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avoidant personality disorder

J Willem L Tideman, Margaretha C C Snabel, Milly S Tedja, Gwyneth A van Rijn, King T Wong, Robert W A M Kuijpers, Johannes R Vingerling, Albert Hofman, Gabriëlle H S Buitendijk, Jan E E Keunen, Camiel J F Boon, Annette J M Geerards, Gregorius P M Luyten, Virginie J M Verhoeven, Caroline C W Klaver
Importance: Myopia (ie, nearsightedness) is becoming the most common eye disorder to cause blindness in younger persons in many parts of the world. Visual impairment due to myopia is associated with structural changes of the retina and the globe because of elongation of the eye axis. How axial length-a sum of the anterior chamber depth, lens thickness, and vitreous chamber depth-and myopia relate to the development of visual impairment over time is unknown. Objectives: To evaluate the association between axial length, spherical equivalent, and the risk of visual impairment and to make projections of visual impairment for regions with high prevalence rates...
October 20, 2016: JAMA Ophthalmology
Elfrida Hartveit Kvarstein, Ola Nordviste, Lone Dragland, Theresa Wilberg
OBJECTIVES: Outpatient group psychotherapy is frequent within specialist services, recruits a mixed population, but effects are poorly documented. This study investigates long-term outcomes for patients with personality disorder (PD) treated in outpatient, psychodynamic groups within secondary mental health service. METHODS: A naturalistic study (N = 103) with repeated assessments of process and clinical outcomes. Longitudinal statistics are linear mixed models...
October 21, 2016: Personality and Mental Health
Florian Weck, Laura Carlotta Nagel, Samantha Richtberg, Julia M B Neng
Previous studies found high prevalence rates of personality disorders (PDs) in patients with hypochondriasis; however, assessment was often based only on questionnaires. In the current study, a sample of 68 patients with hypochondriasis was compared to 31 patients with panic disorder and to 94 healthy controls. Participants were investigated with the Structured Clinical Interview for DSM-IV Personality Disorders questionnaire (SCID-II questionnaire) and the SCID-II interview. Based on the cut-off scores of the SCID-II questionnaire, we found a prevalence rate of 45...
October 17, 2016: Journal of Personality Disorders
Hans M Nordahl, Patrick A Vogel, Gunnar Morken, Tore C Stiles, Pål Sandvik, Adrian Wells
BACKGROUND: The most efficacious treatments for social anxiety disorder (SAD) are the SSRIs and cognitive therapy (CT). Combined treatment is advocated for SAD but has not been evaluated in randomized trials using CT and SSRI. Our aim was to evaluate whether one treatment is more effective than the other and whether combined treatment is more effective than the single treatments. METHODS: A total of 102 patients were randomly assigned to paroxetine, CT, the combination of CT and paroxetine, or pill placebo...
October 15, 2016: Psychotherapy and Psychosomatics
Neil McNaughton, Philip J Corr
We discuss comorbidity, continuity, and discontinuity of anxiety-related disorders from the perspective of a two-dimensional neuropsychology of fear (threat avoidance) and anxiety (threat approach). Pharmacological dissection of the "neurotic" disorders justifies both a categorical division between fear and anxiety and a subdivision of each mapped to a hierarchy of neural modules that process different immediacies of threat. It is critical that each module can generate normal responses, symptoms of another syndrome, or syndromal responses...
November 2016: Development and Psychopathology
Cynthia Lien, Tony Rosen, Elizabeth M Bloemen, Robert C Abrams, Maria Pavlou, Mark S Lachs
OBJECTIVES: To identify patterns of personal experience or behavior in self-neglect by exploring narratives of cognitively intact older adults. DESIGN: Descriptive study involving semistructured interviews and unstructured narratives. SETTING: A parent study of self-neglect characteristics. PARTICIPANTS: Cognitively intact, self-neglecting older adults referred from 11 community-based senior services agencies (N = 69)...
October 14, 2016: Journal of the American Geriatrics Society
Sergio B Chavez, Luis A Alvarado, Robert Gonzalez
INTRODUCTION: Bipolar I disorder is an illness causing mood shifts that can result in personality and character trait alterations. The relationship between mood and personality and character traits in bipolar I disorder is unclear at this time. METHODS: We conducted a study from February 2009 to March 2010 that included 42 subjects with bipolar I disorder, which was confirmed using the Structured Clinical Interview for DSM-IV Axis I Disorders. Mood was assessed via the Young Mania Rating Scale (YMRS) and the 30-item Clinician-rated Inventory of Depressive Symptomatology (IDS-C)...
