Current dimensional taxonomies of personality disorder (PD) establish that intense
traits do not suffice to diagnose a disorder, and additional constructs reflecting dysfunction are required.
...However, traits appear able to predict maladaptation by themselves, which might avoid duplications and
simplify diagnosis. On the other hand, if trait-based diagnoses are feasible, it is the whole personality
profile that should be considered, rather than individual traits. This takes us into multidimensional spaces,
which have their own particular - but poorly understood - logic. The present study examines how
profile-level differences between normal and disordered subjects can be used for diagnosis. The Dimensional
Assessment of Personality Pathology - Basic Questionnaire (DAPP-BQ) and the Personality Inventory for
DSM-5 (PID-5) were administered to a community and a clinical sample each (total
n = 1,925 and 3,543 respectively). Intense traits proved to be common in the
general population, so empirically-based thresholds are indispensable not to take as abnormal what is at most
unideal. Profile-level parameters such as Euclidean and Mahalanobis distances outperformed individual traits
in predicting mental problems and equaled the performance of published measures of dysfunction or severity.
Personality profiles can play a more central role in identifying disorders than is currently acknowledged,
provided that adequate metrics are used.
Cognitive biases have been demonstrated to be important in developing and maintaining psychosis. However, self-report measures for everyday clinical practice have been developed only recently. We ...aimed to study one of these instruments for assessing cognitive biases: the Davos Assessment of Cognitive Biases Scale (DACOBS).
In a Spanish sample of 84 patients diagnosed with schizophrenia-spectrum disorders and 152 healthy controls, we examined a) the factor structure using Confirmatory Factor Analysis (CFA) to test the original one-, three- and seven-factor solutions, b) the reliability (Cronbach's alpha), c) the discriminative power (Multivariate Analysis of Covariance - MANCOVA) and d) the relationships of cognitive biases with positive psychotic-like experiences (PPLEs) in healthy individuals and with psychotic symptoms in schizophrenia-spectrum patients.
The CFA revealed that the seven-factor solution achieved the best fit. The DACOBS overall scale (Cronbach's alpha = .92) and subscales obtained good internal consistencies. MANCOVA, controlling for age and education, demonstrated that all subscales differentiated between healthy controls and psychotic patients (Wilks' Lambda = 0.87; F7, 226 = 4.70; p < .000; partial eta squared = 0.13). In addition, the DACOBS showed high correlations with PPLEs (controls) and moderate correlations with positive and general symptoms (patients), demonstrating its predictive validity.
Concluding, the DACOBS proved to be a psychometrically suitable instrument for assessing cognitive biases in psychosis and adequately differentiated between patients and healthy individuals within the Spanish population. Norm scores are provided.
•Patients with psychosis have a significant Facial Emotion Recognition (FER) deficit.•FER deficit is present early and increases along the psychosis continuum.•Fear recognition is similarly impaired ...in high-risk, first-episode and schizophrenia.•Psychotic-like experiences and symptoms are related to FER.•FER should be included in evaluation and treatment from early stages of the illness.
Our study aimed to explore the recognition of specific emotions across the course of psychosis.
A visual task representing the six basic emotions was used to assess facial emotion recognition (FER) in 204 healthy controls classified into 152 low-risk (LR) and 52 high-risk for psychosis (HR), following a psychometric risk approach; and 100 patients: 44 with first-episode psychosis (FEP) and 56 with multi-episode schizophrenia-spectrum disorders (MES). First, we performed a MANCOVA to compare the four conditions. Next, we conducted a logistic regression to explore whether specific FER deficits predicted the presence of psychosis. Finally, we investigated the relationships of FER with psychosis-like experiences (PLEs) and psychotic symptoms.
Global FER, anger and fear recognition were impaired in HR, FEP and MES. No differences between HR and FEP appeared. Moreover, fear and anger correctly classified 83% of individuals into LR or psychosis. FER was associated with PLEs and psychotic symptoms.
Concluding, FER is early impaired in HR individuals and increases along the psychosis continuum. However, fear recognition is similarly impaired throughout the illness, suggesting a possible vulnerability marker. Furthermore, deficits in anger and fear recognition predicted the presence of psychosis. Therefore, we suggest that FER may be essential in detecting psychosis risk.
