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Meisner MW, Lenzenweger MF, Storebø OJ, Petersen LS, Bach B, Simonsen E. Co-occurrence of borderline and schizotypal personality disorders: a scoping review. Nord J Psychiatry 2024; 78:1-13. [PMID: 37682696 DOI: 10.1080/08039488.2023.2254299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 08/19/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND The historical concept of borderline conditions refers to the pathology on the border between neurosis and psychosis. In DSM-III the conditions were divided into specific but also somewhat overlapping diagnostic criteria for Borderline Personality Disorder (BPD) and Schizotypal Personality Disorder (SPD). This phenomenological overlap, which results in co-occurrence of the two diagnoses, remains a clinical challenge to this day. METHODS To address this issue we examined the co-occurrence of SPD and BPD according to the established DSM-IV/-5 diagnostic criteria. A literature search was conducted including studies that employed a structured interview with defined BPD and SPD criteria. RESULTS Studies from 20 samples were included (i.e. 15 patients, 3 community and 2 forensic samples). For patients diagnosed primarily with BPD, 1-27% also met the criteria for SPD and for patients diagnosed primarily with SPD, 5 - 33% showed co-occurrence with BPD. In the forensic samples, co-occurrence for primary BPD was 10% and 67 - 82% for primary SPD. In the community samples, co-occurrence for primary BPD was 29% and 50% for primary SPD. The pattern of co-occurrence across community samples was particularly heterogeneous. CONCLUSION The identified co-occurrences for BPD and SPD were considerably sample-dependent, and samples and measurements were generally too heterogeneous for a precise meta-analysis. Forensic and community samples generally showed higher co-occurrences, but these findings were characterized by potential methodological limitations.
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Affiliation(s)
| | - Mark F Lenzenweger
- Department of Psychology, The State University of New York, Binghamton, NY, USA
- Department of Psychiatry, Weill Cornell Medical College, NY, USA
| | - Ole J Storebø
- Psychiatric Research Unit, Slagelse, Denmark
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Lea S Petersen
- Psychiatric Research Unit, Slagelse, Denmark
- Division of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Bo Bach
- Psychiatric Research Unit, Slagelse, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Erik Simonsen
- Division of Health and Medical Sciences, University of Copenhagen, Denmark
- Research Unit, Mental Health Services, Roskilde, Denmark
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2
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Asan AE, Pincus AL. Examining Schizotypal Personality Scales Within and Across Interpersonal Circumplex Surfaces. Assessment 2023; 30:2296-2317. [PMID: 36631938 PMCID: PMC10478344 DOI: 10.1177/10731911221143354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Differing perspectives on the operationalization of schizotypal personality pathology (STPP) have led to numerous multidimensional assessment measures. The current study applied the interpersonal construct validation approach to self-report data from 856 undergraduate students to formally examine the interpersonal content, similarities, and differences in the subscales of four measures of STPP within and across two interpersonal circumplex surfaces using a bootstrapping methodology for computing confidence intervals around circumplex structural summary method parameters. Results suggested that negative-like expressions of STPP are prototypically and distinctively interpersonal constructs associated with cold and socially avoidant interpersonal problems and hypersensitivity to others' warmth and affection. Positive-like expressions of STPP as assessed by two out of four measures were prototypically and distinctively interpersonal constructs associated with vindictiveness. Across four measures, there was notable overlap in interpersonal correlates among related subscales, suggesting convergent validity. However, subscales containing social anxiety content were associated with more submissive (i.e., socially avoidant) interpersonal problems than subscales without social anxiety content.
