Editorial

Vicente E. Caballo

University of Granada (Spain)

 

NO ABSTRACT

 

 

An introduction to personality disorders in the 21st century

Vicente E. Caballo

University of Granada (Spain)

 

This article includes a brief description of the different personality disorders following the classification of the DSM-IV-TR (APA, 2000) taking into account some disorders that have been included in Appendix B of this classification system or that were deleted from it but had been included in the DSM-III-R (APA, 1987). After defining personality and pointing out the basic aspects of that which could constitute a personality disorder, these pathologies are described paying attention to their clinical characteristics, their prevalence, gender differences, and some possible hypotheses on their ethiology. Finally, some brief reflections are presented by way of conclusion.

 

 

Personality disorders: A caos theory approach

Xavier Bornas and Gloria García de la Banda

University of Balearic Islands (Spain)

 

Chaos theory can offer a new conceptual and methodological framework for the study Personality Disorders. This new approach considers human beings as dynamic systems, mathematically speaking, in constant evolution-reorganization, with periods of stability and instability and in continuous interaction with the environment. The behavior of these systems will be unpredictable but determined by certain laws that can be expressed by nonlinear equations. Likewise, this approach considers personality disorders as phases in the evolution of systems in which they behave in characteristic patterns. This innovative perspective allows the study of the dimensions and processes over time and the understanding and explanation of behavior at different stages. Dynamic system key concepts can be applied to the ways in which personality disorders are considered, evaluated and treated. Fundamental issues related to these three aspects are revised.

 

 

Resentment in personality disorders

Ernesto Quiroga Romero

University of Almería (Spain)

 

Nowadays resentment is important in Health Psychology within the concept of AHA Syndrome, Anger-Hostility-Aggression, originally proposed by Spielberger, as risk factor in some organic disorders, especially cardiovascular ones. In Clinical Psychology this is not the case, especially in Cognitive-Behavioral Psychology, where aggressiveness due to hate, or resentment, is seldom seen as a main characteristic of psychopathological disorders. Aggressiveness due to hate, or resentment, is formed by unresolved indignity and its later defensive dynamic. The resentful person lives in a world of falsehood in order not to feel indignity, or to express his or her hate through covert aggressions to himself or herself, or to

others. This aggressiveness due to hate can become an interpersonal style that transforms the person’s life into one of the diverse Millon´s personality disorders, which positively consider resentment as one of their main characteristics.

 

 

Comorbidity between personality disorders and eating disorders

Enrique Echeburúa and Izaskun Marañón

University of País Vasco (Spain)

 

The aim of this paper was to review the current knowledge about comorbidity between personality disorders and eating disorders. Personality disorders implicate a poor prognosis in anorexia and bulimia nervosa. Cluster C personality disorders, particularly obsessive, avoidant and dependent personality disorders, are the most relevant in anorexia. However, in bulimia, an impulsive temperament and borderline personality seem to be the most significant psychopathological features. Finally, implications for further research in this field are commented upon.

 

 

Personality disorders and pathological gambling: A critical review

Javier Fernández Montalvo¹ and Enrique Echeburúa²

¹Public University of Navarra; ²University of País Vasco (Spain)

 

The aim of this paper was to review the state of the art in personality traits and personality disorders in pathological gambling. As regards personality traits, the results of specific profiles of pathological gamblers (in terms of neuroticism, extroversion, psychoticism, sensation seeking, etc.) are not conclusive. The personality trait that obtains most support by empirical evidence is impulsivity. Pathological gamblers are more impulsive than the average population. In addition, there are few studies on personality disorders. There is a tendency for a higher proportion of gamblers to be found within the cluster B category (antisocial and borderline, mainly). Finally, implications of this kind of studies for future research and clinical practice are commented upon.

 

 

Relationships among personality disorders and adherence to therapeutic instructions together with relapses in substance use patients

Adolfo J. Cangas and Juan José Olivencia

University of Almería (Spain)

 

Comorbidity is a central aspect in current psychopathology. In the field of the drug addictions, different studies have shown a high prevalence of personality disorders in this population. The goal of the present investigation was centered on analyzing the relation between different personality disorders and the relapses during the therapy. Also, the degree of fulfillment of different therapeutic instructions of these patients was studied. The results obtained indicate the presence of high rates of relapses in subjects with serious personality disorders as well as less fulfillment of therapeutic instructions. The diagnostic and therapeutic implications of these results are discussed.

