Personality Disorders

人格障碍
  • 文章类型: Journal Article
    精神病学病理学在当代社会中脱颖而出,不仅是独立的,而且还通过其与其他医学合并症如肿瘤疾病的关联。专业文献证实了随着时间的推移这些疾病的共存。有一种趋势是发展各种精神表现,如情绪障碍和躯体形式障碍,以及现有的潜在精神疾病(焦虑症和精神障碍)或人格障碍的代偿失调(一个很好的例子是强迫性人格障碍中焦虑的加剧)。乳腺癌,像任何致残疾病一样,影响人的心理和行为作为一个整体。科学证明,心理平衡影响患者的生活质量,也影响疾病的演变和预后,心理过程能够调节肿瘤过程的活动。有必要扩大临床实践和研究,超越简单的症状评估,治疗的目标不仅应该是减轻症状,而且应该在身体和精神上改善癌症患者的生活质量。
    Psychiatric pathology stands out in contemporary society not only as independent but also through its association with other medical comorbidities such as neoplastic diseases. Specialized literature confirms over time the coexistence of these diseases. There is a tendency to develop various psychiatric manifestations such as mood disorders and somatoform disorders, as well as decompensation of underlying existing psychiatric pathologies (anxiety disorders and psychotic disorders) or personality disorders (a good example is the exacerbation of anxiety in obsessive-compulsive personality disorder). Breast cancer, like any disabling disease, affects the person\'s psyche and behaviors as a whole. It is scientifically proven that mental balance influences the quality of life of patients and also the evolution and prognosis of the disease, psychological processes being able to modulate the activity of the tumor process. It is necessary to expand clinical practice and research beyond the simple evaluation of symptoms, and the goal of treatment should not only be to reduce symptoms but also to improve in terms of both physically and mentally the quality of life of cancer patients.
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  • 文章类型: Journal Article
    我们首先指出与心理健康问题相关的共同污名,这通常源于缺乏理解或不完整的知识。神经生物学研究为我们提供了一个新的视角,以帮助挑战和消除常见的假设和误解,并理解影响社会的性行为。因此,它为患有精神障碍的人的大脑的结构和功能不对称提供了大量证据。然而,这种代表性对传统思维提出了许多挑战,并不断引发人们对这些人的观点和同理心的改变。在审查中,我们更深入地研究神经生物学发现对理解犯罪行为和人格障碍的影响,超越行为健康。这些问题,曾经主要讨论道德问题或从性格缺陷的角度来看,今天通过神经系统的考虑来分析它们的复杂性。当发现双相情感障碍的根源是神经学的时候,社会将以更多的信息和理解做出反应,从而减少了对有这些问题的人的污名化和歧视。在宏观层面,神经生物学的发现以超越个人的方式影响社会;社会态度,法律,有关所提供服务的政策也会受到影响。作为社区内的催化剂,神经生物学研究有助于通过创建一个知情的,了解公共论坛。因此,它为那些处理行为和心理健康挑战的人创造了更广泛的价值。这篇叙述性综述的第一个也是最重要的问题是,重点是识别与犯罪行为密切相关的可识别的神经生物学标记,人格障碍,和精神健康障碍。通过这次审查,我们的目标是通过对当代文学的叙事分析,对锚定这些现象的神经基础提出详细的见解。潜在的影响是尽早发现问题以应用特定的治疗方法并学习社会态度的高级策略。这将促进基于有关行为和心理健康问题的充分信息的更人性化方法。
    We begin the review by pointing to the common stigma associated with mental health issues, which often derives from a lack of understanding or incomplete knowledge. Neurobiological research provides us with a new lens to help challenge and dispel common assumptions and misunderstandings and gives an understanding of sexual behaviours that influence society. As such, it generates substantial evidence for the structural and functional asymmetry of the brains of individuals with mental disorders. However, this type of representation poses many challenges to traditional thinking and constantly provokes change in perspective and empathy towards those individuals. In the review, we go deeper into the effects of neurobiological findings on understanding criminal behaviours and personality disorders, looking further beyond behavioural health. These problems, which were once mainly discussed as moral ones or viewed from the perspective of character flaws, are analysed today through neurological considerations pointing to their complexity. When the root of bipolar disorder is revealed to be neurological, society will react with more information and understanding, hence reducing the stigmatisation and discrimination meted out to people with these problems. At a macro level, findings from neurobiology affect society in ways that go beyond individuals; social attitudes, laws, and policies about the services rendered are influenced. Operating as a catalyst within the community, neurobiological research helps to initiate social change through the creation of an informed, understanding public forum. Thus, it creates broader value for those dealing with behavioural and mental health challenges. The first and most important question of this narrative review is focused on identifying identifiable neurobiological markers that are closely related to criminal conduct, personality disorders, and mental health disorders. Through this review, we aim to present detailed insights into the neurological foundations that anchor these phenomena via a narrative analysis of contemporary literature. The potential implications are finding problems early to apply specific treatment and learning an advanced strategy for social attitudes. This will promote a more humanistic approach based on adequate information on the behavioural and mental health issues involved.
