scholarly journals The role of migration processes and cultural factors in the classification of personality disorders

2021 ◽  
pp. 136346152110364
Author(s):  
Ardalan Najjarkakhaki ◽  
Samrad Ghane
Keyword(s):  
Personality Disorders ◽  
Ethnic Minorities ◽  
Historical Trauma ◽  
Cultural Factors ◽  
Cultural Dimensions ◽  
Economic Resources ◽  
Personality Pathology ◽  
Indigenous Populations

Migrants and ethnic minorities are at risk of being under- and overdiagnosed with personality disorders (PDs). A culturally informed approach to the classification of PDs guides clinicians in incorporating migration processes and cultural factors, to arrive at a reliable and valid assessment of personality pathology. In this article, we provide a tentative framework to highlight specific interactions between personality disorders, migration processes, and cultural factors. It is argued that migration processes can merely resemble personality pathology, activate certain (latent) vulnerabilities, and aggravate pre-existing personality pathology. We propose that these migration processes can include manifestations of grief about the loss of pre-migratory psychosocial and economic resources, and the struggle to attain psychosocial and economic resources in the host culture. Moreover, several cultural dimensions are outlined that can either resemble or mask personality pathology. The term “culturally masked personality disorder” is coined, to delineate clinical cases in which cultural factors are overused or misused to rationalize behavioral patterns that are consistently inflexible, distressing, or harmful to the individual and/or significant others, lead to significant impairment, and exceed the relevant cultural norms. Additionally, the role of historical trauma is addressed in the context of potential overdiagnosis of personality disorders in Indigenous persons, and the implications of misdiagnosis in migrants, ethnic minorities, and Indigenous populations are elaborated. Finally, clinical implications are discussed, outlining various diagnostic steps, including an assessment of temperament/character, developmental history, systemic/family dynamics, migration processes, cultural dimensions, and possible historical trauma.

scholarly journals Towards a contemporary approach for understanding personality pathology in developmental context: An integrative model

2021 ◽  
pp. 1-10
Author(s):  
Melody R. Altschuler ◽  
Robert F. Krueger
Keyword(s):  
Personality Disorders ◽  
Personality Pathology ◽  
Integrative Model ◽  
Research Domain Criteria ◽  
Developmental Context ◽  
Dimensional Classification ◽  
Developmental Theories ◽  
Underlying Mechanisms ◽  
Research Domain

Abstract Traditional categorical approaches to classifying personality disorders are limited in important ways, leading to a shift in the field to dimensional approaches to conceptualizing personality pathology. Different areas of psychology – personality, developmental, and psychopathology – can be leveraged to understand personality pathology by examining its structure, development, and underlying mechanisms. However, an integrative model that encompasses these distinct lines of inquiry has not yet been proposed. In order to address this gap, we review the latest evidence for dimensional classification of personality disorders based on structural models of maladaptive personality traits, provide an overview of developmental theories of pathological personality, and summarize the Research Domain Criteria (RDoC) initiative, which seeks to understand underlying mechanisms of psychopathology. We conclude by proposing an integrative model of personality pathology development that aims to elucidate the developmental pathways of personality pathology and its underlying mechanisms.

Managing Countertransference in the Treatment of Personality Disorders

2021 ◽  
Vol 49 (2) ◽  
pp. 339-360
Author(s):  
Monica Carsky
Keyword(s):  
Object Relations ◽  
Personality Disorders ◽  
Emotional Reactions ◽  
Personality Pathology ◽  
Clinical Process ◽  
Internal Object ◽  
Personality Disordered ◽  
Representational World ◽  
Transference Focused Psychotherapy

The clinical and technical difficulties presented by patients with personality disorders are well documented. This article focuses on the challenges faced by therapists when managing their emotional reactions, that is, their countertransferences, to patients with personality disorders. While leaving room for therapists' unique and idiosyncratic countertransferences to the patient with personality pathology, Kernberg emphasized the role of a more general form of countertransference, one reflective largely of the patient's conflicts and defenses, in the treatments of personality disordered individuals. Here, the nature of the patient's internal and external functioning can be seen to lead to similar reactions among different therapists, opening the possibility of utilizing countertransference to better understand the patient's difficulties. In transference-focused psychotherapy (TFP), countertransferences arising in the patient–therapist interaction are first identified and contained by the therapist and then utilized to clarify and explore how the patient's internal object relations are being enacted in the clinical process. This article describes this process and how TFP therapists work with their countertransference to help illuminate the patient's split representational world, paving the way for interpretation and integration.

Does Childhood Trauma Cause Personality Disorders in Adults?

