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Foulds J, Knight J, Young JT, Keen C, Newton-Howes G. A Novel Graphical Method for Data Presentation in Alcohol Systematic Reviews: The Interactive Harvest Plot. Alcohol Alcohol 2021; 57:16-25. [PMID: 33480397 DOI: 10.1093/alcalc/agaa145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 11/22/2020] [Accepted: 11/24/2020] [Indexed: 11/14/2022] Open
Abstract
AIMS To demonstrate a novel method for presenting and exploring data in systematic reviews of the alcohol literature. METHODS Harvest plots are a graphical method for displaying data on the overall pattern of evidence from a systematic review. They can display the direction of effects and risk of bias within studies for multiple outcomes in a single graphical chart. Using data from our previous meta-analysis on the association between personality disorder and alcohol treatment outcome, we extended the application of harvest plots by developing an interactive online harvest plot application. RESULTS Studies included in the review were heterogeneous in design. There were many different primary outcomes, and similar outcomes were often defined differently across studies. The interactive harvest plot allows readers to explore trends in the data across multiple outcomes, including the impact of within-study bias and year of publication. In contrast, meta-analysis on the same data was hampered by a lack of consistency in the way outcomes were measured, and incomplete reporting of effect sizes and their variance. This meant many studies included in the systematic review could not be meta-analysed. CONCLUSIONS Interactive harvest plots are a novel graphical method to present data from systematic reviews. They can supplement or even replace meta-analysis when the studies included in a systematic review use heterogeneous designs and measures, as is often the case in the alcohol literature.
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Affiliation(s)
- James Foulds
- Department of Psychological Medicine, University of Otago at Christchurch, Christchurch 8011, New Zealand
| | - Josh Knight
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria 3053, Australia
| | - Jesse T Young
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria 3053, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC 3052, Australia.,School of Population and Global Health, The University of Western Australia, Perth, WA 6009 Australia.,National Drug Research Institute, Curtin University, Perth, WA 6102, Australia
| | - Claire Keen
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria 3053, Australia
| | - Giles Newton-Howes
- Department of Psychological Medicine, University of Otago at Wellington, Wellington 6242, New Zealand
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Oliveira SESD, Oliveira TCD, Bandeira DR, Krueger RF. Personality Types and Personality Traits in DSM-5: Do They Really Match? PSICOLOGIA: TEORIA E PESQUISA 2020. [DOI: 10.1590/0102.3772e36nspe15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract The alternative model of personality disorders introduced in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders provides a diagnostic system that is expected to correspond to the well-known categorical approach of personality disorder diagnoses. The current study aims to improve knowledge about the relationship between pathological personality traits and their corresponding personality types. A Brazilian sample of 1,162 people took part in this study. The results point to some level of continuity between the two models when the variables were treated as dimensional. Contrariwise, there is a lack of strong scientific evidence to justify the maintenance of the categorical approach. We recommend the exclusion of the categorical approach from personality disorder diagnosis systems.
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Cavicchioli M, Ramella P, Movalli M, Prudenziati F, Vassena G, Simone G, Maffei C. DSM-5 Maladaptive Personality Domains among Treatment-Seeking Individuals with Alcohol Use Disorder: The Role of Disinhibition and Negative Affectivity. Subst Use Misuse 2020; 55:1746-1758. [PMID: 32410484 DOI: 10.1080/10826084.2020.1762650] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background: Dimensional models of personality and personality disorders (PDs) have been widely investigated among individuals with alcohol use disorders (AUD). Nevertheless, DSM-5 maladaptive personality domains showed mixed associations with AUD. Furthermore, no studies have explored the role of DSM-5 maladaptive personality domains on the comorbidity between AUD and different PDs. Objective(s): This study aims at investigating whether DSM-5 maladaptive personality dimensions could differentiate individuals with AUD from normative and healthy controls (HCs) subjects. The study also investigated relationships between these personality dimensions and AUD clinical features (i.e. onset, severity of concurrent substance use disorders), as well as their role in accounting for the comorbidity between AUD and PDs. Methods: This study administered the personality inventory for DSM-5 (PID-5) to 99 treatment-seeking individuals (male 68.8%; female 31.2%; age: 48.12 (14.32)) with AUD (41 AUD only; 58 AUD with PDs), comparing the participants' levels of PID-5 domains with normative data and the data from a HC sample (N = 40; male 50%; female 50%; age: 48.12 (14.32)). Results: Disinhibition and negative affectivity were relevant maladaptive personality dimensions of AUD, even when controlling for the impact of PD diagnoses. Disinhibition and negative affectivity were associated to the onset of AUD and the severity of concurrent substance use disorders. The co-occurrence of AUD and PDs is related to other two domains, namely antagonism and detachment. Conclusions: AUD is a complex psychopathological disorder in which both externalizing and internalizing aspects determine relevant clinical features.
