Interrater Reliability of the Psychological Mindedness Assessment Procedure, Extended (Dutch) Version, in a Clinical Patient Population.

The Psychological Mindedness Assessment Procedure, Extended Dutch Version (PMAP-plus), was developed to assess psychological mindedness in mental health care. Psychological Mindedness represents the ability to understand self and others through mental representations of internal psychodynamic states. In patients, deficits in psychological mindedness capacity can cause problems in self- and interpersonal functioning.

Exploring effectiveness of CBT in obese patients with binge eating disorder: personality functioning is associated with clinically significant change.

Background: Binge eating disorder (BED), as the most prevalent eating disorder, is strongly related to obesity and other somatic and psychiatric morbidity. Despite evidence-based treatments a considerable number of BED patients fail to recover. There is preliminary evidence for the association between psychodynamic personality functioning and personality traits on treatment outcome.

Narcissistic Personality Disorder: Are Psychodynamic Theories and the Alternative DSM-5 Model for Personality Disorders Finally Going to Meet?

Narcissistic Personality Disorder is the new borderline personality disorder of our current era. There have been recent developments on narcissism that are certainly worthwhile examining. Firstly, relational and intersubjective psychoanalysts have been rethinking the underlying concepts of narcissism, focusing on the development of self and relations to others.

Marine Omega-3 Fatty Acid Supplementation for Borderline Personality Disorder: A Meta-Analysis.

Objective: Several promising studies investigated marine omega-3 fatty acids (ie, fish oil) in borderline personality disorder (BPD), but overall effects remain unclear. The aim of this study was to obtain estimates of effectiveness of omega-3 fatty acids in BPD using meta-analysis, with a priori differentiation of affective, impulsive, and cognitive-perceptual symptom domains.

Data Sources: We performed a literature search in PubMed, EMBASE, PsycINFO, and MEDLINE, using terms related to BPD and omega-3 fatty acids.

Selective Serotonin Reuptake-Inhibitors for Symptom-Based Treatment of Borderline Personality Disorders in Older Adults: An International Delphi Study.

Objective: International guidelines on symptom-based treatment of borderline personality disorders (BPD) in older adults are lacking. The number of older adults (≥ 65 years) with borderline personality disorder is rising. Effectiveness of Selective Serotonin Reuptake Inhibitors (SSRIs) on symptoms of BPD has only been investigated in younger adults and results are ambiguous.

Personality Functioning in Obesity and Binge Eating Disorder: Combining a Psychodynamic and Trait Perspective.

Objective: There is preliminary evidence for an association between personality traits and binge eating disorder (BED) in obese patients. In addition, recent studies have shown impaired psychodynamic personality functioning in BED. However, these results are partly inconsistent.

Lower versus higher frequency of sessions in starting outpatient mental health care and the risk of a chronic course; a naturalistic cohort study.

Background: An adequate frequency of treatment might be a prerequisite for a favorable outcome. Unfortunately, there is a diversity of factors that interfere with an adequate frequency of sessions. This occurs especially in the first phase of treatment, while the first phase seems vital for the rest of treatment.

The Developmental Profile Inventory: Constructing a Clinically Useful Self-Report for Levels of Psychodynamic Personality Functioning.

Objective: The Developmental Profile Inventory (DPI) was constructed to assess psychodynamic personality functioning by self-report.

Method: On the basis of the frame of reference of the Development Profile interview method, a self-report was developed covering 3 domains, self, interpersonal functioning, and problem-solving strategies, which represent 6 maladaptive and 3 adaptive developmental levels of psychodynamic functioning. The DPI was administered to patients with personality disorders who were receiving psychotherapy (N=179) and to normal controls (N=228).

Assessment of Pathological Traits in DSM-5 Personality Disorders By the DAPP-BQ: How Do These Traits Relate to the Six Personality Disorder Types of the Alternative Model?

The six personality disorder (PD) types in DSM-5 section III are intended to resemble their DSM-IV/DSM-5 section II PD counterparts, but are now described by the level of personality functioning (criterion A) and an assigned trait profile (criterion B). However, concerns have been raised about the validity of these PD types. The present study examined the continuity between the DSM-IV/DSM-5 section II PDs and the corresponding trait profiles of the six DSM-5 section III PDs in a sample of 350 Dutch psychiatric patients.

Adverse Effects of Outcome Monitoring Feedback in Patients With Personality Disorders: A Randomized Controlled Trial in Day Treatment and Inpatient Settings.

This study aimed to evaluate the differential effect of outcome monitoring feedback to therapists and to patients on outcomes in cluster B, cluster C, and personality disorder not otherwise specified (PD-NOS) patients. Day treatment patients (n = 112) and inpatients (n = 94) were randomly assigned to a feedback to therapist (FbT), feedback to therapist and patient (FbTP), or no feedback (NFb) condition. Feedback was based on weekly administrations of the Outcome Questionnaire-45 (OQ-45).