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Affiliation(s)
- A. Esin Asan
- The Pennsylvania State University, University Park, USA
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Miralles C, Alonso Y, Algora MJ, López-Sánchez L, Sánchez-Gistau V, Vilella E, Baillès E, Gutiérrez-Zotes A, Martorell L. Maladaptive personality traits in patients with recent-onset psychosis: A case-control study using the Personality Inventory for the DSM-5 (PID-5). Schizophr Res 2023; 252:216-224. [PMID: 36669345 DOI: 10.1016/j.schres.2023.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 07/05/2022] [Accepted: 01/07/2023] [Indexed: 01/19/2023]
Abstract
BACKGROUND The relationship between maladaptive personality traits and psychotic disorders in the early stages of disease has not been thoroughly investigated, even though it is essential for developing prevention and early intervention strategies. METHODS The five domains and the 25 facets of the Personality Inventory for DSM-5 (PID-5) were compared between 102 patients with recent-onset psychosis (ROP) and 116 community subjects (C) with a general linear model including age and sex in the analyses. In addition, multiple linear regression models were used to identify which factors associated with the PID-5 domains in ROP, and correlation analyses were used to explore the relationship between personality traits. RESULTS Patients with ROP, compared to C, exhibited higher scores in four out of the five domains with medium effect sizes (Cohen's f2 ≥ 0.15) in two of them: negative affect (NA, p = 0.013, f2 = 0.04), detachment (DET, p < 0.001, f2 = 0.15), disinhibition (DIS, p < 0.001, f2 = 0.14) and psychoticism (PSY, p < 0.001, f2 = 0.16). Significant group differences were observed in 15 of the 25 facets and the largest effects were observed in the facets of withdrawal (p ≤ 0.001, f2 = 0.20), irresponsibility (p < 0.001, f2 = 0.23) and unusual beliefs (p = 0.001, f2 = 0.22). Interestingly, being on antidepressants and high scores on the positive subscale of the Positive and Negative Syndrome Scale (PANSS) were associated with high scores of NA, antagonism (ANT) and PSY. CONCLUSIONS Maladaptive personality traits were prominent in persons with ROP. These findings suggest that personality traits might play a role in vulnerability to psychosis and highlight the importance of evaluating personality in the early stages of psychosis.
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Affiliation(s)
- Carmen Miralles
- Hospital Universitari Institut Pere Mata (HUIPM), Reus, Catalonia, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV-CERCA), Reus, Catalonia, Spain
| | - Yolanda Alonso
- Hospital Universitari Institut Pere Mata (HUIPM), Reus, Catalonia, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV-CERCA), Reus, Catalonia, Spain; Universitat Rovira i Virgili (URV), Reus, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
| | - M José Algora
- Hospital Universitari Institut Pere Mata (HUIPM), Reus, Catalonia, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV-CERCA), Reus, Catalonia, Spain
| | - Lorena López-Sánchez
- Hospital Universitari Institut Pere Mata (HUIPM), Reus, Catalonia, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV-CERCA), Reus, Catalonia, Spain
| | - Vanessa Sánchez-Gistau
- Hospital Universitari Institut Pere Mata (HUIPM), Reus, Catalonia, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV-CERCA), Reus, Catalonia, Spain; Universitat Rovira i Virgili (URV), Reus, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
| | - Elisabet Vilella
- Hospital Universitari Institut Pere Mata (HUIPM), Reus, Catalonia, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV-CERCA), Reus, Catalonia, Spain; Universitat Rovira i Virgili (URV), Reus, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
| | - Eva Baillès
- Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
| | - Alfonso Gutiérrez-Zotes
- Hospital Universitari Institut Pere Mata (HUIPM), Reus, Catalonia, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV-CERCA), Reus, Catalonia, Spain; Universitat Rovira i Virgili (URV), Reus, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
| | - Lourdes Martorell
- Hospital Universitari Institut Pere Mata (HUIPM), Reus, Catalonia, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV-CERCA), Reus, Catalonia, Spain; Universitat Rovira i Virgili (URV), Reus, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain.