Current dimensional taxonomies of personality disorder show a stronger empirical grounding than categories, but may lack the necessary level of detail to make accurate predictions and case ...formulations. We need to further develop the lower levels of the hierarchy until reaching the building blocks of personality pathology. The Dimensional Assessment of Personality Pathology‐Basic Questionnaire (DAPP‐BQ) is well‐suited to this purpose due to its multilayered structure and its agreement with the official dimensional classifications. We disaggregated the 18 DAPP‐BQ mid‐level facets through exploratory and confirmatory factor analysis in a sample of 3233 community subjects and outpatients. We obtained a set of 72 clinically relevant, narrower subfacets, which were reliable, well‐fitted to the data, and invariant between clinical and community subjects and between the sexes. This third level of ion increases by 4.7% the capacity to predict DSM categorical personality disorders, gives a particular advantage in capturing dependent, histrionic, paranoid, obsessive, and schizoid features and can provide the detailed information that clinical decisions demand.
Although normal personality traits change gradually with age, personality disorders have been reported to remit rapidly and completely in little more than 10 years. Such a benign prognosis is ...surprising and may be due in part to the combined use of categorical diagnoses, seriously ill patients, and longitudinal designs in the existing literature. This study examines, for the first time, the development of personality pathology across a life span by means of dimensional models, represented by the Dimensional Assessment of Personality Pathology-Basic Questionnaire and the Personality Inventory for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. We draw upon a cross-sectional design and four large clinical and community samples to avoid previous biases. We found that personality pathology declined by around 0.5 SD overall from age 20 to 60, though with noticeable differences between domains: Dissocial behavior and antagonism decreased by between two thirds and 1 SD; compulsivity increased at the same rate; disinhibition, negative affect, and psychoticism dropped by 0.5 SD; and detachment remained stable or rose slightly. In short, the changes in many clinically important traits are modest, occur at a slow pace, and roughly parallel the maturation effect found for normal personality traits. The resulting picture of personality disorder development is not as optimistic as previous studies would have us believe.
Objective. The purpose of this paper is to provide evidence for the relationship between personality disorders (PDs), obsessive compulsive disorder (OCD), and other anxiety disorders different from ...OCD (non-OCD) symptomatology. Method. The sample consisted of a group of 122 individuals divided into three groups (41 OCD; 40 non-OCD, and 41 controls) matched by sex, age, and educational level. All the individuals answered the IPDE questionnaire and were evaluated by means of the SCID-I and SCID-II interviews. Results. Patients with OCD and non-OCD present a higher presence of PD. There was an increase in cluster C diagnoses in both groups, with no statistically significant differences between them. Conclusions. Presenting anxiety disorder seems to cause a specific vulnerability for PD. Most of the PDs that were presented belonged to cluster C. Obsessive Compulsive Personality Disorder (OCPD) is the most common among OCD. However, it does not occur more frequently among OCD patients than among other anxious patients, which does not confirm the continuum between obsessive personality and OCD. Implications for categorical and dimensional diagnoses are discussed.
Recent neuroimaging studies conducted on obsessive-compulsive disorder (OCD) show alterations in the fronto-thalamic-striatal circuit, which would give rise to an executive dysfunction. This could be ...the neurocognitive substrate underlying the main symptoms of OCD, i.e. obsessions and compulsions.
Both brain activity and behavioural performance of a group of 13 patients with OCD were compared with a control group of 13 healthy subjects by means of functional magnetic resonance imaging while performing an inhibitory control task with reward and punishment contingencies. The effects of medication were also analysed.
The intra-group analyses showed a longer reaction time during the go/no go condition in both groups, although there were no differences between the groups in the performance of the task. With regard to this task, significant activation of large areas of the cerebellum and the occipital, temporal and parietal lobes was observed in the healthy subjects. In comparison with the controls, the obsessive patients showed lower activation in the right-side frontal medial and superior gyri, the anterior cingulate cortex and the caudate nucleus, and greater activation in the inferior parietal convolution and the fusiform gyrus. The effects of medication were found in the frontal cortex and basal structures.
These results agree with the argument claiming that the dysfunction in the corticostriatal system in OCD is associated to diminished brain activity in response to cognitive tasks.
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