Borderline or Schizotypal? Differential Psychodynamic Assessment in Severe Personality Disorders.

Considerable overlap in symptoms between patients with borderline personality disorder (BPD) and schizotypal personality disorder (STPD) complicates personality diagnostics. Yet very little is known about the level of psychodynamic functioning of both personality disorders. Psychodynamic assessment procedures may specify personality characteristics relevant for differential diagnosis and treatment planning.

Pharmacotherapy for borderline patients: business as usual or by default?

In their analysis of a representative sample from the Prescribing Observatory for Mental Health in the UK health services, Paton et al found that 92% of patients with borderline personality disorder (BPD) received prescriptions for psychotropic medications. Although international guidelines recommend pharmacotherapy for comorbid psychiatric disorders whenever necessary, 82% of the UK BPD patients without such comorbid conditions nevertheless received pharmacotherapy "by default," mostly off-label polypharmacy without adequate psychiatric controls for effectiveness and tolerability. Business as usual? Bad care? International practice guidelines for the treatment of BPD all recommend evidence-based psychological treatment whenever possible (especially manualized psychotherapy like dialectical behavior therapy, schema-focused therapy, mentalization-based treatment, transference-focused psychotherapy) as the first-choice treatment.

Treatment duration and premature termination of psychotherapy in personality disorders: predictive performance of psychodynamic personality functioning.

Objective: Little is known about predictors of treatment duration and premature termination of psychotherapy.

Method: Sociodemographic variables, descriptive DSM-IV psychiatric diagnoses, general symptom severity, and psychodynamic personality functioning were assessed in 148 inpatients with personality disorders who were receiving psychotherapy. Psychodynamic personality functioning was assessed using the Developmental Profile (DP).

Differential effectiveness of antipsychotics in borderline personality disorder: meta-analyses of placebo-controlled, randomized clinical trials on symptomatic outcome domains.

Objective: In clinical practice, antipsychotic drugs are widely used in borderline personality disorder (BPD). To evaluate current pharmacological treatment algorithms and guidelines for BPD, the authors reviewed and meta-analyzed studies on the effectiveness of antipsychotics on specific symptom domains in BPD.

Methods: The literature was searched for placebo-controlled, randomized clinical trials (PC-RCTs) on the effectiveness of antipsychotics regarding cognitive perceptual symptoms, impulsive behavioral dyscontrol, and affective dysregulation (with subdomains depressed mood, anxiety, anger, and mood lability) in BPD.

Treatment-disrupting behaviors during psychotherapy of patients with personality disorders: the predictive power of psychodynamic personality diagnosis.

Background: Behavioral dyscontrol and violations of treatment contracts are serious clinical problems during psychotherapy, especially in treating patients with personality disorders. However, little is known about predictors of these treatment-interfering phenomena.

Objective: To identify psychodynamic personality characteristics that can interfere with the psychotherapy process as indicated by treatment-disrupting behaviors.

Making diagnosis more meaningful. The Developmental Profile: a psychodynamic assessment of personality.

The Developmental Profile (DP) offers a psychodynamic description of the degree to which an individual has developed adaptive functioning appropriate to his or her age, and the extent to which daily functioning is determined by "early" maladaptive patterns. In this article we summarize the taxonomic frame of reference of the DP, the constituted Developmental Lines and Developmental Levels, and the way DP can be reliably assessed by a semi-structured interview using a scoring protocol. We describe DP from a theoretical and clinical point of view.

Interrater reliability for Kernberg's structural interview for assessing personality organization.

Interrater reliability is considered a precondition for the validity of theoretical models and their corresponding diagnostic instruments. Studies have documented good interrater reliability for structured interviews measuring personality characteristics on a descriptive-phenomenological level but there is little research on reliability of assessment procedures on a structural level. The current study investigated the interrater reliability of the structural interview (SI) designed to assess neurotic, borderline, and psychotic personality organization according to Kernberg.

Effectiveness of pharmacotherapy for severe personality disorders: meta-analyses of randomized controlled trials.

Context: There has been little systematic attempt to validate current pharmacologic treatment algorithms and guidelines for severe personality disorder.

Objective: We evaluated studies on the effectiveness of psychoactive drugs on specific symptom domains for borderline and/or schizotypal personality disorder.

Data Sources: The literature was searched for placebo-controlled randomized clinical trials (PC-RCTs) on the effectiveness of psychopharmacologic drugs in personality disorder patients.

No allelic association between harm avoidance and the debrisoquine 4-hydroxylase gene.

Background: Several reports suggest that variance in personality traits is inherited, but little is known about the genes responsible. It has been suggested that there is a relationship between personality characteristics and the gene responsible for the activity of the enzyme debrisoquine 4-hydroxylase (CYP2D6).

Objective: To examine the proportion of poor metabolizers in a group of personality disordered patients.