1998 ◽  
Vol 43 (2) ◽  
pp. 148-153 ◽  
Author(s):  
Joel Paris
Keyword(s):  
Personality Disorders ◽  
Childhood Trauma ◽  
Personality Pathology ◽  
Traumatic Experiences ◽  
Review Of The Literature ◽  
Gene Environment ◽  
Research Findings ◽  
The Relationship

Objective: To examine the relationship between trauma in childhood and personality disorders in adulthood. Method: A review of the literature was conducted. Results: The reported associations between trauma and personality pathology are illuminated by the following research findings: 1) personality is heritable; 2) only a minority of patients with severe personality disorders report childhood trauma; and 3) children are generally resilient, and traumatic experiences do not consistently lead to psychopathology. Conclusions: The role of trauma in the personality disorders is best understood in the context of gene–environment interactions.

Understanding Historical Trauma for the Holistic Care of Indigenous Populations: A Scoping Review

2020 ◽  
pp. 089801012097913
Author(s):  
Lucy Joo-Castro ◽  
Amanda Emerson
Keyword(s):  
Indigenous People ◽  
Intergenerational Transmission ◽  
Indigenous Peoples ◽  
Scoping Review ◽  
Historical Trauma ◽  
Indigenous Populations ◽  
Holistic Care ◽  
Research Activity ◽  
The Past

Historical trauma refers to the collective depredations of the past that continue to affect populations in the present through intergenerational transmission. Indigenous people globally experience poorer health outcomes than non-Indigenous people, but the connections between Indigenous people’s health and experiences of historical trauma are poorly understood. To clarify the scope of research activity on historical trauma related to Indigenous peoples’ health, we conducted a scoping review using Arksey and O’Malley’s method with Levac’s modifications. Seventy-five articles (1996-2020) were selected and analyzed. Key themes included (a) challenges of defining and measuring intergenerational transmission in historical trauma; (b) differentiating historical trauma from contemporary trauma; (c) role of racism, discrimination, and microaggression; (d) questing for resilience through enculturation, acculturation, and assimilation; and (e) addressing historical trauma through interventions and programs. Gaps in the research included work to establish mechanisms of transmission, understand connections to physical health, elucidate present and past trauma, and explore epigenetic mechanisms and effects ascribed to it. Understanding first what constitutes historical trauma and its effects will facilitate development of culturally safe holistic care for Indigenous populations.

scholarly journals The role of identity in the DSM-5 classification of personality disorders

2013 ◽  
Vol 7 (1) ◽  
pp. 27 ◽  
Author(s):  
Klaus Schmeck ◽  
Susanne Schlüter-Müller ◽  
Pamela A Foelsch ◽  
Stephan Doering
Keyword(s):  
Personality Disorders ◽  
Dsm 5

scholarly journals Suicidality and Personality Pathology in Adolescence: A Systematic Review

2021 ◽  
Author(s):  
Marta Moselli ◽  
Maria Pia Casini ◽  
Camilla Frattini ◽  
Riccardo Williams
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Borderline Personality ◽  
Personality Pathology ◽  
Suicidal Risk ◽  
Research Papers ◽  
Mediating Role ◽  
Identity Diffusion ◽  
Predictive Role

AbstractThis work presents a review of research papers examining the role of emerging personality pathology in suicidal ideation and behaviours in adolescence. Initially, 226 studies were selected in line with PRISMA guidelines, and 33 articles were finally included in this review. The data show percentages of any personality disorder diagnosis ranging from 19.5 to 22.8% in suicide attempters, while in autopsy studies, the rate of personality disorder diagnosis varied between 29.6 and 42.1%. The overwhelming majority of the studies focus on the role of borderline personality disorder (BPD) in suicidal behaviours, also highlighting its predictive role at a longitudinal level. Furthermore, the literature review shows that personality traits supposed to underlie BPD, such as affective instability, impulsivity and identity diffusion, have specific predictive links with suicidal conduct. Other personality pathology dimensions, such as aggressiveness, sadism and perfectionism that are associated with other personality disorders, namely, antisocial and narcissistic personality disorders, have also shown a significant mediating role for suicidal risk. Overall, these results seem to parallel the role of personality pathology in predicting suicide in adulthood and point to the relevance of assessing the presence of emerging patterns of personality disorders for the clinical management of suicidal risk in adolescence.

