Joel Paris

Personality traits as correlates of suicidal ideation, suicide attempts, and suicide completions: a systematic review

Objective:  Involvement of personality traits in susceptibility to suicidality has been the subject of research since the 1950s. Because of the diversity of conceptual and methodological approaches, the extent of their independent contribution has been difficult to establish. Here, we review conceptual background and empirical evidence investigating roles of traits in suicidal behaviors.

Somatoform disorders : Personality and the social matrix of somatic distress

Personality traits that may contribute to somatization are reviewed. Negative affectivity is associated with high levels of both somatic and emotional distress. Agreeableness and conscientiousness may influence interactions with health care providers that lead to the failure of medical reassurance to reduce distress. Absorption may make individuals more liable to focus attention on symptoms and more vulnerable to suggestions that induce illness anxiety. More proximate influences on the selective amplification of somatic symptoms include repressive style, somatic attributional style, and alexithymia; however, data in support of these factors are scant. Most research on somatoform disorders confounds mechanisms of symptom production with factors that influence help seeking. Longitudinal community studies are needed to explore the interactions of personality with illness experience and the stigmatization of medically unexplained symptoms.

Psychological risk factors for borderline personality disorder in female patients

The purpose of this study was to examine the role of several psychological risk factors, i.e., childhood sexual abuse (CSA) and its parameters, childhood physical abuse (PA), early separation or loss, and abnormal parental bonding, in borderline personality disorder (BPD). Women with personality disorders were divided into BPD (n = 78) and non-BPD (n = 72) groups. Risk factors were measured by a developmental interview and the Parental Bonding Index (PBI). The BPD group had a greater frequency of CSA, more severe CSA, as well as more PA, and a lower maternal affection score on the PBI. Only CSA was significant in the multivariate analysis. CSA is the risk factor that most strongly discriminates between BPD and non-BPD. However, CSA has low specificity to BPD, and only a subgroup reported severe abuse experiences.

Personality disorders over time: precursors, course and outcome.

Personality disorders cause dysfunction over the course of adult life. A chronic course of disorder tends to be associated with an early onset, and personality disorders are preceded by precursor symptoms in childhood. Long-term outcome varies by personality disorder category: antisocial and borderline personality tend to remit with age, an improvement that is not seen in other diagnoses. The chronicity of personality disorders can usefully guide treatment planning, and psychotherapy for personality disorders can focus on rehabilitation.

A Prospective Investigation of Borderline Personality Disorder in Abused and Neglected Children Followed Up into Adulthood

Child abuse has been implicated as a risk factor for borderline personality disorder (BPD), yet few prospective longitudinal studies exist. The current study examined whether 500 individuals with documented cases of childhood physical and sexual abuse and neglect were at elevated risk of BPD in adulthood, compared to 396 demographically similar control children. Results indicated that significantly more abused and/or neglected children overall met criteria for BPD as adults, compared to controls, as did physically abused and neglected children. Having a parent with alcohol/drug problems and not being employed full-time, not being a high school graduate, and having a diagnosis of drug abuse, major depressive disorder, and posttraumatic stress disorder were predictors of BPD and mediated the relationship between childhood abuse/neglect and adult BPD. These results call attention to a heightened risk of BPD in physically abused and neglected children and the need to consider multiple pathways to BPD.

Psychological risk factors for dissociation and self-mutilation in female patients with borderline personality disorder

The purposes of this study were to determine whether or not dissociation in female patients suffering from personality disorder is related to sexual and physical abuse or to abuse parameters and whether or not self-mutilation in the personality disorders is related to psychological risk factors or to dissociation. The sample was divided into 78 borderline and 72 nonborderline personality disorders. Psychological risk factors were measured through histories of childhood sexual abuse, physical abuse and separation or loss as well as scores on the Parental Bonding Index. Dissociation was measured by the Dissociative Experiences Scale. On the diagnostic interview, 48 subjects scored positive for self-mutilation. Dissociative Experiences Scale scores were associated with a borderline diagnosis but not with childhood sexual abuse or physical abuse. The parameters of abuse were not related to dissociation. Subjects who mutilated themselves had higher rates of both childhood sexual abuse and dissociation in univariate analyses. However, in multivariate analyses only diagnosis was significant. None of the other psychological risk factors were significantly linked to self-mutilation. The findings do not support theories that dissociation and self-mutilation in borderline personality disorder are associated with childhood trauma.

