Personality Disorders: A Review of the Current State of Knowledge

World psychiatry : official journal of the World Psychiatric Association (WPA), 2010

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.

The Lancet, 2015

Personality disorders are common and ubiquitous in all medical settings, so every medical practitioner will encounter them frequently. People with personality disorder have problems in interpersonal relationships but often attribute them wrongly to others. No clear threshold exists between types and degrees of personality dysfunction and its pathology is best classifi ed by a single dimension, ranging from normal personality at one extreme through to severe personality disorder at the other. The description of personality disorders has been complicated over the years by undue adherence to overlapping and unvalidated categories that represent specifi c characteristics rather than the core components of personality disorder. Many people with personality disorder remain undetected in clinical practice and might be given treatments that are ineff ective or harmful as a result. Comorbidity with other mental disorders is common, and the presence of personality disorder often has a negative eff ect on course and treatment outcome. Personality disorder is also associated with premature mortality and suicide, and needs to be identifi ed more often in clinical practice than it is at present. which were relevant to recent developments in the specialty.

Personality disorders are common and ubiquitous in all medical settings, so every medical practitioner will encounter them frequently. People with personality disorder have problems in interpersonal relationships but often attribute them wrongly to others. No clear threshold exists between types and degrees of personality dysfunction and its pathology is best classifi ed by a single dimension, ranging from normal personality at one extreme through to severe personality disorder at the other. The description of personality disorders has been complicated over the years by undue adherence to overlapping and unvalidated categories that represent specifi c characteristics rather than the core components of personality disorder. Many people with personality disorder remain undetected in clinical practice and might be given treatments that are ineff ective or harmful as a result. Comorbidity with other mental disorders is common, and the presence of personality disorder often has a negative eff ect on course and treatment outcome. Personality disorder is also associated with premature mortality and suicide, and needs to be identifi ed more often in clinical practice than it is at present.

American family physician, 2011

Personality disorders have been documented in approximately 9 percent of the general U.S. population. Psychotherapy, pharmacotherapy, and brief interventions designed for use by family physicians can improve the health of patients with these disorders. Personality disorders are classified into clusters A, B, and C. Cluster A includes schizoid, schizotypal, and paranoid personality disorders. Cluster B includes borderline, histrionic, antisocial, and narcissistic personality disorders. Cluster C disorders are more prevalent and include avoidant, dependent, and obsessive-compulsive personality disorders. Many patients with personality disorders can be treated by family physicians. Patients with borderline personality disorder may benefit from the use of omega-3 fatty acids, second-generation antipsychotics, and mood stabilizers. Patients with antisocial personality disorder may benefit from the use of mood stabilizers, antipsychotics, and antidepressants. Other therapeutic interventio...

Psychiatric Services, 1990

This review oftbe recent literature on personality disorders summarizes theoretical and methodologic issues, DSM-III-R criteria sets, nosological controversies, and current treatment approaches. Work in the personality disorders is burgeoning, with increasing attention to improved reliability and validity of diagnosis. Investigators are looking at such issues as the development of dimensional taxonomies, the effect ofstate vanables, the problem of diagnostic overlap, the effect ofcomorbid conditions on course and treatment, the predictive power of criteria, and external validatons. The DSM-Ill-R criteria sets, despite their polytheticformat, may be no more reliable than their predecessors. Because treatment remains largely unresearched, the dinician must continue to rely on skillful assessment of each patient, with psychoanalytic psychotherapy and symptom-oriented drug trials providing thefoundation of therapy. Since the last review ofrecent developments in the field of personality disorders in this journal, by Widiger and Frances (1) in 1985, the literature in this area has mushroomed.

Current psychiatry reports, 2018

This review discusses cultural trends, challenges, and approaches to assessment and treatment of personality traits and disorders. Specific focus include current developments in the Asian, Italian, Iranian, and Australian societies, as well as the process of acculturation, following moves between cultures with the impact on healthy and disordered personality function. Each culture with its specific history, dimensions, values, and practices influences and gears the individual and family or group in unique ways that affect personality functioning. Similarly, each culture provides means of protection and assimilation as well as norms for acceptance and denunciations of specific behaviors and personality traits. The diagnosis of personality disorders and their treatment need to take into consideration the individual in the context of the culture and society in which they live. Core personality problems, especially emotion dysregulation and interpersonal functioning are specifically inf...