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Kemp KC, Kaczorowski JA, Burgin CJ, Raulin ML, Lynam DR, Sleep C, Miller JD, Barrantes-Vidal N, Kwapil TR. Association of Multidimensional Schizotypy with PID-5 Domains and Facets. J Pers Disord 2022; 36:680-700. [PMID: 36454161 DOI: 10.1521/pedi.2022.36.6.680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
The underlying vulnerability for schizophrenia-spectrum disorders is expressed across a continuum of clinical and subclinical symptoms referred to as schizotypy. Schizotypy is a multidimensional construct with positive, negative, and disorganized dimensions. The present study examined associations of positive, negative, and disorganized schizotypy with pathological personality traits and facets assessed by the Personality Inventory for DSM-5 (PID-5) in 1,342 young adults. As hypothesized, positive schizotypy was associated with the PID-5 psychoticism domain and facets, negative schizotypy was associated with the detachment domain and facets and the restricted affectivity facet, and disorganized schizotypy's strongest associations were with the distractibility and eccentricity facets and the negative affect domain. The PID-5 facets accounted for upwards of two thirds of the variance in each schizotypy dimension. The authors conclude by providing regression-based algorithms for computing positive, negative, and disorganized schizotypy scores based on the PID-5 facets.
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Affiliation(s)
- Kathryn C Kemp
- University of Illinois at Urbana-Champaign, Champaign, Illinois
| | | | | | | | | | | | | | | | - Thomas R Kwapil
- University of Illinois at Urbana-Champaign, Champaign, Illinois.,University of North Carolina at Greensboro, Greensboro, North Carolina
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Kwapil TR, Edmundson MS, Hernández LM, Kemp KC, Rbeiz KS, Clark HE, Bathery AJ, Raulin ML, Barrantes-Vidal N. Schizotypal ambivalence is associated with schizophrenia-spectrum and borderline personality traits in young adults: Converging results from three interview studies. JOURNAL OF RESEARCH IN PERSONALITY 2022. [DOI: 10.1016/j.jrp.2022.104312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Felsenheimer AK, Kieckhäfer C, Rapp AM. Irony detection in patients with borderline personality disorder: an experimental study examining schizotypal traits, response biases and empathy. Borderline Personal Disord Emot Dysregul 2022; 9:24. [PMID: 36192806 PMCID: PMC9531442 DOI: 10.1186/s40479-022-00194-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 08/15/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND In verbal irony we often convey meanings that oppose the literal words. To look behind these words, we need to integrate perspectives of ourselves, others, and their beliefs about us. Although patients with borderline personality disorder (BPD) experience problems in social cognition and schizotypal symptoms, research on irony comprehension mainly focused on the schizophrenic spectrum. Accounting for possible negative biases in BPD, the current study examined the detection of praising and critical irony in a text messaging interface. METHODS The cross-sectional study included 30 patients and 30 matched controls, who completed measures of cognitive and affective empathy (Interpersonal Reactivity Index, IRI), schizotypal (Schizotypal Personality Questionnaire; SPQ), and borderline symptoms (Borderline Symptom List; BSL-23) and the irony detection task. The irony task contained critical and praising remarks embedded in text messages. Asking for literality (ironic vs. literal) and intention ratings (critical to praising) of the stimuli, it allowed to analyze the sensitivity of literality detection as well as implicit and explicit response biases in a signal detection framework. RESULTS Borderline symptoms explained lower sensitivity for the detection of literal and ironic statements across groups. Whereas HC showed a negativity bias when implicitly asked about the literalness of the statement, patients with BPD perceived praising utterances as less praising when explicitly asked about their perceived intention. Neither empathy nor schizotypy explained outcomes beyond borderline symptoms. CONCLUSIONS This was the first study to show lower detection of verbal irony in patients with BPD. While patients were less biased when asked about the literality of a statement, they perceived praising remarks as less positive on explicit measurements. The results highlight the importance of congruent, transparent communication in promoting epistemic trust in individuals with BPD.
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Affiliation(s)
- Anne Katrin Felsenheimer
- Department of Psychiatry and Psychotherapy, University of Tübingen, 72076, Tübingen, Germany.
