Cluster B and C personality traits, symptom correlates, and treatment utilization in postacute schizophrenia.
ABSTRACT Unusually high levels of Cluster B and C personality traits have been observed in schizophrenia. While these have been linked to poorer function, less clear is the association of these personality traits with symptoms and service utilization. To examine this issue, 46 participants with schizophrenia or schizoaffective disorder were administered the Millon Clinical Multiaxial Inventory, Third Edition, and the Positive and Negative Syndrome Scale, and an inventory was taken of medical and psychiatric service utilization. Two sets of multiple regression analyses using Cluster B and C traits to predict treatment utilization and symptoms revealed that emotional discomfort symptoms were significantly related to level of borderline traits. Higher levels of positive symptoms were linked with more avoidant traits and fewer dependent traits. Higher levels of negative symptoms were linked with greater avoidant traits. Service utilization was predicted by borderline, antisocial, and avoidant traits. Implications for rehabilitation and treatment are discussed.
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- "Cluster B PDs have received the most research attention in Sz, with a distinct focus on antisocial PD and borderline (emotionally unstable) PD. Limited evidence suggests that a quarter to a third of individuals with schizophrenia have a lifetime comorbid cluster B PD, which is remarkably high compared to the general population (1.5%) (Lindstrom et al., 2000; Lysaker et al., 2004; Wickett et al., 2006; Lenzenweger et al., 2007; Huang et al., 2009). Moreover, schizophrenia with comorbid cluster B PD is associated with more substance misuse, criminal offending, more severe neurocognitive deficits, auditory hallucinations, poor global functioning, higher relapse rates, and reports of childhood maltreatment (Lysaker et al., 2004; Bahorik and Eack, 2010; Kingdon et al., 2010). "
ABSTRACT: Accumulating evidence suggests high rates of personality disorder (PD) in schizophrenia (Sz), and as such, the implications of PD in this context are beginning to be studied more thoroughly. We examined clinical, cognitive and experiential (i.e., reported childhood adversity) correlates of aberrant personality traits in schizophrenia and healthy controls (HC) as measured by the International Personality Disorder Examination Questionnaire (IPDEQ). Participants were 549 individuals with schizophrenia or schizoaffective disorder, and 572 healthy adults recruited to the Australian Schizophrenia Research Bank (ASRB). Schizophrenia participants were significantly more likely than healthy controls to screen positive for personality disorder across all ICD-10 subtypes, and there was substantial overlap between clusters, with ∼33% of Sz participants screening positive for all 3 personality disorder clusters. Among both Sz and HC groups, cluster B personality characteristics were significantly associated with increased suicidal behaviours, lower cognitive performance, and the experience of childhood adversity. In addition, Cluster C personality features were associated with higher overall ratings of affective blunting in schizophrenia, and Cluster A personality features were associated with childhood 'loss' in HC participants only. The cumulative effects of screening positive for more than one personality disorder in Sz was associated with higher likelihood of suicidal behaviour, earlier age of onset of Sz, and poorer cognitive functioning. The results suggest that abnormal co-occurrence of personality traits across DSM-IV clusters is evident in a significant proportion of individuals with schizophrenia, and that these personality features impact significantly on clinical and cognitive characteristics of Sz.Journal of Psychiatric Research 12/2011; 46(3):353-9. DOI:10.1016/j.jpsychires.2011.11.012 · 4.09 Impact Factor
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ABSTRACT: Personality traits are important individual characteristics modifying responses to therapy in various diseases. The aim of this study was to identify personality traits that may predict treatment outcome in alcohol-dependent patients. The present analysis was based on a total of 146 alcohol-dependent patients (109 male, 37 female) after detoxification. The variable of interest was treatment outcome (abstinence/relapse) after a 1-year follow-up. To identify personality traits as predictors of treatment outcome, 5 personality questionnaires (NEO 5-Factor Inventory, Temperament and Character Inventory, Eysenck Personality Questionnaire, Eysenck Impulsiveness-Venturesomeness-Empathy Scale and Sensation-Seeking Scale) were applied. Data analysis was performed by using a classification and regression tree analysis (CART; a nonparametric technique for data with a complex structure) in order to find a decision rule to predict treatment outcome from personality traits. The CART model identified psychoticism and persistence as the 2 most relevant discriminatory parameters, of which psychoticism was used as the first node in the model, classifying 64% of the patients correctly as relapsed and 12% correctly as abstinent. In addition, the risk of relapse was even higher in patients with a substantial score in psychoticism and a low score in persistence. When comparing relapsed and abstinent patients, further variables, such as scores for novelty seeking (20.9 +/- 5.5 vs. 18.5 +/- 5.9) and impulsiveness (8.4 +/- 3 vs. 7.2 +/- 3.5), showed significance. In addition, relapsed patients lived alone more often than abstinent patients (52 vs. 25%, p = 0.004). In conclusion, this analysis demonstrated that specific personality characteristics, namely psychoticism and persistence, are usable predictors for the risk of relapse in alcohol-dependent patients.Neuropsychobiology 01/2008; 57(4):159-64. DOI:10.1159/000147469 · 2.30 Impact Factor
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ABSTRACT: Recovery is now a widely discussed concept in the field of research, treatment, and public policy regarding schizophrenia. As it has increasingly become a focus in mainstream psychiatry, however, it has also become clear both that the concept is often used in multiple ways, and that it lacks a strong scientific basis. In this review, we argue that such a scientific basis is necessary for the concept of recovery to have a significant long-term impact on the way that schizophrenia is understood and treated. The discussion focuses on key issues necessary to establish this scientific agenda, including: 1) differences in definitions of recovery and their implications for studying recovery processes and outcomes; 2) key research questions; 3) the implications of data from outcome studies for understanding what is possible for people diagnosed with schizophrenia; 4) factors that facilitate recovery processes and outcomes, and methods for studying these issues; and 5) recovery-oriented treatment, including issues raised by peer support. Additional conceptual issues that have not received sufficient attention in the literature are then noted, including the role of evidence-based practices in recovery-oriented care, recovery-oriented care for elderly people with schizophrenia, trauma treatment and trauma-informed care, and the role of hospitals in recovery-oriented treatment. Consideration of these issues may help to organize approaches to the study of recovery, and in doing so, improve the impact of recovery-based initiatives.Clinical psychology review 04/2008; 28(7):1108-24. DOI:10.1016/j.cpr.2008.03.004 · 7.18 Impact Factor