2016: Primary Care Companion to CNS Disorders
Erik Hedman, Mats Lekander, Bianka Karshikoff, Brjánn Ljótsson, Erland Axelsson, John Axelsson
Severe health anxiety is characterized by a debilitating fear of somatic illness, and avoidance of disease-related stimuli plays a key role in the maintenance of the disorder. The aim of this study was to investigate severe health anxiety within an evolutionary disease-avoidance framework. We hypothesized that, compared to healthy controls, participants with severe health anxiety would perceive others as sicker, more contagious, and less attractive. We also expected individuals with severe health anxiety to be more prone to avoid interaction with persons who appeared sick, as well as to respond with more health-related worry, more disgust, and more anxiety when confronting such individuals...
October 2016: Journal of Abnormal Psychology
C Bass, P Halligan
Interest in malingering has grown in recent years, and is reflected in the exponential increase in academic publications since 1990. Although malingering is more commonly detected in medicolegal practice, it is not an all-or-nothing presentation and moreover can vary in the extent of presentation. As a nonmedical disorder, the challenge for clinical practice remains that malingering by definition is intentional and deliberate. As such, clinical skills alone are often insufficient to detect it and we describe psychometric tests such as symptom validity tests and relevant nonmedical investigations...
2017: Handbook of Clinical Neurology
Alyson Myers, Madhukar H Trivedi
Suicide is the tenth leading cause of death for Americans of all ages. Presence of a chronic medical illness (e.g. Diabetes mellitus) increases the risk of suicide. The goal of this review is to examine the relationship between diabetes and depression, as well as diabetes and suicide. Earlier this year, the U.S. Preventive Task Force (USPTF) escalated their recommendation for depression to include not only routine screening for depression but additional focus on active follow up that requires measurement based care...
October 5, 2016: Current Diabetes Reviews
Astrid Baljé, Anja Greeven, Anne van Giezen, Kees Korrelboom, Arnoud Arntz, Philip Spinhoven
BACKGROUND: Social anxiety disorder (SAD) with comorbid avoidant personality disorder (APD) has a high prevalence and is associated with serious psychosocial problems and high societal costs. When patients suffer from both SAD and APD, the Dutch multidisciplinary guidelines for personality disorders advise offering prolonged cognitive behavioral therapy (CBT). Recently there is increasing evidence for the effectiveness of schema therapy (ST) for personality disorders such as borderline personality disorder and cluster C personality disorders...
October 8, 2016: Trials
Melanie E Bennett, Kristin R Bradshaw, Lauren T Catalano
BACKGROUND: Substance use disorders (SUDs) represent a great barrier to functional recovery for individuals with schizophrenia. It is important to use research on treatment of SUDs in schizophrenia to guide treatment recommendations and program planning. OBJECTIVES: We review studies of pharmacological and psychosocial interventions to treat SUDs in individuals with schizophrenia. METHODS: The criteria used to select studies for inclusion are (1) the percentage of the sample with a schizophrenia spectrum diagnosis is at least 25%; (2) participants have a comorbid SUD or problem use of substances; (3) an intervention for SUD is provided; (4) a substance use-related outcome is measured; and (5) the study design enabled examination of pre-post outcome measures including open label trials, nonrandomized evaluations (quasi-experimental designs, nonrandom assignment to groups), or randomized controlled trials...
August 9, 2016: American Journal of Drug and Alcohol Abuse
Adam Helles, Märta Wallinius, I Carina Gillberg, Christopher Gillberg, Eva Billstedt
BACKGROUND: Temperament and character have been shown to be important factors in understanding psychiatric and neurodevelopmental disorder. Adults with autism spectrum disorder (ASD) have repeatedly been shown to have a distinct temperament and character, but this has not been evaluated in relation to psychiatric comorbidity and ASD diagnostic stability. AIMS: To examine temperament and character in males that were diagnosed with ASD in childhood and followed prospectively over almost two decades...