Assessment of DSM–III–R Personality Disorders by Self-Report Questionnaire: the Role of Informants and a Screening Test for Co-morbid Personality Disorders (STCPD)

1992 ◽  
Vol 161 (3) ◽  
pp. 344-352 ◽  
Author(s):  
J. H. Dowson
Keyword(s):  
Cluster Analysis ◽  
Personality Disorders ◽  
Screening Test ◽  
Psychiatric Patients ◽  
Self Report ◽  
The Mean

A modified version of the revised Personality Diagnostic Questionnaire (PDQ–R), based on DSM–III–R personality disorders (PDs), was completed by 60 psychiatric patients. An informant's version was also completed by 60 relatives or friends nominated by each subject. Discrete DSM–III–R PDs were rare; the mean number of PDs per subject was 4.5. Cluster analysis showed that only antisocial PD was a basis for classification of patients, while most patients formed two groups which were mainly distinguished by quantitative differences related to the total scores of positive PD criteria. A shorter version of the questionnaire can be used as a screening test for co-morbid PDs (STCPD) which can predict the number of co-morbid DSM–III–R PDs. The total scores of positive PD criteria from the STCPD were usually (and significantly) higher than the corresponding scores from informants' questionnaires but when an informant's total score exceeded that of the patient, this indicated a subject's under-reporting.

Dimensional models and neurobiology of personality disorders

1999 ◽  
Vol 11 (1) ◽  
pp. 1-4
Author(s):  
W. van den Brink
Keyword(s):  
Personality Disorders ◽  
Personality Pathology ◽  
Diagnostic Model ◽  
Axis Ii ◽  
Statistical Procedures ◽  
Statistical Studies ◽  
Chronic Disorders ◽  
Theoretical Considerations ◽  
Exclusive Choice

SUMMARYSince the introduction of a separate axis in DSM-III (1980), the validity of the categorical nature of the classification of personality disorders has been seriously questioned. Subsequently, a number of multidimensional alternatives have been proposed based on statistical procedures or theoretical considerations. At the same time, the study of the neurobiological underpinnings of personality and personality disorders has created a better understanding of etiological and pathogenetic processes responsible for these chronic disorders. The findings of these studies corroborate some of the major findings of statistical studies regarding the nature of the frequent comorbidity of axis II disorders. In the discussion, a mixed, two-tier diagnostic model is proposed to serve both scientific and clinical aims without the disadvantages of an exclusive choice for either categorical or dimensional approaches to the classification of personality pathology.

CS04-03 - New developments in the classification of personality disorders

2011 ◽  
Vol 26 (S2) ◽  
pp. 1780-1780
Author(s):  
E. Simonsen
Keyword(s):  
Personality Disorders ◽  
Psychiatric Patients ◽  
Normal Population ◽  
Scientific Basis ◽  
Personality Pathology ◽  
Clinical Validity ◽  
New Developments ◽  
Functional Deficits ◽  
Dsm Iv

Personality disorders are regarded as being among the more important categories within the DSM-IV diagnostic nomenclature, because they have the unique distinction of being placed on a separate diagnostic axis. However, empirical data have pointed out a number of disadvantages and concerns with the categorical system: excessive co-occurrence, inadequate coverage, heterogeneity within diagnoses, arbitrary and unstable diagnostic boundaries and inadequate scientific basis.Alternative dimensional approaches have been considered. There is a surprising consistency over the number and descriptions of the main factors or dimensions both in normal population and among psychiatric patients, at least the following four: an externalizing factor aggression (antagonism), an internalizing anxious-emotional unstable second factor, an inhibited and constraint third factor and fourth factor of compulsivity and perfectionism. Beside this, severity of functional deficits, a number of trait domains and disturbances of self and identity are considered to be included as additional descriptors of personality pathology. It is proposed that only 5 or 6 of the current categories with highest clinical validity will be kept in the system. The aim is to maximize clinical utility, but the current suggestions seem to be too complex for the average clinician to follow.

scholarly journals Diagnosis and classification of personality disorder: difficulties, their resolution and implications for practice

2010 ◽  
Vol 16 (5) ◽  
pp. 388-396 ◽  
Author(s):  
Jaydip Sarkar ◽  
Conor Duggan
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Integrated Approach ◽  
Personality Pathology ◽  
Icd 10 ◽  
Diagnosis And Classification ◽  
Axis I ◽  
Dsm Iv ◽  
Current Systems

SummaryThere are many difficulties associated with the diagnostic guidelines for personality disorder in the current international classificatory systems such as ICD–10 and DSM–IV. These lead not only to significant overlap with DSM Axis I disorders, resulting in high rates of diagnoses of comorbidities and multiple personality disorders, but also to lack of adequate capture of core personality pathology. The current classifications are also unhelpful in treatment selection, presumably the prime reason for assessing individuals in the first place. In this article we highlight various deficits and inadequacies related to the nosology of the current systems and suggest some strategies for dealing with these. We offer an integrated model of assessing and diagnosing personality disorders. We attempt to demonstrate how using a more integrated approach minimises or even eliminates some of the key problems highlighted in the current systems.

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