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  • 文章类型: Meta-Analysis
    DSM-5(PID-5)的人格量表已在人格功能障碍的维度评估中产生影响。尽管大多数研究已经检查了PID-5特质域和人格病理学之间的联系,许多调查评估了PID-5评分与症状障碍之间的关系(例如,抑郁症,焦虑)。我们采用元分析技术来综合这一领域的研究结果,确定26篇出版物,评估PID-5评分与症状障碍之间的关联(5个性状域的N个效应大小=260)。PID-5域评分效应大小(rs)范围从0.20(拮抗作用)到0.35(所有ps<.00001)。PID-5评分与特定形式的精神病理学之间的关系通常与预期一致,还有一些意想不到的关系。研究结果证实,通过PID-5评估的病理性人格特征可预测症状障碍以及人格功能障碍,扩展了该措施的启发式价值和临床实用性。
    The Personality Inventory for DSM-5 (PID-5) has become influential in the dimensional assessment of personality dysfunction. Though most studies have examined links between PID-5 trait domains and personality pathology, a number of investigations have assessed relationships between PID-5 scores and symptom disorders (e.g., depression, anxiety). We employed meta-analytic techniques to synthesize findings in this area, identifying 26 publications assessing associations between PID-5 scores and symptom disorders (N of effect sizes across the five trait domains = 260). PID-5 domain score effect sizes (rs) ranged from 0.20 for Antagonism to 0.35 for Negative Affect (all ps < .00001). Relationships between PID-5 scores and specific forms of psychopathology were generally consistent with expectations, with some unanticipated relationships as well. Findings confirm that the pathological personality traits assessed by the PID-5 predict symptom disorders as well as personality dysfunction, extending the heuristic value and clinical utility of the measure.
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  • 文章类型: Meta-Analysis
    创伤事件会增加精神疾病的风险,但是对精神疾病中儿童忽视的患病率研究不足。这项系统评价和荟萃分析评估了忽视患病率,包括情感忽视(EN)和身体忽视(PN),在患有精神疾病的成年人中。我们在122项评估不同精神疾病的研究中进行了系统的搜索和荟萃分析。未指明的忽视(Ne)的患病率为46.6%(95CI[34.5-59.0]),EN的43.1%(95CI[39.0-47.4]),PN为34.8%(95CI[30.6-39.2])。尽管尚未确认精神病诊断类别的调节作用,一些临床诊断的患病率明显低于其他诊断.双相情感障碍和重度抑郁障碍患者的EN和PN患病率较低,而仅在PN的精神病和饮食失调中发现患病率较低。忽视评估是Ne和PN的重要调节因素。没有发现年龄和性别对忽视患病率的调节作用。精神病诊断类别内部和之间的异质性水平仍然很高。这是第一个考虑不同精神病诊断的不同类型的忽视患病率的荟萃分析。我们的结果探讨了患有精神疾病的成年人中儿童忽视的患病率及其亚型,有助于理解忽视和特定精神病之间的细微差别,并为受影响的个人提供指导干预措施。
    Traumatic events increase risk of mental illnesses, but childhood neglect prevalence in psychiatric disorders is understudied. This systematic review and meta-analysis assessed neglect prevalence, including emotional neglect (EN) and physical neglect (PN), among adults with psychiatric disorders. We conducted a systematic search and meta-analysis in 122 studies assessing different psychiatric disorders. Prevalence was 46.6% (95%CI[34.5-59.0]) for unspecified neglect (Ne), 43.1% (95%CI[39.0-47.4]) for EN, and 34.8% (95%CI[30.6-39.2]) for PN. Although a moderating effect of the psychiatric diagnostic category was not confirmed, some clinical diagnoses had significantly lower prevalence rates than others. Patients with bipolar disorder and major depressive disorder showed lower prevalence rates of EN and PN, whereas lower prevalence was found in psychotic disorders and eating disorders for PN only. Neglect assessment was a significant moderator for Ne and PN. No moderating effect of age and sex on neglect prevalence was found. Heterogeneity levels within and between psychiatric diagnostic categories remained high. This is the first meta-analysis examining diverse types of neglect prevalence considering different psychiatric diagnoses. Our results explore the prevalence of childhood neglect and its subtypes among adults with psychiatric disorders, contributing to understanding the nuanced interplay between neglect and specific psychiatric conditions, and guiding interventions for affected individuals.