May 2016: BJPsych Open
Aleksandra Kupferberg, Oliver M Hager, Urs Fischbacher, Laura S Brändle, Melanie Haynes, Gregor Hasler
BACKGROUND: Price's social competition hypothesis interprets the depressive state as an unconscious, involuntary losing strategy, which enables individuals to yield and accept defeat in competitive situations. AIMS: We investigated whether patients who suffer from major depressive disorder (MDD) would avoid competition more often than either patients suffering from borderline personality disorder (BPD) or healthy controls. METHOD: In a simple paper-folding task healthy participants and patiens with MDD and BPD were matched with two opponents, one with an unknown diagnosis and one who shared their clinical diagnosis, and they had to choose either a competitive or cooperative payment scheme for task completion...
March 2016: BJPsych Open
Akhil D Goel, Sulbha V Akarte, Sumita P Agrawal, Vikas Yadav
BACKGROUND: Medical students can and do suffer from mental disorders is a concept yet to get wide acceptance. There are few studies comprehensively evaluating depression, stress, and burnout in medical students, especially in a longitudinal way in India. The current study aims to assess the impact of medical education on the development of psychological morbidities and the role of personality. MATERIALS AND METHODS: First-year medical students of a leading medical college of India were enrolled on admission and given anonymized, validated, self-administered questionnaires assessing depression, stress, burnout, and personality...
October 2016: Journal of Neurosciences in Rural Practice
J Jaime Miranda, Alvaro Taype-Rondan, Jose Carlos Tapia, Maria Gabriela Gastanadui-Gonzalez, Ricardo Roman-Carpio
Type 2 Diabetes mellitus (DM2) includes a continuum of metabolic disorders characterized by hyperglycemia that causes several chronic long-term complications such as coronary artery disease, peripheral arterial disease, nephropathy, and neuropathy. The hair follicle could reveal signs of early vascular impairment, yet its relationship to early metabolic injuries has been largely ignored. We propose that in earlier stages of the continuum of DM2-related metabolic disorders, a group of susceptible patients who do not yet meet the diagnostic criteria to be considered as persons with DM2 may present chronic vascular impairment and end organ damage, including hair follicle damage, which can be evaluated to identify an early risk marker...
October 2016: Medical Hypotheses
Tilman Steinert
The author discusses a pragmatic approach to decisions about coercive treatment that is based on four principles from principle-based ethics: respect for autonomy, nonmaleficence, beneficence, and justice. This approach can reconcile psychiatry's perspective with the U.N. Convention on the Rights of Persons With Disabilities. Coercive treatment can be justified only when a patient's capacity to consent is substantially impaired and severe danger to health or life cannot be prevented by less intrusive means...
October 3, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
Lynette Holman, Robert McKeever
In a randomized between-subjects design, participants (N = 80) were assigned to one of four conditions, 2 (pregnant, not pregnant) × 2 (extreme prime, moderate prime). It was hypothesized that primes involving moderate mental illness would be positively associated with increased perceived risk of developing postpartum depression. Hayes and Preacher's bootstrapping procedure was used to test the direct, indirect, and conditional indirect effects related to the hypothesized model. In addition, further analyses evaluated whether implicitly activated goals (to be healthy or to be a good mother) were positively associated with increased perceptions of risk and engagement of downstream avoidance behavioral intentions...
October 3, 2016: Health Communication
Andrea Fiorillo, Gaia Sampogna, Mario Luciano, Valeria Del Vecchio, Umberto Volpe, Alessio Maria Monteleone, Antonella Bruni, Cristina Segura-Garcìa, Francesco Catapano, Palmiero Monteleone, Mario Maj
OBJECTIVE: This paper aims to: (1) describe coping strategies in relatives of patients with eating disorders (EDs); (2) analyze coping strategies according to the different EDs; (3) identify correlations between patients' clinical characteristics, relatives' socio-demographic characteristics and coping strategies. METHODS: Patients and their relatives consecutively attending three outpatient units for EDs at the Universities of Naples SUN, Salerno and Catanzaro were recruited...
September 29, 2016: International Journal of Eating Disorders
Eva Fassbinder, Ulrich Schweiger, Desiree Martius, Odette Brand-de Wilde, Arnoud Arntz
Schema therapy (ST) and dialectical behavior therapy (DBT) have both shown to be effective treatment methods especially for borderline personality disorder. Both, ST and DBT, have their roots in cognitive behavioral therapy and aim at helping patient to deal with emotional dysregulation. However, there are major differences in the terminology, explanatory models and techniques used in the both methods. This article gives an overview of the major therapeutic techniques used in ST and DBT with respect to emotion regulation and systematically puts them in the context of James Gross' process model of emotion regulation...
2016: Frontiers in Psychology
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