 

 

Assessment of personality disorders through a new self-report instrument: the CEPER

Vicente E. Caballo and Javier Valenzuela

University of Granada (Spain)

 

Personality disorders are highly complex problems that are attracting increased attention. The information available about them is relatively scarce and their diagnosis many times difficult to carry out. Nowadays we have different instruments for their assessment, such as interviews and self-report questionnaires. A new questionnaire is put forward here for the assessment of styles of personality based on the disorders of personality proposed by the DSM-IV in the official classification and in its appendix. Some psychometric properties of the Exploratory Questionnaire of Personality (CEPER) are presented, including the Cronbach’ alpha, the reliability of the two halves and the convergent validity taking as criterion the Millon Clinical Multiaxial Inventory (MCMI-II). Data on differences between men and women in the different styles of personality of the present questionnaire are also included.

 

 

Psychopharmacological treatment of personality disorders

José Francisco Navarro and María Cavas

University of Málaga (Spain)

 

Recent psychobiological studies indicate that pharmacotherapy could be useful for the treatment of personality disorders. In this paper, the results of clinical pharmacological studies are reviewed according to DSM-IV axis-II categorization, which classified the personality disorders into three clusters: A (paranoid, schizoid and schizotypal), B (antisocial, borderline, histrionic and narcissistic) and C (dependent, avoidant and obsessive-compulsive). Although few controlled studies have been conducted in cluster A personality disorder, low doses of antipsychotic drugs might be useful in these patients. Most studies have been carried out in cluster B, and especially in borderline personality disorder. Partial positive results have been obtained using neuroleptics, antidepressants, benzodiazepines (alprazolam) and antimanic drugs. Finally, in cluster C, some isolated studies suggest a favourable clinical effect of antidepressants (especially SSRIs and venlafaxine) and benzodiazepines.

 

 

Cognitive-behavioral treatments for personality disorders

Vicente E. Caballo

University of Granada (Spain)

 

The treatments available for personality disorders are varied, but, in general, they are not very effective. Current studies offer some guidelines for the treatment of personality disorders that are described here together with some of the cognitive-behavioral procedures used for the modification of these problems. While some disorders are difficult to modify (e.g., schizoid, antisocial or narcissistic personality disorders), others have structured programs of treatment that make us more optimistic about the effectiveness of interventions (e.g., borderline, avoidant or dependent personality disorders). We conclude by pointing out the need for more research on more effective procedures and techniques of intervention for the modification of personality disorders.

 

 

Personality disorders and responsivity to psychological treatment in a severe case of obsessive compulsive disorder

Pedro J. Moreno Gil, Xavier Méndez Carrillo, and Mª Encarnación López Navarro

University of Murcia (Spain)

 

In this paper a case of severe obsessive-compulsive disorder is presented. The patient had alcohol abuse, narcissistic personality disorder and paranoid personality disorder as comorbid conditions. Assessment included Yale-Brown Obsessive-Compulsive scale, Millon Clinical Multiaxial Inventory (second edition), and International Personality Disorders Examination. The psychological treatment was based on cognitive-behavioral and strategic family therapy. The treatment lasted four years and was tailor-made administered. Due to the lack of the patient’s collaboration, the alcohol abstinence and the obsessive-compulsive symptoms were initially treated by means of paradoxical interventions and other strategic family techniques. After obtaining the patient’s collaboration, exposure with response prevention was employed to address the obsessive-compulsive symptoms. These Axis I symptoms were reduced in a clinically significant degree. Paranoid and narcissistic symptoms were treated on the basis of cognitive therapy (Beck and Freeman, 1995) but the clinical change was small. Relations between narcissistic personality disorder, paranoid personality disorder, obsessivecompulsive disorder and their influence in the response to psychological treatment are discussed.