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  • 文章类型: Systematic Review
    总结和分析最近研究ADHD成人自尊的文章,关注人口统计学和临床特征的影响,和方法论问题。
    遵循PRISMA准则,在WebofScience上对2010年至2022年之间发表的文献进行了系统的搜索,奥维德,Pubmed,和EBSCO数据库。
    11项研究符合纳入标准。包括健康对照在内的六项研究中的五项报告了ADHD参与者的自尊心较低。ADHD症状与自尊呈负相关。没有观察到性别差异。自尊介导了与ADHD相关的几个结果。缺乏研究研究自尊降低背后的潜在机制,并研究控制混杂变量。
    在成年人中出现了ADHD和低自尊之间的紧密关联,但是,在解释研究结果时,缺乏对混杂变量的控制是至关重要的。需要进行纵向研究,以解决当前研究的局限性。
    UNASSIGNED: To summarize and analyze recent articles investigating self-esteem in adults with ADHD, focusing on the impact of demographic and clinical characteristics, and methodological issues.
    UNASSIGNED: Following PRISMA guidelines, a systematic search for literature published between 2010 and 2022 was conducted in the Web of Science, Ovid, Pubmed, and EBSCO databases.
    UNASSIGNED: Eleven studies met inclusion criteria. Five of the six studies including healthy controls reported lower self-esteem in participants with ADHD. ADHD symptoms correlated negatively with self-esteem. Gender differences were not observed. Self-esteem mediated several outcomes associated with ADHD. There was a lack of studies that examined potential mechanisms behind the reduced self-esteem, and studies controlling for confounding variables.
    UNASSIGNED: A robust association between ADHD and low self-esteem in adults emerged, but the lack of control of confounding variables is critical to consider when interpreting the findings. Longitudinal studies addressing the limitations of the current studies are needed.
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  • 文章类型: Journal Article
    随着法医心理学作为一个独立的领域不断扩大,专业人员经常诉诸心理评估工具来评估司法系统中涉及的人员。人格评估清单(PAI)是344项,自我报告清单,旨在为诊断和临床决策提供有意义的信息,特别是关于精神病理学,个性,和社会心理环境。与其他自我报告清单相比,其在法医环境中的适用性已得到越来越多的认可(例如,MMPI-2,MCMI-III),因为它包括与法医设置相关的尺度(例如,暴力风险水平,精神病,药物滥用),当处理高度防御性和/或恶意人群时,轮廓扭曲指标的存在是有用的。本文的目的是对PAI在法医环境中的实用程序进行全面审查,通过关注PAI评估的相关法医结构(例如,人格障碍,精神病,药物滥用,侵略,累犯风险,和响应失真),以及它在罪犯和囚犯群体中的应用,亲密伴侣暴力背景,家庭法案件,和法医专业人员。总的来说,PAI继续获得国际认可,其在法医环境中的相关性和有用性得到了普遍接受和认可。
    As Forensic Psychology continues to expand as an independent field, professionals regularly resort to psychological assessment tools to assess people involved within the justice system. The Personality Assessment Inventory (PAI) is a 344-item, self-report inventory that aims to provide meaningful information for diagnosis and clinical decision-making, specifically relating to psychopathology, personality, and psychosocial environment. Its applicability in forensic settings has been increasingly recognized on account of its benefits in comparison to other self-report inventories (e.g., MMPI-2, MCMI-III), since it includes scales that are relevant to forensic settings (e.g., violence risk levels, psychopathy, substance abuse), and the existence of profile distortion indicators is useful when dealing with highly defensive and/or malingering populations. The goal of this paper is to conduct a thorough review of the PAI\'s utility in forensic settings, by focusing on the relevant forensic constructs assessed by the PAI (e.g., personality disorders, psychosis, substance abuse, aggression, recidivism risk, and response distortion), as well as its application to offender and inmate populations, intimate partner violence contexts, family law cases, and forensic professionals. Overall, the PAI continues to gather international recognition and its relevance and usefulness in forensic settings is generally accepted and acknowledged.