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Affiliation(s)
- Marco Cavicchioli
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Pietro Ramella
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Mariagrazia Movalli
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Francesca Prudenziati
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Giulia Vassena
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Giulia Simone
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Cesare Maffei
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
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Borderline personality disorder and substance use disorders: an updated review. Borderline Personal Disord Emot Dysregul 2018; 5:15. [PMID: 30250740 PMCID: PMC6145127 DOI: 10.1186/s40479-018-0093-9] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 09/03/2018] [Indexed: 12/23/2022] Open
Abstract
For decades, clinicians and researchers have recognized that borderline personality disorder (BPD) and substance use disorders (SUDs) are often diagnosed within the same person (e.g., (Gunderson JG. Borderline personality disorder: A clinical guide. Washington, D.C.: American Psychiatric Press, 2001; Leichsenring et al., Lancet 377:74-84, 2011; Paris J. Borderline personality disorder: A multidimensional approach. American Psychiatric Pub, 1994; Trull et al., Clin Psychol Rev 20:235-53, 2000)). Previously, we documented the extent of this co-occurrence and offered a number of methodological and theoretical explanations for the co-occurrence (Trull et al., Clin Psychol Rev 20:235-53, 2000). Here, we provide an updated review of the literature on the co-occurrence between borderline personality disorder (BPD) and substance use disorders (SUDs) from 70 studies published from 2000 to 2017, and we compare the co-occurrence of these disorders to that documented by a previous review of 36 studies over 15 years ago (Trull et al., Clin Psychol Rev 20:235-53, 2000).
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Newton-Howes GM, Foulds JA, Guy NH, Boden JM, Mulder RT. Personality disorder and alcohol treatment outcome: systematic review and meta-analysis. Br J Psychiatry 2017; 211:22-30. [PMID: 28385703 DOI: 10.1192/bjp.bp.116.194720] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 12/14/2016] [Accepted: 01/26/2017] [Indexed: 11/23/2022]
Abstract
BackgroundPersonality disorders commonly coexist with alcohol use disorders (AUDs), but there is conflicting evidence on their association with treatment outcomes.AimsTo determine the size and direction of the association between personality disorder and the outcome of treatment for AUD.MethodWe conducted a systematic review and meta-analysis of randomised trials and longitudinal studies.ResultsPersonality disorders were associated with more alcohol-related impairment at baseline and less retention in treatment. However, during follow-up people with a personality disorder showed a similar amount of improvement in alcohol outcomes to that of people without such disorder. Synthesis of evidence was hampered by variable outcome reporting and a low quality of evidence overall.ConclusionsCurrent evidence suggests the pessimism about treatment outcomes for this group of patients may be unfounded. However, there is an urgent need for more consistent and better quality reporting of outcomes in future studies in this area.
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Affiliation(s)
- Giles M Newton-Howes
- Giles M. Newton-Howes, MRCPsych, Department of Psychological Medicine, University of Otago, Wellington; James A. Foulds, FRANZCP, Department of Psychological Medicine, University of Otago, Christchurch; Nicola H. Guy, MMedSci, Department of Psychological Medicine, University of Otago, Wellington; Joseph M. Boden, PhD, Christchurch Health and Development Study, Roger T. Mulder, FRANZCP, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - James A Foulds
- Giles M. Newton-Howes, MRCPsych, Department of Psychological Medicine, University of Otago, Wellington; James A. Foulds, FRANZCP, Department of Psychological Medicine, University of Otago, Christchurch; Nicola H. Guy, MMedSci, Department of Psychological Medicine, University of Otago, Wellington; Joseph M. Boden, PhD, Christchurch Health and Development Study, Roger T. Mulder, FRANZCP, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Nicola H Guy
- Giles M. Newton-Howes, MRCPsych, Department of Psychological Medicine, University of Otago, Wellington; James A. Foulds, FRANZCP, Department of Psychological Medicine, University of Otago, Christchurch; Nicola H. Guy, MMedSci, Department of Psychological Medicine, University of Otago, Wellington; Joseph M. Boden, PhD, Christchurch Health and Development Study, Roger T. Mulder, FRANZCP, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Joseph M Boden
- Giles M. Newton-Howes, MRCPsych, Department of Psychological Medicine, University of Otago, Wellington; James A. Foulds, FRANZCP, Department of Psychological Medicine, University of Otago, Christchurch; Nicola H. Guy, MMedSci, Department of Psychological Medicine, University of Otago, Wellington; Joseph M. Boden, PhD, Christchurch Health and Development Study, Roger T. Mulder, FRANZCP, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Roger T Mulder
- Giles M. Newton-Howes, MRCPsych, Department of Psychological Medicine, University of Otago, Wellington; James A. Foulds, FRANZCP, Department of Psychological Medicine, University of Otago, Christchurch; Nicola H. Guy, MMedSci, Department of Psychological Medicine, University of Otago, Wellington; Joseph M. Boden, PhD, Christchurch Health and Development Study, Roger T. Mulder, FRANZCP, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
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