Abou-Saleh/Principles and Practice of Geriatric Psychiatry, 2010

E dited by M ohammed T . A bou-Saleh, Cornelius K atona and A nand Kumar

Canadian Psychology / Psychologie canadienne, 2015

Personality disorders are both prevalent and debilitating, but controversies abound concerning the definition, assessment and treatment of these conditions. This review examines major approaches to conceptualizing the personality disorders, as recently emerging in DSM-5, Section III, and the research domain criteria initiative of the National Institute of Mental Health. Three prominent models for understanding these disorders (neural functioning, interpersonal model, and the cognitive-affective processing system model) are considered with their relevant empirical foundations. The implications for future psychopathology and treatment research and practice are detailed.

1991

For more than a decade, research studies on the various personality disorders have been carried out at an ever-expanding pace (Blashfield and McElroy, 1987; Gorton and Akhar, 1990). Factors promoting this research have included the establishment within the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) of a separate axis for the diagnosis of personality disorders, the enumeration within DSM-III of diagnostic criteria for these conditions, and the development of standardized interviews for the assessment of personality disorders. Innovations such as these are expected to advance the scientific stature of personality disorder research.

Journal of Personality Disorders, 2014

The past 25 years have shown major advances in the studies of personality disorders. This collaborative article by the presidents, past and present, of ISSPD reflects on the progress within several significant areas of studies, i.e., assessment, neuroscience, treatment, prevention, advocacy, and mental health policy. INTRODUCTION/ELSA RONNINgSTAM The 25th anniversary of the International Society for the Study of Personality Disorders (ISSPD), celebrated in 2013, provides an opportunity to summarize the major advances in studies of personality disorder and their influence on both psychiatric and societal management. This joint contribution by the presidents, past and present, of ISSPD reflects on the progress within several significant areas of studies, i.e., assessment, neuroscience, treatment, prevention, advocacy, and mental health policy. Applied specifically to the studies and treatment of borderline personality disorder, we can see a remarkable development with significant consequences for both consumers and practitioners in many countries. Overall, this most important development is a result of an integrative process with gradual exchange between different disciplines: empirical research and clinical observations, assessment, treatment modalities, and longitudinal studies. The interaction among neurobiological, genetic, and psychological studies of character development and functioning has been especially valuable for the studies of personality disorders and gradually contributed to major changes in recognition and understanding. Personality disorders are now considered treatable conditions, some even remittable, and their status as major psychiatric conditions is well on its way to be accepted both within the mental health system and in society. Legislation and official guidelines for treatment of personality disorders are major steps toward this recognition 612 RONNINGSTAM ET AL. (Figure 1). Our international society has certainly played a significant role in providing venues for presenting and discussing the latest advances. AN EARLY PRESIDENT'S REFLECTIONS/THEODORE MILLON Two psychiatrists, Niels Strandbygaard and Erik Simonsen, who led a special study group for psychiatrists and psychologists in Denmark in the early to mid-1980s, based on a 1969 book of mine, Modern Psychopathology (MP), came to visit the States to explore the possibility of developing a personality disorders society. These two men were obviously deeply thoughtful and well versed in the subject, as well as sincere and pragmatic in their goal of establishing an international forum for discussing issues relating personality to psychopathology, a central theme of the MP book. They proposed that an international conference on personality disorders for clinicians and researchers be developed. After considering options in the States, it was decided that the first meeting should take place in Copenhagen. As a result, Strandbygaard, Simonsen, and their colleagues established the 1988 ISSPD Conference; the conference has just celebrated its 25th anniversary. This first conference was held with much intellectual and clinical substance, as well as fanfare and optimism. In addition to a series of 20 plenary lectures by distinguished invitees to the 1988 congress, there were over 80 paper sessions and a series of five assessment workshops. Among the plenary lecturers were Mel Sabshin, Medical Director of the American Psychiatric Association, and Fini Schulsinger, Secretary General of the World Psychiatric Association. As with the 25th congress, the first congress's organizing committee was chaired by Erik Simonsen. FIGURE 1. An interactive and integrative model capturing the studies of personality disorders over the past 25 years.