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  • 文章类型: Systematic Review
    背景:临床和亚临床形式的自恋可能会增加自杀风险。然而,鲜为人知,关于这个话题有争议。本系统综述旨在提供调查这种关联的研究概述。
    方法:我们使用PubMed,Scopus,和PsycInfo数据库,并遵循PRISMA。我们专注于队列,病例控制,横断面和案例系列研究。我们提到了两种临床(即,自恋型人格障碍(NPD)和/或NPD标准)和亚临床形式(即,自恋的宏伟和脆弱的自恋特征)。此外,我们考虑:自杀意念(SI),非自杀自我伤害(NSSI),故意自我伤害(DSH),自杀企图(S)(SA),自杀风险(SR),自杀的能力。
    结果:我们纳入了47项研究。发现NPD诊断/标准与自杀相关结果(SI)或混合结果(SA)之间缺乏关联。考虑自恋特征时,出现了更高的同质性。脆弱的自恋与SI有关,不那么冲动的NSSI,DSH。傲慢自恋与严重的NSSI和具有高死亡意图的多发性SA有关,但它对SI和SR有保护作用。脆弱的自恋似乎与自杀相关的结果有关,其特征是死亡意图低,而夸张的自恋似乎是高计划和严重程度结局的风险因素。
    结论:研究之间的异质性和缺乏纵向研究。
    结论:评估具有临床或亚临床形式自恋的受试者的自杀风险可能是有用的。此外,考虑到最脆弱的自恋形式,不仅仅是宏伟的,可能有助于更细致的风险分层和不同治疗方法的识别。
    BACKGROUND: Clinical and subclinical forms of narcissism may increase suicide risk. However, little is known and there are controversies on this topic. This systematic review aims at providing an overview of studies investigating this association.
    METHODS: We used PubMed, Scopus, and PsycInfo databases and followed PRISMA. We focused on cohort, case-control, cross-sectional and case series studies. We referred to both clinical (i.e., narcissistic personality disorder (NPD) and/or NPD criteria) and subclinical forms (i.e., grandiose and vulnerable narcissistic traits) of narcissism. Moreover, we considered: Suicidal Ideation (SI), Non-Suicidal Self-Injury(s) (NSSI), Deliberate Self-Harm (DSH), Suicide Attempt(s) (SA), Suicide Risk (SR), and Capability for Suicide.
    RESULTS: We included 47 studies. Lack of association between NPD diagnosis/criteria and suicide-related outcomes (SI) or mixed results (SA) were found. Higher homogeneity emerged when considering narcissistic traits. Vulnerable narcissism was associated with SI, less impulsive NSSI, and DSH. Grandiose narcissism was associated with severe NSSI and multiple SA with high intent to die, but it was protective against SI and SR. Vulnerable narcissism seemed to be associated with suicide-related outcomes characterized by low intent to die, while grandiose narcissism seemed to be a risk factor for outcomes with high planning and severity.
    CONCLUSIONS: Between-study heterogeneity and lack of longitudinal studies.
    CONCLUSIONS: Assessing suicide risk in subjects with clinical or subclinical forms of narcissism may be useful. Moreover, considering the most vulnerable form of narcissism, and not just the grandiose one, may contribute to a more nuanced risk stratification and to the identification of distinct therapeutic approaches.
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  • 文章类型: Journal Article
    人格障碍的罪犯对社会造成不成比例的伤害,并对负责其护理和康复的人构成重大挑战。人格障碍在症状方面是异质的,以及他们冒犯行为的途径。因此,关于有效干预措施的证据有限.一种解决方案可能是将重点放在干预措施的交付方式以及交付的内容上。在非罪犯人格障碍文献中,识别潜在的变革中介者使干预措施能够专注于它们是如何交付的(例如,治疗联盟),而不是干预本身。我们探索了证据,并对有关人格障碍罪犯的心理治疗改变机制的现有文献进行了范围审查。在范围审查中只发现了一项研究,突出了证据基础上的巨大差距。我们讨论了这一发现的含义和潜在的未来方向。
    Offenders with personality disorder cause disproportionate harm to society and pose significant challenges for those responsible for their care and rehabilitation. Personality disorders are heterogeneous in terms of symptoms, as well as their pathways to offending behaviour. Thus, there is limited evidence regarding effective interventions. One solution might be to focus on how interventions are delivered as well as what is delivered. Within the non-offender personality disorder literature, the identification of potential mediators of change has enabled interventions to focus on \'how\' they are delivered (e.g., therapeutic alliance) rather than the intervention itself. We explore the evidence and present a scoping review of the available literature on the mechanisms of change in psychological treatments for offenders with personality disorder. Only one study was found in the scoping review, highlighting a significant gap in the evidence base. We discuss the implications of this finding and potential future directions.