- Max Planck School of Cognition , Max Planck Institut for Human Cognitive and Brain Sciences , Leipzig, Germany.
| | - Carolin Kieckhäfer
- LVR Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Alexander Michael Rapp
- Department of Psychiatry and Psychotherapy, University of Tübingen, 72076, Tübingen, Germany
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7
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Masucci MD, Martin V, Le TP, Cohen AS. Negative schizotypy attenuates the effect of momentary stress on social dysfunction related to COVID-19 social distancing. Schizophr Res 2022; 243:24-31. [PMID: 35231831 PMCID: PMC9189049 DOI: 10.1016/j.schres.2022.02.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 01/15/2022] [Accepted: 02/18/2022] [Indexed: 10/19/2022]
Abstract
Schizotypy is associated with a broad range of motivational and social dysfunctions. However, there is reason to suspect that negative schizotypy may limit social dysfunction in specific contexts that typically increase isolation and loneliness. We analyzed whether positive, negative and disorganized facets of schizotypy would mitigate detrimental reactions to stress in the context of a global stressor (the COVID-19 pandemic) that has widely necessitated social and physical isolation. Responses to two measures of schizotypy were compared to ecological momentary assessments of social dysfunction for 85 undergraduates using multilevel modelling techniques. Negative schizotypy moderated the relation between momentary stress and loss of social support, such that negative schizotypy limited the magnitude of social dysfunction stemming from increases in momentary stress. This pattern was not seen for other facets of schizotypy. Implications for the treatment and measurement of schizotypy symptoms are discussed.
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Affiliation(s)
- Michael D. Masucci
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA,Address correspondence to: Michael Masucci, Department of Psychology, Louisiana State University, 236 Audubon Hall, Baton Rouge, LA 70808,
| | - Victoria Martin
- The Graduate Center, City University of New York, New York, NY, USA
| | - Thanh P. Le
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA,Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA
| | - Alex S. Cohen
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
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8
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Rbeiz KS, Clark HE, Kemp KC, Bathery AJ, Monette MA, Barrantes-Vidal N, Kwapil TR. The association of multidimensional schizotypy with symptoms and impairment across racial groups. Personal Ment Health 2022; 16:79-89. [PMID: 34528403 DOI: 10.1002/pmh.1528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/23/2021] [Accepted: 09/01/2021] [Indexed: 11/12/2022]
Abstract
The assessment of schizotypy and schizophrenia-spectrum psychopathology has historically been adversely impacted by multiple forms of measurement bias, including racial bias. The Multidimensional Schizotypy Scale (MSS) was developed using modern scale construction methods to minimize measurement bias in the assessment of schizotypic traits. However, studies have not examined the validity of the measurement across different racial groups. The present study examined whether the associations of MSS positive, negative, and disorganized schizotypy subscales with interview-assessed ratings of functioning, schizophrenia-spectrum personality traits, and depressive disorders were generally comparable across nonclinically ascertained samples of Black (n = 46), Asian (n = 87), and White (n = 116) young adults. Consistent with previous findings, all three schizotypy subscales were associated with impairment and schizotypal and paranoid traits. Negative schizotypy was associated with schizoid traits, and disorganized schizotypy was associated with depressive disorders. These associations were comparable across the racial groups, supporting the use of the MSS in these groups. Culturally and empirically valid assessments are essential for providing accurate assessments across racial/ethnic groups and reducing the risk of overpathologizing people of color. The present findings support the cross-cultural validity of the MSS; however, future studies should expand upon these findings by including more diverse samples and longitudinal designs.
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Affiliation(s)
- Katrina S Rbeiz
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
| | - Haley E Clark
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
| | - Kathryn C Kemp
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
| | - Alyssa J Bathery
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
| | - Mahogany A Monette
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Thomas R Kwapil
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA.,Department of Psychology, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
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