg describes these personality styles as largely overlapping in features, whereas McWilliams accentuates important clinical differences that make up two distinct personalities. In this article, their theoretical perspectives are discussed and framed as more complementary than competitive. The malignant self-regard (MSR) construct is introduced and reviewed as an integrative self-representation that is shared by both depressive and masochistic personalities, as well as those often referred to as vulnerably narcissistic. We investigate developmental conflicts, motivations for perfectionism, countertransference patterns, and overall level of functioning as four primary clinical features through which a therapist may differentiate a depressive from a masochistic personality. We argue that depressive personalities tend to have more dependency-related conflicts and perfectionistic strivings motivated by lost object reunification, elicit more insidiously positive countertransference reactions in session, and are generally higher-functioning individuals. Masochistic personalities have more oedipal-related conflicts and perfectionistic strivings motivated by object control, elicit more aggressive countertransference reactions, and are relatively lower functioning. MSR is positioned as a bridge between Kernberg's and McWilliam's ideas. We close with a discussion of treatment implications for both disorders as well as how to understand and treat MSR.


Assuntos
Perfeccionismo , Personalidade , Humanos , Transtornos da Personalidade/terapia , Narcisismo , Motivação
20.
J Psychosom Res ; 169: 111322, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-37018955

RESUMO

OBJECTIVE: Presence of gallstones is associated with a range of risk factors that have previously shown associations with personality traits. Our aim was to assess the differences in personality traits between the patients with and without gallstones. METHODS: This study used a case-control design with 308 participants from the general population, 68.2% female, mean age 49.2 (SD 9.24) years, of whom 154 (50%) participants had asymptomatic gallstones. Personality was assessed with the Temperament and Character Inventory - Revised - 140 (TCI-R-140) and depression with the Center for Epidemiological Study of Depression Scale (CESD). Cut-off ≥16 on the CES-D was used as an exclusion criterion. Subjects were also checked for metabolic risk factors and sociodemographic characteristics. RESULTS: The group with gallstones had significantly more pronounced metabolic risk factors and higher prevalence of smoking and alcohol usage in comparison with the group without gallstones. This group also exhibited higher temperament dimension Harm avoidance (HA) and lower character dimension Self-directedness (SD). Metabolic variables differed based on character dimension Cooperativeness (CO), smoking based on temperament dimensions Novelty seeking (NS) and HA, and alcohol usage on dimension NS within the gallstones group. In the logistic regression, controlled for smoking, alcohol usage and metabolic variables, temperament dimension HA was shown to be a significant predictor of the presence of gallstones. CONCLUSION: Our findings indicate that personality may be associated with the presence of gallstones. Future longitudinal studies addressing the complex interplay of personality traits, psychological mechanisms and the associated behavioral, metabolic and neurobiological factors, are needed.


Assuntos
Cálculos Biliares , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Transtornos da Personalidade/epidemiologia , Personalidade , Temperamento , Caráter , Inventário de Personalidade
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