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  • 文章类型: Journal Article
    理论提出了各种原因,例如人格特质等个体差异导致面对面群体获得社会地位的原因。我们将这些不同的理论观点整合到一个模型中,该模型具有从个体差异到地位的四个路径:优势,能力,一种美德,和微观政治路径。为了调查这些路径,我们荟萃分析了100多年来对人格特质的双变量关联的研究,认知能力,和身体大小,在面对面组中达到与状态相关的结果(来自276个样本的1,064个影响,包括56,153名参与者)。与状态相关的结果变量令人钦佩,社会影响力,受欢迎程度(即,被别人喜欢),领导力的出现,和结果变量的混合。我们发现的元分析相关性在很大程度上与微观政治路径一致,初步符合能力和美德之路,而且只是部分地与主导路径一致。这些发现表明,地位的获得不仅取决于个人的能力和美德,还取决于个人如何通过果断的行为来增强其明显的能力或美德,通过外向,或者通过自我监控。我们还调查了个体差异和状态相关结果之间的关系是如何通过状态相关结果来调节的,小组任务的性质,文化(集体主义/个人主义),和熟人的长度。适度分析产生了混合和不确定的结果。这篇综述以研究方向结尾,例如需要分别评估和研究与状态相关的不同结果。(PsycInfo数据库记录(c)2024APA,保留所有权利)。
    Theories have proposed diverse reasons for why individual differences such as personality traits lead to social status attainment in face-to-face groups. We integrated these different theoretical standpoints into a model with four paths from individual differences to status: a dominance, a competence, a virtue, and a micropolitics path. To investigate these paths, we meta-analyzed over 100 years of research on bivariate associations of personality traits, cognitive abilities, and physical size with the attainment of status-related outcomes in face-to-face groups (1,064 effects from 276 samples including 56,153 participants). The status-related outcome variables were admiring respect, social influence, popularity (i.e., being liked by others), leadership emergence, and a mixture of outcome variables. The meta-analytic correlations we found were largely in line with the micropolitics path, tentatively in line with the competence and virtue paths, and only partly in line with the dominance path. These findings suggest that status attainment depends not only on the competence and virtue of an individual but also on how individuals can enhance their apparent competence or virtue by behaving assertively, by being extraverted, or through self-monitoring. We also investigated how the relations between individual differences and status-related outcomes were moderated by kind of status-related outcome, nature of the group task, culture (collectivism/individualism), and length of acquaintance. The moderation analysis yielded mixed and inconclusive results. The review ends with directions for research, such as the need to separately assess and study the different status-related outcomes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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  • 文章类型: Meta-Analysis
    背景:心态,理解精神状态,假设在自组织和社会学习中发挥核心作用。研究结果支持这个概念,但心理化与各种相关因素之间的关联程度尚未进行荟萃分析.此外,可能会发生(显式)和(隐式)意识,但很少有研究试图解开这些方面。我们对与附件安全领域相关的隐式和显式思维进行了荟萃分析,个性,影响,精神病理学,和功能。
    方法:我们在PsycINFO和相关综述中搜索了成人心理化的研究。总的来说,511项研究(N=78,733)符合标准,并使用多水平荟萃分析进行分析。
    结果:内隐(r=0.19-0.29)和外显(r=0.26-0.40)的心态与精神病理学中度相关,功能,个性,影响,和附件安全。内隐心态的相关性更强,更客观地测量相关(b=0.02,p<.001),而外显心态的相关性不是(b=-0.07,p=.21)。
    结论:心智化与更好的人际和人际功能相关。内隐思维与客观测量的相关性更强。这些发现强调了考虑内隐和外显思维的综合方法的重要性。
    Mentalizing, making sense of mental states, is hypothesized to have a central role in self-organization and social learning. Findings support this notion, but the extent of the association between mentalizing and various correlates has not been meta-analyzed. Furthermore, mentalizing presumably occurs with (explicit) and without (implicit) awareness but few studies have attempted to disentangle these aspects. We conducted a meta-analysis of implicit and explicit mentalizing in relation to the domains of attachment security, personality, affect, psychopathology, and functioning.
    We searched for studies of adult mentalizing in PsycINFO and in related reviews. Overall, 511 studies (N = 78,733) met criteria and were analyzed using multi-level meta-analysis.
    Implicit (r = 0.19-0.29) and explicit (r = 0.26-0.40) mentalizing were moderately correlated with psychopathology, functioning, personality, affect, and attachment security. The correlations of implicit mentalizing were stronger with more objectively measured correlates (b = 0.02, p < .001) while the correlations of explicit mentalizing were not (b = -0.07, p = .21).
    Mentalizing is associated with better intra- and interpersonal functioning. Implicit mentalizing is more strongly associated with objectively measured correlates. These findings underscore the importance of an integrative approach considering both implicit and explicit mentalizing.
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