Risk Factors for Borderline Personality in Male Outpatients

The purpose of the study was to examine the role of several psychological risk factors-childhood sexual abuse (CSA) and its parameters, childhood physical abuse and its parameters, early separation or loss, and abnormal parental bonding-in male patients with borderline personality disorder (BPD). Subjects with personality disorders were divided into BPD (N = 61) and non-BPD (N = 60) groups. The risk factors were measured by a developmental interview and the Parental Bonding Index. The BPD group had a higher frequency of CSA, more severe CSA, a longer duration of physical abuse, increased rates of early separation or loss, and a higher paternal control score on the Parental Bonding Index. CSA and separation or loss were significant in the multivariate analysis. The risk factors suggest that trauma and loss, as well as problems with fathers, are important for the development of BPD in males.

Predicting suicide attempts in young adults with histories of childhood abuse

BACKGROUND Although childhood abuse is an important correlate of suicidality, not all individuals who were abused as children attempt suicide. AIMS To identify correlates and moderators of suicide attempts in adults reporting childhood physical abuse, contact sexual abuse, or both. METHOD A French-Canadian, school-based cohort (n=1684) was prospectively followed. RESULTS The identity of the abuser moderated the relationship of abuse frequency and suicide attempts, with individuals abused by their immediate family being at highest risk. Although paternal education exhibited negative associations (OR=0.71, 95% CI 0.58-0.88), several externalising phenotypes had positive associations with suicide attempts: disruptive disorders (OR=3.10, 95% CI 1.05-9.15), conduct problems (OR=1.09, 95% CI 1.01-1.19) and childhood aggression (OR=1.41, 95% CI 1.08-1.83). CONCLUSIONS Characteristics of the abuser and abusive acts may be important additional indicators of risk for suicide attempts. Future research needs to employ developmental approaches to examine the extent and mechanisms by which childhood abuse contributes to the shared variance of suicidality, maladaptive traits and psychopathology.

Twin study of dissociative experience.

The relative influence of genetic and environmental influences on measures of pathological and nonpathological dissociative experience was estimated using a classic twin-study design. Subjects were 177 monozygotic and 152 dizygotic volunteer general population twin pairs who completed two measures of dissociative capacity identified from the items comprising the Dissociative Experiences Scale (DES). Additive genetic influences accounted for 48% and 55% of the variance in scales measuring pathological and nonpathological dissociative experience, respectively. Heritability estimates did not differ by gender. The genetic correlation between these measures was estimated at .91, suggesting common genetic factors underlying pathological and nonpathological dissociative capacity. Genetic and environmental correlations between the DES scales and measures of personality disorder traits (Dimensional Assessment of Personality Pathology-Basic Questionnaire; DAPP-BQ) were also estimated. Significant genetic correlations (median = .38) were found between the DES scales and DAPP-BQ cognitive dysregulation, affective lability, and suspiciousness, suggesting that the genetic factors underlying particular aspects of personality disorder also influence dissociative capacity.

Antisocial and borderline personality disorders: Two separate diagnoses or two aspects of the same psychopathology?

Antisocial personality disorder (ASPD) and borderline personality disorder (BPD) have a number of points of overlap: in symptoms, in personality dimensions that underlie their phenomenology, in community prevalence, in risk factors, and in outcome and response to treatment. Both disorders have a common base in impulsive personality traits, but the behavioral differences between them are shaped by gender. Further research is suggested to explore the commonalities and differences between ASPD and BPD.